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Abstract Objectives This study aimed to investigate the differences in structural connectivity and glymphatic system function between patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS) and healthy controls. Additionally, we analyzed the association between structural connectivity, glymphatic system function, and antiseizure medication (ASM) response. Methods We retrospectively enrolled patients with TLE and HS and healthy controls who underwent diffusion tensor imaging at our hospital. We assessed structural connectivity in patients with TLE and HS and healthy controls by calculating network measures using graph theory and evaluated glymphatic system function using the diffusion tensor image analysis along the perivascular space (DTI‐ALPS) index. Patients with TLE and HS were categorized into two groups: ASM poor and good responders. Results We enrolled 55 patients with TLE and HS and 53 healthy controls. Of the 55 patients with TLE and HS, 39 were ASM poor responders, and 16 were ASM good responders. The assortativity coefficient in patients with TLE and HS was higher than that in healthy controls (0.004 vs. −0.007, p = 0.004), and the assortativity coefficient in ASM poor responders was lower than that in ASM good responders (−0.001 vs. −0.197, p = 0.003). The DTI‐ALPS index in patients with TLE and HS was lower than that in healthy controls (1.403 vs. 1.709, p

Abstract Background Mongolian cattle are local breeds in northern China with excellent adaptability to harsh environmental conditions. Adipose tissues play essential roles in tolerance to cold and disease, but the associated cellular and molecular mechanisms are unclear. Methods Single-nucleus RNA sequencing (snRNA-seq) was performed on the adipose tissues from the subcutaneous (SAT), greater omentum (OAT) and perirenal (PAT) of 3 healthy cattle. The adipogenic trajectory was analyzed, and the functional roles of gene of interest were verified in vitro. Results There were different cell subpopulations in adipose tissues. The lipid-deposition adipocytes identified by the PTGER3 marker exhibited outstanding characteristics in SAT. In PAT and OAT, aldosterone was expressed to provide clues for the differential brown adipocytes. Among the DEGs by comparing OAT with SAT and PAT with OAT, C3 was significantly expressed in most of the cell populations in SAT. G0S2, LIPE, LPIN1, PTGER3 and RGCC took part in the adipogenic trajectory from preadipocyte commitment to mature adipocytes. S100A4 expression affected Ca2+ signaling and the expression of UCP1 ~ 3, FABP4 and PTGER3. Conclusion The cell heterogeneity and genes expressed in adipose tissues of Mongolian cattle not only determine the endocrine and energy storage, but contribute to adapt to cold and disease resistance.

Background/Aims: With increased life expectancy, the management of elderly hepatocellular carcinoma (HCC) patients became a crucial issue, yet it is still challenging due to comorbidities and high surgical risks. While surgical resection is considered as primary treatment for eligible HCC patients, systematic evidence on its outcomes in elderly patients remains scarce. In this review, we aimed to analyze the efficacy and safety outcomes of surgical resection in elderly HCC patients. Methods: The studies included in this meta-analysis were selected from Ovid-MEDLINE, Ovid-Embase, CENTRAL, KoreaMed, KMbase, and KISS databases following a predefined protocol. Efficacy outcomes included overall survival and disease-free survival, while the safety outcomes included postoperative mortality and complications. Results: Patients in the elderly group (≥65 years) who underwent surgery exhibited non-inferior overall survival (hazard ratio [HR], 1.26; 95% confidence interval [CI], 0.92 to 1.74) and disease-free survival (HR, 1.03; 95% CI, 0.99 to 1.08) compared to the non-elderly group. Overall postoperative mortality exhibited no statistical difference (odds ratio [OR], 1.07; 95% CI, 0.87 to 1.31), but 30-day, 90-day, and in-hospital mortality were higher in the elderly group. The incidence of overall complications was higher in the elderly group (OR, 1.44; 95% CI, 1.22 to 1.69). Sensitivity analysis for the super elderly group (≥80 years) showed significantly higher in-hospital mortality compared to the non-super elderly group (OR, 2.51; 95% CI, 1.16 to 5.45). Conclusion : s: The efficacy outcome of surgical resection in the elderly HCC patients was not worse than that in the non-elderly HCC patients, while in-hospital mortality and complications rates were higher. Therefore, surgical resection should be purposefully considered in the elderly population, with careful candidate selection.

Summary: Proteomics is crucial in clinical research, yet the clinical application of proteomic data remains challenging. Transforming proteomic mass spectrometry (MS) data into red, green, and blue color (MS-RGB) image formats and applying deep learning (DL) techniques has shown great potential to enhance analysis efficiency. However, current DL models often fail to extract subtle, crucial features from MS-RGB data. To address this, we developed ProteoNet, a deep learning framework that refines MS-RGB data analysis. ProteoNet incorporates semantic partitioning, adaptive average pooling, and weighted factors into the Convolutional Neural Network (CNN) model, thus enhancing data analysis accuracy. Our experiments with proteomics data from urine, blood, and tissue samples related to liver, kidney, and thyroid diseases demonstrate that ProteoNet outperforms existing models in accuracy. ProteoNet also provides a direct conversion method for MS-RGB data, enabling a seamless workflow. Moreover, its compatibility with various CNN architectures, including lightweight models like MobileNetV2, underscores its scalability and clinical potential.

Background End-stage kidney disease (ESKD) patients undergoing hemodialysis experience diverse neurological complications. This study investigated prefrontal cerebral blood volume (CBV) and cerebral blood flow (CBF) during hemodialysis using functional near-infrared spectroscopy (fNIRS) to analyze cerebral hemodynamic changes.Methods ESKD patients undergoing maintenance hemodialysis without a history of neurological disorders were enrolled prospectively. The fNIRS data were collected using a NIRSIT Lite device. The fNIRS values were recorded three times for each patient: before the start of hemodialysis (pre-HD), 1 h after the start of hemodialysis (mid-HD), and after the end of hemodialysis (post-HD). The average changes in oxy-hemoglobin (HbO2), deoxy-hemoglobin (HbR), total hemoglobin (HbT, calculated as HbO2 + HbR) concentrations, and in hemoglobin concentration difference (HbD, calculated as HbO2 − HbR) were analyzed. We then compared the differences in changes in HbO2, HbR, HbT, and HbD according to the hemodialysis period.Results Thirty hemodialysis patients were analyzed. The change in HbO2, HbT, and HbD levels showed significant differences according to the hemodialysis period. Between the pre-HD and post-HD periods, there were significant differences in changes in HbO2 (0.005 ± 0.001 µM vs. 0.015 ± 0.004 µM, p = .046) and HbT (0.006 ± 0.001 µM vs. 0.016 ± 0.008 µM, p = .029). Additionally, between pre-HD and post-HD periods, HbD tended to increase (0.005 ± 0.001 µM vs. 0.014 ± 0.004 µM, p = .094).Conclusions We demonstrated that during one hemodialysis session, the relative change in prefrontal CBV increased post-HD compared with pre-HD. These results are expected to help understanding the mechanisms underlying the effects of hemodialysis on brain function.

ABSTRACTThree-dimensional concrete printing (3DCP) is progressing from lab pilots to large-scale manufacturing, encountering limitations with conventional printable material – cement mortar. Coarse aggregate concrete (CAC) emerges as a promising alternative due to its superior material properties, cost-effectiveness, and sustainability, attracting considerable interest in academia and industry. This paper explores the integration of CAC into 3DCP, focusing on three critical aspects: mixture design of 3D printable concrete, innovative methods of 3D printing process, and structural behaviours of 3D printed concrete specimens, structural members and systems. It elucidates the relationships among mixture composition, processing parameters, early-age material properties, and printability requirements. Furthermore, particle-bed 3D printing technology for CAC is discussed, highlighting advantages and challenges compared to extrusion methods. Ultimately, this review provides valuable insights into the technical challenges and prospects of 3D printing coarse aggregate concrete (3DPCAC) technology, aiming to foster advancements in research and construction practices.

ObjectivesThe choroid plexus plays a role in eliminating detrimental metabolites from the brain as an integral component of the glymphatic system. This study aimed to investigate alterations in choroid plexus volume in patients with end-stage renal disease (ESRD) compared with healthy controls.MethodsWe enrolled 40 patients with ESRD and 42 healthy controls. They underwent brain magnetic resonance imaging (MRI), specifically using three dimensional T1-weighted imaging. We analyzed choroid plexus volumes and compared them between patients with ESRD and healthy controls. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was calculated. We compared the DTI-ALPS index between the ESRD patients and healthy controls. Additionally, we evaluated the association between choroid plexus volume and neuropsychological tests results in patients with ESRD.ResultsThere were significant differences in choroid plexus volumes between patients with ESRD and healthy controls. The choroid plexus volumes in patients with ESRD were higher than those in healthy controls (1.392 vs. 1.138%, p

Objective Precise knowledge regarding the mechanical stress applied to the intervertebral disc following each individual spine motion enables physicians and patients to understand how people with discogenic back pain should be guided in their exercises and which spine motions to specifically avoid. We created an intervertebral disc degeneration model and conducted a finite element (FE) analysis of loaded stresses following each spinal posture or motion. Methods A 3-dimensional FE model of intervertebral disc degeneration at L4–5 was constructed. The intervertebral disc degeneration model was created according to the modified Dallas discogram scale. The von Mises stress and range of motion (ROM) regarding the intervertebral discs and the endplates were analyzed. Results We observed that mechanical stresses loaded onto the intervertebral discs were similar during flexion, extension, and lateral bending, which were greater than those occurring during torsion. Based on the comparison among the grades divided by the modified Dallas discogram scale, the mechanical stress during extension was greater in grades 3–5 than it was during the others. During extension, the mechanical stress loaded onto the intervertebral disc and endplate was greatest in the posterior portion. Mechanical stresses loaded onto the intervertebral disc were greater in grades 3–5 compared to those in grades 0–2. Conclusion Our findings suggest that it might be beneficial for patients experiencing discogenic back pain to maintain a neutral posture in their lumbar spine when engaging in daily activities and exercises, especially those suffering from significant intravertebral disc degeneration.

Background : We conducted this study to assess the efficacy and safety of PF-72 (TGel Bio Co. Ltd., Seoul, Korea) combined with 0.75% ropivacaine hydrochloride in relieving the postoperative pain in patients undergoing single-level lumbar discectomy. Methods : A total of 95 eligible patients were randomized to either the trial group (n = 47; PF-72 combined with 0.75% ropivacaine hydrochloride) or the control group (n = 48; ramosetron hydrochloride 0.3 mg). The patients were monitored at 3, 6, 24, 48 and 72 hours postoperatively, for which the cumulative area under the curve (AUC0-72) of NRS pain scores was plotted and the amount of rescue analgesics used at 6, 24, 48 and 72 hours or 24, 48 and 72 hours postoperatively. Moreover, incidences of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs) were analyzed. Results : The amount of analgesics used and the AUC0-72 of the NRS pain scores was significantly smaller and the NRS pain scores were significantly lower in the trial group as compared with the control group (P < 0.05). In addition, there was no significant difference in the number of the patients presenting with no pain (NRS pain scores ≤; 3) between the two groups at 48 and 72 hours postoperatively (P > 0.05). There were no significant differences in the incidences of TEAEs and SAEs between the two groups (P > 0.05). Conclusion : s: PF-72 combined with 0.75% ropivacaine hydrochloride is an effective, safe drug delivery system.

Abstract This cadaveric study aimed to evaluate the safety and usability of a novel robotic system for posterior cervical pedicle screw fixation. Three human cadaveric specimens and C2-T3 were included. Freshly frozen human cadaver specimens were prepared and subjected to robot-assisted posterior cervical pedicle screw fixation using the robotic system. The accuracy of screw placement, breach rate, and critical structure violations were evaluated. The results were statistically compared with those of previous studies that used different robotic systems for cervical pedicle screw fixation. The robotic system demonstrated a high accuracy rate in screw placement. A significant number of screws were placed within predetermined safe zones. The total entry offset was 1.08 ± 0.83 mm, the target offset was 1.86 ± 0.50 mm, and the angle offset was 2.14 ± 0.77°. Accuracy rates comparable with those of previous studies using different robotic systems were achieved. The system was also feasible, allowing precise navigation and real-time feedback during the procedure. This cadaveric study validated the safety and usability of the novel robotic system for posterior cervical pedicle screw fixation. The system exhibited high precision in screw placement, and the results support the extension of the indications for robot-assisted pedicle screw fixation from the lumbar spine to the cervical spine.

In view of the shortage of conventional design methods of pressure curve in the anti-gravity precision casting and taking the structural characteristics of the casting with variable cross-sections into account, automatic calculation of cross-sectional areas was implemented for the casting and gating system by the secondary development of CAD software, and quantitatively describing the variable feature of cross-sections of casting was realized. Based on Bernoulli and flow conservation equations，the relationship between the filling pressure and the rising speed of metal liquid level was deduced. A new design method of pressure curve based on the automatic calculation of cross-sectional areas of the casting was proposed. The simulation results of anti-gravity casting for nickel-based superalloy demonstrate that, compared with the pressure curve of the conventional design method，the new curve can reduce the peak value of filling speed from 0.611 m/s to 0.439 m/s at the minimum cross-sectional area，the falling range of which is 28.15%. It meant that the new method can effectively avoid the shock and splash of liquid metal，meanwhile，shorten the filling time，then the filling process is fast and stable. The hydraulic experiment and pouring experiment show that the new pressure curve has a smoother filling liquid level and can effectively avoid casting defects. Therefore，it proves the effectiveness of the new pressure curve design method and provides a basis for rational design of anti-gravity pressure curve.

Abstract Background Pregnancy-associated spontaneous coronary artery dissection (SCAD) and reversible cerebral vasoconstriction syndrome (RCVS) are rare conditions that may occur during pregnancy and the postpartum period. The coexistence of both diseases may pose a risk to patients, potentially resulting in a variety of complications and clinical manifestations. This is considered the first case of a patient who successfully recovered from a critical condition in the postpartum period, with contemporaneous SCAD and RCVS. Case presentation A 33-year-old female with no known medical history was referred to the emergency department after experiencing cardiac arrest, which occurred 1 week after giving birth to her third child. She complained of sudden anterior squeezing chest pain, accompanied by a headache, and eventually collapsed due to ventricular fibrillation with seizure. She was successfully resuscitated after receiving basic life support. She showed an alert mentality and did not experience any further seizure events or additional neurological symptoms. Although vital sign remained stable, the level of highly sensitive troponin I was significantly elevated. Electrocardiography revealed sinus rhythm with T-wave inversion at V1-4, while chest computed tomography (CT) demonstrated severe aspiration pneumonia. The patient was admitted to the intensive care unit due to a high requirement of O2 supply. A consultation with the neurologic department and a brain magnetic resonance angiography (MRA) were conducted for the thunderclap headache. The brain MRA demonstrated stenosis in the basilar artery, the right M2 segment, and bilateral A1 segments, along with sulcal hyperintensity on post-contrast fluid-attenuated inversion recovery (FLAIR) suggesting blood–brain barrier breakdown due to vasoconstriction. Formal echocardiography showed regional wall motion abnormality in the left anterior descending artery (LAD) territory. After the improvement of pneumonia, a coronary angiography was performed, revealing diffuse luminal narrowing from the mid to distal LAD due to a long segmental, extensive dissection. We decided to maintain the medical therapy. A follow-up coronary CT angiography performed 6 months later revealed complete remission of the dissected coronary vessel, and a brain MRA checked 3 months later showed resolved vasoconstriction of the relevant cerebral vessels. Conclusions The physicians must be aware of pregnancy-associated complications in certain patients. Clear diagnoses and proper treatments are required in pregnant patients who may be exposed to multiple acute conditions, in order to reduce complications and achieve favorable outcomes.

The Trier social stress test (TSST) is considered as the most appropriate standardized protocol for studying stress hormone reactivity. The TSST is distinct from other stress induction protocols in laboratory settings due to its unique ability to create a natural context that includes elements of social and psychological acute stress. However, there has been no investigation of the efficacy of the TSST among the Vietnamese population. Therefore, the purpose of this study is to examine the impact of the TSST on Vietnamese university students. A group of 10 healthy male and female volunteers underwent the TSST protocol, and self-reported values (the positive and negative affect schedule and the visual analogue scale) as well as physiological stress response (heart rate) were measured. The results suggest that the TSST mildly induces acute psychological stress among Vietnamese participants. To enhance the potency of the TSST in future studies, a larger sample size and more consistent adherence to the TSST protocol are crucial.

ObjectivesStudies have recently shown an alteration of the structural connectivity and a dysfunctional glymphatic system in patients with chronic kidney disease (CKD). In this study, we aimed to investigate the effects of the structural connectivity and glymphatic system on the cognitive function of patients with CKD.MethodsWe prospectively enrolled patients with CKD and healthy controls. The CKD group was divided into two regarding their cognitive function. All patients received brain magnetic resonance imaging, including diffusion tensor imaging (DTI). We calculated the measures of structural connectivity and diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, a neuroimaging marker of the glymphatic system function, and compared the indices between groups.ResultsThe mean clustering coefficient, local efficiency, and small-worldness index in patients with CKD were lower than those in healthy controls (0.125 ± 0.056 vs. 0.167 ± 0.082, p = 0.008; 1.191 ± 0.183 vs. 1.525 ± 0.651, p = 0.002; 0.090 ± 0.043 vs. 0.143 ± 0.102, p = 0.003; respectively). The DTI-ALPS index was lower in patients with CKD than in healthy controls (1.436 vs. 1.632, p

IntroductionRoad cracks significantly shorten the service life of roads. Manual detection methods are inefficient and costly. The YOLOv5 model has made some progress in road crack detection. However, issues arise when deployed on edge computing devices. The main problem is that edge computing devices are directly connected to sensors. This results in the collection of noisy, poor-quality data. This problem adds computational burden to the model, potentially impacting its accuracy. To address these issues, this paper proposes a novel road crack detection algorithm named EMG-YOLO.MethodsFirst, an Efficient Decoupled Header is introduced in YOLOv5 to optimize the head structure. This approach separates the classification task from the localization task. Each task can then focus on learning its most relevant features. This significantly reduces the model’s computational resources and time. It also achieves faster convergence rates. Second, the IOU loss function in the model is upgraded to the MPDIOU loss function. This function works by minimizing the top-left and bottom-right point distances between the predicted bounding box and the actual labeled bounding box. The MPDIOU loss function addresses the complex computation and high computational burden of the current YOLOv5 model. Finally, the GCC3 module replaces the traditional convolution. It performs global context modeling with the input feature map to obtain global context information. This enhances the model’s detection capabilities on edge computing devices.ResultsExperimental results show that the improved model has better performance in all parameter indicators compared to current mainstream algorithms. The EMG-YOLO model improves the accuracy of the YOLOv5 model by 2.7%. The mAP (0.5) and mAP (0.9) are improved by 2.9% and 0.9%, respectively. The new algorithm also outperforms the YOLOv5 model in complex environments on edge computing devices.DiscussionThe EMG-YOLO algorithm proposed in this paper effectively addresses the issues of poor data quality and high computational burden on edge computing devices. This is achieved through optimizing the model head structure, upgrading the loss function, and introducing global context modeling. Experimental results demonstrate significant improvements in both accuracy and efficiency, especially in complex environments. Future research can further optimize this algorithm and explore more lightweight and efficient object detection models for edge computing devices.

In response to the problem of lack of shrinkable pressure-allowing performance of steel pipe concrete arch in the current roadway support, an anti-impacting and energy-absorbing steel pipe concrete arch structure is designed from the perspective of energy-absorbing pressure-allowing. The combination model of the new steel pipe concrete arch and the surrounding rock was established by Abaqus, and the support effect and impact resistance of the new arch on the roadway were compared and analyzed under both static and dynamic loading conditions. The conclusions are as follows: ① Designing the wall thickness and size of the energy-absorbing member according to the reasonable yielding resistance characteristics. Energy-absorbing components are installed at the connection between the upper arch and the middle of the bottom arc to prevent excessive bending from causing instability. The sleeve shape is designed as a pleated shape based on the U-shaped steel arch clamp structure, which achieves compression yield through friction with the arch; ② Under the vertical and lateral impact, the displacement of the optimized arch support tunnel at each point is reduced, which reduces the sinking of the top arc section of the arch and the up-arch of the bottom arc section, and the support effect is stronger; ③ Under static loads, after the arch contacts the energy-absorbing component, the plastic strain at each point of the arch no longer increases, and the energy-absorbing component replaces the arch to deform. After being subjected to dynamic loads, the energy-absorbing component can respond quickly, while the corners of the arch bend and deform, and the remaining parts have not undergone significant deformation. After the energy-absorbing component is crushed, the overall plastic strain of the arch starts to increase, and finally the equivalent plastic strain at each point of the arch is reduced by 10%−50% and 13%−78% under vertical and lateral impacts, respectively, after optimization.

Abstract Climate change is closely monitored and numerous studies reports increasing air temperature and weather extremes across the globe. As a direct consequence of the increase of global temperature, the increased heat stress is becoming a global threat to public health. While most climate change and epidemiological studies focus on air temperature to explain the increasing risks, heat strain can be predicted using comprehensive indices such as Universal Thermal Climate Index (UTCI). The Asia–Pacific region is prone to thermal stress and the high population densities in the region impose high health risk. This study evaluated the air temperature and UTCI trends between 1990 and 2019 and found significant increasing trends for air temperature for the whole region while the increases of UTCI are not as pronounced and mainly found in the northern part of the region. These results indicate that even though air temperature is increasing, the risks of heat stress when assessed using UTCI may be alleviated by other factors. The associations between El Niño Southern Oscillation (ENSO) and heat stress was evaluated on a seasonal level and the strongest regional responses were found during December-January (DJF) and March–May (MAM).

Chronic obstructive pulmonary disease (COPD) is one of the major chronic airway diseases, with the highest prevalence among individuals over 60 years old, significantly impacting the health of elderly patients. Both domestic and international COPD prevention and treatment guidelines recommend pulmonary rehabilitation as a complementary and effective adjunct to pharmacological treatment. Pulmonary rehabilitation can significantly improve patients' respiratory function and physical fitness, alleviate symptoms, and reduce hospitalization and mortality rates. However, the specific contents of pulmonary rehabilitation for elderly COPD patients differ depending on the stage of the disease. This expert consensus elaborates on the assessment and treatment contents of pulmonary rehabilitation for elderly COPD patients in the acute exacerbation period, acute exacerbation remission period, and outpatient stable period, aiming to provide guidance for pulmonary rehabilitation treatment at different stages of the disease. This consensus identifies common functional impairments in elderly COPD patients, including respiratory dysfunction, exercise tolerance impairment, psychological issues, swallowing dysfunction and cognitive impairment. It recommends a comprehensive assessment of elderly COPD patients' multifaceted impairments based on the International Classification of Functioning, Disability, and Health (ICF) framework, covering four aspects：body structure, body function (respiratory function, cardiac function, exercise function, psychological and cognitive function, swallowing function, and nutritional factors), activity and participation, and environmental factors. Pulmonary rehabilitation is suitable for all patients exhibiting relevant symptoms and/or those at high risk of acute exacerbations (high-level evidence). As the disease progresses, the rehabilitation team, treatment plan, and treatment location should be adjusted in a timely manner, forming a continuous rehabilitation cycle. Smoking cessation is a crucial intervention to slow down the decline in lung function and the progression of COPD (high-level evidence). Through adequate nutritional support, elderly COPD patients can improve their nutritional status, enhance physical strength and quality of life, better manage the disease, and promote rehabilitation (low to moderate-level evidence). Oxygen therapy is recommended for patients with advanced COPD who remain hypoxemic at rest (low to moderate-level evidence). Some emerging rehabilitation treatments (such as neuromuscular electrical stimulation, acupuncture, and certain traditional Chinese medicines) may have some value for elderly COPD patients (low to moderate-level evidence. This expert consensus divides rehabilitation treatment into three stages：Phase I Pulmonary Rehabilitation, Phase II Pulmonary Rehabilitation, and Phase III Pulmonary Rehabilitation, based on the different stages of elderly COPD patients. It further details the target population, implementation location, rehabilitation content, assessment content, participating disciplines, and rehabilitation goals for each stage, emphasizing the need for clinical respiratory specialists, primary care physicians, rehabilitation physicians/therapists, nurses, nutritionists, psychologists, and social workers to actively coordinate and collaborate throughout the full-cycle rehabilitation process for elderly COPD patients.

Elderly lung cancer is the leading cause of cancer-related deaths worldwide, posing significant challenges to public health. This consensus systematically reviews relevant clinical guidelines and literature both domestically and internationally, integrating recent clinical experiences and research findings. It summarizes new clinical rehabilitation concepts from experts in rehabilitation medicine, respiratory medicine, and nursing regarding elderly lung cancer. The consensus provides detailed discussions on the definition, risk factors, classification, staging, and clinical characteristics of elderly lung cancer, with a focus on functional impairments and their rehabilitation assessment and treatment strategies. Functional impairments encompass multiple aspects, including pulmonary function, cardiac function, exercise capacity, pain, psychological issues, cognition, speech, swallowing, sensory functions, and bowel and bladder dysfunction. The consensus offers comprehensive academic guidance and clinical practice recommendations for rehabilitation professionals across various healthcare settings. It emphasizes that the full-cycle rehabilitation of elderly lung cancer requires multidisciplinary teamwork to ensure seamless integration of clinical care, rehabilitation, and nursing, maximizing patient functional recovery and quality of life. By conducting a comprehensive assessment of patients' overall conditions and formulating personalized rehabilitation treatment plans, effective improvements in functional impairments, symptom relief, and even prolongation of survival can be achieved. Additionally, the consensus outlines the service process for full-cycle rehabilitation of lung cancer, highlighting the interconnectedness of tertiary hospitals, secondary hospitals, community hospitals, and families, as well as the importance of adjusting rehabilitation models based on local circumstances. The promotion and implementation of this consensus aim to provide standardized guidance for the assessment and treatment of full-cycle rehabilitation in elderly lung cancer patients, with the expectation of improving rehabilitation outcomes and quality of life, thereby contributing to the development of elderly lung cancer rehabilitation in China.

Objective: This study introduces a novel system that can simulate diverse mechanical properties of the human chest to enhance the experience of CPR training by reflecting realistic chest conditions of patients. Methods: The proposed system consists of Variable stiffness mechanisms (VSMs) and Variable damper (VD) utilizing stretching silicone bands and dashpot dampers with controllable valves to modulate stiffness and damping, respectively. Cyclic loading was applied with a robot manipulator to the system. Compression force and displacement were measured and analyzed to evaluate the system’s mechanical response. Long-term stability of the system was also validated. Results: A non-linear response of the human chest under compression is realized through this design. Test results indicated non-linear force-displacement curves with hysteresis, similar to those observed in the chest of patients. Controlling the VSM and VD allowed for intentional changes in the slope and area of curves that are related to stiffness and damping, respectively. Stiffness and damping of the system were computed using performance test results. The stiffness ranged from 5.34 N/mm to 13.59 N/mm and the damping ranges from 0.127 N $\cdot $ s/mm to 0.511 N $\cdot $ s/mm. These properties cover a significant portion of the reported mechanical properties of the human chests. The system demonstrated satisfactory stability even when it was subjected to maximum stiffness conditions of the long-term compression test. Conclusion: The system is capable of emulating the mechanical properties and behavior of the human chests, thereby enhancing the CPR training experience.

Objective To investigate the effects of silencing connective tissue growth factor (CTGF) gene on growth, apoptosis, and expression of proliferating cell nuclear antigen (PCNA), CTGF, integrin alpha 5 (Itgα5) and collagen Ⅰ (ColⅠ) in rat hepatic stellate cell line T6 (HSC_T6). Methods The CTGF shRNA lentiviral vectors with high infectivity were transfected into HSC_T6 cells, and the cells transfected with empty virus or not transfected served as control cells. Fluorescence inverted microscopy was used to observe the cell growth and the expression of green fluorescent protein (GFP) in the transfected HSC_T6 cells. CCK-8 assay and flow cytometry were employed respectively to detect the cell viability and apoptosis. The expression changes in PCNA, CTGF, Itgα5 and ColⅠ were measured by real-time PCR, Western blotting and immunofluorescence assay. Results Microscopic observation displayed that transfection with CTGF shRNA lentiviral vectors resulted in high expression of GFP in HSC_T6 cells. CCK-8 assay showed that silencing CTGF induced inhibited growth in the transfected cells, with significant difference since 72 h after transfection (P < 0.05). Flow cytometry indicated that transfection of CTGF shRNA lentivirus led to the apoptosis of HSC_T6 cells. The results of real-time PCR, Western blotting and immunofluorescence assay confirmed that CTGF shRNA lentivirus effectively down-regulated the expression of PCNA, CTGF, Itgα5 and ColⅠ, with notable differences when compared the expression in control cells (P < 0.05). Conclusion Silencing CTGF can down-regulate the expression of CTGF, Itgα5 and ColⅠ, inhibit the growth and induce the apoptosis of HSC_T6 cells, which might be closely associated with its interference for the CTGF/Itgα5 signaling pathway.

Although the disease burden of elderly cancer patients is rapidly increasing, reliable scientific information, value and preference information of domestic patients, and standardized guidelines for determining the treatment of elderly cancer patients are lacking. The aim of this study is to compare the therapeutic effects of radiofrequency ablation (RFA) and surgery in hepatocellular carcinoma (HCC) patients aged 65 years or older. For the meta-analysis, the databases including PubMed (MEDLINE), EMBASE, OVID Medline, and the Cochrane Library were systematically searched. After the abstract-based review by two investigators, selected manuscripts were read in detail. The surgery group showed higher overall survival (OS) (HR 1.44, 95% CI 1.22–1.70) and disease-free survival (DFS) (HR 1.40, 95% CI 1.00–1.97) than the RFA group. This was also shown in small HCC of less than 3 cm (OS, HR 1.42, 95% CI 1.00–2.03; DFS, HR 1.32, 95% CI 0.91–1.91). This might be related to the high local recurrence in the RFA group (OR 4.90, 95% 2.16–11.08). On the other hand, adverse events were significantly lower in the RFA group (OR 0.22, 95% CI 0.14–0.36), which led to a decrease in the duration of hospital stay (mean difference −14.88 days, 95% CI −22.44–−7.32). In elderly HCC patients, survival in the surgery group was significantly higher than in the RFA group, but various complications tended to increase; so, appropriate patient selection is required.

Abstract Introduction Using correlation tractography, this study aimed to find statistically significant correlations between white matter (WM) tracts in participants with obstructive sleep apnea (OSA) and OSA severity. We hypothesized that changes in certain WM tracts could be related to OSA severity. Methods We enrolled 40 participants with OSA who underwent diffusion tensor imaging (DTI) using a 3.0 Tesla MRI scanner. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and quantitative anisotropy (QA)‐values were used in the connectometry analysis. The apnea‐hypopnea index (AHI) is a representative measure of the severity of OSA. Diffusion MRI connectometry that was used to derive correlational tractography revealed changes in the values of FA, MD, AD, RD, and QA when correlated with the AHI. A false‐discovery rate threshold of 0.05 was used to select tracts to conduct multiple corrections. Results Connectometry analysis revealed that the AHI in participants with OSA was negatively correlated with FA values in WM tracts that included the cingulum, corpus callosum, cerebellum, inferior longitudinal fasciculus, fornices, thalamic radiations, inferior fronto‐occipital fasciculus, superior and posterior corticostriatal tracts, medial lemnisci, and arcuate fasciculus. However, there were no statistically significant results in the WM tracts, in which FA values were positively correlated with the AHI. In addition, connectometry analysis did not reveal statistically significant results in WM tracts, in which MD, AD, RD, and QA values were positively or negatively correlated with the AHI. Conclusion Several WM tract changes were correlated with OSA severity. However, WM changes in OSA likely involve tissue edema and not neuronal changes, such as axonal loss. Connectometry analyses are valuable tools for detecting WM changes in sleep disorders.

The marine economic development demonstration zone (MEDDZ) is the regional marine functional policy that assumes the significant tasks of innovation in the system and mechanism of the marine economy, optimization of the marine industrial structures, and the construction of marine ecological civilization. This paper constructs a panel database of 11 coastal provinces in China from 2006 to 2019, takes the Zhejiang Marine Economy Development Demonstration Zone Plan officially approved by the State Council of China in 2011 as a quasi-natural experiment, applies the synthetic control method (SCM) to evaluate the effect of implementation of the MEDDZ policy on marine industrial structure optimization in Zhejiang. The results show that: (1) The MEDDZ policy significantly promotes the structure optimization of the marine industry in Zhejiang and the existence of the policy lag phenomenon. (2) Based on the results of the robustness tests, we find that the fitted path of policy effects is better when the time of MEDDZ implementation is adjusted to 2012. (3) Government financial support and marine cargo capacity play a role in implementing the MEDDZ policy, positively affecting and optimizing the coastal marine industry’s structure. Therefore, we make some suggestions from the perspectives of strengthening the policy implementation process, focusing on the policy lag phenomenon, and broadening funding sources, thus enriching theoretical research on policies in the field of the marine industry and providing practical references for the development of other coastal demonstration zones.

IntroductionThe lighting environment significantly influences fish behavior. This study explores the impact of diverse lighting conditions on the behavior of steelhead trout (Oncorhynchus mykiss) to illuminate the mechanisms underlying their behavioral responses.MethodsThis experiment was set up with six treatments at a constant light intensity of 150 lx: 12h white light + 12h dark (12 W), 12h blue light + 12h dark (12B), 12h red light + 12h dark (12 R), 1.5h blue light + 9h red light + 1.5h blue light + 12h dark (3B9R), 3h blue light + 6h red light + 3h blue light + 12h dark (6B6R), total 12h of blue and red light + 12h dark (T12BR). A multiple object tracking method, YOLOv5 with SORT, was employed to capture the movement trajectory of each fish, quantifying three motion metrics: swimming velocity, swimming angular velocity, and generalized intersection over union.ResultsThe results revealed that fish exposed to 12R light environment showed significantly higher activity levels than other groups. The mixed light environments (3B9R, 6B6R) formed significant differences in behavioral metrics with 12R earlier than pure light environments (12B, 12W, T12BR), indicating sudden light color changes should be avoided. Fish in the 3B9R environment exhibited the lowest activity level but highest growth performance, with the highest specific growth rate of 1.91±0.12 d-1, a value significantly surpassing the lowest recorded rate, supported by a p-value of 0.0054, indicating it is suitable for steelhead trout cultivation.DiscussBehavioral significant differences were observed as early as week eight, much earlier than physiological differences, which became apparent by week 16. Overall, this paper employs computer vision methods to study the impact of different light colors on fish behavior, found that 3B9R is the optimal lighting condition tested and sudden light color changes should be avoided, offering a new perspective on light conditions and behavior in steelhead trout cultivation.

Objective The risks of nonunion and subsidence are high in patients with bone density loss undergoing spinal fusion surgery. The internal application of recombinant human bone morphogenic protein 2 (rhBMP-2) in an interbody cage improves spinal fusion; however, related complications have been reported. Denosumab, a human monoclonal antibody targeting the receptor activator of nuclear factor kappa B ligand (RANKL), hinders osteoblast differentiation and function. Therefore, this study aimed to observe the combined effect of the local application of rhBMP-2 in a lumbar cage and systemic RANKL inhibition on postoperative spinal fusion in patients with bone density loss undergoing posterior lumbar interbody fusion (PLIF). Methods This retrospective observational study included 251 consecutive patients with spinal stenosis who underwent PLIF at a single center between 2017 and 2021. Clinical outcomes were assessed, and radiographic evaluations included lumbar flexion, extension, range of motion, and subsidence. Statistical analyses were conducted to identify the combined effect of the treatment and the subsidence and spinal fusion status. Results One hundred patients were included in the final analysis. Denosumab treatment significantly reduced the rate of osteolysis (p = 0.013). When denosumab was administered in combination with rhBMP-2, the fusion status remained similar; however, the incidences of postoperative osteolysis and postoperative oozing day decreased. Conclusion The combined use of rhBMP-2 and RANKL inhibition in patients with bone density loss can enhance bone formation after PLIF with fewer complications than rhBMP-2 alone.

Abstract This study aimed to determine whether white matter tracts correlate with kidney function using correlation tractography, and to investigate the effects of dialysis on white matter tracts in patients with end-stage renal disease (ESRD) using differential tractography. Ten patients with ESRD, who had a glomerular filtration rate of

Objective The objective of this study was to evaluate the accuracy of pedicle screw placement in patients undergoing percutaneous pedicle screw fixation with robotic guidance, using a newly developed 3-dimensional quantitative measurement system. The study also aimed to assess the clinical feasibility of the robotic system in the field of spinal surgery. Methods A total of 113 patients underwent pedicle screw insertion using the CUVIS-spine pedicle screw guide system (CUREXO Inc.). Intraoperative O-arm images were obtained, and screw insertion pathways were planned accordingly. Image registration was performed using paired-point registration and iterative closest point methods. The accuracy of the robotic-guided pedicle screw insertion was assessed using 3-dimensional offset calculation and the Gertzbein-Robbins system (GRS). Results A total of 448 screws were inserted in the 113 patients. The image registration success rate was 95.16%. The average error of entry offset was 2.86 mm, target offset was 2.48 mm, depth offset was 1.99 mm, and angular offset was 3.07°. According to the GRS grading system, 88.39% of the screws were classified as grade A, 9.60% as grade B, 1.56% as grade C, 0.22% as grade D, and 0.22% as grade E. Clinically acceptable screws (GRS grade A or B) accounted for 97.54% of the total, with no reported neurologic complications. Conclusion Our study demonstrated that pedicle screw insertion using the novel robot-assisted navigation method is both accurate and safe. Further prospective studies are necessary to explore the potential benefits of this robot-assisted technique in comparison to conventional approaches.

Abstract The aim of this study was to identify the treatment status and natural prognosis of hepatocellular carcinoma (HCC) patients aged 65 years or older in Korea. We analyzed 3,492 patients’ data from the liver cancer stage of the Central Cancer Registry of National Cancer Center. The most common etiology of HCC was hepatitis B (32.7%), followed by hepatitis C. 2624 patients (69.2%) received first-line active treatment for HCC. The most frequently selected treatment was transarterial chemoembolization (TACE), followed by surgical resection and radiofrequency ablation (RFA). The proportion of patients receiving supportive care increased with age. Second-line treatment was performed in only 36.7% of cases, with all others choosing supportive care. Among the various treatments, liver transplantation was found to have the greatest effect in reducing the risk of death (HR [hazard ratio] 0.164, 95% CI [confidence interval] 0.061–0.444), followed by resection, RFA, radioembolization, and TACE. A similar pattern was observed when sub-analyzing the age group over 75 years old. The median survival for untreated HCC in Barcelona Clinic Liver Cancer stage 0/A/B/C/D was 3.7 years, 2.3 years, 7.9 months, 3.9 months, and 2.9 months, respectively. This study highlights the current status of elderly patients with HCC in Korea. While the proportion of patients receiving supportive care is high among the elderly, effective treatment can improve their survival rate.

The geological and environmental background conditions of the Qingjiang River Basin are highly complex, particularly with frequent geological disasters along the Qingjiang reservoir bank. Previous susceptibility assessment for geological disasters was mostly focused on administrative areas and seldom specialized evaluations for the reservoir bank zone. Furthermore, there is still room for improvement in the evaluation index system, as well as in the pertinence and reliability of the evaluation method. To address these shortcomings, a more suitable susceptibility evaluation index system was constructed to obtain accurate and applicable susceptibility zoning results. The Yuxiakou to Ziqiu section of the Qingjiang River Basin was chosen as the research area, with the wading slope body on both sides of the river selected as the research object and the slope unit chosen as the evaluation unit. A susceptibility evaluation system composed of ten indicators, including slope, aspect, elevation range, slope type, NDVI, TWI, slope structure type, engineering geological rock formation, accumulation thickness, and valley evolution, was constructed.The logistic regression and random forest methods were used to construct the evaluation model based on the normalized certain factors, and different susceptibility zoning results were obtained. According to the evaluation results, the high-prone areas were mainly distributed in the middle to lower water wading areas of the left bank from the east of Yuxiakou to the east of Ziqiu, along the main stream of the Qingjiang River. The logistic regression model showed better applicability in the reservoir-bank section with complex topography and landforms. The research revealed that the accumulation thickness and valley evolution indicators were effective in representing the unique geological background conditions of the Qingjiang reservoir bank. The logistic regression model was able to learn the developmental law of disasters and has a reliable susceptibility prediction ability.

Abstract Background This study aimed to analyze the structural brain network in patients with occipital lobe epilepsy (OLE) and investigate the differences in structural brain networks between patients with OLE and healthy controls. Methods Patients with OLE and healthy controls with normal brain MRI findings were enrolled. They underwent diffusion tensor imaging using a 3.0T MRI scanner, and we computed the network measures of global and local structural networks in patients with OLE and healthy controls using the DSI studio program. We compared network measures between the groups. Results We enrolled 23 patients with OLE and 42 healthy controls. There were significant differences in the global structural network between patients with OLE and healthy controls. The assortativity coefficient (-0.0864 vs. -0.0814, p = 0.0214), mean clustering coefficient (0.0061 vs. 0.0064, p = 0.0203), global efficiency (0.0315 vs. 0.0353, p = 0.0086), and small-worldness index (0.0001 vs. 0.0001, p = 0.0175) were lower, whereas the characteristic path length (59.2724 vs. 53.4684, p = 0.0120) was higher in patients with OLE than those in the healthy controls. There were several nodes beyond the occipital lobe that showed significant differences in the local structural network between the groups. In addition, the assortativity coefficient was negatively correlated with the duration of epilepsy (r=-0.676, p = 0.001).

Abstract In the Asia–Pacific region (APR), extreme precipitation is one of the most critical climate stressors, affecting 60% of the population and adding pressure to governance, economic, environmental, and public health challenges. In this study, we analyzed extreme precipitation spatiotemporal trends in APR using 11 different indices and revealed the dominant factors governing precipitation amount by attributing its variability to precipitation frequency and intensity. We further investigated how these extreme precipitation indices are influenced by El Niño-Southern Oscillation (ENSO) at a seasonal scale. The analysis covered 465 ERA5 (the fifth-generation atmospheric reanalysis of the European Center for Medium-Range Weather Forecasts) study locations over eight countries and regions during 1990–2019. Results revealed a general decrease indicated by the extreme precipitation indices (e.g., the annual total amount of wet-day precipitation, average intensity of wet-day precipitation), particularly in central-eastern China, Bangladesh, eastern India, Peninsular Malaysia and Indonesia. We observed that the seasonal variability of the amount of wet-day precipitation in most locations in China and India are dominated by precipitation intensity in June–August (JJA), and by precipitation frequency in December–February (DJF). Locations in Malaysia and Indonesia are mostly dominated by precipitation intensity in March–May (MAM) and DJF. During ENSO positive phase, significant negative anomalies in seasonal precipitation indices (amount of wet-day precipitation, number of wet days and intensity of wet-day precipitation) were observed in Indonesia, while opposite results were observed for ENSO negative phase. These findings revealing patterns and drivers for extreme precipitation in APR may inform climate change adaptation and disaster risk reduction strategies in the study region.

Abstract Introduction This study aimed to investigate the presence of sarcopenia in patients with juvenile myoclonic epilepsy (JME) and the association between sarcopenia and response to anti‐seizure medication (ASM) in patients with JME. Methods We enrolled 42 patients with JME and 42 healthy controls who underwent brain magnetic resonance imaging with three‐dimensional T1‐weighted imaging. We measured the temporal muscle thickness (TMT), a radiographic marker for sarcopenia, using T1‐weighted imaging. We compared the TMT between patients with JME and healthy controls and analyzed it according to the ASM response in patients with JME. We also performed a receiver operating characteristic (ROC) curve analysis to evaluate how well the TMT differentiated the groups. Results The TMT in patients with JME did not differ from that in healthy controls (9.630 vs. 9.956 mm, p = .306); however, ASM poor responders had a lower TMT than ASM good responders (9.109 vs. 10.104 mm, p = .023). ROC curve analysis revealed that the TMT exhibited a poor performance in differentiating patients with JME from healthy controls, with an area under the ROC curve of .570 (p = .270), but good performance in differentiating between ASM good and poor responders, with an area under the ROC curve of .700 (p = .015). Conclusion The TMT did not differ between patients with JME and healthy controls; however, it was reduced in ASM poor responders compared to ASM good responders, suggesting a link between ASM response and sarcopenia in patients with JME. TMT can be used to investigate sarcopenia in various neurological disorders.

With the development of China's economy entering a new stage, the quality of life, which centers on the well-being of residents, provides an essential hand in promoting the transformation of the regional economy from high-speed development to high-quality development. Based on a panel threshold regression model, we examine in this paper whether quality of life helps regional economies realize developmental convergence. The research shows that: (1) The quality of life overall can promote regional economic development and passes the series test with relatively robust results. (2) The quality of life has a non-linear effect on regional economic growth, which is mainly manifested in the fact that the impact is more significant in regions with higher levels of quality of life and weaker in regions with lagging quality of life and may widen the gap between regions at the same time. (3) We categorize the study regions to test further regional heterogeneity based on regional location and development status. At the Quality of Life Level-I regions, their influence on economic development has a more substantial pulling effect. Therefore, each region should seize the strategic opportunity to improve the quality of life, focus on the balanced development of the quality of life, strengthen policy support and social security, and strive to promote the coordinated development of China's regional economy.

The assessment of landslide hazards is crucial for disaster prevention and mitigation, but it has not considered the dynamic influencing factors that trigger landslides. The timeliness and practical value of the assessment results still need to be further improved. This study constructed a dynamic landslide hazard assessment system using information value model, dynamic precipitation data, and Backpropagation Neural Network (BPNN) model. Taking the Qingjiang Reservoir landslide in Changyang County, Hubei Province, China as an example, based on dynamic precipitation data and the BPNN model were used to develop a dynamic landslide hazard prediction model, and the temporal assessment and spatial distribution results of slope unit hazards in the study area from the 1980s to the 2010s, 2025, and 2030 were evaluated and predicted. It is predicted that the percentage of very high and high areas in 2025 and 2030 will be 50.5% and 57.5% respectively.

BackgroundRecently, we developed a chest compression device that can move the chest compression position without interruption during CPR and be remotely controlled to minimize rescuer exposure to infectious diseases. The purpose of this study was to compare its performance with conventional mechanical CPR device in a mannequin and a swine model of cardiac arrest.Materials and methodsA prototype of a remote-controlled automatic chest compression device (ROSCER) that can change the chest compression position without interruption during CPR was developed, and its performance was compared with LUCAS 3 in a mannequin and a swine model of cardiac arrest. In a swine model of cardiac arrest, 16 male pigs were randomly assigned into the two groups, ROSCER CPR (n = 8) and LUCAS 3 CPR (n = 8), respectively. During 5 minutes of CPR, hemodynamic parameters including aortic pressure, right atrial pressure, coronary perfusion pressure, common carotid blood flow, and end-tidal carbon dioxide partial pressure were measured.ResultsIn the compression performance test using a mannequin, compression depth, compression time, decompression time, and plateau time were almost equal between ROSCER and LUCAS 3. In a swine model of cardiac arrest, coronary perfusion pressure showed no difference between the two groups (p = 0.409). Systolic aortic pressure and carotid blood flow were higher in the LUCAS 3 group than in the ROSCER group during 5 minutes of CPR (p < 0.001, p = 0.008, respectively). End-tidal CO2 level of the ROSCER group was initially lower than that of the LUCAS 3 group, but was higher over time (p = 0.022). A Kaplan-Meier survival analysis for ROSC also showed no difference between the two groups (p = 0.46).ConclusionThe prototype of a remote-controlled automated chest compression device can move the chest compression position without interruption during CPR. In a mannequin and a swine model of cardiac arrest, the device showed no inferior performance to a conventional mechanical CPR device.

The physiological state of an insect can affect its olfactory system. However, the molecular mechanism underlying the effect of nutrition-dependent states on odour-guided behaviours in hoverflies remains unclear. In this study, comparative transcriptome analysis of the antenna and proboscis from Eupeodes corollae under different feeding states was conducted. Compared with the previously published antennal transcriptome, a total of 32 novel chemosensory genes were identified, including 4 ionotropic receptors, 17 gustatory receptors, 9 odorant binding proteins and 2 chemosensory proteins. Analysis of differences in gene expression between different feeding states in male and female antennae and proboscises revealed that the expression levels of chemosensory genes were impacted by feeding state. For instance, the expression levels of EcorOBP19 in female antennae, EcorOBP6 in female proboscis, and EcorOR6, EcorOR14, EcorIR5 and EcorIR84a in male antennae were significantly upregulated after feeding. On the other hand, the expression levels of EcorCSP7 in male proboscis and EcorOR40 in male antennae were significantly downregulated. These findings suggest that nutritional state plays a role in the adaptation of hoverflies' olfactory system to food availability. Overall, our study provides important insights into the plasticity and adaptation of chemosensory systems in hoverflies.

Marine aquaculture, with the potential of reducing greenhouse gas emissions and increasing carbon sink, has become an important carrier to cope with resource and environmental constraints and promote the low-carbon transformation of the global economy. This study aims to estimate the carbon footprint of fresh Apostichopus japonicus based on marine bottom-sowing cultivation technologies in the coastal area of Shandong Province, which has the main Apostichopus japonicus production in China. The aim of the study is to gain a deeper understanding of the hotspot of greenhouse gas emissions at each stage of Apostichopus japonicus production and to provide scientific and technological support for the establishment of targeted emission reduction technologies. Results showed that in the whole process of marine bottom-sowing cultivation, the growing seedling process has the highest carbon dioxide emission of 3,138.5 kg CO2eq per t, accounting for 53.7 % of the total emission. The second highest carbon-emission stage is the pond cultivation process, which is 2075.0 kg CO2eq per t, accounting for 35.5 % of the total emission. The reproductive process and finished Apostichopus japonicus feeding process have the lowest carbon dioxide emission, with contributions of 8.3 % and 2.5 % to the total emissions. Electricity consumption is the largest contributor to the life cycle emissions of fresh Apostichopus japonicus production based on the marine bottom-sowing.

Abstract Objective Although chronic exposure to air pollution is associated with an increased risk of dementia in normal elderlies, the effect of chronic exposure to air pollution on the rates of cognitive decline in Alzheimer's disease (AD) has not been elucidated. Methods In this longitudinal study, a total of 269 patients with mild cognitive impairment or early dementia due to AD with the evidence of brain β‐amyloid deposition were followed‐up for a mean period of 4 years. Five‐year normalized hourly cumulative exposure value of each air pollutant, such as carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter (PM2.5 and PM10), was computed based on nationwide air pollution database. The effects of chronic exposure to air pollution on longitudinal cognitive decline rate were evaluated using linear mixed models. Results Higher chronic exposure to SO2 was associated with a faster decline in memory score, whereas chronic exposure to CO, NO2, and PM10 were not associated with the rate of cognitive decline. Higher chronic exposure to PM2.5 was associated with a faster decline in visuospatial score in apolipoprotein E ε4 carriers. These effects remained significant even after adjusting for potential confounders. Interpretation Our findings suggest that chronic exposure to SO2 and PM2.5 is associated with faster clinical progression in AD.

Abstract An adequate blood supply to meet the energy demands is essential for any tissue, particularly for high energy demand tissues such as the retina. A critical question is: How is the dynamic match between neuronal demands and blood supply achieved? We present a quantitative assessment of temporal and spatial variations in perfusion in the macular capillary network in 10 healthy human subjects using a non-invasive and label-free imaging technique. The assessment is based on the calculation of the coefficient of variation (CoV) of the perfusion signal from arterioles, venules and capillaries from a sequence of optical coherence tomography angiography images centred on the fovea. Significant heterogeneity of the spatial and temporal variation was found within arterioles, venules and capillary networks. The CoV values of the capillaries and smallest vessels were significantly higher than that in the larger vessels. Our results demonstrate the presence of significant heterogeneity of spatial and temporal variation within each element of the macular microvasculature, particularly in the capillaries and finer vessels. Our findings suggest that the dynamic match between neuronal demands and blood supply is achieved by frequent alteration of local blood flow evidenced by capillary perfusion variations both spatially and temporally in the macular region.

Abstract This study aimed to investigate functional brain connectivity in patients with end-stage renal disease (ESRD) undergoing hemodialysis using functional near-infrared spectroscopy (fNIRS) and to analyze the effect of hemodialysis on functional brain connectivity. We prospectively enrolled patients with ESRD undergoing hemodialysis for > 6 months without any history of neurological or psychiatric disorders. fNIRS data were acquired using a NIRSIT Lite device. Measurements were performed thrice in the resting state for each patient: before the start of hemodialysis (pre-HD), 1 h after the start of hemodialysis (mid-HD), and after the end of hemodialysis (post-HD). We processed and exported all data, and created a weighted connectivity matrix using Pearson correlation analysis. We obtained functional connectivity measures from the connectivity matrix by applying a graph theoretical analysis. We then compared differences in functional connectivity measures according to hemodialysis status in patients with ESRD. We included 34 patients with ESRD. There were significant changes in the mean clustering coefficient, transitivity, and assortative coefficient between the pre- and post-HD periods (0.353 vs. 0.399, p = 0.047; 0.523 vs. 0.600, p = 0.042; and 0.043 vs. − 0.012, p = 0.044, respectively). However, there were no changes in the mean clustering coefficient, transitivity, and assortative coefficient between the pre- and mid-HD periods, or between the mid- and post-HD periods. In addition, there were no significant differences in the average strength, global efficiency, and local efficiency among the pre-, mid-, and post-HD periods. We demonstrated a significant effect of hemodialysis on functional brain connectivity in patients with ESRD. Functional brain connectivity changes more efficiently during hemodialysis.

Most of the current crop row detection algorithms focus on extracting crop canopy rows as location information. However, for some high-pole crops, due to the transverse deviation of the position of the canopy and roots, the agricultural machinery can easily cause the wheel to crush the crop when it is automatically driven. In fact, it is more accurate to use the crop root row as the feature for its location calibration, so a method of crop root row detection is proposed in this paper. Firstly, the ROI (region of interest) of the crop canopy is extracted by a semantic segmentation algorithm, then crop canopy row detection lines are extracted by the horizontal strip division and the midpoint clustering method within the ROI. Next, the Crop Root Representation Learning Model learns the Representation of the crop canopy row and crop root row to obtain the Alignment Equation. Finally, the crop canopy row detection lines are modified according to the Alignment Equation parameters to obtain crop root row detection lines. The average processing time of a single frame image (960 × 540 pix) is 30.49 ms, and the accuracy is 97.1%. The research has important guiding significance for the intelligent navigation, tilling, and fertilization operation of agricultural machinery.

Oxidative stress increases the apoptosis of intestinal epithelial cells and impairs intestinal epithelial cell renewal, which further promotes intestinal barrier dysfunction and even death. Extensive evidence supports that resveratrol and apigenin have antioxidant, anti-inflammatory, and antiproliferative properties. Here, we investigated the ability of these two compounds to alleviate diquat-induced jejunal oxidative stress and morphological injury, using the duck as a model, as well as the effects of apigenin on oxidative stress induced by H2O2 in immortalized duck intestinal epithelial cells (IDECs). Ducks were randomly assigned to the following four groups, with five replicates: a control (CON) group, a diquat-challenged (DIQ) group, a resveratrol (500 mg/kg) + diquat (RES) group, and an apigenin (500 mg/kg) + diquat (API) group. We found that serum catalase (CAT) activity and total antioxidant capacity (T-AOC) markedly reduced in the RES and API groups as compared to the DIQ group (p < 0.05); moreover, serum S superoxide dismutase (SOD) levels increased significantly in the API group as compared to the DIQ group (p < 0.05). In jejunal mucosa, the malondialdehyde (MDA) content in the RES and API groups decreased more than that in the DIQ group (p < 0.05). In addition, the jejunal expression levels of the NRF2 and GCLM genes in the RES and API groups increased notably compared with those in the DIQ group (p < 0.05); meanwhile, CAT activity in the RES and API groups was markedly elevated compared with that in the CON group (p < 0.05). In IDECs, apigenin significantly restrained the H2O2-mediated increase in MDA content and decrease in CAT levels (p < 0.05). Furthermore, apigenin increased the protein expression of p-NRF2, NRF2, p-AKT, and p-P38; downregulated that of cleaved caspase-3 and cleaved caspase-9; and reduced the ratio of Bax/Bcl-2 in H2O2-treated IDECs (p < 0.05). In conclusion, resveratrol and apigenin can be used as natural feed additives to protect against jejunal oxidative stress in ducks.

Abstract Introduction To investigate changes in the multilayer network in patients with migraine compared to healthy controls. Methods: This study enrolled 82 patients with newly diagnosed migraine without aura and 53 healthy controls. Brain magnetic resonance imaging (MRI) was conducted using a 3‐tesla MRI scanner, including three‐dimensional T1‐weighted and diffusion tensor imaging (DTI). A gray matter layer matrix was created with a morphometric similarity network using T1‐weighted imaging and the FreeSurfer program. A white matter layer matrix was also created with structural connectivity using the DTI studio (DSI) program. A multilayer network analysis was then performed by applying graph theory using the BRAPH program. Results Significant changes were observed in the multilayer network at the global level in patients with migraines compared to the healthy controls. The multilayer modularity (0.177 vs. 0.160, p = .0005) and average multiplex participation (0.934 vs. 0.924, p = .002) were higher in patients with migraines than in the healthy controls. In contrast, the average multilayer clustering coefficient (0.406 vs. 0.461, p = .0005), average overlapping strength (56.061 vs. 61.676, p = .0005), and average weighted multiplex participation (0.847 vs. 0.878, p = .0005) were lower in patients with migraine than in the healthy controls. In addition, several regions showed significant changes in the multilayer network at the nodal level, including multiplex participation, multilayer clustering coefficients, overlapping strengths, and weighted multiplex participation. Conclusion This study demonstrated significant changes in the multilayer network in patients with migraines compared to healthy controls. This could aid an understanding of the complex brain network in patients with migraine and may be associated with the pathophysiology of migraines. Patients with migraine show multilayer network changes in widespreading brain regions compared to healthy controls, and specific brain areas seem to play a hub role for pathophysiology of the migraine.

AbstractBackground Probabilistic graphical modelling (PGM) can be used to predict risk at the individual patient level and show multiple outcomes and exposures in a single model.Objective To develop PGM for the prediction of clinical outcome in patients with degenerative cervical myelopathy (DCM) after posterior decompression and to use PGM to identify causal predictors of the outcome.Methods We included data from 59 patients who had undergone cervical posterior decompression for DCM. The candidate predictive parameters were age, sex, body mass index, trauma history, symptom duration, preoperative and last Japanese Orthopaedic Association (JOA) scores, gait impairment, claudication, bladder dysfunction, Nurick grade, American Spinal Injury Association (ASIA) grade, smoking, diabetes mellitus, cardiopulmonary disorders, hypertension, stroke, Parkinson’s disease, dementia, psychiatric disorders, arthritis, ossification of the posterior longitudinal ligament, cord signal change, postoperative kyphosis and the cord compression ratio.Results In regression analyses, preoperative JOA (PreJOA) score, presence of a psychiatric disorder, and ASIA grade were identified as significant factors associated with the last JOS score. Dementia, sex, PreJOA score and gait impairment were causal factors in the PGM. Sex, dementia and PreJOA score were direct causal factors related to the last follow-up JOA (LastJOA) score. Being female, having dementia, and having a low PreJOA score were significantly related to having a low LastJOA score.Conclusions The causal predictors of surgical outcome for DCM were sex, dementia and PreJOA score. Therefore, PGM may be a useful personalized medicine tool for predicting the outcome of patients with DCM.

Abstract We aimed to investigate the alterations of thalamic nuclei volumes and intrinsic thalamic network in patients with primary restless legs syndrome (RLS) compared to healthy controls. Seventy-one patients with primary RLS and 55 healthy controls were recruited. They underwent brain MRI using a three-tesla MRI scanner, including three-dimensional T1-weighted images. The intrinsic thalamic network was determined using graph theoretical analysis. The right and left whole thalamic volumes, and the right pulvinar inferior, left ventral posterolateral, left medial ventral, and left pulvinar inferior nuclei volumes in the patients with RLS were lower than those in healthy controls (0.433 vs. 0.447%, p = 0.034; 0.482 vs. 0.502%, p = 0.016; 0.013 vs. 0.015%, p = 0.031; 0.062 vs. 0.065%, p = 0.035; 0.001 vs. 0.001%, p = 0.034; 0.018 vs. 0.020%, p = 0.043; respectively). There was also a difference in the intrinsic thalamic network between the groups. The assortative coefficient in patients with RLS was higher than that in healthy controls (0.0318 vs. − 0.0358, p = 0.048). We demonstrated the alterations of thalamic nuclei volumes and intrinsic thalamic network in patients with RLS compared to healthy controls. These changes might be related to RLS pathophysiology and suggest the pivotal role of the thalamus in RLS symptoms.

Hongdian Li,1,&ast; Ao Dong,1,&ast; Na Li,1 Yu Ma,1 Sai Zhang,1 Yuanyuan Deng,1 Shu Chen,1 Mianzhi Zhang1,2 1Department of Nephrology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 2Department of Nephrology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Mianzhi Zhang, Email zhangmianzhi@vip.sina.comBackground: Diabetic kidney disease (DKD) is a major cause of end-stage renal disease (ESRD), and inflammation is the main causative mechanism. Schisandra chinensis fruit Mixture (SM) is an herbal formulation that has been used for a long time to treat DKD. However, its pharmacological and molecular mechanisms have not been clearly elucidated. The aim of this study was to investigate the potential mechanisms of SM for the treatment of DKD through network pharmacology, molecular docking and experimental validation.Methods: The chemical components in SM were comprehensively identified and collected using liquid chromatography-tandem mass spectrometry (LC-MS) and database mining. The mechanisms were investigated using a network pharmacology, including obtaining SM-DKD intersection targets, completing protein–protein interactions (PPI) by Cytoscape to obtain key potential targets, and then revealing potential mechanisms of SM for DKD by GO and KEGG pathway enrichment analysis. The important pathways and phenotypes screened by the network analysis were validated experimentally in vivo. Finally, the core active ingredients were screened by molecular docking.Results: A total of 53 active ingredients of SM were retrieved by database and LC-MS, and 143 common targets of DKD and SM were identified; KEGG and PPI showed that SM most likely exerted anti-DKD effects by regulating the expression of AGEs/RAGE signaling pathway-related inflammatory factors. In addition, our experimental validation results showed that SM improved renal function and pathological changes in DKD rats, down-regulated AGEs/RAGE signaling pathway, and further down-regulated the expression of TNF-α, IL-1β, IL-6, and up-regulated IL-10. Molecular docking confirmed the tight binding properties between (+)-aristolone, a core component of SM, and key targets.Conclusion: This study reveals that SM improves the inflammatory response of DKD through AGEs/RAGE signaling pathway, thus providing a novel idea for the clinical treatment of DKD.Keywords: Schisandra chinensis fruit mixture, diabetic kidney disease, traditional Chinese medicine, network pharmacology, molecular docking

Taking the Wapo collapse area in Yuan’an County as an example, a three-dimensional model was established by drone aerial photography, geological survey and field mapping. Based on Rockfall Analyst (RA) analysis software, a large number of three-dimensional rockfalls in the Wapo collapse area were studied. The motion path, height, energy and other factors in the space were simulated to explore the three-dimensional motion characteristics of rockfalls. The risk assessment of rockfalls in the collapsed area was carried out to guide the prevention and control of the rockfalls. The research results showed that the main failure form of the dangerous rock was the toppling, and it was in an under-stable state at present; the three-dimensional motion trajectory of the simulated rockfall basically coincided with the existing rockfall point which indicating the simulation results were in good agreement with the actual situation; The mode of motion of the rocks were collision, bounce and free fall. Rockfalls were mainly concentrated in the gullies and roads but a few rocks reached residential areas. Therefore, the roads, gullies and the right side of the collapse area were in high risk area; Dangerous rock mass and boulders removal and passive protective nets were adopt as the prevention engineering,two passive protection nets which were 5 m high and 3 m high respectively were set on the inner side of the road and below the slope, and a net with an impact resistance of 2 000 kJ could effectively intercept falling rocks.

GH3536 superalloy was fabricated using Selective Laser Melting (SLM) to investigate the effect of process parameters including the laser power and scanning speed on the density, microscopic defects and surface quality of GH3536 samples. According to the measurement of density, it can be found that the density of samples increases rapidly when the laser energy density is less than 57.0 J/mm3, the density of samples fluctuates within the range of 8.30 g/cm3-8.35 g/cm3 as the laser energy density increases from 57.0 J/mm3 to 187.0 J/mm3, while the density of samples decreases slightly when the laser energy further increases. The conclusion is that the inadequate or excessive energy input reduces the density of samples. The metallographic observation shows that there are a large number of lack-of-fusion defects when the laser energy is insufficient. However, when the input laser energy is too much, many evenly distributed microcracks and gas pores appear inside of samples, indicating that defects are the main reason for low density of samples. The optimal process parameters of SLM-processed GH3536 alloy are determined by the statistical analysis of spatter particles which might cause irregular defects. Tensile properties of the sample fabricated under 175 W and 700 mm/s are tested at room temperature and the results show that the SLM-ed GH3536 superalloy has good tensile properties at room temperature.

Understanding the relationships of productivity performance and water utilization and soil nitrogen dynamics after annual forage planting during the fallow period (F) in winter wheat (Triticum aestivum L.; W) mono-cropping is critically important for maintaining sustainable livestock and grain production in semiarid regions. We used 2 years (2017–2019) of data to investigate soil nitrogen dynamics, production, water utilization, and fallow efficiency when forage rape (Brassica campestris L.; R) and common vetch (Vicia sativa L.; V) were planted in a 3-month summer fallow of the W-F-W-F cropping system. Three cropping systems were comprised of winter wheat-summer fallow-winter wheat-summer fallow (W-F-W-F), winter wheat-forage rape-winter wheat-forage rape (W-R-W-R), and winter wheat-forage rape-winter wheat-common vetch (W-R-W-V). The results showed that the annual forage planting decreased the average NO3−-N content by 54.8% compared with the W-F-W-F cropping system. Compared with the W-F-W-F cropping system, planting annual forage in summer fallow increased the average system forage production by 4.93 t ha−1. Local total annual precipitation can meet crop-water requirements, and the limiting factor for agricultural production was the drought due to the uneven seasonal distribution of precipitation. In comparison to the W-F-W-F cropping system, annual forage planting decreased the average available soil moisture storage by 50.3 mm above the 80 cm soil layer. Compared with that in the W-R-W-R (23.21 t ha−1) and W-F-W-F (30.25 t ha−1) cropping systems, the crop productivity in the W-R-W-V cropping system (33.23 t ha−1) was relatively stable and high because the reduction in subsequent winter wheat yield (2.96 t ha−1) was adequately offset by the forage yield (5.15 t ha−1). Adding forage rape to the W-F-W-F cropping system decreased system crop-water productivity (CWP) by 40.9%. However, the CWP, precipitation use efficiency (PUE), and soil nitrate in the W-R-W-V cropping system increased by 30.4, 30.1, 110.9, and 82.0%, respectively, compared with those in the W-R-W-R cropping system. Therefore, the W-R-W-V cropping system is recommended for better water and fertility management as well as grain and forage production in semiarid regions. However, further study is required to involve drought years for better evaluation of the effect of long-term precipitation variability on the crop productivity.