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A two-year long-term workshop centered around a phenotypic whole-cell screening strategy for integrating cutting-edge knowledge and discovery-based laboratory experiences was developed to serve as a preparatory course for enhancing the teaching quality of the upper-level discovery-based research internship curriculum for pharmacy major undergraduates. The workshop comprises four modules that integrate lessons and experiments into a genuine research project, which initiates with a medicinal-chemistry course, run concurrently in the second year and culminates with the discovery-based research internship curriculum for pharmacy major students as a corequisite in the last year. The effective implementation of the featured pedagogical approaches in the modules is detailed as described. A group of students (N = 4) passed the instructor-student two-way choice and were enrolled in the senior-level phenotypic hit discovery laboratory project. The students synthesized a small library of molecules, tested them in an antibacterial assay, and further designed new compounds to analyze structure-activity relationships. Furthermore, positive feedback from students revealed that the phenotypic hit discovery oriented workshop enabled them to gain in-depth cutting-edge knowledge and provided an understanding of how medicinal chemists engage in new drug discovery research. The student's early exposure to troubleshooting or exploring unexpected results in an authentic scientific environment inspired them with ambition and confidence to engage with new drug discovery. We hope that this workshop will serve as a springboard for those wishing to educate medicinal chemists at an undergraduate level with modern strategies that are relevant to the current and future drug discovery landscape.

Although episodic and semantic memory share overlapping neural mechanisms, it remains unclear how our pre-existing semantic associations modulate the formation of new, episodic associations. When freely recalling recently studied words, people rely on both episodic and semantic associations, shown through temporal and semantic clustering of responses. We asked whether orienting participants toward semantic associations interferes with or facilitates the formation of episodic associations. We compared electroencephalographic (EEG) activity recorded during the encoding of subsequently recalled words that were either temporally or semantically clustered. Participants studied words with or without a concurrent semantic orienting task. We identified a neural signature of successful episodic association formation whereby high-frequency EEG activity (HFA, 44-100 Hz) overlying left prefrontal regions increased for subsequently temporally clustered words, but only for those words studied without a concurrent semantic orienting task. To confirm that this disruption in the formation of episodic associations was driven by increased semantic processing, we measured the neural correlates of subsequent semantic clustering. We found that HFA increased for subsequently semantically clustered words only for lists with a concurrent semantic orienting task. This dissociation suggests that increased semantic processing of studied items interferes with the neural processes that support the formation of novel episodic associations.

Abstract Alzheimer’s Disease (AD) is a neurodegenerative disorder, and various molecules associated with PANoptosis are involved in neuroinflammation and neurodegenerative diseases. This work aims to identify key genes, and characterize PANoptosis-related molecular subtypes in AD. Moreover, we establish a scoring system for distinguishing PANoptosis molecular subtypes and constructing diagnostic models for AD differentiation. A total of 5 hippocampal datasets were obtained from the Gene Expression Omnibus (GEO) database. In total, 1324 protein-encoding genes associated with PANoptosis (1313 apoptosis genes, 11 necroptosis genes, and 31 pyroptosis genes) were extracted from the GeneCards database. The Limma package was used to identify differentially expressed genes. Weighted Gene Co-Expression Network Analysis (WGCNA) was conducted to identify gene modules significantly associated with AD. The ConsensusClusterPlus algorithm was used to identify AD subtypes. Gene Set Variation Analysis (GSVA) was used to assess functional and pathway differences among the subtypes. The Boruta, Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest (RF), and Support Vector Machine Recursive Feature Elimination (SVM-RFE) algorithms were used to select the three PANoptosis-related Key AD genes (PKADg). A scoring model was constructed based on the Boruta algorithm. PANoptosis diagnostic models were developed using the RF, SVM-RFE, and Logistic Regression (LR) algorithms. The ROC curves were used to assess the model performance. A total of 48 important genes were identified by intersecting 725 differentially expressed genes and 2127 highly correlated module genes from WGCNA with 1324 protein-encoding genes related to PANoptosis. Machine learning algorithms identified 3 key AD genes related to PANoptosis, including ANGPT1, STEAP3, and TNFRSF11B. These genes had strong discriminatory capacities among samples, with Receiver Operating Characteristic Curve (ROC) analysis indicating Area Under the Curve (AUC) values of 0.839, 0.8, and 0.868, respectively. Using the 48 important genes, the ConsensusClusterPlus algorithm identified 2 PANoptosis subtypes among AD patients, i.e., apoptosis subtype and mild subtype. Apoptosis subtype patients displayed evident cellular apoptosis and severe functionality damage in the hippocampal tissue. Meanwhile, mild subtype patients showed milder functionality damage. These two subtypes had significant differences in apoptosis and necroptosis; however, there was no apparent variation in pyroptosis functionality. The scoring model achieved an AUC of 100% for sample differentiation. The RF PANoptosis diagnostic model demonstrated an AUC of 100% in the training set and 85.85% in the validation set for distinguishing AD. This study identified two PANoptosis-related hippocampal molecular subtypes of AD, identified key genes, and established machine learning models for subtype differentiation and discrimination of AD. We found that in the context of AD, PANoptosis may influence disease progression through the modulation of apoptosis and necrotic apoptosis.

Objective To retrospectively analyze the epidemiological characteristics of supernumerary teeth in patients aged 4-18 years old and the influencing factors on the selection of anesthesia methods, and to provide a reference for the selection of anesthesia plans for children and adolescents with supernumerary teeth. Methods This study is a retrospective study approved by the Institutional Ethics Committee. Based on clinical electronic medical record system and cone beam CT (CBCT) data, a retrospective analysis was conducted on 2 210 patients 4-18 years of age who underwent supernumerary tooth extraction at the School of Stomatology, Fourth Military Medical University from August 2019 to July 2021. Inclusion criteria: ① Age 4-18 years old; and ② The American Society of Anesthesiologists (ASA) classifies anesthesia into grades I-II; and ③ Have complete oral and anesthesia case records and relevant imaging data. Exclusion criteria: ① Incomplete medical records or unclear imaging data; and ② Patients with ASA grade II or above. Patients’ gender and age, the number of supernumerary teeth, arch, location, orientation, eruption status, reason for appointment, anxiety level, degree of cooperation, anesthesia method, and other relevant information were collected and statistically analyzed. Results A total of 1 865 eligible patients were included, with an average age of (8.9±3.2) years old. There were more male patients (71.37%, 1 331 cases) than female patients (28.63%, 534 cases) (P < 0.001), with a gender ratio of 2.49:1. The majority of supernumerary teeth were single (75.97%, 1 417/1 865), primarily located in the maxilla (97.2%, 1 812/1 865) and the anterior dental region (94.2%, 1 757/1 865), and in a centric position (77.3%, 1 442/1 865). The majority of patients with erupted supernumerary teeth were active in seeking treatment (97.67%, 335/343). Patients with supernumerary teeth located in the maxilla and mandible bones, as well as in the nasal floor, were mainly referred to the department for diagnosis, accounting for 94.38%(1 361/1 442) and 90.00% (72/80) (χ2=1 363.24, P < 0.001), respectively. Regarding anesthesia methods, the largest proportion of patients received nitrous oxide sedation-assisted local anesthesia or nerve block anesthesia, accounting for 38.07% (710/1 865), followed by local anesthesia, accounting for 35.23% (657/1 865). The proportion of patients receiving midazolam intravenous sedation with local anesthesia or nerve block anesthesia and general anesthesia was relatively small, accounting for 20.86% (389/1 865) and 5.84% (109/1 865). Patients 13-18 years of age with supernumerary teeth in the mandibular and posterior regions and without anxiety had the highest proportion of local anesthesia use (P < 0.001). In contrast, patients who had supernumerary teeth located at the base of the nose (50%), severe anxiety (94.12%), and poor cooperation (98.18%) had the highest proportion of general anesthesia use (P < 0.001). There was no significant difference (P = 0.35) in the incidence of intraoperative and postoperative complications after the extraction of supernumerary teeth. However, the proportion of anesthesia-related complications, such as dizziness, coughing, and respiratory depression, occurring in patients who received general anesthesia was higher than local anesthesia, accounting for 3.81% (P = 0.006). Conclusion There is a gender difference in the incidence of supernumerary teeth in patients 4-18 years of age, with a higher prevalence in males. The majority of supernumerary teeth are single and located in the maxillary anterior region, predominantly in a centric position. Patients whose teeth had erupted were more likely to seek medical treatment voluntarily, while patients with supernumerary teeth located in the maxilla and mandible bones, as well as in the nasal floor were more likely to be referred to the department. Patients with high levels of anxiety, poor cooperation, young age, multiple teeth, and high surgical difficulty were more inclined to choose general anesthesia.

Objective To investigate the correlation between interleukin 1β gene -511C/T polymorphism of and essential hypertension in the Yi ethnic group of Yunnan province. Methods -511C/T polymorphism of interleukin 1β gene was detected by PCR-RFLP in 85 Yi patients with essential hypertension (EH group) and 106 Yi healthy people (control group) in Shuanghe Township, Jinning County, Yunnan Province. Genotype and allele frequencies were analyzed by SPSS 27.0 software, and association analysis was performed. Results The frequency distribution of CC, CT and TT genotypes at the mutation site 511 of the IL-1βgene in EH group was 18.82%, 44.71% and 36.47%, respectively, and it was 5.66%, 26.42% and 67.92% in the control group. The difference in genotype frequency between the two groups was statistically significant (P＜0.05). The allele frequency of C and T in EH group was 41.18% and 58.82%, respectively, and the allele frequency of C and T in control group was 18.87% and 81.13%. The frequency difference of alleles between the two groups was statistically significant (P＜0.05). Both genotype frequency and allele frequency found in males and females had statistical differences (P＜0.05). Conclusions The distribution of IL-1β gene -511C/T polymorphism is related to the incident of essential hypertension among the Yi ethnic group Yunnan Province, and is the susceptibility gene of the Yi ethnic group to essential hypertension.

Abstract This study aimed to develop a deep learning system for the detection of three-rooted mandibular first molars (MFMs) on panoramic radiographs and to assess its diagnostic performance. Panoramic radiographs, together with cone beam computed tomographic (CBCT) images of the same subjects, were retrospectively collected from 730 patients, encompassing a total of 1444 MFMs (367 teeth were three-rooted and the remaining 1077 teeth were two-rooted). Five convolutional neural network (CNN) models (ResNet-101 and − 50, DenseNet-201, MobileNet-v3 and Inception-v3) were employed to classify three- and two-rooted MFMs on the panoramic radiographs. The diagnostic performance of each model was evaluated using standard metrics, including accuracy, sensitivity, specificity, precision, negative predictive value, and F1 score. Receiver operating characteristic (ROC) curve analyses were performed, with the CBCT examination taken as the gold standard. Among the five CNN models evaluated, ResNet-101 demonstrated superior diagnostic performance, and the AUC value attained was 0.907, significantly higher than that of all other models (all P

Abstract The N-back task is one of the most popular paradigms for studying the cognitive mechanisms of working memory (WM). The task requires the observer to view a sequence of stimuli and judge whether the current stimulus (probe) matches the one presented N stimuli ago (target). A key phenomenon is that the intervening stimuli (distractors) interfere with task performance. Unfortunately, the classic N-back task uses complex categorical stimuli, making it unfit to quantify the effect of feature similarity on interference strength. Here, we introduce the “analog N-back task”, which utilizes stimuli varying continuously in orientation or color. This task variant enables us to measure interference strength on a continuum, providing data suitable for identifying the sources of interference using computational models. In the analog 2-back task, we found that interference increased with feature similarity between the probe and both task-relevant (1-back) and task-irrelevant (3-back) distractors. We next developed and evaluated three main models that each incorporated a Bayesian decision step and differed from an optimal non-interference model in one component only: an early-pooling model, a late-pooling model, and a substitution model. Model comparison suggests that interference emerges late in processing, most likely due to confusion between stimuli during WM retrieval. Our work puts the study of interference in the N-back task on a firmer computational footing and provides a unified framework for examining the sources of interference across domains.

Abstract Secondary zinc oxide dust is rich in high-grade metals such as Zn, In, Pb, and Ga, and in the face of the depletion of ore resources at home and abroad, it is of great significance to seek an efficient process to realize the full resource recovery of valuable metals in secondary zinc oxide dust. In this study, on the basis of the thermodynamic analysis of the wet treatment process, three wet treatment methods, namely “low acid leaching”, “high acid leaching” and “chlorination leaching”, were used to explore the suitable parameters for stepwise extraction of Zn, In and Pb metals. The results showed that the three wet treatment methods could effectively extract the corresponding main elements, and the optimal leaching rates of Zn, In and Pb were 73, 90 and 94%, respectively. Thermodynamic analysis shows that under ideal conditions, the “cascade separation” of some or all metals can be theoretically achieved by using a suitable leaching solvent for zinc oxide dust. The concentration of sulfuric acid, the ratio of liquid solid volume to mass and temperature had great effects on the leaching rate of Zn and In, and the leaching rate of Zn and In also increased with the increase of the values of the three experimental parameters, which was positively correlated. The leaching rate of Pb will increase with the increase of sulfuric acid concentration, but when the pH of the solution system is

Abstract The purpose of this study is to identify and analyze the application barriers and internal mechanisms of BIM technology in green building projects. It is found that BIM technology can effectively integrate information and optimize management, but its application still faces economic externalities and requires government intervention to promote its development. Through the analysis of five aspects of technology, economy, management, policy and environment, we identified 16 influencing factors and focused on nine key factors, such as insufficient technology maturity and high-cost issues. Research shows that policy and management factors play a fundamental role in BIM adoption and influence economic effectiveness through complex interactions. Based on the ISM-ANP coupling model, we propose that the government should encourage technological innovation and personnel training to promote the effective application of BIM technology in green buildings. This study provides a theoretical reference for the application of BIM and green building on a global scale.

Abstract In the era of cloud service popularization, the trustworthiness of service is particularly important. If users cannot prevent the potential trustworthiness problem of the service during long-term use, once the trustworthiness problem occurs, it will cause significant losses. In order to objectively assess the cloud service trustworthiness, and predict its change, this paper establishes a special hierarchical model of cloud service trustworthiness attributes. This paper proposes corresponding management countermeasures around the model, defines the cloud service trustworthiness level, defines the cloud service trusted state based on fuzzy entropy and Markov chain, constructs the membership function of the cloud service trusted state, and realizes the assessment of cloud service trustworthiness and its changes according to the prediction method of Markov chain. Through case analysis and method comparison, it shows that the method proposed in this paper is effective and feasible. This method can provide objective and comprehensive assessment data for the cloud service trustworthiness and its change, makes up the deficiency of fuzzy entropy assessment method. This research has important reference value and significance for the research of cloud service trustworthiness assessment.

Abstract Diabetes foot ulcer (DFU) is one of the common complications of diabetes patients, which may lead to infection, necrosis and even amputation. Therefore, early diagnosis, classification of severity and related treatment are crucial for the patients. Current DFU classification methods often require experienced doctors to manually classify the severity, which is time-consuming and low accuracy. The objective of the study is to propose a few-shot DFU image classification method based on deep residual neural network and transfer learning. Considering the difficulty in obtaining clinical DFU images, it is a few-shot problem. Therefore, the methods include: (1) Data augmentation of the original DFU images by using geometric transformations and random noise; (2) Deep ResNet models selection based on different convolutional layers comparative experiments; (3) DFU classification model training with transfer learning by using the selected pre-trained ResNet model and fine tuning. To verify the proposed classification method, the experiments were performed with the original and augmented datasets by separating three classifications: zero grade, mild grade, severe grade. (1) The datasets were augmented from the original 146 to 3000 image datasets and the corresponding DFU classification’s average accuracy from 0.9167 to 0.9867; (2) Comparative experiments were conducted with ResNet18, ResNet34, ResNet50, ResNet101, ResNet152 by using 3000 image datasets, and the average accuracy/loss is 0.9325/0.2927, 0.9276/0.3234, 0.9901/0.1356, 0.9865/0.1427, 0.9790/0.1583 respectively; (3) Based on the augmented 3000 image datasets, it was achieved 0.9867 average accuracy with the DFU classification model, which was trained by the pre-trained ResNet50 and hyper-parameters. The experimental results indicated that the proposed few-shot DFU image classification method based on deep ResNet and transfer learning got very high accuracy, and it is expected to be suitable for low-cost and low-computational terminal equipment, aiming at helping clinical DFU classification efficiently and auxiliary diagnosis.

Abstract Background Human papillomavirus (HPV) infection is prevalent among people who are sexually active. This study aimed to compare the levels of behavioral intention to receive free clinician-collected and self-collected samples for HPV DNA testing and its determinants between heterosexual males and females in Hong Kong, China. Methods This is a secondary analysis of a territory-wide survey conducted in Hong Kong between May 2021 and March 2022. Participants were sexually active adult Hong Kong residents who were able to communicate in English or Chinese. Invitation letters were mailed to residential addresses that were geographically randomly selected. All sexually active adult household members were invited to complete a self-administered online survey. Multivariate logistic regression analyses were fitted. Results Out of 45,394 invitations, 1265 surveys were collected, and 487 heterosexual males and 741 females were included in the analysis. More females than heterosexual males intended to take up free clinician-collected samples for HPV DNA testing (76.7% versus 62.2%, p

Abstract Emergence agitation (EA) is more commonly observed after thoracic surgeries and can lead to serious complications. This study aimed to evaluate the effectiveness of serratus anterior plane block (SAPB) combined with oxycodone for transitional analgesia in preventing EA after video-assisted thoracoscopic surgery (VATS). A total of 121 adult patients scheduled for VATS under one-lung ventilation anesthesia were enrolled and randomly divided into three groups: preoperative SAPB without opioids for transitional analgesia near the end of the surgery (SAPB + SAL group, n = 39); preoperative SAPB with sufentanil at 0.1 µg/kg for transitional analgesia (SAPB + SF group, n = 42); and preoperative SAPB with oxycodone at 0.1 mg/kg for transitional analgesia (SAPB + OCD group, n = 40). In primary outcomes, the incidences of EA in the SAPB + SAL, SAPB + SF, and SAPB + OCD groups were 38.5%, 28.6%, and 7.5% respectively. There was a statistically significant difference in EA incidence between the SAPB + OCD and SAPB + SF groups (P = 0.0136). In secondary outcomes, compared to the SAPB + SF group, the SAPB + OCD group experienced shorter tracheal extubation time [15(9, 25) min vs. 21.5(14.5, 32.5) min; P = 0.0473] and PACU stay [67.5(55.0, 85.0) min vs. 87.5(70.0, 110.0) min; P = 0.0026]; lower NRS scores at 15 min and 2 h post-extubation (P

Abstract Retinitis pigmentosa (RP) is characterized by progressive photoreceptor cells death accelerated by the proliferation and activation of microglia pathologically. No consensus exists on the treatment. Minocycline is recognized as a microglia inhibitor with great anti-inflammatory and neuro-protective functions. However, efficacy of minocycline in RP patients is lacking. We conducted a prospective, open-label, and single-arm trial, in which daily oral minocycline of 100 mg was administered for 12 months in RP patients with light-adapted 30 Hz flicker electroretinography (ERG) amplitude >0 µV in at least one eye (NCT04068207). The primary outcome was the proportion of participants with improvement in the ERG amplitude at month 12. The secondary outcomes included improvements of the following items: other ERGs amplitudes, visual field, best-corrected visual acuity, contrast sensitivity, color vision, and NEI-VFQ-25. 35 of 288 patients met inclusive criteria were enrolled (median [IQR] age, 36 [31–45] years; 17 female [48.6%]). 32 participants completed all examinations, while 3 participants completed the 12-month online visit via conducting NEI-VFQ-25. The primary outcome showed improvement was 34.3% (12 of 35 [95% CI 19.1–52.2]). Similarly, all secondary outcomes showed improvements. Adverse events were reported in 22 participants (62.9%) and were all resolved without extra medication during the study period. No severe adverse events were recorded. Our findings identified daily oral minocycline of 100 mg for 12 months was beneficial in improving the visual function of RP patients with good safety. This study indicates minocycline may be a promising therapy for RP, but a randomized controlled trial is still needed of further exploration.

Objective To investigate the short-term efficacy of stereotactic-guided neuroendoscopic hematoma clearance via the forehead keyhole approach in the treatment of hypertensive basal ganglia hemorrhage (HBGH). Methods A total of 148 patients with HBGH who were treated in Department of Neurosurgery in our hospital from December 2016 to August 2021 were enrolled and divided into study group and control group according to their surgical plans. The 74 patients who underwent conventional stereotactic hematoma puncture and drainage were enrolled as control group, and the 74 patients who underwent stereotactic-guided neuroendoscopic hematoma clearance via the forehead keyhole approach were enrolled as study group. The two groups were compared in terms of time of operation, the proportion of patients with rebleeding during hospitalization, the proportion of patients with hematoma clearance at 6 hours after surgery, European Stroke Scale (ESS) score and Barthel index before surgery and at 3 months after surgery, the proportion of deaths at 3 months after surgery, the proportion of patients with complications at 3 months after surgery, and the proportion of patients with good prognosis at 6 months after surgery. Results Compared with the control group, the study group had a significantly longer time of operation (t=19.084,P0.05); at 6 months after surgery, compared with the control group, the study group had a significantly higher proportion of patients with good prognosis (χ2=9.483,P

Dyslipidemia constitutes an essential risk factor for atherosclerotic disorders. From employing diverse types of blood lipid indicators as markers for risk prediction to subsequently applying low-density lipoprotein cholesterol as the primary lipid-lowering target in both primary and secondary prevention of cardiovascular diseases, relevant research and clinical practices indicate that the dyslipidemia management system grounded on hierarchical medical care is a significant measure for effective blood lipid control and efficient reduction of cardiovascular diseases. Continuously optimizing the prediction model for cardiovascular diseases, enhancing the construction of the medical consortium specializing in dyslipidemia disorders, and promoting the dyslipidemia management and control system based on hierarchical medical treatment will facilitate elevating the overall prevention and treatment level of dyslipidemia in China, and mitigate the health menace of cardiovascular diseases for Chinese residents.

Familial hypercholesterolemia (FH) is an inherited disorder of lipid metabolism characterized by significant elevation of low-density lipoprotein cholesterol, increasing the risk of atherosclerotic cardiovascular disease and causing serious consequences for FH patients and the whole society. The development of molecular biotechnology is crucial for screening, diagnosing, and treating patients with FH. This paper systematically summarizes how the development of genetic testing technologies, particularly next-generation sequencing, has improved the accuracy of diagnosis and efficiency of genetic screening for FH, while also introducing many variations of unknown significance. In contrast to pharmacotherapy, transgenic technology and gene editing technology offer the potential to rectify the molecular aberration within the patient's physiological system, holding promise for eradicating FH at the molecular level. However, preliminary results have shown that patients could suffer from side-effects, such as liver damage, and long-term follow-up is needed to clarify the efficacy of these technologies. Therefore, this article reviews the latest advances in molecular biotechnology, including genetic testing technology and gene therapy technology, in the diagnosis and treatment of FH, aiming to provide new perspectives for FH related research.

Background Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a crucial role in lipid metabolism. The factors influencing PCSK9 in acute myocardial infarction (AMI) patients have not been fully understood. Objective To investigate the influence factors of PCSK9 among AMI patients. Methods Patients with an admission diagnosis of AMI between 2010 and 2018 were consecutively enrolled in the Department of Cardiology, Peking University First Hospital. Baseline information was collected from patients' current history, past history, and physical examination in the electronic medical record system at admission, and baseline plasma PCSK9 levels were measured. The related factors of PCSK9 were analyzed using univariate and multivariate linear regressions. The LASSO method was employed, the selected variables were subsequently included in the analysis of a multivariate linear regression model. Results 996 AMI patients were consecutively enrolled from 2010 to 2018, and 37 patients with no PCSK9 measurement results due to insufficient volume of retained blood samples were excluded. A total of 959 patients were included in the analysis. The median PCSK9 levels were 543.1 (425.4, 692.1) ng/mL. The multivariate linear regression analysis of non-genetic factors of PCSK9 showed that gender had the greatest effect (standardized regression coefficient was 0.13). Other significant factors related to PCSK9 levels were history of atrial fibrillation (standardized regression coefficient was 0.09), white blood cell count (standardized regression coefficient was 0.07) and uric acid levels (standardized regression coefficient was 0.07) . Conclusion In patients with AMI, gender, history of atrial fibrillation, blood white blood cell count, and uric acid levels were significant independent factors related to plasma PCSK9 levels.

Background Insomnia not only decreases the quality of life and working efficiency, but also relates to other deceases. Suitable exercises may be useful to improve sleep quality. However, comparative studies on the effects of different types of exercise on sleep outcomes are currently lacked. Objective To compare the effects of different exercise types on sleep in insomnia patients and to provide insights for developing exercise prescriptions to improve sleep in this population. Methods Randomized controlled trials (RCT) investigating the effects of different types of exercises on the sleep of people with insomnia were retrieved from the PubMed, Web of Science, EBSCO, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform from database inception to December 2023. The quality of the literatures was assessed using the Jadad scale. A network meta-analysis was performed using the random-effects model of the frequency framework in Stata 17.0 software, and publication bias was observed using a funnel plot. Results A total of 36 articles representing 2 706 participants were included in this study. Exercise interventions were categorized into five types, including the aerobic exercise (AE), resistance training (RT), mind-body exercise (ME), prolonged time of exercise (PTE), and AE combined with RT (AE+RT). The results of the network meta-analysis showed that there was a significant difference in the total score of the subjective evaluation tools between AE group and blank control group (SMD=2.20, 95%CI=0.35-4.05, P0.05). The maximum SUCRA of SQ was detected in the AE group (84.2%), followed by AE+CT (75.5%), ME (24.9%) and CT groups (15.4%). Publication bias analysis of the total score of subjective evaluation tools, SL, SE, WASO, TST, and SQ revealed some asymmetry in all six outcome indicators, indicating a certain risk of publication bias. Conclusion Given the favorable effects of AE on multiple sleep parameters, we recommend insomnia patients engage in moderate-intensity AE, such as jogging or brisk walking, three times a week for approximately 30 minutes. Additionally, options include moderate-intensity RT or AE+RT four to five times a week. When engaging in the above exercises, attention should be paid to the choice of time period, and exercise within 3 hours before bedtime should be avoided as much as possible.

ObjectiveTo explore the ideal pretarsal shows and morphological characteristics of double eyelids in Chinese populations through a morphometric analysis.MethodsThis study employed a convenience sampling method to survey Chinese adults who did not reside abroad for an extended period (with cumulative overseas stay of over one year). From November 2023 to May 2024, electronic questionnaires were distributed to collect attractiveness ratings of nine different images (including one image featuring single eyelid and eight images with varying pretarsal shows and morphologies of double eyelids). Stratified comparisons were conducted based on gender, age, occupation, etc., to determine the ideal pretarsal show and morphology of double eyelids. Quantitative analysis was performed on the aesthetic features of the nine images depicting double eyelids to validate and elucidate the survey findings.ResultsA total of 493 questionnaires were filled out, and 397 valid questionnaires were included for data analysis after quality control. As for the whole cohort, the images feathering 2 mm double eyelid were deemed to be the most attractive, with the in-fold type scoring (3.72±0.97) points and the out-fold type scoring (3.65±1.04) points. The next was 1 mm, followed by 3 mm, single eyelid, and finally, 4 mm. As for morphology, in-fold type achieved higher scores than out-fold type in images with the same pretarsal show. However, statistically significant differences were only found in ratings for the images with 3 mm and 4 mm double eyelids (all P < 0.05). Stratified analysis based on gender, age, occupation, and other factors yielded results that were largely consistent with those of the overall population.The quantitative analysis of aesthetic characteristics of double eyelids revealed that when the pretarsal show was 2 mm, both the Chen's ratio of the in-fold and out-fold type were 0.630, which closely approximates the golden ratio.ConclusionsThis study validates that the pretarsal show of 2 mm and the presence of either an in-fold or out-fold morphology are considered optimal for double eyelids among Chinese individuals. These findings hold significant implications for the planning of double eyelid surgeries, assessment of surgical outcomes, and evaluation of other periocular procedures associated with double eyelid surgeries.

Facial anthropometry has profound importance in clinical diagnosis and the recognition of abnormal facial features. With the development of anthropometry, facial anthropometry has emerged as an independent research field and is widely applied in disciplines such as plastic surgery and cranio-maxillofacial surgery. This paper reviews the evolution of facial anthropometry and discusses its future trends in the context of artificial intelligence (AI). Currently, 3D facial imaging technology can accurately capture and reconstruct the three-dimensional morphology of facial soft tissues, and enhance the precision and objectivity of measurements, thus becoming the new "gold standard" for facial anthropometry. It not only provides reference for disease diagnosis and surgical planning but also plays a crucial role in evaluating cosmetic outcomes and aging research. In recent years, AI technology has developed rapidly, enabling direct recognition of abnormal facial features. Although facial recognition systems based on two-dimensional images are relatively mature, they have to struggle to fully capture facial features as they are limited by the dimensionality of information. While three-dimensional image-based recognition boasts high accuracy, it faces challenges in the recognition and classification of abnormal facial features due to limitations in the number of training samples. The integration of AI and facial anthropometry has effectively promoted automatic recognition technology for facial landmarks, thus providing more precise and interpretable methods for assessing disease-related facial features. Future research should focus on building reliable three-dimensional facial databases to further improve the accuracy of facial recognition. Additionally, developing facial recognition systems based on small sample sizes is necessary to provide robust support for the recognition of facial features associated with rare and special diseases.

In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

Abstract Major Depressive Disorder (MDD) is a common mental disorder characterized by cognitive impairment, and its pathophysiology remains to be explored. In this study, we aimed to explore the efficacy of brain network topological properties (TPs) in identifying MDD patients, revealing variational brain regions with efficient TPs. Functional connectivity (FC) networks were constructed from resting-state functional magnetic resonance imaging (rs-fMRI). Small-worldness did not exhibit significant variations in MDD patients. Subsequently, two-sample t-tests were employed to screen FC and reconstruct the network. The discriminative ability of TPs between MDD patients and healthy controls was analyzed using receiver operating characteristic (ROC), ROC analysis showed the small-worldness of binary reconstructed FC network (p

Abstract Eukaryotic Elongation Factor 2 Kinase (eEF2K), a member of the α-kinase family, services as a crucial negative regulator of protein synthesis, particularly under conditions of cellular stress. A pan-cancer analysis of eEF2K expression, genetic variants, and clinical relevance across multiple tumor types was performed using data from the Cancer Genome Atlas (TCGA) and GEO. Our findings suggest that eEF2K has dual roles in cancer progression, with its expression correlating with patient prognosis. Significant phosphorylation of eEF2 at T57, Y434, and T59 was observed, which may regulate protein synthesis during stress. The elevated T59 phosphorylation in COAD, despite the low eEF2K expression, indicates that this may be regulated by alternative kinases, such as AMPK or mTOR. This suggests that compensatory mechanisms may be involved. In addition to modulating eEF2 phosphorylation, eEF2K is involved in a number of other processes, including peptidyl-serine phosphorylation, the G2/M transition, and the MAPK cascade. The protein products of eEF2K are capable of localizing to the nucleus, cytoplasm, and cytosol, where they bind to a range of proteins, including ATP and calcium ions. These findings provide novel insights into the role of eEF2K in cancer biology and suggest that the targeting of eEF2K and eEF2 phosphorylation may offer promising therapeutic strategies.

Abstract The objective of this study is to investigate key prognostic factors of clinical data and prognostic factors in patients with hypertensive intracerebral hemorrhage (HICH) who have undergone neuroendoscopic hematoma evacuation, specifically focusing on those with a hemorrhage volume of 20-40 mL, to identify the determinants influencing their prognosis. In this study, a total of 113 patients were ultimately included in the analysis. Variables such as age, preoperative Glasgow Coma Scale (GCS) scores, and hemorrhage locations were assessed. LASSO logistic regression was employed to select pertinent variables, which were then incorporated into a multivariate logistic regression model. The model’s performance was evaluated using ROC and calibration curves, along with clinical utility curves, and the recovery times of patients were analyzed using Kaplan–Meier curves, complemented by COX regression analysis. These three variables—Age (OR: 0.811; 95% CI 0.711–0.925), GCS score (OR: 25.923; 95% CI 4.108–163.598), and ICH location (OR: 7.345; 95% CI 1.811–29.783)—are strong predictors of intracerebral hemorrhage prognosis. Among the patients analyzed, 85.84% experienced a favorable prognosis. Younger age, higher preoperative GCS scores, and hemorrhages located in the basal ganglia and cerebral lobes were associated with better outcomes (mRS score of 0–3) . The nomogram, validated by an ROC curve analysis yielding an AUC of 0.9417 and the Hosmer–Lemeshow test, demonstrated accurate predictive and calibration capabilities for postoperative prognosis in patients with hypertensive intracerebral hemorrhage. Kaplan–Meier intervals and COX regression analysis indicated that age is a significant factor affecting the recovery time of these patients. Age, GCS score, and ICH location are significant prognostic factors for patients undergoing neuroendoscopic hematoma evacuation following hypertensive intracerebral hemorrhage, with age being a particularly important determinant of recovery time. Younger age, higher GCS scores, and lobar hemorrhage are associated with better prognosis.

Abstract Prostate cancer (PCa) is the second most common malignancy affecting men globally. Recent advances in metabolomics have highlighted significant alterations in specific amino acid (AA) metabolism linked to PCa, indicating their potential utility in diagnosis and therapy. However, no direct causal association between serum AA levels and PCa risk has been established. A total of 35 patients with PCa and 30 individuals with benign prostatic hyperplasia (BPH) were recruited for this study. Targeted metabolomic analysis was performed using ultra-high-performance liquid chromatography-tandem mass spectrometry on serum samples. Two-sample Mendelian randomization (MR) was applied to explore potential causal links between serum AA levels and PCa risk, including mediator effects using dual-phase MR and assessing reverse causality through reverse MR. Results Targeted metabolomic profiling identified six amino acids—glutamate (Glu), Ser, histidine (His), arginine (Arg), aspartic acid (Asp), and glycine (Gly)—that showed significant area under the ROC curve in differentiating between BPH and PCa cases. Notably, Glu demonstrated an inverse association with PCa risk, distinct from the other AAs identified. However, definitive evidence supporting a causal relationship between low Glu levels and increased PCa risk was not observed. Our results suggest a protective role of Glu against PCa development, which may have implications for disease prognosis. Increasing dietary Glu intake may present a potential preventive or therapeutic approach for PCa.

Abstract To investigate the value and sensitivity of contrast-enhanced ultrasonography (CEUS) combined with fine-needle aspiration biopsy (FNAB) in the diagnosis of thyroid nodules. This study enrolled 120 patients with thyroid nodules who visited our hospital between July 2018 and January 2021. All patients underwent CEU and CEUS-guided FNAB. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CEUS-guided FNAB for the qualitative diagnosis of thyroid nodules were significantly higher compared with CEUS only (P

Abstract Distal cholangiocarcinoma is a rare and highly aggressive malignant tumor. The inherent tumor characteristics and growth pattern of cancer cells pose a challenge for diagnosis and treatment. Chemotherapy resistance leads to limited treatment options for patients with advanced cholangiocarcinoma. However, drug resistance studies in cholangiocarcinoma are often limited by the use of preclinical models that do not accurately replicate the essential features of the disease. In this study, we established and characterized a primary multidrug-resistant distal cholangiocarcinoma cell line, CBC3T-6. STR profiling indicated no evidence of cross-contamination. This cell line remains stable during long-term in vitro culture and is characterized by short doubling times and rapid subcutaneous tumor formation in mice. In addition, among the first-line anticancer drugs for cholangiocarcinoma, CBC3T-6 cells showed varying degrees of resistance to gemcitabine, oxaliplatin, cisplatin, and 5-FU. Whole exome sequencing analysis revealed that CBC3T-6 cells contained a variety of potentially pathogenic somatic cell mutations, such as TP53 and KRAS mutations. ABCB1 mutation as a possible therapeutic target for multidrug resistance. In conclusion, CBC3T-6 cells can be used as a useful tool to study the mechanism of cholangiocarcinoma and develop new therapeutic strategies for multidrug resistance.

Abstract Currently, there is limited evidence regarding the association between prenatal exposure to environmental fine particulate matter (PM2.5) and the occurrence of cryptorchidism. The objective of this study was to evaluate the potential correlation between prenatal exposure to PM2.5 and the likelihood of cryptorchidism developing in offspring. We performed a 1:1 case–control study, defining the cases as children diagnosed with cryptorchidism at the Children’s Hospital Affiliated to Chongqing Medical University from 2013 to 2017, while the control group comprised children born in the corresponding years who did not have any birth defects, chromosomal abnormalities, and had only trauma-related treatments. Between 2012 and 2017, monthly averages of PM2.5, other pollutants (O3, PM10) and temperature were gathered based on the geographical coordinates of patients’ residences. The study assessed the correlation between the two using multivariate logistic regression model, and sensitivity analysis was conducted to assess the stability of the model. We included a total of 2137 cases and 2137 matched controls from 2013 to 2017. Our findings revealed that there was a positive association between exposure to PM2.5 during the first 2 months of pregnancy and the occurrence of cryptorchidism. According to this study, the development of cryptorchidism appears to be associated with maternal exposure to PM2.5 during early pregnancy.

Abstract Dysfunction is a common clinical symptom among rehabilitation patients; however, whether there are sex differences in dysfunctions remains unclear. Therefore, this study aimed to explore this issue by examining a large sample of the population with dysfunctional problems. A multi-stage sampling scheme was used to select the rehabilitation outpatients as study participants. A total of 3415 participants from 21 medical institutions in seven cities in China were included in the final analysis. The measurement included general characteristics (age, sex, educational level, marital status, and household income) and disease-related characteristics (dysfunctions, self-care ability, vital signs, disease status, and disease course). The logistic regression was used to analyse the sex difference in dysfunctions among rehabilitation outpatients. Among 3415 rehabilitation outpatients, the mean age of participants was 45.3 years (SD:24.9), and more than half (54.0%) were male. The male patients were more likely to have cognitive impairment (OR = 1.74; 95% CI = 1.42, 2.13), speech disorders (OR = 2.00; 95% CI = 1.62, 2.48), dysphagia (OR = 1.55; 95% CI = 1.12, 2.16), and multiple dysfunctions (OR = 2.00; 95% CI = 1.57, 2.54) than female. Female patients were more likely to have motor dysfunctions (OR = 0.63; 95% CI = 0.50, 0.78). There are sex differences in dysfunctions among rehabilitation outpatients. This sex difference may provide potential clinical value for the treatment of rehabilitation patients.

Abstract To aid in the diagnosis, monitoring, and surveillance of bladder carcinoma, this study aimed to develop and test an algorithm that creates a referenceable bladder map rendered from standard cystoscopy videos without the need for specialized equipment. A vision-based algorithm was developed to generate 2D bladder maps from individual video frames, by sequentially stitching image frames based on matching surface features, and subsequently localize and track frames during reevaluation. The algorithm was developed and calibrated in a 2D model and 3D anthropomorphic bladder phantom. The performance was evaluated in vivo in swine and with retrospective clinical cystoscopy video. Results showed that the algorithm was capable of capturing and stitching intravesical images with different sweeping patterns. Between 93% and 99% of frames had sufficient features for bladder map generation. Upon reevaluation, the cystoscope accurately localized a frame within 4.5 s. In swine, a virtual mucosal surface map was generated that matched the explant anatomy. A surface map could be generated based on archived patient cystoscopy images. This tool could aid recording and referencing pathologic findings and biopsy or treatment locations for subsequent procedures and may have utility in patients with metachronous bladder cancer and in low-resource settings.

Abstract Heart failure (HF) is the leading cause of death in patients with maintenance hemodialysis (MHD). Biomarkers has an important guiding role in the early diagnosis, risk stratification, and prognostic assessment of HF. Increasing studies have indicated that long non-coding RNAs (lncRNAs) have played an indispensable role in the regulatory network of HF. This study was aiming to explore the expression profiles of lncRNAs in patients treated with MHD developing heart failure. Peripheral blood mononuclear cells were isolated from 4 hemodialysis patients with reduced ejection fraction (HFrEF) and 4 hemodialysis patients with preserved ejection fraction (HFpEF), respectively. The expression profile analysis of lncRNAs was performed by using Illumina Novaseq 6000 sequencer. Quantitative real time polymerase chain reaction (qRT-PCR) was used to verify the expression of representative differentially expressed lncRNAs. Based on lncRNA-miRNA-mRNA-KEGG network analysis, the potential role of candidate lncRNAs and their association with the severity of HF were further evaluated. In total, 1,429 differentially expressed lncRNAs were found between patients with HFrEF and patients with HFpEF, of which 613 were up-regulated and 816 were down-regulated (P

Abstract Neurodegenerative diseases (NDDs) present significant challenges due to limited treatment options, ethical concerns surrounding traditional animal models, and the time-consuming and costly process of using human-induced pluripotent stem cells (iPSCs). We addressed these issues by developing a 3D culture protocol for differentiating SH-SY5Y cells into glutamatergic neurons, enhancing physiological relevance with a 3D microarray culture plate. Our protocol optimized serum concentration and incorporated retinoic acid (RA) to improve differentiation. We analyzed the proportions of N-type and S-type cells, observing that RA in the maturation stage not only reduced cell proliferation but also enhanced the expression of MAP2 and VGLUT1, indicating effective neuronal differentiation. Our approach demonstrates the strong expression of glutamatergic neuron phenotypes in 3D SH-SY5Y neural spheroids, offering a promising tool for high-throughput NDD modeling and advancing drug discovery and therapeutic development. This method overcomes limitations associated with conventional 2D cultures and animal models, providing a more effective platform for NDD research.

Abstract Spinal manipulative therapy (SMT) has been shown to significantly alleviate pain in patients with lumbar disc herniation (LDH), with its effects closely associated with brain function modulation. This study investigates the neural biomarkers linked to pain relief efficacy following a complete SMT treatment cycle in LDH patients. A total of 59 LDH patients were randomized into two groups: SMT treatment (Group 1, n = 28) and sham treatment (ST) (Group 2, n = 31). A matched healthy control group (Group 3, n = 28) was also included. Functional magnetic resonance imaging (fMRI) was performed on LDH patients at two time points (TPs)—before (TP1) and after (TP2) treatment—while healthy controls were scanned once. Clinical assessments were conducted using the Visual Analogue Scale (VAS) and the Japanese Orthopaedic Association (JOA) scale. Post-treatment results indicated significant improvements in both VAS and JOA scores for Group 1, while the improvement was limited to VAS scores for Group 2. Graph properties analysis revealed notable differences in brain network connectivity between LDH patients and healthy controls, particularly between the left precentral gyrus (left PreCG) and left inferior frontal gyrus, opercular part (left IFGoperc). Enhanced functional connectivity (FC) was observed in Group 1, notably between the right angular gyrus (right ANG) and the left middle orbital gyrus (left ORBmid), with right ANG showing a significant positive correlation with clinical scores. This study identifies the sensorimotor network—salience network are significantly activated in chronic pain among LDH patients. The default mode network—dorsal attention network may serve as key neural biomarkers for the efficacy of SMT treatment in alleviating pain in LDH.

Abstract Background Cervical cancer is the fourth most common malignant tumor in childbearing-age women. To date, cervical resection and fertility-sparing surgery are the trends in the era of minimally invasive management. However, a proper management remains crucial. Hereby, we endeavor to underscore an uncommon case of early-stage cervical cancer receiving a tailored surgical technique of abdominal radical trachelectomy at our tertiary referral center and review literature. Case presentation A 33-year-old Vietnamese female patient (E1) was hospitalized for a diagnosis of cervical cancer classified as IB1 stage. The patient was treated with fertility-sparing modified abdominal radical trachelectomy surgery. The postoperative outcome was completely favorable. The patient was sent home after 5 days of hospitalization. In addition, she was monitored without complications. Conclusion Fertility-preserving treatment could be effectively performed with a modified technique of abdominal radical trachelectomy among young women with early-stage cervical cancer. Interdisciplinary management is potentially necessary for favorable outcome. Further data are required for long-term outcomes of pregnancy, recurrent rate, and the risk of pelvic organ prolapse.

Abstract Purpose This study aimed to explore the relationship between knowledge sharing (KS) and knowledge hiding (KH), and the influence of study climate (SC), interpersonal trust (IT) and sharing intention (SI) on KS and KH among Chinese medical undergraduates within the same framework. Method A cross-sectional study was conducted among 761 undergraduates from two medical colleges in Wuhan, China. Measurements included five scales on KS, KH, SC, IT and SI. Three path analysis was performed using a structural equation model (SEM) to examine the influence of SC, IT, and SI on KS and KH for medical students with different academic performance levels. Results The mean scores for SC, IT, SI, KS and KH of medical students were 3.79 ± 0.67, 3.92 ± 0.62, 4.05 ± 0.64, 3.68 ± 0.68 and 1.64 ± 0.67, respectively. Path analysis showed that KS and KH were weakly related among three academic performance subgroups (coefficients ranging from -0.193 to -0.112). IT was significantly positively associated with KS (β = 0.268, 0.112 and 0.227, respectively, all P

Abstract Background Excessive oxidative stress is known to cause endothelial dysfunction and drive cardiovascular diseases (CVD). While telomerase reverse transcriptase (TERT) shows protective effects against oxidative stress in rodents and is associated to human flow-mediated dilation in CVD, its regulatory mechanisms in human vascular systems under pathological oxidative stress require further investigation. Methods Human induced pluripotent stem cells (hiPSCs) were used to create vascular organoids (VOs). These VOs and human umbilical vein endothelial cells (HUVECs) were subjected to oxidative stress through both hydrogen peroxide (H2O2) and oxidized low-density lipoprotein (oxLDL) models. The effects of TERT overexpression by inhibition of the ubiquitin protein ligase E3 component N-recognin 5 (UBR5) on reactive oxygen species (ROS)-induced vascular injury and cellular senescence were assessed using neovascular sprouting assays, senescence-associated β-galactosidase (SA-β-Gal) staining, and senescence-associated secretory phenotype (SASP) assays. Results ROS significantly impaired VO development and endothelial progenitor cell (EPC) angiogenesis, evidenced by reduced neovascular sprouting and increased senescence markers, including elevated SA-β-Gal activity and SASP-related cytokine levels. Overexpression of TERT counteracted these effects, restoring VO development and EPC function. Immunoprecipitation-mass spectrometry identified UBR5 as a critical TERT regulator, facilitating its degradation. Inhibition of UBR5 stabilized TERT, improving VO angiogenic capacity, and reducing SA-β-Gal activity and SASP cytokine levels. Conclusions Inhibiting UBR5 stabilizes TERT, which preserves EPC angiogenic capacity, reduces VO impairment, and delays endothelial cell senescence under oxidative stress. These findings highlight the potential of targeting UBR5 to enhance vascular health in oxidative stress-related conditions. Graphical Abstract

Abstract Body composition assessment is very useful for evaluating a patient’s status in the clinic, but recognizing, labeling, and calculating the body compositions would be burdensome. This study aims to develop a web-based service that could automate calculating the areas of skeleton muscle (SM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) according to L3 computed tomography (CT) images. 1500 L3 CT images were gathered from Xuzhou Central Hospital. Of these, 70% were used as the training dataset, while the remaining 30% were used as the validating dataset. The UNet framework was combined with attention gate (AG), Squeeze and Excitation block (SEblock), and Atrous Spatial Pyramid Pooling (ASSP) modules to construct the segmentation deep learning model. The model’s efficacy was externally validated using two other test datasets with multiple metrics, the consistency test and manual result checking. A graphic user interface was also created and deployed using the Streamlit Python package. The custom deep learning model named L3 Body Composition Segmentation Model (L3BCSM) was constructed. The model’s Median Dice is 0.954(0.930, 0.963)(SATA), 0.849(0.774,0.901)(VATA), and 0.920(0.901, 0.936)(SMA), which is equal to or better than classic models, including UNETR and AHNet. L3BCSM also achieved satisfactory metrics in two external test datasets, consistent with the qualified label. An internet-based application was developed using L3BCSM, which has four functional modules: population analysis, time series analysis, consistency analysis, and manual result checking. The body composition assessment application was well developed, which would benefit the clinical practice and related research.

Abstract Coal mining-induced surface subsidence can significantly impact resident safety and hinder regional sustainable development, making precise subsidence monitoring and prediction critical. Existing mining subsidence monitoring technologies often exhibit low spatiotemporal resolution, while subsidence prediction models suffer from heavy dependence on data quality and model assumptions, as well as imprecise parameters. This study addresses these limitations by proposing a novel mining subsidence monitoring and prediction method based on Small Baseline Subset Interferometric Synthetic Aperture Radar (SBAS-InSAR) and the Convolutional Neural Network—Bidirectional Gated Recurrent Unit—Attention (CNN-BiGRU-Attention) model. Focusing on the Banji mining area in Anhui Province, ground subsidence was monitored from July 15, 2021, to September 3, 2023, utilizing SBAS-InSAR technology with Sentinel-1A satellite data. The monitoring results were validated using leveling measurement data. A CNN-BiGRU-Attention prediction model was subsequently constructed based on the time-series monitoring data. The results indicate that the surface subsidence rate in the study area decreases progressively from northwest to southeast, with an average subsidence rate ranging from -49.844 mm/year to -14.810 mm/year. At feature points, the CNN-BiGRU-Attention model effectively captures the characteristics of subsidence time-series changes. For regional subsidence prediction, this model maintains the smallest error, with Mean Absolute Error (MAE) and Root Mean Square Error (RMSE) values of 1.27 mm and 1.44 mm, respectively, and an absolute prediction error of less than 1 mm in most areas. This study integrates SBAS-InSAR technology with the CNN-BiGRU-Attention model to enable unmanned monitoring and prediction of mining subsidence. In comparison to traditional methods, this approach not only reduces monitoring costs but also enhances the accuracy of subsidence predictions, offering critical technical support for the sustainable development of mining areas.

Abstract Anatomy-based guidelines for shoulder surgery have established the routine preoperative evaluation of the humeral head. Despite recognized sex differences in humeral head size, there has been limited investigation into sex-specific variations in acromiohumeral contact surface (AHCS) arc length. This study aims to assess sex differences in the AHCS arc length within a sample of the Chinese population. We retrospectively analyzed 169 normal shoulder CT images from a single medical center, collected between 2011 and 2021. The AHCS arc length was defined as the distance from the superior glenoid tubercle to the lateral edge of the greater tuberosity, measured using a three-dimensional reconstruction algorithm. Physiological reference values for the AHCS arc length were determined at three abduction angle intervals. Linear regression analysis was used to assess the correlation between the AHCS arc length and abduction angle in both sexes. The reference values for AHCS arc length were significantly lower in women across three abduction angle intervals (male 48.07 ± 3.37 mm vs. female 43.54 ± 2.54 mm, (0–10] °, p 20 °, p = 0.001, respectively). Additionally, the AHCS arc length was linearly and negatively correlated with the abduction angle (male R2 = 0.436, p

Abstract To investigate the energy-saving advantages of truck platoons, this study focused on two, three, and six-axle trucks as research subjects. A non-uniform platoon model of trucks was constructed based on braking performance differences. The aerodynamic characteristics of the non-uniform platoon fleet were analyzed in depth using numerical simulation methods, and the fuel consumption rate of the fleet was calculated. In a heterogeneous three-vehicle platoon, the 3-2-6 platooning approach exhibited the most effective reduction in fuel consumption, whereas the 3-6-2 platooning approach was the least effective. For a four-vehicle heterogeneous platoon comprising a three-axle truck, a six-axle truck, and two two-axle trucks, the 3-2-2-6 platooning approach yielded the best fuel efficiency. In a four-vehicle heterogeneous platoon with a two-axle truck, a six-axle truck, and two three-axle trucks, the 3-2-3-6 platooning approach proved to be the most effective in reducing fuel consumption. In a four-vehicle heterogeneous fleet composed of two-axle trucks, three-axle trucks, and two six-axle trucks, the 3-2-6-6 platooning approach achieved the best fuel efficiency. The conclusions of this study offer a fundamental scheme for truck formation, laying a crucial theoretical foundation for energy conservation and emissions reduction in transport systems.

Abstract The relationship between depression and severe non-alcoholic fatty liver disease (NAFLD) has not been clearly defined. We conducted a longitudinal cohort study and a two-sample Mendelian randomization (MR) analysis to assess the association of depression with severe NAFLD risk. We used individual data from the UK Biobank study with 481,181 participants, and summary data from published genome-wide association studies. The association between depression and severe NAFLD was assessed using Cox proportional hazards regression analysis. Two-sample MR for depression with NAFLD was conducted, the principal analysis employed the inverse variance weighted (IVW) approach. In the observational study, after a median follow-up of 13.46 years, 4,563 participants had severe NAFLD. In multivariable-adjusted model, participants with depression had an increased risk of severe NAFLD (hazards ratio:1.21, 95% confidence interval (CI):1.09–1.34), as compared to those without depression. In subgroup analyses, the association between depression and severe NAFLD risk was generally observed across different subgroups. For the MR, result also showed that genetically predicted depression was causally associated with a higher risk of NAFLD (odds ratio:1.55, 95%CI:1.10–2.19) in IVW. Our study revealed a prospective association of depression with severe NAFLD, thus potentially necessitating clinical monitoring of individuals with depression for severe NAFLD.

Abstract Coal, a vital strategic resource, facilitates industrial development and socio-economic progress. Ensuring the high-quality development of the coal industry is crucial for national energy security and safety. Coal and gas outbursts are frequent hazards in coal mining processes. This research delves into the impact of heterogeneous coal seam strength on hydraulic fracturing propagation, utilizing both physical experimentation and the ABAQUS finite element approach. Experimental findings reveal distinct variations in water injection pressure profiles and fracturing fluid distribution patterns within coal seams of varying strengths, in contrast to those exhibiting uniform strength. When fractures propagate from a weaker to stronger coal seam region, a notable increase in pressure build-up effect is observed, leading to higher water injection pressure, wider fracture widths, augmented coal body displacement, and an elevated rate of rigidity reduction. In this study, the physical test results and numerical simulation results are verified with each other. After fractures propagate across the interface, zone with higher coal seam strength experience decreased fracture width, lower coal body displacement, and slower rates of rigidity decline compared to weaker seam zone. When fractures propagate from high to low coal seam areas, the fracture experiences instantaneous cross-boundary extension, resulting in a decrease in pore pressure, increased coal body displacement, and an elevated rate of rigidity decline.

Abstract Sugarcane molasses is an ideal economical raw material for ethanol production because of its wide availability, low cost and nutrient content. However, benzoic acid compounds with toxic effects on yeast cells are commonly found in sugarcane molasses. At present, the molecular mechanism of the toxic effects of benzoic acid on Saccharomyces cerevisiae has not been elucidated. Here, the toxic effect of exogenous benzoic acid on S. cerevisiae GJ2008 cells was studied, and the genes differentially expressed in S. cerevisiae GJ2008 after 1.2 g/L benzoic acid stress were identified via Illumina RNA-Seq technology. The results indicated that benzoic acid significantly inhibited yeast cell growth, prolonged their rapid growth period, and ultimately reduced their biomass. During ethanol fermentation using 250 g/L sucrose under 1.2 g/L benzoic acid stress, several adverse effects were observed, such as high residual sugar content, low ethanol concentration and low fermentation efficiency. In addition, the cell morphology was damaged, the cell membrane permeability increased, intracellular nucleic acid and protein leakage increased, and the malondialdehyde content significantly increased. Moreover, the cells protected themselves by significantly increasing the intracellular glycerol content. Fourier transform infrared spectroscopy proved that benzoic acid could reduce the degree of unsaturation and increase cell membrane permeability by changing the yeast cell wall and cell membrane composition, leading to cell damage and even death. Transcriptomic analysis revealed that under benzoic acid stress, the expression of genes associated with sucrose and starch metabolism, thiamine metabolism, the glycolysis pathway, fructose and mannose metabolism, galactose metabolism and ABC transporters was significantly downregulated. The expression of genes related to ribosomes, lipid metabolism, ribosome biosynthesis, nucleic acid metabolism, arginine and proline metabolism, RNA polymerase, metabolism related to cofactor synthesis, and biosynthesis of valine, leucine, and isoleucine was significantly upregulated. These results indicated that benzoic acid inhibited glycolysis and reduced sugar absorption and utilization and ATP energy supply in yeast cells. In response to stress, genes related to the ribosome bioanabolic pathway were upregulated to promote protein synthesis. On the other hand, the expression of ELO1, SUR4, FEN1 and ERG1 was upregulated, which led to extension of long-chain fatty acids and accumulation of ergosterol to maintain cell membrane structure. In conclusion, this paper provides important insights into the mechanism underlying the toxicity of benzoic acid to yeast cells and for realizing high-concentration ethanol production by sugarcane molasses fermentation.

Abstract Aim There is no conclusive evidence which one is the optimal methodology for enhancing the quality and efficacy of learning for medical students. Therefore, this systematic review and network meta-analysis aims to evaluate and prioritize various teaching strategies in medical education, including simulation-based learning (SBL), flipped classrooms (FC), problem-based learning (PBL), team-based learning (TBL), case-based learning (CBL), and bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary (BOPPPS). Methods We conducted a comprehensive systematic search of PubMed, Embase, Web of Science, the Cochrane Library, and some key medical education journals up to November 31, 2023. The following keywords were searched in MeSH: (“medical students”) AND (“problem-based learning” OR “problem solving”) AND (“Randomized Controlled Trials as Topic”). Two authors independently carried out data extraction and quality assessment from the final selection of records following a full-text assessment based on strict eligibility criteria. Pairwise and network meta-analyses were then applied to calculate pooled standardized mean differences (SMDs) and 95% confidence intervals (95%CIs) using a random-effects model. Statistical analysis was performed by R software (4.3.1) and Stata 14 software. Results A total of 80 randomized controlled trials with 6,180 students were included in the study. Compared to LBL, CBL (SMD = 1.19; 95% CI 0.49–1.90; p

Abstract Background Postoperative cognitive dysfunction (POCD) is a prevalent complication following anesthesia and surgery, particularly in the elderly, leading to increased mortality and reduced quality of life. Despite its prevalence, there are no effective clinical treatments. Exercise has shown cognitive benefits in aging and various diseases, which can be transferred to sedentary animals through plasma. However, it is unclear if exercise-conditioned plasma can replicate these benefits in the context of POCD. Methods Sixteen-month-old male C57BL/6J mice underwent 30 days of voluntary running wheel training or received systemic administration of exercise-conditioned plasma, followed by tibial fracture surgery under general anesthesia at 17 months of age. Cognitive performance, hippocampal synaptic deficits, neuroinflammation, BDNF/TrkB signaling, and medial septum (MS)-hippocampal cholinergic activity were evaluated through immunohistochemical staining, transmission electron microscopy, Western blotting, and biochemical assays. To investigate the role of hippocampal BDNF signaling and cholinergic activity in the therapeutic effects, the TrkB antagonist ANA-12 and the cholinergic receptor muscarinic 1 (CHRM1) antagonist trihexyphenidyl (THP) were administered via intraperitoneal injection, and adeno-associated virus (AAV) vectors expressing Chrm1 shRNA were delivered via intrahippocampal stereotaxic microinjection. Results Exercise-conditioned plasma mimicked the benefits of exercise, alleviating cognitive decline induced by anesthesia/surgery, restoring hippocampal synapse formation and levels of regulators for synaptic plasticity, inhibiting neuroinflammatory responses to surgery by microglia and astrocytes, augmenting BDNF production and TrkB phosphorylation in hippocampal neurons, astrocytes, and microglia, upregulating MS expression of choline acetyltransferase (CHAT) and hippocampal expression of CHRM1 in neurons and astrocytes, and enhancing hippocampal cholinergic innervation and acetylcholine release. Conversely, ANA-12 administration blocked TrkB activation and reduced the protective effects on cognition, synaptic deficits, and neuroinflammatory reactivity of glial cells post-surgery. Similarly, THP administration or intrahippocampal delivery of AAV-Chrm1 shRNA inhibited the activation of the hippocampal cholinergic circuit by exercise plasma, negating the cognitive and neuropathological benefits and reducing BDNF/TrkB signaling enhancements. Conclusion Exercise-conditioned plasma can replicate the protective effects of exercise against anesthesia/surgery-induced neuroinflammation, synaptic, and cognitive impairments, at least partly, through CHRM1-dependent regulation of hippocampal cholinergic activity and BDNF/TrkB signaling.

Abstract Background Fibrosis is the ultimate, common pathological ending of most chronic inflammatory diseases and increases the chances of developing life-threatening illnesses. Pyroptosis, a newfound form of lytic programmed cell death initiated by the inflammasome, has received more and more attention because of its association with fibrotic diseases. Therefore, this study visualizes the connection between pyroptosis and fibrosis research through bibliometric methods, aimed at providing global research hits and tendencies in the field. Methods We collected and analyzed the articles on pyroptosis and fibrosis from 2010 to 2024 via Web of Science. Visual data analysis was performed for countries, institutions, authors, references, and keywords in the field using VOSviewer, CiteSpace software, the “Bibliometrix” R package, the bibliometric website ( https://bibliometric.com/ ), and Excel software. We analyzed the data by utilizing the bibliometric review method. Results A total of 566 articles and reviews relating to pyroptosis and fibrosis were identified in the Web of Science. The number of publications in the domain has continued to grow since 2010. These scientific outputs were mainly from 129 countries/regions and 1919 institutions, particularly China (n = 423) and the USA (n = 83). More importantly, although China publishes a vast majority of articles, its centrality is lower than that of the USA (0.59 vs 0.61). Among the 3833 authors involved in this field, Feldstein, A. E. is the most prolific author. Shi, J. J. is the world’s most-cited author among the 12,143 authors in these academic journals. Frontiers in Immunology was a prolific contributor, and Nature was the most frequently cited journal. After analysis, Cleavage of GSDMD by inflammatory caspases determines pyroptotic cell death were the top-cited articles. The analysis of keywords displayed that pyroptosis, fibrosis, and pathways were the main research hotspots and frontier directions in recent years. Conclusion We analyzed the characteristics of published articles and drew a fundamental knowledge structure on pyroptosis and fibrosis research via bibliometric analysis. The potential mechanism between fibrosis and pyroptosis is deeply tied to the current moment. Our findings can help researchers make clear the research status and value of fibrosis and pyroptosis and provide new directions for future research as soon as possible.

Abstract Background Esophageal cancer is the 6th most common cancer in terms of incidence and the 4th most common cause of mortality in China. Given the limited survival outcomes observed in patients with locally advanced disease managed exclusively with surgical intervention, postoperative treatment is critically important. This study sought to assess the prognostic value of total cholesterol (TC) levels and the prognostic nutritional index (PNI) in patients undergoing postoperative chemotherapy for esophageal cancer. Methods A total of 101 patients who underwent postoesophagectomy chemotherapy were included in this retrospective analysis. PNI values for prechemotherapy were calculated for each patient [PNI = albumin + 5 × lymphocyte count] and TC. The optimal cutoff values for these indices were calculated from the receiver operating characteristic (ROC) curve. Patients were stratified into three groups on the basis of their PNI and TC levels. A novel nutritional prognostic index, termed the cholesterol-dependent nutritional prognostic index (CPNI), was developed on the basis of the PNI and TC. Univariate and multivariate Cox analyses were employed to determine the associations between each indicator and clinical outcomes. Results The prechemotherapy PNI, TC level, and TNM stage became independent risk factors for OS (p

Abstract To explore the relationship between morphological and hemodynamic parameters, baseline characteristics, and long-term outcomes in patients with moyamoya disease (MMD) using a computational fluid dynamics model. We retrospectively reviewed 129 patients at Beijing Tiantan hospital between July 2020 and December 2021. Perioperative clinical variables and Suzuki stage were recorded. Logistic regression analysis was employed to identify the risk factors for unfavorable long-term outcomes. The association between morphological, CT perfusion parameters, hemodynamic parameters and the Suzuki stage, clinical variables of MMD was also analyzed. Patients with high relative Wall Shear Stress (rWSS) were older and had more cases with higher Suzuki stage and worse follow-up mRS scores (p