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Abstract Aims/Introduction To evaluate the differences in cardiac autonomic function, cardiac structure and diastolic function between individuals with diabetic foot (DF) and those with diabetes but without DF. Materials and Methods A total of 413 individuals with DF and 437 without DF who underwent a 24‐h electrocardiogram Holter and a Doppler echocardiogram were included. The heart rate variability parameters to evaluate cardiac autonomic function, and the indices for the assessment of cardiac structure and left ventricular (LV) diastolic function, including left atrium, LV posterior wall thickness, interventricular septum and E/e′ ratio, were measured or calculated. Propensity score matching was used for the sensitivity analysis to minimize potential imbalance. Results In both the crude and propensity score matching analyses, significant differences were observed in heart rate variability between individuals with and without DF, as evidenced by lower standard deviation of the normal sinus interval, lower low‐frequency power/high‐frequency power ratio, lower standard deviation of the 5‐min average RR intervals, lower low‐frequency power, lower percentage of normal adjacent RR interval difference >50 ms, lower root mean square of successive RR interval differences and lower high‐frequency power (all P

Abstract Background Organophosphate flame retardants (OPFRs) are extensively distributed in our environment, prompting concerns about potential health hazards, including lung injuries resulting from OPFR exposure. Methods The present study recruited 125 lung cancer patients, assessing their exposure to 10 OPFR compounds through urine samples. The final analysis comprised 108 participants after excluding those lacking epidermal growth factor receptor (EGFR) status and those with chronic kidney disease. Demographic and clinical characteristics, as well as urinary OPFR concentrations, were compared based on OPFR detection. Spearman correlation was conducted to explore the relationship between OPFR compounds, while logistic regression was used to identify OPFR compounds associated with EGFR mutation. Results The study revealed widespread OPFR exposure among lung cancer patients, with an overall detection frequency of 99.07%. Tris(2‐butoxyethyl) phosphate (TBEP) exhibited a strong correlation to its metabolite bis(2‐butoxyethyl) phosphate (r = 0.88, p

Abstract Objective To detail a novel technique of robotic‐assisted simple prostatectomy that makes handling the gland protruding into the bladder neck easier and can preserve the urethra and retain ejaculation function as much as possible. Patients and methods This is a prospective case series. Clinical data of 17 male patients who had large volume (>80 mL) benign prostatic hyperplasia (BPH) were enrolled to undergo trans‐rectovesical pouch urethral‐sparing robotic‐assisted simple prostatectomy (usRASP). We adopted the approach through the space between the bladder neck and seminal vesicle to perform a usRASP that can avoid the detrusor skirt and fibrous matrix area of the retropubic prostate. Between the transitional zone and the peripheral zone of the large prostate, the hyperplastic prostatic gland tissue can be enucleated under direct vision while preserving the prostatic urethra and retaining the ejaculatory duct and bladder neck intact. All preoperative, perioperative and postoperative clinical data were collected, and descriptive analysis was performed. Results The median intravesical prostatic protrusion was 19.3 mm (8.5–32.2). The median operative time was 100 min (75–140), and the median estimated blood loss was 100 mL (10–500). The median time to catheter removal was 7 days (5–7), with a median postoperative hospital stay of 2 days (2–4). After at least 6‐month follow‐up, the median maximum urine flow rate and postvoid residual volume were 40.1 mL/s (12.7–52.4) and 15 mL (5–23), respectively; the median International Prostate Symptom Score and Quality of Life score were 0 (0–6.3) and 1 (0–3), respectively; and the median total prostate‐specific antigen was 0.84 ng/mL (0.15–1.01). All patients successfully underwent usRASP. Fifty‐eight percent of patients with normal ejaculation function before surgery can still retain normal ejaculation function. Conclusion We described a new approach to performing usRASP. This new method remarkably improved the voiding function, maintained antegrade ejaculation and did not increase the post‐operative complications.

Abstract Relapse remains the main cause of treatment failure in patients with myeloid malignancies even after allogeneic hematopoietic stem cell transplantation (allo‐HSCT). We observed a particularly low incidence of relapse in patients prepared with fludarabine, busulfan and melphalan in our previous study and this multicenter retrospective analysis aimed to confirm the feasibility of the regimen and to identify the potential prognostic factors. This study was performed using registry data from adults patients with myeloid malignancies who underwent their first allo‐HSCT following fludarabine(≥100 mg/m2), busulfan (≥3.2 mg/kg) and melphalan (≥100 mg/m2) based conditioning at nine transplantation centers in China between Jan. 2020 and Mar. 2022. A total of 221 consecutive patients (AML n = 171, MDS‐IB‐1 or 2 n = 44, CMML n = 6) with median age of 46 were enrolled in this study. The median follow‐up was 507 days for survivors. The 2‐year NRM, CIR, OS and DFS were 10.6% ± 2.2%, 14.8% ± 3.3%, 79.4% ± 3.7% and 74.6% ± 3.7%, respectively. In multivariate analyses, high HCT‐CI (≥3) was the only independent factor for higher NRM [hazard ratio (HR), 2.96; 95% confidence interval (CI), 1.11 to 7.90; p = 0.030] and ECOG score ≥2 was the only independent factor for inferior OS (HR, 2.43; 95%CI, 1.15 to 5.16; p = 0.020) and DFS (HR, 2.12; 95%CI, 1.13 to 4.02; p = 0.020). AML diagnosis and positive measurable residual disease (MRD) at transplantation were predictors for higher CIR (HR = 7.92, 95%CI 1.05‐60.03, p = 0.045; HR = 3.64, 95%CI 1.40‐9.44, p = 0.008; respectively), while post‐transplantation cyclophosphamide based graft‐versus‐host disease prophylaxis was associated with lower CIR (HR = 0.24 95%CI 0.11‐0.54, p = 0.001). The intensity of conditioning regimen did not impact CIR, NRM, DFS and OS. These results supported that double alkylating agents of busulfan and melphalan based conditioning regimens were associated with low relapse rate and acceptable NRM in adult patients with myeloid malignancies. The optimal dose remained to be confirmed by further prospective studies.

Abstract Objective Radiofrequency thermocoagulation (RFTC) has emerged as an effective and safe treatment method for patients with refractory focal epilepsy, when stereo‐electroencephalography (SEEG) is implanted. Although real‐world research results are still limited, a considerable number of patients have shown favorable outcomes with this less invasive method. This study aims to describe the outcomes and predictive factors of SEEG‐RFTC in real‐world research. Methods A retrospective observational study was conducted on patients in the authors' epilepsy center. In total, 121 patients who underwent RFTC were included in the study. Post‐RFTC outcomes were evaluated using the seizure‐free rate and response rate (seizure frequency reduction more than 50%). Predictive factors influencing post‐RFTC outcome were considered by comparing different variables. Results The mean follow‐up period was 18.3 months. Eighty‐two patients (67.8%) were responders and 54 (44.6%) were seizure free. In 36 patients with malformation of cortical development, the seizure‐free rate and the response rate were 69.44% and 83.33%, respectively. In 20 patients with hippocampal sclerosis, 19 patients were responders and 14 (70%) patients were seizure free at the last follow‐up. The MRI feature and etiology of epilepsy are correlated with the outcome. MR‐positive is a predictive factor for seizure freedom (p

Abstract Objective Transcranial sonography (TCS) is a noninvasive neuroimaging technique, visualizing deep brain structures and the ventricular system. Although widely employed in diagnosing various movement disorders, such as Parkinson's disease and dystonia, by detecting disease‐specific abnormalities, the specific characteristics of the TCS in cerebellar ataxia remain inconclusive. We aimed to assess the potential value of TCS in patients with cerebellar ataxias for disease diagnosis and severity assessment. Methods TCS on patients with genetic and acquired cerebellar ataxia, including 94 with spinocerebellar ataxias (SCAs) containing 10 asymptomatic carriers, 95 with cerebellar subtype of multiple system atrophy (MSA‐C), and 100 healthy controls (HC), was conducted. Assessments included third ventricle width, substantia nigra (SN) and lentiform nucleus (LN) echogenicity, along with comprehensive clinical evaluations and genetic testing. Results The study revealed significant TCS abnormalities in patients with cerebellar ataxia, such as enlarged third ventricle widths and elevated rates of hyperechogenic SN and LN. TCS showed high accuracy in distinguishing patients with SCA or MSA‐C from HC, with an AUC of 0.870 and 0.931, respectively. TCS abnormalities aided in identifying asymptomatic SCA carriers, effectively differentiating them from HC, with an AUC of 0.725. Furthermore, third ventricle width was significantly correlated with SARA and ICARS scores in patients with SCA3 and SCOPA‐AUT scores in patients with MSA‐C. The SN area and SARA or ICARS scores in patients with SCA3 were also positively correlated. Interpretation Our findings illustrate remarkable TCS abnormalities in patients with cerebellar ataxia, serving as potential biomarkers for clinical diagnosis and progression assessment.

Abstract Objective Efgartigimod, a neonatal Fc receptor antagonist, facilitates antibody degradation including pathogenic IgGs. The ADAPT study demonstrated the tolerability and efficacy of efgartigimod in the treatment of generalized myasthenia gravis (gMG). However, very limited evidence is available for the Chinese population, and it remains inconclusive about which kind of patients are selected to preferentially receive efgartigimod in real‐world settings. Methods This multicenter cohort study included gMG patients treated at 14 neuromuscular reference centers in China. The Myasthenia Gravis Activities of Daily Living (MG‐ADL) score, immunosuppressants, and the incidence of treatment‐emergent adverse events (TEAEs) were prospectively collected. Results Of the 1640 gMG admitted between September and December 2023, 61 (3.7%) received efgartigimod for at least one treatment cycle. Among them, 56 cases (92%) were anti‐AChR antibody‐positive, 4 were anti‐MuSK antibody‐positive, and 1 was seronegative. Thymoma‐associated myasthenia gravis accounted for most cases (44%, 27 out of 61). The principal causes of efgartigimod initiation included MG acute exacerbation (MGAE) (48%, 29 out of 61) and myasthenic crisis (MC) (15%, 9 out of 61). Clinically meaningful improvement was rapidly achieved in 97% (58 out of 61) of patients at 1.3 ± 0.7 weeks. By week 12, the MG‐ADL score reduced to 3.8 ± 4.1 (baseline:10.5 ± 5.2) for all participants, while it reduced to 4.0 ± 4.7 for MGAE and 3.8 ± 4.2 for MC, respectively. All but one TMG patient required no additional rescue therapies after efgartigimod initiation. 11.5% (7 out of 61) reported ≥1 TEAEs. Interpretation This multicenter cohort study demonstrated the efficacy of efgartigimod in rapid control of gMG. Patients with MGAE or MC would benefit from efgartigimod treatment.

Abstract Monascus red pigments (MRP) may have benefits against NAFLD with an unclear mechanism. This study aimed to explore the protective effect of MRP supplementation against NAFLD through regulation of gut microbiota and metabolites. The C57BL/6 mice animals were randomly allocated into the normal diet (NC), HFHS diet‐induced NAFLD model, and MRP intervention group fed with HFHS diet. Serum lipid profiles and liver function parameters were measured. Liver and colon histopathology analysis was conducted to determine the injury in the liver and colon. 16S rRNA gene sequencing was employed to analyze gut microbial composition from fecal samples. Untargeted metabonomics was performed to analyze changes in metabolites in serum and fecal samples. MRP supplementation significantly improved the HFHS‐induced alterations in body weight, lipid profiles, and liver function (p

Abstract Objectives Epilepsy and migraine are common chronic neurological disease. Epidemiologic studies and shared pathophysiology and treatment suggest that these two diseases overlap. However, migraine is often underestimated among patients with epilepsy. This study aimed to evaluate the prevalence of migraine and identify the related influencing factors among adult patients with epilepsy. Methods Adult patients with epilepsy were recruited at the outpatient epilepsy clinic of 13 tertiary hospitals in China from February to September 2022. ID Migraine questionnaire was applied to evaluate for migraine. Both univariable and multivariable logistic regression models were used to explore the influencing factors of migraine. Results A total of 1326 patients with epilepsy were enrolled in this study. The prevalence of migraine among patients with epilepsy was 19.2% (254/1326). In the multivariable analysis, being female (OR = 1.451, 95% CI: 1.068–1.975; p = 0.018), focal and focal to bilateral tonic–clonic seizures (OR = 1.583, 95% CI: 1.090–2.281; p = 0.015), and current seizure attack in the last 3 months (OR = 1.967, 95% CI: 1.282–3.063; p = 0.002) were the influencing factors for migraine. However,

Abstract Objective Closure surgery of patent foramen ovale (PFO) has been found to effectively control cryptogenic stroke and migraine, but it is uncertain whether PFO closure could also alleviate epileptic seizures. This study aims to observe the therapeutic effect of PFO closure on epileptic seizures. Methods Since July 11th, 2017, in the neurology department of West China Hospital, Sichuan University, Chengdu, we have been regularly monitoring patients with epilepsy who have undergone PFO closure. The patient's clinical information, such as frequency, duration, and severity of seizures, before and after surgery was recorded in detail as well as postoperative safety events. Results Of the 31 epilepsy patients who confirmed PFO observed (27 cases were drug‐resistant epilepsy, 87.10%), average age of surgery was 23.74 years, and 12 cases were female (38.71%). After one‐year follow‐up, 26 patients (83.87%) achieved remission of seizure frequency, and 22 of whom (70.97%) experienced a remission of more than 50%. Additionally, compared to before surgery, 22 cases (70.97%) reported a decrease in the average seizure duration, and 20 cases (64.52%) reported a reduction in seizure severity. In the seizure indicators of frequency, average duration and severity, significant differences were identified between preoperative and postoperative comparisons with all test p values were

Abstract Background There are no effective pharmacological treatments for sarcopenia. We aim to identify potential therapeutic targets for sarcopenia by integrating various publicly available datasets. Methods We integrated druggable genome data, cis‐eQTL/cis‐pQTL from human blood and skeletal muscle tissue, and GWAS summary data of sarcopenia‐related traits to analyse the potential causal relationships between drug target genes and sarcopenia using the Mendelian Randomization (MR) method. Sensitivity analyses and Bayesian colocalization were employed to validate the causal relationships. We also assessed the side effects or additional indications of the identified drug targets using a phenome‐wide MR (Phe‐MR) approach and investigated actionable drugs for target genes using available databases. Results MR analysis identified 17 druggable genes with potential causation to sarcopenia in human blood or skeletal muscle tissue. Six of them (HP, HLA‐DRA, MAP 3K3, MFGE8, COL15A1, and AURKA) were further confirmed by Bayesian colocalization (PPH4 > 90%). The up‐regulation of HP [higher ALM (beta: 0.012, 95% CI: 0.007–0.018, P = 1.2*10−5) and higher grip strength (OR: 0.96, 95% CI: 0.94–0.98, P = 4.2*10−5)], MAP 3K3 [higher ALM (beta: 0.24, 95% CI: 0.21–0.26, P = 1.8*10−94), higher grip strength (OR: 0.82, 95% CI: 0.75–0.90, P = 2.1*10−5), and faster walking pace (beta: 0.03, 95% CI: 0.02–0.05, P = 8.5*10−6)], and MFGE8 [higher ALM (muscle eQTL, beta: 0.09, 95% CI: 0.06–0.11, P = 6.1*10−13; blood pQTL, beta: 0.05, 95% CI: 0.03–0.07, P = 3.8*10−09)], as well as the down‐regulation of HLA‐DRA [lower ALM (beta: ‐0.09, 95% CI: −0.11 to −0.08, P = 5.4*10−36) and lower grip strength (OR: 1.13, 95% CI: 1.07–1.20, P = 1.8*10−5)] and COL15A1 [higher ALM (muscle eQTL, beta: ‐0.07, 95% CI: −0.10 to −0.04, P = 3.4*10−07; blood pQTL, beta: ‐0.05, 95% CI: −0.06 to −0.03, P = 1.6*10−07)], decreased the risk of sarcopenia. AURKA in blood (beta: ‐0.16, 95% CI: −0.22 to −0.09, P = 2.1*10−06) and skeletal muscle (beta: 0.03, 95% CI: 0.02 to 0.05, P = 5.3*10−05) tissues showed an inverse relationship with sarcopenia risk. The Phe‐MR indicated that the six potential therapeutic targets for sarcopenia had no significant adverse effects. Drug repurposing analysis supported zinc supplementation and collagenase clostridium histolyticum might be potential therapeutics for sarcopenia by activating HP and inhibiting COL15A1, respectively. Conclusions Our research indicated MAP 3K3, MFGE8, COL15A1, HP, and HLA‐DRA may serve as promising targets for sarcopenia, while the effectiveness of zinc supplementation and collagenase clostridium histolyticum for sarcopenia requires further validation.

Abstract We present an in‐depth analysis of dyslipidemia management strategies for patients with diabetes mellitus in Taiwan. It critically examines the disparity between established guideline recommendations and actual clinical practices, particularly in the context of evolving policies affecting statin prescriptions. The focus is on synthesizing the most recent findings concerning lipid management in patients with diabetes mellitus, with a special emphasis on establishing consensus regarding low‐density lipoprotein cholesterol treatment targets. The article culminates in providing comprehensive, evidence‐based recommendations tailored to the unique needs of those living with diabetes mellitus in Taiwan. It underscores the criticality of personalized care approaches, which incorporate multifaceted factors, and the integration of novel therapeutic options to enhance cardiovascular health outcomes.

To investigate the effects of patellar denervation (PD) and non‐patellar denervation (NPD) after primary total knee arthroplasty (TKA) without patellar resurfacing, this study conducted systematic electronic searches in November 2023 using PubMed, Embase, Web of Science, Cochrane, and Scopus, adhering to Cochrane Collaboration recommendations. Only randomized controlled trials (RCTs) were included. Additionally, a manual search was performed to identify potentially eligible studies from the reference lists of review articles. Two researchers independently conducted literature reviews, data extraction, and risk of bias assessments. The outcome analysis encompassed the incidence of anterior knee pain (AKP), visual analogue scale (VAS), range of motion (ROM), American Knee Society Score (KSS), Oxford Knee Score (OKS), patellar score (PS), complications, and reoperations. Meta‐analysis was executed using RevMan 5.3 software. To enhance the credibility of the study, TSA v0.9 software was utilized to perform power analysis on the overall efficacy of primary and secondary outcomes. Twelve studies involving 1745 patients (1587 knees) were included, with 852 undergoing PD and 893 undergoing NPD. Results indicated a superior reduction in AKP incidence in the PD group compared to the NPD group. Statistically significant differences were observed between PD and NPD in KSS, OKS, and PS. However, the upper limit of the 95% confidence interval for each outcome fell below the minimal clinically important difference (MCID). No significant differences were found in VAS and ROM between PD and NPD. Additionally, PD was not associated with an increased incidence of complications or reoperations. Within 12 months and beyond, PD was proven to be a beneficial intervention in reducing AKP following TKA without patellar resurfacing, achieved without an increase in complications or reoperations. Regarding KSS, OKS, and PS, the minimal advantage achievable through PD may not be clinically significant.

Objective The accurate measurement of Cobb angles is crucial for the effective clinical management of patients with adolescent idiopathic scoliosis (AIS). The Lenke classification system plays a pivotal role in determining the appropriate fusion levels for treatment planning. However, the presence of interobserver variability and time‐intensive procedures presents challenges for clinicians. The purpose of this study is to compare the measurement accuracy of our developed artificial intelligence measurement system for Cobb angles and Lenke classification in AIS patients with manual measurements to validate its feasibility. Methods An artificial intelligence (AI) system measured the Cobb angle of AIS patients using convolutional neural networks, which identified the vertebral boundaries and sequences, recognized the upper and lower end vertebras, and estimated the Cobb angles of the proximal thoracic, main thoracic, and thoracolumbar/lumbar curves sequentially. Accordingly, the Lenke classifications of scoliosis were divided by oscillogram and defined by the AI system. Furthermore, a man–machine comparison (n = 300) was conducted for senior spine surgeons (n = 2), junior spine surgeons (n = 2), and the AI system for the image measurements of proximal thoracic (PT), main thoracic (MT), thoracolumbar/lumbar (TL/L), thoracic sagittal profile T5–T12, bending views PT, bending views MT, bending views TL/L, the Lenke classification system, the lumbar modifier, and sagittal thoracic alignment. Results In the AI system, the calculation time for each patient's data was 0.2 s, while the measurement time for each surgeon was 23.6 min. The AI system showed high accuracy in the recognition of the Lenke classification and had high reliability compared to senior doctors (ICC 0.962). Conclusion The AI system has high reliability for the Lenke classification and is a potential auxiliary tool for spinal surgeons.

Abstract This study aimed to investigate the therapeutic potential of human adipose‐derived mesenchymal stem cells (hADSCs) modified with recombinant adeno‐associated virus (rAAV) carrying the vascular endothelial growth factor 165 (VEGF165) gene in peripheral nerve injury (PNI). The hADSCs were categorized into blank, control (transduced with rAAV control vector), and VEGF165 (transduced with rAAV VEGF165 vector) groups. Subsequently, Schwann cell differentiation was induced, and Schwann cell markers were assessed. The sciatic nerve injury mouse model received injections of phosphate‐buffered saline (PBS group), PBS containing hADSCs (hADSCs group), rAAV control vector (control‐hADSCs group), or rAAV VEGF165 vector (VEGF165‐hADSCs group) into the nerve defect site. Motor function recovery, evaluated through the sciatic function index (SFI), and nerve regeneration, assessed via toluidine blue staining along with scrutiny of Schwann cell markers and neurotrophic factors, were conducted. Modified hADSCs exhibited enhanced Schwann cell differentiation and elevated expression of Schwann cell markers [S100 calcium‐binding protein B (S100B), NGF receptor (NGFR), and glial fibrillary acidic protein (GFAP)]. Mice in the VEGF165‐hADSCs group demonstrated improved motor function recovery compared to those in the other three groups, accompanied by increased fiber diameter, axon diameter, and myelin thickness, as well as elevated expression of Schwann cell markers (S100B, NGFR, and GFAP) and neurotrophic factors [mature brain‐derived neurotrophic factor (BDNF) and glial cell‐derived neurotrophic factor (GDNF)] in the distal nerve segment. rAAV‐VEGF165 modification enhances hADSC potential in PNI, promoting motor recovery and nerve regeneration. Elevated Schwann cell markers and neurotrophic factors underscore therapy benefits, providing insights for nerve injury strategies.

Abstract Objective The objective of this study was to explore the clinical characteristics and management of sudden hearing loss (HL) during pregnancy, thus better guiding the clinical practice. Methods The clinical and follow‐up data of 17 patients (17 ears) with sudden HL during pregnancy were analyzed retrospectively (the observe group). Twelve nonpregnant female patients (12 ears) with sudden HL of similar clinical characteristics were selected as the control group. The prognosis of the two groups was compared. All the patients were followed up after delivery, and two of them were readmitted to the hospital 1–2 months after delivery. Results The observe group had better improvement in hearing and a higher response rate compared to the control group. The pure tone hearing and speech recognition rate of patients could still be improved after the readmitted treatment, and the hearing could partially recover spontaneously during follow‐up. The laboratory indicators that affect the inflammatory response and coagulation pathway were significantly different between the two groups. Conclusions The hearing condition of sudden HL during pregnancy is severe, and the prognosis of these patients is better than nonpregnant patients of similar clinical characteristics. Postpartum treatment is still effective, and some patients showed self‐healing with time during follow‐up. The inflammatory response and coagulation function may affect the hearing of patients through a metabolic pathway.

Abstract This article introduces a Wasserstein distance‐based distributionally robust optimization model to address the transmission expansion planning considering renewable‐based microgrids (MGs) under the impact of uncertainties. The primary objective of the presented methodology is to devise a robust expansion strategy that accounts for both long‐term uncertainty and short‐term variability over the planning horizon from the perspective of a central planner. In this framework, the central planner fosters the construction of appropriate transmission lines and the deployment of optimal MG‐based generating units among profit‐driven private investors. The Wasserstein distance uncertainty set is used to characterize the long‐term uncertainty associated with future load demand. Short‐term uncertainties, stemming from variations in load demands and production levels of stochastic units, are modeled through operating conditions. To ensure the tractability of the proposed planning model, the authors introduce a decomposition framework embedded with a modified application of Bender's method. To validate the efficiency and highlight the potential benefits of the proposed expansion planning methodology, two case studies based on simplified IEEE 6‐bus and IEEE 118‐bus systems are included. These case studies assess the effectiveness of the presented approach, its ability to navigate uncertainties, and its capacity to effectively optimize expansion decisions.

Abstract In recent years, deep learning methods were good solutions for object detection in synthetic aperture radar (SAR) images. However, the problems of complex scenarios, large object scale differences and imperfect fine‐grained classification in ship detection were intractable. In response, an improved model GDB‐YOLOv5s (Improved YOLOv5s model incorporating global attention mechanism (GAM), DCN‐v2 and BiFusion) is designed. This model introduces deformable convolution networks (DCN‐v2) into the Backbone to enhance the adaptability of the receptive field. It replaces the original Neck's PANet structure with a BiFusion structure to better fuse the extracted multiscale features. Additionally, it integrates GAM into the network to reduce information loss and improve global feature interaction. Experiments were conducted on single‐class dataset SSDD and multi‐class dataset SRSSD‐V1.0. The results show that the GDB‐YOLOv5s model improves mean average precision scores (mAP) significantly, outperforming the original YOLOv5s model and other traditional methods. GDB‐YOLOv5s also improves Precision‐score (P) and Recall‐score (R) for fine‐grained classification to some extent, thereby reducing false alarms and missed detections. It has been proved that the improved model is relatively effective.

Abstract In view of the fact that dynamic stall models in the wind energy industry such as ONERA model, Beddoes–Leishman model, and Snel model are mostly semi‐empirical models, and the determination of empirical time constants has a great influence on the model accuracy. To optimize the time constant in dynamic stall model and improve the prediction accuracy of unsteady aerodynamics, the influence of boundary layer and pressure lag on the unsteady performance of the S809 airfoil under 2D flow conditions is explored using a simple semi‐empirical dynamic stall engineering model. The proposed model consists of four first‐order differential equations accounting for attached flow and dynamic separation flow of trailing edge based on the Theodorsen theory. A validation is carried out by the wind tunnel experiment in the Key Laboratory of Wind and Solar Energy Utilization Technology of the Ministry of Education at Inner Mongolia University of Technology. The main conclusions are as follows. The time constants for lag in pressure and boundary layer both have a great influence on the unsteady lift coefficient. When the mean angle of attack is relatively small and the airflow is between the attached flow and the separated flow, appropriately reducing the time constant can make the prediction results closer to the experimental values. When the mean angle of attack is relatively large and the airflow is in condition of fully separated flow, the time constant value can be appropriately increased. The influence of pressure lag and boundary layer lag on the unsteady drag coefficient is not significant.

Abstract Background To explore potential biomarkers for early diagnosis of atherosclerosis (AS) and provide basic data for further research on AS, the characteristics of serum metabolomics during the progression of AS in mini‐pigs were observed dynamically. Methods An AS model in Bama miniature pigs was established by a high‐cholesterol and high‐fat diet. Fasting serum samples were collected monthly for metabolomics and serum lipid detection. At the end of the treatment period, pathological analysis of the abdominal aorta and coronary artery was performed to evaluate the lesions of AS, thereby distinguishing the susceptibility of mini‐pigs to AS. The metabolomics was detected using a high‐resolution untargeted metabolomic approach. Statistical analysis was used to identify metabolites associated with AS susceptibility. Results Based on pathological analysis, mini‐pigs were divided into two groups: a susceptible group (n = 3) and a non‐susceptible group (n = 6). A total of 1318 metabolites were identified, with significant shifting of metabolic profiles over time in both groups. Dynamic monitoring analysis highlighted 57 metabolites that exhibited an obvious trend of differential changes between two groups with the advance of time. The KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment analysis indicated significant disorders in cholesterol metabolism, primary bile acid metabolism, histidine metabolism, as well as taurine and hypotaurine metabolism. Conclusions During the progression of AS in mini‐pigs induced by high‐cholesterol/high‐fat diet, the alterations in serum metabolic profile exhibited a time‐dependent pattern, accompanied by notable disturbances in lipid metabolism, cholesterol metabolism, and amino acid metabolism. These metabolites may become potential biomarkers for early diagnosis of AS.

Abstract Introduction This study aimed to establish an animal model of open abdomen (OA) through temporary abdominal closure via different techniques. Methods Adult male Sprague–Dawley rats were randomly divided into three groups: group A (OA with polypropylene mesh alone); group B (OA with polypropylene mesh combined with a patch); and group C (OA with polypropylene mesh and a sutured patch). Vital signs, pathophysiological changes, and survival rates were closely monitored in the rats for 7 days after surgery. Abdominal X‐rays and histopathological examinations were performed to assess abdominal organ changes and wound healing. Results The results showed no significant difference in mortality rates among the three groups (p > 0.05). However, rats in group B exhibited superior overall condition, cleaner wounds, and a higher rate of wound healing compared to the other groups (p

Abstract The mouse genome has a high degree of homology with the human genome, and its physiological, biochemical, and developmental regulation mechanisms are similar to those of humans; therefore, mice are widely used as experimental animals. However, it is undeniable that interspecies differences between humans and mice can lead to experimental errors. The differences in the immune system have become an important factor limiting current immunological research. The application of immunodeficient mice provides a possible solution to these problems. By transplanting human immune cells or tissues, such as peripheral blood mononuclear cells or hematopoietic stem cells, into immunodeficient mice, a human immune system can be reconstituted in the mouse body, and the engrafted immune cells can elicit human‐specific immune responses. Researchers have been actively exploring the development and differentiation conditions of host recipient animals and grafts in order to achieve better immune reconstitution. Through genetic engineering methods, immunodeficient mice can be further modified to provide a favorable developmental and differentiation microenvironment for the grafts. From initially only being able to reconstruct single T lymphocyte lineages, it is now possible to reconstruct lymphoid and myeloid cells, providing important research tools for immunology‐related studies. In this review, we compare the differences in immune systems of humans and mice, describe the development history of human immune reconstitution from the perspectives of immunodeficient mice and grafts, and discuss the latest advances in enhancing the efficiency of human immune cell reconstitution, aiming to provide important references for immunological related researches.

Abstract Background Calcific aortic valve stenosis (CAVS) is one of the most challenging heart diseases in clinical with rapidly increasing prevalence. However, study of the mechanism and treatment of CAVS is hampered by the lack of suitable, robust and efficient models that develop hemodynamically significant stenosis and typical calcium deposition. Here, we aim to establish a mouse model to mimic the development and features of CAVS. Methods The model was established via aortic valve wire injury (AVWI) combined with vitamin D subcutaneous injected in wild type C57/BL6 mice. Serial transthoracic echocardiography was applied to evaluate aortic jet peak velocity and mean gradient. Histopathological specimens were collected and examined in respect of valve thickening, calcium deposition, collagen accumulation, osteogenic differentiation and inflammation. Results Serial transthoracic echocardiography revealed that aortic jet peak velocity and mean gradient increased from 7 days post model establishment in a time dependent manner and tended to be stable at 28 days. Compared with the sham group, simple AVWI or the vitamin D group, the hybrid model group showed typical pathological features of CAVS, including hemodynamic alterations, increased aortic valve thickening, calcium deposition, collagen accumulation at 28 days. In addition, osteogenic differentiation, fibrosis and inflammation, which play critical roles in the development of CAVS, were observed in the hybrid model. Conclusions We established a novel mouse model of CAVS that could be induced efficiently, robustly and economically, and without genetic intervention. It provides a fast track to explore the underlying mechanisms of CAVS and to identify more effective pharmacological targets.

Abstract Background The number of medical research publications by Chinese clinical investigators has risen substantially, contributing to 14.63% of the global total in 2019; however, their tangible impact on clinical decision‐making remains limited. Various evaluation methods have been developed to measure hospital research competence in China, such as Fudan University's China hospital ranking and Science and Technology Evaluation Metrics (STEM) ranking, which predominantly focuses on factors such as academic reputation, volume of publications and patents, and research resources. However, composite indices may not fully capture the actual clinical value generated by medical research. To address this gap, we introduced the “Clinical Influence and Timeliness Evaluation (CITE)” metric to assess both the clinical importance of a given medical research study and the clinical influence of the hospital where it originated. The methodology used relies on the premise that influential medical research would be referenced in clinical guidelines, which serve as critical resources for clinicians. Methods The CITE metric was applied for 78,636 medical studies concerning chronic obstructive pulmonary disease (COPD) published between 2000 and 2020 and referenced in both Chinese and international clinical guidelines for COPD. Specific indexes and formulas were derived to quantify the clinical weight of a medical research study (W) and its timeliness (T), enabling a dynamic assessment of the clinical value of each study and the overall contribution of a particular hospital. Results In this analysis, we incorporated 499 hospitals in China and quantitatively identified their dynamic clinical influence in COPD from 2000 to 2020. Our findings offer objective and targeted evaluation metrics by focusing on clinical relevance and recognizing the collaborative nature of medical research. Conclusion The CITE metric provides an innovative method to gauge the true impact of medical research in China, with potential applications across different medical specialties. CITE can serve as a useful tool for understanding the relationship between research input and practical clinical outcomes, ultimately promoting more clinically relevant research endeavors.

Abstract To optimally harness the adjustable capabilities of reactive power sources for voltage control, a dynamic partitioning method that uses reactive power flow tracking for branch cutting through Binary Particle Swarm Optimisation (BPSO) is proposed for Active Distribution Networks (ADNs). Initially, the limitations of existing Voltage/Var Sensitivity (VVS) calculation methods are analysed, leading to the proposition of a novel VVS calculation method capable of capturing variations in source‐load timing characteristics. Subsequently, the fuzzification of the VVS matrix between nodes is used to derive the membership degree matrix. Next, based on the membership relationship between reactive power source nodes, these nodes are pre‐partitioned, and the number of leading nodes and zones alongside are preliminarily determined. Then, the range of the branch to be cut is established, guided by the reactive power flow direction of the branch. Employing the zonal comprehensive coupling degree as the objective function of the BPSO facilitates the identification of optimal branch cutting points, thereby determining the partitioning outcome. Finally, a reactive power reserve check is executed to rectify any non‐compliant zones. In this study, numerical simulations are conducted using the enhanced IEEE 33‐node power system to demonstrate the efficacy of the proposed method.

Abstract The weak AC grid in a modular multilevel converter modular multilevel converter based high voltage direct current (MMC‐HVDC) receiving‐end system requires faster reactive power support from the receiving‐end MMC. However, under the MMC traditional constant AC voltage dual‐loop control strategy, the increase in MMC's reactive power support speed will reduce the system stability. The reactive power cascade control strategy is a novel MMC control strategy. The analysis in this paper demonstrates that it possesses advanced performance under faster reactive power support, which is required by the MMC connected to a weak AC grid, but, some of its control links and operations can cause impacts exceeding that a weak AC grid can undertake. To solve this problem, based on the original control strategy, this paper proposes an improved reactive power cascade control strategy for weak AC grid conditions. The complete framework and the detailed design of primary control links of the improved cascade control strategy are displayed in this paper. Finally, a digital simulation has been conducted to validate the analysis and the proposed improved control strategy in this paper.

Abstract Objectives Acute ischemic stroke (AIS) is caused by cerebral ischemia due to thrombosis in the blood vessel. The purpose of this study is to identify key genes related to metabolism to aid in the mechanism research and management of AIS. Materials and Methods Gene expression data were downloaded from the Gene Expression Omnibus database. Weighted gene co‐expression network analysis, Gene Ontology and kyoto encyclopedia of genes and genomes analysis were used to identify metabolism‐related genes that may be involved in the regulation of AIS. A protein protein interaction network was mapped using Cytoscape based on the STRING database. Subsequently, hub metabolism‐related genes were identified based on Cytoscape‐CytoNCA and Cytoscape‐MCODE plug‐ins. Least absolute shrinkage and selection operator algorithm and differential expression analysis. In addition, drug prediction, molecular docking, ceRNA network construction, and correlation analysis with immune cell infiltration were performed to explore their potential molecular mechanisms of action in AIS. Finally, the expression of hub gene was verified by real‐time PCR. Results Metabolism‐related genes FBL, HEATR1, HSPA8, MTMR4, NDUFC1, NDUFS8 and SNU13 were identified. The AUC values of FBL, HEATR1, HSPA8, MTMR4, NDUFS8 and SNU13 were all greater than 0.8, suggesting that they had good diagnostic accuracy. Correlation analysis found that their expression levels were also related to the infiltration levels of multiple immune cells, such as Activated.CD8.T.cell and Activated.dendritic.cell. It was found that only HSPA8 was successfully matched to drugs with literature support, and these drugs were acetaminophen, bupivacaine, dexamethasone, gentamicin, tretinoin and cisplatin. Moreover, it was also identified that the ENSG000000218510‐hsa‐miR‐330‐3p‐HEATR1 axis may be involved in regulating AIS. Conclusions The identification of FBL, HEATR1, HSPA8, MTMR4, NDUFC1, NDUFS8 and SNU13 provides a new research direction for exploring the molecular mechanisms of AIS, which can help in clinical management and diagnosis.

Abstract EMT dysfunction is a dominant mechanisms of hypospadias. Thus, identification of EMT‐related lncRNAs based on transcriptome sequencing data of hypospadias might provide novel molecular markers and therapeutic targets for hypospadias. First, the microarray data related to hypospadias were downloaded from Gene Expression Omnibus (GEO). Besides, the differentially expressed lncRNAs and messenger RNAs (mRNAs) related to EMT were screened to construct lncRNA‐mRNA co‐expression interaction pairs. In addition, the microRNA (miRNA) prediction analysis was performed through bioinformatics methods to construct a ceRNA network. Moreover, function prediction and function enrichment and pathway analyses were also performed. Finally, the core EMT‐related lncRNAs were verified based on mRNA expression changes and cell functions. A total of 6 EMT‐related lncRNAs were identified and 123 mRNA‐lncRNA co‐expression interaction pairs were screened in this study. Additionally, a ceRNA regulatory network comprising 17 mRNAs, 4 lncRNAs, and 28 miRNAs was constructed based on the prediction of hypospadias‐related miRNAs. The validation results of the dataset GSE121712 revealed that only BEX1 was positively correlated with the expression of the lncRNA GNAS‐AS1 (r = 0.874, P < 0.01), both of which had high expression. The cell experiment results demonstrated that interfering with the expression of GNAS‐AS1 significantly promoted the proliferation, migration, and EMT of cells. Importantly, it was confirmed that GNAS‐AS1 can serve as a ceRNA and play an important role in the EMT of hypospadias. Hence, it may be considered as a potential target in the treatment of this disease.

Abstract This paper proposes a predictive power control strategy for the three‐phase, six‐switch Vienna rectifier without grid voltage sensors to reduce the hardware cost and complexity of a high‐power PWM rectifier system. Firstly, an algorithm for calculating the AC‐side voltage in the αβ coordinate system is derived according to the operating principle of the Vienna rectifier, and a voltage observer is constructed by combining a second‐order low‐pass filter to estimate the grid voltage. Secondly, a soft start method is designed to solve the problem that the rectifier is prone to inrush current when it is started. Furthermore, the control method of grid voltage sensorless is combined with predictive power control with good dynamic characteristics and simple parameter settings to form the control strategy proposed in this paper. Finally, simulation analysis and experimental verification are carried out on the proposed control strategy. Simulation and experimental results show that the grid voltage estimation has high accuracy, a good surge current suppression effect, unit power factor operation, low input current harmonic content, and good dynamic and steady‐state performance. Therefore, the correctness and effectiveness of the strategy proposed in this paper are verified.

Abstract The high‐voltage pulse discharge technology, which is based on the electrohydraulic effect, can generate powerful, controllable, and repetitive electrohydraulic shock waves (EHSWs) in underground confined space, so it has been applied in the petroleum industry to improve the permeable of the reservoir. In this paper, a numerical model based on LS‐DYNA is built to study the damage analysis of the cement sheath and rock subjected to EHSWs during perforation completion. The results show that the stress state of the cement sheath and rock surrounding the perforation hole is determined by the shock pressure from both the perforation hole and the wellbore; the damage of the cement sheath and rock is mainly caused by tensile stress; the damage zone of the cement sheath is mainly distributed on the inner surface and near the perforation hole, while the damage zone of rock is distributed near the perforation hole; after multiple discharges, the damage of cement sheath and rock gradually accumulates, and the damage zone eventually forms a vertical plane along perforation holes. Overall, these results provide guidance for the safe application of the high‐voltage pulse discharge technology in the oil field.

Abstract Pyrolysis of two types of pellets (T1: 100% wheat straw, and T2: 70% wheat straw; 10% sawdust, 10% biochar, and 10% bentonite clay) was performed in a pilot‐scale reactor under a nitrogen environment at 20°C to 700°C. This was to investigate slow pyrolysis yields and gas composition as a function of temperature and residence time. The experimental data were obtained between 300°C and 600°C, with a residence time of 90 min, a nitrogen flow rate of 50 cm3/min, and a heating rate of 20°C/min. The results indicated that the maximum pyrolysis temperature is 605°C with a residence time of 55 min. The product analysis showed that the proportion of gas was higher than that of biochar and bio‐oil. The conversion efficiency increased with higher temperatures and varied between 66% and 76%. The results showed that carbon dioxide was the main component in the produced gas, and the maximum gas concentration was 63.6% at 300°C for T1. The higher temperature and longer residence time increased the syngas (CO + H2) composition for both T1 and T2 treatments. Nevertheless, the produced biochar had a high carbon content and retained a high calorific value, indicating slow pyrolysis is the ideal utilization route of wheat straw pellet biomass for biochar.

Abstract Heptafluoroisobutyronitrile (C4F7N) is being considered as a promising alternative to the greenhouse gas SF6 in the electrical industry. However, its biotoxicity necessitates the development of gas sensing technology to detect leaked C4F7N. A combination of density functional theory and experiments was employed to evaluate the adsorption and sensing performance of different metal‐phthalocyanines as potential sensing materials for C4F7N detection. The study included exploring adsorption configurations with adsorption energies, electron transfer, and adsorption distance, as well as comparisons of electronic properties, electron distribution, and density of states (DOS) among the MPcs. Furthermore, gas sensing experiments were conducted using different MPcs to detect 25–100 ppm C4F7N. The results revealed that Mn‐Pc, Fe‐Pc, Co‐Pc, and Zn‐Pc exhibited considerable chemical interactions, while Ni‐Pc and Cu‐Pc showed weaker adsorption strength. These findings were further elucidated based on the electron density and DOS of atomic orbitals. Moreover, gas sensing experiments indicated that Co‐Pc demonstrated a higher response compared to Fe‐Pc at the same concentration of C4F7N. Overall, the theoretical and experimental insights offer valuable guidance for C4F7N detection and provide a systematic approach to screen and explore organometallic polymer‐based gas sensors applicable in various fields.

Abstract The dielectric performance of the pristine and the electrothermal‐aged metallised polypropylene capacitors are investigated under different magnetic fields. The energy storage capacity decreases under the magnetic field. At 12 T, the capacitance value of the pristine capacitors decreases by 8.4%–17% and that of the aged capacitors declines by 15%–20%. The dielectric loss is reduced by 2.6%–6.3%, but the equivalent series resistance shows an 8.3%–23.1% growth. The leakage conductivity increases to 202%–354%, which leads to a weakened voltage holding capacity. In addition to the effects of the magnetic fields, the impacts of ageing have also been investigated. The effects of the magnetic field and ageing on the electrical parameters of the capacitors are discussed separately. The molecular chains of the dielectric are oxidised and decomposed during the ageing process, which reduces the insulating properties of the dielectric. The magnetic field inhibits polarisation by changing the polarisation behaviour through Lorentz force and excites the electrons to enhance charge transmission.

Abstract Ionic liquid (IL) as the dispersant can help disperse the organic nanofillers to improve the performance of epoxy resin remarkably. However, the effect of IL on the electrical properties of epoxy composites is not well documented. This comprehensive study consists of the preparation, material characterisation and systematical investigation of electrical properties of 1‐Butyl‐3‐methylimidazole hexafluorophosphate‐modified chitin fibre/epoxy composites. The findings show that introducing IL into a chitin/epoxy composite can minimise porosity defects and improve the compatibility between filler and matrix. However, a high concentration of IL induces severe charge injection into chitin/epoxy composites and internal electric field distortion. The addition of 0.75%–1.5% mass fraction IL results in maximum enhancement in the AC breakdown strength of the chitin/epoxy composite (by ∼71%) compared with the non‐IL composites. The non‐linear conductivity and non‐uniform charge injection phenomena of IL‐modified composites can be attributed to the movement of radicals and anions due to the decomposition of IL. Through this study, it is highly expected that the organic filler dispersion in the epoxy matrix can be optimised by tuning IL to improve the insulation properties.

Abstract The authors investigate the effects of nanofillers with varying band‐gap energies on the space charge properties, breakdown field strength, and bulk resistivity of epoxy (EP)‐based composites. Additionally, the molecular orbital distribution of both the epoxy resin and nanofillers were examined through density functional theory. Experimental results indicate that the space charge accumulation within silicon dioxide/EP and germanium oxide/EP is reduced, leading to a more uniformly distributed electric field intensity within the specimen when compared to epoxy. As a result, both materials exhibit improved AC breakdown field strength and volume resistivity. Conversely, the amount of charge accumulated within tin dioxide/EP is higher, resulting in lower breakdown field strength than epoxy. The lowest unoccupied molecular orbital and the highest occupied molecular orbital energy level differences between epoxy and nanofillers introduce electron traps and hole traps at the interface, forming interfacial traps that affect the space charge distribution within the specimen, as well as the trap energy levels within the material. From the experimental results, shallow traps promote space charge accumulation and reduce the breakdown field strength, while deep traps have the opposite effect.

Abstract In the detection of multi‐component gas based on tunable diode laser absorption spectroscopy (TDLAS), the problem of overlapping interference between the absorption lines of each gas is often encountered. For example, when detecting a gas mixture of sulphur dioxide (SO2) and thionyl fluoride (SOF2), the characteristic decomposition components of SF6, there is overlapping interference in the absorption lines of the two gases, which makes it difficult to detect the concentration of gases accurately. In view of this problem, a novel method based on support vector regression model used for TDLAS is proposed to detect two gases simultaneously. The detection results show that the correlation coefficients between the concentration of SO2 and SOF2 and the average value of the second harmonic peak reached 0.992 and 0.993. In addition, through model testing, different concentrations of SO2 and SOF2 gas mixture are simultaneously detected, and the resulting maximum errors for measuring SO2 and SOF2 concentrations are less than 7.13 × 10−5 and 0.26 × 10−2. The maximum errors of the measurement results in the verification test are not more than 6.4 × 10−3 and 4.6 × 10−2. Therefore, with assistance of the novel method, the detection of multiple gases by using a single laser is achieved.

Abstract In order to achieve accurate quantitative evaluation of the ageing state of oil paper insulation, an evaluation method of polymerisation degree (DP) of oil–paper insulation based on Raman spectroscopic plot is presented. Samples covering the full ageing stage of oil–paper insulation were obtained by accelerated thermal ageing experiments. The samples were tested by Raman spectra, and the Raman spectra were converted into Raman spectroscopic plot using Gramian angular field. Feature extraction was performed on the images using local binary pattern (LBP), and 28 feature variables were selected by competitive adaptive reweighted sampling and uninformative variable elimination. Finally, the DP prediction model was constructed by long short‐term memory neural network (LSTM). The training accuracy exceeded 90%, and the mean absolute deviation of DP prediction for 45 test samples was only 40.70. A new visual detection method for transformer ageing diagnosis is presented.

Abstract Background Primary thymic adenocarcinoma (PTAC) is an extremely rare disease with a poor prognosis. In the present study, we sought to analyze the clinical characteristics and prognostic factors of patients with PTAC. Methods A total of 14 patients with PTAC treated at our center from January 2000 to January 2019 were included in this study. We retrospectively collected information on sex, age, history of smoking, family history of cancer, comorbidities, symptoms, imaging tests, serum tumor marker levels, tumor, node, metastasis (TNM) staging, and treatment records. Follow‐up information was obtained by telephone interviews or outpatient clinic visit. Univariate and multivariate Cox regression analyses were performed to investigate the clinicopathological factors associated with survival. Results Among 14 patients with PTAC, there were five males and nine females, with an average age of 48.7 ± 9.3 years. A total of 23.1% of the patients had a history of smoking. The clinical symptoms of the patients were nonspecific and seven patients had elevated levels of serum tumor markers. Surgery was performed for nine patients, among which only four received R0 resection. The median survival time of the 14 patients was 16.0 months, and the 1‐, 3‐ and 5‐year survival rates were 57.1%, 35.7% and 21.4%, respectively. TNM stage was identified as an independent prognostic factor for PTAC patients (the median survival time of stage I–IIIA vs. stage IV was 44.0 months vs. 9.0 months, p = 0.002). Conclusions PTAC is highly aggressive malignancy with poor prognosis. Surgical treatment is feasible, but R0 resection is challenging. TNM staging is significantly associated with patient survival.

Abstract Introduction The use of stereotactic ablative radiotherapy (SABR) over conventional fractionated radiotherapy (CFRT) for early‐stage non‐small‐cell lung cancer (NSCLC) has been advocated, but is also debated in the literature. Methods In this retrospective cohort study, we adopted a target trial emulation framework to identify eligible patients diagnosed between 2011 and 2021 using the Taiwan Cancer Registry. In the primary analysis, the overall survival (OS) was the primary endpoint, whereas incidences of lung cancer mortality and radiation pulmonary toxicity were the secondary endpoints. Extensive supplementary analyses were also conducted. Results We included 351 patients in the primary analysis and found that the OS was not significantly different between the SABR (n = 290) and CFRT (n = 61) groups. The propensity score weighting adjusted hazard ratio of death was 0.75 (95% confidence interval 0.53–1.07, p = 0.118). The secondary endpoints and supplementary analyses showed no significant differences. Conclusions The OS of patients with early‐stage NSCLC treated with SABR was not significantly different from that of patients treated with CFRT alone. The results of the relevant ongoing clinical trials are eagerly awaited.

Abstract In the current WHO classification, a T‐cell prolymphocytic leukemia (T‐PLL) diagnosis requires lymphocytosis of >5 × 109/L, evidence of monoclonality, and TCL1A or MTCP1 rearrangement. However, the 2019 consensus document suggested that in the absence of rearrangement of TCL1‐family, the presence of abnormalities involving chromosome 11 (11q22.3; ATM), chromosome 8 (idic(8)(p11), t(8;8), trisomy 8q), 5, 12, 13, 22, or a complex karyotype, as well as involvement specific sites (e.g., splenomegaly, effusions) would suffice for a diagnosis of T‐PLL. We present a patient diagnosed with T‐PLL with MTCP1 rearrangement who was successfully treated with alemtuzumab followed by consolidative allogeneic unrelated donor stem cell transplantation. Eight years later, the patient presented with inguinal lymphadenopathy with features more akin to peripheral T‐cell lymphoma, NOS (PTCL, NOS) of the GATA3 subtype, and there was no evidence of peripheral blood involvement. However, the lymphoma cells were clonally related to those at presentation. Currently, literature on T‐PLL‐like cases lacking the rearrangement of TCL1A is limited, and the possibility of whether a proportion of such cases could represent PTCL, NOS (with leukemic involvement) needs consideration.

Abstract Introduction IDH2 mutation is an unfavorable prognostic factor in patients with primary myelofibrosis (PMF) but its effect on myelofibrosis (MF) remains largely unclear. Methods In this study, we aimed to elucidate the roles of IDH2 mutation in the development and progression of MF by transcriptomic and molecular techniques using the Idh2R172K transgenic mice. Results We found that thrombopoietin (TPO)‐overexpressed Idh2R172K (Idh2R172K + TPO) mice had accelerated progression to MF, compared with TPO‐overexpressed Idh2‐wild (WT + TPO) mice, showing activation of multiple inflammatory pathways, among which nuclear factor κB (NFκB) was the most significantly enhanced. Single‐cell transcriptomes of the marrow cells in early MF showed that S100a8/a9 expression was mainly confined to neutrophil progenitors in the WT + TPO mice, but highly expressed in several types of myeloid precursor cells, including the megakaryocyte progenitors in the Idh2R172K + TPO group. Furthermore, Idh2R172K mice at age of 18 months had larger spleens, increased S100a8/a9‐Tlr4 expression, and elevated serum S100a8/a9 levels compared with WT mice. PMF patients with IDH2 mutations had higher bone marrow plasma S100A8/A9 levels than those without IDH2 mutations. Conclusion Overall, our findings showed that IDH2 mutation induced proinflammatory effects, which further exacerbated MF, as evidenced by the increase in S100a8/a9 levels and NFκB hyperactivation in Idh2R172K + TPO mice.

Abstract CD4+ chronic lymphocytic leukemia (CLL) represents an extremely rare example of phenotypic aberrancy within CLL. We present a case of an 86‐year‐old male veteran with a history of multiple comorbidities who was incidentally diagnosed with CD4+ CLL during a routine peripheral blood workup. This case highlights the diagnostic challenges and characteristic features of CD4+ CLL, including flow cytometric analysis, molecular, and fluorescence in situ hybridization findings. The patient was classified as asymptomatic CLL Rai stage 0, warranting regular monitoring without a need for treatment intervention.

Abstract The Scale for the Assessment and Rating of Ataxia (SARA) is widely used for assessing the severity and progression of genetic cerebellar ataxias. SARA is now considered a primary end point in several ataxia treatment trials, but its underlying composite item measurement model has not yet been tested. This work aimed to evaluate the composite properties of SARA and its items using item response theory (IRT) and to demonstrate its applicability across even ultra‐rare genetic ataxias. Leveraging SARA subscores data from 1932 visits from 990 patients of the Autosomal Recessive Cerebellar Ataxias (ARCA) registry, we assessed the performance of SARA using IRT methodology. The item characteristics were evaluated over the ataxia severity range of the entire ataxia population as well as the assessment validity across 115 genetic ARCA subpopulations. A unidimensional IRT model was able to describe SARA item data, indicating that SARA captures one single latent variable. All items had high discrimination values (1.5–2.9) indicating the effectiveness of the SARA in differentiating between subjects with different disease statuses. Each item contributed between 7% and 28% of the total assessment informativeness. There was no evidence for differences between the 115 genetic ARCA subpopulations in SARA applicability. These results show the good discrimination ability of SARA with all of its items adding informational value. The IRT framework provides a thorough description of SARA on the item level, and facilitates its utilization as a clinical outcome assessment in upcoming longitudinal natural history or treatment trials, across a large number of ataxias, including ultra‐rare ones.

Abstract Objective Employing whole‐exome sequencing (WES) technology to investigate the etiology of infantile epileptic spasm syndrome (IESS), and determining whether different etiologies exhibit phenotypic variations, while elucidating the potential associated factors, might improve short‐term responses to first‐line treatment. Methods We retrospectively evaluated patients with IESS admitted for treatment between January 2018 and June 2023. Clinical phenotypic differences among etiological classifications and clinical manifestations were analyzed. Variable selection using the best subset method was performed, followed by logistic regression analysis to identify the factors influencing treatment response. Results A total of 577 patients were included; 412 completed trio‐WES. Magnetic resonance imaging abnormalities were detected in 387 patients (67.1%). Patients with etiology as structural abnormalities were likelier to have non‐spasms at the initial seizure onset. A total of 532 patients completed the first‐line treatment; 273 patients received it for the first time at our hospital (initial response rates: 30.1% and 42.1%, respectively). The response group had a lower proportion of early‐onset seizures (≤3 months) than the no‐response group (11.3% vs. 23.7%, p

Abstract Achieving high‐precision extraction of sea islands from high‐resolution satellite remote sensing images is crucial for effective resource development and sustainable management. Unfortunately, achieving such accuracy for sea island extraction presents significant challenges due to the presence of extensive background interference. A more widely applicable noise‐tolerant matched filter (NTMF) scheme is proposed for sea island extraction based on the MF scheme. The NTMF scheme effectively suppresses the background interference, leading to more accurate and robust sea island extraction. To further enhance the accuracy and robustness of the NTMF scheme, a neural dynamics algorithm is supplemented that adds an error integration feedback term to counter noise interference during internal computer operations in practical applications. Several comparative experiments were conducted on various remote sensing images of sea islands under different noisy working conditions to demonstrate the superiority of the proposed neural dynamics algorithm‐assisted NTMF scheme. These experiments confirm the advantages of using the NTMF scheme for sea island extraction with the assistance of neural dynamics algorithm.