Search

Abstract Objectives This study aimed to investigate the differences in structural connectivity and glymphatic system function between patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS) and healthy controls. Additionally, we analyzed the association between structural connectivity, glymphatic system function, and antiseizure medication (ASM) response. Methods We retrospectively enrolled patients with TLE and HS and healthy controls who underwent diffusion tensor imaging at our hospital. We assessed structural connectivity in patients with TLE and HS and healthy controls by calculating network measures using graph theory and evaluated glymphatic system function using the diffusion tensor image analysis along the perivascular space (DTI‐ALPS) index. Patients with TLE and HS were categorized into two groups: ASM poor and good responders. Results We enrolled 55 patients with TLE and HS and 53 healthy controls. Of the 55 patients with TLE and HS, 39 were ASM poor responders, and 16 were ASM good responders. The assortativity coefficient in patients with TLE and HS was higher than that in healthy controls (0.004 vs. −0.007, p = 0.004), and the assortativity coefficient in ASM poor responders was lower than that in ASM good responders (−0.001 vs. −0.197, p = 0.003). The DTI‐ALPS index in patients with TLE and HS was lower than that in healthy controls (1.403 vs. 1.709, p

Abstract Background Mongolian cattle are local breeds in northern China with excellent adaptability to harsh environmental conditions. Adipose tissues play essential roles in tolerance to cold and disease, but the associated cellular and molecular mechanisms are unclear. Methods Single-nucleus RNA sequencing (snRNA-seq) was performed on the adipose tissues from the subcutaneous (SAT), greater omentum (OAT) and perirenal (PAT) of 3 healthy cattle. The adipogenic trajectory was analyzed, and the functional roles of gene of interest were verified in vitro. Results There were different cell subpopulations in adipose tissues. The lipid-deposition adipocytes identified by the PTGER3 marker exhibited outstanding characteristics in SAT. In PAT and OAT, aldosterone was expressed to provide clues for the differential brown adipocytes. Among the DEGs by comparing OAT with SAT and PAT with OAT, C3 was significantly expressed in most of the cell populations in SAT. G0S2, LIPE, LPIN1, PTGER3 and RGCC took part in the adipogenic trajectory from preadipocyte commitment to mature adipocytes. S100A4 expression affected Ca2+ signaling and the expression of UCP1 ~ 3, FABP4 and PTGER3. Conclusion The cell heterogeneity and genes expressed in adipose tissues of Mongolian cattle not only determine the endocrine and energy storage, but contribute to adapt to cold and disease resistance.

Background/Aims: With increased life expectancy, the management of elderly hepatocellular carcinoma (HCC) patients became a crucial issue, yet it is still challenging due to comorbidities and high surgical risks. While surgical resection is considered as primary treatment for eligible HCC patients, systematic evidence on its outcomes in elderly patients remains scarce. In this review, we aimed to analyze the efficacy and safety outcomes of surgical resection in elderly HCC patients. Methods: The studies included in this meta-analysis were selected from Ovid-MEDLINE, Ovid-Embase, CENTRAL, KoreaMed, KMbase, and KISS databases following a predefined protocol. Efficacy outcomes included overall survival and disease-free survival, while the safety outcomes included postoperative mortality and complications. Results: Patients in the elderly group (≥65 years) who underwent surgery exhibited non-inferior overall survival (hazard ratio [HR], 1.26; 95% confidence interval [CI], 0.92 to 1.74) and disease-free survival (HR, 1.03; 95% CI, 0.99 to 1.08) compared to the non-elderly group. Overall postoperative mortality exhibited no statistical difference (odds ratio [OR], 1.07; 95% CI, 0.87 to 1.31), but 30-day, 90-day, and in-hospital mortality were higher in the elderly group. The incidence of overall complications was higher in the elderly group (OR, 1.44; 95% CI, 1.22 to 1.69). Sensitivity analysis for the super elderly group (≥80 years) showed significantly higher in-hospital mortality compared to the non-super elderly group (OR, 2.51; 95% CI, 1.16 to 5.45). Conclusion : s: The efficacy outcome of surgical resection in the elderly HCC patients was not worse than that in the non-elderly HCC patients, while in-hospital mortality and complications rates were higher. Therefore, surgical resection should be purposefully considered in the elderly population, with careful candidate selection.

Summary: Proteomics is crucial in clinical research, yet the clinical application of proteomic data remains challenging. Transforming proteomic mass spectrometry (MS) data into red, green, and blue color (MS-RGB) image formats and applying deep learning (DL) techniques has shown great potential to enhance analysis efficiency. However, current DL models often fail to extract subtle, crucial features from MS-RGB data. To address this, we developed ProteoNet, a deep learning framework that refines MS-RGB data analysis. ProteoNet incorporates semantic partitioning, adaptive average pooling, and weighted factors into the Convolutional Neural Network (CNN) model, thus enhancing data analysis accuracy. Our experiments with proteomics data from urine, blood, and tissue samples related to liver, kidney, and thyroid diseases demonstrate that ProteoNet outperforms existing models in accuracy. ProteoNet also provides a direct conversion method for MS-RGB data, enabling a seamless workflow. Moreover, its compatibility with various CNN architectures, including lightweight models like MobileNetV2, underscores its scalability and clinical potential.

Background End-stage kidney disease (ESKD) patients undergoing hemodialysis experience diverse neurological complications. This study investigated prefrontal cerebral blood volume (CBV) and cerebral blood flow (CBF) during hemodialysis using functional near-infrared spectroscopy (fNIRS) to analyze cerebral hemodynamic changes.Methods ESKD patients undergoing maintenance hemodialysis without a history of neurological disorders were enrolled prospectively. The fNIRS data were collected using a NIRSIT Lite device. The fNIRS values were recorded three times for each patient: before the start of hemodialysis (pre-HD), 1 h after the start of hemodialysis (mid-HD), and after the end of hemodialysis (post-HD). The average changes in oxy-hemoglobin (HbO2), deoxy-hemoglobin (HbR), total hemoglobin (HbT, calculated as HbO2 + HbR) concentrations, and in hemoglobin concentration difference (HbD, calculated as HbO2 − HbR) were analyzed. We then compared the differences in changes in HbO2, HbR, HbT, and HbD according to the hemodialysis period.Results Thirty hemodialysis patients were analyzed. The change in HbO2, HbT, and HbD levels showed significant differences according to the hemodialysis period. Between the pre-HD and post-HD periods, there were significant differences in changes in HbO2 (0.005 ± 0.001 µM vs. 0.015 ± 0.004 µM, p = .046) and HbT (0.006 ± 0.001 µM vs. 0.016 ± 0.008 µM, p = .029). Additionally, between pre-HD and post-HD periods, HbD tended to increase (0.005 ± 0.001 µM vs. 0.014 ± 0.004 µM, p = .094).Conclusions We demonstrated that during one hemodialysis session, the relative change in prefrontal CBV increased post-HD compared with pre-HD. These results are expected to help understanding the mechanisms underlying the effects of hemodialysis on brain function.

ABSTRACTThree-dimensional concrete printing (3DCP) is progressing from lab pilots to large-scale manufacturing, encountering limitations with conventional printable material – cement mortar. Coarse aggregate concrete (CAC) emerges as a promising alternative due to its superior material properties, cost-effectiveness, and sustainability, attracting considerable interest in academia and industry. This paper explores the integration of CAC into 3DCP, focusing on three critical aspects: mixture design of 3D printable concrete, innovative methods of 3D printing process, and structural behaviours of 3D printed concrete specimens, structural members and systems. It elucidates the relationships among mixture composition, processing parameters, early-age material properties, and printability requirements. Furthermore, particle-bed 3D printing technology for CAC is discussed, highlighting advantages and challenges compared to extrusion methods. Ultimately, this review provides valuable insights into the technical challenges and prospects of 3D printing coarse aggregate concrete (3DPCAC) technology, aiming to foster advancements in research and construction practices.

ObjectivesThe choroid plexus plays a role in eliminating detrimental metabolites from the brain as an integral component of the glymphatic system. This study aimed to investigate alterations in choroid plexus volume in patients with end-stage renal disease (ESRD) compared with healthy controls.MethodsWe enrolled 40 patients with ESRD and 42 healthy controls. They underwent brain magnetic resonance imaging (MRI), specifically using three dimensional T1-weighted imaging. We analyzed choroid plexus volumes and compared them between patients with ESRD and healthy controls. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was calculated. We compared the DTI-ALPS index between the ESRD patients and healthy controls. Additionally, we evaluated the association between choroid plexus volume and neuropsychological tests results in patients with ESRD.ResultsThere were significant differences in choroid plexus volumes between patients with ESRD and healthy controls. The choroid plexus volumes in patients with ESRD were higher than those in healthy controls (1.392 vs. 1.138%, p

Objective Precise knowledge regarding the mechanical stress applied to the intervertebral disc following each individual spine motion enables physicians and patients to understand how people with discogenic back pain should be guided in their exercises and which spine motions to specifically avoid. We created an intervertebral disc degeneration model and conducted a finite element (FE) analysis of loaded stresses following each spinal posture or motion. Methods A 3-dimensional FE model of intervertebral disc degeneration at L4–5 was constructed. The intervertebral disc degeneration model was created according to the modified Dallas discogram scale. The von Mises stress and range of motion (ROM) regarding the intervertebral discs and the endplates were analyzed. Results We observed that mechanical stresses loaded onto the intervertebral discs were similar during flexion, extension, and lateral bending, which were greater than those occurring during torsion. Based on the comparison among the grades divided by the modified Dallas discogram scale, the mechanical stress during extension was greater in grades 3–5 than it was during the others. During extension, the mechanical stress loaded onto the intervertebral disc and endplate was greatest in the posterior portion. Mechanical stresses loaded onto the intervertebral disc were greater in grades 3–5 compared to those in grades 0–2. Conclusion Our findings suggest that it might be beneficial for patients experiencing discogenic back pain to maintain a neutral posture in their lumbar spine when engaging in daily activities and exercises, especially those suffering from significant intravertebral disc degeneration.

Background : We conducted this study to assess the efficacy and safety of PF-72 (TGel Bio Co. Ltd., Seoul, Korea) combined with 0.75% ropivacaine hydrochloride in relieving the postoperative pain in patients undergoing single-level lumbar discectomy. Methods : A total of 95 eligible patients were randomized to either the trial group (n = 47; PF-72 combined with 0.75% ropivacaine hydrochloride) or the control group (n = 48; ramosetron hydrochloride 0.3 mg). The patients were monitored at 3, 6, 24, 48 and 72 hours postoperatively, for which the cumulative area under the curve (AUC0-72) of NRS pain scores was plotted and the amount of rescue analgesics used at 6, 24, 48 and 72 hours or 24, 48 and 72 hours postoperatively. Moreover, incidences of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs) were analyzed. Results : The amount of analgesics used and the AUC0-72 of the NRS pain scores was significantly smaller and the NRS pain scores were significantly lower in the trial group as compared with the control group (P < 0.05). In addition, there was no significant difference in the number of the patients presenting with no pain (NRS pain scores ≤; 3) between the two groups at 48 and 72 hours postoperatively (P > 0.05). There were no significant differences in the incidences of TEAEs and SAEs between the two groups (P > 0.05). Conclusion : s: PF-72 combined with 0.75% ropivacaine hydrochloride is an effective, safe drug delivery system.

Abstract This cadaveric study aimed to evaluate the safety and usability of a novel robotic system for posterior cervical pedicle screw fixation. Three human cadaveric specimens and C2-T3 were included. Freshly frozen human cadaver specimens were prepared and subjected to robot-assisted posterior cervical pedicle screw fixation using the robotic system. The accuracy of screw placement, breach rate, and critical structure violations were evaluated. The results were statistically compared with those of previous studies that used different robotic systems for cervical pedicle screw fixation. The robotic system demonstrated a high accuracy rate in screw placement. A significant number of screws were placed within predetermined safe zones. The total entry offset was 1.08 ± 0.83 mm, the target offset was 1.86 ± 0.50 mm, and the angle offset was 2.14 ± 0.77°. Accuracy rates comparable with those of previous studies using different robotic systems were achieved. The system was also feasible, allowing precise navigation and real-time feedback during the procedure. This cadaveric study validated the safety and usability of the novel robotic system for posterior cervical pedicle screw fixation. The system exhibited high precision in screw placement, and the results support the extension of the indications for robot-assisted pedicle screw fixation from the lumbar spine to the cervical spine.

In view of the shortage of conventional design methods of pressure curve in the anti-gravity precision casting and taking the structural characteristics of the casting with variable cross-sections into account, automatic calculation of cross-sectional areas was implemented for the casting and gating system by the secondary development of CAD software, and quantitatively describing the variable feature of cross-sections of casting was realized. Based on Bernoulli and flow conservation equations，the relationship between the filling pressure and the rising speed of metal liquid level was deduced. A new design method of pressure curve based on the automatic calculation of cross-sectional areas of the casting was proposed. The simulation results of anti-gravity casting for nickel-based superalloy demonstrate that, compared with the pressure curve of the conventional design method，the new curve can reduce the peak value of filling speed from 0.611 m/s to 0.439 m/s at the minimum cross-sectional area，the falling range of which is 28.15%. It meant that the new method can effectively avoid the shock and splash of liquid metal，meanwhile，shorten the filling time，then the filling process is fast and stable. The hydraulic experiment and pouring experiment show that the new pressure curve has a smoother filling liquid level and can effectively avoid casting defects. Therefore，it proves the effectiveness of the new pressure curve design method and provides a basis for rational design of anti-gravity pressure curve.

Abstract Background Pregnancy-associated spontaneous coronary artery dissection (SCAD) and reversible cerebral vasoconstriction syndrome (RCVS) are rare conditions that may occur during pregnancy and the postpartum period. The coexistence of both diseases may pose a risk to patients, potentially resulting in a variety of complications and clinical manifestations. This is considered the first case of a patient who successfully recovered from a critical condition in the postpartum period, with contemporaneous SCAD and RCVS. Case presentation A 33-year-old female with no known medical history was referred to the emergency department after experiencing cardiac arrest, which occurred 1 week after giving birth to her third child. She complained of sudden anterior squeezing chest pain, accompanied by a headache, and eventually collapsed due to ventricular fibrillation with seizure. She was successfully resuscitated after receiving basic life support. She showed an alert mentality and did not experience any further seizure events or additional neurological symptoms. Although vital sign remained stable, the level of highly sensitive troponin I was significantly elevated. Electrocardiography revealed sinus rhythm with T-wave inversion at V1-4, while chest computed tomography (CT) demonstrated severe aspiration pneumonia. The patient was admitted to the intensive care unit due to a high requirement of O2 supply. A consultation with the neurologic department and a brain magnetic resonance angiography (MRA) were conducted for the thunderclap headache. The brain MRA demonstrated stenosis in the basilar artery, the right M2 segment, and bilateral A1 segments, along with sulcal hyperintensity on post-contrast fluid-attenuated inversion recovery (FLAIR) suggesting blood–brain barrier breakdown due to vasoconstriction. Formal echocardiography showed regional wall motion abnormality in the left anterior descending artery (LAD) territory. After the improvement of pneumonia, a coronary angiography was performed, revealing diffuse luminal narrowing from the mid to distal LAD due to a long segmental, extensive dissection. We decided to maintain the medical therapy. A follow-up coronary CT angiography performed 6 months later revealed complete remission of the dissected coronary vessel, and a brain MRA checked 3 months later showed resolved vasoconstriction of the relevant cerebral vessels. Conclusions The physicians must be aware of pregnancy-associated complications in certain patients. Clear diagnoses and proper treatments are required in pregnant patients who may be exposed to multiple acute conditions, in order to reduce complications and achieve favorable outcomes.

The Trier social stress test (TSST) is considered as the most appropriate standardized protocol for studying stress hormone reactivity. The TSST is distinct from other stress induction protocols in laboratory settings due to its unique ability to create a natural context that includes elements of social and psychological acute stress. However, there has been no investigation of the efficacy of the TSST among the Vietnamese population. Therefore, the purpose of this study is to examine the impact of the TSST on Vietnamese university students. A group of 10 healthy male and female volunteers underwent the TSST protocol, and self-reported values (the positive and negative affect schedule and the visual analogue scale) as well as physiological stress response (heart rate) were measured. The results suggest that the TSST mildly induces acute psychological stress among Vietnamese participants. To enhance the potency of the TSST in future studies, a larger sample size and more consistent adherence to the TSST protocol are crucial.

ObjectivesStudies have recently shown an alteration of the structural connectivity and a dysfunctional glymphatic system in patients with chronic kidney disease (CKD). In this study, we aimed to investigate the effects of the structural connectivity and glymphatic system on the cognitive function of patients with CKD.MethodsWe prospectively enrolled patients with CKD and healthy controls. The CKD group was divided into two regarding their cognitive function. All patients received brain magnetic resonance imaging, including diffusion tensor imaging (DTI). We calculated the measures of structural connectivity and diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, a neuroimaging marker of the glymphatic system function, and compared the indices between groups.ResultsThe mean clustering coefficient, local efficiency, and small-worldness index in patients with CKD were lower than those in healthy controls (0.125 ± 0.056 vs. 0.167 ± 0.082, p = 0.008; 1.191 ± 0.183 vs. 1.525 ± 0.651, p = 0.002; 0.090 ± 0.043 vs. 0.143 ± 0.102, p = 0.003; respectively). The DTI-ALPS index was lower in patients with CKD than in healthy controls (1.436 vs. 1.632, p

IntroductionRoad cracks significantly shorten the service life of roads. Manual detection methods are inefficient and costly. The YOLOv5 model has made some progress in road crack detection. However, issues arise when deployed on edge computing devices. The main problem is that edge computing devices are directly connected to sensors. This results in the collection of noisy, poor-quality data. This problem adds computational burden to the model, potentially impacting its accuracy. To address these issues, this paper proposes a novel road crack detection algorithm named EMG-YOLO.MethodsFirst, an Efficient Decoupled Header is introduced in YOLOv5 to optimize the head structure. This approach separates the classification task from the localization task. Each task can then focus on learning its most relevant features. This significantly reduces the model’s computational resources and time. It also achieves faster convergence rates. Second, the IOU loss function in the model is upgraded to the MPDIOU loss function. This function works by minimizing the top-left and bottom-right point distances between the predicted bounding box and the actual labeled bounding box. The MPDIOU loss function addresses the complex computation and high computational burden of the current YOLOv5 model. Finally, the GCC3 module replaces the traditional convolution. It performs global context modeling with the input feature map to obtain global context information. This enhances the model’s detection capabilities on edge computing devices.ResultsExperimental results show that the improved model has better performance in all parameter indicators compared to current mainstream algorithms. The EMG-YOLO model improves the accuracy of the YOLOv5 model by 2.7%. The mAP (0.5) and mAP (0.9) are improved by 2.9% and 0.9%, respectively. The new algorithm also outperforms the YOLOv5 model in complex environments on edge computing devices.DiscussionThe EMG-YOLO algorithm proposed in this paper effectively addresses the issues of poor data quality and high computational burden on edge computing devices. This is achieved through optimizing the model head structure, upgrading the loss function, and introducing global context modeling. Experimental results demonstrate significant improvements in both accuracy and efficiency, especially in complex environments. Future research can further optimize this algorithm and explore more lightweight and efficient object detection models for edge computing devices.

In response to the problem of lack of shrinkable pressure-allowing performance of steel pipe concrete arch in the current roadway support, an anti-impacting and energy-absorbing steel pipe concrete arch structure is designed from the perspective of energy-absorbing pressure-allowing. The combination model of the new steel pipe concrete arch and the surrounding rock was established by Abaqus, and the support effect and impact resistance of the new arch on the roadway were compared and analyzed under both static and dynamic loading conditions. The conclusions are as follows: ① Designing the wall thickness and size of the energy-absorbing member according to the reasonable yielding resistance characteristics. Energy-absorbing components are installed at the connection between the upper arch and the middle of the bottom arc to prevent excessive bending from causing instability. The sleeve shape is designed as a pleated shape based on the U-shaped steel arch clamp structure, which achieves compression yield through friction with the arch; ② Under the vertical and lateral impact, the displacement of the optimized arch support tunnel at each point is reduced, which reduces the sinking of the top arc section of the arch and the up-arch of the bottom arc section, and the support effect is stronger; ③ Under static loads, after the arch contacts the energy-absorbing component, the plastic strain at each point of the arch no longer increases, and the energy-absorbing component replaces the arch to deform. After being subjected to dynamic loads, the energy-absorbing component can respond quickly, while the corners of the arch bend and deform, and the remaining parts have not undergone significant deformation. After the energy-absorbing component is crushed, the overall plastic strain of the arch starts to increase, and finally the equivalent plastic strain at each point of the arch is reduced by 10%−50% and 13%−78% under vertical and lateral impacts, respectively, after optimization.

Abstract Climate change is closely monitored and numerous studies reports increasing air temperature and weather extremes across the globe. As a direct consequence of the increase of global temperature, the increased heat stress is becoming a global threat to public health. While most climate change and epidemiological studies focus on air temperature to explain the increasing risks, heat strain can be predicted using comprehensive indices such as Universal Thermal Climate Index (UTCI). The Asia–Pacific region is prone to thermal stress and the high population densities in the region impose high health risk. This study evaluated the air temperature and UTCI trends between 1990 and 2019 and found significant increasing trends for air temperature for the whole region while the increases of UTCI are not as pronounced and mainly found in the northern part of the region. These results indicate that even though air temperature is increasing, the risks of heat stress when assessed using UTCI may be alleviated by other factors. The associations between El Niño Southern Oscillation (ENSO) and heat stress was evaluated on a seasonal level and the strongest regional responses were found during December-January (DJF) and March–May (MAM).

Chronic obstructive pulmonary disease (COPD) is one of the major chronic airway diseases, with the highest prevalence among individuals over 60 years old, significantly impacting the health of elderly patients. Both domestic and international COPD prevention and treatment guidelines recommend pulmonary rehabilitation as a complementary and effective adjunct to pharmacological treatment. Pulmonary rehabilitation can significantly improve patients' respiratory function and physical fitness, alleviate symptoms, and reduce hospitalization and mortality rates. However, the specific contents of pulmonary rehabilitation for elderly COPD patients differ depending on the stage of the disease. This expert consensus elaborates on the assessment and treatment contents of pulmonary rehabilitation for elderly COPD patients in the acute exacerbation period, acute exacerbation remission period, and outpatient stable period, aiming to provide guidance for pulmonary rehabilitation treatment at different stages of the disease. This consensus identifies common functional impairments in elderly COPD patients, including respiratory dysfunction, exercise tolerance impairment, psychological issues, swallowing dysfunction and cognitive impairment. It recommends a comprehensive assessment of elderly COPD patients' multifaceted impairments based on the International Classification of Functioning, Disability, and Health (ICF) framework, covering four aspects：body structure, body function (respiratory function, cardiac function, exercise function, psychological and cognitive function, swallowing function, and nutritional factors), activity and participation, and environmental factors. Pulmonary rehabilitation is suitable for all patients exhibiting relevant symptoms and/or those at high risk of acute exacerbations (high-level evidence). As the disease progresses, the rehabilitation team, treatment plan, and treatment location should be adjusted in a timely manner, forming a continuous rehabilitation cycle. Smoking cessation is a crucial intervention to slow down the decline in lung function and the progression of COPD (high-level evidence). Through adequate nutritional support, elderly COPD patients can improve their nutritional status, enhance physical strength and quality of life, better manage the disease, and promote rehabilitation (low to moderate-level evidence). Oxygen therapy is recommended for patients with advanced COPD who remain hypoxemic at rest (low to moderate-level evidence). Some emerging rehabilitation treatments (such as neuromuscular electrical stimulation, acupuncture, and certain traditional Chinese medicines) may have some value for elderly COPD patients (low to moderate-level evidence. This expert consensus divides rehabilitation treatment into three stages：Phase I Pulmonary Rehabilitation, Phase II Pulmonary Rehabilitation, and Phase III Pulmonary Rehabilitation, based on the different stages of elderly COPD patients. It further details the target population, implementation location, rehabilitation content, assessment content, participating disciplines, and rehabilitation goals for each stage, emphasizing the need for clinical respiratory specialists, primary care physicians, rehabilitation physicians/therapists, nurses, nutritionists, psychologists, and social workers to actively coordinate and collaborate throughout the full-cycle rehabilitation process for elderly COPD patients.

Elderly lung cancer is the leading cause of cancer-related deaths worldwide, posing significant challenges to public health. This consensus systematically reviews relevant clinical guidelines and literature both domestically and internationally, integrating recent clinical experiences and research findings. It summarizes new clinical rehabilitation concepts from experts in rehabilitation medicine, respiratory medicine, and nursing regarding elderly lung cancer. The consensus provides detailed discussions on the definition, risk factors, classification, staging, and clinical characteristics of elderly lung cancer, with a focus on functional impairments and their rehabilitation assessment and treatment strategies. Functional impairments encompass multiple aspects, including pulmonary function, cardiac function, exercise capacity, pain, psychological issues, cognition, speech, swallowing, sensory functions, and bowel and bladder dysfunction. The consensus offers comprehensive academic guidance and clinical practice recommendations for rehabilitation professionals across various healthcare settings. It emphasizes that the full-cycle rehabilitation of elderly lung cancer requires multidisciplinary teamwork to ensure seamless integration of clinical care, rehabilitation, and nursing, maximizing patient functional recovery and quality of life. By conducting a comprehensive assessment of patients' overall conditions and formulating personalized rehabilitation treatment plans, effective improvements in functional impairments, symptom relief, and even prolongation of survival can be achieved. Additionally, the consensus outlines the service process for full-cycle rehabilitation of lung cancer, highlighting the interconnectedness of tertiary hospitals, secondary hospitals, community hospitals, and families, as well as the importance of adjusting rehabilitation models based on local circumstances. The promotion and implementation of this consensus aim to provide standardized guidance for the assessment and treatment of full-cycle rehabilitation in elderly lung cancer patients, with the expectation of improving rehabilitation outcomes and quality of life, thereby contributing to the development of elderly lung cancer rehabilitation in China.

Objective: This study introduces a novel system that can simulate diverse mechanical properties of the human chest to enhance the experience of CPR training by reflecting realistic chest conditions of patients. Methods: The proposed system consists of Variable stiffness mechanisms (VSMs) and Variable damper (VD) utilizing stretching silicone bands and dashpot dampers with controllable valves to modulate stiffness and damping, respectively. Cyclic loading was applied with a robot manipulator to the system. Compression force and displacement were measured and analyzed to evaluate the system’s mechanical response. Long-term stability of the system was also validated. Results: A non-linear response of the human chest under compression is realized through this design. Test results indicated non-linear force-displacement curves with hysteresis, similar to those observed in the chest of patients. Controlling the VSM and VD allowed for intentional changes in the slope and area of curves that are related to stiffness and damping, respectively. Stiffness and damping of the system were computed using performance test results. The stiffness ranged from 5.34 N/mm to 13.59 N/mm and the damping ranges from 0.127 N $\cdot $ s/mm to 0.511 N $\cdot $ s/mm. These properties cover a significant portion of the reported mechanical properties of the human chests. The system demonstrated satisfactory stability even when it was subjected to maximum stiffness conditions of the long-term compression test. Conclusion: The system is capable of emulating the mechanical properties and behavior of the human chests, thereby enhancing the CPR training experience.

Objective To investigate the effects of silencing connective tissue growth factor (CTGF) gene on growth, apoptosis, and expression of proliferating cell nuclear antigen (PCNA), CTGF, integrin alpha 5 (Itgα5) and collagen Ⅰ (ColⅠ) in rat hepatic stellate cell line T6 (HSC_T6). Methods The CTGF shRNA lentiviral vectors with high infectivity were transfected into HSC_T6 cells, and the cells transfected with empty virus or not transfected served as control cells. Fluorescence inverted microscopy was used to observe the cell growth and the expression of green fluorescent protein (GFP) in the transfected HSC_T6 cells. CCK-8 assay and flow cytometry were employed respectively to detect the cell viability and apoptosis. The expression changes in PCNA, CTGF, Itgα5 and ColⅠ were measured by real-time PCR, Western blotting and immunofluorescence assay. Results Microscopic observation displayed that transfection with CTGF shRNA lentiviral vectors resulted in high expression of GFP in HSC_T6 cells. CCK-8 assay showed that silencing CTGF induced inhibited growth in the transfected cells, with significant difference since 72 h after transfection (P < 0.05). Flow cytometry indicated that transfection of CTGF shRNA lentivirus led to the apoptosis of HSC_T6 cells. The results of real-time PCR, Western blotting and immunofluorescence assay confirmed that CTGF shRNA lentivirus effectively down-regulated the expression of PCNA, CTGF, Itgα5 and ColⅠ, with notable differences when compared the expression in control cells (P < 0.05). Conclusion Silencing CTGF can down-regulate the expression of CTGF, Itgα5 and ColⅠ, inhibit the growth and induce the apoptosis of HSC_T6 cells, which might be closely associated with its interference for the CTGF/Itgα5 signaling pathway.

Although the disease burden of elderly cancer patients is rapidly increasing, reliable scientific information, value and preference information of domestic patients, and standardized guidelines for determining the treatment of elderly cancer patients are lacking. The aim of this study is to compare the therapeutic effects of radiofrequency ablation (RFA) and surgery in hepatocellular carcinoma (HCC) patients aged 65 years or older. For the meta-analysis, the databases including PubMed (MEDLINE), EMBASE, OVID Medline, and the Cochrane Library were systematically searched. After the abstract-based review by two investigators, selected manuscripts were read in detail. The surgery group showed higher overall survival (OS) (HR 1.44, 95% CI 1.22–1.70) and disease-free survival (DFS) (HR 1.40, 95% CI 1.00–1.97) than the RFA group. This was also shown in small HCC of less than 3 cm (OS, HR 1.42, 95% CI 1.00–2.03; DFS, HR 1.32, 95% CI 0.91–1.91). This might be related to the high local recurrence in the RFA group (OR 4.90, 95% 2.16–11.08). On the other hand, adverse events were significantly lower in the RFA group (OR 0.22, 95% CI 0.14–0.36), which led to a decrease in the duration of hospital stay (mean difference −14.88 days, 95% CI −22.44–−7.32). In elderly HCC patients, survival in the surgery group was significantly higher than in the RFA group, but various complications tended to increase; so, appropriate patient selection is required.

Abstract Introduction Using correlation tractography, this study aimed to find statistically significant correlations between white matter (WM) tracts in participants with obstructive sleep apnea (OSA) and OSA severity. We hypothesized that changes in certain WM tracts could be related to OSA severity. Methods We enrolled 40 participants with OSA who underwent diffusion tensor imaging (DTI) using a 3.0 Tesla MRI scanner. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and quantitative anisotropy (QA)‐values were used in the connectometry analysis. The apnea‐hypopnea index (AHI) is a representative measure of the severity of OSA. Diffusion MRI connectometry that was used to derive correlational tractography revealed changes in the values of FA, MD, AD, RD, and QA when correlated with the AHI. A false‐discovery rate threshold of 0.05 was used to select tracts to conduct multiple corrections. Results Connectometry analysis revealed that the AHI in participants with OSA was negatively correlated with FA values in WM tracts that included the cingulum, corpus callosum, cerebellum, inferior longitudinal fasciculus, fornices, thalamic radiations, inferior fronto‐occipital fasciculus, superior and posterior corticostriatal tracts, medial lemnisci, and arcuate fasciculus. However, there were no statistically significant results in the WM tracts, in which FA values were positively correlated with the AHI. In addition, connectometry analysis did not reveal statistically significant results in WM tracts, in which MD, AD, RD, and QA values were positively or negatively correlated with the AHI. Conclusion Several WM tract changes were correlated with OSA severity. However, WM changes in OSA likely involve tissue edema and not neuronal changes, such as axonal loss. Connectometry analyses are valuable tools for detecting WM changes in sleep disorders.

The marine economic development demonstration zone (MEDDZ) is the regional marine functional policy that assumes the significant tasks of innovation in the system and mechanism of the marine economy, optimization of the marine industrial structures, and the construction of marine ecological civilization. This paper constructs a panel database of 11 coastal provinces in China from 2006 to 2019, takes the Zhejiang Marine Economy Development Demonstration Zone Plan officially approved by the State Council of China in 2011 as a quasi-natural experiment, applies the synthetic control method (SCM) to evaluate the effect of implementation of the MEDDZ policy on marine industrial structure optimization in Zhejiang. The results show that: (1) The MEDDZ policy significantly promotes the structure optimization of the marine industry in Zhejiang and the existence of the policy lag phenomenon. (2) Based on the results of the robustness tests, we find that the fitted path of policy effects is better when the time of MEDDZ implementation is adjusted to 2012. (3) Government financial support and marine cargo capacity play a role in implementing the MEDDZ policy, positively affecting and optimizing the coastal marine industry’s structure. Therefore, we make some suggestions from the perspectives of strengthening the policy implementation process, focusing on the policy lag phenomenon, and broadening funding sources, thus enriching theoretical research on policies in the field of the marine industry and providing practical references for the development of other coastal demonstration zones.

IntroductionThe lighting environment significantly influences fish behavior. This study explores the impact of diverse lighting conditions on the behavior of steelhead trout (Oncorhynchus mykiss) to illuminate the mechanisms underlying their behavioral responses.MethodsThis experiment was set up with six treatments at a constant light intensity of 150 lx: 12h white light + 12h dark (12 W), 12h blue light + 12h dark (12B), 12h red light + 12h dark (12 R), 1.5h blue light + 9h red light + 1.5h blue light + 12h dark (3B9R), 3h blue light + 6h red light + 3h blue light + 12h dark (6B6R), total 12h of blue and red light + 12h dark (T12BR). A multiple object tracking method, YOLOv5 with SORT, was employed to capture the movement trajectory of each fish, quantifying three motion metrics: swimming velocity, swimming angular velocity, and generalized intersection over union.ResultsThe results revealed that fish exposed to 12R light environment showed significantly higher activity levels than other groups. The mixed light environments (3B9R, 6B6R) formed significant differences in behavioral metrics with 12R earlier than pure light environments (12B, 12W, T12BR), indicating sudden light color changes should be avoided. Fish in the 3B9R environment exhibited the lowest activity level but highest growth performance, with the highest specific growth rate of 1.91±0.12 d-1, a value significantly surpassing the lowest recorded rate, supported by a p-value of 0.0054, indicating it is suitable for steelhead trout cultivation.DiscussBehavioral significant differences were observed as early as week eight, much earlier than physiological differences, which became apparent by week 16. Overall, this paper employs computer vision methods to study the impact of different light colors on fish behavior, found that 3B9R is the optimal lighting condition tested and sudden light color changes should be avoided, offering a new perspective on light conditions and behavior in steelhead trout cultivation.

Abstract Introduction This study aimed to investigate the presence of sarcopenia in patients with juvenile myoclonic epilepsy (JME) and the association between sarcopenia and response to anti‐seizure medication (ASM) in patients with JME. Methods We enrolled 42 patients with JME and 42 healthy controls who underwent brain magnetic resonance imaging with three‐dimensional T1‐weighted imaging. We measured the temporal muscle thickness (TMT), a radiographic marker for sarcopenia, using T1‐weighted imaging. We compared the TMT between patients with JME and healthy controls and analyzed it according to the ASM response in patients with JME. We also performed a receiver operating characteristic (ROC) curve analysis to evaluate how well the TMT differentiated the groups. Results The TMT in patients with JME did not differ from that in healthy controls (9.630 vs. 9.956 mm, p = .306); however, ASM poor responders had a lower TMT than ASM good responders (9.109 vs. 10.104 mm, p = .023). ROC curve analysis revealed that the TMT exhibited a poor performance in differentiating patients with JME from healthy controls, with an area under the ROC curve of .570 (p = .270), but good performance in differentiating between ASM good and poor responders, with an area under the ROC curve of .700 (p = .015). Conclusion The TMT did not differ between patients with JME and healthy controls; however, it was reduced in ASM poor responders compared to ASM good responders, suggesting a link between ASM response and sarcopenia in patients with JME. TMT can be used to investigate sarcopenia in various neurological disorders.

With the development of China's economy entering a new stage, the quality of life, which centers on the well-being of residents, provides an essential hand in promoting the transformation of the regional economy from high-speed development to high-quality development. Based on a panel threshold regression model, we examine in this paper whether quality of life helps regional economies realize developmental convergence. The research shows that: (1) The quality of life overall can promote regional economic development and passes the series test with relatively robust results. (2) The quality of life has a non-linear effect on regional economic growth, which is mainly manifested in the fact that the impact is more significant in regions with higher levels of quality of life and weaker in regions with lagging quality of life and may widen the gap between regions at the same time. (3) We categorize the study regions to test further regional heterogeneity based on regional location and development status. At the Quality of Life Level-I regions, their influence on economic development has a more substantial pulling effect. Therefore, each region should seize the strategic opportunity to improve the quality of life, focus on the balanced development of the quality of life, strengthen policy support and social security, and strive to promote the coordinated development of China's regional economy.

The assessment of landslide hazards is crucial for disaster prevention and mitigation, but it has not considered the dynamic influencing factors that trigger landslides. The timeliness and practical value of the assessment results still need to be further improved. This study constructed a dynamic landslide hazard assessment system using information value model, dynamic precipitation data, and Backpropagation Neural Network (BPNN) model. Taking the Qingjiang Reservoir landslide in Changyang County, Hubei Province, China as an example, based on dynamic precipitation data and the BPNN model were used to develop a dynamic landslide hazard prediction model, and the temporal assessment and spatial distribution results of slope unit hazards in the study area from the 1980s to the 2010s, 2025, and 2030 were evaluated and predicted. It is predicted that the percentage of very high and high areas in 2025 and 2030 will be 50.5% and 57.5% respectively.

BackgroundRecently, we developed a chest compression device that can move the chest compression position without interruption during CPR and be remotely controlled to minimize rescuer exposure to infectious diseases. The purpose of this study was to compare its performance with conventional mechanical CPR device in a mannequin and a swine model of cardiac arrest.Materials and methodsA prototype of a remote-controlled automatic chest compression device (ROSCER) that can change the chest compression position without interruption during CPR was developed, and its performance was compared with LUCAS 3 in a mannequin and a swine model of cardiac arrest. In a swine model of cardiac arrest, 16 male pigs were randomly assigned into the two groups, ROSCER CPR (n = 8) and LUCAS 3 CPR (n = 8), respectively. During 5 minutes of CPR, hemodynamic parameters including aortic pressure, right atrial pressure, coronary perfusion pressure, common carotid blood flow, and end-tidal carbon dioxide partial pressure were measured.ResultsIn the compression performance test using a mannequin, compression depth, compression time, decompression time, and plateau time were almost equal between ROSCER and LUCAS 3. In a swine model of cardiac arrest, coronary perfusion pressure showed no difference between the two groups (p = 0.409). Systolic aortic pressure and carotid blood flow were higher in the LUCAS 3 group than in the ROSCER group during 5 minutes of CPR (p < 0.001, p = 0.008, respectively). End-tidal CO2 level of the ROSCER group was initially lower than that of the LUCAS 3 group, but was higher over time (p = 0.022). A Kaplan-Meier survival analysis for ROSC also showed no difference between the two groups (p = 0.46).ConclusionThe prototype of a remote-controlled automated chest compression device can move the chest compression position without interruption during CPR. In a mannequin and a swine model of cardiac arrest, the device showed no inferior performance to a conventional mechanical CPR device.

The physiological state of an insect can affect its olfactory system. However, the molecular mechanism underlying the effect of nutrition-dependent states on odour-guided behaviours in hoverflies remains unclear. In this study, comparative transcriptome analysis of the antenna and proboscis from Eupeodes corollae under different feeding states was conducted. Compared with the previously published antennal transcriptome, a total of 32 novel chemosensory genes were identified, including 4 ionotropic receptors, 17 gustatory receptors, 9 odorant binding proteins and 2 chemosensory proteins. Analysis of differences in gene expression between different feeding states in male and female antennae and proboscises revealed that the expression levels of chemosensory genes were impacted by feeding state. For instance, the expression levels of EcorOBP19 in female antennae, EcorOBP6 in female proboscis, and EcorOR6, EcorOR14, EcorIR5 and EcorIR84a in male antennae were significantly upregulated after feeding. On the other hand, the expression levels of EcorCSP7 in male proboscis and EcorOR40 in male antennae were significantly downregulated. These findings suggest that nutritional state plays a role in the adaptation of hoverflies' olfactory system to food availability. Overall, our study provides important insights into the plasticity and adaptation of chemosensory systems in hoverflies.

Most of the current crop row detection algorithms focus on extracting crop canopy rows as location information. However, for some high-pole crops, due to the transverse deviation of the position of the canopy and roots, the agricultural machinery can easily cause the wheel to crush the crop when it is automatically driven. In fact, it is more accurate to use the crop root row as the feature for its location calibration, so a method of crop root row detection is proposed in this paper. Firstly, the ROI (region of interest) of the crop canopy is extracted by a semantic segmentation algorithm, then crop canopy row detection lines are extracted by the horizontal strip division and the midpoint clustering method within the ROI. Next, the Crop Root Representation Learning Model learns the Representation of the crop canopy row and crop root row to obtain the Alignment Equation. Finally, the crop canopy row detection lines are modified according to the Alignment Equation parameters to obtain crop root row detection lines. The average processing time of a single frame image (960 × 540 pix) is 30.49 ms, and the accuracy is 97.1%. The research has important guiding significance for the intelligent navigation, tilling, and fertilization operation of agricultural machinery.

Oxidative stress increases the apoptosis of intestinal epithelial cells and impairs intestinal epithelial cell renewal, which further promotes intestinal barrier dysfunction and even death. Extensive evidence supports that resveratrol and apigenin have antioxidant, anti-inflammatory, and antiproliferative properties. Here, we investigated the ability of these two compounds to alleviate diquat-induced jejunal oxidative stress and morphological injury, using the duck as a model, as well as the effects of apigenin on oxidative stress induced by H2O2 in immortalized duck intestinal epithelial cells (IDECs). Ducks were randomly assigned to the following four groups, with five replicates: a control (CON) group, a diquat-challenged (DIQ) group, a resveratrol (500 mg/kg) + diquat (RES) group, and an apigenin (500 mg/kg) + diquat (API) group. We found that serum catalase (CAT) activity and total antioxidant capacity (T-AOC) markedly reduced in the RES and API groups as compared to the DIQ group (p < 0.05); moreover, serum S superoxide dismutase (SOD) levels increased significantly in the API group as compared to the DIQ group (p < 0.05). In jejunal mucosa, the malondialdehyde (MDA) content in the RES and API groups decreased more than that in the DIQ group (p < 0.05). In addition, the jejunal expression levels of the NRF2 and GCLM genes in the RES and API groups increased notably compared with those in the DIQ group (p < 0.05); meanwhile, CAT activity in the RES and API groups was markedly elevated compared with that in the CON group (p < 0.05). In IDECs, apigenin significantly restrained the H2O2-mediated increase in MDA content and decrease in CAT levels (p < 0.05). Furthermore, apigenin increased the protein expression of p-NRF2, NRF2, p-AKT, and p-P38; downregulated that of cleaved caspase-3 and cleaved caspase-9; and reduced the ratio of Bax/Bcl-2 in H2O2-treated IDECs (p < 0.05). In conclusion, resveratrol and apigenin can be used as natural feed additives to protect against jejunal oxidative stress in ducks.

The difficult separation of magnesium–lithium has always been a problem that impedes the comprehensive utilization of salt lake brine resources. In this paper, a method for the separation of magnesium and lithium based on the crystallization of magnesium sulfate at high-temperature supersaturation and a low viscosity was investigated. The microstructure of soluble solutions was analyzed, and the results showed that, in a single-salt solution, controlling the temperature can change the contact ion pair structure of MgSO4 solution, and the arrangement of SO42− and H2O in the second hydration layer changes. In the Li2SO4 solution, the hydrogen bonds between SO42− and H2O break, and the surrounding water structure changes, breaking the similarity of the microstructure of magnesium–lithium and enhancing the separation effect. In a multi-ion system, the change in water structure in the solution decreases with the increase in Cl− concentration. Controlling the temperature of salt lake brine with different magnesium–lithium mass ratios, it was found that the magnesium–lithium mass ratio in the brine could be reduced by one-third; when the magnesium–lithium mass ratio was 10:1~160:1, the loss of lithium could be controlled within 5%, but when the magnesium–lithium mass ratio was 5:1, the loss of lithium was 25.06%. The main reason for lithium loss is that Li2SO4 in the liquid phase enters the solid phase as a cluster and is entrapped during the MgSO4 crystallization process. The entire experiment shows that controlling the temperature process is more suitable for salt lake brine with a high magnesium–lithium ratio.

In this paper, the strategies to enhance the stability of fuel cell catalyst support are reviewed, with an emphasis on enhancing the graphitization degree (GD) of carbon support. Carbon-based materials are popular as support for O2 reduction reaction cathode catalysts owing to their high specific surface area, remarkable electronic conductivity and low cost. However, long-term operation in the harsh conditions of high acidity, high potential and extreme humidity, can easily lead to electrochemical corrosion of carbon support, thus affecting the activity and life of the catalyst. This paper reviews the judgment method of GD of carbon carrier, the influence of GD on material stability, and the strategy of enhancing the GD value.

This study investigates the integrated application of cloud computing and big data in the field of education and its impact on curriculum teaching. Through a comprehensive review of the fundamental principles, current applications, and relevant literature, the study reveals the advantages and challenges of cloud computing and big data in aspects such as curriculum design, learning analytic, and personalized teaching. It also explores their influence on aspects like the sharing of teaching resources, the construction of online learning environments, and the evaluation of student learning outcomes. Furthermore, through case analysis and empirical studies, this paper provides a more in-depth validation of the practical effects of cloud computing and big data in improving teaching effectiveness, promoting educational innovation, and cultivating students’ information literacy. In summary, the integration of cloud computing and big data provides new perspectives and solutions for building smart education, while also laying a solid foundation for nurturing talents capable of meeting the demands of future society.