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To investigate the potential of T1-weighted imaging (T1WI)-based hippocampal radiomics as imaging markers for the diagnosis of Alzheimer's disease (AD) and their efficacy in discriminating between mild cognitive impairment (MCI) and dementia in AD. A total of 126 AD patients underwent T1WI-based magnetic resonance imaging (MRI) examinations, along with 108 age-sex-matched healthy controls (HC). This was a retrospective, single-center study conducted from November 2021 to February 2023. AD patients were categorized into two groups based on disease progression and cognitive function: AD-MCI and dementia (AD-D). T1WI-based radiomics features of the bilateral hippocampi were extracted. To diagnose AD and differentiate between AD-MCI and AD-D, predictive models were developed using random forest (RF), logistic regression (LR), and support vector machine (SVM). We compared radiomics features between the AD and HC groups, as well as within the subgroups of AD-MCI and AD-D. Area under the curve (AUC), accuracy, sensitivity, and specificity were all used to assess model performance. Furthermore, correlations between radiomics features and Mini-Mental State Examination (MMSE) scores, tau protein phosphorylated at threonine 181 (P-tau-181), and amyloid β peptide1–42 (Aβ1–42) were analyzed. The RF model demonstrated superior performance in distinguishing AD from HC (AUC = 0.961, accuracy = 90.8%, sensitivity = 90.7%, specificity = 90.9%) and in identifying AD-MCI and AD-D (AUC = 0.875, accuracy = 80.7%, sensitivity = 87.2%, specificity = 73.2%) compared to the other models. Additionally, radiomics features were correlated with MMSE scores, P-tau-181, and Aβ1–42 levels in AD. T1WI-based hippocampal radiomics features are valuable for diagnosing AD and identifying AD-MCI and AD-D. [ABSTRACT FROM AUTHOR]

Thrombosis and plasma leakage are two of the most frequent dysfunctions of polypropylene (PP) hollow fiber membrane (PPM) used in extracorporeal membrane oxygenation (ECMO) therapy. In this study, a superhydrophilic endothelial membrane mimetic coating (SEMMC) was constructed on polydopamine-polyethyleneimine pre-coated surfaces of the PPM oxygenator and its ECMO circuit to explore safer and more sustainable ECMO strategy. The SEMMC is fabricated by multi-point anchoring of a phosphorylcholine and carboxyl side chained copolymer (PMPCC) and grafting of heparin (Hep) to form PMPCC-Hep interface, which endows the membrane superior hemocompatibility and anticoagulation performances. Furthermore, the modified PPM reduces protein adsorption amount to less than 30 ng/cm2. More significantly, the PMPCC-Hep coated ECMO system extends the anti-leakage and non-clotting oxygenation period to more than 15 h in anticoagulant-free animal extracorporeal circulation, much better than the bare and conventional Hep coated ECMO systems with severe clots and plasma leakage in 4 h and 8 h, respectively. This SEMMC strategy of grafting bioactive heparin onto bioinert zwitterionic copolymer interface has great potential in developing safer and longer anticoagulant-free ECMO systems. A superhydrophilic endothelial membrane mimetic coating was constructed on surfaces of polypropylene hollow fiber membrane (PPM) oxygenator and its ECMO circuit by multi-point anchoring of a phosphorylcholine and carboxyl side chain copolymer (PMPCC) and grafting of heparin (Hep). The strong antifouling nature of the PMPCC-Hep coating resists the adsorption of plasma bio-molecules, resulting in enhanced hemocompatibility and anti-leakage ability. The grafted heparin on the zwitterionic PMPCC interface exhibits superior anticoagulation property. More significantly, the PMPCC-Hep coating achieves an extracorporeal circulation in a pig model for at least 15 h without any systemic anticoagulant. This endothelial membrane mimetic anticoagulation strategy shows great potential for the development of safer and longer anticoagulant-free ECMO systems. [Display omitted] [ABSTRACT FROM AUTHOR]

Currently, the regulation of specific gut microbial metabolism for the development and/or treatment of hypertension remains largely unexplored. Here, we show that α-lipomycin, produced by Streptomyces aureofaciens (S. aureofaciens) Tü117, is upregulated in the serum of high-salt diet (HSD) mice and patients with essential hypertension. α-lipomycin causes vasodilation impairment involving transient receptor potential vanilloid 4 (TRPV4)-mediated nitric oxide and endothelium-derived hyperpolarizing factor pathways in mice. We also find that Lactobacillus plantarum (L. plantarum) CCFM639 attenuates the increase in blood pressure (BP) potentially through inhibiting the proliferation of S. aureofaciens Tü117 in mice. An exploratory intervention trial indicates that L. plantarum CCFM639 supplementation reduces BPs in subjects newly diagnosed with pre-hypertension or stage 1 hypertension without antihypertensive medication. Our findings provide evidence for a role of S. aureofaciens Tü117-associated α-lipomycin elevation in the pathogenesis of HSD-induced hypertension, highlighting that targeting gut bacteria serves as a new therapeutic intervention for hypertension. [Display omitted] • The serum α-lipomycin level and fecal mRNA level of LipReg4 are elevated in HSD mice • S. aureofaciens Tü117 increases the serum α-lipomycin concentration and BPs in mice • α-lipomycin impairs vasodilation and increases BPs relying on endothelial TRPV4 • L. plantarum CCFM639 reduces BPs involving inhibition against S. aureofaciens Tü117 Zhou et al. reveal that the S. aureofaciens Tü117-α-lipomycin axis is correlated with HSD and an increase in BPs. Mechanistically, α-lipomycin causes vasodilation impairment involving TRPV4 -mediated NO and EDHF pathways. Targeting S. aureofaciens Tü117 by L. plantarum CCFM639 might be a promising strategy for mild hypertension treatment. [ABSTRACT FROM AUTHOR]

There are currently no pediatric studies examining the effects of deep breathing on perioperative pain and anxiety. This study sought to determine the effect of short-term deep breathing exercises on perioperative anxiety and pain in pediatric patients and their parents. A randomized controlled trial was conducted in the Department of Orthopaedic Surgery where pediatric patients about to undergo surgery were allocated to a control group or a deep breathing group. In the intervention group, patients and their main guardian were guided to practice 10 minutes of deep breathing exercises twice a day for 3 to 4 days prior to surgery. Perioperative anxiety and pain were measured for both the children and parents as outcome indicators. Perioperative anxiety was measured using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) and state anxiety was measured using the State-Trait Anxiety Inventory (STAI). Patients reported their pain levels daily using the Wong-Baker FACES Pain Rating Scale. The following cutoffs were determined as high levels of anxiety: STAI (adult) > 44, STAI (child) > 36, and mYPAS-SF ≥ 30. No significant differences were found in the STAI, mYPAS-SF, and Wong-Baker FACES Pain Rating Scale scores of the patients between the intervention and control group. Overall statistics showed that parents had significantly higher postoperative state anxiety levels toward female children (44.93 ± 9.01) compared to male children (40.18 ± 9.89). Preoperative and postoperative parental state anxiety levels were correlated with the child's postoperative anxiety. Furthermore, children's postoperative state anxiety was slightly correlated with postoperative pain. Short-term use of our deep breathing exercises was ineffective in reducing incidences of perioperative pain and anxiety in pediatric orthopedic patients. A longer period of deep breathing administration may be required for the intervention to be effective. Parental anxiety may have an effect on anxiety levels in children, and postoperative parental anxiety may be affected by the gender of the child. [ABSTRACT FROM AUTHOR]

To investigate the influencing factors of intraoperative hypothermia (IOH) in patients undergoing total joint arthroplasty (TJA) of the lower extremities, establish a risk prediction model, and test the effect of application. A prospective, observational study was conducted. Patients who underwent total knee arthroplasty and total hip arthroplasty from June 2020 to December 2021 were prospectively analyzed. According to the occurrence of IOH, patients were divided into the IOH group (temperature less than 36 °C) and non-IOH group (temperature ≥36 °C). We collected demographic, anesthesia, and surgical data for both groups to identify risk factors for IOH and develop a predictive model. The model's goodness of fit was assessed using the Hosmer-Lemeshow test, and its predictive efficacy was evaluated using the receiver operating characteristic curve. A total of 258 patients were included in this study, with 79 patients in the IOH group and 179 patients in the non-IOH group. Logistic regression analysis showed that American Society of Anesthesiologists' grade, blood loss, and duration of surgery were independent risk factors for IOH in lower extremity TJA patients. Hosmer-Lemeshow test P =.803, area under receiver operating characteristic curve was 0.846, Youden index was 0.490, sensitivity was 65.4%, specificity was 83.6%. In the external validation cohort, the application accuracy of the model was 83.3%. The prediction model established in this study is suitable for the risk assessment of IOH in TJA patients with good prediction effect, which can provide a tool for clinical medical staff to identify high-risk populations preoperatively. [ABSTRACT FROM AUTHOR]

• Differential impact on root length and alveolar bone in surgical orthodontic patients. • Reduced root resorption with clear aligners. • Clear aligners increase labial bone loss. • Fixed appliances reduce palatal bone more. The retrospective study examined changes in the root length and alveolar bone surrounding maxillary incisors in patients with skeletal Class III malocclusion treated by surgical orthodontic treatment with either fixed appliances (FAs) or clear aligners (CAs). A total of 60 subjects were divided based on appliance type used. Cone beam computed tomography scans were taken at three stages: before treatment, after presurgical orthodontic treatment, and post-treatment for both groups. Vertical alveolar bone level and horizontal alveolar bone thickness (ABT) were measured at four heights (3, 6, and 9 mm from the cementoenamel junction, and the root apex), along with root length, at these time points. Both groups showed a decrease in root length, with the CA group experiencing a significantly smaller reduction (0.4 ± 0.79 mm) compared with the FA group (0.64 ± 0.8 mm; P = 0.02). The FA group demonstrated more significant reduction in palatal ABT (P < 0.05) and greater root resorption, whereas the CA group exhibited considerable labial marginal bone resorption (P = 0.007) and a notable decrease in labiolingual inclination (P = 0.042). The findings suggest that FA and CA might lead to decreased ABT and significant root resorption, with FA therapy likely resulting in more pronounced effects. Both modalities led to notable vertical bone loss, particularly, on the labial side of the maxillary incisors in the CA group during postsurgical orthodontic treatment. Preventing iatrogenic deterioration of periodontal support surrounding the incisors is crucial during presurgical and postsurgical phases. [ABSTRACT FROM AUTHOR]

The resolution of obstructive sleep apneas syndrome (OSAS) following bariatric surgery appears to be promising for the majority of patients although this resolution does not necessarily exhibit a linear correlation with weight loss. Previous small-scale studies have pinpointed a younger age and preoperative weight under 100kg as predictive factors of OSAS improvement The primary objective was to evaluate the evolution of OSAS in patients treated with continuous positive airway pressure (CPAP). Additionally, we tried to identify potential predictive factors for OSAS improvement postsurgery. Brest Hospital, France, University Hospital. In this retrospective, observational study we analyzed a cohort of 44 patients who underwent bariatric surgery, between January 2015 and December 2021. Each patient underwent respiratory polygraphy (RP) or polysomnography (PSG) before and after the surgical procedure. We collected CPAP data (including effective pressure and adherence) before and during the 6 months following the intervention. Within the study population, 68.18% of patients exhibited improved OSAS, as defined as an apnea-hypopnea index of less than 15 per hour. A higher mean oxygen saturation prior to surgery emerged as the sole predictive factor for OSAS improvement. CPAP adherence and therapeutic pressure value, 2 rarely studied parameters, did not show significant difference between improved and nonimproved patients. The rate of OSAS resolution after surgery is 68.18%, with only a higher mean oxygen saturation before surgery identified as a predictive factor for OSAS resolution. • Within the study population, 68.18% of patients exhibited improved obstructive sleep apneas syndrome (OSAS), as defined as an apnea-hypopnea index of less than 15 per hour. • A higher mean oxygen saturation prior to surgery emerged as the sole predictive factor for OSAS improvement. • Continuous positive airway pressure (CPAP) adherence and therapeutic pressure value, 2 rarely studied parameters, did not show significant difference between improved and nonimproved patients. • No significant linear correlation emerged between weight loss and the variation of apnea hypopnea index (AHI). [ABSTRACT FROM AUTHOR]

Short line segment toolpaths widely used in five-axis CNC machine tools has the defects of low-order continuity, the tangential and curvature discontinuities at the corners, which result in frequent fluctuation of feedrate, thus degrading the machining quality and efficiency. Therefore, smoothing interpolation of the path becomes significant. Although the local corner smoothing methods are relative mature, the global smoothing methods can hardly be fulfilled in real time, because either the replacing of line segments by global smooth curves or the scheduling of five-axis feedrate requires time-consuming iterative or pre-processed computing. To deal with above problem, this paper proposes a real-time global smoothing and interpolation method for five-axis short line segment toolpaths. This is realized by a G0-G1-C2 two layered fairing method, containing a G0-G1 outer-layer smoothing step and a G1-C2 inner-layer smoothing step. In the outer layer, a piecewise dual B-spline with globally G1 continuity is constructed for replacing the G0 continuous line-segment toolpath. Further, in the inner layer, a FIR (Finite Impulse Response) convolving algorithm is presented for generating C2-continuous axial trajectories with bounded acceleration and jerk, according to the G1 dual-spline path. Both of the two layers are lightweight in computation, which makes the proposed global smoothing method have strong real-time capability. Verification and comparison tests demonstrate that the proposed method performs similarly with existing off-line methods in smoothing results, but performs overwhelmingly in real-time capability, and its single-step computation calls for merely about 12 % of the total interpolation period. • Presents a G0-G1-C2 two layered fairing method for real-time global smoothing of five-axis toolpaths. • In the G0-G1 outer layer, G0 path is smoothed as a piecewise dual B-spline with globally G1 continuity. • In the G1-C2 inner layer, the G1 path is smoothed as a C1 trajectory by a FIR convolving algorithm. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome with diarrhea (IBS-D) is a common and chronic gastrointestinal disorder that is characterized by abdominal discomfort and occasional diarrhea. The pathogenesis of IBS-D is thought to be related to a combination of factors, including psychological stress, abnormal muscle contractions, and inflammation and disorder of the gut microbiome. However, there is still a lack of comprehensive analysis of the logical regulatory correlation among these factors. In this study, we found that stress induced hyperproduction of xanthine and altered the abundance and metabolic characteristics of Lactobacillus murinus in the gut. Lactobacillus murinus -derived spermidine suppressed the basal expression of type I interferon (IFN)-α in plasmacytoid dendritic cells by inhibiting the K63-linked polyubiquitination of TRAF3. The reduction in IFN-α unrestricted the contractile function of colonic smooth muscle cells, resulting in an increase in bowel movement. Our findings provided a theoretical basis for the pathological mechanism of, and new drug targets for, stress-exposed IBS-D. [Display omitted] • Stress-induced xanthine upregulation in CD4+ T cells drives IBS-D symptoms • IFN-α deficiency in plasmacytoid dendritic cells contributes to IBS-D • AdorA2B receptor inhibition attenuates stress-induced IBS-D responses • Lactobacillus murinus -derived spermidine directly triggers visceral hypersensitivity Zhang et al. revealed that stress triggers irritable bowel syndrome with diarrhea by raising systemic purine levels, which stimulates the proliferation of Lactobacillus in the gut and leads to spermidine accumulation. Spermidine inhibits the expression of IFN-α in plasmacytoid dendritic cells, ultimately impairing smooth muscle cell contraction and resulting in intestinal spasms. [ABSTRACT FROM AUTHOR]

Named after the Greek term for "hard fat", stearic acid has gradually entered people's field of vision. As an important component of various physiological cellular functions, stearic acid plays a regulatory role in diverse aspects of energy metabolism and signal transduction. Its applications range from serving as a bodily energy source to participating in endogenous biosynthesis. Similar to palmitate, stearic acid serves as a primary substrate for the stearoyl coenzyme A desaturase, which catalyzes the conversion of stearate to oleate and is involved in the synthesis of triglyceride and other complex lipids. Additionally, stearic acid functions as a vital signaling molecule in pathological processes such as cardiovascular diseases, diabetes development, liver injury and even nervous system disorders. Therefore, we conduct a comprehensive review of stearic acid, summarizing its role in various diseases and attempting to provide a systematic overview of its homeostasis, physiological functions, and pathological process. From a medical standpoint, we also explore potential applications and discuss stearic acid as a potential therapeutic target for the treatment of human diseases. [ABSTRACT FROM AUTHOR]

Salivary gland diseases encompass a broad range of conditions, including autoimmune, inflammatory, obstructive, and neoplastic disorders, significantly impacting oral health and overall well-being. Recent research has highlighted the crucial role of exosomes, small extracellular vesicles, in these diseases. Exosomes mediate intercellular communication by transferring bioactive molecules such as proteins, microRNAs, and lipids, positioning them as potential diagnostic biomarkers and therapeutic agents. In primary Sjögren's syndrome (pSS), exosomes derived from Epstein–Barr virus-infected B cells and activated T cells transfer key microRNAs that impair calcium signaling, contributing to glandular dysfunction. Exosome-based biomarkers like Ro/SSA and La/SSB, found in saliva, serum, and tears, offer non-invasive diagnostic tools for early disease detection. Furthermore, mesenchymal stem cell-derived exosomes show promise in treating pSS by modulating immune responses and promoting tissue repair. While exosomes hold promise for the diagnosis and treatment of other salivary gland diseases, such as radiation-induced xerostomia and sialolithiasis, their application remains limited, necessitating further research to unlock their full diagnostic and therapeutic potential. This review focuses on the role of exosomes in salivary gland diseases, with an emphasis on pSS, and highlights the need for future clinical applications and large-scale trials. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) can assist in medical diagnosis owing to its high accuracy and efficiency. This study aimed to develop a diagnostic system for automatically determining the degree of tooth wear (TW) using intraoral photographs with deep learning. The study included 388 intraoral photographs. A tooth segmentation model was first established using the Mask R-CNN architecture, which incorporated U-Net and SGE attention mechanisms. Subsequently, 2774 individual tooth images output from the segmentation model were included into the classification task, labeled and randomized into training, validation, and test sets with 6.0:2.0:2.0 ratio. A vision transformer model optimized using a mask mechanism was constructed for TW degree classification. The models were evaluated using the accuracy, precision, recall, and F1-score metrics. The time required for AI analysis was calculated. The accuracy of the tooth segmentation model was 0.95. The average accuracy, precision, recall, and F1-score in the classification task were 0.93, 0.91, 0.88, and 0.89, respectively. The F1-score differed in different grades (0.97 for grade 0, 0.90 for grade 1, 0.88 for grade 2, and 0.82 for grade 3). No significant difference was observed in the accuracy between different surfaces. The AI system reduced the time required to grade an individual tooth surface to 0.07 s, compared to the 2.67 s required by clinicians. The developed system provides superior accuracy and efficiency in determining TW degree using intraoral photographs. It might assist clinicians in the decision-making for TW treatment and help patients perform self-assessments and disease follow-ups. [ABSTRACT FROM AUTHOR]

We used computer-assisted image analysis to determine whether preexisting histological features of the cephalic vein influence the risk of non-maturation of wrist fistulas. This study focused on patients aged 20–80 years who underwent their first wrist fistula creation. A total of 206 patients participated, and vein samples for Masson's trichrome staining were collected from 134 patients. From these, 94 patients provided a complete girth of the venous specimen for automatic image analysis. Maturation was assessed using ultrasound within 90 days after surgery. The collagen to muscle ratio in the target vein, measured by computer-assisted imaging, was a strong predictor of non-maturation in wrist fistulas. Receiver operating characteristic analysis revealed an area under the curve of 0.864 (95% confidence interval of 0.782–0.946, p < 0.001). The optimal cut-off value for the ratio was 1.138, as determined by the Youden index maximum method, with a sensitivity of 89.0% and specificity of 71.4%. For easy application, we used a cutoff value of 1.0; the non-maturation rates for patients with ratios >1 and ≤ 1 were 51.7% (15 out of 29 patients) and 9.2% (6 out of 65 patients), respectively. Chi-square testing revealed significantly different non-maturation rates between the two groups (X 2 (1, N = 94) = 20.9, p < 0.01). Computer-assisted image interpretation can help to quantify the preexisting histological patterns of the cephalic vein, while the collagen-to-muscle ratio can predict non-maturation of wrist fistula development at an early stage. [ABSTRACT FROM AUTHOR]

To develop and test a radiomics nomogram based on magnetic resonance imaging (MRI) and clinicopathological factors for predicting the axillary pathologic complete response (apCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients with axillary lymph node (ALN) metastases. A total of 319 patients who underwent MRI examination and received NAC treatment were enrolled from two centers, and the presence of ALN metastasis was confirmed by biopsy pathology before NAC. The radiomics features were extracted from regions of interest of ALNs before (pre-radiomics) and after (post-radiomics) NAC. The difference of features before and after NAC, named delta radiomics, was calculated. The variance threshold, selectKbest and least absolute shrinkage and selection operator algorithm were used to select radiomics features. Radscore was calculated by a linear combination of selected features, weighted by their respective coefficients. The univariate and multivariate logistic regression was used to select the clinicopathological factors and radscores, and a radiomics nomogram was built by multivariable logistic regression analysis. The performance of the nomogram was evaluated by the area under the receiver operator characteristic curve (AUC), decision curve analysis (DCA) and calibration curves. Furthermore, to explore the biological basis of radiomics nomogram, 16 patients with RNA-sequence data were included for genetic analysis. The radiomics nomogram was constructed by two radscores (post- and delta- radscores) and one clinicopathological factor (progesterone hormone, PR), and showed powerful predictive performance in both internal and external test sets, with AUCs of 0.894 (95% confidence interval [CI], 0.877–0.959) and 0.903 (95% CI, 0.801–0.986), respectively. The calibration curves and DCA showed favorable consistency and clinical utility. With the assistance of nomogram, the rate of unnecessary ALND would be reduced from 60.42% to 21.88%, and the rate of final benefit rate would be increased from 39.58% to 70.83%. Moreover, genetic analysis revealed that high apCR prediction scores were associated with the upregulation of immune-mediated genes and pathways. The radiomics nomogram showed great performance in predicting apCR after NAC for breast cancer patients, which could help clinicians to identify patients with apCR and avoid unnecessary axillary lymph node dissection. [ABSTRACT FROM AUTHOR]

Deep learning can enhance the performance of multimodal image analysis, which is known for its noninvasive attributes and complementary efficacy, in predicting axillary lymph node (ALN) metastasis. Therefore, we established a multimodal deep learning model incorporating ultrasound (US) and magnetic resonance imaging (MRI) images to predict ALN metastasis in patients with breast cancer. A retrospective cohort of patients with histologically confirmed breast cancer from two hospitals composed of the primary cohort (n = 465) and the external validation cohort (n = 123). All patients had undergone both preoperative US and MRI scans. After data preprocessing, three convolutional neural network models were used to analyze the US and MRI images, respectively. After integrating the US and MRI deep learning prediction results (DL US and DL MRI , respectively), a multimodal deep learning (DL MRI+US +Clinical parameter) model was constructed. The predictive ability of the proposed model was compared to that of the DL US , DL MRI , combined bimodal (DL MRI+US), and clinical parameter models. Evaluation was performed using the area under the receiver operating characteristic curves (AUCs) and decision curves. A total of 588 patients with breast cancer participated in this study. The DL MRI+US +Clinical parameter model outperformed the alternative models, achieving the highest AUCs of 0.819 (95% confidence interval [CI] 0.734–0.903) and 0.809 (95% CI 0.723–0.895) on the internal and external validation sets, respectively. The decision curve analysis confirmed its clinical usefulness. The DL MRI+US ＋Clinical parameter model demonstrates the feasibility and reliability of its performance for ALN metastasis prediction in patients with breast cancer. [ABSTRACT FROM AUTHOR]

The tumor-tropic properties of mesenchymal stem cells (MSCs) enable them to serve as appealing cellular vehicles for delivering therapeutic agents to treat malignant glioma. However, the exact engraftment status of MSCs in glioma via different administration routes remains unclear due to the lack of quantitative analysis. This study aimed to quantify the engraftment of MSCs in glioma after administration via different routes using non-invasive dual-modality magnetic resonance imaging (MRI) and bioluminescence imaging (BLI). MSCs were transduced with a lentivirus overexpressing ferritin heavy chain (FTH) and firefly luciferase (FLUC) reporter genes to yield FTH- and FLUC-overexpressed MSCs (FTH-FLUC-MSCs). Wistar rats bearing intracranial C6 glioma received peritumoral, intratumoral, intra-arterial, and intravenous injection of FTH-FLUC-MSCs, respectively. MRI and BLI were performed to monitor FTH-FLUC-MSCs in vivo. FTH-FLUC-MSCs administered via peritumoral, intratumoral and intra-arterial routes migrated specially toward the intracranial glioma in vivo, as detected by MRI and BLI. As quantified by the BLI signal intensity, the percentages of FTH-FLUC-MSCs in the glioma were significantly higher with peritumoral injection (61%) and intratumoral injection (71%) compared to intra-arterial injection (30%) and intravenous injection (0%). Peritumorally injected FTH-FLUC-MSCs showed a gradual decline, with approximately 6% of FTH-FLUC-MSCs still retained within the tumor up to 11 days after injection. Meanwhile, the number of FTH-FLUC-MSCs injected via other routes dropped quickly, and none were detectable by day 11 post-injection. Peritumoral delivery of FTH-FLUC-MSCs offers robust engraftment and could be used as the optimal delivery route for treating malignant glioma. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate outcomes of the Denali inferior vena cava filter (Bard Peripheral Vascular, Tempe, Arizona). Five hundred patients had 508 filters placed between 2015 and 2022. Filters were retrieved at the study site in 284 patients: 159 (31.4%) filters were deemed permanent and 21 (4.1%) filters were retrieved at an outside hospital; 27 (5.3%) patients had outside-hospital follow-up without known retrieval and 17 (3.3%) patients were lost to follow-up. Initial retrieval at the study site was successful in 275 cases, while 7 cases had successful second retrieval attempts (99.3% overall success). Initial retrieval venogram showed clot in filter in 18 of 284 (6.3%) and an occluded cava in 12 of 284 (4.2%). Contrast-enhanced imaging was available in 79 patients without retrieval at study site: 7 of 79 (8.9%) had thrombus within the filter, 7 of 79 (8.9%) had caval thrombosis/occlusion/severe stenosis, and 1 of 75 (1.2%) had new nonocclusive caval thrombus. No filter fracture, clinically significant extravascular strut penetration, or migration was reported. [Display omitted] [ABSTRACT FROM AUTHOR]

[Display omitted] • HSPA12A expression was decreased during CF activation. • Ablation of HSPA12A in mice aggravated injury-induced cardiac fibrosis. • HSPA12A was required for suppressing CF activation, and this action of HSPA12A was achieved by inhibiting glycolysis via increasing p53 protein stability. • HSPA12A acted as a scaffolding protein to binding both p53 and USP10. • USP10 mediated the HSPA12A-increased p53 protein stability. Cardiac fibrosis is the main driver for adverse remodeling and progressive functional decline in nearly all types of heart disease including myocardial infarction (MI). The activation of cardiac fibroblasts (CF) into myofibroblasts is responsible for cardiac fibrosis. Unfortunately, no ideal approach for controlling CF activation currently exists. This study investigated the role of Heat shock protein A12A (HSPA12A), an atypical member of the HSP70 family, in CF activation and MI-induced cardiac fibrosis. Primary CF and Hspa12a knockout mice were used in the experiments. CF activation was indicated by the upregulation of myofibroblast characters including alpha-Smooth muscle actin (αSMA), Collagen, and Fibronectin. Cardiac fibrosis was illustrated by Masson's trichrome and picrosirius staining. Cardiac function was examined using echocardiography. Glycolytic activity was indicated by levels of extracellular lactate and the related protein expression. Protein stability was examined following cycloheximide and MG132 treatment. Protein-protein interaction was examined by immunoprecipitation-immunoblotting analysis. HSPA12A displayed a high expression level in quiescent CF but showed a decreased expression in activated CF, while ablation of HSPA12A in mice promoted CF activation and cardiac fibrosis following MI. HSPA12A overexpression inhibited the activation of primary CF through inhibiting glycolysis, while HSPA12A knockdown showed the opposite effects. Moreover, HSPA12A upregulated the protein expression of transcription factor p53, by which mediated the HSPA12A-induced inhibition of glycolysis and CF activation. Mechanistically, this action of HSPA12A was achieved by acting as a scaffolding protein to bind p53 and ubiquitin specific protease 10 (USP10), thereby promoting the USP10-mediated p53 protein stability and the p53-medicated glycolysis inhibition. The present study provided clear evidence that HSPA12A is a novel endogenous inhibitor of CF activation and cardiac fibrosis. Targeting HSPA12A in CF could represent a promising strategy for the management of cardiac fibrosis in patients. [ABSTRACT FROM AUTHOR]

The current work deals with the precipitation behaviors and mechanical properties of the high zinc content of the Mg-Zn-Cu system alloys using gravity casting. Differential scanning calorimetry (DSC) was conducted to describe the solidification process and precipitation behaviors. Thermodynamic calculations were carried out to determine the precipitation conditions using the Thermo-calc software. The microstructures were characterized by an optical microscope (OM), scanning electron microscope (SEM), electron probe micro analysis (EPMA), transmission electron microscopy (TEM), and confocal laser scanning microscope (CLSM). Tensile tests and micro-hardness tests were applied to investigate the mechanical properties. The results substantiated that the MgZnCu phase precipitates in Cu-containing alloys and that the precipitate content, as well as the precipitate temperature, increased with the Cu content from 0 to 3 wt.% according to the thermodynamic calculations and the DSC results. The measured micro-hardness of the alloy was 53.2, 57.9, 55.8, and 52.5 VHN, respectively. The ultimate tensile strength (UTS), yield strength (YS), and elongation (EL) revealed a λ-like trend of the alloys, and Mg-7Zn-1Cu alloy exhibits the optimum tensile properties with the UTS of 258.9 MPa, YS of 126.2 MPa, and the EL of 14.2%. [ABSTRACT FROM AUTHOR]

[Display omitted] • WGS from 1496 Taiwanese has been reanalyzed with benchmarked quality scores. • Taiwanese genomic profiles for SNV, indel, CYP/HLA allele and copy number variant. • Variant annotation can be accessed at TaiwanGenomes (https://genomes.tw) database. • 16.5 million variants were found with an average 6,871 novel variants per sample. • 75.3% and 1.67% had at least one PGx allele and actionable variant, respectively. The population of Taiwan has a long history of ethno-cultural evolution. The Taiwanese population was isolated from other large populations such as the European, Han Chinese, and Japanese population. The Taiwan Biobank (TWB) project has built a nationwide database, particularly for personal whole-genome sequence (WGS) to facilitate basic and clinical collaboration nationally and internationally, making it one of the most valuable public datasets of the East Asian population. This study provides comprehensive medical genomic findings from TWB WGS data, for better characterization of disease susceptibility and the choice of ideal treatment regimens in Taiwanese population. We reanalyzed 1496 WGS using a PrecisionFDA Truth challenge winner method Sentieon DNAscope. Single nucleotide variants (SNV) and small insertions/deletions (INDEL) were benchmarked. We also analyzed pharmacogenomic (PGx) drug-associated alleles, and copy number variants (CNV). Multiple practicing clinicians reviewed and curated the clinically significant variants. Variant annotations can be browsed at TaiwanGenomes (https://genomes.tw). We found that each participant had an average of 6,870.7 globally novel variants and 75.3% (831/1103) of the participants harbored at least one PharmGKB-selected high evidence level human leukocyte antigen (HLA) risk allele. 54 PharmGKB-reported high-level instances of evidence of Cytochrome P450 variant-drug pairs, with a population frequency of over 13.2%. We also identified 23 variants in the ACMG secondary finding V3 gene list from 25 participants, suggesting that 1.67% (25/1496) of the population is harboring at least one medical actionable variant. Our carrier status analyses suggest that one in 25 couples (3.94%) would risk having offspring with at least one pathogenic variant, which is in line with rates found in Japan and Singapore. For pathogenic CNV, we detected 6.88% and 2.02% carrier rates for alpha thalassemia and spinal muscular atrophy, respectively. Our study highlights the overall medical insights of a complete Taiwanese genomic profile. [ABSTRACT FROM AUTHOR]

[Display omitted] • Concentrated starter readily results in rumen epithelial parakeratosis. • ScRNA-seq elucidates rumen epithelial heterogeneity and developmental trajectories. • Developmental impediments in the transition from differentiated keratinocytes to terminally differentiated keratinocytes lead to parakeratosis. • The first well-established rumen epithelial organoid model can mimic the keratinization process of rumen tissue in vitro. • High dose butyrate contributes to rumen epithelial parakeratosis. Rumen epithelial parakeratosis, a common disease in ruminants caused by abnormalities in the ruminal stratified squamous epithelial keratinization process, negatively impacts ruminant health and performance. However, we still lack a comprehensive perception of the underlying mechanisms and the predisposing factors for this disorder. Here, we investigated rumen epithelial cell heterogeneity, differentiation trajectories, and cornification to clarify the rumen epithelial keratinization process and discern the key ruminal metabolites contributing to rumen epithelial parakeratosis. Twenty-four 14-day-old lambs were divided into three groups, including only milk feeding, milk plus alfalfa hay feeding, and milk plus corn-soybean concentrate starter feeding. At 42 days of age, the lambs were slaughtered, and rumen tissues were collected for single-cell RNA-sequencing (scRNA-seq), immunofluorescence, and quantitative real-time PCR (qRT-PCR) analyses. Ruminal fluid samples were collected for metabolomic analyses. Rumen epithelial organoid was used to verify the key ruminal metabolites contributing to parakeratosis. As expected, we observed that concentrate starter introduction resulted in rumen epithelial parakeratosis. Moreover, scRNA-seq analysis revealed a developmental impediment in the transition from differentiated keratinocytes to terminally differentiated keratinocytes (TDK) in lambs with concentrate starter introduction. Immunofluorescence and qRT-PCR analyses further verified the location and expression of marker genes of TDK. Metabolomic analysis showed a robust positive correlation between ruminal butyrate levels and rumen epithelial keratinization. More importantly, we successfully established a rumen organoid model capable of facilitating the study of the keratinization process in the rumen epithelia and further confirmed that high dose butyrate indeed contributed to rumen epithelial parakeratosis. Collectively, concentrate starter introduction induces ruminal epithelial parakeratosis by blocking keratinocyte differentiation with excessive ruminal butyrate accumulation in a neonatal lamb model. These findings enhance our understanding of rumen epithelial keratinization and provide valuable insights for addressing rumen epithelial parakeratosis using early nutritional intervention strategies. [ABSTRACT FROM AUTHOR]

Secondary unilateral cleft lip nasal deformity is a prevalent condition in the world, and surgical repair remains a formidable challenge. The objective of the study is to investigate functionally and aesthetically outcomes of a new technique using a complex of autologous costal cartilage and fascia grafts to repair the secondary unilateral cleft lip nasal deformity. First, the autologous costal cartilage and fascia were harvested from a total of 34 patients with secondary unilateral cleft lip nasal deformity, who were undergoing treatments at the First Affiliated Hospital of Xi'an Jiaotong University from April 2020 to June 2023. Then, the cartilage was sub-divided into 6 pieces and placed on the depressed alar base, nasal columella, lower lateral cartilage, and nasal tip. At the same time, the fascia was trimmed to cover the nasal tip cap graft and augment the dorsum of the nose. Patient outcomes were assessed through subjective evaluation and objective anthropometric measurements. In addition, associated complications were also examined. All were primary healing incisions, and no patients were encountered with any clinical complications. We found that the overall mean score of the Independent Rhinoplasty Outcome Score (IROS) was very good during the subjective assessment. Also, the objective measurements indicated an excellent nasal symmetry. Furthermore, both functionally and aesthetically satisfactory outcomes were obtained in all the patients during long-time follow-up. Secondary rhinoplasty using the complex of autologous costal cartilage and fascia grafts is a safe and effective approach for unilateral cleft lip nasal deformity repair. [ABSTRACT FROM AUTHOR]

Alpha-s1 casein hydrolysate (ACH; Lactium®) is recognized as a supplementary treatment to enhance sleep quality. However, limited studies utilizing objective sleep assessment tools have resulted in a lack of substantial validation. This study aimed to assess the effects of ACH on both subjective sleep assessments and objective polysomnography (PSG) recordings in a hospital-based cohort of Taiwanese individuals with chronic insomnia. In this 4-week randomized, double-blind, placebo-controlled trial, 36 participants diagnosed with chronic insomnia were enrolled and randomly assigned to either the ACH or placebo groups. Initially, participants in the ACH group received 600 mg of ACH daily, which was reduced to 300 mg for the latter two weeks; the placebo group received maltodextrin capsules throughout the study. The study utilized polysomnography (PSG), along with detailed sleep questionnaires including the Insomnia Severity Index (ISI), Global Sleep Disorders Score (GSDS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS), to assess improvements in sleep quality and related health markers. The efficacy of the intervention was assessed through measures of sleep efficiency, stage distribution, and psychological well-being, comparing results from before to after the treatment phase. The study demonstrated that ACH treatment notably enhanced sleep quality, evidenced by significant improvements in ISI, GSDS, PSQI, ESS, and HADS scores at both week 2 and 4 (all p-values <0.05) compared with baseline scores. When compared to the placebo group, the ACH group experienced a marked reduction in GSDS scores over time (p = 0.045). Furthermore, PSG data revealed a significant decrease in sleep onset latency from baseline in the ACH group compared to the placebo group (p = 0.012; −7.7 ± 16.0 min vs. 6.1 ± 17.7 min for ACH and placebo groups, respectively). These results indicate that ACH treatment effectively improved sleep initiation and overall sleep quality. ACH Supplementation significantly improved sleep quality, particularly by reducing GSDS scores and sleep onset latency, demonstrating its potential as an effective intervention for chronic insomnia. Future studies with larger samples and exploration of long-term effects are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Perineural invasion (PNI) is an important prognostic biomarker for prostate cancer (PCa). This study aimed to develop and validate a predictive model integrating biparametric MRI-based deep learning radiomics and clinical characteristics for the non-invasive prediction of PNI in patients with PCa. In this prospective study, 557 PCa patients who underwent preoperative MRI and radical prostatectomy were recruited and randomly divided into the training and the validation cohorts at a ratio of 7:3. Clinical model for predicting PNI was constructed by univariate and multivariate regression analyses on various clinical indicators, followed by logistic regression. Radiomics and deep learning methods were used to develop different MRI-based radiomics and deep learning models. Subsequently, the clinical, radiomics, and deep learning signatures were combined to develop the integrated deep learning-radiomics-clinical model (DLRC). The performance of the models was assessed by plotting the receiver operating characteristic (ROC) curves and precision–recall (PR) curves, as well as calculating the area under the ROC and PR curves (ROC-AUC and PR-AUC). The calibration curve and decision curve were used to evaluate the model's goodness of fit and clinical benefit. The DLRC model demonstrated the highest performance in both the training and the validation cohorts, with ROC-AUCs of 0.914 and 0.848, respectively, and PR-AUCs of 0.948 and 0.926, respectively. The DLRC model showed good calibration and clinical benefit in both cohorts. The DLRC model, which integrated clinical, radiomics, and deep learning signatures, can serve as a robust tool for predicting PNI in patients with PCa, thus aiding in developing effective treatment strategies. [ABSTRACT FROM AUTHOR]

The expression levels of hypoxia-inducible factor 1 alpha (HIF-1α) have been identified as a pivotal marker, correlating with treatment response in patients with locally advanced rectal cancer (LARC). This study aimed to develop and validate a nomogram based on dynamic contrast-enhanced MRI (DCE-MRI) radiomics and clinical features for predicting the expression of HIF-1α in patients with LARC. A total of 102 patients diagnosed with locally advanced rectal cancer were divided into training (n = 71) and validation (n = 31) cohorts. The expression statuses of HIF-1α were histopathologically classified, categorizing patients into high and low expression groups. The intraclass correlation coefficient (ICC), minimum redundancy maximum relevance (mRMR), and the least absolute shrinkage and selection operator (LASSO) were employed for feature selection to construct a radiomics signature and calculate the radiomics score (Rad-score). Univariate and multivariate analyses of clinical features and Rad-score were applied, and the clinical model and the nomogram were constructed. The predictive performance of the nomogram incorporating clinical features and Rad-score was assessed using Receiver Operating Characteristics (ROC) curves, decision curve analysis (DCA), and calibration curves. Seven radiomics features from DCE-MRI were used to build the radiomics signature. The nomogram incorporating CEA, Ki-67 and Rad-score had the highest AUC values in the training cohort and in the validation cohort (AUC: 0.918 and 0.920). Decision curve analysis showed that the nomogram outperformed the clinical model and radiomics signature in terms of clinical utility. In addition, the calibration curve for the nomogram demonstrated good agreement between prediction and actual observation. The nomogram based on DCE-MRI radiomics and clinical features showed favorable predictive efficacy and might be useful for preoperatively discriminating the expression of HIF-1α. [ABSTRACT FROM AUTHOR]

Lymphovascular invasion (LVI) plays a significant role in precise treatments of non-small cell lung cancer (NSCLC). This study aims to build a non-invasive LVI prediction diagnosis model by combining preoperative CT images with deep learning technology. This retrospective observational study included a series of consecutive patients who underwent surgical resection for non-small cell lung cancer (NSCLC) and received pathologically confirmed diagnoses. The cohort was randomly divided into a training group comprising 70 % of the patients and a validation group comprising the remaining 30 %. Four distinct deep convolutional neural network (DCNN) prediction models were developed, incorporating different combination of two-dimensional (2D) and three-dimensional (3D) CT imaging features as well as clinical-radiological data. The predictive capabilities of the models were evaluated by receiver operating characteristic curves (AUC) values and confusion matrices. The Delong test was utilized to compare the predictive performance among the different models. A total of 3034 patients with NSCLC were recruited in this study including 106 LVI+ patients. In the validation cohort, the Dual-head Res2Net_3D23F model achieved the highest AUC of 0.869, closely followed by the models of Dual-head Res2Net_3D3F (AUC, 0.868), Dual-head Res2Net_3D (AUC, 0.867), and EfficientNet-B0_2D (AUC, 0.857). There was no significant difference observed in the performance of the EfficientNet-B0_2D model when compared to the Dual-head Res2Net_3D3F and Dual-head Res2Net_3D23F. Findings of this study suggest that utilizing deep convolutional neural network is a feasible approach for predicting pathological LVI in patients with NSCLC. [ABSTRACT FROM AUTHOR]

The causes of symptoms in patients with paroxysmal atrial fibrillation (AF) remains unclear. The purpose of this study was to correlate the magnitudes of skin sympathetic nerve activity (SKNA) with symptoms in patients with AF. We prospectively enrolled patients with symptomatic paroxysmal AF for ambulatory electrocardiography and SKNA recording. Heart rhythms at the time of symptoms were categorized as AF or normal sinus rhythm (NSR). Maximal and average skin sympathetic nerve activity (aSKNA) and heart rate (HR) were compared between symptomatic and asymptomatic AF and NSR episodes using mixed effects models to account for within-patient correlations. Among the 31 enrolled patients, 16 (52%) had at least 1 episode of AF, and 24 (77%) endorsed symptoms during the monitoring period. Compared with asymptomatic AF episodes, symptomatic AF episodes had higher maximal aSKNA (1.260 [interquartile range (IQR) 1.114–1.723] μV vs 1.108 [IQR 0.974–1.312] μV; P <0.001) and higher maximal HR (152 ± 24 bpm vs 132 ± 19 bpm; P <.001). Symptomatic NSR episodes were associated with higher maximal aSKNA (1.612 [IQR 1.287–2.027] μV vs 1.332 [IQR 1.033–1.668] μV; P =.001) and higher maximal HR (152 ± 24 bpm vs 105 ± 16 bpm; P <.001) than asymptomatic NSR episodes. Of the symptomatic episodes, 66 (73%) occurred during NSR and 24 (27%) during AF. All P values were obtained from mixed effects models. Symptomatic episodes in patients with paroxysmal AF were more frequently associated with NSR than AF. Symptomatic AF and NSR episodes were associated with higher aSKNA than asymptomatic episodes. In patients with paroxysmal AF, symptoms correlate better with SKNA than heart rhythm. [ABSTRACT FROM AUTHOR]

To evaluate the performance of convolutional neural networks (CNNs) for the automated detection and classification of mandibular fractures on multislice spiral computed tomography (MSCT). MSCT data from 361 patients with mandibular fractures were retrospectively collected. Two experienced maxillofacial surgeons annotated the images as ground truth. Fractures were detected utilizing the following models: YOLOv3, YOLOv4, Faster R-CNN, CenterNet, and YOLOv5-TRS. Fracture sites were classified by the following models: AlexNet, GoogLeNet, ResNet50, original DenseNet-121, and modified DenseNet-121. The performance was evaluated for accuracy, sensitivity, specificity, and area under the curve (AUC). AUC values were compared using the Z -test and P values <.05 were considered to be statistically significant. Of all of the detection models, YOLOv5-TRS obtained the greatest mean accuracy (96.68%). Among all of the fracture subregions, body fractures were the most reliably detected (with accuracies of 88.59%-99.01%). For classification models, the AUCs for body fractures were higher than those of condyle and angle fractures, and they were all above 0.75, with the highest AUC at 0.903. Modified DenseNet-121 had the best overall classification performance with a mean AUC of 0.814. The modified CNN-based models demonstrated high reliability for the diagnosis of mandibular fractures on MSCT. [ABSTRACT FROM AUTHOR]

Nursing care activities conducted at night tend to disturb their sleep, but to our knowledge, no nocturnal care protocols for pressure injury prevention have been established. This scoping review aimed to map the nocturnal care for pressure injury prevention and propose nocturnal care recommendations that have a reduced impact on the patient's care environment. Literature databases were searched and two independent researchers screened the articles according to the inclusion criteria and extracted the data. The inclusion criteria were original articles/case studies, studies involving human subjects, and studies on nocturnal care for the prevention of pressure injuries. Eight met the inclusion criteria, three studies focused on bedding and five on care activities. Parasympathetic activity was more likely to be maintained or enhanced when an automatic repositioning function was used. Additionally, the time to sleep resumption was significantly shorter when repositioning was performed during deep sleep than during shallow sleep. Significantly fewer awakenings in response to light or sound occurred when incontinence care was provided to awake patients than when it was performed regularly. Moreover, some studies have highlighted the usefulness of the small change method and the 30° side-lying position for repositioning. Using a mattress with an automated turning function, providing care during wakefulness or deep sleep, and using repositioning methods with small positional changes may be effective in reducing the impact on patient's care environment. Further research is needed to determine nocturnal care for pressure injury prevention with less impact on the patient's care environment. • This review summarizes research on nocturnal care for pressure injury prevention. • An automated turning function is likely not to disturb the patient's sleep. • Providing care during wakefulness or deep sleep may reduce the impact of care activities at night. • Repositioning methods with small positional changes may help reduce the number of awakenings. • Few studies have evaluated both the effectiveness of care and its impact on patients. [ABSTRACT FROM AUTHOR]

to develop a deep learning radiomics graph network (DLRN) that integrates deep learning features extracted from gray scale ultrasonography, radiomics features and clinical features, for distinguishing parotid pleomorphic adenoma (PA) from adenolymphoma (AL) A total of 287 patients (162 in training cohort, 70 in internal validation cohort and 55 in external validation cohort) from two centers with histologically confirmed PA or AL were enrolled. Deep transfer learning features and radiomics features extracted from gray scale ultrasound images were input to machine learning classifiers including logistic regression (LR), support vector machines (SVM), KNN, RandomForest (RF), ExtraTrees, XGBoost, LightGBM, and MLP to construct deep transfer learning radiomics (DTL) models and Rad models respectively. Deep learning radiomics (DLR) models were constructed by integrating the two features and DLR signatures were generated. Clinical features were further combined with the signatures to develop a DLRN model. The performance of these models was evaluated using receiver operating characteristic (ROC) curve analysis, calibration, decision curve analysis (DCA), and the Hosmer-Lemeshow test. In the internal validation cohort and external validation cohort, comparing to Clinic (AUC=0.767 and 0.777), Rad (AUC=0.841 and 0.748), DTL (AUC=0.740 and 0.825) and DLR (AUC=0.863 and 0.859), the DLRN model showed greatest discriminatory ability (AUC=0.908 and 0.908) showed optimal discriminatory ability. The DLRN model built based on gray scale ultrasonography significantly improved the diagnostic performance for benign salivary gland tumors. It can provide clinicians with a non-invasive and accurate diagnostic approach, which holds important clinical significance and value. Ensemble of multiple models helped alleviate overfitting on the small dataset compared to using Resnet50 alone. [ABSTRACT FROM AUTHOR]

Percutaneous lung tumor ablations are mostly performed in computed tomography (CT) rooms under local anesthesia with conscious sedation. However, maintaining the breath-hold phase during this can be challenging, affecting image quality and increasing complications. With the advent of hybrid operating rooms (HORs), this procedure can be performed with endotracheal tube (ETGA) intubation under general anesthesia with lung separation, ensuring precise imaging in a single-stage setting. Lung separation provides surgical exposure of one lung while ensuring ample gas exchange with the other. This study evaluated tumor ablations performed in an HOR equipped with cone beam CT and laser guidance. This retrospective study included patients who underwent lung tumor ablation under general anesthesia with an ETGA in an HOR between July 2020 and May 2023. Anesthesia considerations, perioperative management, and postoperative follow-ups were evaluated. 65 patients (78 tumors) underwent ablation using two types of lung ventilation methods including a single-lumen tube with a blocker (SLT/BL) (n = 15) and double-lumen tube (DLT) (n = 50). Most patients experienced desaturation during the apnea phase of dynamic CT and needling. The average SpO 2 value was significantly lower in the DLT group than in the SLT/BL group during the procedure (81.1% versus 88.7%, P = 0.033). Five, three, and two patients developed pneumothorax, subcutaneous emphysema, and pleural effusion, respectively. Percutaneous ablation under general anesthesia with endotracheal intubation and lung separation performed in HORs was feasible and safe. The setup minimized complication risks and maintained a balance between patient safety and successful procedures. [ABSTRACT FROM AUTHOR]

Prior studies have described risk factors associated with amputation in patients with concomitant diabetes and peripheral arterial disease (DM/PAD). However, the association between the severity and extent of tissue loss type and amputation risk remains less well-described. We aimed to quantify the role of different tissue loss types in amputation risk among patients with DM/PAD, in the context of demographic, preventive, and socioeconomic factors. Applying International Classification of Diseases (ICD)-9 and ICD-10 codes to Medicare claims data (2007-2019), we identified all patients with continuous fee-for-service Medicare coverage diagnosed with DM/PAD. Eight tissue loss categories were established using ICD-9 and ICD-10 diagnosis codes, ranging from lymphadenitis (least severe) to gangrene (most severe). We created a Cox proportional hazards model to quantify associations between tissue loss type and 1- and 5-year amputation risk, adjusting for age, race/ethnicity, sex, rurality, income, comorbidities, and preventive factors. Regional variation in DM/PAD rates and risk-adjusted amputation rates was examined at the hospital referral region level. We identified 12,257,174 patients with DM/PAD (48% male, 76% White, 10% prior myocardial infarction, 30% chronic kidney disease). Although 2.2 million patients (18%) had some form of tissue loss, 10.0 million patients (82%) did not. The 1-year crude amputation rate (major and minor) was 6.4% in patients with tissue loss, and 0.4% in patients without tissue loss. Among patients with tissue loss, the 1-year any amputation rate varied from 0.89% for patients with lymphadenitis to 26% for patients with gangrene. The 1-year amputation risk varied from two-fold for patients with lymphadenitis (adjusted hazard ratio, 1.96; 95% confidence interval, 1.43-2.69) to 29-fold for patients with gangrene (adjusted hazard ratio, 28.7; 95% confidence interval, 28.1-29.3), compared with patients without tissue loss. No other demographic variable including age, sex, race, or region incurred a hazard ratio for 1- or 5-year amputation risk higher than the least severe tissue loss category. Results were similar across minor and major amputation, and 1- and 5-year amputation outcomes. At a regional level, higher DM/PAD rates were inversely correlated with risk-adjusted 5-year amputation rates (R2 = 0.43). Among 12 million patients with DM/PAD, the most significant predictor of amputation was the presence and extent of tissue loss, with an association greater in effect size than any other factor studied. Tissue loss could be used in awareness campaigns as a simple marker of high-risk patients. Patients with any type of tissue loss require expedited wound care, revascularization as appropriate, and infection management to avoid amputation. Establishing systems of care to provide these interventions in regions with high amputation rates may prove beneficial for these populations. [ABSTRACT FROM AUTHOR]

The periodontal ligament (PDL) is a unique fibrous connective tissue that regulates periodontal homeostasis mechanisms. Its biomechanical properties primarily reside in the hierarchical and non-uniform collagenous network. This study aimed to investigate the region-specific structure and composition of collagen fibers in the PDL at various scales and to explore their relationship with mechanical properties in a split-mouth design. Fresh human cadaver transverse PDL specimens of maxillary anterior teeth were categorized into cervical, middle, and apical groups. These specimens were analyzed via Masson's trichrome staining, scanning electron microscopy, picrosirius red (PSR) staining, three-dimensional (3D) reconstruction, Raman spectroscopy, and uniaxial tensile test. Statistical analyses were performed to compare the structural, compositional, and tensile properties among the groups. Notably, the middle PDL samples exhibited superior tensile strength and higher fiber area fraction than the other two transverse sections. Despite a higher mineral-to-matrix ratio and a different collagen secondary structure, the apical PDL demonstrated a relatively weaker tensile strength, possibly associated with its discovered sparser collagen fiber areal fraction. The cervical region, characterized by a mediocre fiber areal fraction, displayed diminished tensile strength. The 3D reconstructed collagenous network model and PSR staining exposed the fiber interaction and the micropores. Microscale porosity and variations in collagen secondary structure, particularly in the apical region, suggest adaptive mechanisms for accommodating compressive forces and maintaining functional integrity. Variance in the tensile properties of samples in different force directions indicated the significant influence of fiber orientation and root level on tissue mechanics. This study provides critical insights into the biomechanical and structural properties of the human periodontal ligament (PDL), particularly focusing on the underexplored anterior teeth. Through advanced techniques like SEM, histological staining, 3D reconstruction, Raman spectroscopy, and tensile testing, we reveal significant regional variations in PDL collagen organization, composition, and biomechanical properties. Our findings address a crucial knowledge gap concerning the material mechanics of the PDL, offering a foundational understanding for future periodontal tissue engineering and biomimetic material development. This multi-scale analysis underscores the importance of both mesoscale structural characteristics and nanoscale molecular structures in maintaining PDL mechanical integrity. [Display omitted] [ABSTRACT FROM AUTHOR]

Probiotic supplementation has a positive effect on endurance exercise performance and body composition in athletes, but the underlying mechanisms remain unclear. Gut microbiota can provide measurable markers of immune function in athletes, and microbial composition analysis may be sensitive enough to detect stress and metabolic disorders caused by exercise. Nineteen healthy active amateur marathon runners (15 male and 4 female) with a mean age of 29.11 years volunteered to participate in this double-blind controlled study. Based on the performance of the Cooper 12-min running test (CRT), the participants were allocated into two groups to receive either a probiotic formulation comprising lactobacillus acidophilus and bifidobacterium longum (n = 10) or placebo containing maltodextrin (n = 9) for five weeks. Consistency of diet and exercise was ensured throughout the experimental period. Before and after the intervention, all participants were assessed for CRT, emotional stability and gastrointestinal symptoms, gut microbiota composition, body composition and magnetic resonance imaging (MRI) indicators of skeletal muscle microcirculation. Compared to before the intervention, the probiotics group showed an increase in CRT score (2.88 ± 0.57 vs 3.01 ± 0.60 km, P ＜0.05), significant improvement in GSRS and GIQLI (9.20 ± 4.64 vs 7.40 ± 3.24, 118.90 ± 12.30 vs 127.50 ± 9.85, P ＜0.05), while these indicators remained unchanged in the control group, with a significant time-group interaction effect on gastrointestinal symptoms. Additionally, some MRI metabolic cycling indicators of the thigh skeletal muscle also changed in the probiotics group (P ＜0.05). Regarding microbiota abundance, the probiotics group exhibited a significant increase in the abundance of beneficial bacteria and a significant decrease in the abundance of harmful bacteria post-intervention (P ＜0.05). As a sports nutritional supplement, probiotics have the potential to improve athletic performance by optimizing the balance of gut microbiota, alleviating gastrointestinal symptoms. [ABSTRACT FROM AUTHOR]

This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region (Xinjiang) and thus provide a theoretical basis and data support for improving the health of residents in this region. We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016. The normalized difference vegetation index (NDVI) was used to estimate residential greenness. The generalized linear mixed model (GLMM) was used to examine the association between residential greenness and cardiometabolic risk factors. Higher residential greenness was associated with lower cardiometabolic risk factor prevalence. After adjustments were made for age, sex, education, and marital status, for each interquartile range (IQR) increase of NDVI 500-m , the risk of hypertension was reduced by 10.3% (OR = 0.897, 95% CI = 0.836–0.962), the risk of obesity by 20.5% (OR = 0.795, 95% CI = 0.695–0.910), the risk of type 2 diabetes by 15.1% (OR = 0.849, 95% CI = 0.740–0.974), and the risk of dyslipidemia by 10.5% (OR = 0.895, 95% CI = 0.825–0.971). Risk factor aggregation was reduced by 20.4% (OR = 0.796, 95% CI = 0.716–0.885) for the same. Stratified analysis showed that NDVI 500-m was associated more strongly with hypertension, dyslipidemia, and risk factor aggregation among male participants. The association of NDVI 500-m with type 2 diabetes was stronger among participants with a higher education level. PM 10 and physical activity mediated 1.9%–9.2% of the associations between NDVI 500-m and obesity, dyslipidemia, and risk factor aggregation. Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang. Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aimed to evaluate the effect of foam rolling (FR) on exercise-induced muscle soreness. PubMed, EMBASE, Web of Science, ProQuest, Cochrane Library and China National Knowledge databases were searched to identify randomized controlled trials (RCTs) of the effect of FR intervening muscle soreness after exercise, from their inception to August 2022. The outcome indicators were visual analogue scale (VAS) and pressure-pain threshold (PPT). A total of 16 studies were included, involving 515 subjects. Meta-analysis results show that FR has a certain effect of elimination of muscle soreness after exercise. The standard mean deviation (SMD) and 95% confidence interval (95%CI) of VAS and PPT immediately after intervention, 24, 48 and 72 h: [SMD = −0.38, 95%CI (−0.61, −0.15), P = 0.001], [SMD = −0.53, 95%CI (−0.82, −0.25), P = 0.0003], [SMD = −0.77, 95%CI (−1.12, −0.42), P < 0.00001], [SMD = −0.67, 95%CI (−1.09, −0.24), P = 0.002], [SMD = 0.23, 95%CI (0.62, 0.16), P = 0.25], [SMD = 0.48, 95%CI (0.11, 1.07), P = 0.11], [SMD = 0.39, 95%CI (−0.24, 1.02), P = 0.22], [SMD = 0.37, 95%CI (0.01, 0.74), P = 0.04]. Using foam rolling after exercise has a certain preventive effect on muscle soreness. Our study found that the effect of intervention of FR immediately is tiny after exercise, while the effective of intervening is relative obvious above 24 h. PROSPERO (registration number: CRD42021250174) • Be similar to VAS, PPT has strong sensitivity to changes in muscle soreness. • Foam rolling had small and moderate intervention effects on muscle soreness. • Foam rolling can be used as a muscle relaxation tool after high-intensity exercise. [ABSTRACT FROM AUTHOR]

Purinergic signaling plays a causal role in the modulation of immune inflammatory response in the course of psoriasis, but its regulatory mechanism remains unclear. As a member of purinoceptors, P2Y 6 R mainly distributed in macrophages was significantly up-expressed in skin lesions from patients with psoriasis in the present study. Here, the severity of psoriasis was alleviated in imiquimod-treated mice with macrophages conditional knockout of P2Y 6 R, while the cell-chat algorithm showed there was a correlation between macrophage P2Y 6 R and Th1 cells mediated by IL-27. Mechanistically, P2Y 6 R enhanced PLC β /p-PKC/MAPK activation to induce IL-27 release dependently, which subsequently regulated the differentiation of Th1 cells, leading to erythematous and scaly plaques of psoriasis. Interestingly, we developed a novel P2Y 6 R inhibitor FS-6, which bonds with the ARG266 side chain of P2Y 6 R, exhibited remarkable anti-psoriasis effects targeting P2Y 6 R. Our study provides insights into the role of P2Y 6 R in the pathogenesis of psoriasis and suggests its potential as a target for the development of therapeutic interventions. A novel P2Y 6 R inhibitor FS-6 could be developed as an anti-psoriasis drug candidate for the clinic. Macrophage P2Y 6 R enhances release of IL-27 to mediate Th1 cell differentiation in the pathogenesis of psoriasis via PLC β /p-PKC/MAPK signaling, which could be reversed by a novel P2Y 6 R inhibitor FS-6. [Display omitted] [ABSTRACT FROM AUTHOR]

To summarize and systematically analyze the efficacy of laser acupuncture (LA) interventions in reducing pain scores in patients suffering from chronic low back pain (LBP). PubMed, EMBASE, and Scopus databases were searched for randomized controlled trials, published in peer-reviewed journals, and reporting LA interventions in patients with chronic LBP. All included studies had a comparison group of patients, receiving placebo treatment, sham intervention, conventional therapy, or no treatment. The outcome of interest was the pain intensity score. Pooled effect estimates were calculated using random-effects models and reported as weighted mean difference (WMD) with 95% confidence intervals (CI). A total of 20 studies were included. Compared to the control group, patients who underwent LA experienced a significant reduction in reported pain scores immediately after completing the treatment (WMD –1.14, 95% CI: –1.68 to –0.61). High dose of LA was associated with a more significant decrease in the pain scores (WMD –1.40, 95% CI: –1.94 to –0.85; N = 15, I 2 = 81.0%). However, reported pain scores of patients who received LA were statistically similar to those of the control group at short-term (4-8 weeks after the treatment) and long-term (12 months) follow-ups. In patients with chronic LBP, LA may help in alleviating pain immediately after the treatment. However, this effect does not appear to be sustained on later follow-up assessments. Consequently, patients should be informed about the potential limitations of the treatment in providing lasting pain relief. [ABSTRACT FROM AUTHOR]

Rho GTPase activating protein 11A (ARHGAP11A) can facilitate GTP hydrolysis in RhoA. The functions of ARHGAP11A in oral squamous cell carcinoma (OSCC) have not yet been explored. This study aimed to investigate the expression profile of ARHGAP11A in OSCC, its correlation with patient prognosis, its effect on cell-cycle progression, and the mechanisms by which it is dysregulated. Bioinformatics analysis was conducted using data from The Cancer Genome Atlas-Head and Neck Squamous Cell Carcinoma (TCGA-HNSC). Lentiviruses carrying ARHGAP11A shRNAs were employed to determine the effects of ARHGAP11A knockdown on tumor cell proliferation and cell-cycle progression. Dual-luciferase reporter assays were utilized to examine how FOXM1 transcriptionally regulates ARHGAP11A expression. ARHGAP11A upregulation was associated with unfavorable overall survival (OS) in patients with TSCC (HR: 2.142, 95%CI: 1.224–3.749, P = 0.007), but not in patients with OSCC of sites other than the tongue. ARHGAP11A knockdown inhibited the proliferation of TSCC cells in vitro and in vivo , and induced G1 phase arrest. ARHGAP11A knockdown increased GTP-RhoA but decreased p-RB levels, while it did not affect the total expression of RhoA and RB. ARHGAP11A knockdown increased p27 and decreased cyclin E1 expression. ARHGAP11A is transcriptionally activated by FOXM1 via multiple FOXM1 binding sites in the promoter regions in TSCC cells. This study revealed the oncogenic role of ARHGAP11A in TSCC, highlighting its impact on cell-cycle control and tumor proliferation. Furthermore, the regulatory relationship between FOXM1 and ARHGAP11A provides new insights into the transcriptional networks in TSCC. [ABSTRACT FROM AUTHOR]

In vivo molecular imaging tools hold immense potential to drive transformative breakthroughs by enabling researchers to visualize cellular and molecular interactions in real-time and/or at high resolution. These advancements will facilitate a deeper understanding of fundamental biological processes and their dysregulation in disease states. Here, we develop and characterize a self-assembling protein nanomicelle called collagen type I binding – thermoresponsive assembled protein (Col1-TRAP) that binds tightly to type I collagen in vitro with nanomolar affinity. For ex vivo visualization, Col1-TRAP is labeled with a near-infrared fluorescent dye (NIR-Col1-TRAP). Both Col1-TRAP and NIR-Col1-TRAP display approximately a 3.8-fold greater binding to type I collagen compared to TRAP when measured by surface plasmon resonance (SPR). We present a proof-of-concept study using NIR-Col1-TRAP to detect fibrotic type I collagen deposition ex vivo in the livers of mice with non-alcoholic steatohepatitis (NASH). We show that NIR-Col1-TRAP demonstrates significantly decreased plasma recirculation time as well as increased liver accumulation in the NASH mice compared to mice without disease over 4 hours. As a result, NIR-Col1-TRAP shows potential as an imaging probe for NASH with in vivo targeting performance after injection in mice. Direct molecular imaging of fibrosis in NASH patients enables the diagnosis and monitoring of disease progression with greater specificity and resolution than do elastography-based methods or blood tests. In addition, protein-based imaging probes are more advantageous than alternatives due to their biodegradability and scalable biosynthesis. With the aid of computational modeling, we have designed a self-assembled protein micelle that binds to fibrillar and monomeric collagen in vitro. After the protein was labeled with near-infrared fluorescent dye, we injected the compound into mice fed on a NASH diet. NIR-Col1-TRAP clears from the serum faster in these mice compared to control mice, and accumulates significantly more in fibrotic livers.This work advances the development of targeted protein probes for in vivo fibrosis imaging. [Display omitted] [ABSTRACT FROM AUTHOR]

Malnutrition is prevalent among hospitalised patients, and increases the morbidity, mortality, and medical costs; yet nutritional assessments on admission are not routine. This study assessed the clinical and economic benefits of using an artificial intelligence (AI)-based rapid nutritional diagnostic system for routine nutritional screening of hospitalised patients. A nationwide multicentre randomised controlled trial was conducted at 11 centres in 10 provinces. Hospitalised patients were randomised to either receive an assessment using an AI-based rapid nutritional diagnostic system as part of routine care (experimental group), or not (control group). The overall medical resource costs were calculated for each participant and a decision-tree was generated based on an intention-to-treat analysis to analyse the cost-effectiveness of various treatment modalities. Subgroup analyses were performed according to clinical characteristics and a probabilistic sensitivity analysis was performed to evaluate the influence of parameter variations on the incremental cost-effectiveness ratio (ICER). In total, 5763 patients participated in the study, 2830 in the experimental arm and 2933 in the control arm. The experimental arm had a significantly higher cure rate than the control arm (23.24% versus 20.18%; p = 0.005). The experimental arm incurred an incremental cost of 276.52 CNY, leading to an additional 3.06 cures, yielding an ICER of 90.37 CNY. Sensitivity analysis revealed that the decision-tree model was relatively stable. The integration of the AI-based rapid nutritional diagnostic system into routine inpatient care substantially enhanced the cure rate among hospitalised patients and was cost-effective. NCT04776070 (https://clinicaltrials.gov/study/NCT04776070). [ABSTRACT FROM AUTHOR]

The accuracy and optimal dimensions of computer numerical control (CNC)-milled polyetheretherketone (PEEK) removable partial denture (RPD) clasps are unclear. The purpose of this in vitro study was to investigate the trueness and precision of CNC-milled PEEK clasps with different thicknesses and lengths. Ladder-shaped specimens of 2 thicknesses with 5 lengths of clasps were designed and milled with PEEK and commercially pure titanium (CP Ti) (n=6). All milled specimens were scanned and superimposed onto the design data. Three-dimensional and 2-dimensional deviation analyses were carried out to evaluate the trueness of milled PEEK clasps. The scanning data of each group were superimposed pairwise, and the 3-dimensional deviations were analyzed to evaluate the precision. Nonparametric tests, ANOVA, the Pearson correlation, and univariate linear regression were used for statistical analysis (α=.05). The deviation of trueness of the PEEK clasps (0.047 to 0.164 mm) was higher than that of the CP Ti clasps (0.037 to 0.060 mm) (P <.001). Increasing the length of the clasps increased the deviations (P <.001). Deviation in the 2 thicknesses was not significantly different (P =.210). The correlation coefficients of 1.0-mm-thick and 1.5-mm-thick PEEK and CP Ti clasps were 0.843, 0.794, 0.638, and 0.405. The positive correlation coefficients of PEEK were higher than those of CP Ti and those of 1.0-mm-thick clasps was higher than those of 1.5-mm-thick clasps. The deviations were evenly distributed in the 9-mm length of the clasp for CP Ti and in the 6-mm length of the clasp for PEEK. Beyond these lengths, deviations increased with increased length. The increasing amplitude of CP Ti was smaller than that of the PEEK group, and that of the 1.5-mm-thick clasp was smaller than that of the1.0-mm-thick clasp. The measured range of precision of PEEK clasps was 0.079 to 0.152 mm, while that of CP Ti clasps was 0.036 to 0.096 mm. CP Ti clasps tended to have better precision than PEEK clasps, except for the 1.0-mm-thick clasps with a length greater than 9 mm and the 1.5-mm-thick clasp with a 12-mm length. The correlation of the clasp length with precision showed that the lengths of 1.0-mm-thick clasps strongly influenced precision (PEEK, P =.020; CP Ti, P <.001); this correlation decreased sharply when the thickness of clasps was 1.5 mm (PEEK, P =.199; CP Ti, P =.107). Greater elasticity increased the deviations of milled clasps. The increased thickness helped the clasp remain stable during the milling process. The 1.5-mm-thick PEEK clasps in the 3-mm and 6-mm lengths were the optimal design tested. [ABSTRACT FROM AUTHOR]

To examine the effectiveness of pelvic-abdominal mechanics exercise in reducing cesarean section rates and preventing pelvic floor dysfunction in primiparous women. Randomized controlled trial. A single-center prospective study was conducted among 200 primiparous participants (aged 18–38 years) who undertook formal card-issuing maternity tests between June 1, 2022, and June 30, 2023. Participants were divided into two groups: exercise (intervention) and control using the random number table method. Participants of the intervention group performed pelvic-abdominal mechanics exercise at least 1 h each time per week for three months. Participants of the control group did not perform any pelvic-abdominal mechanics exercise during pregnancy. This study conducted a comprehensive evaluation from three perspectives, including maternal and neonatal health outcomes during delivery, the recovery status of pelvic floor muscles at 42 days postpartum, and the quality of life during late pregnancy (36–38 weeks) and 42 days postpartum. A significant difference was found in delivery outcomes. The cesarean section rates are significantly higher (p < 0.05) in the control group (36 %) than in the exercise group (19 %). At 42 days postpartum, pelvic floor assessment showed that the exercise group had significantly better results in pelvic floor muscle strength compared to the control group, with statistical significance (p < 0.05). Pelvic-abdominal mechanics exercise lowers the rate of cesarean section and improves postpartum pelvic floor function. [ABSTRACT FROM AUTHOR]

User identification is an essential technical support for downstream tasks such as recommendation systems, information retrieval, and collaborative filtering. Computing the similarity between user display names through classifiers is an effective solution for user identification across social networks. However, there are two problems with existing methods. Applying expert domain knowledge to extract handcrafted features of display names ignores the semantic information, resulting in poor performance of these methods. Selecting influential display names, and handcrafted features in user identification problems are also one of the difficulties. To solve these two problems, we propose a method based on the multi-feature fusion of display names using gated units. First, we extract the deep semantic features of display names through the BERT pre-trained multi-language model. Then, the gated mechanism is applied to select the handcrafted features we extracted to retain the essential features. Then, the adaptive factors are used to fuse handcrafted features and deep features to obtain user identification results across social networks. Finally, the efficiency of our model is verified on three constructed real-world multilingual display names datasets across multiple online social networks and compared with existing state-of-the-art methods. Experimental results show that the proposed algorithm outperforms the compared algorithms. [ABSTRACT FROM AUTHOR]

Human activity recognition(HAR) is an important research focus in ubiquitous computing. It has been widely applied in various domains, such as smart homes, healthcare assistance, and sports training. Accurate human activity recognition directly impacts the performance of downstream tasks. Existing methods for human activity recognition primarily rely on extracting temporal or spatial features from the data. These features are used for the task of human activity recognition. The existing methods mainly use CNN or RNN models to model the Euclidean correlations among spatially adjacent sensors or channels. However, non-Euclidean pairwise correlations among all sensors or channels are even critical for accurate classification, which has been ignored by the existing methods. In this paper, we incorporate fine-grained spatial structural data into the model to overcome these limitations. A novel deep learning model for human activity recognition is proposed, which is called the fine-grained data-oriented Spatial-Temporal Graph Transformer network (STGT). The introduction of the STGT model can eliminate the limitations of existing spatial feature extraction methods by leveraging a novel data organization approach proposed in this study. This model enhances the spatial features within the time feature extraction module for effective spatio-temporal feature extraction. We conducted experiments on four large-scale real-world HAR datasets to evaluate its performance. The experimental results demonstrate the superiority of our method over state-of-the-art approaches. [ABSTRACT FROM AUTHOR]