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Abstract Background As a new type of intravenous anesthetic, ciprofol has the advantages of fast onset of action, fast recovery and high clearance rate. This study aimed to investigate the effectiveness and safety of ciprofol versus traditional propofol for anesthesia and sedation in and out of the operating room. Methods We searched the literature in PubMed, Web of Science, Cochrane Library, and Embase databases from January 2021 to December 2023. All clinical studies comparing the sedative effects of propofol and ciprofol, both inside and outside the operating room, were included in our trial. The main outcome measures were induction time and incidence of injection-site pain. Data are merged using risk ratio and standardized mean difference with 95% confidence interval. Subgroup analysis, meta-regression, sensitivity analysis, and publication bias were performed. The study protocol was prospectively registered with PROSPERO (CRD42023447747). Results A total of 15 randomized, controlled trials involving 2002 patients were included in this study. Compared with propofol, ciprofol has a longer induction time in the operating room but a shorter induction time in non-operating room settings. Ciprofol can effectively reduce the risk of injection-site pain and respiratory depression both inside and outside the operating room. In addition, the risk of drug-related hypotension induced with ciprofol in the operating room is lower, but the awakening time is also longer. Meta-regression analysis showed that neither age nor BMI were potential sources of heterogeneity. Funnel plot, egger and begg tests showed no significant publication bias. Sensitivity analyzes indicate that our results are robust and reliable. Conclusion Ciprofol has absolute advantages in reducing the risk of injection-site pain and respiratory depression, both in and outside operating room. Intraoperative use of ciprofol reduces the risk of drug-related hypotension and may also reduce the risk of intraoperative physical movements. However, ciprofol may have longer induction and awakening time than propofol.

Abstract Background This study aimed to develop a novel six-gene expression biomarker panel to enhance the early detection and risk stratification of peritoneal recurrence and micrometastasis in locally advanced gastric cancer (LAGC). Methods We used genome-wide transcriptome profiling and rigorous bioinformatics to identify a six-gene expression biomarker panel. This panel was validated across multiple clinical cohorts using both tissue and liquid biopsy samples to predict peritoneal recurrence and micrometastasis in patients with LAGC. Results Through genome-wide expression profiling, we identified six mRNAs and developed a risk prediction model using 196 samples from a surgical specimen training cohort. This model, incorporating a 6-mRNA panel with clinical features, demonstrated high predictive accuracy for peritoneal recurrence in gastric cancer patients, with an AUC of 0.966 (95% CI: 0.944–0.988). Transitioning from invasive surgical or endoscopic biopsy to noninvasive liquid biopsy, the model retained its predictive efficacy (AUC = 0.963; 95% CI: 0.926–1.000). Additionally, the 6-mRNA panel effectively differentiated patients with or without peritoneal metastasis in 95 peripheral blood specimens (AUC = 0.970; 95% CI: 0.936–1.000) and identified peritoneal micrometastases with a high efficiency (AUC = 0.941; 95% CI: 0.874–1.000). Conclusions Our study provides a novel gene expression biomarker panel that significantly enhances early detection of peritoneal recurrence and micrometastasis in patients with LAGC. The RSA model's predictive capability offers a promising tool for tailored treatment strategies, underscoring the importance of integrating molecular biomarkers with clinical parameters in precision oncology.

Radix Rehmanniae (RR) has three processing forms in clinical practice, including fresh Radix Rehmanniae (FRR), raw Radix Rehmanniae (RRR), and processed Radix Rehmanniae (PRR). However, the sensory criterion, “black as lacquer and sweetness as candy”, which was traditionally used to evaluate the quality of PRR, have not been fully elucidated. In this study, the mechanism of chemical transformation based on oligosaccharide hydrolysis, crosslinking coloring, and Maillard reactions was explored to clarify the observed changes in appearance and flavor. The physicochemical properties of different processed RR products were characterized. Besides, “sweetness as candy” was explained by oligosaccharides hydrolysis, and “black as lacquer” can attribute to crosslinking coloring and Maillard reactions. Importantly, this study provided the first evidence for the existence of crosslinking coloring reaction during the processing of RR. In conclusion, our results unveiled the scientific basis of the sensory attributes “black as lacquer and sweetness as candy” in PRR, offering valuable insights for enhancing quality control of PRR.

Abstract Patients with multiple myeloma (MM) are likely to achieve poor therapeutic response when organs are involved. We produced anti‐B‐cell maturation antigen (BCMA) chimeric antigen receptor (CAR)‐T cells, which are in a trial for patients with relapsed/refractory MM. One enrolled patient developed severe heart failure, highly suspected as light chain cardiac amyloidosis. He exhibited increased N‐terminal pro‐brain natriuretic peptide with a peak of 32 299 ng/mL and heart failure with an ejection fraction of 30%. Anti‐BCMA CAR‐T cells were administered following lymphodepletion. The patient achieved cardiac response within 1 week with a decrease in N‐terminal pro‐brain natriuretic peptide by 80%, an increase in ejection fraction from 30% to 56%, and a haematological response with negative minimal residual disease at 1 month and a complete response at 1 year. To date, this patient has maintained good health without heart failure or haematological relapse. Herein, we show the efficacy of anti‐BCMA CAR‐T cells in patients with MM and severe heart failure.

Objective: In view of the problems of large size and low heating uniformity of the existing cooking machine, a miniaturized drum-type automatic cooking machine with electromagnetic heating was designed to reduce the equipment volume and improve the cooking effect. Methods: The modular design method oriented to function and structure was adopted to design each module mechanism of the frying machine. Then, based on Biot-Savart law, the relationship between the magnetic field generated by the coil in space and the current and distance is obtained, and the distribution curves of magnetic field intensity and temperature on the surface of the cooker under three coil arrangements are obtained by Ansys-Maxwell joint simulation. Secondly, the modal analysis of the sliding rail mechanism is carried out by Ansys software, and the frequency band of improper deformation of the mechanism is obtained. Finally, a prototype was developed and compared with three cooking methods to verify the cooking effect of the proto type. Results: Compared with the existing cooking machine, the heating uniformity was greatly improved, and the structural design and actual cooking effect met the use requirements. Conclusion: The research and design of automatic cooking machine has high feasibility and practicability.

ObjectiveThe Da Vinci Robot is the most advanced micro-control system in endoscopic surgical instruments and has gained a lot of valuable experience today. However, the technical feasibility and oncological safety of the robot over open surgery are still uncertain. This work is to systematically evaluate the efficacy of the unilateral axillary approach for robotic surgery compared to open surgery for differentiated thyroid carcinoma.MethodsPubMed, Embase, Cochrane Library, and Web of Science databases were utilized to search for relevant literatures of robotic thyroid surgery using unilateral axillary approach compared to open thyroid surgery, and a meta-analysis was performed using RevMan software version 5.3. Statistical analysis was performed through Mantle-Haenszel and inverse variance methods.ResultsTwelve studies with a total of 2660 patients were included in the meta-analysis. The results showed that compared with the open group, the robotic group had a longer total thyroidectomy time, shorter hospital stay, less intraoperative bleeding, more postoperative drainage, fewer retrieved central lymph nodes, and higher cosmetic satisfaction (all P < 0.05). In contrast, temporary and permanent laryngeal recurrent nerve injury, temporary and permanent hypoparathyroidism or hypocalcemia, brachial plexus nerve injury, number of retrieved central lymph nodes, number of retrieved lymph nodes in the lateral cervical region, number of lymph node metastases in the lateral cervical region, hematoma, seroma, lymphatic leak, stimulated thyroglobulin (sTg) and unstimulated thyroglobulin (uTg), and the number and recurrence rate of patients with sTg 0.05).ConclusionsThe unilateral axillary approach for robotic thyroid surgery may achieve outcomes similar to those of open surgery. Further validation is required in a prospective randomized controlled trial.

According to the orthopedic principle based on the three-point force system, this study aimed to reveal the orthopedic effect and patterns of the orthopedic based on this system in 3 patients with strephenopodia through the weight-bearing stance phase experiment and numerical simulation analysis of ankle-foot orthoses (AFOs). After the correction with AFOs, Under the pressure tolerance of human skin, different three correction forces were applied to the medial heel, above the medial ankle, below the lateral ankle and the first metatarsal bone,the weight-bearing region of the affected foot gradually shifted to the normal region of the first metatarsal bone, the fifth metatarsal bone, and the heel. The weight-bearing capacity of the affected foot increased by 11.4 %. After the three-point force was adjusted for the AFO, the distribution of the plantar weight-bearing region became more uniform, and the supporting force of the affected foot increased significantly, the weight-bearing capacity of the affected foot increased to 15.19 %, which approached the theoretical value. When the three-point force of was over-adjusted to exceed the pain threshold, the weight-bearing capacity of the affected foot decreased by 2.79 % compared with the theoretical value. It was confirmed that the foot varus angle was attenuated significantly 8 weeks after the orthopedic with three-point force system. Further, the strephenopodia with 10° was corrected with the finite element method based on the three-point force principle, and orthopedic angle and the plantar weight-bearing region before and after the correction were also obtained, The visualization of orthopedic effects and the orthotic principle is clear contributes to clinicians provide important scientific reference for the formulation of scientific and accurate orthopedic regimens.

Objective: Aiming at the problems of unstable 3D printing quality and low printing efficiency of adipose tissue part of artificial meat based on plant raw materials, studied and improve the intelligent 3D printing trajectory motion algorithm matching with food materials, to reduce the accumulation and corners in the printing path. Methods: A trajectory planning method adapted to the characteristics of artificial meat adipose tissue raw materials was proposed. The complex section layer of the sliced model was divided into several simple polygon sub-partition contours using Bayesian algorithm, and an improved nearest neighbor method was used to determine the optimal motion starting point of each contour. At the same time, the genetic algorithm was integrated into the ant colony algorithm was applied to solve the optimal printing path of the partition contour, and finally the interior of the contour was filled with the improved zigzag scanning algorithm. Results: For the artificial meat adipose tissue in this study, through experimental verification, comparing the existing trajectory planning methods of Cura and Prusa, the established model was printed on a single-layer cross-section, and the printing time and motion path length were reduced, and the quality was good. Conclusion: The proposed trajectory planning algorithm for 3D printing of artificial meat adipose tissue has high feasibility and effectiveness.

Mental health problems in nurses are prevalent and impairing. To date, no literature has comprehensively synthesised cohort evidence on mental health among nurses. This scoping review aimed to synthesise the existing literature on the risk factors and consequences of mental health problems in nurses. A systematic search was conducted on PubMed, EMBASE, Epistemonikos database, Web of Science, CINAHL, and PsycINFO from inception to March 2023. We identified 171 cohort studies from 16 countries, mostly (95.3%) from high‐income economies. This review indicated that nurses worldwide encountered significant mental health challenges, including depression, cognitive impairment, anxiety, trauma/post‐traumatic stress disorder, burnout, sleep disorder, and other negative mental health problems. These problems were closely related to various modifiable risk factors such as nurses' behaviours and lifestyles, social support, workplace bullying and violence, shift work, job demands, and job resources. Moreover, nurses' mental health problems have negative effects on their physical health, behaviour and lifestyle, occupation and organisation, and intrapersonal factors. These findings provided an enhanced understanding of mental health complexities among nurses, and shed light on policy enactment to alleviate the negative impact of mental health problems on nurses. Addressing mental health among nurses should be a top priority. [ABSTRACT FROM AUTHOR]

Over the past few decades, the transportation sector has been the largest contributor to CO2 emissions in China. Research and Development spending leads to technological innovation in the country and could affect the CO2 emission in the country. Therefore, this study analyzes the nexus between CO2 emissions, transport infrastructure and R&D spending in China. A QARDL approach was used for the data analysis, which revealed Research and Development and Transport infrastructure has a positive impact on CO2 emissions. R&D was only significant in the first 25% quantile, while transportation was significant in almost all quantiles. These results suggest that R&D spending in China is mainly allocated to the sectors that emit the CO2 emission. It is recommended that government should allocate more R&D to carbon-reducing sectors. Furthermore, the government should consider green transportation investments and renewable energy projects in the transportation sector to reduce CO2 emissions in the country.

IntroductionRecent evidence supports a role for the gut microbe-metabolites in longevity. However, the phenomenon of hypertension is more common in the longevity area and whether hypertension is associated with longevity remains unclear. Here, we hypothesize that the levels of gut microbiota, SCFAs, and urine metabolites were different between hypertension elderly and hypertension longevity.MethodsWe recruited 46 elderly volunteers from Donglan County, Guangxi, and 32 were selected and included in the experiment. The subjects with hypertension were divided into two groups according to age, Hypertension Elderly (HTE, aged 70.5 ± 8.59, n = 19) and Hypertension Longevity (HTL, aged 100 ± 5.72, n = 13). The gut microbiota, SCFAs, and urine metabolites were determined by three-generation 16S rRNA full-length sequencing, GC-MS, and 1H-NMR, respectively.ResultsCompared with the HTL group, the HTE group had higher levels of hypertension-related genera Klebsiella and Streptococcus, while having lower levels of the SCFA-producing genera Bacteroides, Faecalibacterium, and Alistipes. Based on LEFse analysis, Klebsiella pneumoniae, Lactobacillus gasseri, Streptococcus salivarius, Ruminococcus, Actinomyces, Rikenellaceae, f_Saccharimonadaceae, Clostridium perfringens, and Bacteroids, Faecalibacterium prausnitzii, Parabacteroides, Alistipes were biomarkers that showed significant differences between the groups. In addition, the microbial pathways associated with K. pneumoniae and E. coli may promote hypertension, while A. muciniphila may play a role in reversing the development of hypertension in long-lived elderly. Metabolomics revealed that HTL contained a lower concentration of fecal acetate and propionate than HTE, while it contained a higher concentration of serum acetate and urine acetate. Furthermore, their immune cells exhibited no significant changes in SCFAs receptors.ConclusionAlthough long-lived elderly have extremely high systolic blood pressure, their unique gut microbiota composition and efficient acetate absorption in the colon may offset the damages caused by hypertension and maintain healthy homeostasis.

By avoiding the filtration step and utilizing the whole components of oats, the highest utilization rate of raw materials, improving the nutritional value of products and reducing environmental pollution, can be achieved in the production of whole-grain oat drinks. This study innovatively introduced a dynamic high-pressure microfluidizer (DHPM) into the processing of whole-grain oat pulp, which aimed to achieve the efficient crushing, homogenizing and emulsification of starch, dietary fiber and other substances. Due to DHPM processing, the instability index and slope value were reduced, whereas the β-glucan content, soluble protein content and soluble dietary fiber content were increased. In the samples treated with a pressure of 120 MPa and 150 MPa, 59% and 67% more β-glucan content was released, respectively. The soluble dietary fiber content in the samples treated with a pressure of 120 MPa and 150 MPa was increased by 44.8% and 43.2%, respectively, compared with the sample treated with a pressure of 0 MPa. From the perspective of the relative stability of the sample and nutrient enhancement, the processing pressure of 120 MPa was a good choice. In addition, DHPM processing effectively reduced the average particle size and the relaxation time of the water molecules of whole-grain oat pulp, whereas it increased the apparent viscosity of whole-grain oat pulp; all of the above changes alleviated the gravitational subsidence of particles to a certain extent, and thus the overall stability of the system was improved. Furthermore, CLSM and AFM showed that the samples OM-120 and OM-150 had a more uniform and stable structural system as a whole. This study could provide theoretical guidance for the development of a whole-grain oat drink with improved quality and consistency.

Multimodal automatic modulation recognition (MAMR) has emerged as a prominent research area. The effective fusion of features from different modalities is crucial for MAMR tasks. An effective multimodal fusion mechanism should maximize the extraction and integration of complementary information. Recently, fusion methods based on cross-modal attention have shown high performance. However, they overlook the differences in information intensity between different modalities, suffering from quadratic complexity. To this end, we propose an efficient Alignment before Fusion Transformer Network (AbFTNet) based on an in-phase quadrature (I/Q) and Fractional Fourier Transform (FRFT). Specifically, we first align and correlate the feature representations of different single modalities to achieve mutual information maximization. The single modality feature representations are obtained using the self-attention mechanism of the Transformer. Then, we design an efficient cross-modal aggregation promoting (CAP) module. By designing the aggregation center, we integrate two modalities to achieve the adaptive complementary learning of modal features. This operation bridges the gap in information intensity between different modalities, enabling fair interaction. To verify the effectiveness of the proposed methods, we conduct experiments on the RML2016.10a dataset. The experimental results show that multimodal fusion features significantly outperform single-modal features in classification accuracy across different signal-to-noise ratios (SNRs). Compared to other methods, AbFTNet achieves an average accuracy of 64.59%, with a 1.36% improvement over the TLDNN method, reaching the state of the art. [ABSTRACT FROM AUTHOR]

During the drying and processing of raisins, the presence of foreign matter such as fruit stems, branches, stones, and plastics is a common issue. To address this, we propose an enhanced real-time detection approach leveraging an improved YOLOv8 model. This novel method integrates the multi-head self-attention mechanism (MHSA) from BoTNet into YOLOv8's backbone. In the model's neck layer, selected C2f modules have been strategically replaced with RFAConv modules. The model also adopts an EIoU loss function in place of the original CIoU. Our experiments reveal that the refined YOLOv8 boasts a precision of 94.5%, a recall rate of 89.9%, and an F1-score of 0.921, with a mAP reaching 96.2% at the 0.5 IoU threshold and 81.5% across the 0.5–0.95 IoU range. For this model, comprising 13,177,692 parameters, the average time required for detecting each image on a GPU is 7.8 milliseconds. In contrast to several prevalent models of today, our enhanced model excels in mAP0.5 and demonstrates superiority in F1-score, parameter economy, computational efficiency, and speed. This study conclusively validates the capability of our improved YOLOv8 model to execute real-time foreign object detection on raisin production lines with high efficacy. [ABSTRACT FROM AUTHOR]

App-based carpooling is recognized as a solution for sustainable commuting. However, there is currently no widespread acceptance and adoption of app-based carpooling services among urban commuters. The study aims to predict residents' intention to use app-based carpooling services for commuting trips based on the extended Technology Acceptance Model, focusing on perceived risk, social influence, and environmental awareness, and further explore whether there are significant gender differences among these influential factors. A questionnaire was created to empirically test the model and a total of 392 valid surveys were collected in Hefei, China. The results confirm that commuter intention was positively affected by perceived usefulness, social influence, and environmental awareness, while it was negatively influenced by perceived risk. Although the effect of perceived ease of use on intention was not significant, it played a role in enhancing commuters' perceived usefulness of the service. Moreover, gender differences exist regarding the strength of the relationship between environmental awareness and commuter intention. These findings provide practical insights for app-based carpooling providers and transportation departments aiming to promote their services and foster sustainable commuting practices. [ABSTRACT FROM AUTHOR]

Background: Cell‐free long RNAs in human plasma and extracellular vesicles (EVs) have shown promise as biomarkers in liquid biopsy, despite their fragmented nature. Methods: To investigate these fragmented cell‐free RNAs (cfRNAs), we developed a cost‐effective cfRNA sequencing method called DETECTOR‐seq (depletion‐assisted multiplexed cell‐free total RNA sequencing). DETECTOR‐seq utilised a meticulously tailored set of customised guide RNAs to remove large amounts of unwanted RNAs (i.e., fragmented ribosomal and mitochondrial RNAs) in human plasma. Early barcoding strategy was implemented to reduce costs and minimise plasma requirements. Results: Using DETECTOR‐seq, we conducted a comprehensive analysis of cell‐free transcriptomes in both whole human plasma and EVs. Our analysis revealed discernible distributions of RNA types in plasma and EVs. Plasma exhibited pronounced enrichment in structured circular RNAs, tRNAs, Y RNAs and viral RNAs, while EVs showed enrichment in messenger RNAs (mRNAs) and signal recognition particle RNAs (srpRNAs). Functional pathway analysis highlighted RNA splicing‐related ribonucleoproteins (RNPs) and antimicrobial humoral response genes in plasma, while EVs demonstrated enrichment in transcriptional activity, cell migration and antigen receptor‐mediated immune signals. Our study indicates the comparable potential of cfRNAs from whole plasma and EVs in distinguishing cancer patients (i.e., colorectal and lung cancer) from healthy donors. And microbial cfRNAs in plasma showed potential in classifying specific cancer types. Conclusions: Our comprehensive analysis of total and EV cfRNAs in paired plasma samples provides valuable insights for determining the need for EV purification in cfRNA‐based studies. We envision the cost effectiveness and efficiency of DETECTOR‐seq will empower transcriptome‐wide investigations in the fields of cfRNAs and liquid biopsy. Keypoints: DETECTOR‐seq (depletion‐assisted multiplexed cell‐free total RNA sequencing) enabled efficient and specific depletion of sequences derived from fragmented ribosomal and mitochondrial RNAs in plasma.Distinct human and microbial cell‐free RNA (cfRNA) signatures in whole Plasma versus extracellular vesicles (EVs) were revealed.Both Plasma and EV cfRNAs were capable of distinguishing cancer patients from normal individuals, while microbial RNAs in Plasma cfRNAs enabled better classification of cancer types than EV cfRNAs. [ABSTRACT FROM AUTHOR]

Abstract Although adipose‐derived mesenchymal stem cells (ADMSCs) isolated from patients’ fat are considered as the most important autologous stem cells for tissue repair, significant difficulties in the neural differentiation of ADMSCs still impede stem cell therapy for neurodegenerative diseases. Herein, a wireless‐electrical stimulation method is proposed to direct the neural differentiation of ADMSCs based on the electromagnetic effect using a graphene film as a conductive scaffold. By placing a rotating magnet on the top of a culture system without any inducer, the ADMSCs cultured on graphene differentiate into functional neurons within 15 days. As a conductive biodegradable nanomaterial, graphene film acts as a wireless electrical signal generator driven by the electromagnetic induction, and millivolt‐level voltage generated in situ provokes ADMSCs to differentiate into neurons, proved by morphological variation, extremely high levels of neuron‐specific genes, and proteins. Most importantly, Ca2+ intracellular influx is observed in these ADMSC‐derived neurons once exposure to neurotransmitters, indicating that these cells are functional neurons. This research enhances stem cell therapy for neurodegenerative diseases using autologous ADMSCs and overcomes the lack of neural stem cells. This nanostructure‐mediated physical‐signal simulation method is inexpensive, safe, and localized, and has a significant impact on neural regeneration.