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Spacecraft electromagnetic docking has many potential advantages, such as no propellant consumption and plume contamination, while providing high-precision, continuous, reversible, synchronous, and noncontacting control capabilities. With these advantages, there are strong dynamic nonlinearity and coupling, which are not friendly to controller design. Electromagnetic actuation has capabilities of force/torque symmetry and self-alignment, which could be exploited not only to simplify the controller but also to reduce the demand of relative motion measurement and improve control precision. In this paper, based on the theoretical derivation of nonlinear relative motion dynamic models, the magnetic force/torque symmetries and the self-alignment capability are analyzed, and then the self-attraction magnetic dipoles are solved. In addition, several numerical simulation cases are given to verify these capabilities and dipole solutions.

There are several potential advancements within cancer immunotherapy, but cells of chimeric antigen receptor-T stand out. Recently, two CAR-T cell designs targeting CD19 have been approved for use in the US and the European Union due to their promising results in the treatment of hematologic malignancies. Currently, researchers are focusing on evaluating the efficientness of CAR-T cell treatment for a variety of cancer of the solid tissues. Melanoma is caused by the malignant transformation of melanocytes. In addition to the skin, melanomas can also develop in other locations where neural crest cells migrate, such as the digestive system or the brain. Melanocytes are formed in the neural crest. Since transformed cells must overcome extra obstacles to survive, the treatment of solid cancers with cells that produce CAR-T has been less successful than the treatment of hematologic malignancies with cells that produce CAR-T. A solid cancer's immunosuppressive microenvironment and the inability to migrate cells that produce CAR-T to the site of the cancer are two significant barriers. In addition, finding the optimal target antigens to avoid on-target toxicity and non-cancer toxicity is a challenge. To lessen the harmful effects of systemic chemotherapy, Creech & Krementz developed isolated limb perfusion in 1956 to create high levels of chemotherapy in limbs affected by unresectable cancers, particularly soft tissue sarcomas and melanomas. By using these targets, it is possible to remove the wounded limb's circulation from the body's circulation and connect it to an extracorporeal system. When the patient becomes excessively hot, chemotherapeutic medications, primarily melphalan & cancer necrosis factor, are administered via a perfusion circuit. The objective of this article is to provide a summary of the benefits and drawbacks of employing car-t-cell therapy to cure solid cancers, particularly melanoma. It also investigates the possibilities of curing melanoma using car-T treatment as well as isolated limb perfusion.

Pneumonia and COVID-19 are the most infected infectious diseases that deteriorate health of all range of people. If the early treatment is not provided, it may lead to severe heart disease and eventually to mortality. Therefore, continuous heart rate (HR), as well as blood oxygen saturation (SpO2) monitoring can help to detect abnormalities early. As a result, this paper presents a combination of portable continuous SpO2 and HR monitor which focuses on the improvement of internal design and graphical user interface of the mobile application. In this system, MAX30100, a photoplethysmography (PPG) sensor, was used to measure SpO2 and HR. Then, the signal was transmitted to Arduino Nano as the master microcontroller to process all acquired data from the sensor. The device was integrated with Android-based mobile application through Bluetooth communication, for displaying the result of the measured real-time parameters continuously and for battery status indication. Quantitative measurements showed that the precision of the circuit system implemented for HR and SpO2 were 99.16% and 99.06%, respectively. This system would improve the working efficiency and life efficiency of the healthcare provider and public.

Advances in the last decade related to cellular epigenetic reprogramming (e.g. DNA methylome remodeling) toward a pluripotent state via the Yamanaka transcription factors Oct3/4, Klf4, Sox2, and Myc (OKSM) provide a window into potential mechanisms for combatting the deleterious effects of cellular ageing Using global gene expression analysis, we compared the effects of in vivo OKSM-mediated partial reprogramming in skeletal muscle fibres of mice to the effects of late-life murine exercise training in muscle Myc is the Yamanaka factor most induced by exercise in skeletal muscle, so we compared the MYC-controlled transcriptome in muscle to Yamanaka factor-mediated and exercise adaptation gene landscapes in mice and humans A single pulse of MYC is sufficient to remodel the muscle methylome We identify partial reprogramming-associated genes that are innately altered by exercise training and conserved in humans, and propose that MYC contributes to some of these responses ABSTRACT: Exercise promotes functional improvements in aged tissues, but the extent to which it simulates partial molecular reprogramming is unknown. Using transcriptome profiling from 1) a skeletal muscle-specific in vivo Oct3/4, Klf4, Sox2, and Myc (OKSM) reprogramming-factor expression murine model, 2) an in vivo inducible muscle-specific Myc induction murine model, 3) a translatable high-volume hypertrophic exercise training approach in aged mice, and 4) human exercise muscle biopsies, we collectively defined exercise-induced genes that are common to partial reprogramming. Late-life exercise training lowered murine DNA methylation age according to several contemporary muscle-specific clocks. A comparison of the murine soleus transcriptome after late-life exercise training to the soleus transcriptome after OKSM induction revealed an overlapping signature that included higher JunB and Sun1. Also, within this signature, downregulation of specific mitochondrial and muscle-enriched genes was conserved in skeletal muscle of long-term exercise-trained humans; among these was muscle-specific Abra/Stars. Myc is the OKSM factor most induced by exercise in muscle and was elevated following exercise training in aged mice. A pulse of MYC rewired the global soleus muscle methylome, and the transcriptome after a MYC pulse partially recapitulated OKSM induction. A common signature also emerged in the murine MYC-controlled and exercise adaptation transcriptomes, including lower muscle-specific Melusin and reactive oxygen species-associated Romo1. With Myc, OKSM, and exercise training in mice as well habitual exercise in humans, the complex I accessory subunit Ndufb11 was lower; low Ndufb11 is linked to longevity in rodents. Collectively, exercise shares similarities with genetic in vivo partial reprogramming. Abstract figure legend Diverse forms of exercise training improve muscle function and whole-body health, even if initiated late in life. Information on conserved exercise-controlled molecular cues that underpin a younger muscle phenotype in aged muscle has potential utility in the development of anti-ageing therapies. Induction of the Yamanaka factors Oct3/4, Klf4, Sox2, and Myc are known to ameliorate ageing hallmarks. Comparison of transcriptomic data from aged exercise-trained mice and humans to muscle fibre-specific genetically driven models of epigenetic reprogramming (e.g. Yamanaka factor or Myc expression) unearthed conserved biomarkers associated with molecular age mitigation. Considering reduced biological age according to DNA methylome analysis, high-volume exercise training can be classified as an epigenetic reprogramming stimulus. Chronic exercise should be considered alongside and/or as a method to inform healthspan-extending longevity approaches such as pharmacologic and dietary interventions. This article is protected by copyright. All rights reserved.

BACKGROUND: The present study aimed to assess the efficacy of a new haplo-paraspinal-muscle-preserving (HMP) laminoplasty technique in the treatment of cervical myelopathy. METHODS: The medical records of 68 patients diagnosed with multisegmental cervical myelopathy were retrospectively reviewed. Of these, 22 patients who underwent HMP laminoplasty were defined as the muscle-preserved group (MP), and 46 patients who underwent traditional open-door laminoplasty were enrolled and defined as the traditional open-door laminoplasty group (LP). Patient demographic data and surgical parameters like clinical and radiological parameters, operation duration, blood loss, and spinal canal expansion distance were compared. RESULTS: Average surgical time and blood loss were significantly reduced in the MP group when compared with the LP group (P < 0.05). Both groups demonstrated significant improvements in neurological function and spinal canal expansion (P > 0.05). However, the visual analog scale score in the MP group was significantly lower compared with the LP group at the 6-month follow-up (P < 0.05), but no differences were found at the 1-year follow-up. The loss of lordosis was more prominent in the LP group when compared with the MP group at 1-year follow-up (P < 0.05). Lower events of persistent axial pain were found in the MP group but with no statistical significance. More hinge side laminae fractures could be found in the MP group, but more hinge side displacements were found in the LP group. CONCLUSIONS: The HMP laminoplasty technique is relatively safe, effective, easier to perform, and better for lordosis maintenance and complication control compared with the traditional open-door technique. CLINICAL RELEVANCE: Although traditional open-door laminoplasty is an efficient approach in treating multisegmental cervical myelopathy, the complications could significantly affect the clinical outcome. Our new HMP laminoplasty technique has a lower complication rate and a better lordosis maintenance ability; therefore, it could be a better choice in treating multisegmental cervical myelopathy. LEVEL OF EVIDENCE: 3.

Lanthanide-doped upconversion nanoparticles (UCNPs) and cesium lead halide perovskite quantum dots (PeQDs) are highly compatible with each other: UCNPs produce anti-Stokes upconversion luminescence (UCL) under near-infrared (NIR) excitation and the emissive profiles of PeQDs can be conveniently tuned by varying the halide composition ratio. Therefore, in this study, UCNPs and PeQDs are mixed together, producing colorful UCL under 980 nm laser excitation. In addition, ZnI

Cardiovascular disease (CVD) is a heart related disease and is the top silent killer in worldwide. Frequent electrocardiogram (ECG) monitoring for patients with CVD is vital to check if arrhythmia occurs. Though there are lots of commercialized portable ECG monitoring device available, many of them are dedicated to professional clinical staff with complex user interface, or only targeted to specific arrhythmia for home monitoring with lack of data management system. In this study, an in-house developed ECG monitoring device was integrated with an Android-based mobile application through Bluetooth wireless communication and implements Google Cloud Technology. The Android-based mobile app supports main features of real-time ECG graph display, automated location detector, data management system and simple arrhythmia detection. The ECG graph displays acquired ECG signal in real-time by ­in-house ECG acquisition unit through Bluetooth wireless communication and stored as text files in phone’s local memory. Firebase Authentication and Firebase Storage based on Google Cloud technology are implemented for data management system development. This allows users and administrators to upload or access data securely through online Google Cloud Platform. Three types of heart rhythm, namely normal sinus rhythm, bradycardia and tachycardia can be classified based on heart rate analysis. Smartphone’s location service is enabled to allow user shares their location with caretaker in emergency case. The final solution utilizes the Internet-of-Things (IoT) technology to facilitate heart disease management towards telemedicine applications.

Objective: This study was designed to investigate the prognostic factors for immune checkpoint inhibitors (ICIs) combined utilization with radiotherapy (RT)/chemoradiotherapy (CRT) and to evaluate their toxicity in locally advanced or recurrent/metastatic esophageal squamous cell carcinoma (LA/RM ESCC). Methods: In this study, 198 LA/RM ESCC patients who received ICIs combined with RT/CRT in the Department of Radiotherapy of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS) and progression-free survival (PFS). Subgroup analysis was utilized to explore the prognostic factors, the treatment respond and treatment-related adverse events (trAEs) were analyzed. Results: The median OS and PFS were 30.4 months (95% confidence interval [CI]: 15.1–45.7 months) and 15.3 months (95% CI: 12.8–17.8 months), respectively. The median OS and PFS for patients achieving objective respond (ORR group, including complete response and partial response) were 50.8 months (95% CI: 25.8–75.7 months) and 20.5 months (95% CI: 14.1–27.0), respectively, which were higher than those in non-ORR group (OSnon-ORR:17.5 months, 95% CI: 14.0–21.0; χ2 = 13.881, P < 0.001; PFSnon-ORR: 12.1 months, 95% CI: 10.1–14.1, χ2 = 10.676, P = 0.001). Results from subgroup analysis illustrated combined ICIs with radiotherapy could improve the treatment respond (χ2 = 47.725, P = 0.000). The OS rate (χ2 = 18.836, P < 0.001) and PFS rate (χ2 = 6.881, P = 0.009) were significantly higher in the whole-lesion radiotherapy group than in the partial-lesion radiotherapy group. Multivariate analysis showed that the number of immune cycles, the coverage of radiotherapy target, the modality of ICIs-combination therapy and treatment response were independent prognosis factors for OS (hazard ratio [HR] = 0.512, 2.043, 1.889, and 1.912, respectively; P = 0.001, 0.001, 0.013, and 0.002, respectively). Radiotherapy coverage and treatment response were independent factors for PFS (HR = 1.478 and 1.597, respectively; P = 0.032 and 0.012, respectively). In the entire study population, 83 patients (41.9%) had ≥ grade 2 trAEs. Conclusions: ICIs combined with radiotherapy/chemoradiotherapy are safe and effective in LA/RM ESCC patients. The addition of radiotherapy could improve the treatment respond and whole-lesion radiotherapy improve prognosis compared with partial-lesion radiotherapy group. The number of immunotherapy cycles and treatment response are the main factors affecting prognosis.

Deforestation is a major contributor to biodiversity loss, yet the impact of forest loss on daily microclimate variability and its implications for species with different daily activity patterns remain poorly understood. Using a recently developed microclimate model, we investigated the effects of deforestation on the daily temperature range (DTR) in low-elevation tropical regions and high-elevation temperate regions. Our results show that deforestation substantially increases DTR in these areas, suggesting a potential impact on species interactions. To test this hypothesis, we studied the competitive interactions between nocturnal burying beetles and all-day-active blowfly maggots in forested and deforested habitats in Taiwan. We show that deforestation leads to increased DTR at higher elevations, which enhances the competitiveness of blowfly maggots during the day and leads to a higher failure rate of carcass burial by the beetles at night. Thus, deforestation-induced temperature variability not only modulates exploitative competition between species with different daily activity patterns, but also likely exacerbates the negative impacts of climate change on nocturnal organisms. In order to limit potential adverse effects on species interactions and their ecological functions, our study highlights the need to protect forests, especially in areas where deforestation can greatly alter temperature variability.

The objectives of this study were to measure to what extent exercise stimulates partial molecular reprogramming in skeletal muscle. We hypothesized that exercise training, beyond its known functional improvements in aged tissues, could recapitulate some of the same effects that are seen with in vivo partial reprogramming by Yamanaka factors. Using transcriptome profiling from 1) a skeletal muscle-specific in vivo Oct3/4, Klf4, Sox2, and Myc (OKSM) reprogramming-factor expression murine model, 2) an in vivo inducible muscle-specific Myc induction murine model, 3) a translatable high-volume hypertrophic exercise training approach in aged mice, and 4) human exercise muscle biopsies, we collectively defined exercise-induced genes common to partial reprogramming. Late-life exercise training lowered murine DNA methylation age according to several contemporary muscle-specific clocks. A comparison of the murine soleus transcriptome after late-life exercise training to the soleus transcriptome after OKSM induction revealed an overlapping signature. Within this signature, downregulation of specific mitochondrial and muscle-enriched genes was conserved in skeletal muscle of long-term exercise-trained humans; among these was muscle-specific Abra/Stars. Myc is the OKSM factor most induced by exercise in muscle and was elevated following exercise training in aged mice. A pulse of MYC rewired the global soleus muscle methylome, and the transcriptome after a MYC pulse partially recapitulated OKSM induction. A common signature also emerged in the murine MYC-controlled and exercise adaptation transcriptomes, including lower muscle-specific Melusin and reactive oxygen species-associated Romo1. With Myc, OKSM, and exercise training in mice as well habitual exercise in humans, the complex I accessory subunit Ndufb11 was lower; low Ndufb11 is linked to longevity in rodents. Our data collectively suggest: 1) a biological age-mitigating effect on the epigenetic landscape by late-life exercise-training in murine skeletal muscle, 2) a common gene expression signature of partial reprogramming by OKSM and exercise training in muscle of humans and aged mice, and 3) that Myc is an exercise-responsive factor that contributes to a rewired molecular profile at the transcriptome and methylome levels. National Institutes of Health: Kevin A. Murach, AG063994; American Federation for Aging Research (AFAR): Kevin A. Murach, Junior Investigator Grant This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Background Guillain–Barre syndrome after myocardial infarction occurs infrequently, and its occurrence following percutaneous coronary intervention is extremely rare. Due to the high mortality rate of myocardial infarction and the disability of Guillain–Barre syndrome, early identification of Guillain–Barre syndrome after myocardial infarction and early intervention can decrease the mortality rate, lead to early recovery, and provide a better outcome. Case presentation Herein, we reported a rare case of Guillain–Barre syndrome after myocardial infarction treated with percutaneous coronary intervention. The patient was a 75-year-old woman from China who was admitted to hospital due to sudden loss of consciousness. Electrocardiography showed acute myocardial infarction in the right ventricle and inferior and posterior walls. The patient underwent emergency percutaneous intervention of the posterior collateral artery of the right coronary artery. Soon after, her condition worsened resulting in limb weakness and numbness. Unfortunately, she continued to develop respiratory failure, and treated with intravenous immunoglobulin and ventilator-assisted breathing. A physical examination showed hypotonia of all four limbs, complete quadriplegia, bulbar palsy, dysarthria, and tendon areflexia. Serum immunoglobulin (Ig) G anti-ganglioside antibody analysis was positive with anti-GT1a antibodies (+ +), anti-GM1 antibodies ( +), anti-GM2 antibodies ( +), and anti-GM4 antibodies ( +), and he was diagnosed with Guillain–Barre syndrome after myocardial infarction. She was discharged due to poor response to treatment. The patient died two days after being discharged. Conclusions Myocardial infarction and/or percutaneous coronary intervention may activate immune-mediated response and cause severe complications. Clinician should be alert to Guillain–Barre syndrome after myocardial infarction and/or percutaneous coronary intervention.

Cigarette smoking is associated with surgical complications, including wound healing and surgical site infection. However, the association between smoking status and postoperative wound complications is not completely understood. Our objective was to investigate the effect of smoking on postoperative wound complications for major surgeries. Data were collected from the 2013 to 2018 participant use files of the American College of Surgeons National Surgical Quality Improvement Program database. A propensity score matching procedure was used to create the balanced smoker and nonsmoker groups. Multivariable logistic regression was used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative wound complications, pulmonary complications, and in-hospital mortality associated with smokers. A total of 1 156 002 patients (578 001 smokers and 578 001 nonsmokers) were included in the propensity score matching analysis. Smoking was associated with a significantly increased risk of postoperative wound disruption (OR 1.65, 95% CI 1.56-1.75), surgical site infection (OR 1.31, 95% CI 1.28-1.34), reintubation (OR 1.47, 95% CI 1.40-1.54), and in-hospital mortality (OR 1.13, 95% CI 1.07-1.19) compared with nonsmoking. The length of hospital stay was significantly increased in smokers compared with nonsmokers. Our analysis indicates that smoking is associated with an increased risk of surgical site infection, wound disruption, and postoperative pulmonary complications. The results may drive the clinicians to encourage patients to quit smoking before surgery.

The purpose of the article is to investigate social media use (Face book, Twitter, You Tube, Instagram) and its influence on companies in Ghana. The research selected eight firms from each of the 16 regions in Ghana. A total of 128 questionnaires were administered to the companies. By employing the Smart PLS3, the article analysis the proposed hypothesis developed for the research. The findings of the investigations indicated that cost benefit, interactivity, management support, entrepreneurial orientation had an insignificant affiliation with social media use. However, environmental factors such as competition, supplier needs, and customers needs had a positive and a material nexus with social media usage. Finally, social media use had a positive and a favorable association effect on the organisations. This article recommend that organizations may use social media to get a lot of information about their consumers and rivals. Customers’ preferences, requirements, expectations, and frustrations are all understood by them. Social media aids in the retrieval of more information about the company’s rivals, their actions, strategies, and brand feelings, allowing them to improve their goods and services and have a bigger influence on the company’s performance. KEYWORDS: Social media usage, organizational performance, enterprise in Ghana, environmental factors, technological factors, organizational factors.

Delimiting species requires multiple sources of evidence. Here, we delimited two varieties of Halenia elliptica (Gentianaceae) using several lines of evidence, including morphological traits and mating system in a sympatric population, phylogenetic relationships based on nrITS and cpDNA (rpl16) data, and complete chloroplast genome sequences. Comparative analysis of 21 morphological traits clearly separates the two varieties of H. elliptica. Examination of the flowering process and pollination treatments indicate that H. elliptica var. grandiflora produces seeds via outcrossing, whereas H. elliptica var. elliptica produces seeds via mixed mating. Furthermore, hand-pollinated hybridization of the two varieties produced no seeds. Observations of pollinators showed that when bees began a pollination bout on H. elliptica var. grandiflora they preferred to continue pollinating this variety; however, when they began a pollination bout on H. elliptica var. elliptica, they showed no preference for either variety. Phylogenetic analysis confirmed the monophyly of H. elliptica, which was further divided into two monophyletic clades corresponding to the two varieties. A large number of variants from the chloroplast genomes reflected remarkable genetic dissimilarities between the two varieties of H. elliptica. We recommend that the two varieties of H. elliptica should be revised as two species (H. elliptica and Halenia grandiflora). Our findings indicate that H. elliptica varieties may have split into two separate species due to a shift in mating system, changes in flowering phenology and/or post-pollination reproductive isolation.

Background The crucial role that nurses play in offering palliative care to patients with life-threatening diseases is widely acknowledged, but the correlation between their eHealth literacy and their knowledge, attitudes, and practice in this domain has yet to be investigated. This study is conducted to investigate the status of eHealth literacy and knowledge, attitudes, and practice regarding palliative care among nurses, and to examine their relationship. Methods A cross-sectional study design was conducted among 546 nurses selected from the first-class tertiary hospitals located both inside and outside of Zhejiang Province between May 12 and May 20, 2022. The online survey of eHealth literacy scale (eHEALS) and scale of knowledge, attitudes, and practice (KAP) regarding palliative care was performed using snowball sampling through the WeChat mini program “Questionnaire Star”. The Spearman rank correlation and binary logistic regression model were used to analyze the independent association between eHealth literacy and KAP toward palliative care. Results The median scores of eHEALS and KAP regarding palliative care were 32 (interquartile range[IQR] 29 to 38) and 82 (IQR 54 to 106) points. The results of correlation analysis showed that the KAP regarding palliative care was significantly correlated with eHEALS (rho = 0.189, P OR = 2.109; P Conclusion Nurses who worked in first-class tertiary hospitals have good levels of eHealth literacy, while the overall level of KAP regarding palliative care is moderate. Our findings highlight that the eHEALS score is independently associated with the KAP score regarding palliative care. Therefore, nursing managers should adopt multiple measures to comprehensively improve eHealth literacy among nurses, further enrich their knowledge of palliative care, promote a positive transformation of attitudes towards palliative care, and efficiently implement palliative care practice, in order to promote high-quality development of palliative care.

Background Early-life environmental exposures are suspected to be involved in the development of chronic diseases later in life. Most studies conducted so far considered single or few exposures and single-health parameter. Our study aimed to identify a childhood general health score and assess its association with a wide range of pre- and post-natal environmental exposures. Methods The analysis is based on 870 children (6–12 years) from six European birth cohorts participating in the Human Early-Life Exposome project. A total of 53 prenatal and 105 childhood environmental factors were considered, including lifestyle, social, urban and chemical exposures. We built a general health score by averaging three sub-scores (cardiometabolic, respiratory/allergy and mental) built from 15 health parameters. By construct, a child with a low score has a low general health status. Penalized multivariable regression through Least Absolute Shrinkage and Selection Operator (LASSO) was fitted in order to identify exposures associated with the general health score. Findings: The results of LASSO show that a lower general health score was associated with maternal passive and active smoking during pregnancy and postnatal exposure to methylparaben, copper, indoor air pollutants, high intake of caffeinated drinks and few contacts with friends and family. Higher child’s general health score was associated with prenatal exposure to a bluespace near residency and postnatal exposures to pets, cobalt, high intakes of vegetables and more physical activity. Against our hypotheses, postnatal exposure to organochlorine compounds, perfluorooctanoate and childhood medium intake of sodas and bakery products were associated with a higher child’s general health score. Conclusion By using a general health score summarizing the child cardiometabolic, respiratory/allergy and mental health, this study reinforced previously suspected environmental factors associated with various child health parameters (e.g. tobacco, air pollutants) and identified new factors (e.g. pets, bluespace) warranting further investigations.

Nonalcoholic fatty liver disease (NAFLD) is one of major causes of end-stage liver disease in the coming decades, but it shows few symptoms until it develops into cirrhosis. We aim to develop classification models with machine learning to screen NAFLD patients among general adults. This study included 14,439 adults who took health examination. We developed classification models to classify subjects with or without NAFLD using decision tree, random forest (RF), extreme gradient boosting (XGBoost) and support vector machine (SVM). The classifier with SVM was showed the best performance with the highest accuracy (0.801), positive predictive value (PPV) (0.795), F1 score (0.795), Kappa score (0.508) and area under the precision-recall curve (AUPRC) (0.712), and the second top of area under receiver operating characteristic curve (AUROC) (0.850). The second-best classifier was RF model, which was showed the highest AUROC (0.852) and the second top of accuracy (0.789), PPV (0.782), F1 score (0.782), Kappa score (0.478) and AUPRC (0.708). In conclusion, the classifier with SVM is the best one to screen NAFLD in general population based on the results from physical examination and blood testing, followed by the classifier with RF. Those classifiers have a potential to screen NAFLD in general population for physician and primary care doctors, which could benefit to NAFLD patients from early diagnosis.

BackgroundPost-acute coronavirus disease 2019 (COVID-19) symptoms occurred in most of the COVID-19 survivors. However, few studies have examined the issue of whether hospitalization results in different post-acute COVID-19 symptom risks. This study aimed to compare potential COVID-19 long-term effects in hospitalized and non-hospitalized COVID-19 survivors.MethodsThis study is designed as a systematic review and meta-analysis of observational studies. A systematic search of six databases was performed for identifying articles published from inception until April 20th, 2022, which compared post-acute COVID-19 symptom risk in hospitalized and non-hospitalized COVID-19 survivors using a predesigned search strategy included terms for SARS-CoV-2 (eg, COVID, coronavirus, and 2019-nCoV), post-acute COVID-19 Syndrome (eg, post-COVID, post COVID conditions, chronic COVID symptom, long COVID, long COVID symptom, long-haul COVID, COVID sequelae, convalescence, and persistent COVID symptom), and hospitalization (hospitalized, in hospital, and home-isolated). The present meta-analysis was conducted according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement using R software 4.1.3 to create forest plots. Q statistics and the I2 index were used to evaluate heterogeneity in this meta-analysis.ResultsSix observational studies conducted in Spain, Austria, Switzerland, Canada, and the USA involving 419 hospitalized and 742 non-hospitalized COVID-19 survivors were included. The number of COVID-19 survivors in included studies ranged from 63 to 431, and follow-up data were collected through visits in four studies and another two used an electronic questionnaire, visit and telephone, respectively. Significant increase in the risks of long dyspnea (OR = 3.18, 95% CI = 1.90–5.32), anxiety (OR = 3.09, 95% CI = 1.47–6.47), myalgia (OR = 2.33, 95% CI = 1.02–5.33), and hair loss (OR = 2.76, 95% CI = 1.07–7.12) risk were found in hospitalized COVID-19 survivors compared with outpatients. Conversely, persisting ageusia risk was significantly reduced in hospitalized COVID-19 survivors than in non-hospitalized patients.ConclusionThe findings suggested that special attention and patient-centered rehabilitation service based on a needs survey should be provided for hospitalized COVID-19 survivors who experienced high post-acute COVID-19 symptoms risk.

BackgroundFree-living amoebae (FLA) including Naegleria fowleri, Acanthamoeba spp., and Balamuthia mandrillaris can become pathogenic and cause severe cerebral infections, named primary amoebic meningoencephalitis (PAM), granulomatous amoebic encephalitis (GAE), and balamuthia amoebic encephalitis (BAE), respectively. FLA encephalitis has been reported across China, but the clinical data descriptions and analytical results of these different reports vary widely. Currently, no consensus treatment has been established. We conduct a systematic review to evaluate the exposure location, clinical symptoms, diagnosis, treatment, and prognosis of three FLA encephalitis and aim to reveal the differences between three FLA encephalitis in China.MethodsWe used MEDLINE (PubMed interface), EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang database, and China Biology Medicine disc (CBMdisc) databases for literatures published and manually retrieve the hospital records of our hospital. The search time was up to August 30, 2022, with no language restrictions.ResultsAfter excluding possible duplicate cases, a total of 48 patients of three FLA encephalitis were collected. One from the medical records of our hospital and 47 patients from 31 different studies. There were 11 patients of PAM, 10 patients of GAE, and 27 patients of BAE. The onset of PAM is mostly acute or subacute, and the clinical symptoms are acute and fulminant hemorrhagic meningoencephalitis. Most patients with GAE and BAE have an insidious onset and a chronic course. A total of 21 BAE patients (77.8%) had skin lesions before onset of symptoms. Additionally, 37 cases (77.1%) were diagnosed with FLA encephalitis before death. And there were 4 of PAM, 2 of GAE, and 10 of BAE diagnosed using next generation sequencing. No single agent can be proposed as the ideal therapy by itself. Only 6 cases were successfully treated.ConclusionsThis review provides an overview of the available data and studies of FLA encephalitis in China and identify some potential differences. FLA encephalitis is a rare but pathogenic infection, and physicians should early identify this encephalitis to improve survival.

With aging, skeletal muscle plasticity is attenuated in response to exercise. Here, we report that senescent cells, identified using senescence-associated β-galactosidase (SA β-Gal) activity and p21 immunohistochemistry, are very infrequent in resting muscle, but emerge approximately 2 weeks after a bout of resistance exercise in humans. We hypothesized that these cells contribute to blunted hypertrophic potential in old age. Using synergist ablation-induced mechanical overload (MOV) of the plantaris muscle to model resistance training in adult (5–6-month) and old (23–24-month) male C57BL/6 J mice, we found increased senescent cells in both age groups during hypertrophy. Consistent with the human data, there were negligible senescent cells in plantaris muscle from adult and old sham controls, but old mice had significantly more senescent cells 7 and 14 days following MOV relative to young. Old mice had blunted whole-muscle hypertrophy when compared to adult mice, along with smaller muscle fibers, specifically glycolytic type 2x + 2b fibers. To ablate senescent cells using a hit-and-run approach, old mice were treated with vehicle or a senolytic cocktail consisting of 5 mg/kg dasatinib and 50 mg/kg quercetin (D + Q) on days 7 and 10 during 14 days of MOV; control mice underwent sham surgery with or without senolytic treatment. Old mice given D + Q had larger muscles and muscle fibers after 14 days of MOV, fewer senescent cells when compared to vehicle-treated old mice, and changes in the expression of genes (i.e., Igf1, Ddit4, Mmp14) that are associated with hypertrophic growth. Our data collectively show that senescent cells emerge in human and mouse skeletal muscle following a hypertrophic stimulus and that D + Q improves muscle growth in old mice.

Objectives Intervertebral disc (IVD) degeneration is an important disease with no efficient biological therapy identified. Autophagy, a wildly known therapeutic target for human disease, has been demonstrated to be activated under hypoxia, with underlying mechanism remains elusive. Thus, this study aims to specify the role of autophagy in IVD degeneration, the regulating mechanism of hypoxia-inducing autophagy, and the therapeutic value of autophagy for IVD degeneration. Methods RNA-seq was used to screen the primary pathway affected in NP cells under hypoxia, the specific link between hypoxia and autophagy were investigated using ChIP-seq and dual luciferase reporter assay. Conditional ATG7 knockout mice (ATG7-/-) were constructed for assessing the effect of autophagy on IVD degeneration, and puncture induced mice model of IVD degeneration were used for intradiscal injection to evaluate the therapeutic value of autophagy. Results We demonstrated that hypoxia induces autophagy by transcriptional activation of autophagic gene LC3B and ATG7, which is controlled by PERK signaling. Then, we observed that inhibiting autophagy or PERK signaling leads to impaired NP cell viability and function, furthermore, using ATG7 knockout (ATG7-/-) mice, we identified the protective role of autophagy in IVD. Furthermore, we found that intradiscal injection of PERK signaling agonist, CCT020312, significantly restores the degeneration level of needle punctured mice IVD. Conclusion We showed that the activation of PERK signaling upon hypoxia serves as a vital mechanism to induce autophagy and identified the therapeutic value of PERK signaling agonist for IVD degeneration treatment.

Sepsis can cause sepsis-associated encephalopathy (SAE), but whether SAE was induced or exacerbated by ferroptosis remains unknown. In this study, the rat sepsis model was constructed using the cecal ligation and puncture method. The blood–brain barrier (BBB) permeability was measured by Evans blue dye (EBD) in vivo. The levels of ROS, Fe ion, MDA, GSH, and GPX4 were assessed by enzyme-linked immunosorbent assay (ELISA). The exosomes isolated from serum were cultured with bEnd.3 cells for the in vitro analysis. Moreover, bEnd.3 cells cultured with 100 μM FeCl3 (iron-rich) were to simulate ferroptosis stress. The cell viability was evaluated by Cell Counting Kit-8 (CCK-8) assay. A dual-luciferase reporter gene assay was performed to confirm the relationship between miR-9-5p with NEAT1, TFRC, and GOT1. In vivo, it is found that BBB permeability was damaged in model rats. Level of ROS, Fe ion, and MDA was increased, and level of GSH and GPX4 was decreased, which means ferroptosis was induced by sepsis. Exosome-packaged NEAT1 in serum was significantly upregulated in model rats. In vitro, it is found that NEAT1 functions as a ceRNA for miR-9-5p to facilitate TFRC and GOT1 expression. Overexpression of NEAT1 enhanced ferroptosis stress in bEnd.3 cells. Increased miR-9-5p alleviated sepsis-induced ferroptosis by suppressing the expression of TFRC and GOT1 both in vivo and in vitro. In conclusion, these findings suggest that sepsis induced high expression of serous exosome-derived NEAT1, and it might exacerbate SAE by promoting ferroptosis through regulating miR-9-5p/TFRC and GOT1 axis.

Muscle fibers are syncytial postmitotic cells that can acquire exogenous nuclei from resident muscle stem cells, called satellite cells. Myonuclei are added to muscle fibers by satellite cells during conditions such as load-induced hypertrophy. It is difficult to dissect the molecular contributions of resident versus satellite cell-derived myonuclei during adaptation due to the complexity of labeling distinct nuclear populations in multinuclear cells without label transference between nuclei. To sidestep this barrier, we used a genetic mouse model where myonuclear DNA can be specifically and stably labeled via nonconstitutive H2B-GFP at any point in the lifespan. Resident myonuclei (Mn) were GFP-tagged in vivo before 8 wk of progressive weighted wheel running (PoWeR) in adult mice (>4-mo-old). Resident + satellite cell-derived myonuclei (Mn+SC Mn) were labeled at the end of PoWeR in a separate cohort. Following myonuclear isolation, promoter DNA methylation profiles acquired with low-input reduced representation bisulfite sequencing (RRBS) were compared to deduce epigenetic contributions of satellite cell-derived myonuclei during adaptation. Resident myonuclear DNA has hypomethylated promoters in genes related to protein turnover, whereas the addition of satellite cell-derived myonuclei shifts myonuclear methylation profiles to favor transcription factor regulation and cell-cell signaling. By comparing myonucleus-specific methylation profiling to previously published single-nucleus transcriptional analysis in the absence (Mn) versus the presence of satellite cells (Mn+SC Mn) with PoWeR, we provide evidence that satellite cell-derived myonuclei may preferentially supply specific ribosomal proteins to growing myofibers and retain an epigenetic “memory” of prior stem cell identity. These data offer insights on distinct epigenetic myonuclear characteristics and contributions during adult muscle growth.

As the design complexity keeps increasing, the 2.5D FPGA with large logic capacity has become popular in modern circuit applications. A 2.5D FPGA consists of multiple dies connected through super long lines (SLLs) on an interposer. Each die contains heterogeneous logic blocks and ASIC-like clocking architectures to achieve better skew and timing. Existing works consider these problems separately and thus may lead to serious timing issues or routing failure. This paper presents an analytical placement algorithm for the 2.5D FPGA to simultaneously minimize the number of inter-die SLL signals and intra-die clocking violations. Using a lifting dimension technique, we first formulate the 2.5D global placement problem as a three-dimensional continuous and differential minimization problem, where the SLL-aware block distribution is modeled by 3D Poisson’s equation and directly solved to obtain an analytical solution. Then, we further reformulate the minimization problem as a separable optimization problem with linear constraints. Based on the proximal alternating direction method of multipliers (ADMM) optimization method, we efficiently optimize the separable subproblems one by one in an alternating fashion. Finally, clock-aware legalization and detailed placement are applied to legalize and improve our placement results. Compared with the state-of-the-art works, experimental results show that our algorithm can resolve all clocking constraints and reduce the number of SLL crossing signals by 36.9% with similar wirelength in a comparable running time.

Background Autonomic dysfunctions including bladder dysfunction, gastrointestinal dysfunction and orthostasis are common symptoms of autoimmune glial fibrillary acidic protein astrocytopathy (A-GFAP-A); however, cardiac autonomic dysfunction and abnormal circadian rhythm of blood pressure, which can lead to poor prognosis and even sudden cardiac death, has never been reported in A-GFAP-A patient. Case presentation A 68-year-old male Chinese patient presented to our hospital with headache, fever, progressive disturbance of consciousness, dysuria, and limb weakness. Abnormal heart rate variability and non-dipper circadian rhythm of blood pressure gradually developed during hospitalization, which is rare in A-GFAP-A. He had positive GFAP IgG in cerebrospinal fluid (CSF). Enhanced brian MRI showed uneven enhancement and T2 hyperintense lesions of medulla oblongata; Cervical spine MRI showed T2 hyperintense lesions in medulla oblongata and upper margin of the T2 vertebral body. A contrast-enhanced thoracic spine MRI showed uneven enhancement and T2 hyperintense lesions of T1 to T6 vertebral segments. After treatment with intravenous immunoglobulin and corticosteroids, the patient’s symptoms, including autonomic dysfunction, alleviated dramatically. Finally, his heart rate variability and blood pressure variability became normal. Conclusions Our case broadens the spectrum of expected symptoms in A-GFAP- A syndromes as it presented with heart rate variability and blood pressure variability.

Four-level cervical spondylotic myelopathy (CSM) is a common disease affecting a large number of people, with the optimal surgical strategy remaining controversial. This study compared the clinical outcomes, radiological parameters, and postoperative complications of primarily performed surgical procedures such as anterior cervical discectomy and fusion (ACDF), open-door laminoplasty (LAMP), and laminectomy with fusion (LF) in treating four-level CSM. A total of 116 patients who received ACDF (38 cases), LAMP (45 cases), and LF (33 cases) were followed up for a minimum of 24 months were enrolled in this study and retrospectively analyzed. Clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) scoring system, the Neck Disability Index (NDI), and the Visual Analogue Scale (VAS). Changes in the curvature of the cervical spine were determined using the cervical curvature index (CCI) and the C2–C7 Cobb angle. Cervical mobility was evaluated using the C2–C7 range of motion (ROM) and active cervical ROM (aROM). Complications were recorded and compared among the three groups. All patients achieved significant improvement in JOA, NDI, and VAS scores at the final follow-up (P P > 0.05). In addition, both C2–7 ROM and aROM were significantly reduced in the three groups and LAMP showed the least reduction relatively. As for complications, LAMP showed the lowest overall incidence of postoperative complications, and patients in the ACDF group were more susceptible to dysphagia, pseudoarthrosis than LAMP and LF. Considering improvements in clinical symptoms and neurological function, no remarkable difference was found among the groups. Nevertheless, LAMP had advantages over the other two surgical procedures in terms of preserving cervical mobility and reducing postoperative complications.

Previous evidence suggested that maternal diet might influence her child development through placental exchanges and breastfeeding. Active transfer of fatty acids through placenta, e.g. polyunsaturated fatty acids, are of great interest because of their implications in the child’s brain development. There is a lack of evidence regarding the influence of maternal dairy consumption during pregnancy on the fatty acids’ composition of blood cells membrane in maternal or cord blood and colostrum.

Let $\gamma\in\mathbb{R}\setminus\{0\}$ and $X(\mathbb{R}^n)$ be a ball Banach function space satisfying some mild assumptions. Assume that $\Omega=\mathbb{R}^n$ or $\Omega\subset\mathbb{R}^n$ is an $(\varepsilon,\infty)$-domain for some $\varepsilon\in(0,1]$. In this article, the authors prove that a function $f$ belongs to the homogeneous ball Banach Sobolev space $\dot{W}^{1,X}(\Omega)$ if and only if $f\in L_{\mathrm{loc}}^1(\Omega)$ and $$ \sup_{\lambda\in(0,\infty)}\lambda \left\|\left[\int_{\{y\in\Omega:\ |f(\cdot)-f(y)|>\lambda|\cdot-y|^{1+\frac{\gamma}{p}}\}} \left|\cdot-y\right|^{\gamma-n}\,dy \right]^\frac{1}{p}\right\|_{X(\Omega)}, Comment: arXiv admin note: text overlap with arXiv:2304.00949