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BackgroundPrimary hepatic neuroendocrine tumors (PHNETs) are an utterly rare entity. The diagnosis of PHNETs could legitimize when an extrahepatic primary NET must always be excluded. PHNETs can achieve a high survival rate after complete surgical resection, however, most patients still have an 18% risk of recurrence within 5 years after surgery. In our case, the recurrence occurred 8 years after the first hepatectomy, which is relatively rare in the current literature. Therefore, rigorous postoperative follow-up is necessary for early detection and timely treatment of recurrent PHNETs.Case informationWe report a case of PHNET in a 24-year-old previously healthy female patient who relapsed 8 years after hepatectomy. This case focuses on the importance of diagnosis of primary and recurrent PHNETS in young patients, rare pathological types, and post-operative follow-up.ConclusionThis case report detailed the rare pathological morphology and characteristic immunohistochemical markers in our case for PHNETS, which enhanced the new understanding of the diagnosis of this entity. In addition, we also highlighted the variable duration of recurrence after treatment of PHNETs. The 8-year recurrent period in our case suggests the importance of regular examination in patients with PHNETs by following the doctor’s instructions.

IntroductionThis study aimed to investigate the relationship between athletes' training satisfaction and competitive state anxiety, by examining the mediating roles of psychological resilience and coping strategies. The findings provide a theoretical foundation and practical recommendations for enhancing athletes' training and mental health services.MethodsA questionnaire was utilized to assess training satisfaction, psychological resilience, coping strategies, and Competitive State Anxiety among a sample of 447 athletes. The data was examined through descriptive statistics, correlation analysis, and structural equation modeling, employing SPSS and the Process 3.5 plug-in.ResultsTraining satisfaction had a significant positive effect on psychological resilience (β = 0.726, p

More than 619 million people in the world suffer from low back pain (LBP). As two potential inducers of LBP, intervertebral disc degeneration (IVDD) and fat infiltration of paraspinal muscles (PSMs) have attracted extensive attention in recent years. So far, only one review has been presented to summarize their relationship and relevant mechanisms. Nevertheless, it has several noticeable drawbacks, such as incomplete categorization and discussion, lack of practical proposals, etc. Consequently, this paper aims to systematically summarize and classify the interaction between IVDD and fat infiltration of PSMs, thus providing a one-stop search handbook for future studies. As a result, four mechanisms of IVDD leading to fat infiltration of PSMs and three mechanisms of fat infiltration in PSMs causing IVDD are thoroughly analyzed and summarized. The typical reseaches are tabulated and evaluated from four aspects, i.e., methods, conclusions, benefits, and drawbacks. We find that IVDD and fat infiltration of PSMs is a vicious cycle that can promote the occurrence and development of each other, ultimately leading to LBP and disability. Finally, eight perspectives are proposed for future in-depth research.

Human epidermal growth factor 2 (HER2) mutations are uncommon in non-small cell lung cancer (NSCLC), and the lack of established, effective, targeted drugs has resulted in a persistently poor prognosis. Herein, we report the case of a non-smoking, 58-year-old man diagnosed with lung adenocarcinoma (cT3N0M1c, stage IVB) harboring a HER2 mutation (Y772_A775dupYVMA) and PD-L1 (-). The patient’s Eastern Cooperative Oncology Group performance status (PS) score was assessed as 1. He commenced first-line treatment with chemotherapy, followed by immuno-chemotherapy, and with disease progression, he received HER2-targeted therapy and chemotherapy with an anti-angiogenic agent. However, HER2-targeted therapy, including pan-HER tyrosine kinase inhibitors (afatinib, pyrotinib, and pozitinib) and antibody–drug conjugate (T-DM1), produced only stable disease (SD) as the best response. After the previously described treatment, primary tumor recurrence and multiple brain metastases were observed. Despite the patient’s compromised overall physical condition with a PS score of 3-4, he was administered T-DXd in addition to whole-brain radiotherapy (WBRT). Remarkably, both intracranial metastases and primary lesions were significantly reduced, he achieved a partial response (PR), and his PS score increased from 3-4 to 1. He was then treated with T-DXd for almost 9 months until the disease again progressed, and he did not discontinue the drug despite the occurrence of myelosuppression during this period. This is a critical case as it exerted an effective response to T-DXd despite multiple lines therapy, including T-DM1. Simultaneously, despite the occurrence of myelosuppression in the patient during T-DXd, it was controlled after aggressive treatment.

The increasing use of underwater vehicles facilitates deep-sea exploration at a wide range of depths and spatial scales. In this paper, we make an initial attempt to develop online computing strategies to identify seafloor categories and predict biogeographic patterns with a deep learning-based architecture, DenseNet, integrated with joint morphological cues, with the expectation of potentially developing its embedded smart capacities. We utilized high-resolution multibeam bathymetric measurements derived from MBES and denoted a collection of joint morphological cues to help with semantic mapping and localization. We systematically strengthened dominant feature propagation and promoted feature reuse via DenseNet by applying the channel attention module and spatial pyramid pooling. From our experiment results, the seafloor classification accuracy reached up to 89.87%, 82.01%, and 73.52% on average in terms of PA, MPA, and MIoU metrics, achieving comparable performances with the state-of-the-art deep learning frameworks. We made a preliminary study on potential biogeographic distribution statistics, which allowed us to delicately distinguish the functionality of probable submarine benthic habitats. This study demonstrates the premise of using underwater vehicles through unbiased means or pre-programmed path planning to quantify and estimate seafloor categories and the exhibited fine-scale biogeographic patterns.

IntroductionAs an important human-computer interaction technology, steady-state visual evoked potential (SSVEP) plays a key role in the application of brain computer interface (BCI) systems by accurately decoding SSVEP signals. Currently, the majority SSVEP feature recognition methods use a static classifier. However, electroencephalogram (EEG) signals are non-stationary and time-varying. Hence, an adaptive classification method would be an alternative option to a static classifier for tracking the changes in EEG feature distribution, as its parameters can be re-estimated and updated with the input of new EEG data.MethodsIn this study, an unsupervised adaptive classification algorithm is designed based on the self-similarity of same-frequency signals. The proposed classification algorithm saves the EEG data that has undergone feature recognition as a template signal in accordance with its estimated label, and the new testing signal is superimposed with the template signals at each stimulus frequency as the new test signals to be analyzed. With the continuous input of EEG data, the template signals are continuously updated.ResultsBy comparing the classification accuracy of the original testing signal and the testing signal superimposed with the template signals, this study demonstrates the effectiveness of using the self-similarity of same-frequency signals in the adaptive classification algorithm. The experimental results also show that the longer the SSVEP-BCI system is used, the better the responses of users on SSVEP are, and the more significantly the adaptive classification algorithm performs in terms of feature recognition. The testing results of two public datasets show that the adaptive classification algorithm outperforms the static classification method in terms of feature recognition.DiscussionThe proposed adaptive classification algorithm can update the parameters with the input of new EEG data, which is of favorable impact for the accurate analysis of EEG data with time-varying characteristics.

IntroductionApproximately 40% of patients with acute low back pain (LBP) develop chronic low back pain, which significantly increases the risk of poor prognosis. To reduce the risk of acute LBP becoming chronic, effective preventive strategies are needed. Early identification of risk factors for the development of chronic LBP can help clinicians choose appropriate treatment options and improve patient outcomes. However, previous screening tools have not considered medical imaging findings. The aim of this study is to identify factors that can predict the risk of acute LBP becoming chronic based on clinical information, pain and disability assessment, and MRI imaging findings. This protocol describes the methodology and plan for investigating multidimensional risk factors for acute LBP becoming chronic, in order to better understand the development of acute LBP and prevent chronic LBP.MethodsThis is a prospective multicenter study. We plan to recruit 1,000 adult patients with acute low back pain from four centers. In order to select four representative centers, we find the larger hospitals from different regions in Yunnan Province. The study will use a longitudinal cohort design. Patients will undergo baseline assessments upon admission and will be followed up for 5 years to collect the time of chronicity and associated risk factors. Upon admission, patients will be collected detailed demographic information, subjective and objective pain scores, disability scale, and lumbar spine MRI scanning. In addition, patient’s medical history, lifestyle, psychological factors will be collected. Patients will be followed up at 3 months, 6 months, 1 year, 2 years and up for 5 years after admission to collect the time of chronicity and associated factors. Multivariate analysis will be used to explore the multidimensional risk factors affecting the chronicity of acute LBP patients (such as age, gender, BMI, degree of intervertebral disc degeneration, etc.), and survival analysis will be performed to explore the impact of each factor on the time of chronicity.Ethics and disseminationThe study has been approved by the institutional research ethics committee of each study center (main center number: 2022-L-305). Results will be disseminated through scientific conferences and peer-reviewed publications, as well as meetings with stakeholders.

IntroductionProviding stimulation enhancements to existing hand rehabilitation training methods may help stroke survivors achieve better treatment outcomes. This paper presents a comparison study to explore the stimulation enhancement effects of the combination of exoskeleton-assisted hand rehabilitation and fingertip haptic stimulation by analyzing behavioral data and event-related potentials.MethodsThe stimulation effects of the touch sensations created by a water bottle and that created by cutaneous fingertip stimulation with pneumatic actuators are also investigated. Fingertip haptic stimulation was combined with exoskeleton-assisted hand rehabilitation while the haptic stimulation was synchronized with the motion of our hand exoskeleton. In the experiments, three experimental modes, including exoskeleton-assisted grasping motion without haptic stimulation (Mode 1), exoskeleton-assisted grasping motion with haptic stimulation (Mode 2), and exoskeleton-assisted grasping motion with a water bottle (Mode 3), were compared.ResultsThe behavioral analysis results showed that the change of experimental modes had no significant effect on the recognition accuracy of stimulation levels (p = 0.658), while regarding the response time, exoskeleton-assisted grasping motion with haptic stimulation was the same as grasping a water bottle (p = 0.441) but significantly different from that without haptic stimulation (p = 0.006). The analysis of event-related potentials showed that the primary motor cortex, premotor cortex, and primary somatosensory areas of the brain were more activated when both the hand motion assistance and fingertip haptic feedback were provided using our proposed method (P300 amplitude 9.46 μV). Compared to only applying exoskeleton-assisted hand motion, the P300 amplitude was significantly improved by providing both exoskeleton-assisted hand motion and fingertip haptic stimulation (p = 0.006), but no significant differences were found between any other two modes (Mode 2 vs. Mode 3: p = 0.227, Mode 1 vs. Mode 3: p = 0.918). Different modes did not significantly affect the P300 latency (p = 0.102). Stimulation intensity had no effect on the P300 amplitude (p = 0.295, 0.414, 0.867) and latency (p = 0.417, 0.197, 0.607).DiscussionThus, we conclude that combining exoskeleton-assisted hand motion and fingertip haptic stimulation provided stronger stimulation on the motor cortex and somatosensory cortex of the brain simultaneously; the stimulation effects of the touch sensations created by a water bottle and that created by cutaneous fingertip stimulation with pneumatic actuators are similar.

IntroductionHemiparesis is a common consequence of stroke that severely impacts the life quality of the patients. Active training is a key factor in achieving optimal neural recovery, but current systems for wrist rehabilitation present challenges in terms of portability, cost, and the potential for muscle fatigue during prolonged use.MethodsTo address these challenges, this paper proposes a low-cost, portable wrist rehabilitation system with a control strategy that combines surface electromyogram (sEMG) and electroencephalogram (EEG) signals to encourage patients to engage in consecutive, spontaneous rehabilitation sessions. In addition, a detection method for muscle fatigue based on the Boruta algorithm and a post-processing layer are proposed, allowing for the switch between sEMG and EEG modes when muscle fatigue occurs.ResultsThis method significantly improves accuracy of fatigue detection from 4.90 to 10.49% for four distinct wrist motions, while the Boruta algorithm selects the most essential features and stabilizes the effects of post-processing. The paper also presents an alternative control mode that employs EEG signals to maintain active control, achieving an accuracy of approximately 80% in detecting motion intention.DiscussionFor the occurrence of muscle fatigue during long term rehabilitation training, the proposed system presents a promising approach to addressing the limitations of existing wrist rehabilitation systems.

BackgroundWhen thyroid cancer invades the trachea, tumor resection and trachea reconstruction are required. Although the traditional way of anesthesia and tracheal intubation can maintain the necessary ventilation function during the operation, tracheal intubation affects the surgical field of vision and is not conducive to the protection of the recurrent laryngeal nerve beside the trachea during the operation.Case presentationExtracorporeal membrane oxygenation (ECMO) is used to replace traditional tracheal intubation in the process of resection and end-to-end anastomosis of tracheal tumors, and complete tracheal tumor resection and trachea reconstruction are achieved.ConclusionUsing ECMO for thyroid carcinoma resection, invaded trachea resection, and trachea reconstruction is safe and effective, which reduces the obstruction of endotracheal intubation on the operative field, guarantees the rapid and efficient end-to-end anastomosis in the upper trachea, and clearly avoids laryngeal recurrent nerve injury in the process of anastomosis.

ObjectiveThe purpose of this study was to analyze the clinical effect of percutaneous endoscopic medial foraminal discectomy (PEMFD) in the treatment of lumbar disc herniation (LDH).MethodsWe retrospectively examined and compared clinical data from 39 single-level LDH patients who underwent PEID and 47 who underwent PEMFD. All the patients were diagnosed with single-level LDH and were treated in Xuzhou Central Hospital for single-segmental lumbar disc herniation between June 2017 and December 2019. Collect and count surgical-related indicators, intraoperative bleeding volume and 24-hour postoperative drainage volume, lower extremity numbness Visual Analogue Scale (VAS), the pain VAS and lumbar Oswestry Disability Index (ODI) scores.ResultsIntraoperative bleeding volume and 24-hour postoperative drainage volume were significantly lower in the PEMFD group (p

IntroductionMusculoskeletal system gradually degenerates with aging, and a hypoxia environment at a high altitude may accelerate this process. However, the comprehensive effects of high-altitude environments on bones and muscles remain unclear. This study aims to compare the differences in bones and muscles at different altitudes, and to explore the mechanism and influencing factors of the high-altitude environment on the skeletal muscle system.MethodsThis is a prospective, multicenter, cohort study, which will recruit a total of 4000 participants over 50 years from 12 research centers with different altitudes (50m~3500m). The study will consist of a baseline assessment and a 5-year follow-up. Participants will undergo assessments of demographic information, anthropomorphic measures, self-reported questionnaires, handgrip muscle strength assessment (HGS), short physical performance battery (SPPB), blood sample analysis, and imaging assessments (QCT and/or DXA, US) within a time frame of 3 days after inclusion. A 5-year follow-up will be conducted to evaluate the changes in muscle size, density, and fat infiltration in different muscles; the muscle function impairment; the decrease in BMD; and the osteoporotic fracture incidence. Statistical analyses will be used to compare the research results between different altitudes. Multiple linear, logistic regression and classification tree analyses will be conducted to calculate the effects of various factors (e.g., altitude, age, and physical activity) on the skeletal muscle system in a high-altitude environment. Finally, a provisional cut-off point for the diagnosis of sarcopenia in adults at different altitudes will be calculated.Ethics and disseminationThe study has been approved by the institutional research ethics committee of each study center (main center number: KHLL2021-KY056). Results will be disseminated through scientific conferences and peer-reviewed publications, as well as meetings with stakeholders.Clinical Trial registration numberhttp://www.chictr.org.cn/index.aspx, identifier ChiCTR2100052153.

AimsThis study aims to assess left ventricular (LV) function in hypertrophic cardiomyopathy (HCM) patients with preserved left ventricular ejection fraction (LVEF) by LV strain patterns based on cardiac magnetic resonance feature tracking (CMR-FT) and to explore the relationships between LV strain patterns and cardiac biomarkers in these patients, such as cardiac troponin (cTnT) and N-terminal prohormone of the brain natriuretic peptide (NT-proBNP).MethodsA total of 64 HCM patients with preserved LVEF and 33 healthy people were included in this study. All subjects underwent contrast-enhanced CMR, and all patients took blood tests for cTnT and NT-proBNP during hospitalization.ResultsDespite the absence of a significant difference in LVEF between HCM patients and healthy controls, almost all global and segmental strains in radial, circumferential, and longitudinal directions in the HCM group deteriorated significantly as compared to controls (p < 0.05). Moreover, some global and segmental strains correlated significantly with NT-proBNP and cTnT in HCM patients, and the best correlations were global radial strain (GRS) (r = −0.553, p < 0.001) and mid-ventricular radial strain (MRS) (r = −0.582, p < 0.001), respectively, with a moderate correlation. The receiver operating characteristic (ROC) results showed that among the LV deformation parameters, GRS [area under the curve (AUC), 0.76; sensitivity, 0.49; specificity, 1.00], MRS (AUC, 0.81; sensitivity, 0.77; specificity, 0.79) demonstrated greater diagnostic accuracy to predict elevated NT-proBNP, and abnormal cTnT, respectively. Their cut-off values were 21.17 and 20.94%, respectively. Finally, all global strains demonstrated moderate, good, and excellent intra- and inter-observer reproducibility.ConclusionLV strain patterns can be used to assess the subclinical cardiac function of HCM patients on the merit of being more sensitive than LVEF. In addition, LV strain patterns can detect serious HCM patients and may be helpful to non-invasively predict elevated NT-proBNP and cTnT.

PurposeThis study aims to investigate the role of sex and ovarian hormones in hippocampal damage and cognitive deficits and behavioral dysfunction in rats induced by chronic exposure to hypobaric hypoxia.MethodsSix-week-old male and female SD rats were housed for 3 months either in a real altitude (4,250 m) environment as the model of chronic hypobaric-hypoxia (CHH) or in a plain as controls. The animal behavioral and hippocampal neurons at subcellular, molecular, and ultrastructural levels were characterized after CHH exposure.ResultsAfter 3 months of CHH exposure, (1) male CHH rats’ serum testosterone level was lower than male controls’ whereas female CHH rats’ serum estradiol level was higher than female controls’; (2) Morris water maze test finds that male rats showed more learning and spatial memory deficits than female rats; (3) male rats showed more severe hippocampal damage, hippocampal inflammation, oxidative stress and decreased hippocampal integrity (neurogenesis and dendritic spine density) than female rats; (4) Western blot analysis shows that, compared with the male control group, in male CHH group’s hippocampus, expression of nNOS, HO-1, and Bax protein increased whereas that of Bcl-2 protein decreased; (5) Expression of PON2 protein in male rats (CHH and controls) was lower than female rats (CHH and controls). In addition, CHH exposure decreased the expression of PON2 protein in both male and female rats; (6) qPCR analysis reveals that CHH exposure reduced the gene expression of N-methyl-D-aspartate receptor NR2A and NR2B subunits in male rats’ hippocampus. In addition, compared with the sham CHH group, the expression level of PON2 protein decreased in the OVX-CHH group’s hippocampus whereas oxidative stress, neuroinflammation, and degeneration of hippocampal neurons increased in the OVX-CHH group’s hippocampus.ConclusionAfter CHH exposure, male rats were significantly more likely than female rats to develop hippocampal damage, hippocampal neuroinflammation, and cognitive decline and deficits, suggesting that sex and ovarian hormones were significantly involved in regulating the rats’ susceptibility to CHH exposure-induced hippocampal damage.

Shanghai Soft X-ray Free-Electron Laser (SXFEL) is the first X-ray free-electron laser facility in China. The initial commissioning of the beamline was carried out in May 2021. Herein, we present a status report and the first experimental results obtained during the early commissioning of Kirkpatrick-Baez (KB) mirrors for the Coherent Scattering and Imaging (CSI) endstation, including three types of diagnostics. A bright X-ray focal spot of less than 3 μm was achieved by using edge-scan and silicon ablation imprint measurements. In order to confirm the spot size, the attenuated beam and full beam are used respectively for the two measurement methods.

BackgroundArtificial intelligence has far surpassed previous related technologies in image recognition and is increasingly used in medical image analysis. We aimed to explore the diagnostic accuracy of the models based on deep learning or radiomics for lung cancer staging.MethodsStudies were systematically reviewed using literature searches from PubMed, EMBASE, Web of Science, and Wanfang Database, according to PRISMA guidelines. Studies about the diagnostic accuracy of radiomics and deep learning, including the identifications of lung cancer, tumor types, malignant lung nodules and lymph node metastase, were included. After identifying the articles, the methodological quality was assessed using the QUADAS-2 checklist. We extracted the characteristic of each study; the sensitivity, specificity, and AUROC for lung cancer diagnosis were summarized for subgroup analysis.ResultsThe systematic review identified 19 eligible studies, of which 14 used radiomics models and 5 used deep learning models. The pooled AUROC of 7 studies to determine whether patients had lung cancer was 0.83 (95% CI 0.78–0.88). The pooled AUROC of 9 studies to determine whether patients had NSCLC was 0.78 (95% CI 0.73–0.83). The pooled AUROC of the 6 studies that determined patients had malignant lung nodules was 0.79 (95% CI 0.77–0.82). The pooled AUROC of the other 6 studies that determined whether patients had lymph node metastases was 0.74 (95% CI 0.66–0.82).ConclusionThe models based on deep learning or radiomics have the potential to improve diagnostic accuracy for lung cancer staging.Systematic Review Registrationhttps://inplasy.com/inplasy-2022-3-0167/, identifier: INPLASY202230167.

Background: Histone deacetylase (HDAC) plays a crucial role in regulating the expression and activity of a variety of genes associated with tumor progression and immunotherapeutic processes. The aim of this study was to characterize HDAC pathway copy number variation (CNV) in pan-cancer.Methods: A total of 10,678 tumor samples involving 33 types of tumors from The Cancer Genome Atlas (TCGA) were included in the study.Results: HDAC pathway CNV and CNV gain were identified as prognostic risk factors for pan-cancer species. The differences of tumor characteristics including tumor mutational burden, tumor neoantigen burden, high-microsatellite instability, and microsatellite stable between HDAC pathway CNV altered-type group and wild-type group varied among the various cancer species. In some cancer types, HDAC pathway CNV alteration was positively correlated with loss of heterozygosity, CNV burden, ploidy, and homologous recombination defect score markers, while it was significantly negatively correlated with immune score and stroma score. There were significant differences in immune characteristics such as major histocompatibility complex class I (MHC-I), MHC-II, chemokines, cytolytic-activity, and IFN-γ between the two groups. Immune cycle characteristics varied from one cancer type to another.Conclusion: This study reveals a tumor and immune profile of HDAC pathway CNV as well as its unlimited potential in immune prognosis.

There is an interaction between the lumbar spine and paraspinal muscles, which may play a role in the development of intervertebral disc (IVD) degeneration and may affect CLBP. The study aims to assess the relationship between IVD degeneration and paraspinal muscle fat infiltration in CLBP patients by quantitative MR imaging, and to evaluate the influence of sex and age on CLBP muscle fat infiltration. Sixty CLBP patients (46.3 years ±17.0) and thirty-two healthy subjects (44.9 years ±17.6) were recruited for this study. 3.0 T MRI was used to perform the sagittal and axial T1, T2 of the lumbar spine, and axial paraspinal muscle IDEAL imaging at the L4/5 and L5/S1 levels. Proton density fat fraction (PDFF) of the multifidus and erector spinae at two IVD levels were measured. The Pfirrmann grades of IVD degeneration, Oswestry Disability Index (ODI), and Visual Analog Scale (VAS) were also evaluated. Compare the cross-sectional area (CSA) and PDFF of the paraspinal muscles between CLBP patients and healthy subjects, and analyze the relationship between the muscle PDFF and Pfirrmann grades, gender, and age of CLBP patients. Compared with healthy subjects, the CSA of the multifidus muscle in CLBP patients decreased (1320.2±188.1mm2vs. 1228.7±191.0 mm2, p

Accompanied with intervertebral disc (IVD) degeneration, increasing fat infiltration of paraspinal muscles may be related to discogenic low back pain (DLBP), but their relationship is still unclear and the classical animal models are not completely applicable. The purpose of this study was to assess the paraspinal muscle fat infiltration in patients with DLBP by quantitative MRI, and to develop a novel DLBP rat model to explore the potential relationship between DLBP paraspinal muscle fat infiltration and TNF-α levels. We measured the proton density fat fraction (PDFF) of the multifidus and erector spinae muscles of 70 DLBP patients and 36 healthy volunteers by using quantitative MRI IDEAL-IQ. In addition, we developed a DLBP experimental rat model by puncturing the L4/5 and L5/6 IVDs under the guidance of X-ray fluoroscopy. Then various behavioral experiments, MRI and pathological examination of IVDs were used to evaluate the performance of the DLBP animal model. The gait analysis, hot plate test, acetone test, grasping test and tail suspension test were used to evaluate the pain and muscle dysfunction in rats. Through quantitative MRI and histological examination, the degeneration of IVDs and fat infiltration in the muscles were observed in vivo and ex vivo. Enzyme linked immunosorbent assay detects the level of TNF-α in rat IVDs and paraspinal muscles. In the human study, compared with healthy volunteers, the PDFF of multifidus and erector muscles of DLBP patients increased significantly at L4/5 and L5/S1 levels (p

BackgroundThe present study investigated the safety and efficacy of mapping and ablating isolated premature atrial contractions (PACs) in patients with a structurally normal heart, as well as whether the elimination of PACs by radiofrequency catheter ablation (RFCA) improved symptoms and the quality of life.MethodsForty-three consecutive patients with frequent, symptomatic, and drug-refractory PACs, but without atrial tachyarrhythmias (≥5 beats), were enrolled. In all patients, we performed physical, laboratory, and imaging examinations to exclude structural heart disease. The quality of life questionnaire SF-36 before and 3 months after RFCA was performed in each patient.ResultsTwenty-three men and 20 women with an average age of 52.6 ± 17.6 years were finally enrolled. The mean number of PACs was 21,685 ± 9,596 per 24 h, and the mean PACs' burden was 28.9 ± 13.7%. Short runs of tachycardia (

Hydraulic fracturing is a key technology for shale gas production. Activating the natural fracture (NF) system in shale reservoirs and forming a complex fracture network can greatly improve the effect of fracturing. The effect of fracturing is mainly influenced by geological factors and operational parameters of a reservoir. Effectively reforming a reservoir under unfavourable geological conditions and maximizing the activation of NFs in the reservoir can substantially increase its reformed volume and the production of shale gas. Alternating fluid injection (AFI) fracturing technologies using multiple fracturing fluids with different viscosities can activate closed NFs while retaining the high conductivity of the principal fracture to achieve a larger stimulated reservoir volume (SRV). In this paper, a hydraulic-mechanical coupling finite element method (FEM) of a reservoir is established, and AFI fracturing technology is numerically simulated using the continuum method. In addition, the fracture propagation stage and path propagation for AFI technology are discussed. The results show that AFI fracturing technology can form principal fractures with high conductivity and activate NFs in a reservoir to form comparatively complex fracture propagation paths.

Ocean mesoscale eddies contribute significantly to water transport on a global scale, constituting the ubiquitous, irregular, discrete, nonlinear components. In this manuscript, we propose to explore whether and how the topographic effect of one meridional ridge, could exert considerable influences on the evolution and propagation of mesoscale eddies through their life cycle, directly from the perspectives of real observation statistics. We systematically investigate the known variability of mesoscale eddy trajectories, derived by multimission satellite altimetry from 1993 to 2018, of a life cycle more than 6 months, over the Izu-Ogasawara Ridge, and quantitatively examined the eddy-ridge interaction by observation statistics and wavelet coherence map, with respect to the intrinsic attributes, namely, the amplitude, the rotation speed, the radius. Due to the spatial-temporal diversity, a series of correlative steps have been particularly designed along time-frequency domain to trace back mesoscale eddy trajectories in a variety of origins, location, lifespan, polarity, either completely or partially passing over the ridge, and to facilitate the standardization in statistics across three phases of their life cycle, i.e., before, during and after the interaction with the ridge. It has been revealed in our experiment that three intrinsic attributes of mesoscale eddies within 25 years, all demonstrated noticeable correlation with the variation of topographic relief over the ridge. We observed that most of the cyclonic eddies obviously tended to begin to decay or even demise, while on the contrary, some of the anticyclonic eddies preferred to intensify slightly, or making no significant difference when encountering the upslope until climbing across the top, basically consistent with the expectation of potential vorticity (PV) conservation. The drifting velocity agreed with the tendency that the direction would be more probably modified toward equatorward or poleward by forcing to meridional component, with zonal component reduced at the beginning. The mesoscale eddies with the passage over the ridge exhibited the relatively high average horizontal scales, amplitude, rotation speed on the whole, compared to those with only partially passage. The developed scheme could integrate more evidences on how mesoscale eddies response to the topographic effects during their time-varying evolution and propagation process, and help provide opportunities to potentially identify and predict the underlying dynamic patterns and mechanisms that mesoscale eddies engage in ocean dynamics when proceeding toward meridional ridges on a global scale, with the promise of the end-to-end data-driven solution, such as deep learning architecture involved in the future.

PurposeWe hypothesized that inferior vena cava collapsibility index (IVCCI)-guided fluid management would reduce the incidence of postspinal anesthesia hypotension in patients undergoing non-cardiovascular, non-obstetric surgery.MethodsA receiver operating characteristic (ROC) curve was used to determine the diagnostic value of IVCCI for predicting hypotension after induction of spinal anesthesia and calculate the cut-off value. Based on the cut-off variation value, the following prospective randomized controlled trial aimed to compare the incidence of postspinal anesthesia hypotension between the IVCCI-guided fluid administration group and the standard fluid administration group. Secondary outcomes included the rate of vasoactive drug administration, the amount of fluid administered, and the incidence of nausea and vomiting.ResultsROC curve analysis revealed that IVCCI had a sensitivity of 83.9%, a specificity of 76.3%, and a positive predictive value of 84% for predicting postspinal anesthesia hypotension at a cut-off point of >42%. The area under the curve (AUC) was 0.834 (95% confidence interval: 0.740–0.904). According to the cut-off variation value of 42%, the IVCCI-guided group exhibited a lower incidence of hypotension than the standard group [9 (15.3%) vs. 20 (31.7%), P = 0.032]. Total fluid administered was lower in the IVCCI-guided group than in the standard group [330 (0–560) mL vs. 345 (285–670) mL, P = 0.030].ConclusionsPrespinal ultrasound scanning of the IVCCI provides a reliable predictor of hypotension following spinal anesthesia at a cut-off point of >42%. IVCCI-guided fluid management before spinal anesthesia can reduce the incidence of hypotension following spinal anesthesia.

Ocean mesoscale eddies are ubiquitous in world ocean and account for 90% oceanic kinetic energy, which dominate the upper ocean flow field. Accurately predicting the variation of ocean mesoscale eddies is the key to understand the oceanic flow field and circulation system. In this article, we propose to make an initial attempt to explore spatio-temporal predictability of mesoscale eddies, employing deep learning architecture, which primarily establishes Memory In Memory (MIM) for sea level anomaly (SLA) prediction, combined with the existing mesoscale eddy detection. Oriented to the western Pacific ocean (125°−137.5°E and 15°−27.5°N), we quantitatively investigate the historic daily SLA variability at a 0.25° spatial resolution from 2000 to 2018, derived by satellite altimetry. We develop the enhanced MIM prediction strategies, equipped with Gated Recurrent Unit (GRU) and spatial attention module, in a scheduled sampling manner, which overcomes the gradient vanishing and complements to strengthen spatio-temporal features for long-term dependencies. At the early stage, the real value SLA input guides the model training process for initialization, while the scheduled sampling intentionally feeds the newly predicted value, to resolve the distribution inconsistency of inference. It has been demonstrated in our experiment results that our proposed prediction scheme outperformed the state-of-art approaches for SLA time series, with MAPE, RMSE of the 14-day prediction duration, respectively, 5.1%, 0.023 m on average, even up to 4.6%, 0.018 m for the effective sub-regions, compared to 19.8%, 0.086 m in ConvLSTM and 8.3%, 0.040 m in original MIM, which greatly facilitated the mesoscale eddy prediction. This proposed scheme will be beneficial to understand of the underlying dynamical mechanism behind the predictability of mesoscale eddies in the future, and help the deployment of ARGO, glider, AUV and other observational platforms.

Topological design for band structures of artificial materials such as acoustic crystals provides a powerful tool to manipulate wave propagating in a robust and symmetry-protected way. In this paper, based on the band folding and breaking mechanism by building blocks with acoustic atoms, we construct a three-dimensional topological acoustic crystal with a large complete bandgap. At a mirror-symmetry domain wall, two gapped symmetry and anti-symmetry surface states can be found in the bandgap, originated from two opposite Su-Schrieffer-Heeger chains. Remarkably, by enforcing a glide symmetry on the domain wall, we can tune the original gapped surface states in a gapless fashion at the boundaries of surface Brillouin zone, acting as omnidirectional acoustic quantum spin Hall effect. Our tunable yet straightforward acoustic crystals offer promising potentials in realizing future topological acoustic devices.

To preliminarily explore the primary changes in the expression of genes involved in peripheral nerve processes, namely, regeneration, angiogenesis, and the immune response, and to identify important molecular therapeutic targets, 45 Sprague-Dawley (SD) rats were randomly divided into a control group and an injury group. In the injury group, tissue samples were collected at 4 and 7 days after the injury for next-generation sequencing (NGS) analysis combined with gene ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Venn diagram construction to identify the differentially expressed mRNAs (DEmRNAs) associated with regeneration, angiogenesis, and the immune response of the nerve. The expression of genes in the distal and proximal ends of the injured nerve after injury was analyzed by qRT-PCR. NGS revealed that compared with the control group, the injury group had 4020 DEmRNAs 4 days after injury and 3278 DEmRNAs 7 days after injury. A bioinformatics analysis showed that C-C chemokine receptor type 5 (CCR5), Thy1 cell surface antigen (Thy1), Notch homolog 1 (Notch1), and semaphorin 4A (Sema4A) were all associated with regeneration, angiogenesis, and the immune response of the nerve at both 4 and 7 days after injury, but qPCR revealed no significant difference in the expression of Thy1 (P = 0.29) or Sema4A (P = 0.82) in the proximal end, whereas a significant difference was observed in CCR5 and Notch1 (P < 0.05). The trend in the Notch1 change was basically consistent with the RNA-seq result after injury, which implied its indispensable role during endothelial cell proliferation and migration, macrophage recruitment, and neurotrophic factor secretion.

The population of Atlantic cod significantly contributes to the prosperity of fishery production in the world. In this paper, we quantitatively investigate the global abundance variation in Atlantic cod from 1919 to 2016, in favor of spatiotemporal interactions over manifold impact factors at local observation sites, and propose to explore the predictive mechanism with the help of its periodicity, time–frequency co-movement, and lead-lag effects, via long short-term memory (LSTM). We first integrate evidences yielded from wavelet coefficients, to suggest that the abundance variation potentially follows a 36-year major cycle and 24-year secondary cycle at the time scales of 55 years and 37 years. We further evaluate the responses of Atlantic cod abundance to the external impact factors, including sea surface temperature (SST), catches, prey biomass, and sea surface salinity (SSS), in aid of the wavelet coherence and phase difference, which allows us to identify the dominantly correlative factors and capture the leading roles along the time domain and then divide the responses around the recent 60 years into three stages: before 1985, 1985–1995, and after 1995. At the first stage, the reason for the decline in abundance could be mainly attributed to the rapid rise of fish catches. At the second stage, the impact of SST and SSS also provides significant indices, besides overfishing; meanwhile, the mortality of primary producers and forced migration of fish species indirectly cause the decline. At the third stage, warming SST and growing SSS directly led to the decrease of abundance. Finally, we establish one ensemble of LSTM-SAE architecture to comprehensively reflect the predictive patterns at each stage. It has been demonstrated from experimental results that the models behaved better when intentionally feeding with the dominantly correlative multivariate inputs, instead of either all factors or only the abundance. The proposed scheme provides opportunities to symmetrically identify the underlying predictive attributes of Atlantic cod abundance and potentially perform as the quantitative references in reasonably making fishing decision. With the rapid development in deep learning capabilities, it is hopeful to expect better predictions of the responses to global changes, not only for Atlantic cod but also for other fish species and the ecosystem as a whole.

Clinical drug–drug interactions (DDIs) have been a major cause for not only medical error but also adverse drug events (ADEs). The published literature on DDI clinical toxicity continues to grow significantly, and high-performance DDI information retrieval (IR) text mining methods are in high demand. The effectiveness of IR and its machine learning (ML) algorithm depends on the availability of a large amount of training and validation data that have been manually reviewed and annotated. In this study, we investigated how active learning (AL) might improve ML performance in clinical safety DDI IR analysis. We recognized that a direct application of AL would not address several primary challenges in DDI IR from the literature. For instance, the vast majority of abstracts in PubMed will be negative, existing positive and negative labeled samples do not represent the general sample distributions, and potentially biased samples may arise during uncertainty sampling in an AL algorithm. Therefore, we developed several novel sampling and ML schemes to improve AL performance in DDI IR analysis. In particular, random negative sampling was added as a part of AL since it has no expanse in the manual data label. We also used two ML algorithms in an AL process to differentiate random negative samples from manually labeled negative samples, and updated both the training and validation samples during the AL process to avoid or reduce biased sampling. Two supervised ML algorithms, support vector machine (SVM) and logistic regression (LR), were used to investigate the consistency of our proposed AL algorithm. Because the ultimate goal of clinical safety DDI IR is to retrieve all DDI toxicity–relevant abstracts, a recall rate of 0.99 was set in developing the AL methods. When we used our newly proposed AL method with SVM, the precision in differentiating the positive samples from manually labeled negative samples improved from 0.45 in the first round to 0.83 in the second round, and the precision in differentiating the positive samples from random negative samples improved from 0.70 to 0.82 in the first and second rounds, respectively. When our proposed AL method was used with LR, the improvements in precision followed a similar trend. However, the other AL algorithms tested did not show improved precision largely because of biased samples caused by the uncertainty sampling or differences between training and validation data sets.

5,10-Methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism is considered as a predisposition and promising genetic candidate to major depressive disorder (MDD), as it is associated with impaired one-carbon cycles, which may be involved in the pathogenesis of depression. Cortical thickness (CT) and subcortical structure volumes have been extensively studied in MDD and have been proposed as one of the phenotypes for MDD. We intend to discuss the association between CT, subcortical structure volume, and MTHFR C677T polymorphism in first-episode, treatment-naive patients with MDD. In this study, 127 adult patients with MDD and 101 age- and gender-matched healthy controls (HCs) were included. All subjects underwent T1-weighted MRI, MTHFR C677T genotyping, and FreeSurfer software-based morphological analysis. MDD patients have been detected to have significantly decreased volumes in the left nucleus accumbens (P < 0.001). The MTHFR 677 T allele carriers manifested with thinner CT in the left caudal anterior cingulate cortex (cACC, P = 0.009) compared with CC genotype. There were significant genotype-by-diagnosis interactions for the CT in the left cACC (P = 0.009), isthmus cingulate (P = 0.002), medial orbitofrontal lobe (P = 0.012), posterior cingulate (P = 0.030), and the right lateral orbitofrontal lobe (P = 0.012). We also found a trend in the interaction effect on the volume of the left putamen (P = 0.050). Our results revealed that MTHFR C677T polymorphism may be involved in the dysfunction of limbic–cortical–striatal–pallidal–thalamic (LCSPT) circuits mediating emotion processing, which may contribute to pathogenesis of MDD.

Non-invasive ultrasonic neural modulation (UNM), a non-invasive technique with enhanced spatial focus compared to conventional electrical neural modulation, has attracted much attention in recent decades and might become the mainstream regimen for neurological disorders. However, as ultrasonic bioeffects and its adjustments are still unclear, it remains difficult to be extensively applied for therapeutic purpose, much less in the setting of human skull. Hence to comprehensively understand the way ultrasound exerts bioeffects, we explored UNM from a basic perspective by illustrating the parameter settings and the underlying mechanisms. In addition, although the spatial resolution and precision of UNM are considerable, UNM is relatively non-specific to tissue or cell type and shows very low specificity at the molecular level. Surprisingly, Ibsen et al. (2015) first proposed the concept of sonogenetics, which combined UNM and mechanosensitive (MS) channel protein. This emerging approach is a valuable improvement, as it may markedly increase the precision and spatial resolution of UNM. It seemed to be an inspiring tool with high accuracy and specificity, however, little information about sonogenetics is currently available. Thus, in order to provide an overview of sonogenetics and prompt the researches on UNM, we summarized the potential mechanisms from a molecular level.

This article presents a systematically study through experimental and theoretical methods to better understand the mechanism of the geometric deformation produced during selective laser melting (SLM) treatment of the Ti6Al4V blade. Ti6Al4V blade was prepared by SLM. Microstructure, dimensional deviation and residual stress were investigated. The microstructure observation illustrates that the acicular α′ martensite formed in prior β grain, in addition, the smaller the grain size, the larger the dimensional deviation. The geometric deviation demonstrates that the directions of dimensional deviation at the leading and trailing edges of the blade are opposite to those in the middle. The distribution of dimensional deviation exhibits a parabolic change at the trailing edge of blade. The thermal stresses along the edges are much larger than that of the blade body, which cause the severe deformation of the edges toward the suction side of the blade. This conclusion is further verified by the XRD method. The residual stress distribution measured through X-ray diffraction is consistent with the simulation results.

A healthy gut is very important for young animal development. The rumen of ruminants expands in size with the colonization of microbiota by 2 months of age. This process is promoted by alfalfa intervention. To elucidate the mechanism of this promotion, we performed transcriptomic analyses using a cohort of 23 lambs to evaluate the effects of starter diets plus alfalfa on the development of the rumen wall from the pre- to the postweaning period. The quantitative PCR analyses were used to validate selected genes that were differentially expressed in the transcriptome mapping. We found that several metabolic processes associated with rumen tissue development were affected by solid feed intake, with genes linked to the calcium signaling transduction pathway and the metabolism of pteridine-containing compounds and homocysteine metabolic process being upregulated in the group with alfalfa intervention. The results suggest that the pteridine-containing compounds and calcium signaling are targets for precise regulation of rumen development.

Genetic variants can influence the expression of mRNA and protein. Genetic regulatory loci such as expression quantitative trait loci (eQTLs) and protein quantitative trait loci (pQTLs) exist in several species. However, it remains unclear how human genetic variants regulate mRNA and protein expression. Here, we characterized six mechanistic models for the genetic regulatory patterns of single-nucleotide polymorphisms (SNPs) and their actions on post-transcriptional expression. Data from Yoruba HapMap lymphoblastoid cell lines were analyzed to identify human cis-eQTLs and pQTLs, as well as protein-specific QTLs (psQTLs). Our results indicated that genetic regulatory loci primarily affected mRNA and protein abundance in patterns where the two were well-correlated. While this finding was observed in both humans and mice (57.5% and 70.3%, respectively), the genetic regulatory patterns differed between species, implying evolutionary differences. Mouse SNPs generally targeted changes in transcript expression (51%), whereas in humans, they largely regulated protein abundance, independent of transcription levels (55.9%). The latter independent function can be explained by psQTLs. Our analysis suggests that local functional genetic variants in the human genome mainly modulate protein abundance independent of mRNA levels through post-transcriptional mechanisms. These findings clarify the impact of genetic variation on phenotype, which is of particular relevance to disease risk and treatment response.

Hand rehabilitation exoskeletons are in need of improving key features such as simplicity, compactness, bi-directional actuation, low cost, portability, safe human-robotic interaction, and intuitive control. This article presents a brain-controlled hand exoskeleton based on a multi-segment mechanism driven by a steel spring. Active rehabilitation training is realized using a threshold of the attention value measured by an electroencephalography (EEG) sensor as a brain-controlled switch for the hand exoskeleton. We present a prototype implementation of this rigid-soft combined multi-segment mechanism with active training and provide a preliminary evaluation. The experimental results showed that the proposed mechanism could generate enough range of motion with a single input by distributing an actuated linear motion into the rotational motions of finger joints during finger flexion/extension. The average attention value in the experiment of concentration with visual guidance was significantly higher than that in the experiment without visual guidance. The feasibility of the attention-based control with visual guidance was proven with an overall exoskeleton actuation success rate of 95.54% (14 human subjects). In the exoskeleton actuation experiment using the general threshold, it performed just as good as using the customized thresholds; therefore, a general threshold of the attention value can be set for a certain group of users in hand exoskeleton activation.

It is crucial to explore the pathogenesis of major depressive disorder (MDD) at the early stage for the better diagnostic and treatment strategies. It was suggested that MDD might be involving in functional or structural alternations at the brain network level. However, at the onset of MDD, whether the whole brain white matter (WM) alterations at network level are already evident still remains unclear. In the present study, diffusion MRI scanning was adopt to depict the unique WM structural network topology across the entire brain at the early stage of MDD. Twenty-one first episode, short duration (

Background: Bladder cancer, a highly fatal disease, poses a significant threat to patients. Positioned at 19q13.2-13.3, LIG1, one of the four DNA ligases in mammalian cells, is frequently deleted in tumour cells of diverse origins. Despite this, the precise involvement of LIG1 in BLCA remains elusive. This pioneering investigation delves into the uncharted territory of LIG1's impact on BLCA. Our primary objective is to elucidate the intricate interplay between LIG1 and BLCA, alongside exploring its correlation with various clinicopathological factors. Methods: We retrieved gene expression data of para-carcinoma tissues and bladder cancer (BLCA) from the GEO repository. Single-cell sequencing data were processed using the "Seurat" package. Differential expression analysis was then performed with the "Limma" package. The construction of scale-free gene co-expression networks was achieved using the "WGCNA" package. Subsequently, a Venn diagram was utilized to extract genes from the positively correlated modules identified by WGCNA and intersect them with differentially expressed genes (DEGs), isolating the overlapping genes. The "STRINGdb" package was employed to establish the protein-protein interaction (PPI) network.Hub genes were identified through the PPI network using the Betweenness Centrality (BC) algorithm. We conducted KEGG and GO enrichment analyses to uncover the regulatory mechanisms and biological functions associated with the hub genes. A machine-learning diagnostic model was established using the R package "mlr3verse." Mutation profiles between the LIG1^high and LIG1^low groups were visualized using the BEST website. Survival analyses within the LIG1^high and LIG1^low groups were performed using the BEST website and the GENT2 website. Finally, a series of functional experiments were executed to validate the functional role of LIG1 in BLCA. Results: Our investigation revealed an upregulation of LIG1 in BLCA specimens, with heightened LIG1 levels correlating with unfavorable overall survival outcomes. Functional enrichment analysis of hub genes, as evidenced by GO and KEGG enrichment analyses, highlighted LIG1's involvement in critical function such as the DNA replication, cellular senescence, cell cycle and the p53 signalling pathway. Notably, the mutational landscape of BLCA varied significantly between LIG1high and LIG1low groups. Immune infiltrating analyses suggested a pivotal role for LIG1 in immune cell recruitment and immune regulation within the BLCA microenvironment, thereby impacting prognosis. Subsequent experimental validations further underscored the significance of LIG1 in BLCA pathogenesis, consolidating its functional relevance in BLCA samples. Conclusions: Our research demonstrates that LIG1 plays a crucial role in promoting bladder cancer malignant progression by heightening proliferation, invasion, EMT, and other key functions, thereby serving as a potential risk biomarker. [ABSTRACT FROM AUTHOR]

Salmonella enterica serovar Paratyphi A (S. Paratyphi A) is a pathogen that can cause enteric fever. According to the recent epidemic trends of typhoid fever, S. Paratyphi A has been the major important causative factor in paratyphoid fever. An effective vaccine for S. Paratyphi A has not been developed, which made it a tricky public health concern. Until now, how S. Paratyphi A interacts with organisms remain unknown. Here using lifespan assay, we found that S. Paratyphi A could infect Caenorhabditis elegans (C. elegans) at 25°C, and attenuate thermotolerance. The immune response of C. elegans was mediated by tir-1, nsy-1, sek-1, pmk-1, mpk-1, skn-1, daf-2 and daf-16, suggesting that S. Paratyphi A could regulate the MAPK and insulin pathways. Furthermore, we observed several phenotypical changes when C. elegans were fed S. Paratyphi A, including an accelerated decline in body movement, reduced the reproductive capacity, shortened spawning cycle, strong preference for OP50, arrested pharyngeal pumping and colonization of the intestinal lumen. The virulence of S. Paratyphi A requires living bacteria and is not mediated by secreting toxin. Using hydrogen peroxide analysis and quantitative RT-PCR, we discovered that S. Paratyphi A could increase oxidative stress and regulate the immune response in C. elegans. Our results sheds light on the infection mechanisms of S. Paratyphi A and lays a foundation for drugs and vaccine development. [ABSTRACT FROM AUTHOR]

Introduction: Because of the outbreak of COVID-19, several colleges and universities in Xi’an, China, implemented quarantine measures and closed their gates, which increased anxiety among the students. Methods: The Perceived Social Support Scale, Perceived Risk of COVID-19 Pandemic Scale, Connor–Davidson Resilience Scale, and Self-Rating Anxiety Scale were used for measurements. SPSS26 and AMOS26 (IBM SPSS AMOS Statistics, New York, United States) were used for data analysis. Structural equation modeling (SEM) was used to test the data from the 2,251 respondents and the hypothetical model. Results: The students’ perceived social support was discovered to have had a significant negative effect on anxiety. The students’ perceived COVID-19 risk and resilience played significant mediating roles in the relationship between social support and anxiety. Discussion: When college students feel social support and have resilience, they can reduce anxiety during the epidemic stage. Therefore, education administrators and parents should help college students to identify the current situation of the epidemic environment, enrich relevant knowledge. [ABSTRACT FROM AUTHOR]

Objective: The mortality rate of ovarian cancer (OC) is the highest among all gynecologic cancers. To predict the prognosis and the efficacy of immunotherapy, we identified new biomarkers. Methods: The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression Project (GTEx) databases were used to extract ovarian cancer transcriptomes. By performing the co-expression analysis, we identified necroptosis-associated long noncoding RNAs (lncRNAs). We used the least absolute shrinkage and selection operator (LASSO) to build the risk model. The qRT-PCR assay was conducted to confirm the differential expression of lncRNAs in the ovarian cancer cell line SKOV-3. Gene Set Enrichment Analysis, Kaplan-Meier analysis, and the nomogram were used to determine the lncRNAs model. Additionally, the risk model was estimated to evaluate the efficacy of immunotherapy and chemotherapy. We classified necroptosis-associated IncRNAs into two clusters to distinguish between cold and hot tumors. Results: The model was constructed using six necroptosis-associated lncRNAs. The calibration plots from the model showed good consistency with the prognostic predictions. The overall survival of one, three, and fiveyear areas under the ROC curve (AUC) was 0.691, 0.678, and 0.691, respectively. There were significant differences in the IC50 between the risk groups, which could serve as a guide to systemic treatment. The results of the qRT-PCR assay showed that AL928654.1, AL133371.2, AC007991.4, and LINC00996 were significantly higher in the SK-OV-3 cell line than in the Iose-80 cell line (P < 0.05). The clusters could be applied to differentiate between cold and hot tumors more accurately and assist in accurate mediation. Cluster 2 was more vulnerable to immunotherapies and was identified as the hot tumor. Conclusion: Necroptosis-associated lncRNAs are reliable predictors of prognosis and can provide a treatment strategy by screening for hot tumors. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical characteristics of patients with recurrent trigeminal neuralgia (TN) and the experience of microvascular decompression (MVD) in the treatment of such patients.Methods: We retrospectively analyzed clinical data, imaging examination results, surgical methods, and treatment efficacies in 127 patients with recurrent typical TN from January 2005 to December 2014.Results: The age of the recurrent group was higher than that of the non-recurrent group (p < 0.05). The duration of pain before the first MVD procedure was longer in the recurrent group than in the non-recurrent group (p < 0.05). Patients in the recurrent group were more likely to have compression of the trigeminal nerve by the vertebrobasilar artery (VBA) or multiple vessels than patients in the non-recurrent group (p < 0.05). A Kaplan–Meier curve showed a median pain-free survival of 12 months after the first MVD procedure. The severity of pain (preoperative visual analog scale [VAS] score) in patients with recurrence was lower than that in patients with first-onset TN (p < 0.05). Vessel compression, Teflon compression or granuloma and arachnoid adhesion were considered the main causes of recurrence. Postoperative Barrow Neurological Institute (BNI) scores in the redo MVD group were excellent (T = 2) for 69 patients (53.33%) and good (T = 3) for 46 patients (36.22%). The postoperative follow-up was 63–167 months (105.92 ± 25.66). During the follow-up, no recurrence was noted. All complications were cured or improved.Conclusions: Microvascular decompression (MVD) is an effective surgical method for the treatment of TN. For recurrent patients, reoperation can achieve good results.

Objective: To investigate whether small volumes of the posterior cranial fossa and cerebellopontine cisterns are associated with bilateral trigeminal neuralgia (BTN) and to provide further knowledge regarding the etiology and treatment of this rare disease.Methods: We retrospectively analyzed clinical data and imaging examination results for 30 BTN patients between January 2009 and December 2019. Thirty age- and sex-matched healthy individuals and 30 patients with unilateral trigeminal neuralgia (UTN) were selected as two control groups. The volume of the posterior cranial fossa (VPCF) and volumes of the cerebellopontine cisterns were measured using ITK-SNAP 3.0, which considers the cerebrospinal fluid (CSF) volume based on the region of interest (ROI). Preoperative and postoperative statuses were based on visual analog scale (VAS) pain scores and Barrow Neurological Institute (BNI) scores.Results: A total of 30 patients (11 males; 19 females) were included, and the age of the BTN participants ranged from 41 to 77 (59.93 ± 9.89) years. The duration of TN ranged from 1 to 20 (5.36 ± 3.92) years, and the interval between the two sides ranged from 0 to 3 (1.10 ± 0.79) years. Three patients (10%) in the BTN group had familial trigeminal neuralgia, with no other hereditary history of neurological disorders. In BTN patients, with 25 (83.3%) cases on the left side and 26 (86.7%) on the right side, veins were identified in the operative field and regarded as the individual or offending vessel. The mean VPCF was significantly lower in the patients with BTN than in the healthy controls (4,813 ± 1,155 mm3 vs. 5,127 ± 1,129 mm3, p = 0.008). The volumes of the cerebellopontine cisterns on both sides were significantly smaller in the BTN patients than in the healthy controls (477 ± 115 mm3 vs. 515 ± 112 mm3 on the left side, p = 0.001; and 481 ± 114 mm3 vs. 515 ± 110 mm3 on the right side, p = 0.007). There was no significant difference between the BTN group and the UTN group in terms of the VPCF (4,843 ± 1,184 mm3 vs. 4,813 ± 1,155 mm3, p = 0.402), and there was also no significant difference between the two groups in terms of preoperative VAS pain scores or BNI scores.Conclusion: Overcrowding in the posterior fossa will lead to closer neurovascular relations and, a higher incidence of NVC, and ultimately may be more likely to lead to TN. Veins are the common offending vessels that cause BTN; they might be associated with abnormal vascular development leading to NVC. Microsurgical vascular decompression (MVD) is a safe and effective method for the treatment of BTN, similar to UTN.

Guillain-Barré syndrome (GBS) is an acute inflammatory peripheral nerve disorder mediated by autoimmune mechanisms. However, its co-occurrence with autoimmune encephalitis (AE) is rare. We present a 51-year-old man who initially presented with symmetrical numbness and weakness in all limbs, followed by hallucinations, behavioral abnormalities, and consciousness disturbances. Cerebrospinal fluid (CSF) analysis revealed protein-cell dissociation, indicative of GBS. Brain magnetic resonance imaging (MRI) showed abnormal signals in the splenium of the corpus callosum. Electromyography showed reduced amplitude in motor nerve conduction of bilateral common peroneal nerves and left tibial nerves. He developed respiratory distress, requiring tracheal intubation and mechanical ventilation. Finally, he was diagnosed with GBS combined with AE and received treatment with intravenous immunoglobulin (IVIG) and plasma exchange (PLEX). Subsequently, he experienced paroxysmal sympathetic hyperactivity (PSH) and refractory hypotension requiring vasopressor support. After comprehensive treatment, he was successfully weaned off the ventilator, and his refractory hypotension resolved after more than six months. This case illustrates that severe autonomic dysfunction can occur at any stage of GBS companied with AE. Furthermore, these patients often require prolonged ICU stays and experience slower recovery, but may still achieve a favorable outcome with appropriate integrated therapy.

The article provides an overview of the current understanding of the interplay between metabolic pathways and immune function in the context of triple-negative breast cancer (TNBC). It highlights recent advancements in single-cell and spatial transcriptomics technologies, which have revolutionized the analysis of tumor heterogeneity and the immune microenvironment in TNBC. The review emphasizes the crucial role of metabolic reprogramming in modulating immune cell function, discussing how specific metabolic pathways, such as glycolysis, lipid metabolism, and amino acid metabolism, can directly impact the activity and phenotypes of various immune cell populations within the TNBC tumor microenvironment. Furthermore, the article explores the implications of these metabolic-immune interactions for the efficacy of immune checkpoint inhibitor (ICI) therapies in TNBC, suggesting that strategies targeting metabolic pathways may enhance the responsiveness to ICI treatments. Finally, the review outlines future directions and the potential for combination therapies that integrate metabolic modulation with immunotherapeutic approaches, offering promising avenues for improving clinical outcomes for TNBC patients.

BackgroundChen’s Peiyuan Tang (CSPYT) is a compound herbal formula that has shown the potential to enhance ovarian function and reduce autophagy in ovarian granulosa cells, which plays a crucial role in follicular development and maturation. The application of Chinese herbal medicine offers a promising alternative to traditional hormone replacement therapy (HRT).MethodsThis study explores CSPYT’s therapeutic mechanisms in treating POF, focusing on its modulation of autophagy through network pharmacology and transcriptomics-based analysis, predicting potential interactions and pathways. KGN cell line and rat ovarian granulosa cells were used for in vitro experiment. 4-Hydroperoxy cyclophosphamide(4-HC) stimulation was carried out for establishing the POF cell model. Q-PCR, Western Blot, Transmission electron microscopy to detect the results.ResultsAccording to the drug and disease database, the common targets of Chen’s Peiyuan Tang and premature ovarian failure were screened, combined with autophagy gene targets and transcriptome analysis, and finally 8 intersection targets were obtained, namely CDKN1B, MAPK3, PRKCD, CDKN1A, MAPK1, RAF1, BIRC5, CTSB. Enrichment analysis of 8 genes found that they were closely related to the animal autophagy pathway. Construct PPI network diagram. CytoScape 3.9.1 builds CSPYT Drug Target-POF Disease Target-Autophagy Gene Network Diagram. Based on the PPI network diagram and CytoScape 3.9.1 analysis results, it is estimated that MAPK1 and MAPK3 are the key targets of CSPYT in the treatment of POF. The eight final intersection targets were docked with the corresponding active pharmaceutical ingredients. The one that docked most closely with the MAPK family was naringenin. In cell experiment verification, it was confirmed that Chen’s Peiyuan Tang can inhibit the MAPK signaling pathway, significantly reduce the number of autophagosomes, and reduce autophagy damage in ovarian granulosa cells.DiscussionCSPYT can inhibit the MAPK signaling pathway, prevent autophagy overexpression and restore ovarian granulosa cell function, effectively alleviating the disease pressure of POF.

Sequences of the complete mitochondrial cytochrome oxidase subunit I gene were used to identify Trichiurus species and examine their population genetic structure and demographic history along the coast of China. Three Trichiurus species were found. Trichiurus japonicus lives in colder waters along the continental shelves in the China Seas, while Trichiurus nanhaiensis lives warmer waters along continental slopes in the South China Sea, and Trichiurus brevis lives in shallow and warmer waters in the South China Sea. The migrations of these species were mainly associated with feeding and spawning preferences. Two major wintering and spawning grounds in the East China Sea and South China Sea were found. All species showed a lack of population genetic structure resulting from their oceanodromous life cycle (the degree of population substructure index NST = 0.000–0.149), but the results of approximate Bayesian computational approaches suggested population declines or stabilization and differentiation. The results of the TMRCA (time to the most recent common ancestor) showed that during glaciations, the Yellow Sea and the East China Sea were completely exposed, and the South China Sea acted as a refugium. Thus, the populations of these three species experienced differentiation during glaciations. This study also examined the limitations of Bayesian skyline plot analysis.

Autosomal dominant osteopetrosis type II (ADO II), characterized by increased bone mass and density, is caused by mutations in the chloride channel 7 (CLCN7) gene. In this study, a novel missense variant in CLCN7 (c.1678A > G; p.Met560Val) was identified in three symptomatic subjects and one carrier of a Chinese family with ADO II. Notably, bone formation markers, including osteocalcin and total procollagen type N-terminal propeptide, have increased or presented at the upper limit of the normal range in the three patients. Serum factors secreted by osteoclast lineage cells and affecting the CD31hiEMCNhi vessel formation, such as tartrate-resistant acid phosphatase 5b, platelet-derived growth factor-BB, vascular endothelial growth factor, and SLIT3, had a higher expression in three ADO II subjects than in 15 healthy age-matched and sex-matched controls. Moreover, the conditioned medium was obtained from preosteoclast induced from the ADO II patients’ peripheral blood mononuclear cells. It was found to promote the CD31hiEMCNhi vessel formation of human microvascular endothelial cells and osteogenic differentiation of bone marrow-derived stem cells. Taken together, our finding revealed a novel CLCN7 variant associated with ADO II and suggested that the sclerotic bone was potentially associated with the increase of the CD31hiEMCNhi vessel formation and bone formation.