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Jun-Peng Zhang,1,&ast; Jun Shen,2,3,&ast; Yun-Ting Xiang,1,&ast; Xiang-Xin Xing,4 Bing-Xin Kang,5 Chi Zhao,2 Jia-Jia Wu,4 Mou-Xiong Zheng,4,6 Xu-Yun Hua,4,6 Lian-Bo Xiao,2,3 Jian-Guang Xu1,4,7 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Department of Orthopedic, Guanghua Hospital of Integrative Chinese and Western Medicine, Shanghai, People’s Republic of China; 3Arthritis Institute of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 4Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 5The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, People’s Republic of China; 6Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 7Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China&ast;These authors contributed equally to this workCorrespondence: Jian-Guang Xu, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, People’s Republic of China, Email xjg@shutcm.edu.cn Lian-Bo Xiao, Department of Orthopedic, Guanghua Hospital of Integrative Chinese and Western Medicine, 540 Xinhua Road, Changning District, Shanghai, People’s Republic of China, Email xiao_lianbo@163.comIntroduction: Osteoarthritis is a chronic, ongoing disease that affects patients, and pain is considered a key factor affecting patients, but the brain changes during the development of osteoarthritis pain are currently unclear. In this study, we used electroacupuncture (EA) to intervene the rat model of knee osteoarthritis and analyzed the changes in topological properties of brain networks using graph theory.Methods: Sixteen SD rat models of right-knee osteoarthritis with anterior cruciate ligament transection (ACLT) were randomly divided into electroacupuncture intervention group and control group. The electroacupuncture group was intervened on Zusanli (ST36) and Futu (ST32) for 20 min each time, five times a week for 3 weeks, while the control group was applied sham stimulation. Both groups were measured for pain threshold. The small-world properties and node properties of the brain network between the two groups after the intervention were statistically analyzed by graph theory methods.Results: The differences are mainly in the changes in node attributes between the two groups, such as degree centrality, betweenness centrality, and so on in different brain regions (P< 0.05). Both groups showed no small-world characteristics in the brain networks of the two groups. The mechanical thresholds and thermal pain thresholds were significantly higher in the EA group than in the control group (P< 0.05).Conclusion: The study demonstrated that electroacupuncture intervention enhanced the activity of nodes related to pain circuit and relieved pain in osteoarthritis, which provides a complementary basis for explaining the effect of electroacupuncture intervention on pain through graphical analysis of changes in brain network topological properties and helps to develop an imaging model for pain affected by electroacupuncture.Keywords: osteoarthritis, electroacupuncture, pain, spatio-temporal analysis, neural plasticity

Introduction : Brain has a spontaneous recovery after stroke, reflecting the plasticity of the brain. Currently, TMS is used for studies of single-target brain region modulation, which lacks consideration of brain networks and functional connectivity. Cortico-cortical paired associative stimulation (ccPAS) promotes recovery of motor function. Multisensory effects in primary visual cortex(V1) directly influence behavior and perception, which facilitate motor functional recovery in stroke patients. Therefore, in this study, dual-targeted precise stimulation of V1 and primary motor cortex(M1) on the affected hemisphere of stroke patients will be used for cortical visuomotor multisensory integration to improve motor function. Method This study is a randomized, double-blind controlled clinical trial over a 14-week period. 69 stroke subjects will be enrolled and divided into sham stimulation group, ccPAS low frequency group, and ccPAS high frequency group. All groups will receive conventional rehabilitation. The intervention lasted for two weeks, five times a week. Assessments will be performed before the intervention, at the end of the intervention, and followed up at 6 and 14 weeks. The primary assessment indicator is the ‘Fugl-Meyer Assessment of the Upper Extremity ’, secondary outcomes were ‘The line bisection test’, ‘Modified Taylor Complex Figure’, ‘NIHSS’ and neuroimaging assessments. All adverse events will be recorded. Discussion Currently, ccPAS is used for the modulation of neural circuits. Based on spike-timing dependent plasticity theory, we can precisely intervene in the connections between different cortices to promote the recovery of functional connectivity on damaged brain networks after stroke. We hope to achieve the modulation of cortical visuomotor interaction by combining ccPAS with the concept of multisensory integration. We will further analyze the correlation between analyzing visual and motor circuits and explore the alteration of neuroplasticity by the interactions between different brain networks. This study will provide us with a new clinical treatment strategy to achieve precise rehabilitation for patient with motor dysfunction after stroke. Trial registration This trial was registered in the Chinese Clinical Trial Registry with code ChiCTR2300067422 and was approved on January 16, 2023.

One critical issue for wireless power transfer is to avoid human health impairments caused by electromagnetic radiation (EMR) exposure. The existing studies mainly focus on scheduling wireless chargers so that (expected) EMR at any point in the area does not exceed a threshold Rt. Nevertheless, they overlook the EMR jitter that leads to exceeding of Rt even if the expected EMR is no more than Rt. This paper studies the fundamental problem of RObustly SafE charging for wireless power transfer (ROSE), that is, scheduling the power of chargers so that the charging utility for all echargeable devices is maximized while the probability that EMR anywhere does not exceed Rt is no less than a given confidence. We first build our empirical probabilistic charging model and EMR model. Then, we present EMR approximation and area discretization techniques to formulate ROSE into a Second-Order Cone Program, and the first redundant second-order cone constraints reduction algorithm to reduce the computational cost, and therefore obtain a (1-ϵ)-approximation centralized algorithm. Further, we propose a (1-ϵ)-approximation fully distributed algorithm scalable with network size for ROSE. Simulations and field experiments show that our algorithms can outperform comparison algorithms by 480.19%.

The information integrity is needed to solving socio-economic statistical problems. However, the information integrity is destroyed by missing data which is caused by various subjective and objective reasons. So the missing data interpolation is used to supplement missing data. In this paper, missing data interpolation with variational Bayesian inference is proposed. This method is combined with Gaussian model to approximate the posterior distribution to obtain complete data. The experiments include two datasets (artificial dataset and actual dataset) based on three missing ratios separately. The missing data interpolation performance of variational Bayesian method is compared with that which is obtained by mean interpolation and K-nearest neighbor interpolation methods separately in MSE (Mean Square Error) and MAPE (Mean Absolute Percentage Error). The experimental results show that the proposed variational Bayesian method is better in MSE and MAPE. &nbsp

Background Connectome mapping may reveal new treatment targets for patients with neurological and psychiatric diseases. However, the long-term delayed recall based-network with structural and functional connectome is still largely unknown. Our objectives were to (1) identify the long-term delayed recall-based cortex-hippocampus network with structural and functional connectome and (2) investigate its relationships with various cognitive functions, age, and activities of daily living. Methods This case-control study enrolled 131 subjects (73 amnestic mild cognitive impairment [aMCI] patients and 58 age- and education-matched healthy controls [HCs]). All subjects completed a neuropsychological battery, activities of daily living assessment, and multimodal magnetic resonance imaging. Nodes of the cortical-hippocampal network related to long-term delayed recall were identified by probabilistic fiber tracking and functional connectivity (FC) analysis. Then, the main and interaction effects of the network on cognitive functions were assessed by a generalized linear model. Finally, the moderating effects of the network on the relationships between long-term delayed recall and clinical features were analyzed by multiple regression and Hayes’ bootstrap method. All the effects of cortex-hippocampus network were analyzed at the connectivity and network levels. Results The result of a generalized linear model showed that the bilateral hippocampus, left dorsolateral superior frontal gyrus, right supplementary motor area, left lingual gyrus, left superior occipital gyrus, left superior parietal gyrus, left precuneus, and right temporal pole (superior temporal gyrus) are the left and right cortex-hippocampus network nodes related to long-term delayed recall (P < 0.05). Significant interaction effects were found between the Auditory Verbal Learning Test Part 5 (AVLT 5) scores and global properties of the left cortex-hippocampus network [hierarchy, clustering coefficient, characteristic path length, global efficiency, local efficiency, Sigma and synchronization (P < 0.05 Bonferroni corrected)]. Significant interaction effects were found between the general cognitive function/executive function/language and global properties of the left cortex-hippocampus network [Sigma and synchronization (P < 0.05 Bonferroni corrected)]. Conclusion This study introduces a novel symptom-based network and describes relationships among cognitive functions, brain function, and age. The cortex–hippocampus network constrained by the structural and functional connectome is closely related to long-term delayed recall.

We propose a family of mixed finite elements that are robust for the nearly incompressible strain gradient model, which is a fourth-order singular perturbed elliptic system. The element is similar to [C. Taylor and P. Hood, Comput. & Fluids, 1(1973), 73-100] in the Stokes flow. Using a uniform discrete B-B inequality for the mixed finite element pairs, we show the optimal rate of convergence that is robust in the incompressible limit. By a new regularity result that is uniform in both the materials parameter and the incompressibility, we prove the method converges with $1/2$ order to the solution with strong boundary layer effects. Moreover, we estimate the convergence rate of the numerical solution to the unperturbed second-order elliptic system. Numerical results for both smooth solutions and the solutions with sharp layers confirm the theoretical prediction., 27 pages, 1 figures, 4 tables

BackgroundOnline lending on campus is given more attention by researchers as its prominent adverse effects on students. The deficiencies of the previous studies on its psychological factors and intervention strategies were only based on qualitative research. Moreover, there is no study on gender differences. Therefore, our study aims to analyze the gender differences in psychological risk factors and give some practical suggestions for the intervention by quantitative methods.MethodThis is a cross-sectional survey among medical college students in Chengdu. A total of 984 effective questionnaires were collected. The questionnaire includes demographic data, monthly expenses, self-evaluation for three central psychology causing online lending based on empiricism (conformity, comparison, and hedonism), and three psychological assessment instruments (the Chinese version of the Satisfaction with Life Scale, Egna Minnen av Barndoms Uppfostran, and 144-item version of Temperament and Character Inventory). T-test/χ2-test and Binary logistic regression were used to analyze the gender differences in variables and the risk factors of online lending for males and females, respectively.ResultsThe utilization rate of online lending exhibited a significant gender difference (p ConclusionThe utilization rate of online lending in males was significantly higher than in females. More attention should be paid to gender differences and the impact of family members’ using online lending on students when intervening in online lending.

Patients with osteonecrosis of the femoral head commonly present with sensorimotor anomalies. With independent component analysis, it is possible to explore the intrinsic alternations in highly specific functional networks. We used independent component analysis to examine the intrinsic changes and interactive connectivity between related functional resting-state networks.The purpose of this study was to strengthen the theoretical basis of brain plasticity after osteonecrosis of the femoral head to provide new insights into clinical treatment.Observational study.School of rehabilitation science of a university.Functional magnetic resonance imaging data were acquired from 14 patients with osteonecrosis of the femoral head and 20 healthy controls. All the data underwent preprocessing and analysis of the intrinsic brain functional connectivity within and between resting-state networks.Nine resting-state networks were identified via independent component analysis. When compared to healthy controls, the osteonecrosis of the femoral head patients showed abnormal activity in these networks. With respect to the internetwork interactions, increased functional connectivity was detected between the sensorimotor network and right frontoparietal network and between the dorsal attention network and frontoparietal network bilaterally.This study was a cross-sectional design. A longitudinal study of the dynamic changes in multinetwork functional connectivity can help to elucidate the central mechanisms of osteonecrosis of the femoral head.This study investigated the alterations in resting-state network functional connectivity in osteonecrosis of the femoral head patients. Examining the large-scale functional reorganization in osteonecrosis of the femoral head patients may be helpful for us to understand the pathological mechanisms underlying dysfunction and shed light on potential behavioral treatments for osteonecrosis of the femoral head based on functional magnetic resonance imaging in clinical practice. Understanding the mechanisms of the disease may shed light on potential behavioral treatments for patients with osteonecrosis of the femoral head based on functional magnetic resonance imaging findings.

Additional file 1: Supplemental Table 1. Descriptions of global properties examined in the study.

The surface frustrated Lewis pairs (SFLPs), in which the Lewis acid and Lewis base are sterically hindered, open up new opportunities for small molecule activation. However, the construction of SFLPs currently needs various elaborate synthesis processes, leading to the low density and low stability of the SFLPs. Herein, the wurtzite crystal structures are discovered for developing natural SFLPs possessing dense and stable active sites. The SFLPs can naturally exist on the (100) and (110) surfaces of wurtzite-structured GaN, ZnO, and AlP. All the surface cations and anions serve as the Lewis acid and Lewis base in SFLPs, respectively, contributing to a high SFLPs density of 7.26 * 10^14 cm^(-2) on GaN(110). Ab initio molecular dynamics simulations reveal that the SFLPs can maintain stable structures under high temperatures and the atmospheres of CO and H2O. Moreover, outstanding performance for activating small molecules (H2, CH4, and NH3) is demonstrated on these natural SFLPs, which originated from the unique orbital orientation of SFLPs. Overall, these findings provide a simple method to obtain dense and stable SFLPs and unfold the nature of SFLPs toward the facile activation of small molecules.

Supplemental material, sj-doc-1-tct-10.1177_15330338231155721 for Impact of Radiotherapy Combined With Chemotherapy on Long-Term Outcomes of Patients With Recurrent Nasopharyngeal Carcinoma by Ying Li, Wei Liu, Yun Xu, Lan-Yan Guo and You-Liang Weng, Zong-Wei Huang, Xiao-Chuan Chen, Ting Lin, Jun Lu, Su-Fang Qiu in Technology in Cancer Research & Treatment

Let μ \mu be a positive Borel measure on the interval [ 0 , 1 ) \left[0,1) . The Hankel matrix H μ = ( μ n , k ) n , k ≥ 0 {{\mathcal{ {\mathcal H} }}}_{\mu }={\left({\mu }_{n,k})}_{n,k\ge 0} with entries μ n , k = μ n + k {\mu }_{n,k}={\mu }_{n+k} , where μ n = ∫ [ 0 , 1 ) t n d μ ( t ) {\mu }_{n}={\int }_{\left[0,1)}{t}^{n}{\rm{d}}\mu \left(t) , induces formally the operator as follows: DH μ ( f ) ( z ) = ∑ n = 0 ∞ ∑ k = 0 ∞ μ n , k a k ( n + 1 ) z n , z ∈ D , {{\mathcal{D {\mathcal H} }}}_{\mu }(f)\left(z)=\mathop{\sum }\limits_{n=0}^{\infty }\left(\mathop{\sum }\limits_{k=0}^{\infty }{\mu }_{n,k}{a}_{k}\right)\left(n+1){z}^{n},\hspace{1em}z\in {\mathbb{D}}, where f ( z ) = ∑ n = 0 ∞ a n z n f\left(z)={\sum }_{n=0}^{\infty }{a}_{n}{z}^{n} is an analytic function in D {\mathbb{D}} . In this article, we characterize those positive Borel measures on [ 0 , 1 ) \left[0,1) for which DH μ {{\mathcal{D {\mathcal H} }}}_{\mu } is bounded (resp. compact) from Dirichlet spaces D α ( 0 < α ≤ 2 ) {{\mathcal{D}}}_{\alpha }\hspace{0.33em}\left(0\lt \alpha \le 2) into D β ( 2 ≤ β < 4 ) {{\mathcal{D}}}_{\beta }\hspace{0.33em}\left(2\le \beta \lt 4) .

Using animal models to study the underlying mechanisms of aging will create a critical foundation from which to develop new interventions for aging-related brain disorders. Aging-related reorganization of the brain network has been described for the human brain based on functional, metabolic and structural connectivity. However, alterations in the brain metabolic network of aging rats remain unknown. Here, we submitted young and aged rats to [18F]fluorodeoxyglucose with positron emission tomography (18F-FDG PET) and constructed brain metabolic networks. The topological properties were detected, and the network robustness against random failures and targeted attacks was analyzed for age-group comparison. Compared with young rats, aged rats showed reduced betweenness centrality (

Traffic incidents endanger the smooth running of vehicles. Congestion caused by traffic incidents has caused a waste of time and fuel and seriously affected transportation efficiency. At present, most methods use manual judgment or image features to detect traffic incidents, but these methods lack timeliness, leading to secondary incidents. For dangerous road sections such as ramp-free and long downhills, this paper proposes an algorithm to quickly detect traffic incidents based on a spatiotemporal map of vehicle trajectories. First, a vehicle dataset from the monitoring perspective is constructed, and an improved YOLOv4 detection algorithm is used to detect images organized as batches. Based on the detection result, the multi-object tracking method of vehicle speed prediction in key frames is used to obtain the vehicle trajectory. Then according to the vehicle trajectory obtained in a single scene, the vehicle trajectory is reidentified and associated in the continuous monitoring scene to construct a long-distance vehicle trajectory spatiotemporal map. Finally, according to the distribution and generation status of the trajectory in the spatiotemporal map, traffic incidents such as vehicle parking, vehicle speeding, and vehicle congestion are analyzed. Experimental results show that the proposed method greatly increases the speed of vehicle detection and tracking and obtains high mAP, MOTA, and MOTP indicators. The global spatiotemporal map constructed by trajectory reidentification can achieve high detection rates for traffic incidents, reduce the average elapsed time, and avoid the problems of the inaccuracy of analyzing image features.

We present optical frequency combs with a spectral emission of 48 cm-1 and an output power of 420 mW based on a single-core quantum cascade laser at λ~8.7 μm. A flat top spectrum sustains up to 130 comb modes delivering ~3.2 mW of optical power per mode, making it a valuable tool for dual comb spectroscopy. The homogeneous gain medium, relying on a slightly-diagonal bound-to-continuum structure, promises to provide broad and stable gain for comb operating. Remarkably, the dispersion of this device is measured within 300 fs2/mm to ensure stable comb operation over 90% of the total current range. The comb is observed with a narrow beatnote linewidth around 2 kHz and has weak dependence on the applied current for stable comb operation.

Background:During the unpredictable and long-term COVID-19 epidemic lockdown (Shanghai, April 2022 to May 2022), a large number of patients with post-stroke dysfunction exercised at home, without going to specialized rehabilitation institutions for systematic rehabilitation treatment. To date, there are few relevant studies on the effect of home exercise in patients with post-stroke dysfunction in the case of long-term COVID-19 epidemic lockdown. Methods: First, we collected the factors that might affect the post-stroke sensorimotor dysfunction during the long-term lockdown. The evaluation indicators of post-stroke sensorimotor dysfunction before and after the long-term lockdown were recorded. Second, we analyzed the recovery effect of sensorimotor dysfunction in post-stroke patients who can only rely on home exercise during the long-term lockdown. Third, we sequentially performed univariate and multivariate Logistic regression analyses to see which factors might influence post-stroke sensorimotor dysfunction during the long-term lockdown. Results: We report the results of a retrospective single-center cohort study of 104 post-stroke sensorimotor dysfunction patients. For post-stroke sensory dysfunction, patients with shorter disease courses or personalized home exercise programs recovered better. For post-stroke motor dysfunction, patients with younger age, shorter disease courses, or personalized home exercise programs recovered better. For post-stroke balance dysfunction and ADL dysfunction, patients with shorter disease courses recovered better. Conclusion:During the unpredictable and long-term COVID-19 epidemic lockdown, patients with post-stroke sensorimotor dysfunction who had personalized home exercise programs had better recovery of sensorimotor dysfunction than those who did not have personalized home exercise programs. Trial registration: This trial was prospectively registered at ClinicalTrials.gov (ChiCTR2200063781; 16 September, 2022).

Currently, the treatments for postparalysis facial synkinesis are still inadequate. However, neuroimaging mechanistic studies are very limited and blurred. Instead of mapping activation regions, we were devoted to characterizing the organizational features of brain regions to develop new targets for therapeutic intervention. Eighteen patients with unilateral facial synkinesis and 19 healthy controls were enrolled. They were instructed to perform task functional magnetic resonance imaging (eye blinking and lip pursing) examinations and resting-state scans. Then, we characterized group differences in task-state fMRI to identify three foci, including the contralateral precentral gyrus (PreCG), supramarginal gyrus (SMG), and superior parietal gyrus (SPG). Next, we employed a novel approach (using dynamic causal modeling) to identify directed connectivity differences between groups in different modes. Significant patterns in multiple regions in terms of regionally specific actions following synkinetic movements were demonstrated, although the resting state was not significant. The couplings from the SMG to the PreCG (p = 0.03) was significant in the task of left blinking, whereas the coupling from the SMG to the SPG (p = 0.04) was significant in the task of left smiling. We speculated that facial synkinesis affects disruption among the brain networks, and specific couplings that are modulated simultaneously can compensate for motor deficits. Therefore, behavioral or brain stimulation technique treatment could be applied to alter reorganization within specific couplings in the rehabilitation of facial function.

To investigate the effects of acupuncture on phosphorylated P38 mitogen-activated protein kinase (p-P38MAPK), intercellular adhesion molecule-1 (ICAM-1), interferon γ (IFN-γ), and eosinophilic granulocytes (EOS) in lung tissue of asthmatic rats, and to explore the mechanism of acupuncture in regulating the apoptosis of EOS.Clean-grade male Wistar rats were randomly divided into normal, model, dexamethasone and acupuncture groups, 8 rats in each group. The asthmatic model was established by intraperitoneal injection of mixture suspension (1 mL) of 10% ovalbumin and 10% Al(OH)_3+ normal saline, followed by inhalation of atomized 1% ovalbumin solution for 30 min, once daily for 2 weeks to trigger occurrence of asthmatic symptoms. The rats in dexamethasone group were intraperitoneally injected with 0.9 mg/kg dexamethasone since day 15 once a day for two consecutive weeks. In the acupuncture group, bilateral "Feishu" (BL13), "Pishu" (BL20), "Shenshu" (BL23), "Dingchuan" (EX-B1), and "Danzhong" (CV17) were selected for acupuncture treatment once every other day since day 15 for two consecutive weeks. Uniform reinforcing and reducing manipulation was carried out, and the needles were retained for 30 min. The pathological changes of the lung tissue were observed by hematoxylin-eosin (HE) staining. The apoptosis of EOS in the lung tissue of rats was detected by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. The expression of p-P38MAPK in the lung tissue was detected by Western blot. The protein and mRNA levels of ICAM-1 and IFN-γ in the lung tissue were determined by immunohistochemistry and real-time PCR, respectively.The results of HE staining showed that the pulmonary alveoli and surrounding tissues were intact with no inflammatory cell infiltration in the normal group. The model group showed massive exudation of inflammatory materials and thickened pulmonary interstitium. The dexamethasone group and acupuncture group showed less damage of the alveolar structure and only a small number of inflammatory cells around the airway. Compared with the normal group, the apoptosis rate of EOS in lung tissue was decreased (Acupuncture may inhibit the P38MAPK signaling pathway, down-regulate ICAM-1 expression, and up-regulate IFN-γ expression to promote the apoptosis of EOS and reduce EOS aggregation, thus alleviating the inflammatory response of airway in asthma.

Post-stroke cognitive impairment (PSCI) is one of the common symptoms in stroke survivors, by which their quality of life and rehabilitation progress are severely limited. Repetitive transcranial magnetic stimulation (rTMS) has been proven to regulate cognition in a non-invasive way. However, the inconsistency in its effectiveness on PSCI reported in previous studies cannot be ruled out. A critical and comprehensive systematic review of rTMS on PSCI patients is necessary.Trials published before the end of February 2022 on rTMS and PSCI were systematically retrieved from PubMed, Cochrane Library, EBSCO, Embase and SCOPUS. High-quality literature was selected following the inclusion and exclusion criteria, with their references being screened. Meta-analysis of data was carried out using RevMan 5.4 software.Ten trials involving 347 participants were included in the current review. Global cognition as measured by MMSE or MoCA (SMD=0.54; 95% CI=0.31, 0.76; P 0.00001; IrTMS provides a non-invasive and effective technique for the treatment of post-stroke patients with cognitive impairment.

Background Upper limb motor dysfunction is a common sequela of stroke, and its clinical efficacy needs to be improved. This protocol describes a trial to verify the clinical efficacy of robot-assisted virtual reality mirror therapy (RAVRMT) in improving upper limb motor dysfunction in stroke patients, and to explore the central mechanism by using functional magnetic resonance imaging (fMRI). Methods This trial will be a single-center, assessor-blinded, randomized controlled clinical study. Thirty-two eligible patients will be randomly divided into 2 groups according to the ratio of 1:1, namely virtual reality mirror therapy (VRMT) group and robot-assisted virtual reality mirror therapy (RAVRMT) group. The interventions will be performed once a day for 4 weeks. Primary outcome is Fugl–Meyer motor function assessment-Upper Extremity (FMA-UE), secondary outcomes are the Montreal Cognitive Assessment (MoCA), activities of daily living (ADL), quality of life (QOL), the pain visual analogue scale (VAS-pain) and fMRI. Adverse events will be recorded, and severe adverse events will be used as criteria to discontinue the intervention. Discussion Combined application of robot-assisted therapy and virtual reality mirror therapy could theoretically activate mirror neuron system and reward circuits to a greater extent, but further high-quality research is needed. The results of this trial will determine whether RAVRMT could better improve upper limb motor dysfunction after stroke and explore its central mechanism using fMRI. Trial registration This trial was prospectively registered at ClinicalTrials.gov (ChiCTR2200061721; 01 July 2022).

Motor dysfunction is the major sequela of ischemic stroke. Motor recovery after stroke has been shown to be associated with remodeling of large-scale brain networks, both functionally and structurally. Electroacupuncture (EA) is a traditional Chinese medicine application that has frequently been recommended as an alternative therapy for ischemic stroke and is reportedly effective for alleviating motor symptoms in patients. In the present study, the effect of EA on the alterations of functional resting state networks (RSNs) was explored after middle cerebral artery occlusion/reperfusion (MCAO/R) injury using resting-state functional MRI. Rats were randomly assigned to three groups, including the sham group, MCAO/R group and MCAO/R+EA group. The ladder rung walking test was conducted prior to and after modeling to assess behavioral changes. RSNs were identified based on the independent component analysis (ICA) performed on the fMRI data from groups. EA treatment effectively reduced the occurrence of contralateral forelimb foot faults. Furthermore, our results suggested the disrupted function of the whole-brain network following ischemic stroke and the modulatory effect of acupuncture. The sensorimotor network (SMN), interoceptive network (IN), default mode network (DMN) and salience network (SN) were related to the therapeutic effect of EA on stroke recovery. Collectively, our findings confirmed the effect of EA on motor function recovery after cerebral ischemia reperfusion and shed light on the assessment of EA intervention-induced effects on brain networks. This study provides neuroimaging evidence to explain the therapeutic effects of EA in ischemic stroke and will lay the groundwork for further studies.

Post-stroke depression (PSD) is a serious complication of stroke that significantly restricts rehabilitation. The use of immersive virtual reality for stroke survivors is promising. Herein, we investigated the effects of a novel immersive virtual reality training system on PSD and explored induced effective connectivity alterations in emotional networks using multivariate Granger causality analysis (GCA). Forty-four patients with PSD were equally allocated into an immersive-virtual reality group and a control group. In addition to their usual rehabilitation treatments, the participants in the immersive-virtual reality group participated in an immersive-virtual reality rehabilitation program, while the patients in the control group received 2D virtual reality rehabilitation training. The Hamilton Depression Rating Scale, modified Barthel Index (MBI), and resting-state functional magnetic resonance imaging (rsfMRI) data were collected before and after a 4-week intervention. rsfMRI data were analyzed using multivariate GCA. We found that the immersive virtual reality training was more effective in improving depression in patients with PSD but had no statistically significant improvement in MBI scores compared to the control group. The GCA showed that the following causal connectivities were strengthened after immersive virtual reality training: from the amygdala, insula, middle temporal gyrus, and caudate nucleus to the dorsolateral prefrontal cortex; from the insula to the medial prefrontal cortex; and from the thalamus to the posterior superior temporal sulcus. These causal connectivities were weakened after treatment in the control group. Our results indicated the neurotherapeutic use of immersive virtual reality rehabilitation as an effective non-pharmacological intervention for PSD; the alteration of causal connectivity in emotional networks might constitute the neural mechanisms underlying immersive-virtual reality rehabilitation in PSD.

BackgroundSpinal stretch reflex (SSR) hyperexcitability reflected by the H-reflex has been reported in more strongly affected extremities after stroke. The H-reflex in the lower extremities is modulated by body position normally and alternatively modulated post-stroke.ObjectiveThis study aimed to preliminarily explore how upper extremity (UE) H-reflexes are modulated by body position after stroke, which remains unknown.Materials and methodsThree patients after stroke with hemiparesis/hemiplegia were included. Bilateral flexor carpi radialis (FCR) H-reflexes were examined in the supine position while standing. Other clinical evaluations include the modified Ashworth scale (MAS) and postural stability measurement.ResultsThe three cases herein showed that (1) SSR excitability was higher in more strongly affected UEs than less-affected UEs, (2) down-modulation of SSR excitability occurred in less-affected UEs in static standing compared with the supine position, but modulation of SSR excitability in more-affected UEs varied, and (3) bilateral UE SSR excitability in case 3 was down-modulated the most. Moreover, case 3 showed no difference in muscle tone of the more affected UE between supine and standing positions, and case 3 showed the best postural stability.ConclusionSpinal stretch reflex hyperexcitability in strongly affected UEs could commonly occur in different phases of recovery after stroke. Down-modulation of SSR excitability could occur in less-affected UEs in the standing position compared with the supine position, while modulation of SSR excitability might be altered in strongly affected UEs and vary in different phases of recovery. There could be some correlation between postural control and UE SSR hyperexcitability. The H-reflex may help to offer a new perspective on rehabilitation evaluation and interventions to promote UE motor control after stroke.

This study explored the relationship between BMI and regional cerebral glucose metabolism and explicitly detected regions with significant differences in cerebral metabolism using positron emission tomography (PET)/magnetic resonance imaging in the resting state.Corresponding PET images acquired from 220 participants were sorted into four groups according to Asian BMI standards: underweight, normal weight, overweight, and obesity. Pearson correlation coefficient analysis was performed to assess the association between BMI and standard uptake value. The regional cerebral glucose metabolism was measured in the fasted state. The PET images were analyzed using statistical parameter maps. One-way ANOVA was used to explore differences in the standard uptake value as an indicator of regional cerebral glucose metabolism.This study found that lower cerebral glucose metabolism in reward- and motivation-related regions was accompanied by more severe obesity and that regional cerebral glucose metabolism activities were negatively correlated with BMI. In addition, more severe obesity was accompanied by a larger range of areas with significant differences independent of current dietary status.These findings suggest that the reward and motivation circuits may be a factor regulating energy balance and influencing the degree of obesity.

Neuropathic pain (NeuP) is shown to be associated with abnormal changes in several specific brain regions. However, the large-scale interactivity of neuronal networks underlying the sensory and emotional abnormalities during NeuP remains unexplored. The present study aimed to explore the alterations in the relevant functional resting-state networks (RSNs) and their intra-networks at the different stages of NeuP based on resting-state functional magnetic resonance imaging (rs-fMRI). A NeuP rat model was established by chronic constriction injury (CCI). Three RSNs were identified to be associated with the NeuP, including the default mode network (DMN), sensorimotor network (SMN), and interoceptive network (IN). The functional connectivity (FC) of the left caudate putamen (CPu) within the DMN and the right piriform cortex within the IN were significantly reduced at the early stage of NeuP, when the maximum allodynia was apparent early, which reflected the suppressed function of the DMN and IN. At 4 weeks post-CCI, when negative emotions were present, the FC of the right insular cortex in the SMN and left visual cortex in the IN were significantly elevated, representing the increased excitability of both SMN and IN. Our study revealed the characteristic functional organization at the network level induced by NeuP and emphasized the role of SMN, DMN, and IN in the pathological mechanisms of NeuP.

Whether metabolic redistribution occurs in patients with white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) is unknown. This study aimed 1) to propose a measure of the brain metabolic network for an individual patient and preliminarily apply it to identify impaired metabolic networks in patients with WMHs, and 2) to explore the clinical and imaging features of metabolic redistribution in patients with WMHs.This study included 50 patients with WMHs and 70 healthy controls (HCs) who underwentThe means ± standard deviations of the individual contribution index were (0.697 ± 10.9) × 10The individual contribution index may demonstrate the redistribution of the brain metabolic network in patients with WMHs.

Neuropathic pain (NeuP), a challenging medical condition, has been suggested by neuroimaging studies to be associated with abnormalities of neural activities in some brain regions. However, aberrancies in brain functional alterations underlying the sensory-discriminative abnormalities and negative emotions in the setting of NeuP remain unexplored. Here, we aimed to investigate the functional alterations in neural activity relevant to pain as well as pain-related depressive-like and anxiety-like behaviors in NeuP by combining amplitude of low frequency fluctuation (ALFF) and degree centrality (DC) analyses methods based on resting-state functional magnetic resonance imaging (rs-fMRI). A rat model of NeuP was established

Background To compare the clinical efficacy and safety of catheter-directed thrombolysis（CDT）with anticoagulation vs anticoagulation alone（AC）in patients with submassive pulmonary embolism（sPE）.METHODS Included in this analysis were patients with submassive pulmonary embolism. Two researchers independently screened the literature, submitted the data and cross-checked them. In case of differences, the third researcher would assist to make the judgment. RevMan5.4 was used for Meta analysis. Odds ratio (OR) was used as outcome index for dichotomous variables, and weighted mean difference (WMD) was used as outcome index for continuous variables. Point valuation/95%CI was given for each indicator. With P > 0.05 and I2 < 0.5, the fixed effect model was used for Meta analysis. The primary outcomes were all-cause death at 30 days and 1 year. Secondary outcomes were total bleeding and major bleeding.RESULTS A total of 7 articles and 874 patients were included in this study. 323 patients were in the CDT+AC group and 551 patients were in the AC group. 30 days and 1 year mortality were lower in the CDT+AC group compared to AC group [（OR：0.35，95%CI：0.14-0.88，P=0.03，I2=0%),（OR：0.36，95%CI：0.18-0.71，P=0.004，I2=0%）]. In subgroup analysis 30 days and 1 year mortality were lower in the USAT+AC group compared to AC group[（OR：0.28，95%CI：0.08-0.98，P=0.05，I2=0%),（OR：0.32，95%CI：0.11-0.95，P=0.04，I2=0%）]. The incidence of total bleeding was lower in AC group compared to CDT+AC/USAT+AC group. Major bleeding were similar between them.Conclusion Results thus confirmed that CDT reduced 30-days and 1-year all-cause mortality in patients with sPE compared to anticoagulation alone (AC). Nonetheless, a higher risk of bleeding was associated with the CDT group.

Xiang-Xin Xing,1,2,* Xu-Yun Hua,3,4,* Mou-Xiong Zheng,3,* Jia-Jia Wu,2 Bei-Bei Huo,1,2 Jie Ma,1,2 Zhen-Zhen Ma,1,2 Si-Si Li,1,2 Jian-Guang Xu1 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Department of Rehabilitation Medicine, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 3Department of Traumatology and Orthopedics, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 4Yangzhi Rehabilitation Hospital, Tongji University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jian-Guang XuSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, No. 1200 Cailun Road, Shanghai, People’s Republic of ChinaTel +86-21-51322091Fax +86-21-51322042Email xjg@shutcm.edu.cnIntroduction: Numerous resting-state functional magnetic resonance imaging (fMRI) researches have indicated that large-scale functional and structural remodeling occurs in the whole brain despite an intact sensorimotor network after carpal tunnel syndrome (CTS). Investigators aimed to explore alterations of the global and nodal properties that occur in the whole brain network of patients with CTS based on topographic theory.Methods: Standard-compliant fMRI data were collected from 27 patients with CTS in bilateral hands and 19 healthy control subjects in this cross-sectional study. The statistics based on brain networks were calculated the differences between the patients and the healthy. Several topological properties were computed, such as the small-worldness, nodal clustering coefficient, characteristic path length, and degree centrality.Results: Compared to those of the healthy controls, the global properties of the CTS group exhibited a decreased characteristic path length. Changes in the local-level properties included a decreased nodal clustering coefficient in 6 separate brain regions and significantly different degree centrality in several brain regions that were related to sensorimotor function and pain.Discussion: The study suggested that CTS reinforces global connections and makes their networks more random. The changed nodal properties were affiliated with basal ganglia-thalamo-cortical circuits and the pain matrix. These results provided new insights for improving our understanding of abnormal topological theory in relation to the functional brain networks of CTS patients.Perspective: This article presents that the CTS patients’ brain with a higher global efficiency. And the significant alterations in several brain regions which are more related to pain and motor processes. The results provided effective complements to the neural mechanisms underlying CTS.Keywords: small-worldness, nodal clustering coefficient, degree centrality, pain, circuits

Characterized by high morbidity, mortality, and disability, stroke usually causes symptoms of cerebral hypoxia due to a sudden blockage or rupture of brain vessels, and it seriously threatens human life and health. Rehabilitation is the essential treatment for post-stroke patients suffering from functional impairments, through which hemiparesis, aphasia, dysphagia, unilateral neglect, depression, and cognitive dysfunction can be restored to various degrees. Noninvasive brain stimulation (NIBS) is a popular neuromodulatory technology of rehabilitation focusing on the local cerebral cortex, which can improve clinical functions by regulating the excitability of corresponding neurons. Increasing evidence has been obtained from the clinical application of NIBS, especially repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). However, without a standardized protocol, existing studies on NIBS show a wide variation in terms of stimulation site, frequency, intensity, dosage, and other parameters. Its application for neurorehabilitation in post-stroke patients is still limited. With advances in neuronavigation technologies, functional near-infrared spectroscopy, and functional MRI, specific brain regions can be precisely located for stimulation. On the basis of our further understanding on neural circuits, neuromodulation in post-stroke rehabilitation has also evolved from single-target stimulation to co-stimulation of two or more targets, even circuits and the network. The present study aims to review the findings of current research, discuss future directions of NIBS application, and finally promote the use of NIBS in post-stroke rehabilitation.

Peniophora is an old corticioid genus, from which two small satellite genera, Dendrophora and Duportella, were derived based on morphological differences. Molecular systematic studies showed that they belong to Peniophoraceae, Russulales, but the inter- and intra-generic phylogenetic relationships are still unclear. Moreover, the species diversity of this group in subtropical and tropical Asia has not been sufficiently investigated and studied. In this study, we carried out an intensive taxonomic and phylogenetic study on Peniophora sensu lato based on analyses of concatenated ITS1-5.8S-ITS2 (ITS, Internal Transcribed Spacer) and 28S (D1–D2 domains of nuc 28S rDNA) sequence data of all available species worldwide. In the phylogenetic trees, species of Peniophora s. l. (sensu lato) including types of Peniophora s.s. (sensu stricto), Dendrophora and Duportella were interspersed within a strongly supported clade. It means that the morphological delimitations of the three genera are not reliable, and they should be regarded as a large genus. As a result, eight species of Duportella were transferred to Peniophora, although five of them have not been sequenced. Four new distinct lineages, corresponding to Peniophora cremicolor, P. major, P. shenghuae and P. vietnamensis spp. nov., were recovered in the trees. Peniophora taiwanensis is treated as a later synonym of P. malaiensis based on morphological and molecular evidence. Duportella renispora is excluded from Peniophoraceae, because BLAST results of the ITS and 28S sequences of the holotype showed that it is closely related to Amylostereum. Descriptions and illustrations are provided for the four new species, and an identification key is given for all 25 species of Peniophora in China. Our results indicated that the species diversity of the corticioid fungi in Asia is rich and deserves further study.

Modified constraint-induced movement therapy (mCIMT) has shown beneficial effects on motor function improvement after brain injury, but the exact mechanism remains unclear. In this study, amplitude of low frequency fluctuation (ALFF) metrics measured by resting-state functional magnetic resonance imaging was obtained to investigate the efficacy and mechanism of mCIMT in a control cortical impact (CCI) rat model simulating traumatic brain injury. At 3 days after control cortical impact model establishment, we found that the mean ALFF (mALFF) signals were decreased in the left motor cortex, somatosensory cortex, insula cortex and the right motor cortex, and were increased in the right corpus callosum. After 3 weeks of an 8-hour daily mCIMT treatment, the mALFF values were significantly increased in the bilateral hemispheres compared with those at 3 days postoperatively. The mALFF signal values of left corpus callosum, left somatosensory cortex, right medial prefrontal cortex, right motor cortex, left postero dorsal hippocampus, left motor cortex, right corpus callosum, and right somatosensory cortex were increased in the mCIMT group compared with the control cortical impact group. Finally, we identified brain regions with significantly decreased mALFF values at 3 days postoperatively. Pearson correlation coefficients with the right forelimb sliding score indicated that the improvement in motor function of the affected upper limb was associated with an increase in mALFF values in these brain regions. Our findings suggest that functional cortical plasticity changes after brain injury, and that mCIMT is an effective method to improve affected upper limb motor function by promoting bilateral hemispheric cortical remodeling. mALFF values correlate with behavioral changes and can potentially be used as biomarkers to assess dynamic cortical plasticity after traumatic brain injury.

Normal aging causes profound changes of structural degeneration and glucose hypometabolism in the human brain, even in the absence of disease. In recent years, with the extensive exploration of the topological characteristics of the human brain, related studies in rats have begun to investigate. However, age-related alterations of topological properties in individual brain metabolic network of rats remain unknown. In this study, a total of 48 healthy female Sprague–Dawley (SD) rats were used, including 24 young rats and 24 aged rats. We used Jensen-Shannon Divergence Similarity Estimation (JSSE) method for constructing individual metabolic networks to explore age-related topological properties and rich-club organization changes. Compared with the young rats, the aged rats showed significantly decreased clustering coefficient (Cp) and local efficiency (Eloc) across the whole-brain metabolic network. In terms of changes in local network measures, degree (D) and nodal efficiency (Enod) of left posterior dorsal hippocampus, and Enod of left olfactory tubercle were higher in the aged rats than in the young rats. About the rich-club analysis, the existence of rich-club organization in individual brain metabolic networks of rats was demonstrated. In addition, our findings further confirmed that rich-club connections were susceptible to aging. Relative to the young rats, the overall strength of rich-club connections was significantly reduced in the aged rats, while the overall strength of feeder and local connections was significantly increased. These findings demonstrated the age-related reorganization principle of the brain structure and improved our understanding of brain alternations during aging.

The present study aimed to investigate the interactive effect between aging and type 2 diabetes mellitus (T2DM) on brain glucose metabolism, individual metabolic connectivity and network properties. A 2 × 2 factorial-designed study was conducted, 83 T2DM patients (40 elderly and 43 middle-aged) and 69 gender-matched HCs (34 elderly and 35 middle-aged) underwent an 18F fluorodeoxyglucose-positron emission tomography/magnetic resonance (18F-FDG PET/MR) scanning. The Jensen-Shannon Divergence was applied to construct individual metabolic connectivity and network. The topological properties of network were quantified with graph theoretical analysis. The general linear model (GLM) was used to mainly estimate the interaction effect between aging and T2DM on glucose metabolism, metabolic connectivity and network. There was an interaction effect between aging and T2DM on glucose metabolism, metabolic connectivity and regional metabolic network properties (all P < 0.05). The post-hoc analyses showed that compared with the elderly HCs and middle-aged with T2DM groups, elderly T2DM group had decreased glucose metabolism, increased metabolic connectivity and regional metabolic network properties in cognition-related brain regions (all P < 0.05). The age and fasting plasma glucose had negative correlations with glucose metabolism, and positive correlations with metabolic connectivity. The elderly with T2DM had glucose hypometabolism, strengthened functional integration and increased efficiency of information communication mainly located in cognition-related brain regions, above metabolic connectivity patterns changes might be compensatory changes for glucose hypometabolism.

To observe the effect of acupoint catgut embedment(ACE) on expression of p38 mitogen activated protein kinase (p38MAPK), intercellular adhesion molecule-1(ICAM-1), interleukin-4 (IL-4) and eosinophils (EOS) in lung tissue of asthmatic rats, so as to explore its mechanism underlying improvement of asthma.Forty male Wistar rats were randomly divided into control, model, ACE and dexamethasone (DEX) groups, with 10 rats in each group. The asthmatic model was established by intraperitoneal injection of mixture suspension (1 mL) of ovalbumin (OVA,10%) and 10% Al (OH)Findings of optical microscope and TEM showed obvious bronchial deformation and inflammatory cell infiltration, rupture of EOS cell membrane, uneven cytoplasm with swelling and uneven density of eosinophilic granules in EOS of the model group, which was relatively milder in the ACE and DEX groups. Compared with the control group, the EOS number in BALF and the expressions of p38MAPK, ICAM-1 and IL-4 mRNAs in the lung tissue were significantly increased (Catgut embedding at acupoints may alleviate the airway inflammatory response in asthma rats, which may be related with its effects in down-regulating p38MAPK signaling, ICAM-1 and IL-4 mRNA expression, reducing the aggregation of EOS, and promoting the apoptosis of EOS.

BackgroundUpper-extremity hemiplegia after stroke remains a significant clinical problem. The supplementary motor area (SMA) is vital to the motor recovery outcomes of chronic stroke patients. Therefore, rebuilding the descending motor tract from the SMA to the paralyzed limb is a potential approach to restoring arm motor function after stroke. Paired associative stimulation (PAS), which is based on Hebbian theory, is a potential method for reconstructing the connections in the impaired motor neural circuits. The study described in this protocol aims to assess the effects of cortico–peripheral Hebbian-type stimulation (HTS), involving PAS, for neural circuit reconstruction to rescue the paralyzed arm after stroke.MethodsThe study is a 4-month double-blind randomized sham-controlled clinical trial. We will recruit 90 post-stroke individuals with mild to moderate upper limb paralysis. Based on a 1:1 ratio, the participants will be randomly assigned to the HTS and sham groups. Each participant will undergo 5-week HTS or sham stimulation. Assessments will be conducted at baseline, immediately after the 5-week treatment, and at a 3-month follow-up. The primary outcome will be the Wolf Motor Function Test (WMFT). The secondary outcomes will be Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Functional Independence Measure (FIM), and functional near-infrared spectroscopy (fNIRS) parameters. The adverse events will be recorded throughout the study.DiscussionUpper-limb paralysis in stroke patients is due to neural circuit disruption, so the reconstruction of effective motor circuits is a promising treatment approach. Based on its anatomical structure and function, the SMA is thought to compensate for motor dysfunction after focal brain injury at the cortical level. Our well-designed randomized controlled trial will allow us to analyze the clinical efficacy of this novel Hebbian theory-based neuromodulation strategy regarding promoting the connection between the cortex and peripheral limb. The results may have significance for the development and implementation of effective neurorehabilitation treatments.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ChiCTR2000039949].

BackgroundInterhemispheric and intrahemispheric long-range synchronization and information communication are crucial features of functional integration between the bilateral hemispheres. Previous studies have demonstrated that disrupted functional connectivity (FC) exists in the bilateral hemispheres of patients with carpal tunnel syndrome (CTS), but they did not clearly clarify the phenomenon of central dysfunctional connectivity. This study aimed to further investigate the potential mechanism of the weakened connectivity of primary somatosensory cortex (S1) based on a precise template.MethodsPatients with CTS (n = 53) and healthy control subjects (HCs) (n = 23) participated and underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning. We used FC to investigate the statistical dependency of the whole brain, effective connectivity (EC) to analyze time-dependent effects, and voxel-mirrored homotopic connectivity (VMHC) to examine the coordination of FC, all of which were adopted to explore the change in interhemispheric and intrahemispheric S1.ResultsCompared to the healthy controls, we significantly found a decreased strength of the two connectivities in the interhemispheric S1hand, and the results of EC and VMHC were basically consistent with FC in the CTS. The EC revealed that the information output from the dominant hemisphere to the contralateral hemisphere was weakened.ConclusionThis study found that maladjusted connections between and within the bilateral S1 revealed by these methods are present in patients with CTS. The dominant hemisphere with deafferentation weakens its effect on the contralateral hemisphere. The disturbance in the bilateral S1 provides reliable evidence to understand the neuropathophysiological mechanisms of decreased functional integration in the brains of patients with CTS.

Neuropathic pain following brachial plexus avulsion injury (BPAI) induces plastic changes in multiple brain regions associated with somatosensory function, pain, or cognition at the group level. The alternation of the whole pattern of resting-state brain activity and the feasibility of a brain imaging, information-based diagnosis of pain following BPAI is poorly investigated.To investigate whether brain pattern alternation can identify neuropathic pain from healthy controls at an individual level and the specific regions that can be used as diagnostic neuroimaging biomarkers.Controlled animal study.The research took place in the school of rehabilitation science of a university and affiliated hospitals.A total of 48 female Sprague-Dawley rats weighing 180 g-200 g were randomly assigned to either the BPAI group (n = 24) or normal control group (n = 24). A neuropathic pain rat model following BPAI was established in the BPAI group and a mechanical withdrawal threshold (MWT) test was performed to verify the presence of neuropathic pain. Micro-positron emission tomography with [Fluorine-18]-fluoro-2-deoxy-D-glucose (18F-FDG-PET) was used to obtain the whole brain metabolic activity scans. Multivariate pattern analysis (MVPA) was performed with a linear support vector machine (SVM) analysis both in PRoNTo toolbox (based on regions of interests) and SearchlightSearchlight approach (based on voxels within the region).Compared with baseline status, MWT of the left (intact) forepaw was significantly reduced in the BPAI group (P0.001). The accuracy of a whole brain image that correctly discriminated BPAI from normal controls rats was 87.5% with both the PRoNTo toolbox and SearchlightSearchlight method. Pearson's correlation analysis revealed significant positive correlations (P0.05) between MWT and the standard taken values of brain regions including the left olfactory nucleus, right entorhinal cortex in the PRoNTo toolbox, and bilateral amygdala, right piriform cortex and right ventral hippocampus in Searchlight method.The alternation of metabolic connectivity among regions and functional connectivity among different networks were not investigated in the present study.Our study indicated that MVPA based on the PET scans of rats' brains could successfully identify neuropathic pain from health condition at the individual level and predictive regions could potentially be provided as neuroimaging biomarkers for the neuropathic pain following BPAI.

Additional file 1: Figure S1 Kaplan-Meier curves for OS of 131 patients with de novo metastatic NPC based on whether patients received RT to metastatic bone lesions or not that was divided by the cut-off values of 1 (a and b) and 3 bone metastases (c and d).

Supplemental material, sj-docx-3-ict-10.1177_15347354211002919 for Exploring the Safety, Effectiveness, and Cost-Effectiveness of a Chinese Patent Medicine (Fufang E’jiao Syrup) for Alleviating Cancer-Related Fatigue: A Protocol for a Randomized, Double-Blinded, Placebo-Controlled, Multicenter Trial by Zhuo Song, Ling-yun Sun, Shan-shan Gu, Xiao-shu Zhu, He-zheng Lai, Fang Lu, Ning Cui, Qiong-yang Li, Yu Wu and Yun Xu in Integrative Cancer Therapies

Supplemental material, sj-docx-3-ict-10.1177_15347354211002919 for Exploring the Safety, Effectiveness, and Cost-Effectiveness of a Chinese Patent Medicine (Fufang E’jiao Syrup) for Alleviating Cancer-Related Fatigue: A Protocol for a Randomized, Double-Blinded, Placebo-Controlled, Multicenter Trial by Zhuo Song, Ling-yun Sun, Shan-shan Gu, Xiao-shu Zhu, He-zheng Lai, Fang Lu, Ning Cui, Qiong-yang Li, Yu Wu and Yun Xu in Integrative Cancer Therapies

Supplemental material, sj-docx-2-ict-10.1177_15347354211002919 for Exploring the Safety, Effectiveness, and Cost-Effectiveness of a Chinese Patent Medicine (Fufang E’jiao Syrup) for Alleviating Cancer-Related Fatigue: A Protocol for a Randomized, Double-Blinded, Placebo-Controlled, Multicenter Trial by Zhuo Song, Ling-yun Sun, Shan-shan Gu, Xiao-shu Zhu, He-zheng Lai, Fang Lu, Ning Cui, Qiong-yang Li, Yu Wu and Yun Xu in Integrative Cancer Therapies

The material for this study was the objects of furniture designed by modern designers and made in Ming-style and presented at numerous design and modern furniture exhibitions in various cities of China. We also analyzed objects of Ming-style furniture presented in the catalogs of companies developing interior design and auction house furniture.

Supplemental material, sj-docx-2-ict-10.1177_15347354211002919 for Exploring the Safety, Effectiveness, and Cost-Effectiveness of a Chinese Patent Medicine (Fufang E’jiao Syrup) for Alleviating Cancer-Related Fatigue: A Protocol for a Randomized, Double-Blinded, Placebo-Controlled, Multicenter Trial by Zhuo Song, Ling-yun Sun, Shan-shan Gu, Xiao-shu Zhu, He-zheng Lai, Fang Lu, Ning Cui, Qiong-yang Li, Yu Wu and Yun Xu in Integrative Cancer Therapies