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A multi-shift tooling coordinated operation control strategy based on the backstepping method is investigated, a desired motion state planning scheme based on the improved artificial potential field method and the pure trajectory tracking method is proposed, and the actual situation is determined according to the adaptive Monte Carlo positioning method. For the estimated value of the motion state, a queue controller in combination the anti-stepping method and the virtual pilot following method is designed. A simulation model based on the robot operation system (ROS) environment is constructed, and the simulation is verified. The results show that the proposed formation error calculation method can improve the accuracy of error estimation. The formation control strategy can make the formation error converge within 6.2 s, and the designed formation controller can meet the operation requirements of multi-shift tooling.

Abstract Background The double-lumen tube (DLT) is an essential equipment for thoracic anesthesia and the precise position of DLT placement is particularly important for anesthesia and surgery. However, the incidence of DLT malposition remains high and it leads to lung isolation failure and hypoxemia during one-lung ventilation. This trial aims to explore the clinical application and efficacy of intubation in the lateral position under general anesthesia induction to reduce the incidence of DLT malposition in patients undergoing unilateral video-assisted thoracic surgery (VATS). Methods In this prospective, single-center, parallel group, randomized, controlled trial, we will recruit 108 patients, aged 18–80 years, scheduled for elective unilateral VATS with DLT intubation under general anesthesia, and they will be randomly assigned to two groups: a lateral DLT intubation group (group L) and a conventional supine DLT intubation group (group C). The left-sided DLT will be used to intubate in patients of both groups. The position of DLT will be confirmed and adjusted by using the fiberoptic bronchoscopy (FOB). The primary outcome is the incidence of DLT malposition observed via the FOB, and the secondary outcomes include the time of intubation, the frequency and duration of re-adjustments of DLT placement under FOB, whether to re-intubate, intraoperative vital signs, and postoperative recovery. Discussion Accurate DLT positioning is crucially important for thoracic surgery, but the incidence of DLT malposition is still high in the present clinical practice of thoracic anesthesia. This trial aims to investigate whether lateral DLT intubation can reduce the incidence of DLT malposition, with more stable intraoperative vital signs and less postoperative complications. Trial registration The study protocol was registered at Chinese Clinical Trial Registry ( http://www.chictr.org.cn ) with registration number: ChiCTR2200060794 on June 11, 2022.

The proliferation of artificial intelligence (AI) has emerged as a critical metric for assessing a country's technological advancement, but also for regional economic coordination and high-quality development in China. Based on panel data collected from 31 provinces between 2006 and 2021, this study employs the DEA-Malmquist index model and panel Tobit model to examine the scale, distributional attributes, and influencing factors of AI resource allocation. Results indicate that China's AI resource allocation efficiency has generally increased, with technical efficiency generating a “pull effect” that propels total factor productivity growth rates higher than those attributable to technological progress. Furthermore, AI efficiency in non-coastal regions outstrips that in coastal areas, with total factor productivity growth arising from a substantial increase in technological progress rates. Regional economic development, labor demand, openness to foreign participation, and human capital level exert pivotal roles in enhancing AI resource allocation efficiency. Based on these findings, we suggest a set of strategies aimed at enhancing China's AI resource allocation efficiency, including amplifying government guidance, increasing R&D investments, upgrading economic development levels, fostering the development and strengthening of tangible economy, and attracting and nurturing high-quality scientific research talent.

AIM: To compare the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)peeling or inverted ILM flap for the treatment of macular hole retinal detachment(MHRD)in high myopia.METHODS: A retrospective clinical study. A total of 38 cases(38 eyes)with MHRD in high myopia were treated with PPV combined with ILM peeling or PPV combined with inverted ILM flap in our hospital from January 2020 to June 2021. They were divided into control group(PPV combined with ILM peeling)and observation group(PPV combined with inverted ILM flap)according to the surgical method. Follow-up to 3mo after surgery, the surgery time, best corrected visual acuity(BCVA), the rate of macular hole closure and retinal reattachment were compared between two groups.RESULTS: The surgery time of two groups were compared and there were no statistically significant difference(30.71±4.55min vs. 35.20±5.44min, P=0.384). The BCVA in the two groups were significantly improved at the last follow-up(all P

Spindle assembly checkpoint controls anaphase onset and guarantees appropriate chromosome segregation. Here, the authors report that dynamin-related protein 1 is recruited to kinetochores by CENP-F to regulate metaphase-to-anaphase transition by controlling APC/C activity in mouse oocyte meiosis

Record-breaking numbers of Northeast China cold vortex (NCCV) occurred during the late spring (April–May) of 2021, which provided favorable background for more severe convection weather (such as hailstorm and tornado) happened and struck Jiangsu and Hubei provinces, China, causing heavy casualties and property losses. To better understand the possible causes of extremely abnormal NCCV activities, the external forcing and dynamical analysis was conducted. The results show that the extreme NCCV activity is regulated by the preceding sea surface temperature (SST) anomalies in the tropical Pacific, the snow conditions over the Tibetan Plateau, and the wave-mean flow interaction over the Eurasian continent. During the preceding autumn and winter in 2020, a moderate La Niña event occurred over the tropical Pacific, which triggered the Pacific–North America teleconnection pattern (PNA) like wave train and further dispersed the Rossby wave energy downstream along the mid-latitude westerly jet, forming a zonal wave train over the Eurasian continent. Moreover, the second minimum snow depth was recorded over the southeastern Tibetan Plateau during the boreal winter of 2020/2021, which induced a concurrent local anomalous anticyclone and a cyclone over northeast Asia in the following spring. Finally, the anomalous circulation is capable of achieving energy from the mean state through barotropic energy conversion and strengthening the downstream wave train accordingly. This study highlights the joint impacts of external forcings and internal atmospheric processes on the NCCV activity.

In September 2021, southern China witnessed an extreme high-temperature and high-humidity event. The average regional wet bulb globe temperature (WBGT) anomaly (relative to 1961–1990 mean) in 110.0°–120.0°E, 27.5°–32.5°N region was the highest on record at 3.28 °C and exceeded three times the observed standard deviation. To investigate the underlying causes, we examine the effects of anthropogenic forcings and anomalous circulation patterns on this event using the multi-model ensembles from the Coupled Model Intercomparison Project Phase 6. Results indicate that 2021-like events would happen extremely rarely without anthropogenic warming (would not occur in counterfactual world simulations) and have become a 1-in-16-year event in the factual world. For the threshold of the second most extreme year, the occurrence probability of extreme WBGT events increases approximately 50 times due to the impact of anthropogenic forcings. The effect of anthropogenic warming under similar atmosphere circulation increases the probability of extreme WBGT events by 13–60 times, and that of corresponding circulation patterns under the same anthropogenic warming increases the probability by 1.3–1.8 times.

Abstract Objective This paper aims to explore the diagnostic value of enhanced magnetic resonance imaging (MRI) combined with a carcinoembryonic antigen (CEA) and carbohydrate antigen in terms of the liver metastasis of colorectal cancer. Methods A total of 167 colorectal cancer patients with liver metastasis and 167 colorectal cancer patients without liver metastasis were selected as the subjects. An automatic electrochemiluminescence analyser was then used to detect the tumour markers CEA, CA19-9, CA125 and CA72-4. The consistency between the MRI examination and clinical pathological examination was also analysed, and the sensitivity, specificity and positive and negative predictive values of various combined detection methods were compared. Results The abnormal rates of CEA, CA19-9, CA125 and CA72-4 in the two groups were statistically significant (P < 0.05), while the results of the enhanced MRI and clinicopathological examination for liver metastasis in patients with colon cancer were largely consistent (Kappa coefficient = 0.788, P < 0.000). However, the two methods were inconsistent. The false positive rate of the enhanced MRI examination was 15.3%, while the false negative rate was 6.0%. The specificity (94.61%), positive predictive value (92.68%) and positive likelihood ratio (12.67%) were the highest for the MRI combined with serial CEA, while the sensitivity (98.80%) and negative predictive value (97.22%) were the highest with the MRI combined with parallel CEA, and this combination returned the lowest negative likelihood ratio (0.03). Conclusion The combination of MRI and CEA excludes non-metastatic patients and identifies colorectal liver metastasis cancer patients. Overall, it has a higher diagnostic value.

Objective To identify pathogenic gene variants of glutaric aciduria typeⅠ (GAⅠ) and provide reference for prenatal diagnosis of this disease. Methods Genomic DNA was extracted from the family members of a suspected case of GAⅠ. Whole exome sequencing was performed on the proband, and DNA Sanger sequencing was performed on the parents to verify the variants and analyze their pathogenicity. Amniotic fluid fetal cells were extracted by amniocentesis at 18 weeks of gestation to detect GCDH gene. Literature review was conducted from PubMed, CNKI, Wanfang Data and Chongqing VIP databases using the keywords of “glutaric aciduria typeⅠ”, “GCDH” and prenatal diagnosis in both Chinese and English. Results Two variants of GCDH gene were detected in the proband： c.206_207delAC(p.Thr70Leufs*117) and c.892G>A(p.Ala298Thr), from the father and mother, respectively. The paternal variant was a novel variant, and the maternal variant was a known variant. And two variants were both pathogenic. GCDH gene variant analysis of amniotic fluid fetal cells showed compound heterozygous c.206_207delAC and c.892G>A variants. The couple decided to terminate the pregnancy thereafter. A total of 9 families with prenatal diagnosis of GAⅠ were retrieved by GCDH gene sequencing analysis. Among them, 5 fetuses from 4 families had prenatal diagnosis of GAⅠ. Four families decided to terminate the pregnancy, and only 1 family insisted on continuing pregnancy until full-term delivery. Conclusions The novel variant of GCDH gene (c.206_207delAC) is detected in this family of GAⅠ. The pathogenic variant sites of GCDH gene are identified in the proband of this GAⅠ family.

ObjectivesThis study summarizes the epidemiological characteristics, species distribution, and drug sensitivity of clinical nontuberculous mycobacteria (NTM) isolates at the Public Health Clinical Center of Chengdu, China, from January 2017 to December 2022.MethodsWe retrospectively analyzed data from patients with clinically isolated NTM strains. Chi-square analysis assessed the rate of Mycobacterium strain isolation over 6 years.ResultsThe number of samples tested for Mycobacterium tuberculosis (MTB) and/or NTM increased each year, while MTB detection decreased and NTM detection rose significantly each year (P=0.03). The average age of NTM patients was 51 ± 17.53 years, with a 14.1% HIV infection rate. The predominant isolates were Mycobacterium avium-intracellulare (MAC) and M. chelonae/M. abscessus, with 96.4% of cases being of Han ethnicity. Amikacin, moxifloxacin, and clarithromycin were effective against M. avium and M. intracellulare; linezolid, amikacin, and cefoxitin were effective against M. chelonae/M. abscessus. Over 90% of NTM cases originated from the respiratory tract.ConclusionThe NTM isolation rate in Southwest China has risen in recent years, primarily among elderly patients with a high HIV co-infection rate. The main NTM isolates were MAC and M. chelonae/M. abscessus. Amikacin, moxifloxacin, clarithromycin, and linezolid exhibited strong antibacterial activity against SGM, while amikacin and linezolid displayed relatively better antibacterial activity against RGM. The prevalence of NTM infection may be positively associated with regional economic development and health conditions.

When rockfall occurs along dense rock slopes, the rotation direction of rockfall is not always downhill. Specifically, the rockfall may obtain a reverse rotation speed (RRS) after impact under certain conditions, the effect of which on the restitution coefficient (RC) cannot be ignored. According to the statistical results of the reverse rotation (RR) phenomena of blocks obtained from previous experiments, the occurrence of RR is correlated to the block shape, incident angle, and contact attitude. In this study, considering a typically shaped cubic block, the critical condition for the RR is preliminarily deduced. Based on the results, the influence of the RRS on the RC for four typically shaped blocks is examined using a customized device. Results show that the tangential RC (Rt) values of each block are not sensitive to the change in the RRS, the distribution is relatively concentrated and the values are high. Moreover, the normal RC (Rn) values are not sensitive to the RRS, and the distribution is relatively discrete. The RRS influences Rn; however, it is difficult to directly establish the relationship between them. To this end, considering the contact attitude and shape of the block, an integral variable, the impact coefficient (Ic), is proposed to determine the influence of RRS on Rn. Moreover, the impact-bounce behaviours of the block are categorized and analysed. For the block rebound following a single impact, Ic and Rn are positively and negatively correlated when the mass centre of the block (MC) is in front and behind the contact point (CP), respectively. For the block rebound following two successive impacts, with the increase in Ic, the Rn increases. These conclusions help clarify the mechanism of the influence of the RRS on RC and provide vital information and ideas for the development and optimization of a program to accurately predict rockfall trajectories.

Abstract Organometal halide perovskites are promising semiconducting materials for photodetectors because of their favorable optoelectrical properties. Although nanoscale perovskite materials such as quantum dots (QDs) show novel behavior, they have intrinsic stability issues. In this study, an effectively silane barrier‐capped quantum dot (QD@APDEMS) is thinly applied onto a bulk perovskite photosensitive layer for use in photodetectors. QD@APDEMS is synthesized with a silane ligand with hydrophobic CH3‐terminal groups, resulting in excellent dispersibility and durability to enable effective coating. The introduction of the QD@APDEMS layer results in the formation of a low‐defect perovskite film with enlarged grains. This is attributed to the grain boundary interconnection effect via interaction between the functional groups of QD@APDEMS and uncoordinated Pb2+ in grain boundaries. By passivating the grain boundaries, where various trap sites are distributed, hole charge‐carrier injection and shunt leakage can be suppressed. Also, from the energy point of view, the deep highest occupied molecular orbital (HOMO) level of QD@APDEMS can work as a hole charge injection barrier. Improved charge dynamics (generation, transfer, and recombination properties) and reduced trap density of QD@APDEMS are demonstrated. When this perovskite film is used in a photodetector, the device performance (especially the detectivity) stands out among existing perovskites evaluated for energy sensing device applications.

BackgroundThe incidence of prostate cancer (PCa) has continued to increase since the US Preventive Services Task Force (USPSTF) recommendations against prostate-specific antigen (PSA)-based screening for all men in 2012, approximately half of additional diagnosed cases are advanced-stage, including regional PCa and metastatic PCa (mPCa). It is very important to investigate the shift in mPCa incidence and mPCa-related mortality risk, as the survival of mPCa remains poor.ObjectiveTo investigate the incidence temporal trend of mPCa stratified by metastatic site, including bone and visceral metastatic involvement, and potential survival improvements.MaterialsBased on the recently released Surveillance, Epidemiology, and End Results (SEER) data (2010-2019), the age-adjusted incidence rates of mPCa with bone and visceral involvement with annual percentage changes (APCs) were assessed by a joinpoint regression model in men aged 45 years and older by age and race groups, and potential recent improvements in overall survival (OS) and cancer-specific survival (CSS) were estimated by the Kaplan−Meier method and Cox regression model.ResultsFrom 2010 to 2019, a total of 19081 (84.8%) and 3413 (15.2%) mPCa patients with bone and visceral involvement, respectively, were recorded in the SEER database. Considering all races and age groups, the incidence rate of mPCa with bone metastasis remained stable during 2017-2019 (APC, 0.9%; p=0.421) after increasing during 2010-2017 (APC, 5.8%; p

As a typical solitary animal, adult giant pandas rely on chemical signals (sex pheromones) to transmit reproductive information during oestrous. Although researchers have confirmed that the gut microbiota is related to the emission and reception of sex pheromones, there is no clear correlation between the gut microbes and the synthesis of sex pheromone of giant pandas, that is, which gut microbes and microbial metabolites are participate in the synthesis of giant panda’s sex pheromone. As a mirror of gut microbiota, fecal microbiota can reflect the composition of gut microbiota and its interaction with host to some extent. The purpose of this study is to explore how the gut microbes affect the synthesis of sex pheromones in captive giant pandas by combining analysis of the fecal microbiome and metabolomics. The results of correlation and microbial function analysis show that intestinal microorganisms such as Veillonellaceae and Lactobacillilaceae are associated with the synthesis of short chain fatty acid (acetic acid) and volatile ester metabolites, such as 1-butanol, 3-methyl, acetate, acetic acid, hexyl ester and 3-hexen-1-ol, acetate, (Z). In summary, based on this study, we believe that volatile metabolites such as fecal acetate participate in the process of mate preference of captive giant pandas and affect their expression of natural mating behavior. The possible mechanism is that the gut microbes can promote the synthesis of key chemical signaling substances in perianal glands through mediated intermediate fecal metabolites, thus affecting the normal information exchange between giant pandas individuals. The results of this study have greatly enriched our understanding of gut microbes regulating the synthesis of sex pheromones in giant pandas.

Wheat grain yield is generally sink-limited during grain filling. The grain-filling rate (GFR) plays a vital role but is poorly studied due to the difficulty of phenotype surveys. This study explored the grain-filling traits in a recombinant inbred population and wheat collection using two highly saturated genetic maps for linkage analysis and genome-wide association study (GWAS). Seventeen stable additive quantitative trait loci (QTLs) were identified on chromosomes 1B, 4B, and 5A. The linkage interval between IWB19555 and IWB56078 showed pleiotropic effects on GFR1, GFRmax, kernel length (KL), kernel width (KW), kernel thickness (KT), and thousand kernel weight (TKW), with the phenotypic variation explained (PVE) ranging from 13.38% (KW) to 33.69% (TKW). 198 significant marker-trait associations (MTAs) were distributed across most chromosomes except for 3D and 4D. The major associated sites for GFR included IWB44469 (11.27%), IWB8156 (12.56%) and IWB24812 (14.46%). Linkage analysis suggested that IWB35850, identified through GWAS, was located in approximately the same region as QGFRmax2B.3-11, where two high-confidence candidate genes were present. Two important grain weight (GW)-related QTLs colocalized with grain-filling QTLs. The findings contribute to understanding the genetic architecture of the GFR and provide a basic approach to predict candidate genes for grain yield trait QTLs.

The use of machine learning to characterise quantum states has been demonstrated, but usually training the algorithm using data from the same state one wants to characterise. Here, the authors show an algorithm that can learn all states that share structural similarities with the ones used for the training.

Abstract Cosmological correlation functions contain valuable information about the primordial Universe, with possible signatures of new massive particles at very high energies. Recent developments, including the cosmological bootstrap, bring new perspectives and powerful tools to study these observables. In this paper, we systematically classify inflationary three-point correlators of scalar perturbations using the bootstrap method. For the first time, we derive a complete set of single-exchange cosmological collider bispectra with new shapes and potentially detectable signals. Specifically, we focus on the primordial scalar bispectra generated from the exchange of massive particles with all possible boost-breaking interactions during inflation. We introduce three-point “seed” functions, from which we bootstrap the inflationary bispectra of scalar and spinning exchanges using weight-shifting and spin-raising operators. The computation of the seed function requires solving an ordinary differential equation in comoving momenta, a boundary version of the equation of motion satisfied by a propagator that linearly mixes a massive particle with the external light scalars. The resulting correlators are presented in analytic form, for any kinematics. These shapes are of interest for near-future cosmological surveys, as the primordial non-Gaussianity in boost-breaking theories can be large. We also identify new features in these shapes, which are phenomenologically distinct from the de Sitter invariant cases. For example, the oscillatory shapes around the squeezed limit have different phases. Furthermore, when the massive particle has much lower speed of sound than the inflaton, oscillatory features appear around the equilateral configuration.

Abstract Cancers are highly complex diseases that are characterized by not only the overgrowth of malignant cells but also an altered immune response. The inhibition and reprogramming of the immune system play critical roles in tumor initiation and progression. Immunotherapy aims to reactivate antitumor immune cells and overcome the immune escape mechanisms of tumors. Represented by immune checkpoint blockade and adoptive cell transfer, tumor immunotherapy has seen tremendous success in the clinic, with the capability to induce long-term regression of some tumors that are refractory to all other treatments. Among them, immune checkpoint blocking therapy, represented by PD-1/PD-L1 inhibitors (nivolumab) and CTLA-4 inhibitors (ipilimumab), has shown encouraging therapeutic effects in the treatment of various malignant tumors, such as non-small cell lung cancer (NSCLC) and melanoma. In addition, with the advent of CAR-T, CAR-M and other novel immunotherapy methods, immunotherapy has entered a new era. At present, evidence indicates that the combination of multiple immunotherapy methods may be one way to improve the therapeutic effect. However, the overall clinical response rate of tumor immunotherapy still needs improvement, which warrants the development of novel therapeutic designs as well as the discovery of biomarkers that can guide the prescription of these agents. Learning from the past success and failure of both clinical and basic research is critical for the rational design of studies in the future. In this article, we describe the efforts to manipulate the immune system against cancer and discuss different targets and cell types that can be exploited to promote the antitumor immune response.

为了研究焙炒对植物油品质的影响，以油菜籽、亚麻籽、花生、葵花籽和芝麻为原料，经焙炒处理后采用液压压榨法制油（热榨油），分析植物油的理化指标（酸值、过氧化值、水分及挥发物、色泽）、主体组分（脂肪酸组成及含量、甘三酯组成及含量、挥发性组分）和总酚含量，并与未焙炒处理直接压榨制取的油（冷榨油）作对比。结果表明：热榨油酸值和过氧化值显著高于冷榨油（p0.05）；热榨油中醇类、醛类和酸类等挥发性组分较少，但杂环类物质较多；热榨菜籽油、亚麻籽油、花生油、葵花籽油和芝麻油总酚含量分别是其冷榨油的1.38、1.57、1.51、1.80倍和1.27倍。因此，焙炒对植物油品质影响较大，应根据生产需要选择合适的预处理方式。 In order to study the effect of roasting on the quality of vegetable oils, rapeseed, flaxseed, peanut, sunflower seed and sesame were used as raw materials, and the oils were obtained by hydraulic pressing after roasting(hot pressed oil). The physicochemical indexes (acid value, peroxide value, moisture and volatile, color), main components (fatty acid composition and content, triglyceride composition and content, volatile components) and total phenols of the five hot pressed vegetable oils were analyzed and compared with those of the oils direct pressed with unroasted oilseeds(cold pressed oil). The results showed that the acid value and peroxide value of hot pressed oils were significantly higher than those of cold pressed oils (p0.05). The hot pressed oils contained less volatile components, such as alcohols, aldehydes and acids, but more heterocyclic substances. The contents of total phenols in hot pressed rapeseed oil, flaxseed oil, peanut oil, sunflower seed oil and sesame oil were 1.38, 1.57, 1.51, 1.80, 1.27 times of the cold pressed oil, respectively. Therefore, roasting has a great influence on the quality of vegetable oil, and an appropriate pretreatment method should be selected according to production needs.

Abstract Objective The diagnostic and prognostic value of quantitative electroencephalogram (qEEG) parameters, specifically the symmetry of amplitude‐integrated electroencephalography (aEEG) and relative band power (RBP), in the postoperative stroke of the cerebral hemisphere following type A aortic dissection, remains an area of inquiry. Methods We analyzed and processed 56 patients with type A aortic dissection who underwent bedside qEEG monitoring and analyzed the qEEG indices, brain CT, and clinical data of these patients. qEEG (symmetry of aEEG and RBP, and affected/unaffected hemisphere) indices were analyzed at discharge and 60 days after discharge. Results A total of 56 patients were studied. The 60‐day mortality rate was 12.5%. The affected hemisphere's diagnosis and mortality after 1‐year follow‐up were evaluated, and RBP beta demonstrated the highest area under the curve values with 95% confidence intervals (CI) of .849 (95% CI: .771–.928) and .91 (95% CI: .834–.986), respectively. According to the results of the logistic regression analysis, we have identified the strongest predictors for cerebral hemisphere stroke and 1‐year mortality in stroke patients. Specifically, aEEGmin exhibited the highest predictive power with an odds ratio (OR) of .735 for cerebral hemisphere stroke, whereas DTABR was confirmed as one of the strongest predictors with an OR of 1.619 for 1‐year mortality in stroke patients, indicating a high level of reliability. Spearman correlation coefficients showed that aEEGmax and aEEGmin were positively correlated with Alberta Stroke Program Early CT Score (aEEGmax: rho = .50, p

Summary: Background: Anaesthesia may impact long-term cancer survival. In the Cancer and Anaesthesia study, we hypothesised that the hypnotic drug propofol will have an advantage of at least five percentage points in five-year survival over the inhalational anaesthetic sevoflurane for breast cancer surgery. Methods: From 2118 eligible breast cancer patients scheduled for primary curable, invasive breast cancer surgery, 1764 were recruited after ethical approval and individual informed consent to this open label, single-blind, randomised trial at four county- and three university hospitals in Sweden and one Chinese university hospital. Of surveyed patients, 354 were excluded, mainly due to refusal to participate. Patients were randomised by computer at the monitoring organisation to general anaesthesia maintenance with either intravenous propofol or inhaled sevoflurane in a 1:1 ratio in permuted blocks. Data related to anaesthesia, surgery, oncology, and demographics were registered. The primary endpoint was five-year overall survival. Data are presented as Kaplan-Meier survival curves and Hazard Ratios based on Cox univariable regression analyses by both intention-to-treat and per-protocol. EudraCT, 2013-002380-25 and ClinicalTrials.gov, NCT01975064. Findings: Of 1764 patients, included from December 3, 2013, to September 29, 2017, 1670 remained for analysis. The numbers who survived at least five years were 773/841 (91.9% (95% CI 90.1–93.8)) in the propofol group and 764/829 (92.2% (90.3–94.0)) in the sevoflurane group, (HR 1.03 (0.73–1.44); P = 0.875); the corresponding results in the per-protocol-analysis were: 733/798 (91.9% (90.0–93.8)) and 653/710 (92.0% (90.0–94.0)) (HR = 1.01 (0.71–1.44); P = 0.955). Survival after a median follow-up of 76.7 months did not indicate any difference between the groups (HR 0.97, 0.72–1.29; P = 0.829, log rank test). Interpretation: No difference in overall survival was found between general anaesthesia with propofol or sevoflurane for breast cancer surgery. Funding: Swedish Research Council; Uppsala-Örebro Regional Research Council; Västmanland Regional Research Fund; Västmanland Cancer Foundation; Stig and Ragna Gohrton Foundation; Birgit and Henry Knutsson Foundation.

Major psychiatric disorders create a significant public health burden, and mental disorders such as major depressive disorder, bipolar disorder, and schizophrenia are major contributors to the national disease burden. The search for biomarkers has been a leading endeavor in the field of biological psychiatry in recent decades. And the application of cross-scale and multi-omics approaches combining genes and imaging in major psychiatric studies has facilitated the elucidation of gene-related pathogenesis and the exploration of potential biomarkers. In this article, we summarize the results of using combined transcriptomics and magnetic resonance imaging to understand structural and functional brain changes associated with major psychiatric disorders in the last decade, demonstrating the neurobiological mechanisms of genetically related structural and functional brain alterations in multiple directions, and providing new avenues for the development of quantifiable objective biomarkers, as well as clinical diagnostic and prognostic indicators.

As an excellent fluorescent nanomaterial, carbon quantum dots (CQDs) have the properties of small molecular weight, small particle size, high fluorescence stability, no optical flicker, wide excitation spectrum, continuous, long adjustable emission wavelength, good biocompatibility and low toxicity. At present, it has been widely used in biological detection, in vivo and in vitro imaging, drug delivery and diagnostic drugs. This review presents a broad overview of recent progress in synthesis, optical properties, and biomedical applications of CQDs. The synthesis methods of CQDs are first introduced, followed by an extensive discussion of its purification, surface functionalization methods and stability. Furthermore, the optical properties of CQDs are presented, with an emphasis on photoluminescence mechanism and the relationship between synthesis conditions and optical properties. This review's much focus is given to the biomedical applications of CQDs, including detection, imaging (in vivo and in vitro imaging) and drug delivery (targeted therapy, photodynamic and photothermal therapy, and immunological and gene therapy). Finally, we cover the key issues and future prospects/advances that CQDs still have to deal with in the biomedical sector as well as possible solutions.

Abstract Background Postoperative pneumonia (PP) is one of the most common complications after cardiac surgery. This study was designed to access the diagnostic value of interleukin-6 (IL-6) for pneumonia within the first 5 days after cardiac surgery in adults. Method This prospective observational study enrolled 694 patients who admitted to our center from 10 October 2020 to 30 June 2021. Blood samples were collected after admission and on five consecutive days after surgery to measure IL-6, procalcitonin (PCT), C-reactive protein (CRP) and white blood cells (WBC) respectively. Combined with clinical data, we assessed the diagnostic performance of different biomarkers using univariate and multifactorial analyses as well as receiver operating characteristic curves (ROC) and the area under the curve (AUC). Result Finally, 68 patients were diagnosed with PP (PP Group). In addition, 626 cases were assigned to the control group (Non-PP Group). From postoperative day 1 (POD1) to day 5, IL-6 and PCT levels showed higher diagnostic value (P

Abstract Objective Based on the social-ecological model, this study aimed to comprehensively explore factors affecting the risk of ischemic cerebrovascular disease (ICVD) in postmenopausal women to provide theoretical bases for further prevention and intervention for postmenopausal women. Methods Postmenopausal women who underwent medical examinations in one health-checkup agency in Tianjin from May 2015 to October 2015 were enrolled in this study. The ICVD 10-year Risk Assesment Form developed by the research team of the National "Tenth Five-Year Plan" research project was used to assess the factors affecting the risk of ICVD. Based on the social-ecological model, multiple types of scales, including physical activities, depression, Type D personality, social supports, and environment score, were used to comprehensively explore the factors associated with ICVD in postmenopausal women. Results 300 valid questionnaires were obtained, with an effective rate of 92.0%. The subjects aged 44–74 years, with the average age of 62.06 ± 7.09 years. Among them, 58.67% of the subjects only obtained high-school diploma, 32.67% obtained college or university diploma, 90.33% were retirees, 95.33% were married, 92.33% experienced the natural menopause, 93.33% lived in urban or suburban areas, and 1.00% had a history of breast cancer. Multivariate logistic regression analysis suggested that monthly income (¥), parity, exposure to second-hand or third-hand smoke, easy access to healthy food, physical activities, depression, Type D personality, social support and environmental factors were associated with the risk of ICVD in postmenopausal women (P 1 means that the exposure factor is positively correlated with the disease, and the exposure factor increases the risk of disease occurrence. Conclusions For postmenopausal women, in the future, in addition to prevention and management of the conventional risks, the conditions of their mentality and social support should be paid attention to, at the same time, and if they can, try to choose a good community environment to live in, which could better reduce the incidence and mortality of ICVD in postmenopausal women.

The differences in the characteristics of the rapid intensification (RI) during the TCs that form in the SCS (referred as local TCs) and that enter the SCS from the western North Pacific (WNP; referred as entering TCs) have not been well studied, which could contribute the inaccuracy of current TC intensity forecast in the SCS. In this study, we used TC observations, reanalysis data and model experiments to analyze the RI occurrences during local TCs and entering TCs in 1980–2016. We found that the significant interannual and interdecadal variations in RI occurrences during local eastward-moving TCs were related to the strong intraseasonal oscillation (ISO) over the SCS and the WNP under La Niña conditions. RI during local westward-moving TCs showed insignificant variations as a result of the complex interactions among the monsoon trough, ISO and the large-scale circulation. RI during entering TCs showed strong interdecadal variations, with increased RI after 1997, even though the total number of entering TCs has decreased since 1997, which is a result of a higher number of entering TCs in the northwestern quadrant of the WNP, a stronger ISO and weak vertical windshear over the SCS and east of the Philippines under negative phase of Pacific Decadal Oscillation. The different variations and related mechanisms of RI indicates that distinct forecasting factors should be considered for intensity prediction during local eastward- and westward-moving TCs and entering TCs.

Abstract Accumulating evidence indicates that long noncoding RNAs (lncRNAs) act as tumor promoters or suppressors in various types of cancer. Previous investigations suggest that ceramide synthase 6 (CERS6) antisense RNA 1 (CERS6‐AS1) acts as an oncogene in breast cancer; however, its role in colorectal cancer is unknown. This study aimed to explore the molecular mechanism of CERS6‐AS1 in colorectal cancer. Gene expression in colorectal cancer was examined using reverse transcription‐quantitative polymerase chain reaction and western blot analyses. The viability and proliferation of colorectal cancer cells were measured by Cell Counting Kit‐8 assays and colony formation assays. The migratory and invasive capacities of the colorectal cancer cells were assessed by Transwell assay. Cell stemness was examined by sphere‐formation assay. Mechanistically, RNA pull‐down assays, RNA immunoprecipitation assays, and luciferase reporter assays were performed to explore the relationship among CERS6‐AS1, miR‐15b‐5p and spectrin beta, non‐erythrocytic 2 (SPTBN2). Moreover, a xenograft tumor model was established to investigate the role of CERS6‐AS1 in vivo. We found that CERS6‐AS1 and SPTBN2 were highly expressed in colorectal cancer tissues and cells. CERS6‐AS1 depletion inhibited cell viability, proliferation, migration, and invasion; the epithelial‐mesenchymal transition process and stemness. It suppressed xenograft tumor growth in colorectal cancer. Moreover, SPTBN2 levels were positively regulated by CERS6‐AS1 and negatively regulated by miR‐15b‐5p in colorectal cancer cells. Rescue assays revealed that SPTBN2 reversed the inhibitory effect of CERS6‐AS1 deficiency on the malignant behaviors of colorectal cancer cells. Overall, the lncRNA CERS6‐AS1 facilitates malignant phenotypes of colorectal cancer cells by targeting miR‐15b‐5p to upregulate SPTBN2.

Abstract Study objective The purpose of the present study was to evaluate the efficacy of levosimendan in patients with acute myocardial infarction related ventricular septal rupture (AMI-VSR) underwent cardiac surgery. Design Prospective observational cohort study with propensity score analysis. Patients There were 261 patients with AMI-VSR in our study. After 1:1 propensity matching, 106 patients (53 levosimendan and 53 control) were selected in the matched cohort. Interventions None. Measurements Patients who received levosimendan were assigned to the levosimendan group (n = 164). The patients who were not received were levosimendan assigned to the control group (n = 97). The levosimendan was initiated immediately after cardiopulmonary bypass. Then, it has been maintained during the postoperative 3 days. The poor outcomes were identified as follows: death and postoperative complications (postoperative stroke, low cardiac output syndromeneeded mechanical circulatory support after surgery, acute kidney injury (≥ stage III), postoperative infection or septic shock, new developed atrial fibrillation or ventricular arrhythmias). Main results Before matching, the control group had more length of ICU stay (6.69 ± 3.90 d vs. 5.20 ± 2.24 d, p

Objective We previously showed that HSP90 is involved in postconditioning cardioprotection by inhibiting complement C5a. Here, we investigated whether HSP90-mediated C5a/NF-κB inhibition is responsible for the cardioprotection conferred by liraglutide. Methods Rat hearts underwent a 30 min occlusion of the anterior descending coronary artery, after which reperfusion was performed for 2 h. A total of 100 rats were randomly assigned to the following groups: ischemia/reperfusion (I/R), sham, liraglutide preconditioning (LP, liraglutide, 0.18 mg/kg, intravenously, 12 h before ischemia), HSP90 inhibitor geldanamycin (GA, 1 mg/kg, intraperitoneally, 30 min before ischemia) plus LP, and C5a receptor antagonist PMX53 (1 mg/kg, intravenously, 30 min before ischemia) plus LP. Cardiac injury, C5a/NF-κB activation, and inflammation were investigated. Results LP significantly attenuated I/R-induced cardiomyocyte apoptosis, infarct size, and secretion of creatine kinase-MB, lactate dehydrogenase and cardiac troponin I. These effects were complemented by decreased C5a levels, nuclear factor (NF)-κB signaling, inflammatory cytokine expression, and increased HSP90 levels. GA, an HSP90 inhibitor, promotes C5a activation, NF-κB signaling, and inflammation and suppresses cardioprotection by LP. By contrast, PMX53, a C5a inhibitor, suppressed C5a activation, NF-κB signaling, and inflammation, and enhanced cardioprotection by LP. Conclusion HSP90 markedly contributes to LP cardioprotection by inhibiting inflammatory responsesand C5a/NF-κB signaling , ultimately attenuating I/R-induced cardiomyocyte apoptosis by suppressing the proapoptotic factor Bax, and inducing the anti-apoptotic factor Bcl2.

The Planetary Health Diet (PHD), also known as the EAT-Lancet reference diet, was developed to optimize global dietary quality while keeping the environmental impacts of food production within sustainable planetary boundaries. We calculated current national and global adherence to the PHD using the Planetary Health Dietary Index (PHDI). In addition, we used data on diet and mortality from three large US cohorts (n = 206,404 men and women, 54,536 deaths) to estimate the total and cause-specific mortality among adults 20 y of age and older that could be prevented by shifting from current diets to the reference PHD. The PHDI varied substantially across countries, although adherence was universally far from optimal (mean PHDI = 85 out of 140). By improving the global PHDI to 120, approximately 15 million deaths (27% of total deaths) could be prevented annually. Estimates of preventable deaths due to this shift ranged from 2.5 million for cardiovascular diseases to 0.7 million for neurodegenerative diseases. Our analysis suggests that adopting healthy and sustainable diets would have major direct health benefits by reducing mortality due to multiple diseases and could contribute substantially to achieving the United Nations Sustainable Development Goals. These numbers of preventable deaths are based on evidence that human biology is similar across racial and ethnic groups, but the exact numerical estimates should be interpreted with caution because some assumptions used for the calculations build on limited data. Refinement of these estimates will be possible when additional regional data on diet and mortality become available. [ABSTRACT FROM AUTHOR]

With the increase in video traffic on wireless networks, content delivery networks and mobile edge computing are considered effective solutions to this problem, whereas caching strategy problem is an important issue of research.When facing different application scenarios and requirements, caching strategies are designed with different objectives.This study focuses on the fairness problem among different optimization objectives.For video service providers, the quality of experience (QoE) reflects the service performance, and energy efficiency reflects the cost-effectiveness and green energy-saving indicators.When designing a caching strategy, it is difficult to specify the objective with higher priority.Therefore, they need to be fairly optimized.First, the two important optimization objectives in the caching strategy problem(QoE and energy efficiency) are mathematically modeled, and the principle of fairness is proposed.Second, these two optimization objectives are innovatively consider as game players and are substituted into the Nash bargaining game model.Third, a multi-round bargaining algorithm is novelly proposed to ensure fairness, and the rationality and effectiveness of the proposed algorithm are rigorously proved.Finally, simulation experiments demonstrate that the proposed algorithm can optimize the QoE and energy efficiency of caching strategies while maintaining a ba-lance between them.

Abstract Background Labor represents a period of significant physical activity. Inefficient energy supply may delay labor process and even lead to cesarean delivery. Herein we investigated whether ingestion of a carbohydrate-rich beverage could reduce cesarean delivery in laboring women with epidural analgesia. Methods This multicenter randomized trial was conducted in obstetrician-led maternity units of nine tertiary hospitals in China. Primigravidae with single term cephalic pregnancy who were preparing for vaginal birth under epidural analgesia were randomized to intake a carbohydrate-rich beverage or commercially available low-carbohydrate beverages during labor. The primary outcome was the rate of cesarean delivery. Secondary outcomes included maternal feeling of hunger, assessed with an 11-point scale where 0 indicated no hunger and 10 the most severe hunger, and maternal and neonatal blood glucose after childbirth. Results Between 17 January 2018 and 20 July 2018, 2008 women were enrolled and randomized, 1953 were included in the intention-to-treat analysis. The rate of cesarean delivery did not differ between the two groups (11.3% [111/982] with carbohydrate-rich beverage vs. 10.9% [106/971] with low-carbohydrate beverages; relative risk 1.04, 95% CI 0.81 to 1.33; p = 0.79). Women in the carbohydrate-rich beverage group had lower subjective hunger score (median 3 [interquartile range 2 to 5] vs. 4 [2 to 6]; median difference − 1; 95% CI − 1 to 0; p

Background and purpose: Deep inferior epigastric perforator (DIEP) is attracting increasing attention in breast reconstruction surgery. How to safely and effectively locate, choose and anatomize perforating vessels is a huge challenge for the preparation of DIEP flaps. This study aimed to explore the value of computed tomographic angiography (CTA) in delayed DIEP reconstruction after breast cancer surgery. Methods: From January 2016 to January 2021, 298 patients underwent delayed DIEP flap breast reconstruction surgery in The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Among them, 92 cases were set as the control group (US group), and the perforation of the flap was evaluated by ultrasound doppler before surgery. A total of 206 cases were selected as the observation group (CTA group). Preoperative perforation of the flap was evaluated by CTA, and the CTA data were imported into HOROS software for processing and analysis, so as to select the preoperatively dominant perforation of the flap and identify the anatomical information such as the diameter of perforation vessel, the way of intramural movement and the position of perforation point, for directing operation. The number of preoperative location perforations, number of intraoperative choice perforations, perforation choice time, perforation anatomy time, donor site flap acquisition time, flap weight, total operation time and incidence of postoperative complications (abdominal incision infection rate, fat necrosis rate, secondary surgical exploration rate and complete flap necrosis rate) were compared and analyzed between the two groups. And the consistency rate of imaging surgery was compared between the two groups. Results: All the 298 patients underwent delayed DIEP flap breast reconstruction, and the flap survival rate was 99.3% (296/298). The number of preoperative located perforations in the two groups was: CTA group (2.90±1.13) vs US group (3.21±1.46) (P0.05). In the comparison of the second surgical exploration rate, the CTA group was lower than the US group (P

Red claw crayfish (Cherax quadricarinatus) is a valuable aquatic species with fast growth, big size, delicious meat, and strong resistance to diseases worldwide. Microcystin-LR (MC-LR) is the most common and potently toxic and is known to infect aquatic animals. The present study was performed at the transcriptome level to investigate the mechanism of C. quadricarinatus in responses to MC-LR by RNA sequencing (RNA-seq) analysis. A total of 57,153,501, 51,955,723, and 56,316,927 clean reads were retrieved from the three libraries of C. quadricarinatus (0 h, 6 h, and 48 h). A total of 37,616 unigenes were identified and compared with NR, Swiss-Prot, Pfam, COG, GO, and KEGG databases. A total of 4980 and 4585 differentially expressed genes (DEGs) were obtained at 6 h and 48 h compared with control (0 h), respectively. Most of these DEGs were up-regulated in 6 h, but most were down-regulated in 48 h, indicating that gene expression levels were inhibited by MC-LR in 48 h. Based on the GO and KEGG pathways analyses of DEGs, we obtained various pathways related to apoptosis, immunity, and detoxification. A total of 234 DEGs were related to the immune system, including 19 immune metabolic pathways, such as the Toll-like receptor signaling pathway, Toll and Imd signaling pathway, interleukin-17 (IL-17) signaling pathway, etc. Besides, detoxification-associated and apoptosis-associated pathways were also identified, including drug metabolism-cytochrome P450 and glutathione metabolism, apoptosis and p53 signaling pathway, etc. Twelve DGEs involved in immune response and MC-LR detoxification were discovered and validated by quantitative real-time polymerase chain reaction (qRT-PCR). The results indicated that the C. quadricarinatus might counteract the toxicity of MC-LR at the transcriptomic level by increasing expression levels of immune- and detoxification-related genes. In summary, this study first reported the response mechanism of the C. quadricarinatus with injected MC-LR at the transcriptional level. The identification of differential expression genes and pathways can help us to understand further the response mechanism of C. quadricarinatus under MC-LR stress.