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Background: Few community-based studies have examined occurrence and progression of subjective cognitive decline (SCD). Objective: To investigate prevalence and progression of SCD among rural-dwelling Chinese elderly people. Methods: This cohort study included 2,488 cognitively unimpaired adults (age≥65 years) who were examined at baseline (2014-2015) and followed in 2018. Demographic, epidemiological, clinical, and neuropsychological data were collected via in-person interviews and clinical examinations following a structured questionnaire. At baseline, SCD was assessed using the self-rated Ascertain Dementia 8-item Questionnaire. At follow-up, Alzheimer’s disease (AD) and vascular dementia (VaD) were clinically diagnosed following the international criteria. Data were analyzed using logistic regression models. Results: The prevalence of SCD was 40.07%. SCD at baseline was associated with the multivariable-adjusted odds ratio (OR) of 1.51 (95% confidence interval 1.10–2.07) for incident cognitive impairment, no dementia (CIND) and 3.11 (1.64–5.93) for incident AD. Among people with SCD at baseline, the multivariable-adjusted OR of incident CIND was 0.55(0.32–0.96) for hyperlipidemia; the multivariable-adjusted OR of incident AD was 1.21 (1.14–1.30) for older age, 0.32 (0.12–0.88) for high education, 2.60 (1.11–6.08) for carrying APOE ɛ4 allele, and 0.34 (0.13–0.86) for high social support, whereas the multivariable-adjusted OR of incident VaD was 6.30 (1.71–23.18) for obesity. Conclusion: SCD affects over 40% of rural-dwelling cognitively unimpaired older adults in China. SCD is associated with accelerated progression to CIND and AD. Older age, lack of school education, APOE ɛ4 allele, and low social support are associated with an increased risk of progression from SCD to AD, whereas obesity is related to accelerated progression to VaD.

Background: Microvascular dysfunction (MVD) may contribute to cognitive impairment and Alzheimer’s disease, but evidence is limited. Objective: To investigate the association of composite and organ-specific MVD burden with mild cognitive impairment (MCI) and cognition among rural-dwelling Chinese older adults. Methods: In this population-based cross-sectional study, we assessed MVD makers using optical coherence tomographic angiography for retinal microvasculature features, brain magnetic resonance imaging scans for cerebral small vessel disease (CSVD), and serum biomarkers for MVD. A composite MVD score was generated from the aforementioned organ-specific parameters. We used a neuropsychological test battery to assess memory, verbal fluency, attention, executive function, and global cognitive function. MCI, amnestic MCI (aMCI), and non-amnestic MCI (naMCI) were diagnosed following the Petersen’s criteria. Data was analyzed with the linear and logistic regression models. Results: Of the 274 dementia-free participants (age≥65 years), 56 were diagnosed with MCI, including 47 with aMCI and 9 with naMCI. A composite MVD score was statistically significantly associated with an odds ratio (OR) of 2.70 (95% confidence interval 1.12–6.53) for MCI and β-coefficient of –0.29 (–0.48––0.10) for global cognitive score after adjustment for socio-demographics, lifestyle factors, APOE genotype, the Geriatric Depression Scale score, serum inflammatory biomarkers, and cardiovascular comorbidity. A composite score of retinal microvascular morphology was associated with a multivariable-adjusted OR of 1.72 (1.09–2.73) for MCI and multivariable-adjusted β-coefficient of –0.11 (–0.22––0.01) for global cognitive score. A composite CSVD score was associated with a lower global cognitive score (β= –0.10; –0.17––0.02). Conclusion: Microvascular dysfunction, especially in the brain and retina, is associated with MCI and poor cognitive function among rural-dwelling older adults.

Background: Emerging evidence has linked electrocardiographic parameters with serum adhesion molecules and cognition; however, their interrelationship has not been explored. Objective: We sought to investigate the associations of ventricular depolarization and repolarization intervals with serum adhesion molecules and cognitive function among rural-dwelling older adults. Methods: This population-based study engaged 4,886 dementia-free participants (age ≥60 years, 56.2% women) in the baseline examination (March-September 2018) of MIND-China. Of these, serum intercellular and vascular adhesion molecules (ICAM-1 and VCAM-1) were measured in 1591 persons. We used a neuropsychological test battery to assess cognitive function. Resting heart rate, QT, JT intervals, and QRS duration were assessed with electrocardiogram. Data were analyzed using general linear models adjusting for multiple confounders. Results: Longer JT interval was significantly associated with lower z-scores of global cognition (multivariable-adjusted β= –0.035; 95% confidence interval = –0.055, –0.015), verbal fluency (–0.035; –0.063, –0.007), attention (–0.037; –0.065, –0.010), and executive function (–0.044; –0.072, –0.015), but not with memory function (–0.023; –0.054, 0.009). There were similar association patterns of QT interval with cognitive functions. In the serum biomarker subsample, longer JT and QT intervals remained significantly associated with poorer executive function and higher serum adhesion molecules. We detected statistical interactions of JT interval with adhesion molecules (pinteraction

Background: Cognitive reserve (CR) partly explains cognitive variability in the presence of pathological brain aging. Objective: We investigated the interplay of lifelong CR with age, sex, and brain aging markers in cognitive phenotypes among older adults with very limited education. Methods: This population-based cross-sectional study included 179 dementia-free participants (age ≥65 years; 39.7% women; 67.0% had no or elementary education) examined in 2014–2016. We assessed lacunes and volumes of hippocampus, ventricles, grey matter, white matter (WM), and white matter hyperintensities. Lifelong CR score was generated from six lifespan intellectual factors (e.g., education and social support). We used Mini-Mental State Examination (MMSE) score to assess cognition and Petersen’s criteria to define mild cognitive impairment (MCI). Data were analyzed using general linear and logistic models. Results: The association of higher lifelong CR score (range: –4.0–5.0) with higher MMSE score was stronger in women (multivariable-adjusted β-coefficient and 95% CI: 1.75;0.99–2.51) than in men (0.68;0.33–1.03) (pinteraction = 0.006). The association of higher CR with MCI (multivariable-adjusted odds ratio and 95% CI: 0.77;0.60–0.99) did not vary by age or sex. Among participants with low CR (

Photophysical processes occurring within organic semiconductors is important for designing and fabricating organic solar cells. Copper phthalocyanine (CuPc) is a typical electron acceptor. In this work, the triplet exciton lifetime is prolonged by altering the molecular stacking pattern of the CuPc film. For CuPc thin films, the excited state decays are mainly determined by the triplet-triplet annihilation process. The ultrafast transient absorption measurements indicate that the primary annihilation mechanism is one-dimensional exciton diffusion collision destruction. The decay kinetics show a clearly time-dependent annihilation rate constant with γ∝ t−1/2. Annihilation rate constants are determined to be γ0 = (2.87±0.02)×10−20 cm3·s−1/2 and (1.42±0.02)×10−20 cm3·s−1/2 for upright and lying-down configurations, respectively. Compared to the CuPc thin film with an upright configuration, the thin film with a lying-down configuration shows longer exciton lifetime and higher absorbance, which are beneficial to organic solar cells. The results in this work have important implications on the design and mechanistic understanding of organic optoelectronic devices.

Time-series classification approaches based on deep neural networks are easy to be overfitting on UCR datasets, which is caused by the few-shot problem of those datasets. Therefore, in order to alleviate the overfitting phenomenon for further improving the accuracy, we first propose Label Smoothing for InceptionTime (LSTime), which adopts the information of soft labels compared to just hard labels. Next, instead of manually adjusting soft labels by LSTime, Knowledge Distillation for InceptionTime (KDTime) is proposed in order to automatically generate soft labels by the teacher model. At last, in order to rectify the incorrect predicted soft labels from the teacher model, Knowledge Distillation with Calibration for InceptionTime (KDCTime) is proposed, where it contains two optional calibrating strategies, i.e. KDC by Translating (KDCT) and KDC by Reordering (KDCR). The experimental results show that the accuracy of KDCTime is promising, while its inference time is two orders of magnitude faster than ROCKET with an acceptable training time overhead.

Due to the worldwide epidemic of allergic disease and a cure nowhere in sight, there is a crucial need to explore its pathophysiological mechanisms. As allergic disease has been associated with gut dysbiosis, we searched for a possible mechanism from the perspective of the molecular interface between host and microbiota with concurrent metabolomics and microbiome composition analysis. Sprague-Dawley rats were injected with Artemisia pollen extract to stimulate a hyper reaction to pollen. This hyper reaction decreased the circulation of valine, isoleucine, aspartate, glutamate, glutamine, indole-propionate (IPA), and myo-inositol, and reduced short-chain fatty acids (SCFAs) in feces. Several beneficial genera belonging to Ruminococcaceae, Lachnospiraceae, and Clostridiales declined in the model group, whereas Helicobacter and Akkermansia were only expressed in the model group. Furthermore, the expression of intestinal claudin-3 and liver fatty acid binding protein was downregulated in the model group and associated with metabolic changes and bacteria. Our results suggest that alterations in amino acids as well as their derivatives (especially valine, and IPA which is the reductive product of tryptophan) , SCFAs, and the gut microbiome (specifically Akkermansia and Helicobacter) may disrupt the intestinal barrier function by inhibiting the expression of claudin proteins and affecting the mucus layer, which further results in hay fever.

This study was designed to evaluate the bioequivalence of the newly developed delayed-release oral suspension (test) 40 mg esomeprazole magnesium compared to its marketed counterpart (40 mg; reference) in healthy adult Chinese subjects. We conducted randomized, open-label, two-period, single-dose, two-way crossover trials over a 7-day washout period, comprising a fasting trial and a fed trial. The subjects were administered the test or reference products in a 1:1 ratio at random throughout each period. Then, in the next session, they received the alternate products. Liquid chromatography-tandem mass spectrometry and WinNonlin software were used to assess the bioequivalence of esomeprazole peak plasma concentration (C

Metasurfaces have exhibited unprecedented degree of freedom (DOF) in manipulating electromagnetic (EM) waves and thus provide fantastic front-end interfaces for smart systems. In this work, we present a framework for perception enhancement based on vision-driven metasurface. Under this framework, human's eye movements are matched up with microwave radiations using metasurface, which synergizes visual information and invisible microwave information to extend the spectrum of humans' perception. By this means, information that cannot be obtained using our eyes can be "sensed", such as physiological signals, hidden motions and speech. Such a framework offloads the vision system to improve information acquisition ability and also allows for other advanced features such as disability healthcare. Several experimental demonstrations are given for specific implementations of this framework, including a physiological-signal-monitoring system, an "X-ray-eye" system, a "glimpse-and-forget" tracking system and a barrier-free speech reception system for deaf people. Both the simulation and experiment results verify the perception enhancement effects of this framework, which exhibits evident advantages in improving acquisition efficiency of visual information. In addition, this framework can be readily integrated into healthcare systems to monitor physiological signals and to offer assistance for people with disabilities. This work provides an alternative framework for perception enhancement and may find wide applications in healthcare, new-generation communication, wearable devices, search-and-rescue and others.

As a promising ultra-wide bandgap semiconductor material, gallium oxide (Ga2O3) is attracting an extensive attention of researchers due to its feasible growth process, appropriate bandgap of 4.4-5.3 eV allowing for deep-ultraviolet (deep-UV) detection, good physical and chemical stability, high breakdown field strength and electron mobility, etc. Different from the strict processes for controllable crystalline Ga2O3 (usually refer to stable monoclinic β-Ga2O3), amorphous Ga2O3 (a-Ga2O3) film can be prepared uniformly at low temperature on a large-area deposition substrate, suggesting great advantages such as low manufacturing cost and excellent flexibility, dispensing with high-temperature and high vacuum techniques. Thus, a-Ga2O3 extremely facilitates important applications in various applied fields. Therefore, in this concise review, we summarized several major deposition methods for a-Ga2O3 films, of which the characteristics were discussed. Additionally, potential methods to optimize the film properties were proposed by right of the inspiration from some recent studies. Subsequently, the applications of a-Ga2O3 thin films, e.g., in photodetectors, resistive random access memories (RRAMs) and gas sensors, were represented with a fruitful discussion of their structures and operating mechanisms.

Cerebral ischemia/reperfusion is the major pathophysiological process in stroke and could lead to severe and permanent disability. The current study aimed to investigate the effects of dedicator of cytokinesis 2 (DOCK2) on cerebral ischemia/reperfusion-induced cerebral injury. We established a mouse middle cerebral artery occlusion (MCAO) model with suture-occluded method in vivo. Then, BV-2 cells were conducted to oxygen-glucose deprivation and re-oxygenation (OGD/R) in vitro. The results showed that DOCK2 was highly expressed in ischemic brain following MCAO and in BV-2 cells induced by OGD/R. DOCK2 depletion protected against MCAO-induced brain infarcts and neuron degeneration. DOCK2 downregulation improved long-term neurological function, which was assessed by the Morris water-maze test. Moreover, silencing of DOCK2 promoted M2 polarization (anti-inflammation) and repressed M1 polarization (pro-inflammation) of microglia both in vivo and in vitro. Subsequently, we found that the loss of DOCK2 upregulated the expression of p-STAT6. DOCK2 knockdown-induced microglial cell polarization towards M2 phenotype was partly abrogated by the STAT6 inhibitor AS1517499. In conclusion, DOCK2 downregulation protected against cerebral ischemia/reperfusion by modulating microglia polarization via the activation of the STAT6 signaling pathway.

Genetic studies have identified Alzheimer's disease (AD)-associated SNPs in TOMM40 and PVRL2 genes, but the underlying mechanisms remain unknown. We examined their associations and interactions with AD risk and plasma biomarkers among Chinese older adults. This population-based study included 4876 participants. TOMM40(rs2075650) and PVRL2(rs6859) polymorphisms were detected using multiple-polymerase chain reaction amplification. Plasma Aβ40, Aβ42, and t-tau concentrations were measured using SIMOA in a subsample (n = 1257). AD was diagnosed following the international criteria. Data were analyzed using multiple logistic and general linear models. AD was diagnosed in 182 participants. The multiadjusted odds ratio of AD was 6.24 (95% CI 1.73-22.48) for TOMM40GG, 1.47 (0.89-2.42) for PVRL2AA, and 12.87 (3.97-41.73) for having both risk alleles (P

Yu Qin,1,2,* Rui Liu,1,2,* Yongxiang Wang,1– 3 Jiyou Tang,4 Lin Cong,1– 3 Juan Ren,1,2 Shi Tang,1– 3 Yifeng Du1– 3 1Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China; 2Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China; 3Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China; 4Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yifeng Du; Shi Tang, Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, Shandong, 250021, People’s Republic of China, Tel +86 531 68776354 ; +86-18678780912, Fax +86 531 68776354, Email duyifeng2013@163.com; tangshi@sdfmu.edu.cnPurpose: To investigate the cross-sectional associations of self-reported sleep characteristics with cardiovascular diseases (CVDs) and cardiovascular multimorbidity in older adults living in rural Eastern China.Patients and Methods: This population-based study included 4618 participants (age ≥ 65 years; 56.5% women) living in rural Eastern China. In March–September 2018, data were collected through interviews, clinical examinations, neuropsychological testing, and laboratory tests. Sleep parameters were assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Score, and Berlin questionnaire. Coronary heart disease (CHD), heart failure (HF), and stroke were defined according to in-person interviews, clinical and neurological examinations, and electrocardiogram examination. Data were analyzed using logistic regression and restricted cubic spline regression.Results: CHD was diagnosed in 991 participants, HF in 135 participants, and stroke in 696 participants. The multivariable-adjusted odds ratio (OR) of CHD was 1.27 (95% CI, 1.09– 1.49) for sleep duration ≤ 6 hours/night (vs > 6– 8 hours/night), 1.40 (1.20– 1.62) for poor sleep quality, and 1.22 (1.04– 1.43) for high risk for obstructive sleep apnea (OSA). The OR of HF was 2.16 (1.38– 3.39) for sleep duration > 8 hours/night, and 1.76 (1.22– 2.54) for high risk for OSA. In addition, the OR of stroke was 1.23 (1.04– 1.46) for poor sleep quality, 1.32 (1.01– 1.72) for excessive daytime sleepiness, and 1.42 (1.19– 1.70) for high risk for OSA. The associations of poor sleep with cardiovascular multimorbidity (≥ 2 CVDs) were stronger than that of sleep problems with a single CVD.Conclusion: Extreme sleep duration, high risk for OSA, and other sleep problems were associated with CVDs, especially cardiovascular multimorbidity.Keywords: sleep, coronary heart disease, heart failure, stroke, cardiovascular multimorbidity

Purpose This study evaluated the clinical safety and efficacy of tanfanercept (HBM9036) ophthalmic solution as a novel treatment for dry eye disease (DED) in a controlled adverse environment (CAE) study conducted in China. Methods In a single-center, double-masked, randomized, placebo-controlled study, 100 patients received 0.25% tanfanercept, or placebo, twice daily for eight weeks. A mobile international CAE® DE Model was used for patient selection with a standardized challenge endpoint. Primary efficacy endpoint was fluorescein inferior corneal staining score (ICSS) pre- to post-CAE challenge from baseline. Secondary endpoints included Schirmer’s Tear Test, Tear-Film Break-Up Time, Ocular Discomfort Score, Ora Calibra® Ocular Discomfort and 4-Symptom Questionnaire, total corneal staining score (TCSS), and drop comfort. Signs and symptoms were assessed both pre- and post-CAE to evaluate the efficacy of tanfanercept on both environmental and CAE endpoints. Results The tanfanercept treatment group showed improvement in ICSS pre- to post-CAE change from baseline scores when compared to placebo (− 0.61 ± 0.11 and − 0.54 ± 0.11, respectively; mean difference = 0.07, p = 0.65). TCSS pre–post-CAE change from baseline scores was also in favor of active when compared to placebo (− 1.03 ± 0.21 and − 0.67 ± 0.21, respectively; mean difference = 0.37, p = 0.23). Schirmer’s score improvement was demonstrated in favor of active (1.87 ± 0.62 mm) as compared to placebo (1.28 ± 0.62 mm; mean difference = 0.59 mm, p = 0.50). Change from baseline in mean Tear-Film Break-up Time favored active treatment over placebo (mean difference = 1.21 s, p = 0.45). Notably, the tanfanercept showed more obvious benefits for each DED sign in a subgroup of subjects ≥ 35 years of age. Tanfanercept was well tolerated with no serious adverse events occurring during the study. Conclusion Tanfanercept demonstrated improvements in favor of active as compared to placebo in the signs of DED, being safe and well tolerated. These data support further evaluation of tanfanercept for the treatment of DED in China. Trial registration This study was retrospectively registered at ClinicalTrials.gov (NCT04092907) on September 17, 2019.

Background: Few studies have examined occurrence and progression of cognitive impairment, no dementia (CIND) in rural China. Objective: To determine the prevalence and incidence of CIND in rural-dwelling Chinese older adults, and to examine risk and protective factors associated with progression to CIND and dementia. Methods: This population-based study included 2,781 dementia-free participants (age≥65 years) who were examined at baseline (2014) and followed in 2018. Demographic, epidemiological, clinical, and neuropsychological data were collected following a structured questionnaire. We defined CIND according to subjective cognitive complaints and the age- and education-specific Mini-Mental State Examination (MMSE) score. Data were analyzed with the multinomial logistic regression models. Results: The overall prevalence of CIND was 10.54% and the incidence was 28.26 per 1,000 person-years. CIND at baseline was associated with the multi-adjusted odds ratio (OR) of 2.06 (95% confidence interval = 1.23–3.47) for incident dementia. Multinomial logistic regression analysis suggested that compared with no CIND, the multi-adjusted OR of incident CIND was 2.21 (1.51–3.23) for women and 0.62 (0.38–0.99) for high social support, whereas the multi-adjusted OR of incident dementia was 1.14 (1.09–1.18) for older age, 0.29 (0.16–0.53) for high education, and 2.91 (1.47–5.74) for having a stroke history. Conclusion: CIND affects over one-tenth of older adults living in rural communities of western Shandong province. People with CIND are twice as likely to progress to dementia as people without CIND. Female sex, low education, stroke history, and low social support are associated with an increased risk of progression from normal cognition to CIND or dementia.

Atherosclerosis (AS), a significant contributor to cardiovascular disease (CVD), is steadily rising with the aging of the global population. Pyroptosis and apoptosis, both caspase-mediated cell death mechanisms, play an essential role in the occurrence and progression of AS. The human pineal gland is the primary producer of melatonin (MT), an indoleamine hormone with powerful anti-oxidative, anti-pyroptosis, and anti-apoptotic properties. This study examined MT's antioxidative stress and anti-pyroptotic effects on human THP-1 macrophages treated with nicotine. Our research found that MT downregulated NOD-like receptor family protein 3 (NLRP3) inflammasome, ASC, and caspase-1 expressions and abrogated the release of Interleukin-1β (IL1β) and Interleukin-18 (IL-18), indicating effective pyroptosis inhibition. These changes were paralleled by a reduction in reactive oxygen species (ROS) production, reversal of sirtuin3 (SIRT3), and Forkhead box O3 (FOXO3α) upregulation. The findings suggest that MT is a viable strategy for counteracting pyroptosis and apoptosis in AS patients by up-regulating SIRT3, promoting FOXO3α, and suppressing ROS production. In inhibiting pyroptosis, MT also inhibits apoptosis, mainly caused by the interaction of caspase-1 and caspase-3 proteins. In vivo studies using ApoE-/- mice confirmed that nicotine could accelerate plaque formation caused by high-fat diets. Moreover, mice treated with MT showed a significant reduction in AS lesion area and increased in cellulose level. Importantly, our understanding of the inhibitory pathways for macrophage pyroptosis will allow us to identify other novel therapeutic targets that will help treat, prevent, and reduce AS-associated mortality.

ObjectiveTo explore the associations of macular microvascular parameters with cerebral small vessel disease (CSVD) in rural-dwelling older adults in China.MethodsThis population-based cross-sectional study included 195 participants (age ≥ 60 years; 57.4% women) in the optical coherence tomographic angiography (OCTA) sub-study within the Multimodal Interventions to delay Dementia and disability in rural China (MIND-China). Macular microvascular parameters were measured using the OCTA. We automatically estimated volumes of gray matter, white matter, and white matter hyperintensity (WMH), and manually assessed numbers of enlarged perivascular spaces (EPVS) and lacunes on brain magnetic resonance imaging. Data were analyzed with the general linear models.ResultsAdjusting for multiple confounders, lower vessel skeleton density (VSD) and higher vessel diameter index (VDI) were significantly associated with larger WMH volume (P < 0.05). Lower VSD and foveal density-300 (FD-300) of left eye were significantly associated with lower brain parenchymal volume (P < 0.05). In addition, lower areas of foveal avascular zone (FAZ) and FD-300 of left eye were significantly associated with more EPVS (P < 0.05). The associations of abnormal macular microvascular parameters with WMH volume were evident mainly among females. Macular microvascular parameters were not associated with lacunes.ConclusionMacular microvascular signs are associated with WMH, brain parenchymal volume, and EPVS in older adults. The OCTA-assessed macular microvascular parameters can be valuable markers for microvascular lesions in the brain.

ObjectiveTo evaluate the global research productivity in the field of discectomy for lumbar disc herniation (LDH) through bibliometric analysis and mapping knowledge domains.MethodsA systematic literature search was performed on the Web of Science (WoS), including the Science Citation Index Expanded (SCIE) database and PubMed. The number of publications, countries of publications, journals of publications, total citation frequency, impact factors of journals, and Institutional sources were analyzed by Microsoft Excel 2019, the Online Analysis Platform of Bibliometrics, and VOSviewer. Hotspots were also analyzed and visualized based on VOSviewer.ResultsA total of 2,066 papers were identified. The United States ranked first in the number of total citations (7,970). China ranked first in the number of publications (556, 26.9%), which has surpassed the United States in terms of the number of publications published annually since 2016. Wooridul Spine Hospital published the most papers (43). For journals, Spine has published the largest number of papers (289) in this field with the most citation frequencies (6,607). Hotspots could be divided into three clusters: surgery, lumbar disc herniation, and diagnoses. The most recent topic that appeared was symptomatic re-herniation.ConclusionsThe United States is the most significant contributor to the development of discectomy for LDH. The current research focus of discectomy on LDH was the comparison between surgical approaches and evaluation of current minimally invasive discectomy. At present, minimally invasive techniques, such as endoscopic discectomy, cannot completely replace non-endoscopic discectomy (open discectomy and microdiscectomy) through bibliometric analysis and mapping knowledge domains.

Background Extracorporeal membrane oxygenation (ECMO) can be used as salvage therapy for multitrauma patients with acute respiratory distress syndrome (ARDS) when conventional treatment fails to maintain oxygenation. However, controversy exists between ECMO application and the risk of bleeding due to systemic anticoagulation during the treatment. Non-heparin introduction seems to be a possible solution for this dilemma, owing to technical improvements in the device and management methods of ECMO. Case presentation A 58-year-old woman suffered from blunt thoracic, pelvic, and right lower limb fractures due to a falling accident, which resulted in acute respiratory distress syndrome (ARDS). Although the patient received intubation and mechanical ventilation (MV), respiratory failure was not alleviated. Venous-venous (V-V) ECMO was used as a salvage therapy. With the support of V-V ECMO, we safely cleared blood clots in the bronchus and avoided secondary lung injury caused by pressure trauma and oxygen poisoning of the MV. We introduced heparin-free ECMO management as a solution to reduce the risk of bleeding associated with pulmonary contusion and other organ injuries. To prevent thrombosis, we set the blood rate of ECMO to 4.0 L/min, which is much higher than the usual parameter. During ECMO, coagulation factors, such as prothrombin time, activated partial thromboplastin time, and D-dimer, were examined. ECMO was maintained for 5 days without any complications; MV was stopped on the 13th day, extubated on the 24th day, and discharged from ICU on the 28th day. Conclusion ECMO with non-heparin could be an optimal treatment for multitrauma patients with ARDS when traditional treatment cannot sustain oxygenation. High blood flow rate could prevent thrombosis through ongoing ECMO therapy without systemic anticoagulation. In addition, monitoring D-dimer value change (Δ D-dimer) may be better than D-dimer value in predicting clot formation in the membrane oxygenator.

IntroductionThe fusion of infrared and visible images can improve image quality and eliminate the impact of changes in the agricultural working environment on the information perception of intelligent agricultural systems.MethodsIn this paper, a distributed fusion architecture for infrared and visible image fusion is proposed, termed RADFNet, based on residual CNN (RDCNN), edge attention, and multiscale channel attention. The RDCNN-based network realizes image fusion through three channels. It employs a distributed fusion framework to make the most of the fusion output of the previous step. Two channels utilize residual modules with multiscale channel attention to extract the features from infrared and visible images, which are used for fusion in the other channel. Afterward, the extracted features and the fusion results from the previous step are fed to the fusion channel, which can reduce the loss in the target information from the infrared image and the texture information from the visible image. To improve the feature learning effect of the module and information quality in the fused image, we design two loss functions, namely, pixel strength with texture loss and structure similarity with texture loss.Results and discussionExtensive experimental results on public datasets demonstrate that our model has superior performance in improving the fusion quality and has achieved comparable results over the state-of-the-art image fusion algorithms in terms of visual effect and quantitative metrics.

Miscanthus, a promising bioenergy plant, has a high biomass yield with high cellulose content suitable for biofuel production. However, harsh climatic and poor soil conditions, such as barren lands or abandoned mines, pose a challenge to the survival and yield of Miscanthus feedstock on the marginal land. The selection from the interspecific hybrids of Miscanthus might combine high survival rates and high yield, which benefits energy crop development in multi-stressful environments. A total of 113 F1 hybrids between Miscanthus sacchariflorus and M. lutarioriparius together with the parents were planted and evaluated for multiple morphological and physiological traits on the mine land of the Loess Plateau of China. The majority of hybrids had higher establishment rates than M. sacchariflorus while M. lutarioriparius failed to survive for the first winter. Nearly all hybrid genotypes outperformed M. lutarioriparius for yield-related traits including plant height, tiller number, tiller diameter, and leaf area. The average biomass of the hybrids was 20 times higher than that of surviving parent, M. sacchariflorus. Furthermore, the photosynthetic rates and water use efficiency of the hybrids were both significantly higher than those of the parents, which might be partly responsible for their higher yield. A total of 29 hybrids with outstanding traits related to yield and stress tolerance were identified as candidates. The study investigated for the first time the hybrids between local individuals of M. sacchariflorus and high-biomass M. lutarioriparius, suggesting that this could be an effective approach for high-yield energy crop development on vast of marginal lands.

IntroductionThe mid-transverse colon cancer is relatively uncommon in all colon cancers and the optimal surgical approach of mid-transverse colon cancer remains debatable.Aim and ObjectivesOur study aimed to depict the techniques and outcomes of laparoscopic transverse colectomy in one single clinical center and compare this surgical approach to traditional laparoscopic right hemicolectomy and laparoscopic left hemicolectomy.MethodThis was a retrospective cohort study of patients with mid-transverse colon cancer in one single clinical center from February 2012 to October 2020. The enrolled patients were divided into two groups undergoing laparoscopic transverse colectomy and laparoscopic right/left hemicolectomy, respectively. The intraoperative, postoperative complications, oncological outcomes and functional outcomes were compared between the two groups. The primary endpoint was disease free survival (DFS).ResultsThe study enrolled 70 patients with 40 patients undergoing laparoscopic transverse colectomy and 30 patients undergoing laparoscopic hemicolectomy. The intraoperative accidental hemorrhage and multiple organ resection occurred similarly in the two groups. In transverse colectomy, caudal-to-cephalic approach was likely to harvest more lymph nodes although require more operation time than cephalic-to-caudal approach (23.1 ± 14.3 vs. 13.4 ± 5.4 lymph nodes, P = 0.004; 184.3 ± 37.1 min vs. 146.3 ± 44.4 min, P = 0.012). The laparoscopic transverse colectomy was marginally associated with lower incidence of overall postoperative complications and shorter postoperative hospital stay although without statistical significance (8(20.0%) vs. 12(40.0%), P = 0.067; 7(5–12) vs. 7(5–18), P = 0.060). The 3-year DFS showed no significant difference (3-year DFS 89.7% in transverse colectomy vs. 89.9% in hemicolectomy, P = 0.688) between the two groups. The alternating consistency of defecation occurred significantly less after laparoscopic transverse colectomy than laparoscopic hemicolectomy (15(51.7%) vs. 20(80.0%), P = 0.030).ConclusionThe laparoscopic transverse colectomy is technically feasible with satisfactory oncological and functional outcomes for mid-transverse colon cancer. Performing the caudal-to-cephalic approach might be more advantageous in lymphadenectomy.