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Abstract Background Depression, anxiety and high-sensitivity C-reactive protein (hs-CRP) are individually associated with poor prognosis in patients with coronary heart disease (CHD). However, the combined effects of depression with inflammation or anxiety with inflammation on the prognosis have been rarely explored. Methods This prospective cohort study included 414 patients diagnosed with CHD. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess depression and anxiety. A score ≥ 5 points was defined as elevated depression or anxiety. High hs-CRP was defined as ≥ 3 mg/L. Follow-up was performed 2 years after the patients were discharged. The clinical results included noncardiac readmission, cardiac readmission, major cardiovascular events (MACEs), and composite events. The composite events included noncardiac readmission and MACEs. The Cox proportional hazard regression model was used to analyze the prognostic risk. Results After full adjustment, patients with elevated depression and high hs-CRP had a higher risk in predicting noncardiac readmission (hazard ratio (HR) = 3.87, 95% confidence interval (CI) = 1.10–9.02, p = 0.002) and composite events (HR = 1.93, 95% CI = 1.13–3.30, p = 0.016) than those with high hs-CRP alone. For the anxiety and hs-CRP group, high hs-CRP alone predicted a higher risk of noncardiac readmission (HR = 3.32, 95% CI = 1.57–7.03, p = 0.002) and composite events (HR = 1.75, 95% CI = 1.12–2.76, p = 0.015) than references. Elevated anxiety had no significant effects on all the endpoints. Furthermore, we didn’t find interactions between depression and hs-CRP or anxiety and hs-CRP. Conclusion In patients with CHD, elevated depression with high hs-CRP was found to be significant in predicting the risk of noncardiac readmission and composite events. Early diagnosis and treatment of depression with inflammation are necessary in CHD patients.

Summary: Generative design of promoters has enhanced the efficiency of de novo creation of functional sequences. Though several deep generative models have been employed in biological sequence generation, including variational autoencoder (VAE) or Wasserstein generative adversarial network (WGAN), these models might struggle with mode collapse and low sample diversity. In this study, we introduce the multinomial diffusion model (MDM) for promoter sequence design and propose a structured set of criteria for effectively comparing the performance of generative models. In silico experiments demonstrate that MDM outperforms existing generative AI approaches. MDM demonstrates superior performance in various computational evaluations, remains robust during the training process, and exhibits a strong ability in capturing weak signals. In addition, we experimentally validated that the majority of our model designed promoters have expression activities in vivo, indicating the practicality and potential of MDM for bioengineering.

Abstract Background The ricefield eel Monopterus albus undergoes a natural sex change from female to male during its life cycle, and previous studies have shown the potential mechanisms of this transition at the transcriptional and protein levels. However, the changes in protein levels have not been fully explored, especially in the intersexual stage. Results In the present study, the protein expression patterns in the gonadal tissues from five different periods, the ovary (OV), early intersexual stage gonad (IE), middle intersexual stage gonad (IM), late intersexual stage gonad (IL), and testis (TE), were determined by untargeted proteomics sequencing. A total of 5125 proteins and 394 differentially expressed proteins (DEPs) were detected in the gonadal tissues. Of the 394 DEPs, there were 136 between the OV and IE groups, 20 between the IM and IE groups, 179 between the IL and IM groups, and 59 between the TE and IL groups. Three candidate proteins, insulin-like growth factor 2 mRNA-binding protein 3 isoform X1 (Igf2bp3), triosephosphate isomerase (Tpi), and Cu-Zn superoxide dismutase isoform X1 [(Cu-Zn) Sod1], were validated by western blotting to verify the reliability of the data. Furthermore, metal metabolite-related proteins were enriched in the IL vs. IM groups and TE vs. IL groups, which had close relationships with sex change, including Cu2+-, Ca2+-, Zn2+- and Fe2+/Fe3+-related proteins. Analysis of the combined transcriptome data revealed consistent protein/mRNA expression trends for two metal metabolite-related proteins/genes [LOC109953912 and calcium Binding Protein 39 Like (cab39l)]. Notably, we detected significantly higher levels of Cu2+ during the sex change process, suggesting that Cu2+ is a male-related metal metabolite that may have an important function in male reproductive development. Conclusions In summary, we analyzed the protein profiles of ricefield eel gonadal tissues in five sexual stages (OV, IE, IM, IL, and TE) and verified the plausibility of the data. After preforming the functional enrichment of metal metabolite-related DEPs, we detected the contents of the metal metabolites Zn2+, Cu2+, Ca2+, and Fe2+/Fe3+ at these five stages and screened for (Cu-Zn) Sod1 and Mmp-9 as possible key proteins in the sex reversal process.

Real-time ship detection using SAR images is crucial for maritime operations but remains challenging due to issues such as sidelobes, complex background interferences, and target defocusing. Studies have shown that deep learning can address these problems, current deep learning algorithms often suffer from achieving the necessary accuracy due to complex noise and background characteristics. Additionally, advanced algorithms excelling in feature extraction usually require significant computational resources. This paper proposes a novel deep learning approach based on YOLOv8 to improve accuracy while reducing model complexity and computational burden. The approach innovatively integrates a knowledge distillation module into the YOLOv8. We further enhance the model by replacing the original YOLOv8 backbone, neck, and head with lightweight alternatives: HGNetv2, SlimNeck, and a newly designed decoupled head. The enhanced model, YOLOSAR-Lite, demonstrated exceptional performance on both accuracy and model complexity metrics. Rigorous evaluation on the Official-SSDD dataset and the SAR-Ship-Dataset revealed recognition accuracies of 95.32% and 96.06%, respectively. Furthermore, YOLOSAR-Lite achieved significant reduction in complexity compared to the YOLOv8: 4.48G FLOPs (45.30% reduction), 2.05M parameters (31.89% reduction), and 3.91MB model size (31.76% reduction). These improvements demonstrate YOLOSAR-Lite achieves higher accuracy with minimal complexity. Consequently, YOLOSAR-Lite is a promising solution for real-time ship detection.

Background Angina with no obstructive coronary disease (ANOCA) and ischemia with no obstructive coronary disease, prevalent yet underrecognized conditions, mostly affect women. Previous studies rarely distinguished between them. We aimed to compare the prevalence of objective ischemia through various examinations in women with ANOCA and assess the impact of objective and subjective ischemia on their mental health. Methods and Results A total of 84 eligible women with ANOCA and 42 controls underwent mental stress, pharmacological stress, exercise stress, and Holter testing. Objective evidence of myocardial ischemia was assessed by positron emission tomography‐computed tomography and ECG, and subjective symptoms were graded using the Canadian Cardiovascular Society scale (CCS). Psychological assessments were conducted using 6 scales. Among 84 women with ANOCA, 37 (44%) received a diagnosis of ischemia with no obstructive coronary disease following mental stress testing, 20 (28.6%) through pharmacological stress testing, 14 (21.2%) via exercise stress testing, and 24 (32.9%) from Holter. Mental stress‐induced myocardial ischemia was more prevalent (P0.05). However, ANOCA with milder angina (CCS I) exhibited higher scores across the Hospital Anxiety and Depression Scale, State‐Trait Anxiety Inventory, Perceived Stress Scale, and Posttraumatic Stress Disorder Checklist‐Civilian Version and a higher prevalence of Type D personality traits (P

Abstract Background Schizothorax o’connori is an endemic fish distributed in the upper and lower reaches of the Yarlung Zangbo River in China. It has experienced a fourth round of whole gene replication events and is a good model for exploring the genetic differentiation and environmental adaptability of fish in the Qinghai-Tibet Plateau. The uplift of the Qinghai-Tibet Plateau has led to changes in the river system, thereby affecting gene exchange and population differentiation between fish populations. With the release of fish whole genome data, whole genome resequencing has been widely used in genetic evolutionary analysis and screening of selected genes in fish, which can better elucidate the genetic basis and molecular environmental adaptation mechanisms of fish. Therefore, our purpose of this study was to understand the population structure and adaptive characteristics of S. o’connori using the whole-genome resequencing method. Results The results showed that 23,602,746 SNPs were identified from seven populations, mostly distributed on chromosomes 2 and 23. There was no significant genetic differentiation between the populations, and the genetic diversity was relatively low. However, the Zangga population could be separated from the Bomi, Linzhi, and Milin populations in the cluster analysis. Based on historical dynamics analysis of the population, the size of the ancestral population of S. o’connori was affected by the late accelerated uplift of the Qinghai Tibet Plateau and the Fourth Glacial Age. The selected sites were mostly enriched in pathways related to DNA repair and energy metabolism. Conclusion Overall, the whole-genome resequencing analysis provides valuable insights into the population structure and adaptive characteristics of S. o’connori. There was no obvious genetic differentiation at the genome level between the S. o’connori populations upstream and downstream of the Yarlung Zangbo River. The current distribution pattern and genetic diversity are influenced by the late accelerated uplift of the Qinghai Tibet Plateau and the Fourth Ice Age. The selected sites of S. o’connori are enriched in the energy metabolism and DNA repair pathways to adapt to the low temperature and strong ultraviolet radiation environment at high altitude.

As a renewable and clean source, biomass energy is one of the substitutes for traditional fossil energy. However, when biomass is burned as an industrial fuel, it produces a large amount of biomass ash with considerable pozzolanic activity. Currently, the activity of biomass ash is ignored in the utilization of biomass energy. Therefore, research on the regulation mechanism of calcination temperature on the pozzolanic activity of biomass ash will facilitate its efficient utilization. Therefore, we reviewed previous research and selected 500, 700, and 850 ℃ temperatures to calcinate willow leaves. The contents of SiO2, CaO, and other oxides in the willow leaf ash were determined through X-ray fluorescence spectrometer(XRF). The specific surface area of willow leaf ash was determined using a laser particle size analyzer. The mineral composition of willow leaf ash was characterized by X-ray diffraction (XRD), and the characterization of the chemical bonds of the minerals was supplemented by Fourier-transform infrared (FTIR) spectroscopy. The zeta potential of the willow leaf ash–Ca(OH)2 solution was determined through microelectrophoresis to evaluate the system’s stability. After determining the basic physical and chemical properties of willow leaf ash, the mechanical properties of willow leaf ash–cement-based materials were investigated by replacing 20% (mass fraction) cement with the ash, and the factors affecting performance were analyzed. The pozzolanic activity of willow leaf ash at 500, 700, and 850 ℃ was evaluated through the activity index. Rapid evaluation of pozzolanic activity was conducted by active ion extraction capability and inductively coupled plasma-optical emission spectrometer (ICP-OES) analyses. Scanning electron microscopy and XRD characterization methods were combined to analyze the effect of calcination temperature on the structure and composition of the ash and to elucidate the mechanism of the effect of calcination temperature on its pozzolanic activity. The results show that the SiO2 content in the ash was 20% to 30%, and the specific surface area increased with increasing temperature. However, the presence of xonotlite in willow leaf ash was detected through XRD at 850 ℃ Furthermore, the observed FTIR absorption peak at 1120.74 cm−1 corresponded to the stretching vibration of the Si–O–Si structure, which indicated that some amorphous SiO2 was crystallized. The absolute value of the zeta potential of the solution containing willow leaf ash at 500 ℃ and 700℃ was considerably higher than that at 850℃. After replacing a part of the cement with willow leaf ash, the willow leaf ash–cement-based material exhibited the highest compressive strength at 500 ℃ with an activity index of 0.79. The rate of conductivity variation of the willow leaf ash–Ca(OH)2 solution at 500 ℃ and 700 ℃ was higher than that at 850 ℃. The concentration of Si4+ precipitation decreased with the increase in calcination temperature, indicating that willow leaf ash had the highest pozzolanic activity at 500 ℃ followed by 700 ℃. Excessively high calcination temperatures lead to the crystallization of amorphous SiO2 and slagging in willow leaf ash, along with a decrease in the pozzolanic activity. This study provides theoretical support for the regulation of the pozzolanic activity of biomass ash and its applications.

The use of conformal arrays offers a significant advancement in Multiple-Input–Multiple-Output (MIMO) radar, enabling the placement of antennas on irregular surfaces. For joint Direction-of-Departure (DOD) and Direction-of-Arrival (DOA) estimation in conformal-array MIMO radar, the current spectrum-searching methods are computationally too expensive, while the existing rotation-invariant method may suffer from phase ambiguity caused by the non-Nyquist spacing of the sensors. In this paper, an improved rotationally invariant technique is proposed. The core function of the proposed algorithm is to estimate the phase differences between the adjacent sensors; then, it eliminates phase ambiguity via the previous estimated standard phase difference. Thereafter, DODs and DOAs are obtained via Least Squares (LS) fitting. The proposed method provides closed-form estimates for joint DOD and DOA estimation, which is much more efficient than the existing spectrum-searching techniques. Numerical simulations show that the proposed algorithm can accurately determine 2D DODs and DOAs of targets, only requiring approximately 1% of the running time required by existing spectrum-searching approaches.

Well placement optimization is one of the most important means to control the decline of oilfields and improve the recovery rate in the development process of deep and heterogeneous reservoirs, such as deep buried carbonate oil reservoirs. However, the mapping relationship from deployed well positions to actual profits is non-linear and multi-modal. At the same time, the injection and production relationship of new wells also affects the contribution of well positions to final profits. Currently, common algorithms include gradient-based and heuristic non-gradient algorithms, which have advantages, but face problems of high computational complexity, slow optimization speed, and difficulty in convergence. We propose an evolutionary algorithm for well placement optimization in carbonate reservoirs. This algorithm improves well placement optimization and computational speed by constraining the sampling process to effective sampling spaces, integrating prior knowledge to enhance sampling efficiency, strengthening local optima exploration, and utilizing parallel computing. Additionally, it refines the optimized variable content based on actual control factors, enhancing the algorithm’s robustness in practical applications. A case study from a carbonate reservoir in northwestern China demonstrated that this algorithm not only improved the performance by 50% compared to the classic DE algorithm but also achieved 15% higher optimization effectiveness than the current state-of-the-art algorithms.

Bioinspired, bistable snap-through structures are promising to release a burst of mechanical energy transformed from chemical energy, stored, and released incrementally during swelling/deswelling. Thin, disk-like hopper can harness the inhomogeneous deswelling to create the required constraint and flexible snap-through part. Here, hoppers composed of a single type of polydimethylsiloxane (PDMS) or concentric PDMS rimmed by a stiffer PDMS are cast into precisely micromachined molds. The mechanical properties and swelling/deswelling behavior of the constraining rim and flexible snap-through materials, in concert, allow a superior specific power of 1782 W kg−1, specific energy of 4.44 J kg−1 for a jump up to 321 mm, outperforming many more complex implementations. The jump benefits from an improved storage modulus ratio and a lower swell of the rim to the snap-through center part, which enhanced the confinement and elastic energy storage. A sharp spatial gradient in volume change between the two materials during deswelling, tunable by the porosity of the rim materials, enhances the jumping by allowing more material to store and release elastic energy, revealed by the strain analysis with 3D-digital image correlation. The illustrated multimaterials and porous materials strategies can promote the development of integrated energy harvesting and actuation for soft robotics.

Background: Impact of outdoor and household air pollution on physical function remains unelucidated. This study examined the influence of various ambient particulate sizes (PM1, PM2.5, and PM10) and household fuel usage on physical function. Methods: Data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011 and 2015 were utilized. The physical functional score was computed by summing scores from four tests: grip strength, gait speed, chair stand test, and balance. Multivariate linear and linear mixed-effects models were used to explore the separate and combined effects of PM1, PM2.5, PM10 and household fuel use on physical function in the cross-sectional and longitudinal analyses, respectively, and to further observe the effects of fuel cleanup on physical function in the context of air pollution exposure. Results: Both cross-sectional and longitudinal analyses revealed negative correlations between PM1 (β = −0.044; 95% CI: −0.084, −0.004), PM2.5 (β = −0.024; 95% CI: −0.046, −0.001), PM10 (β = −0.041; 95% CI: −0.054, −0.029), and physical function, with a more pronounced impact observed for fine particulate matter (PM1). Cleaner fuel use was associated with enhanced physical function compared to solid fuels (β = 0.143; 95% CI: 0.070, 0.216). The presence of air pollutants and use of solid fuels had a negative impact on physical function, while cleaner fuel usage mitigated the adverse effects of air pollutants, particularly in areas with high exposure. Conclusion: This study underscores the singular and combined detrimental effects of air pollutants and solid fuel usage on physical function. Addressing fine particulate matter, specifically PM1, and prioritizing efforts to improve household fuel cleanliness in regions with elevated air pollution levels are crucial for preventing physical disability.

Introduction: Implantable medical devices continue to be vulnerable to bacterial infections. The unrelenting formation of antibiotic resistant bacterial strains not only exacerbates these infections but also renders the current treatment strategies impotent. The need is greater than ever for innovative and effective approaches to counteract drug-resistant bacteria. This study examines the innate antibacterial properties of TiO2 nanotube arrays (TNAs) and their ability to locally deliver antibiotics to inactivate gram-positive and gram-negative bacteria, in vitro.Methods: Using a two-step electrochemical anodization process, TNAs with a diameter of ∼100 nm and a length of ∼5 µm were grown on titanium substrates.Results and Discussion: After 24 h of incubation, as-fabricated TNAs showed 100% clearance of Escherichia coli, and 97% clearance of Staphylococcus aureus growth. The antibiotic-loaded TNAs demonstrated sustained slow-release of cefotaxime and imipenem measured over 14 days. In vitro bacterial studies revealed the capability of cefotaxime- and imipenem-loaded TNAs in completely inhibiting the growth with 100% clearance of Klebsiella pneumoniae after 24 and 48 h of incubation. Bacterial inhibition assay revealed a significantly enlarged inhibition zone difference of 18 mm around the imipenem-loaded TNAs against K. pneumoniae compared to the as-fabricated TNAs which was maintained for 7 days with ∼10 μgmL−1 of antibiotic released from the TNAs which was found to be lower than the dose required to completely eradicate multidrug resistant bacteria when used in conjunction with the antibacterial TNAs. The results of our study highlight the potential of TNAs as a versatile platform for addressing treatment strategies related to bacterial infections and antibiotic resistance in implantable medical devices.

Bone defects caused by diseases or surgery are a common clinical problem. Researchers are devoted to finding biological mechanisms that accelerate bone defect repair, which is a complex and continuous process controlled by many factors. As members of transcriptional costimulatory molecules, Yes-associated protein (YAP) and transcriptional co-activator with PDZ-binding motif (TAZ) play an important regulatory role in osteogenesis, and they affect cell function by regulating the expression of osteogenic genes in osteogenesis-related cells. Macrophages are an important group of cells whose function is regulated by YAP/TAZ. Currently, the relationship between YAP/TAZ and macrophage polarization has attracted increasing attention. In bone tissue, YAP/TAZ can realize diverse osteogenic regulation by mediating macrophage polarization. Macrophages polarize into M1 and M2 phenotypes under different stimuli. M1 macrophages dominate the inflammatory response by releasing a number of inflammatory mediators in the early phase of bone defect repair, while massive aggregation of M2 macrophages is beneficial for inflammation resolution and tissue repair, as they secrete many anti-inflammatory and osteogenesis-related cytokines. The mechanism of YAP/TAZ-mediated macrophage polarization during osteogenesis warrants further study and it is likely to be a promising strategy for bone defect repair. In this article, we review the effect of Hippo-YAP/TAZ signaling and macrophage polarization on bone defect repair, and highlight the regulation of macrophage polarization by YAP/TAZ.

Abstract Silicone elastomers are widely used to encapsulate power electronic devices. However, such devices may be subjected to square‐wave pulsed voltages with a high rate of change, which can create significant challenges for encapsulation insulation. In this article, the molecular vibration of silicon elastomer at the edge of pulsed electric field is studied. Firstly, the relationship between the intensity of molecular vibration and the parameters of pulsed electric field is explored. The experimental results show that the amplitude of the vibrations decreases as the pulse‐edge time increases, and it increases linearly as the pulse‐edge slope increases. Furthermore, the amplitude of the vibrations is proportional to the square of the amplitude of the pulsed electric field, and it increases as the space charge density increases. Then, the force analysis of charged molecule at the pulse edges is calculated, and the theoretical change law of molecular vibration intensity with pulse edge slope is deduced. Comparing the theoretical results with the experimental results, it is found that they are highly consistent. Finally, electrically induced mechanical stress caused by molecular vibration was shown to be an important factor in insulation failure.

Abstract Designing promoters with desirable properties is essential in synthetic biology. Human experts are skilled at identifying strong explicit patterns in small samples, while deep learning models excel at detecting implicit weak patterns in large datasets. Biologists have described the sequence patterns of promoters via transcription factor binding sites (TFBSs). However, the flanking sequences of cis-regulatory elements, have long been overlooked and often arbitrarily decided in promoter design. To address this limitation, we introduce DeepSEED, an AI-aided framework that efficiently designs synthetic promoters by combining expert knowledge with deep learning techniques. DeepSEED has demonstrated success in improving the properties of Escherichia coli constitutive, IPTG-inducible, and mammalian cell doxycycline (Dox)-inducible promoters. Furthermore, our results show that DeepSEED captures the implicit features in flanking sequences, such as k-mer frequencies and DNA shape features, which are crucial for determining promoter properties.

During the manufacturing of surgical forceps, the flashes of the blanks need to be removed. Manual production has problems such as high labor intensity, low efficiency, and high-risk factors. To solve this problem and realize fully automatic resection, a novel modular workstation was designed and a corresponding process method was proposed. The workstation adopts robots, non-standard automation equipment, and image recognition technology instead of manual loading and blanking, but the blank storage still needs to be performed manually. The critical components were selected according to the workstation design scheme and process method, and the control system design was completed. The reliability of the separation unit was studied through a test platform, and the failure problem caused by uneven force was solved using a blank locking device, which showed that the separation success rate was stabilized at 100%. The detection speed of the image recognition system can reach 100 ms/piece, and the product qualification rate can reach 95.7%. The advantages of the workstation in terms of output and productivity were further analyzed by comparing it to manual production, where the average daily output increased by 12.5% (4500 pieces). In addition, the results of long-term test experiments and power consumption comparison tests showed that the workstations are highly stable and consume little additional power.

Abstract Human epidermal growth factor receptor 2 (HER2) gene amplification helps identify breast cancer patients who may respond to targeted anti-HER2 therapy. This study aims to develop an automated method for quantifying HER2 fluorescence in situ hybridization (FISH) signals and improve the working efficiency of pathologists. An Aitrox artificial intelligence (AI) model based on deep learning was constructed, and a comparison between the AI model and traditional manual counting was performed. In total, 918 FISH images from 320 consecutive invasive breast cancers were analysed and automatically classified into 5 groups according to the 2018 ASCO/CAP guidelines. The overall classification accuracy was 85.33% (157/184) with a mean average precision of 0.735. In Group 5, the most common group, the consistency was as high as 95.90% (117/122), while the consistency was low in the other groups due to the limited number of cases. The causes of this inconsistency, including clustered HER2 signals, coarse CEP17 signals and some section quality problems, were analysed. The developed AI model is a reliable tool for evaluating HER2 amplification statuses, especially for breast cancer in Group 5; additional cases from multiple centres could further improve the accuracy achieved for other groups.

Soft robotics is an emerging field showing immense potential for biomedical applications. This review summarizes recent advancements in soft robotics for in vitro and in vivo medical contexts. Their inherent flexibility, adaptability, and biocompatibility enable diverse capabilities from surgical assistance to minimally invasive diagnosis and therapy. Intelligent stimuli-responsive materials and bioinspired designs are enhancing functionality while improving biocompatibility. Additive manufacturing techniques facilitate rapid prototyping and customization. Untethered chemical, biological, and wireless propulsion methods are overcoming previous constraints to access new sites. Meanwhile, advances in tracking modalities like computed tomography, fluorescence and ultrasound imaging enable precision localization and control enable in vivo applications. While still maturing, soft robotics promises more intelligent, less invasive technologies to improve patient care. Continuing research into biocompatibility, power supplies, biomimetics, and seamless localization will help translate soft robots into widespread clinical practice.

Hepatocellular carcinoma (HCC) remains a major global health burden, and sorafenib, a multi-kinase inhibitor, has shown effectiveness in the treatment of HCC and is considered as the first-line therapy for advanced HCC. However, the response to sorafenib varies among patients, and the development of drug resistance poses a prevalent obstacle. Ferroptosis, a newly characterized form of cell death featured by iron-dependent lipid peroxidation, has emerged as a critical player in the reaction to sorafenib therapy in HCC. The induction of ferroptosis has been shown to augment the anticancer benefits of sorafenib. However, it has also been observed to contribute to sorafenib resistance. This review presents a comprehensive and thorough analysis that elucidates the intricate relationship between ferroptosis and sorafenib over recent years, aiming to formulate effective therapeutic approaches for liver cancer. Based on this exploration, we propose innovative strategies intended to overcome sorafenib resistance via targeted modulation of ferroptosis.

Introduction Perioperative rehabilitation (PORT) has shown a positive effect on patients undergoing cardiac surgery. However, there are minimal data on the impact of short-term PORT in cardiac surgery, which is associated with higher postoperative morbidity and mortality. The trial will assess the efficacy of short-term PORT in reducing in-hospital mortality, postoperative pulmonary complications and length of stay, compared with the usual care in cardiac surgical patients.Methods and analysis This is a single-centre prospective, randomised, open, controlled trial with a 1:1 ratio. Consecutive 800 adult patients undergoing elective valve surgery will be randomised to either usual care or in-hospital short-term PORT that consists of education, inspiratory muscle training, active cycle of breathing techniques and early mobilisation. The primary outcome of this study will be a composite of in-hospital all-cause mortality, incidence of postoperative pulmonary complications and the ratio of postoperative hospitalisation >7 days.Ethics and dissemination The PORT study was granted by the Medical Research Ethics Committee of Guangdong Provincial People’s Hospital in August 2018. Findings will be disseminated to patients, clinicians and commissioning groups through peer-reviewed publication.Trial registration number NCT03709511.

PURPOSEThe prognostic role of the tumor volume in patients with hepatocellular carcinoma (HCC) at the Barcelona Clinic Liver Cancer (BCLC) 0 and A stages remains unclear. This study aims to compare the volumetric measurement with linear measurement in early HCC burden profile and clarify the optimal cut-off value of the tumor volume.METHODSThe consecutive patients diagnosed with HCC who underwent initial and curative-intent radiofrequency ablation (RFA) were included retrospectively. The segmentation was performed semi-automatically, and enhanced tumor volume (ETV) as well as total tumor volume (TTV) were obtained. The patients were categorized into high- and low-tumor burden groups according to various cutoff values derived from commonly used diameter values, X-tile software, and decision-tree analysis. The inter- and intra-reviewer agreements were measured using the intra-class correlation coefficient. Univariate and multivariate time-to-event Cox regression analyses were performed to identify the prognostic factors of overall survival.RESULTSA total of 73 patients with 81 lesions were analyzed in the whole cohort with a median follow-up of 31.0 (interquartile range: 16.0–36.3). In tumor segmentation, excellent consistency was observed in intra- and inter-reviewer assessments. There was a strong correlation between diameter-derived spherical volume and ETV as well as ETV and TTV. As opposed to all linear candidates and 4,188 mm3 (sphere equivalent to 2 cm in diameter), ETV >14,137 mm3 (sphere equivalent to 3 cm in diameter) or 23,000 mm3 (sphere equivalent to 3.5 cm in diameter) was identified as an independent risk factor of survival. Considering the value of hazard ratio and convenience to use, when ETV was at 23,000 mm3, it was regarded as the optimal volumetric cut-off value in differentiating survival risk.CONCLUSIONThe volumetric measurement outperforms linear measurement on tumor burden evaluation for survival stratification in patients at BCLC 0 and A stages HCC after RFA.

Due to structural abnormalities in the leaflets, patients with bicuspid aortic valve (BAV) may develop isolated aortic valve disease, such as aortic regurgitation, aortic stenosis, or a combination of both. In addition to valvular pathology, numerous studies have indicated that approximately 40% of BAV patients exhibit aortic pathologies characterized by aortic dilatation. According to guidelines for valvular diseases, patients with BAV who require surgical aortic valve replacement (SAVR) and have a diameter of the aortic sinuses or ascending aorta ≥4.5 cm are recommended to undergo concomitant replacement of the aortic sinuses or ascending aorta. However, we encountered a case in 2020 involving a patient with severe aortic regurgitation due to BAV and an ascending aortic diameter of 4.2 cm. This patient underwent SAVR and ascending aortoplasty surgery at our center. Remarkably, three years postoperatively, the patient's aortic diameter rapidly expanded by nearly threefold, which also suggests the risk of encountering a giant aortic root aneurysm during reoperation. Unfortunately, a fatal rupture of a giant aortic root aneurysm was encountered during re-sternotomy. Fortunately, with adequate preoperative planning, we successfully managed to avert this perilous situation. The patient recovered without complications and was discharged on the 8th day. Individualized surgical plans were formulated based on a comprehensive evaluation of the perioperative conditions.

Abstract Background Hypertensive patients with depression have a higher mortality rate and a worse prognosis compared with hypertensive only. Depression may reduce medication adherence in hypertension patients. Methods This study includes respondents in the National Health and Nutritional Examination Survey (NHANES) database from 2005 to 2018 who had previously been diagnosed with hypertension. Medication adherence was defined as taking medication as recommended by a physician. The depressive state was assessed using the patient health questionnaire (PHQ)-9. Results Nine thousand one hundred eighty-six respondents were included in the analysis. Medication adherence was associated with depression (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.26 to1.75) and depression score (OR: 1.04 per each point increase, 1.03 to 1.05) in the unadjusted analyses. After adjusting for clinical and socioeconomic/demographic factors, there were significant statistical correlations between depression score and medication adherence (aOR: 1.02 per each point increase, 1.00 to 1.03, p 0.05). It was still statistically significant relationships between sex, age, body mass index (BMI), race, marital status, and health insurance with medication adherence after adjusted socioeconomic/demographic factors. Conclusion Depression was marginally associated with poor medication adherence in hypertensive patients, and the correlation increased with depression degree. Moreover, socioeconomic/demographic factors have an independent impact on medication adherence including sex, age, BMI, race, marital status, and health insurance.

Petroleum is widely used as one of the important energy sources. Engineers need to continuously adjust strategies to maximize oil recovery during development. Then strategy adjustment requires a lot of cost, so it is necessary to select the optimal strategy through production forecasting. In this paper, a self-defined Double-channel Heterogeneous Dynamical Graph network (DHDG) is proposed deal with this problem. It can receive different development strategies predict future production indices base on that. Particularly, the concept of graph network is used for the first time to simulate the well pattern and predict production of all wells in the block at same time. At the same time, in order to fully fit the seepage process between wells, we complicate the edge features of the graph, so that it has enough capacity to express the state information of the formation between wells. Finally, we amplify the features of network output through engineering calculations, which further ensured the integrity of the information transmitted in the recursive process. The example results in two benchmark reservoirs show that it is accurate enough to predict oil production rate in future 600 days and more accurate than LSTM networks.

DNA origami is a cutting-edge DNA self-assembly technique that neatly folds DNA strands and creates specific structures based on the complementary base pairing principle. These innovative DNA origami nanostructures provide numerous benefits, including lower biotoxicity, increased stability, and superior adaptability, making them an excellent choice for transporting anti-tumor agents. Furthermore, they can considerably reduce side effects and improve therapy success by offering precise, targeted, and multifunctional drug delivery system. This comprehensive review looks into the principles and design strategies of DNA origami, providing valuable insights into this technology’s latest research achievements and development trends in the field of anti-tumor drug delivery. Additionally, we review the key function and major benefits of DNA origami in cancer treatment, some of these approaches also involve aspects related to DNA tetrahedra, aiming to provide novel ideas and effective solutions to address drug delivery challenges in cancer therapy.

A direct consequence of Faraday rotation is that the polarized radio sky does not resemble the total intensity sky at long wavelengths. We analyze G137+7, which is undetectable in total intensity but appears as a depolarization feature. We use the first polarization maps from the Canadian Hydrogen Intensity Mapping Experiment. Our 400–729 MHz bandwidth and angular resolution, $17^{\prime} $ – $30^{\prime} $ , allow us to use Faraday synthesis to analyze the polarization structure. In polarized intensity and polarization angle maps, we find a tail extending 10° from the head and designate the combined object, the tadpole . Similar polarization angles, distinct from the background, indicate that the head and tail are physically associated. The head appears as a depolarized ring in single channels, but wideband observations show that it is a Faraday rotation feature. Our investigations of H i and H α find no connections to the tadpole. The tail suggests motion of either the gas or an ionizing star through the interstellar medium; the B2(e) star HD 20336 is a candidate. While the head features a coherent, ∼ −8 rad m ^−2 Faraday depth, Faraday synthesis also identifies multiple components in both the head and tail. We verify the locations of the components in the spectra using QU fitting. Our results show that approximately octave-bandwidth Faraday rotation observations at ∼600 MHz are sensitive to low-density ionized or partially ionized gas, which is undetectable in other tracers.

In 2021, a catalog of 536 fast radio bursts (FRBs) detected with the Canadian Hydrogen Intensity Mapping Experiment (CHIME) radio telescope was released by the CHIME/FRB Collaboration. This large collection of bursts, observed with a single instrument and uniform selection effects, has advanced our understanding of the FRB population. Here we update the results for 140 of these FRBs for which channelized raw voltage (“baseband”) data are available. With the voltages measured by the telescope’s antennas, it is possible to maximize the telescope sensitivity in any direction within the primary beam, an operation called “beamforming.” This allows us to increase the signal-to-noise ratios of the bursts and to localize them to subarcminute precision. The improved localizations are also used to correct the beam response of the instrument and to measure fluxes and fluences with an ∼10% uncertainty. Additionally, the time resolution is increased by 3 orders of magnitude relative to that in the first CHIME/FRB catalog, and, applying coherent dedispersion, burst morphologies can be studied in detail. Polarization information is also available for the full sample of 140 FRBs, providing an unprecedented data set to study the polarization properties of the population. We release the baseband data beamformed to the most probable position of each FRB. These data are analyzed in detail in a series of accompanying papers.

We report the detection of 21 cm emission at an average redshift $\bar{z}=2.3$ in the cross-correlation of data from the Canadian Hydrogen Intensity Mapping Experiment (CHIME) with measurements of the Ly α forest from eBOSS. Data collected by CHIME over 88 days in the 400–500 MHz frequency band (1.8 < z < 2.5) are formed into maps of the sky and high-pass delay filtered to suppress the foreground power, corresponding to removing cosmological scales with k _∥ ≲ 0.13 Mpc ^−1 at the average redshift. Line-of-sight spectra to the eBOSS background quasar locations are extracted from the CHIME maps and combined with the Ly α forest flux transmission spectra to estimate the 21 cm–Ly α cross-correlation function. Fitting a simulation-derived template function to this measurement results in a 9 σ detection significance. The coherent accumulation of the signal through cross-correlation is sufficient to enable a detection despite excess variance from foreground residuals ∼6–10 times brighter than the expected thermal noise level in the correlation function. These results are the highest-redshift measurement of 21 cm emission to date, and they set the stage for future 21 cm intensity mapping analyses at z > 1.8.

Efficient geometric evaluation of roads and tunnels is crucial to traffic management, especially in post-disaster situations. This paper reports on a study of the geometric feature detection method based on multi-sensor mobile laser scanning (MLS) system data. A portable, low-cost system that can be mounted on vehicles and utilizes integrated laser scanning devices was developed. Coordinate systems and timestamps from numerous devices were merged to create 3D point clouds of objects being measured. Feature points reflecting the geometric information of measuring objects were retrieved based on changes in the point cloud’s shape, which contributed to measuring the road width, vertical clearance, and tunnel cross section. Self-developed software was used to conduct the measuring procedure, and a real-time online visualized platform was designed to reconstruct 3D models of the measured objects, forming a 3D digital map carrying the obtained geometric information. Finally, a case study was carried out. The measurement results of several representative nodes are discussed here, verifying the robustness of the proposed system. In addition, the main sources of interference are also discussed.

Abstract Background To evaluate the prognostic value of skeletal muscle index (SMI) and its change in patients with hepatocellular carcinoma (HCC) experiencing curative hepatectomy plus adjuvant transarterial chemoembolization (TACE). Materials and methods A total of 62 patients with HCC who underwent adjuvant TACE after curative hepatectomy were analysed retrospectively. Skeletal muscle area at the third lumbar level was quantitated using computed tomography images and was normalized for height squared to obtain skeletal muscle index (SMI). Skeletal muscle loss (SML) over 6 months was computed with two SMIs before and after hepatectomy plus adjuvant TACE. Correlation analyses were preformed to investigate factors associated with SML. The curves of cause-specific survival (CSS) were analysed using the Kaplan–Meier method. A Cox proportional hazards model was used to assess prognostic factors. Results Low SMI was diagnosed in 23(37.1%) patients preoperatively. The median SML standardized by 6 months was − 1.6% in the entire cohort. Liver cirrhosis and microvascular invasion correlated negatively with SML, respectively (r = − 0.320, P = 0.002; r = − 0.243, P = 0.021). Higher SML ( 400 ng/ml (HR, 5.643; 95%CI, 3.608–17.833; P

ObjectivesTo examine national trends in unhealthy lifestyle factors among adults with cardiovascular disease (CVD) in the United States (US) between 1999 and 2018.MethodsWe analyzed data from National Health and Nutrition Examination Survey (NHANES), a nationally representative survey of participants with CVD who were aged ≥20 years, which was conducted between 1999 and 2000 and 2017–2018. CVD was defined as a self-report of congestive heart failure, coronary heart disease, angina, heart attack, or stroke. The prevalence rate of each unhealthy lifestyle factor was calculated among adults with CVD for each of the 2-year cycle surveys. Regression analyses were used to assess the impact of sociodemographic characteristics (age, sex, race/ethnicity, family income, education level, marital status, and employment status).ResultsThe final sample included 5610 NHANES respondents with CVD. The prevalence rate of their current smoking status remained stable among respondents with CVD between 1999 and 2000 and 2017–2018. During the same period, there was a decreasing trend in the age-adjusted prevalence rate of poor diet [primary American Heart Association (AHA) score

AimsEvidence suggested that dietary inflammatory potential may be associated with age-related skeletal muscle decline, but the results remained controversial. To summarize the evidence for the relationships between dietary inflammatory potential and skeletal muscle strength, mass, and sarcopenia in adults we conducted this meta-analysis.MethodsEmbase, Pubmed, and Web of Science were searched from inception up to 12 March 2023 for studies that evaluated the associations of dietary inflammatory potential [estimated by the Dietary inflammatory index (DII)] with skeletal muscle strength, mass, and sarcopenia. A meta-analysis was then performed to calculate the pooled regression coefficient (β) and odds ratio (OR). The non-linear dose-response relation between DII and sarcopenia was assessed using random-effects dose-response meta-analysis.ResultsThis meta-analysis included 24 studies involving 56,536 participants. It was found that high DII was associated with low skeletal muscle strength [OR 1.435, 95% confidence interval (CI) 1.247–1.651, P < 0.001, I2 = 4.97%]. There was a negative association of DII with skeletal muscle strength (β−0.031, 95% CI −0.056 to −0.006, P = 0.017, I2 = 72.69%). High DII was also associated with low skeletal muscle mass (OR 1.106, 95% CI 1.058–1.157, P < 0.001, I2 = 0%). DII had a negative relationship with skeletal muscle mass with high heterogeneity (β−0.099, 95% CI −0.145 to −0.053, P < 0.001, I2 = 88.67%); we downgraded the inconsistency in the subgroup analysis of overweight/obese participants (β−0.042, 95% CI −0.065 to −0.019, I2 = 12.54%). Finally, the pooled results suggested that high DII was significantly associated with sarcopenia with significant heterogeneity (OR 1.530, 95% CI 1.245–1.880, P < 0.001, I2 = 69.46%); age and BMI may contribute partially to the heterogeneity since heterogeneity was decreased in the subgroup of older age (OR 1.939, 95% CI 1.232–3.051, I2 = 0%) and the group of overweight/obesity (OR 1.853, 95% CI 1.398–2.456, I2 = 0%). There was a non-linear dose-response association between DII and sarcopenia (P = 0.012 for non-linearity).ConclusionThis meta-analysis suggested that higher dietary inflammatory potential was significantly associated with lower skeletal muscle strength, mass, and risk of sarcopenia. Future studies with consistent assessment and standardized methodology are needed for further analysis.

Osteoarthritis (OA) is one of the most common degenerative joint diseases, often involving the entire joint. The degeneration of articular cartilage is an important feature of OA, and there is growing evidence that the mitochondrial biogenesis master regulator peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) exert a chondroprotective effect. PGC-1α delays the development and progression of OA by affecting mitochondrial biogenesis, oxidative stress, mitophagy and mitochondrial DNA (mtDNA) replication in chondrocytes. In addition, PGC-1α can regulate the metabolic abnormalities of OA chondrocytes and inhibit chondrocyte apoptosis. In this paper, we review the regulatory mechanisms of PGC-1α and its effects on OA chondrocytes, and introduce potential drugs and novel nanohybrid for the treatment of OA which act by affecting the activity of PGC-1α. This information will help to further elucidate the pathogenesis of OA and provide new ideas for the development of therapeutic strategies for OA.

Metabolic-associated fatty liver disease (MAFLD) is a chronic liver disease characterized by fatty infiltration of the liver. In recent years, the MAFLD incidence rate has risen and emerged as a serious public health concern. MAFLD typically progresses from the initial hepatocyte steatosis to steatohepatitis and then gradually advances to liver fibrosis, which may ultimately lead to cirrhosis and carcinogenesis. However, the potential evolutionary mechanisms still need to be clarified. Recent studies have shown that nucleotide methylation, which was directly associated with MAFLD’s inflammatory grading, lipid synthesis, and oxidative stress, plays a crucial role in the occurrence and progression of MAFLD. In this review, we highlight the regulatory function and associated mechanisms of nucleotide methylation modification in the progress of MAFLD, with a particular emphasis on its regulatory role in the inflammation of MAFLD, including the regulation of inflammation-related immune and metabolic microenvironment. Additionally, we summarize the potential value of nucleotide methylation in the diagnosis and treatment of MAFLD, intending to provide references for the future investigation of MAFLD.

Abstract Background Hip fractures are anatomically classified in relation to femoral neck, intertrochanteric or subtrochanteric fractures. Simple hip fractures discussed in this study are femoral neck fractures or intertrochanteric fractures, which are the most common types of hip fractures. Controversy remains regarding the value of biochemical indices of thrombosis in elderly patients with fractures. A retrospective study was conducted to investigate the index admission data in blood draws of elderly patients with hip fractures and their high-risk factors for deep venous thrombosis (DVT). A nomogram prediction model for DVT was established to facilitate a rapid, accurate, and effective prediction based on the results. Methods The data were based on 562 elderly patients undergoing hip fracture surgery, from whom 274 patients were selected for enrollment. The 274 patients were divided into two groups using preoperative vascular color Doppler ultrasonography. Chi-square tests, t-tests, and U tests were conducted, and logistic regression analysis was conducted showing different factors between the two groups. Independent risk factors with statistical significance (P

Urumqi City, located in the northwest of China, is a city with a high indoor radon concentration in a nationwide indoor radon survey in China. This study focuses on the assessment of the indoor radon level and its distribution in this city. Indoor radon measurement using RAD7 and solid nuclear track detector (SSNTD), soil gas radon measured by RAD7, and the determination of the specific activity of uranium and radium in soil samples by a high pure germanium spectrometer were performed from 2021 to 2023. The results reveal a wide range of indoor radon concentrations in Urumqi, with anomalies above 400 Bq/m3 in some dwellings. The arithmetical and geometric mean values of indoor radon concentration are 80 ± 77 Bq/m3 and 58 Bq/m3, respectively. The geometric mean value of radon measured by SSNTD is 101 Bq/m3. The distribution of areas with a high indoor radon concentration is spatially consistent with deep and large active faults or overlapping and intersection zones of multiple groups of faults. It is recommended to conduct a more comprehensive investigation and research into the elevated radon potential and radioactivity associated with building materials.

Abstract Background Adipokines gene polymorphisms are speculated to be associated with the risk of knee osteoarthritis (OA), but evidence remains conflicting. This study therefore aimed to examine whether associations exist between adipokines gene polymorphisms and knee OA by considering the evidence collected from eligible studies through a meta-analysis. Methods A systematic search was performed on PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang up to March 31, 2020. Meta-analysis was carried out by focusing on the associations between adipokines gene polymorphisms and knee OA with the allele model, dominant model, and recessive model. Results The present meta-analysis included 5 eligible studies for ADIPOQ rs1501299 with 1,021 cases and 1,097 controls, 3 eligible studies for ADIPOQ rs2241766 with 549 cases and 544 controls, 3 eligible studies for LEPR rs1137101 with 808 cases and 856 controls, 2 eligible studies for VISFATIN rs4730153 with 339 cases and 680 controls and 2 eligible studies for VISFATIN rs16872158 with 339 cases and 680 controls. Significant association was observed between LEPR rs1137101 and knee OA in the overall population (recessive: OR = 0.40, 95% CI 0.21–0.79). Limited data revealed that associations may exist between ADIPOQ rs2241766 and knee OA in Asians (dominant: OR = 1.35, 95% CI 1.03–1.78), between VISFATIN rs4730153 and knee OA in Asians (allele: OR = 0.58, 95% CI 0.41–0.83; dominant: OR = 0.57, 95% CI 0.39–0.83), and between VISFATIN rs16872158 and knee OA in Asians (allele: OR = 1.84, 95% CI 1.26–2.68; dominant: OR = 1.94, 95% CI 1.31–2.89). Conclusions Adipokines gene polymorphisms may be associated with knee OA. The association was observed in LEPR rs1137101 in the present study. In addition, limited data revealed that associations may also exist in ADIPOQ rs2241766, VISFATIN rs4730153 and VISFATIN rs16872158. Prospero registration CRD42020187664.

The adenosine stress test and exercise stress test have been widely used in the diagnosis of coronary heart disease, which has high sensitivity and specificity for diagnosis of coronary heart disease. The myocardial bridge is a congenital dysplasia of the coronary artery which may cause severe myocardial ischemia, acute myocardial infarction, arrhythmia, and sudden death. Although drug therapy for this disease is clear and widely used, indication for open-chest surgery is still vague. This case shows a patient with long-term chest pain undergoing the coronary computed tomographic angiography in our hospital 1 month ago, which showed the mild myocardial bridge in the left anterior descending (LAD) branch. Then, she did the mental stress-induced myocardial ischemia and cardiopulmonary exercise test which the results were negative. After the informed consent, the patient took the adenosine stress test and severe angina occurred during the test. Later, coronary angiography showed that the myocardial bridge caused 70% contraction of the middle segment of the LAD branch. In the case of long-term ineffective drug treatment, the patient underwent a open-chest surgery called coronary artery myotomy and her chest discomfort eventually recovered. To a degree, adenosine stress test may be more sensitive than exercise stress test in predicting the severity of coronary artery stenosis. Moreover, we may provide a unique direction of indication for surgeons to operate open-chest surgery on the myocardial bridge.

ObjectiveThe aim of this study was to explore the different predictive values of depression among patients with different cardiac systolic function levels.MethodsFour hundred eighty-three consecutive patients with obstructive coronary artery disease (CAD) were included the depressive state was assessed using the Chinese version of the Patient Health Questionnaire 9 (PHQ-9). Depression was defined as have depressive symptoms with a PHQ-9 score ≥5. The level of cardiac systolic function was classified as left ventricular ejection fraction (LVEF) ≥50 and

The leaf microbiota plays a key role in plant development, but a detailed mechanism of microbe-plant relationships remains elusive. Many genome-wide association studies (GWAS) have begun to map leaf microbes, but few have systematically characterized the genetics of how microbes act and interact. Previously, we integrated behavioral ecology and game theory to define four types of microbial interactions – mutualism, antagonism, aggression, and altruism, in a microbial community assembly. Here, we apply network mapping to identify specific plant genes that mediate the topological architecture of microbial networks. Analyzing leaf microbiome data from an Arabidopsis GWAS, we identify several heritable hub microbes for leaf microbial communities and detect 140–728 SNPs (Single nucleotide polymorphisms) responsible for emergent properties of microbial network. We reconstruct Bayesian genetic networks from which to identify 22–43 hub genes found to code molecular pathways related to leaf growth, abiotic stress responses, disease resistance and nutrition uptake. A further path analysis visualizes how genetic variants of Arabidopsis affect its fecundity through the internal workings of the leaf microbiome. We find that microbial networks and their genetic control vary along spatiotemporal gradients. Our study provides a new avenue to reveal the “endophenotype” role of microbial networks in linking genotype to end-point phenotypes in plants. Our integrative theory model provides a powerful tool to understand the mechanistic basis of structural-functional relationships within the leaf microbiome and supports the need for future research on plant breeding and synthetic microbial consortia with a specific function.

Resulting from the restricted size of incisions and confined surgical space, the existing rigid and slender minimally invasive surgery (MIS) instruments are inefficient in providing an optimum articulation to handle certain minimally invasive surgery tasks. Thus, developments of novel articulating actuators are of urgent requirement. In this paper, with the aim to enhance the flexibility and maneuverability of surgical instruments in diverse minimally invasive surgery scenarios, two types of spring-roll dielectric elastomer (DE) actuators, namely linear-type and bending-type, are proposed. The actuators’ parameters were optimized and calibrated using a novel step-by-step procedure, based on the characterization and modeling of dielectric elastomer material (VHB 4905). Critical design factors including dimensions of the core spring, the pre-stretch ratio of the dielectric elastomer, and the excitation level of the actuator were identified, while the boundary conditions for the modeling of the actuator were derived from the requirements of minimally invasive surgery applications. The dielectric elastomer actuators’ deformation behavior and force response were analyzed both theoretically and experimentally, and the results from the two approaches were in good agreement. The linear-type actuator could achieve a maximum strain of 29% and a blocking force up to 5.05 N, while the bending-type actuator could achieve angulation over 70° and a blocking force of up to 0.22 N. The proposed actuators are lightweight, compact, and cost-effective, which could provide novel design inspiration for minimally invasive surgery instruments.

With the coming of the green chemistry era, the tunable porosity and superb environmental friendliness accompanied by outstanding electrical conductivity of cellulose-derived carbon aerogels (CDCAs) have remarkably promoted the development of high-performance green supercapacitor electrodes. In this review, a detailed overview on the preparation strategies of CDCAs and their precursors (regenerated cellulose aerogels and nanofibrillated cellulose aerogels) are presented. Two crucial approaches for the improvement of energy storage ability, i.e., hetero-atom doping and integration with pseudocapacitive materials, are summarized. Moreover, the role of CDCAs in the energy storage ability is analyzed from the view of structure–response relationship. A comprehensive overview of the fundamental aspects related to the configuration and energy storage mechanism of supercapacitors and the synthesis, structure, and property of cellulose is provided. Finally, this review presents a brief summary, challenges, and perspectives of CDCA-based supercapacitor electrodes and devices.

Abstract Background Depression and anxiety are two common mood problems among patients with cardiovascular disease (CVD) and are associated with poor cardiac prognoses. The comorbidity of depression and anxiety is considered to be a more severe psychological status than non-comorbid mood disorders. However, little is known about the relationship between depression or anxiety and noncardiac readmission. We conducted a prospective study on the prognostic impact of depression, anxiety, and the comorbidity of the two among angina pectoris (AP) patients. Method In this prospective study, 443 patients with AP were included in the analysis. Follow-up assessments were performed 1 year, and 2 years after patient discharges. Clinical outcomes of interest included noncardiac readmission, major adverse cardiovascular events (MACEs), and composite events. Depression and anxiety symptom scores derived from the patient health questionnaire-9 (PHQ-9) and generalised anxiety disorder-7 (GAD-7) questionnaire were used to assess mood symptoms at baseline. Participants with symptom scores of ≥10 on both the depression and anxiety questionnaires formed the clinical comorbidity subgroup. We used multivariable Cox proportional hazards models to evaluate the impact of individual mood symptom and comorbidity on clinical outcomes. Results Among all the AP patients, 172 (38. 9%) were determined to have depression symptoms, 127 (28.7%) patients had anxiety symptoms and 71 (16.0%) patients suffered from their comorbidity. After controlling covariates, we found that patients who endured clinical depression (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.06–5.33, p = 0.035) and anxiety ([HR] 2.85, 95% [CI] 1.10–7.45, p = 0.032) had a high risk of noncardiac readmission. Compared to participants with no mood symptoms, those with clinical comorbidity of depression and anxiety presented a greater risk of noncardiac readmission ([HR] 2.91, 95% [CI] 1.03–8.18, p = 0.043) MACEs ([HR] 2.38, 95% [CI] 1.11–5.10, p = 0.025) and composite event ([HR] 2.52, 95% [CI] 1.35–4.69, p = 0.004). Conclusion Depression and anxiety were found to have predictive value for noncardiac readmission among patients with AP. Furthermore, prognoses were found to be worse for patients with comorbidity of depression and anxiety than those with single mood symptom. Additional attention needs to be focused on the initial identification and long-term monitoring of mood symptom comorbidity.

The well pattern and boundary shape of reservoirs determine the distribution of the remaining oil distribution to a large extent, especially for small-scale reservoir blocks. However, it is difficult to replicate experiences from other reservoirs directly to predict the remaining oil distribution because of the variety of irregular boundary shapes and corresponding well patterns. Meanwhile, the regular well pattern can hardly suit irregular boundary shapes. In this paper, we propose a well placement method for undeveloped irregular reservoirs and a multi-step prediction framework to predict both oil saturation and pressure fields for any reservoir shape and well pattern. To boost the physical information of input characteristics, a feature amplification approach based on physical formulae is initially presented. Then, 3D convolution technology is employed for the first time in 3D reservoir prediction to increase the spatial information in the vertical direction of the reservoir in the input. Moreover, to complete the two-field prediction, the concept of multi-task learning is adopted for the first time, improving the rationality of the forecast. Through the loss-based ablation test, we found that the operation we adopt will increase the accuracy of prediction to some extent. By testing on both manually designed and real irregular-shape reservoirs, our method is proven to be an accurate and fast oil saturation prediction method with its prediction loss less than 0.01 and calculation time less than 10 s in the future one year.

AimExploring the risk factors of prognosis in patients undergoing percutaneous coronary intervention (PCI) is of great importance. Our aim of the study is to investigate the association between variability in total cholesterol (TC) level and major adverse cardiovascular and cerebrovascular events (MACCE) in patients after PCI.MethodsBetween April 2004 and December 2009, 909 patients who underwent primary PCI and with at least three TC values were included in the final study. TC variability was calculated using four indices: standard deviation (SD), coefficient of variation (CV), the average successive variability (ASV), variability independent of the mean (VIM). MACCE comprised all-cause mortality, non-fatal myocardial infarction (MI), unplanned revascularization, hospitalization for heart failure, and non-fatal stroke.ResultsThere were 394 cases of MACCE during the follow-up period. When the subjects were divided into quartile groups by CV of TC, high CV groups were associated with a higher hazard ratio of MACCE than for lower CV groups. In multivariable adjusted models, TC variability and MACCE remained correlated [HR (95% CI): Q2, 1.17 (0.86–1.58); Q3, 1.38 (1.03–1.85); Q4, 1.63 (1.22–2.17)]. Similar patterns of MACCE were noted by quartiles of SD, ASV, and VIM.ConclusionVisit-to-visit TC variability is positively correlated with MACCE in patients after PCI.

Background Sarcopenia, a relatively new syndrome referring to the age-related decline of muscle strength and degenerative loss of skeletal muscle mass and function, often resulting in frailty, disability, and mortality. Osteoarthritis, as a prevalent joint degenerative disease, is affecting over 250 million patients worldwide, and it is the fifth leading cause of disability. Despite the high prevalence of osteoarthritis, there are still lack of efficient treatment potions in clinics, partially due to the heterogeneous and complexity of osteoarthritis pathology. Previous studies revealed the association between sarcopenia and osteoarthritis, but the conclusions remain controversial and the prevalence of sarcopenia within osteoarthritis patients still needs to be elucidated. To identify the current evidence on the prevalence of sarcopenia and its association with osteoarthritis across studies, we performed this systematic review and meta-analysis that would help us to further confirm the association between these two diseases. Methods and analysis Electronic sources including PubMed, Embase, and Web of Science will be searched systematically following appropriate strategies to identify relevant studies from inception up to 28 February 2022 with no language restriction. Two investigators will evaluate the preselected studies independently for inclusion, data extraction and quality assessment using a standardized protocol. Meta-analysis will be performed to pool the estimated effect using studies assessing an association between sarcopenia and osteoarthritis. Subgroup analyses will also be performed when data are sufficient. Heterogeneity and publication bias of included studies will be investigated. PROSPERO registration number CRD42020155694.

We present the discovery of 25 new repeating fast radio burst (FRB) sources found among CHIME/FRB events detected between 2019 September 30 and 2021 May 1. The sources were found using a new clustering algorithm that looks for multiple events colocated on the sky having similar dispersion measures (DMs). The new repeaters have DMs ranging from ∼220 to ∼1700 pc cm ^−3 , and include sources having exhibited as few as two bursts to as many as twelve. We report a statistically significant difference in both the DM and extragalactic DM (eDM) distributions between repeating and apparently nonrepeating sources, with repeaters having a lower mean DM and eDM, and we discuss the implications. We find no clear bimodality between the repetition rates of repeaters and upper limits on repetition from apparently nonrepeating sources after correcting for sensitivity and exposure effects, although some active repeating sources stand out as anomalous. We measure the repeater fraction over time and find that it tends to an equilibrium of ${2.6}_{-2.6}^{+2.9}$ % over our total time-on-sky thus far. We also report on 14 more sources, which are promising repeating FRB candidates and which merit follow-up observations for confirmation.

We present a detection of 21 cm emission from large-scale structure (LSS) between redshift 0.78 and 1.43 made with the Canadian Hydrogen Intensity Mapping Experiment. Radio observations acquired over 102 nights are used to construct maps that are foreground filtered and stacked on the angular and spectral locations of luminous red galaxies (LRGs), emission-line galaxies (ELGs), and quasars (QSOs) from the eBOSS clustering catalogs. We find decisive evidence for a detection when stacking on all three tracers of LSS, with the logarithm of the Bayes factor equal to 18.9 (LRG), 10.8 (ELG), and 56.3 (QSO). An alternative frequentist interpretation, based on the likelihood ratio test, yields a detection significance of 7.1 σ (LRG), 5.7 σ (ELG), and 11.1 σ (QSO). These are the first 21 cm intensity mapping measurements made with an interferometer. We constrain the effective clustering amplitude of neutral hydrogen (H i ), defined as ${{ \mathcal A }}_{{\rm{H}}\,{\rm\small{I}}}\equiv {10}^{3}\,{{\rm{\Omega }}}_{{\rm{H}}\,{\rm\small{I}}}\left({b}_{{\rm{H}}\,{\rm\small{I}}}+\langle \,f{\mu }^{2}\rangle \right)$ , where Ω _H _i is the cosmic abundance of H i , b _H _i is the linear bias of H i , and 〈 f μ ^2 〉 = 0.552 encodes the effect of redshift-space distortions at linear order. We find ${{ \mathcal A }}_{{\rm{H}}\,{\rm\small{I}}}={1.51}_{-0.97}^{+3.60}$ for LRGs ( z = 0.84), ${{ \mathcal A }}_{{\rm{H}}\,{\rm\small{I}}}={6.76}_{-3.79}^{+9.04}$ for ELGs ( z = 0.96), and ${{ \mathcal A }}_{{\rm{H}}\,{\rm\small{I}}}={1.68}_{-0.67}^{+1.10}$ for QSOs ( z = 1.20), with constraints limited by modeling uncertainties at nonlinear scales. We are also sensitive to bias in the spectroscopic redshifts of each tracer, and we find a nonzero bias Δ v = − 66 ± 20 km s ^−1 for the QSOs. We split the QSO catalog into three redshift bins and have a decisive detection in each, with the upper bin at z = 1.30 producing the highest-redshift 21 cm intensity mapping measurement thus far.

Federated learning has a distributed collaborative training mode, widely used in IoT scenarios of edge computing intelligent services. However, federated learning is vulnerable to malicious attacks, mainly backdoor attacks. Once an edge node implements a backdoor attack, the embedded backdoor mode will rapidly expand to all relevant edge nodes, which poses a considerable challenge to security-sensitive edge computing intelligent services. In the traditional edge collaborative backdoor defense method, only the cloud server is trusted by default. However, edge computing intelligent services have limited bandwidth and unstable network connections, which make it impossible for edge devices to retrain their models or update the global model. Therefore, it is crucial to detect whether the data of edge nodes are polluted in time. This paper proposes a layered defense framework for edge-computing intelligent services. At the edge, we combine the gradient rising strategy and attention self-distillation mechanism to maximize the correlation between edge device data and edge object categories and train a clean model as much as possible. On the server side, we first implement a two-layer backdoor detection mechanism to eliminate backdoor updates and use the attention self-distillation mechanism to restore the model performance. Our results show that the two-stage defense mode is more suitable for the security protection of edge computing intelligent services. It can not only weaken the effectiveness of the backdoor at the edge end but also conduct this defense at the server end, making the model more secure. The precision of our model on the main task is almost the same as that of the clean model.