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BackgroundHip fracture is the most common type of fracture in elderly individuals. Numerous deep learning (DL) algorithms for plain pelvic radiographs (PXRs) have been applied to improve the accuracy of hip fracture diagnosis. However, their efficacy is still undetermined. ObjectiveThe objective of this study is to develop and validate a human-algorithm integration (HAI) system to improve the accuracy of hip fracture diagnosis in a real clinical environment. MethodsThe HAI system with hip fracture detection ability was developed using a deep learning algorithm trained on trauma registry data and 3605 PXRs from August 2008 to December 2016. To compare their diagnostic performance before and after HAI system assistance using an independent testing dataset, 34 physicians were recruited. We analyzed the physicians’ accuracy, sensitivity, specificity, and agreement with the algorithm; we also performed subgroup analyses according to physician specialty and experience. Furthermore, we applied the HAI system in the emergency departments of different hospitals to validate its value in the real world. ResultsWith the support of the algorithm, which achieved 91% accuracy, the diagnostic performance of physicians was significantly improved in the independent testing dataset, as was revealed by the sensitivity (physician alone, median 95%; HAI, median 99%; P

Abstract Background The survival benefit of venovenous extracorporeal membrane oxygenation (VV-ECMO) in adult patients with severe acute respiratory distress syndrome (ARDS) remains controversial. This study aimed to investigate the efficiency and potential prognostic factors of VV-ECMO for severe ARDS in adults by evaluating our institutional experience and results. Materials and methods This research studied ARDS patients receiving VV-ECMO between June 2011 and May 2023. The inclusion criteria were PaO2/FiO2

Vulnerability of morphosyntactic production, including grammatical aspect, has been identified in at least some children with autism spectrum disorder (ASD) exposed to typologically different languages. However, Tovar et al. (2015) found strengths in comprehending grammatical aspect in English-exposed children with ASD, suggesting that the challenges in production are pragmatically based. Using the eye-movement measures of Intermodal Preferential Looking, this study further explored whether Mandarin-exposed preschoolers with ASD were able to map aspect morphemes onto their distinct meanings in comprehension, despite their apparent impairments in aspect production. The results revealed that a diverse sample of 2-6-year-old Mandarin-exposed children with ASD demonstrated similar patterns of comprehending the perfective morpheme "le" and the progressive morpheme "zai" as younger 1-3-year-old TD children, even though the children with ASD's vocabulary production scores were dramatically delayed. Specifically, both groups of children associated the perfective morpheme "le" with the completed action and the progressive morpheme "zai" with the ongoing action. Our findings suggest that despite their apparent deficits of using/producing grammatical aspect, comprehension of grammatical aspect is a strength in children with ASD across languages. Moreover, grammatical aspect appears to be preserved in children with ASD, despite their pragmatic deficits and vocabulary disadvantages. The experimental findings shed light on the sharp contrast between linguistic competence versus linguistic performance in autistic grammatical acquisition. Furthermore, the results highlight the dissociation between the grammatical vs. the pragmatic and lexical language modules in children with ASD.

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease characterized by hepatic fat accumulation, while nonalcoholic steatohepatitis (NASH) is an advanced form of NAFLD characterized by hepatic inflammation, fibrosis, and liver injury, resulting in liver cirrhosis and hepatocellular carcinoma (HCC). Given the evidence that ginseng and its major bioactive components, ginsenosides, have potent anti-adipogenic, anti-inflammatory, anti-oxidative, and anti-fibrogenic effects, the pharmacological effect of ginseng and ginsenosides on NAFLD and NASH is noteworthy. Furthermore, numerous studies have successfully demonstrated the protective effect of ginseng on these diseases, as well as the underlying mechanisms in animal disease models and cells, such as hepatocytes and macrophages. This review discusses recent studies that explore the pharmacological roles of ginseng and ginsenosides in NAFLD and NASH and highlights their potential as agents to prevent and treat NAFLD, NASH, and liver diseases caused by hepatic steatosis and inflammation.

In order to establish the internal relationship between the composition and crystallization characteristics of fat and the product quality and whipping properties, the fat composition and crystallization characteristics, emulsion quality, whipped product quality and whipping properties of dairy, non-dairy and mixed creams were analyzed in this study. The results showed that the crystal network formed by mixed animal and vegetable fats had a dense structure and high susceptibility to shear-induced partial aggregation, the resulting emulsion had high viscosity and low overrun, while the whipped product had high hardness and moderate conformal capacity. However, the crystallization properties of vegetable fat were opposite to those of mixed animal and vegetable fats, and the susceptibility to shear-induced partial aggregation was low. The vegetable cream emulsion had low viscosity and high overrun, whereas the whipped product has low hardness and the best conformal capacity. Animal fat had the lowest solid fat content, resulting in the weakest crystal network structure; the rate of partial aggregation, viscosity and overrun of the resulting emulsion were the lowest, and the whipped product had the lowest hardness and conformal capacity. Therefore, the product quality and whipping performance can be controlled by regulating the fat composition and crystallization characteristics. This study can provide theoretical guidance for the development of high-quality whipped cream.

Peritoneal fibrosis, a common complication observed in long-term peritoneal dialysis patients, can gradually lead to ultrafiltration failure and the development of encapsulating peritoneal sclerosis. Although mechanisms of peritoneal fibrosis have been proposed, effective therapeutic options are unsatisfactory. Recently, several tyrosine kinase inhibitors have proven to be anti-fibrosis in rodent models. To assess the potential therapeutic effects of tyrosine kinase inhibitors on peritoneal fibrosis in the larger animal model, a novel porcine model of peritoneal fibrosis induced by 40 mM methylglyoxal in 2.5 % dialysate was established, and two different doses (20 mg/kg and 30 mg/kg) of sorafenib were given orally to evaluate their therapeutic efficacy in this study. Our results showed that sorafenib effectively reduced adhesions between peritoneal organs and significantly diminished the thickening of both the parietal and visceral peritoneum. Angiogenesis, vascular endothelial growth factor A production, myofibroblast infiltration, and decreased endothelial glycocalyx resulting from dialysate and methylglyoxal stimulations were also alleviated with sorafenib. However, therapeutic efficacy in ameliorating loss of mesothelial cells, restoring decreased ultrafiltration volume, and improving elevated small solutes transport rates was limited. In conclusion, this study demonstrated that sorafenib could potentially be used for peritoneal fibrosis treatment, but applying sorafenib alone might not be sufficient to fully rescue methylglyoxal-induced peritoneal defects.