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Unmanned Aerial Vehicles (UAVs) image object detection has great application value in military and civilian fields. However, the objects in the captured images from UAVs have problems of large scale variation, complex backgrounds, and a large proportion of small objects. To resolve these problems, a multi-scale object detector based on coordinate and global information aggregation is proposed, named CGMDet. Firstly, a Coordinate and Global Information Aggregation Module (CGAM) is designed by aggregating local, coordinate, and global information, which can obtain features with richer context information. Secondly, a Multi-Feature Fusion Pyramid Network (MF-FPN) is proposed, which can better fuse features of different scales and obtain features containing more context information through repeated use of feature maps, to better detect multi-scale targets. Moreover, more location information of low-level feature maps is integrated to improve the detection results of small targets. Furthermore, we modified the bounding box regression loss of the model to make the model more accurately regress the bounding box and faster convergence. Finally, the proposed CGMDet was tested on VisDrone and UAVDT datasets and mAP0.5 of 50.9% and 48% was obtained, respectively. At the same time, our detector achieved the best results compared to other detectors.

Qiang Peng,1,&ast; Wenxiu Chen,2,&ast; Yan E,1,&ast; Yang Deng,3 Zhaohan Xu,1 Siyu Wang,1 Xinxin Fu,3 Bin Wei,1 Meng Wang,1 Jiankang Hou,1 Yingdong Zhang,1 Rui Duan1 1Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210006, People’s Republic of China; 2Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210006, People’s Republic of China; 3School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, 210000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yingdong Zhang; Rui Duan, Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, People’s Republic of China, Email zhangyingdong@njmu.edu.cn; duanruicpu@163.comPurpose: Neuron-specific enolase (NSE) is considered a biomarker for the severity of nervous system diseases. We sought to explore whether serum NSE concentration in ischemic stroke patients undergoing mechanical thrombectomy (MT) is related to 3-month functional outcome and symptomatic intracranial hemorrhage (sICH).Patients and Methods: We retrospectively collected the data of acute ischemic stroke patients with anterior circulation infarction receiving MT within 6 h in our stroke center. Favorable outcome and poor outcome at 3 months were defined as modified Rankin Scale (mRS) score 0– 2 and 3– 6, respectively. sICH was defined according to the Heidelberg bleeding classification. We used multivariate logistic regression model and receiver operating characteristic curves to investigate the correlation between NSE and clinical outcomes.Results: Among the 426 patients enrolled, 40 (9.4%) patients developed sICH. Three-month favorable outcome in 160 (37.6%) and poor outcome in 266 (62.4%) patients were observed. Serum NSE levels was significantly correlated with 3-month mRS score (R = 0.473, P < 0.001). A cutoff value of 15.29 and 23.12 ng/mL for serum NSE was detected in discriminating 3-month poor outcome (area under the curve, 0.724) and sICH (area under the curve, 0.716), respectively. Multivariate analysis showed that high serum NSE levels were independently associated with 3-month poor outcome (odds ratio [OR] 5.049, 95% confidence interval [CI] 2.933– 8.689, P< 0.001) and sICH (OR 5.111, 95% CI 2.210– 11.820, P < 0.001).Conclusion: Our study demonstrated that high serum NSE levels after receiving MT were independently associated with 3-month poor outcome and sICH in acute ischemic stroke patients. Serum NSE levels could be a good predictor of clinical outcomes for patients receiving MT.Keywords: neuron-specific enolase, ischemic stroke, mechanical thrombectomy, symptomatic intracranial hemorrhage, prognosis

Nursing practices based on the dynamic interaction model have been shown to be superior to generic nursing practices. However, whether this model is effective in patients recovering from intracranial aneurysm surgery is not well studied.To investigate the effect of nursing based on a dynamic interaction model on functional rehabilitation of patients after aneurysm surgery.A total of 86 cases in our hospital with intracranial aneurysm from April 2019 to April 2021, were selected and divided into the study group and the control group, with 43 patients in each group. The control group received routine nursing, and the research group received nursing intervention based on a dynamic interaction model. The daily living ability (activities of daily living, ADL), cognitive function (Simple Intelligent Mental State Scale, MMSE), quality of life (Generic Quality of Life Inventory-74, GQOL-74), self-care ability (Exercise of Self-Care Agency scale), incidence of complications, and nursing satisfaction were recorded before and after intervention.Before intervention, ADL (52.09 ± 6.44), MMSE (18.03 ± 4.11), and GQOL-74 (53.68 ± 4.34) scores in the study group were not significantly different from those in the control group (ADL: 50.97 ± 7.32, MMSE: 17.59 ± 3.82, GQOL-74: 55.06 ± 3.98) (Nursing intervention based on a dynamic interaction model can improve postoperative cognitive function, daily living ability, self-care ability, quality of life, and patient satisfaction, while reducing the risk of complications.

To investigate the characteristics of respiratory involvement in Chinese paediatric neuromuscular disease (NMD) at early stage and to explore convenient monitoring methods.Children with NMD (age18) diagnosed at a multidisciplinary joint NMD clinic at Peking University First Hospital from January 2016 to April 2021 were included. Overnight polysomnography (PSG) and pulmonary function test (PFT) data were analysed, and the characteristics of four groups: congenital muscular dystrophy (CMD), congenital myopathy, spinal muscular atrophy, and Duchenne muscular dystrophy (DMD) were compared.A total of 83 children with NMD were referred for respiratory assessment, of who 80 children underwent PSG; 41 performed spirometry and 38, both. The duration of pulse oxygen saturation (SpOAHI and hypoxia burden were independent factors in children with NMD in PSG and attention needed to be paid in both. FVC might be a daytime predictor for significant sleep-disordered breathing or hypoxia. Nocturnal consecutive oximetry with diurnal peak flow measurement may be convenient and effective for home monitoring at early stage of respiratory involvement.

The waxberry-like mixed-phase TiO2 hollow microstructures (WMTHMs) are controllably prepared via a topotactic synthetic method, involving the synthesis of monodispersed CaTiO3 precursors by a solvothermal method and subsequently transforming them into TiO2 through a Na2EDTA-assisted ion-exchange process. The ratio of anatase-rutile is adjustable, and the two phases are connected well with each other. WMTHMs are composed of radially aligned nanorods, speeding up the electron transport. The optimum WMTHMs sample shows a specific surface area of 68.05 m2/g and exhibits an excellent light scattering capacity. The cell based on WMTHMs light scattering layer obtained an optimal efficiency of 9.12%. The improvement of cell efficiency is mainly attributed to the high specific surface area, the efficient light scattering, the appropriate ratio of anatase-rutile, the staggered bandgap structure, and the convenient one-dimensional electron transport channel.

Shuaiyu Chen,1,&ast; Yan E,1,&ast; Xiaohao Zhang,1,&ast; Bin Wei,1 Siyu Wang,1 Zhaohan Xu,1 Pengyu Gong,2 Yi Xie,3 Chunhua Qin,1 Yingdong Zhang1 1Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China; 2Department of Neurology, Affiliated Hospital of Nantong University, Nantong, People’s Republic of China; 3Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chunhua Qin; Yingdong Zhang, Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, People’s Republic of China, Tel/Fax +86 2552271000, Email 15366136164@163.com; zhangyingdong@njmu.edu.cnBackground and Purpose: Insulin resistance plays a pivotal role in the pathophysiology of ischemic stroke. This study aimed to determine the relationship between the novel metabolic score for insulin resistance (METS-IR) and symptomatic intracranial hemorrhage (sICH) after endovascular thrombectomy (EVT) in stroke patients.Methods: We retrospectively included patients with large artery occlusion in the anterior circulation and treated by EVT from 2 stroke centers (Nanjing First Hospital from September 2019 to April 2022, and Jinling Hospital from September 2019 to July 2021). The METS-IR was used as an alternative marker of insulin resistance and calculated using laboratory data after admission. sICH was diagnosed according to the Heidelberg Bleeding Classification.Results: Of the 410 enrolled patients (mean age, 69.8 ± 11.7 years; 60.7% men), 50 (12.2%) were diagnosed as sICH. After adjusting for demographic characteristics, poor collateral status, and other potential confounders, higher METS-IR was revealed to be independently associated with sICH (odds ratio, 1.076; 95% confidence interval, 1.034− 1.120; P = 0.001). Similar significant results were obtained when defining METS-IR as a categorical variable. The restricted cubic spline uncovered a linear relationship between METS-IR and sICH (P < 0.001 for linearity). Furthermore, adding METS-IR to the conventional model significantly improved the risk prediction for sICH (net reclassification improvement = 15.8%, P = 0.035; integrated discrimination index = 2.6%; P = 0.017).Conclusion: This study demonstrated a significant association between METS-IR score and sICH in ischemic stroke patients treated with EVT. It could help monitor and manage sICH in patients after EVT.Keywords: METS-IR, insulin resistance, ischemic stroke, symptomatic intracranial hemorrhage, endovascular thrombectomy

With the development of Internet technology, the problem of information overload has increasingly attracted attention. Nowadays, the recommendation system with excellent performance in information retrieval and filtering would be widely used in the business field. However, most existing recommendation systems are considered a static process, during which recommendations for internet users are often based on pre-trained models. A major disadvantage of these static models is that they are incapable of simulating the interaction process between users and their systems. Moreover, most of these models only consider users’ real-time interests while ignoring their long-term preferences. This paper addresses the abovementioned issues and proposes a new recommendation model, DRR-Max, based on deep reinforcement learning (DRL). In the proposed framework, this paper adopted a state generation module specially designed to obtain users’ long-term and short-term preferences from user profiles and user history score item information. Next, Actor-Critical algorithm is used to simulate the real-time recommendation process.Finally, this paper uses offline and online methods to train the model. In the online mode, the network parameters were dynamically updated to simulate the interaction between the system and users in a real recommendation environment. Experimental results on the two publicly available data sets were used to demonstrate the effectiveness of our proposed model.

Background: Chronic cerebral hypoperfusion (CCH) is a contributing factor for neurodegenerative diseases. As a recently identified heptapeptide of the brain renin-angiotensin system, angiotensin-(1-7) has been revealed to activate its receptor MAS1 and thus ameliorated cognitive impairments in rats with CCH. Since hippocampal synaptic degeneration represents an important pathological basis of cognitive deficits, we hypothesize that activating MAS1-mediated signaling may alleviate CCH-induced synaptic degeneration in the hippocampus. Methods: In this study, we tested this hypothesis and uncovered the underlying mechanisms in a rat model of CCH induced by bilateral common carotid artery ligation surgery. At one week after the surgery, rats received a daily intraperitoneal vehicle injection or a non-peptidic MAS1 agonist AVE0991 for 8 weeks. During this procedure, Cerebral Blood Flow (CBF) was recorded. The levels of MAS1, amyloid-β (Aβ), neuroinflammatory cytokines, glial cell markers, and synaptophysin in the hippocampus were assessed at the end of the treatment period. Results : We showed that AVE0991 significantly alleviated hippocampal synaptic degeneration in rats with CCH. This protection might be achieved by facilitating CBF recovery, reducing hippocampal Aβ levels, and suppressing neuroinflammatory responses. Conclusions: These findings indicate that MAS1-mediated signaling may represent a novel therapeutic target for CCH-related neurodegenerative diseases.

In recent years, metagenomics(MGS)is the fastest growing fields in microbiology, and has been broadly applied in the detection of pathogenic microorganisms. Comparing with the traditional poly merase chain reaction(PCR)-based detecting technology which relies on microbial culture, MGS can directly detect the sequences of the total microbial DNA from uncultured samples with the high-throughput sequencing platform. It can help the doctors identify the involved pathogens more quickly and provide better medication guidance. Among the known ophthalmic diseases, a lot of them are caused by the infection of pathogens and have many difficulties in clinical diagnosis and treatment. The development of metagenomics provides us a more effective and reliable way for detecting the pathogens of ophthalmic diseases. This article was aimed to review the development of MGS, applications and in the field of ophthalmology, as well as its current deficiencies and the possible development directions in the future.

Aims The objective of this study is to explore and compare the strength of associations between work-related potential traumatic events and burnout among operating room nurses based on three different approaches. Design The study followed a multisite cross-sectional design. Methods A stratified sampling method was conducted. Cities in the Shandong Province were divided into four groups, and two tertiary hospitals were randomly selected from all tertiary hospitals in cities of each group. A total of 361 eligible operating room nurses provided valid questionnaires between June and November 2019. Work-related potential traumatic events questionnaire and the Chinese version of the Maslach Burnout Inventory were conducted. Associations between individual, cumulative potential traumatic events, as well as latent class analysis-derived patterns of potential traumatic experiences with burnout were examined using logistic regression analysis. Results Specific traumatic events (e.g., patients' sudden death, bullying and ostracism from colleagues) were independently associated with an increased risk of burnout. Work-related potential traumatic events had a cumulative effect on burnout, whereby operating room nurses exposed to cumulative potential traumatic events carried a higher risk for burnout than others. The "multiple work-related potential traumatic events" pattern derived by latent class analysis was related to an increased risk of high depersonalization. Conclusion Operating room nurses who reported specific or multiple work-related potential traumatic events were at high risk for burnout. It is of great significance to provide qualified and timely counselling or support. Impact This study is the first to focus on work-related potential traumatic events among operating room nurses and examine their relationship with burnout based on three perspectives. The findings could help identify those operating room nurses who are at high risk of burnout in clinical practice. Hospital managers should develop targeted interventions to prevent or mitigate the harmful impact of potential traumatic events on occupational health.

Lithium–sulfur batteries with high theoretical energy density are attracting more and more attention as candidate materials for next-generation energy storage systems. However, the insulating properties and poor shuttle effect of sulfur are still the main challenges faced by high-performance lithium–sulfur batteries. For this reason, we developed 3D MXene/T-CNF (three-dimensional Ti3C2Tx MXene/TEMPO-oxidized cellulose nanofibers) aerogel composite membrane by freeze-drying and high-temperature carbonization, which proved to be a good material for high-performance lithium–sulfur batteries. The MXene is a two-dimensional layered structure with high specific surface area and abundant active sites, which can provide electrodes with good conductivity and chemical stability as a supporting framework. Moreover, the addition of one-dimensional T-CNF strengthens the MXene structure and prevents it from collapsing while forming a three-dimensional conductive network, ensuring sufficient electron diffusion and electrolyte ion transportation channels. The material exhibits excellent electrochemical properties based on rational design. The 3D MXene/T-CNF-3 has an admirable reversible discharge specific capacity of 1119.6 mAh g−1 at the current density of 0.1 C, which is nearly 3 times as much as pure MXene. The Li–S battery exhibits good conductivity, rate performance, and cycle performance with the capacity retention of 99.4% after 200 cycles. This work offers a novel delicate design strategy for functional materials to achieve high-performance lithium–sulfur batteries.

YKL-40 mediates vascular inflammation and plays a crucial role in the pathogenesis of acute ischemic stroke (AIS). Previous studies have identified YKL-40 as a potential diagnostic biomarker for AIS. However, in patients with AIS, the effects of YKL-40 on long-term clinical outcomes including poor clinical outcome, all-cause mortality, and stroke recurrence remained elusive.The purpose of this study was to explore the association between serum YKL-40 at admission and one-year clinical outcomes in AIS patients. In this prospective cohort study, a total of 1002 participants out of 1361 AIS patients from two centers were included for current analysis. Serum YKL-40 concentrations were measured via enzyme-linked immunosorbent assay. Multivariable logistic or Cox regression were performed to explore the independent association of YKL-40 with one-year clinical outcomes, including poor outcome (modified Rankin Scale of 3-6), all-cause mortality, and recurrent stroke. C-statistic, net reclassification index (NRI) and integrated discrimination improvement (IDI) were calculated to evaluate the discriminatoryand predictive power of YKL-40 when added to conventional model. Compared with the first quartile of YKL-40, the adjusted odds ratios or hazard ratios (95% CI) of the fourth quartile was 3.032 (1.627-5.650) for poor outcome, 2.886 (1.320-6.308) for all-cause mortality and 1.694 (0.906-3.169) for recurrent stroke. The addition of serum YKL-40 to conventional model significantly improved reclassification for poor outcome (NRI 0.053, P = 0.031; IDI 0.018, P = 0.001) and all-cause mortality (NRI 0.162, P = 0.036). In conclusion, elevated serum YKL-40 at baseline might be independently associated with one-year poor outcome and all-cause mortality but not stroke recurrence among Chinese AIS patients, suggesting that YKL-40 can potentially serve as a valuable prognosticbiomarker for AIS.

Heavy metals in cultivated soil may migrate and transform through the food chain to harm the ecological environment and human health. At present, the ecological environment and human health risks of heavy metals in cultivated soil in Lanzhou city remain unclear, which impacts the effective management and control of heavy metals. The potential ecological risk hazard index was used to evaluate the ecological environmental risks of As, Cd, Cr, Hg, and Pb in the surface soil of cultivated land in Lanzhou, and the health risk model proposed by USEPA and the recommended standard were used to evaluate their human health risk. The main factors influencing the spatial differentiation of human health risk were explored by using geographic detectors. The risk of heavy metals to the ecological environment of the cultivated land surface soil in the study area was mainly medium (65.25%), and small portions were low (13.80%) and high (20.95%). The low-risk areas were mainly located in the southeast of Yongdeng County, the middle and north of Yuzhong County, and the southwest of Gaolan County. Moderate risk areas were distributed in three counties and five districts. The high-risk areas were located in the north and southeast of Yongdeng County, the south of Chengguan District, the northeast of Qilihe, the east of Xigu District, and the middle of Yuzhong County. The non-carcinogenic and carcinogenic risks of five types of heavy metal exposure pathways were as follows:oral ingestionskin contactrespiratory ingestion; generally speaking, children were at higher risk than adults. The non-carcinogenic risk in children was higher than that in adults; however, there was no such risk for local residents, as they were all less than 1. At the same time, the carcinogenic risk of As was greater than 1×10

In previous studies, low-dose dexmedetomidine supplemented opioid analgesia improved sleep architecture but increased sedation level. Herein we tested the hypothesis that mini-dose dexmedetomidine supplemented analgesia improves sleep structure without increasing sedation.In this randomized trial, 118 older patients (≥65 years) following major noncardiac surgery were randomized to receive patient-controlled intravenous analgesia supplemented with either placebo or dexmedetomidine (median 0.02 μg kgAll 118 patients completed the study; of these, 85 were included in sleep structure analysis. Dexmedetomidine supplemented analgesia increased the percentage of N2 sleep (median difference, 10%; 95% CI, 1%-20%; P = 0.03). It also prolonged total sleep time (median difference, 78 min; 95% CI, 21 to 143; P = 0.01), increased sleep efficiency (median difference, 14%; 95% CI, 4%-26%; P = 0.01), decreased percentage of N1 sleep (median difference, -10%; 95% CI, -20% to -1%; P = 0.04), and lowered sleep fragmentation index (median difference, -1.6 times⋅hSupplementing intravenous analgesia with mini-dose dexmedetomidine improved sleep structure without increasing sedation in older patients recovering from major surgery.www.gov (NCT03117790), registered 2 April 2017.

Three bottom trawl surveys over the northern continental slope in the South China Sea (18°50′–20°40′N, 112°50′–115°10′E) were carried out, in June 2015, March 2017 and September 2018, to investigate species composition, biodiversity and community structure of demersal fish. Surveys in 2015, 2017 and 2018 captured 97 fish species (representing 77 genera, 52 families, 26 orders), 108 fish species (representing 84 genera, 61 families, 19 orders) and 126 fish species (representing 105 genera, 74 families, 25 orders), respectively. Three surveys captured a total of 252 fish species, representing 164 genera, 97 families, 30 orders. Perciformes dominated. Species richness in station linking shallow continental shelf with deep slope was the lowest among stations. In three surveys, 16 species occurred in the catches of three surveys, accounting for 6.35% of all species. Species replacement rate between stations showed a significant linear relationship with the depth difference and latitude difference. Margalef’s species richness index (D), Shannon–Weiner diversity index (H’) and Pielou’s evenness index (J’) among stations ranged 2.65–6.74, 1.02–4.15 and 0.28–1.14, respectively. Differences of D, H’ and J’ were insignificant among seasons. There were significant positive linear relations between H’ and J’ and latitude. D, H’ and J’ decreased with increasing sampling depth, however the relations were not significant. Based on multivariate statistical analysis, fish community at species level was divided into five groups with average dissimilarities of 95.69%–99.96%. In terms of genus and family, average dissimilarities among groups were more than 88.11% and 82.69%. There were significant differences in species composition between depths, but no significant differences between seasons and temperatures, as well as in genus and family composition.