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The current carrying capacity of power cables is an important parameter for the operation and scheduling of power cables, which is limited by the maximum allowable operating temperature of the cables. Establishing a cable temperature field and current carrying capacity model considering the influence of airflow in complex environments is of great significance for studying cable current carrying capacity. Based on the coupling theory of electric field and heat flow field, a temperature field and current carrying capacity analysis model for high-voltage three core cross-linked polyethylene cable and its laying environment was established using finite element analysis technology. Studied the effects of external air velocity and temperature on the current carrying capacity of cables under two laying methods: direct burial and air laying. Research has shown that the allowable operating time of short-term emergency current carrying capacity of cables is positively correlated with their size, and inversely proportional to the initial temperature of the cable core. The steady-state and transient analysis results of this model provide important reference value for cable operation scheduling, and the correctness and effectiveness of the model have been further verified through experiments based on actual scenarios.

Fault problems associated with submarine cables caused by variations in their burial depth are becoming increasingly prominent. To address the difficulty of detecting the burial depth of submarine cables and trends in its variation, a prediction model for submarine cable burial depth was proposed which considers the dynamic characteristics of thermal resistance. First, a parallel thermal circuit model of a three-core submarine cable was established, and a formula for calculating the submarine cable’s burial depth was derived based on a formula for calculating the submarine cable’s core temperature. Then, the calculation result was corrected by considering the dynamic characteristics of the thermal resistance of the submarine cable’s structural materials. On this basis, feature vectors associated with the seabed cable burial depth calculation data and time nodes were mined by a convolutional neural network and used as the input parameters of a long short-term memory network for optimization and training, and a prediction model for trends in seabed cable burial depth variation was obtained. Finally, an example analysis was carried out based on the actual electrical parameter data of submarine cables buried by an offshore oil and gas platform. The results showed that the prediction model for trends in variations in the burial depth of submarine cables based on the CNN-LSTM neural network can achieve high prediction accuracy and prediction efficiency.

IntroductionInter- and intra-subject variability are caused by the variability of the psychological and neurophysiological factors over time and across subjects. In the application of in Brain-Computer Interfaces (BCI), the existence of inter- and intra-subject variability reduced the generalization ability of machine learning models seriously, which further limited the use of BCI in real life. Although many transfer learning methods can compensate for the inter- and intra-subject variability to some extent, there is still a lack of clear understanding about the change of feature distribution between the cross-subject and cross-session electroencephalography (EEG) signal.MethodsTo investigate this issue, an online platform for motor-imagery BCI decoding has been built in this work. The EEG signal from both the multi-subject (Exp1) and multi-session (Exp2) experiments has been analyzed from multiple perspectives.ResultsFirstly we found that with the similar variability of classification results, the time-frequency response of the EEG signal within-subject in Exp2 is more consistent than cross-subject results in Exp1. Secondly, the standard deviation of the common spatial pattern (CSP) feature has a significant difference between Exp1 and Exp2. Thirdly, for model training, different strategies for the training sample selection should be applied for the cross-subject and cross-session tasks.DiscussionAll these findings have deepened the understanding of inter- and intra-subject variability. They can also guide practice for the new transfer learning methods development in EEG-based BCI. In addition, these results also proved that BCI inefficiency was not caused by the subject’s unable to generate the event-related desynchronization/synchronization (ERD/ERS) signal during the motor imagery.

EEG signals exhibit commonality and variability across subjects, sessions, and tasks. But most existing EEG studies focus on mean group effects (commonality) by averaging signals over trials and subjects. The substantial intra- and inter-subject variability of EEG have often been overlooked. The recently significant technological advances in machine learning, especially deep learning, have brought technological innovations to EEG signal application in many aspects, but there are still great challenges in cross-session, cross-task, and cross-subject EEG decoding. In this work, an EEG-based biometric competition based on a large-scale M3CV (A Multi-subject, Multi-session, and Multi-task Database for investigation of EEG Commonality and Variability) database was launched to better characterize and harness the intra- and inter-subject variability and promote the development of machine learning algorithm in this field. In the M3CV database, EEG signals were recorded from 106 subjects, of which 95 subjects repeated two sessions of the experiments on different days. The whole experiment consisted of 6 paradigms, including resting-state, transient-state sensory, steady-state sensory, cognitive oddball, motor execution, and steady-state sensory with selective attention with 14 types of EEG signals, 120000 epochs. Two learning tasks (identification and verification), performance metrics, and baseline methods were introduced in the competition. In general, the proposed M3CV dataset and the EEG-based biometric competition aim to provide the opportunity to develop advanced machine learning algorithms for achieving an in-depth understanding of the commonality and variability of EEG signals across subjects, sessions, and tasks.

ABSTRACT: Introduction: Female Genital Sexual Arousal Disorder (FGSAD) seriously affects women's quality of life and Sexual life, but it still lacks ideal FGSAD animal models for further study. Aim: To establish a specific model of female genital sexual arousal disorder and explore the mechanisms resulting in FGSAD. Methods: After delivery, female rats were guided by expansions of the vagina and ovariectomy (VD+OVX, n = 10); in VD group female rats were just extended by the vagina (VD, n = 10), in OVX group female rats were treated with ovariectomy (OVX, n = 10);the remaining had 1 longitudinal incision as sham group(n = 10). Outcomes: Vaginal dilatation combined with ovariectomy in rats may reflect female genital sexual arousal disorder with high reproducibility and stability. Results: Vaginal tissue of female rats in OVX group and VD+OVX group showed an increase in blood flow, decrease in muscle content compared to the sham group. The proportion of collagen fiber I/III decreased and the elastic fiber showed significant rupture and fragmentation; Structural reticular integrity was also significantly separated and broken from the muscle fibers. However, there was no significant difference in vaginal blood flow, fibers and vascular between VD group and Sham group. The damage of vaginal tissue in VD+OVX group was more significant than that in OVX and VD groups. Clinical Translation: We have constructed a specific animal model that can provide clinical insights into the mechanism of FGSAD and serves as a good avenue for further research of its treatment. Strengths and Limitations: Vaginal dilatation combined with ovariectomy in rats is a specific animal model with high reproducibility and stability, but we do acknowledge the shortcomings and limitation present in our study. Since genital arousal disorder has many different etiologies that impact the vagina, the clitoris and surrounding tissues, there is no “gold standard” model that different models attempt to investigate different etiologies. Conclusion: The female genital sexual arousal disorder model established by vaginal dilatation combined with ovariectomy is a novel rat model with simple induction conditions, which pathogenic mechanism of female genital sexual arousal disorders maybe connected with the change of VEGF and MMP-9 in vaginal fibromuscular system and microvascular.Li G, Yu P, Hu Y, et al. Establishment of Rat Model of Female Genital Sexual Arousal Disorder. Sex Med 2022;XX:XXXXXX.

The dominant approach in investigating the individual reliability for event-related potentials (ERPs) is to extract peak-related features at electrodes showing the strongest group effects. Such a peak-based approach implicitly assumes ERP components showing a stronger group effect are also more reliable, but this assumption has not been substantially validated and few studies have investigated the reliability of ERPs beyond peaks. In this study, we performed a rigorous evaluation of the test-retest reliability of ERPs collected in a multisensory and cognitive experiment from 82 healthy adolescents, each having two sessions. By comparing group effects and individual reliability, we found that a stronger group-level response in ERPs did not guarantee higher reliability. A perspective of neural oscillation should be adopted for the analysis of reliability. Further, by simulating ERPs with an oscillation-based computational model, we found that the consistency between group-level ERP responses and individual reliability was modulated by inter-subject latency jitter and inter-trial variability. The current findings suggest that the conventional peak-based approach may underestimate the individual reliability in ERPs and a neural oscillation perspective on ERP reliability should be considered. Hence, a comprehensive evaluation of the reliability of ERP measurements should be considered in individual-level neurophysiological trait evaluation and psychiatric disorder diagnosis.

Abstract Background Traditional Chinese medicine (TCM) usually involves syndrome differentiation and treatment. Acupuncture, one form of TCM, requires the selection of appropriate acupoints and needling techniques, but many clinical trials on acupuncture have used fixed acupuncture protocols without accounting for individual patient differences. We have designed a multicenter randomized controlled trial (RCT) to evaluate whether personalized or fixed acupuncture increases the likelihood of live births in infertile women with polycystic ovary syndrome (PCOS) compared with letrozole or placebo letrozole. We hypothesize that letrozole is more effective than personalized acupuncture, which in turn is more effective than fixed acupuncture, and that placebo letrozole is the least effective intervention. Moreover, we hypothesize that personalized acupuncture is more likely to reduce the miscarriage rate and the risk of pregnancy complications compared with letrozole. Methods/design The study is designed as an assessor-blinded RCT. A total of 1100 infertile women with PCOS will be recruited from 28 hospitals and randomly allocated to 4 groups: personalized acupuncture, fixed acupuncture, letrozole, or placebo letrozole. They will receive treatment for 16 weeks, and the primary outcome is live birth. Secondary outcomes include ovulation rate, conception rate, pregnancy rate, pregnancy loss rate, changes in hormonal and metabolic parameters, and changes in quality of life scores. Adverse events will be recorded throughout the trial. All statistical analyses will be performed using IBM SPSS Statistics version 21.0 software (IBM Corp., Armonk, NY, USA), and a P value

Additive parts made of 2205 duplex stainless steel were fabricated by cold metal transfer (CMT) wire and arc additive manufacturing (WAAM), and their microstructure and properties were systematically studied. The X-ray diffraction results show that austenite phase and ferrite phase were formed in the additive parts. Due to the low heat input characteristics of CMT-WAAM, no σ phase was observed. The microstructure in the additive parts was different from the bottom to the top, with the content of austenite phase gradually increasing and that of ferrite gradually decreasing. The EBSD results indicate that the ferrite phase in the bottom part grew parallel to the normal direction of {100}. However, the ferrite phase in the middle part grew parallel to the plane composed of the build direction and normal direction, and along {100} and {111}. The effect of the ferrite and austenite contents on the mechanical performance of the additive parts was simulated using the LAMMPS software. The simulation results exhibit a common characteristic in that the dislocations move mainly along the 1/6 crystallographic direction families. The simulated maximum tensile stress values of the bottom, middle, and top parts were 23.3 GPa, 22.3 Gpa, and 22.5 Gpa, respectively. The data from the bottom tensile strength simulation were consistent with the actual data, and the bottom tensile strength was the largest in the actual tensile process.

Negative Poisson’s ratio, offering unusual properties, is displayed by several materials and predicted for graphene. This work demonstrates such behaviors in monolithic films with interconnected networks of close-packed graphene laminates, and tunability through the chemistry and microstructures.

Objective: Although many clinical studies have shown that ROUX-en-Y gastric bypass (RYGB) surgery significantly improves metabolic syndrome-related erectile dysfunction (MED), the role and mechanism are unclear. Aim: In this study we used a mouse model to explore how RYGB improves MED induced by a high-fat diet (HFD). Methods: We established a mouse model of metabolic syndrome by feeding an HFD for 16 weeks. The mice were randomly assigned to the standard chow diet (SCD), HFD, or RYGB groups. Body weight, fasting blood glucose, plasma insulin, and total plasma cholesterol were analyzed. Erectile responses were evaluated by determining the mean systolic blood pressure and the intracavernosal pressure (ICP). Penile histologic examination (Masson's trichrome and immunohistochemical stain) and Western blot were performed. Result: Compared with the SCD group, the ICP in the sham group was significantly lower, and the ICP of the RYGB was significantly increased. Masson's trichrome and immunohistochemical staining showed that the content of endothelium and smooth muscle in the corpus cavernosum of mice with MED was significantly reduced. Western blot analysis showed a significant decrease in α-smooth muscle actin and a significant increase in osteopontin in penile tissue in the sham group, which was improved by RYGB surgery. Furthermore, RYGB significantly increased IRS-1/PI3K/Akt/eNOS phosphorylation. Clinical translation: In this study we explored the mechanism of bariatric surgery to improve erectile dysfunction associated with metabolic syndrome and provided a theoretical basis for clinical research. Strengths and limitations: First, we did not investigate the mechanism by which RYGB affects the IRS-1/PI3K/Akt/eNOS signaling pathway. Second, the effect of the IRS-1/PI3K/Akt/eNOS signaling pathway on the function of corpus cavernosum endothelial cells and smooth muscle cells remains to be investigated in cellular studies. Conclusion: This study demonstrated that RYGB may not only improve metabolic parameters but also restore erectile function in MED patients. The mechanism of the therapeutic effect of RYGB may be reactivation of the IRS-1/PI3K/Akt/eNOS pathway. [ABSTRACT FROM AUTHOR]

Abstract Purpose Total-body dynamic positron emission tomography (PET) imaging with total-body coverage and ultrahigh sensitivity has played an important role in accurate tracer kinetic analyses in physiology, biochemistry, and pharmacology. However, dynamic PET scans typically entail prolonged durations ( $$\:\ge\:$$ 60 minutes), potentially causing patient discomfort and resulting in artifacts in the final images. Therefore, we propose a dynamic frame prediction method for total-body PET imaging via deep learning technology to reduce the required scanning time. Methods On the basis of total-body dynamic PET data acquired from 13 subjects who received [68Ga]Ga-FAPI-04 (68Ga-FAPI) and 24 subjects who received [68Ga]Ga-PSMA-11 (68Ga-PSMA), we propose a bidirectional dynamic frame prediction network that uses the initial and final 10 min of PET imaging data (frames 1–6 and frames 25–30, respectively) as inputs. The peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM) were employed as evaluation metrics for an image quality assessment. Moreover, we calculated parametric images (68Ga-FAPI: $$\:{K}_{1}$$ , 68Ga-PSMA: $$\:{K}_{i}$$ ) based on the supplemented sequence data to observe the quantitative accuracy of our approach. Regions of interest (ROIs) and statistical analyses were utilized to evaluate the performance of the model. Results Both the visual and quantitative results illustrate the effectiveness of our approach. The generated dynamic PET images yielded PSNRs of 36.056 ± 0.709 dB for the 68Ga-PSMA group and 33.779 ± 0.760 dB for the 68Ga-FAPI group. Additionally, the SSIM reached 0.935 ± 0.006 for the 68Ga-FAPI group and 0.922 ± 0.009 for the 68Ga-PSMA group. By conducting a quantitative analysis on the parametric images, we obtained PSNRs of 36.155 ± 4.813 dB (68Ga-PSMA, $$\:{K}_{1}$$ ) and 43.150 ± 4.102 dB (68Ga-FAPI, $$\:{K}_{i}$$ ). The obtained SSIM values were 0.932 ± 0.041 (68Ga-PSMA) and 0.980 ± 0.011 (68Ga-FAPI). The ROI analysis conducted on our generated dynamic PET sequences also revealed that our method can accurately predict temporal voxel intensity changes, maintaining overall visual consistency with the ground truth. Conclusion In this work, we propose a bidirectional dynamic frame prediction network for total-body 68Ga-PSMA and 68Ga-FAPI PET imaging with a reduced scan duration. Visual and quantitative analyses demonstrated that our approach performed well when it was used to predict one-hour dynamic PET images. https://github.com/OPMZZZ/BDF-NET .

Abstract Aims This study is designed to identify risk factors of postoperative nausea and vomiting (PONV) in patients after gynecologic laparoscopic surgery and establish a nomogram model. Methods In this retrospective and multicenter study, we collected and analyzed data from 1233 patients who underwent gynecologic laparoscopic surgery. The Lasso algorithm was used to optimize the selection of independent variables in the development group. Multivariate logistic regression analysis was used to explore the risk factors of PONV to develop the predictive nomogram model. Finally, we used an internal and external verification group and machine learning (ML) to evaluate the accuracy and clinical applicability of the model. Results The dosage of sufentanil in patient-controlled intravenous analgesia (PCIA), the dosage of remifentanil, the use of neostigmine, duration of surgery and the maximum value of the PETCO2 were risk factors of PONV in patients after gynecologic laparoscopic surgery. In contrast, the dosage of propofol during the surgery and the use of steroids were protective factors. The nomogram was then established to predict the incidence of PONV in these patients based on the above eight indicators. The C-index of the development group, internal, and external verification groups are 0.802, 0.857, and 0.966, respectively. Conclusion A nomogram model was developed to predict the incidence of PONV in patients after gynecologic laparoscopic surgery. This model was found to be reliable and of high clinical value.

Abstract Background Somatic mutations have been observed to induce aldosterone-producing adenomas (APAs). These may be accelerated during pregnancy. Somatic PRKACA mutations are common in cortisol-producing adenomas (CPAs). However, their role in APAs, particularly aldosterone- and cortisol-producing adenomas (A/CPAs), is not well understood. This study aims to investigate the association between PRKACA mutations and the accelerated development of A/CPAs during pregnancy. Case presentation A patient with primary aldosteronism (PA) associated with severe Cushing’s syndrome (CS) underwent surgical resection of an adrenal tumor one year after delivery. Pathologic examination revealed an adrenocortical adenoma characterized primarily by zona glomerulosa hyperplasia. Somatic mutation analysis revealed the presence of the somatic PRKACA mutation, which was validated as a deleterious mutation by various computational databases. Immunohistochemical results showed positive staining for cytochrome P450 family 11 subfamily B member 1 (CYP11B1), cytochrome P450 family 11 subfamily B member 2 (CYP11B2), and luteinizing hormone/chorionic gonadotropin receptor (LHCGR). Our study included a review of 20 previously documented cases of aldosterone- and cortisol-producing adenomas (A/CPAs), two of which were concurrently positive for both CYP11B1 and CYP11B2, consistent with our findings. Conclusion Somatic mutations in PRKACA may correlate with the upregulation of LHCGR, which synergistically drives the accelerated growth of co-secretion tumors during pregnancy, thereby exacerbating disease progression.

Introduction The role of sodium-glucose cotransporter 2 inhibitors (SGLT2is) in diabetes treatment is expanding; however, few studies have investigated the efficacy and safety of combining SGLT2is with insulin pump therapy. Notably, there is a scarcity of high-quality, multicentre, clinical trials. Therefore, we aim to conduct a prospective multicentre, randomised, controlled, study to investigate whether treatment of type 2 diabetes patients with continuous subcutaneous insulin infusion (CSII) combined with henagliflozin can reduce the time required for blood glucose control, decrease total insulin requirements, mitigate blood glucose fluctuations and enhance beta-cell function.Methods and analysis In this inpatient, open-label, multicentre, randomised, controlled trial, 200 patients with type 2 diabetes who have not received hypoglycaemic drugs will be randomly allocated at a 1:1 ratio to either the henagliflozin combined with CSII group or the CSII group. The efficacy and safety of treatment in both groups will be compared. We will use a real-time continuous glucose monitoring system for blood glucose monitoring. The primary aim of this study is to compare the time (% time in range (TIR)) in the range of 3.9~10.0 mmol/L blood glucose between the two treatment groups. The secondary outcome measures will include comparisons of the two treatment groups with respect to the (a) time at TIR >70%; (b) mean amplitude of glycaemic excursions; (c) time below range; (d) total insulin dosage; and (e) time above range.Ethics and dissemination This study was approved by the Ethics Committee of the First Affiliated Hospital of Guangxi Medical University and is to be conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. The study will be disseminated through peer-reviewed publications and conference presentations.Trial registration number NCT05677334.

ABSTRACT Objective: Both pulsatile gonadotropin-releasing hormone (GnRH) and combined gonadotropin therapy are effective to induce spermatogenesis in men with congenital hypogonadotropic hypogonadism (CHH). This study aimed to evaluate the effect of pulsatile GnRH therapy on spermatogenesis in male patients with CHH who had poor response to combined gonadotropin therapy. Materials and methods: Patients who had poor response to combined gonadotropin therapy ≥ 6 months were recruited and shifted to pulsatile GnRH therapy. The rate of successful spermatogenesis, the median time to achieve spermatogenesis, serum gonadotropins, testosterone, and testicular volume were used for data analysis. Results: A total of 28 CHH patients who had poor response to combined gonadotropin (HCG/HMG) therapy for 12.5 (6.0, 17.75) months were recruited and switched to pulsatile GnRH therapy for 10.0 (7.25, 16.0) months. Sperm was detected in 17/28 patients (60.7%). The mean time for the appearance of sperm in semen was 12.0 (7.5, 17.5) months. Compared to those who could not achieve spermatogenesis during pulsatile GnRH therapy, the successful group had a higher level of LH60min (4.32 vs. 1.10 IU/L, P = 0.043) and FSH60min (4.28 vs. 1.90 IU/L, P = 0.021). Testicular size increased during pulsatile GnRH therapy, compared to previous HCG/HMG therapy (P < 0.05). Conclusion: For CHH patients with prior poor response to one year of HCG/HMG therapy, switching to pulsatile GnRH therapy may induce spermatogenesis.

Peritoneal fibrosis (PF) is the main reason leading to declining efficiency and ultrafiltration failure of peritoneum, which restricts the application of peritoneal dialysis (PD). We aimed to investigate the effects and mechanisms of miR-122-5p on the PF. Sprague-Dawley (SD) rats were infused with glucose-based standard PD fluid to establish PF model. HE staining was performed to evaluate the extent of PF. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) and fluorescence in situ hybridization (FISH) were performed to measure the expression level of miR-122-5p. Western blot was used to test the expression of transforming growth factor (TGF)-β1, platelet-derived growth factor (PDGF)-A, Fibronectin 1 (FN1), extracellular matrix protein 1 (ECM1), Smad5, α-smooth muscle actin (SMA), collagen type 1(COL-1), Vimentin, E-Cadherin, Wnt1, β-catenin, p-β-catenin, c-Myc, c-Jun, and Cyclin D1. Immunohistochemistry (IHC) staining was used to detect type I collagen alpha 1 (Col1α1), α-SMA, and E-Cadherin expression. We found PF was glucose concentration-dependently enhanced in peritoneum of PD rat. The PD rats showed increased miR-122-5p and decreased Smad5 expression. MiR-122-5p silencing improved PF and epithelial–mesenchymal transition (EMT) process in PD rats. MiR-122-5p silencing attenuated the activity of the Wnt/β-catenin signaling pathway. Importantly, dual-luciferase reporter assay showed Smad5 was a target gene of miR-122-5p. Smad5 overexpression significantly reversed the increases of PF and EMT progression induced by miR-122-5p overexpression. Moreover, miR-122-5p mimic activated Wnt/β-catenin activity, which was blocked by Smad5 overexpression. Overall, present results demonstrated that miR-122-5p overexpression showed a deterioration effect on PD-related PF by targeting Smad5 to activate Wnt/β-catenin pathway.

Abstract Many deep learning methods have been proposed to improve the quality of low‐dose PET images (LPET), which usually construct end‐to‐end networks with certain radiation dose inputs. However, these approaches have omitted the noise disparity in PET images, which may differ among manufacturers or populations. Therefore, we tend to exploit these noise differences among PET images to achieve adaptive restoration. We proposed a 3D noise level‐guided PET restoration network for LPET including (1) adaptive noise level‐aware subnetwork and (2) LPET restoration subnetwork. The first subnetwork aims to predict the noise level of the given LPET, while the second subnetwork treats the estimated noise level as a priori information to guide the restoration process from LPET to standard‐dose PET images. Experiments were performed on real human head and neck datasets while the peak signal‐to‐noise ratio and structural similarity index measure were used to evaluate LPET recovery performance. Moreover, we also compared the proposed network with several deep‐learning approaches. Experimental results demonstrate that our network with dual‐stage design can perform adaptive restoration for LPET, yielding better visual and quantitative results. In future work, we attempt to apply our method to other imaging tasks and adapt it for clinical practice.

BackgroundMixed pituitary TSH/GH adenomas are rare adenomas associated with acromegaly and/or thyrotoxicosis, with or without varying degrees of goiter. In this report, we show a case of pituitary adenoma producing both GH and TSH simultaneously.Case presentationA 27-year-old man was diagnosed with pituitary adenoma based on various symptoms and clinical findings. For further examination and treatment, he was hospitalized in our institution. It was likely that this subject had pituitary adenoma producing both GH and TSH. In brain magnetic resonance imaging, there was a giant tumor in the sellar region. After the diagnosis of mixed pituitary TSH/GH adenoma, he was treated with octreotide, then underwent tumor resection, and then received hydrocortisone acetate and levothyroxine sodium. After then, GH and IGF-1 levels were suppressed and thyroid function was normalized. Postoperative immunohistochemistry reports showed GH (+) but TSH (-), which may be insensitive to the antibody used to detect TSH or combined with other factors.ConclusionsThe diagnosis of mixed pituitary TSH/GH adenoma must be combined with clinical manifestations, immunohistochemical staining and relevant hormone levels, and genetic testing if necessary for comprehensive judgment. For patients with large adenomas, it is recommended to use somatostatin analogs to restore TH levels and control the excessive secretion of GH levels before surgery.

IntroductionInsular gliomas have complex anatomy and microvascular supply that make resection difficult. Furthermore, resection of insular glioma is associated with a significant risk of postoperative ischemic complications. Thus, this study aimed to assess the incidence of ischemic complications related to insular glioma resection, determine its risk factors, and describe a single surgeon’s experience of artery-preserving tumor resection.MethodsWe enrolled 75 consecutive patients with insular gliomas who underwent transcortical tumor resection. Preoperative and postoperative demographic, clinical, radiological [including diffusion-weighted imaging (DWI)], intraoperative neurophysiological data, and functional outcomes were analyzed. Motor evoked potentials (MEPs) and radiological characteristics like the relationship between the proximal segment of the lateral lenticulostriate arteries (LLSAs) and the tumor, the flat inner edge sign (the inner edge of the insular glioma is well-defined) or obscure inner edge sign, the distance between the lesion and posterior limb of the internal capsule and the invasion of the superior limiting sulcus by the tumor were analyzed. Strategies such as “residual triangle,” “basal ganglia outline reappearance,” and “sculpting” technique were used to preserve the LLSAs and the main branches of M2 for maximal tumor resection according to the Berger–Sinai classification.ResultsPostoperative DWI showed acute ischemia in 44 patients (58.7%). Moreover, nine patients (12%) had developed new motor deficits, as determined by the treating neurosurgeons. The flat inner edge sign [odds ratio (OR), 0.144; 95% confidence interval (CI), 0.024–0.876) and MEPs (>50%) (OR, 18.182; 95% CI, 3.311–100.00) were significantly associated with postoperative core ischemia, which affected the posterior limb of the internal capsule or corona radiata.ConclusionsInsular glioma resection was associated with a high incidence of ischemia, as detected by DWI, as well as new motor deficits that were determined by the treating neurosurgeons. Insular glioma patients with obscure inner edge signs and intraoperative MEPs decline >50% had a higher risk of developing core ischemia. With our strategies, maximal safe resection of insular gliomas may be achieved.

An increasing number of studies have shown that nicotinamide mononucleotide (NMN) can inhibit not only ageing but also oxidative stress and inflammatory reactions by improving energy metabolism. However, the role of NMN in regulating the anti‐apoptotic, antioxidative stress and inflammatory responses of brain microvascular endothelial cells is still unknown. Therefore, here we studied the effects of NMN on H2O2‐induced oxidative damage of bEnd.3 cells. In this study, we found that NMN could inhibit the NF‐κBp65 inflammatory signalling pathway and increase the expression of the enzymes NAMPT, VEGF and eNOS, alleviating H2O2‐induced apoptosis in bEnd.3 cells. Taken together, these results suggest that NMN reduces H2O2‐induced oxidative stress and apoptosis and improves cell functions by inhibiting the NF‐κBp65 inflammatory pathway and increasing NAMPT expression.

Background: Our prospective pilot study of acupuncture affecting insulin sensitivity on polycystic ovary syndrome (PCOS) combined with insulin resistance (IR) showed that acupuncture had a significant effect on improving the insulin sensitivity of PCOS. But there is still no randomized controlled trial to determine the effect of acupuncture on the insulin sensitivity in women with PCOS and IR. In this article, we present the protocol of a randomized controlled trial to compare the effect of true acupuncture on the insulin sensitivity of these patients compared with metformin and sham acupuncture. Acupuncture may be an effective therapeutic alternative that is superior to metformin and sham acupuncture in improving the insulin sensitivity of PCOS combined with IR.Methods: This study is a multi-center, controlled, double-blind, and randomized clinical trial aiming to evaluate the effect of acupuncture on the insulin sensitivity in PCOS combined with IR. In total 342 patients diagnosed with PCOS and IR will be enrolled. Participants will be randomized to one of the three groups: (1) true acupuncture + metformin placebo; (2) sham acupuncture + metformin, and (3) sham acupuncture + metformin placebo. Participants and assessors will be blinded. The acupuncture intervention will be given 3 days per week for a total of 48 treatment sessions during 4 months. Metformin (0.5 g per pill) or placebo will be given, three times per day, and for 4 months. Primary outcome measures are changes in homeostasis model assessment of insulin resistance (HOMA-IR) and improvement rate of HOMA-IR by oral glucose tolerance test (OGTT) and insulin releasing test (Ins). Secondary outcome measures are homeostasis model assessment-β (HOMA-β), area under the curve for glucose and insulin, frequency of regular menstrual cycles and ovulation, body composition, metabolic profile, hormonal profile, questionnaires, side effect profile, and expectation and credibility of treatment. Outcome measures are collected at baseline, at the end of treatments, and 3 months after the last acupuncture treatment. On completion of the screening visit, randomization will be conducted using a central randomization system.Discussion: This study will investigate the effects of acupuncture on the insulin sensitivity of PCOS and IR women compared with metformin and sham acupuncture. We will test whether true acupuncture with needles placed in skeletal muscles and stimulated manually and by electrical stimulation is more effective than metformin and sham acupuncture with superficial needle placement with no manual or electrical stimulation in improving the insulin sensitivity in PCOS women with IR.Trial Registration: ClinicalTrials.gov, NCT02491333 ; Chinese Clinical Trial Registry, ChiCTR-ICR-15006639. Registered on 24 June 2015. [ABSTRACT FROM AUTHOR]

Background. GLP-1 receptor agonists (GLP-1RA) are common clinical agents that are clinically protective against diabetic complications, such as diabetic retinopathy (DR). Previous studies have shown that the RhoA/ROCK pathway plays an important role in the development of DR. However, the specific mechanism of action between GLP-1RA and DR remains unclear. The aim of this study was thus to investigate the main mechanism involved in the protective effect of GLP-1RA on DR. Methods. Type 2 diabetic mice were fed a high-sugar, high-fat diet. Changes in the retinal structure were observed via HE staining and transmission electron microscopy. The expression of retinal GLP-1R, blood-retinal barrier- (BRB-) related proteins, inflammatory factors, and related pathway proteins were studied via Western blot or immunohistochemistry/immunofluorescence analysis. Results. GLP-1RA treatment reduced the blood glucose and lipid levels as well as the body weight of the diabetic mice while also improving retinal thickness, morphology, and vascular ultrastructure. Moreover, restored GLP-1R expression, increased Occludin and ZO-1 levels, and decreased albumin expression led to reduced retinal leakage and improved the BRB by inhibiting the RhoA/ROCK pathway. Conclusions. We found that the protective effect of GLP-1RA on the retina may be realized through the GLP-1R-ROCK-p-MLC signaling pathway.

Previous studies have shown that the insula is closely related to addiction, and the structure’s role in delay discounting can be measured by a specific task, but the specific role of the insula has been less studied. In this study, we first conducted a lesion study in which we recruited healthy controls (n = 30) and patients with unilateral insula injury (n = 16) to complete a behavioral delay discounting task. Then we conducted a functional magnetic resonance imaging (fMRI) study, and a separate group healthy volunteers (n = 51) completed a delay discounting task during the fMRI scan. The lesion study showed a significant difference between the two groups in the delay discounting task, which revealed that insula injury was associated with impaired decision making. The fMRI study revealed choice-sensitive insula activation that was modulated by delayed time and delayed reward, indicating an important role of the insula in delay discounting. Overall, our results provide evidence for a role of the insular lobe in delay discounting and suggests that this structure may be considered an important factor in the future treatment and diagnosis of addiction disorders.

Abstract Background Many peripheral blood biomarkers are associated with glioma grade, but eosinophils (Eo) are scarcely reported. This study assessed preoperative peripheral eosinophil levels and other peripheral biomarkers presented in prior literature, probing their associations and diagnostic value in the grading of glioma, including its most aggressive type, glioblastoma (GBM). Methods Patients newly diagnosed with neuroepithelial tumors were included and divided into low-grade glioma (LGG)/high-grade glioma (HGG) groups and non-GBM/GBM groups separately. Preoperative peripheral biomarkers were collected, such as the counts of Eo, neutrophils (Neu), and lymphocytes (Ly), and values such as the eosinophil to lymphocyte ratio (ELR) and neutrophil to lymphocyte ratio (NLR) were calculated. Correlation analyses were also performed between these biomarkers and the groups. Receiver operating characteristic curves were utilized to assess the individual and joint diagnostic values of the biomarkers. Results The HGG patients presented lower Eo and ELR values, which had negative correlations with glioma grade. The diagnostic efficiency of Eo and ELR could be enhanced when combined other biomarkers. In the non-GBM vs GBM analysis, GBM patients displayed reduced Eo and a negative correlation between Eo and a GBM diagnosis The combination of Eo and other biomarkers enhanced the diagnostic efficiency. Conclusions A negative correlation between peripheral eosinophils and glioma grade was found in our study. Numerous cytokines derived from eosinophils could regulate the immune response and affect the tumor microenvironment; moreover, eosinophils may inhibit the tumorigenesis of glioma, which should be explored in the future and may enlighten some new paths for glioma therapy.