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Displaced fragility fractures of the pelvis (FFP) pose significant challenges in orthopaedic trauma, owing to patient comorbidities, deteriorating bone quality, and surgical complexities. Despite technological advancements, no robotic methods have been documented for displaced FFP management. To address this, we introduced an advanced robot-assisted fracture reduction system, comprising a tracking device, path planning software, and robotic arms. This study evaluated fifteen consecutive patients with displaced FFP (average age 80.4 ± 9.1 years), who underwent robot-assisted reduction and internal fixation (RARIF) between January 2022 and May 2023. All were categorized as Rommens FFP type III, with a median time of 6 days (range 4–11) from injury to surgery. Operative times averaged 165 ± 44 min, with median blood loss of 50 mL. Postoperative radiographs showed all patients achieved excellent or good reductions as per Matta criteria, marking a 100 % success rate. A 6-month follow-up revealed an average modified Majeed score of 81.4, with 85.7 % of patients rated excellent or good. All fractures healed without complications. Leveraging our intelligent system, RARIF proves to be a safe and effective approach for displaced FFP, facilitating postoperative pain alleviation and early mobilization despite compromised health and bone conditions. This approach may revolutionize the management of FFP in an increasingly aging population, signaling a significant shift in therapeutic strategies.Translational Potential of this Article: Elderly patients with displaced FFP often present complex surgical challenges due to comorbidities and poor bone quality, complicating reduction procedures and often leading to ineffective fixation. Addressing these challenges, we have developed an innovative robot-assisted fracture reduction system, offering a practical alternative to conventional methods. This system optimizes the applied force and direction during the reduction process, thereby reducing the needs for manual and repetitive attempts. Our report, detailing the successful implementation of this technique in 15 FFP cases, signifies a considerable leap forward in the field of orthopaedic surgery. This technique notably benefits the elderly population, a group traditionally marginalized in receiving care for complex orthopedic conditions.

Abstract Oxidative stress (OS) is strongly implicated in the pathophysiology of major depressive disorder (MDD) but the molecular mechanisms remain largely unknown. The purpose of this study is to identify genes related to both OS and MDD, and further to evaluate the utility of these genes as diagnostic markers and potential treatment targets. We searched datasets related to MDD from the Gene Expression Omnibus (GEO) database for differentially expressed genes (DEGs) also related to OS according to GeneCards. Bioinformatics analyses and machine learning algorithms were used to identify hub genes mediating OS–MDD interactions. A summary data-based Mendelian randomization (SMR) approach was employed to identify possible causal genes for MDD from blood tissue eQLT data. These investigations identified 32 genes mediating OS–MDD interactions, while SMR analysis identified KCNE1 (OR = 1.057, 95%CI = 1.013–1.102, P value = 0.010), MAPK3 (OR = 1.023, 95%CI = 1.004–1.043, P value = 0.020), and STIP1 (OR = 0.792, 95%CI = 0.641–0.979, P value = 0.031) as OS-related causal genes for MDD. These genes may thus serve as useful diagnostic markers and potential therapeutic targets.

Abstract Objective Employing whole‐exome sequencing (WES) technology to investigate the etiology of infantile epileptic spasm syndrome (IESS), and determining whether different etiologies exhibit phenotypic variations, while elucidating the potential associated factors, might improve short‐term responses to first‐line treatment. Methods We retrospectively evaluated patients with IESS admitted for treatment between January 2018 and June 2023. Clinical phenotypic differences among etiological classifications and clinical manifestations were analyzed. Variable selection using the best subset method was performed, followed by logistic regression analysis to identify the factors influencing treatment response. Results A total of 577 patients were included; 412 completed trio‐WES. Magnetic resonance imaging abnormalities were detected in 387 patients (67.1%). Patients with etiology as structural abnormalities were likelier to have non‐spasms at the initial seizure onset. A total of 532 patients completed the first‐line treatment; 273 patients received it for the first time at our hospital (initial response rates: 30.1% and 42.1%, respectively). The response group had a lower proportion of early‐onset seizures (≤3 months) than the no‐response group (11.3% vs. 23.7%, p

Abstract To improve the heat extraction efficiency from the wellbore fluids to the stratum in the geothermal well, thermal insulation cement, which contains of waste glass powder as a heat-insulating material, is proposed to apply in geothermal well’s middle and upper sections in the paper. Effect of such glass powers on mechanic and thermal property of thermal insulation cement was then investigated. Various tests were carried out to measure compressive strength, thermal conductivity, microstructure porosity etc. parameters of the thermal insulation cement. Results showed that the waste glass powder would enhance its the compressive strength and improve its the thermal insulation performance. Correlation study between contents of the added waste glass powder in geothermal cements and its mechanic and thermal property was conducted. It was found that thermal insulation cement exhibited its optimum performance when the added content of glass powers was 20% in weight. Analysis of the microstructure porosity with SEM found that the pores in thermal insulation cement with added waste glass powders were mostly closed, tiny and even, and therefore contributed to the compressive strength of the thermal insulation cement; such pores would be also beneficial to improving its thermal insulation performance.

Fiberglass-reinforced ultraviolet cured-in-place pipe (UV–CIPP) composite material is one of the most trenchless materials for underground pipelines’ rehabilitation. In this paper, the bending resistance and damage evolution mechanism of glass fiber-reinforced UV-CIPP composites were investigated under the influence of glass fiber structure, the number of layers of glass fibers, the angle of fiber layups, and the thickness of the material by high-definition video, SEM and infrared thermal imaging. The results indicate that the damage evolution modes of UV-CIPP materials mainly include: (1) fiber pull-out and overall fiber bundle tensile failure caused by strong interfacial bonding, (2) fiber/matrix debonding and delamination, fiber fracture, and matrix cracking caused by weak interfacial bonding. Furthermore, among the seven different fiberglass structures of UV-CIPP materials, the [0°/90°] warp-knit axial/short-cut felt fiberglass fabric exhibit the best flexural performance, with a bending strength of 412 MPa and a bending modulus of 16.1 GPa for the 4 layers glass fiber fabric. Moreover, in the bending process of UV-CIPP materials, the surface temperature rises primarily due to fiber break, the temperature transition aligning with the stress transition. Finally, the energy release is mainly caused by the failure of the glass fibers, but the resin contributed comparatively little. This study provides a scientific reference for the structural design and optimization of UV-CIPP materials.

ObjectiveTo evaluate the safety and efficacy of employing LEO stents in dual stent-assisted embolization (DSAE) for wide-necked intracranial bifurcation aneurysms, and to assess the effectiveness of combined IA and IV intra-procedural infusion of tirofiban in mitigating perioperative complications.MethodsClinical data and follow-up images from 562 patients with wide-necked intracranial bifurcation aneurysms treated at First Affiliated Hospital of Army Medical University from 2018–2022 were collected. Among them, 65 received DSAE with LEO stents. The study observed treatment success rates, procedure-related complications, perioperative thromboembolic events (TEs) and hemorrhagic events (HEs), immediate postoperative modified Raymond-Roy classification (mRR), and follow-up imaging. Glasgow Outcome Scale (GOS) at discharge and clinical follow-ups were recorded.ResultsThe study enrolled 65 patients (mean age: 56.77 ± 10.07) with wide-necked intracranial bifurcation aneurysms. Among them, 58 had unruptured aneurysms, 7 ruptured (Hunt-Hess II-III). All aneurysms were successfully embolized without significant stent or bleeding complications. Only one case had intraoprative thrombosis; two postoperative ischemic incidents occurred within three days, no severe bleeding events. Immediate imaging showed modified Raymond-Roy classification: mRRC I (92.3%), mRRC II (4.6%), mRRC III b (3.1%). A total of 43 patients were followed up postoperatively with DSA. Among them, 41 patients exhibited mRRC I, while 2 patients exhibited mRRC II. No aneurysm was recanalized. Discharge GOS: GOS 5–60, GOS 4–1, GOS 3–4. One patient, GOS 1, died from lung cancer; others improved.ConclusionThe utilization of LEO stents for dual stent-assisted embolization of wide-necked intracranial bifurcation aneurysms demonstrated remarkable success and safety, yielding favorable postoperative outcomes and no instances of aneurysm recurrence. The concomitant administration of perioperative antiplatelet medications alongside IA and IV intra-procedural infusion of tirofiban effectively attenuated thromboembolic events (TEs) without concomitant elevations in bleeding risks.

Objective: To investigate the efficacy and safety of MMA embolization in patients with CSDH who failed atorvastatin treatment. Methods: Seventeen CSDH patients who failed atorvastatin treatment from Jan 1, 2021 to Dec 31, 2021 were included in the study. All patients were treated with MMA embolization using polyvinyl alcohol (PVA) particles. Results: Twenty-six MMAs (unilateral embolization in 8 patients and bilateral embolization in 9 patients) were successfully embolized in all patients. Hematoma re-accumulated in only one patient (5.9%) after MMA embolization and was surgically evacuated. Procedural adverse events, mortality, or complications were not observed. At the last follow-up of an average of 51.5 days post MMA embolization, maximum hematoma thickness improved in 95.2% of CSDHs with a mean reduction of 52.1%, while mRS score improved in 94.1% of patients. In addition, 5 (29.4%) patients with unilateral hematoma underwent bilateral MMA embolization and hematoma absorbed completely in all 5 cases. Conclusions: MMA embolization may be a minimally invasive alternative to surgical evacuation for CSDH patients resistant to atorvastatin. In unilateral CSDH, bilateral superselective angiography and bilateral MMA embolization could be a useful and effective treatment strategy.

Abstract Background Several biallelic truncating and missense variants of the gem nuclear organelle–associated protein 5 (GEMIN5) gene have been reported to cause neurodevelopmental disorders characterized by cerebellar atrophy, intellectual disability, and motor dysfunction. However, the association between biallelic GEMIN5 variants and early‐infantile developmental and epileptic encephalopathies (EIDEEs) has not been reported. Purpose This study aimed to expand the phenotypic spectrum of GEMIN5 and explore the correlations between epilepsy and molecular sub‐regional locations. Methods We performed whole‐exome sequencing in two patients with EIDEE with unexplained etiologies. The damaging effects of variants were predicted using multiple in silico tools and modeling. All reported patients with GEMIN5 pathogenic variants and detailed neurological phenotypes were analyzed to evaluate the genotype–phenotype relationship. Results Novel biallelic GEMIN5 variants were identified in two unrelated female patients with EIDEE, including a frameshift variant (Hg19, chr5:154284147‐154284148delCT: NM_015465: c.2551_c.2552delCT: p.(Leu851fs*30)), a nonsense mutation (Hg19, chr5:154299603‐154299603delTinsAGA: NM_015465: c.1523delTinsAGA: p.(Leu508*)), and two missense variants (Hg19, chr5:154282663T > A: NM_015465: c.2705T > A: p.(Leu902Gln) and Hg19, chr5:154281002C > G: NM_015465: c.2911C > G: p.(Gln971Glu)), which were inherited from asymptomatic parents and predicted to be damaging or probably damaging using in silico tools. Except p.Leu508*, all these mutations are located in tetratricopeptide repeat (TPR) domain. Our two female patients presented with seizures less than 1 month after birth, followed by clusters of spasms. Brain magnetic resonance imaging suggests dysgenesis of the corpus callosum and cerebellar hypoplasia. Video electroencephalogram showed suppression‐bursts. Through a literature review, we found 5 published papers reporting 48 patients with biallelic variants in GEMIN5. Eight of 48 patients have epilepsy, and 5 patients started before 1 year old, which reminds us of the relevance between GEMIN5 variants and EIDEE. Further analysis of the 49 GEMIN5 variants in those 50 patients demonstrated that variants in TPR‐like domain or RBS domain were more likely to be associated with epilepsy. Conclusions We found novel biallelic variants of GEMIN5 in two individuals with EIDEE and expanded the clinical phenotypes of GEMIN5 variants. It is suggested that the GEMIN5 gene should be added to the EIDEE gene panel to aid in the clinical diagnosis of EIDEE and to help determine patient prognosis.

Abstract Depression is highly prevalent and easily relapses. Psychological interventions are effective for the prevention of depression relapse. This systematic review and network meta-analysis aimed to compare the efficacy at the same follow-up time points of psychological interventions in depression. We searched PubMed, Embase, and PsycINFO via OVID, and the Cochrane Library published up to December 12, 2021, and PubMed up to July 1, 2022. The primary outcome was depression relapse, considering the same time points that were extracted on survival curves or relapse curves. The study protocol was registered with PROSPERO, CRD42022343327. A total of 2,871 patients were included from 25 RCTs. Mindfulness-based cognitive therapy (MBCT) was significantly better than placebo at the 3 months, the 6 months, and the 9 months at follow-up. Cognitive behavioral therapy (CBT) was significantly better than treatment as usual at the 3 months, the 9 months, the 12 months, and the 15 months at follow-up. CBT was significantly better than placebo at the 21 months and the 24 months at follow-up. Behavioral activation therapy was significantly better than placebo at the 21 months and the 24 months at follow-up. Interpersonal psychotherapy was significantly better than placebo at the 24-month follow-up. All psychological interventions included in the study were significantly better than supportive counseling most of the time. The results were robust in various sensitivity and subgroup analyses. In conclusion, MBCT had a continuous effect in preventing relapse of depression. CBT had the longest but not continuous effect in preventing relapse of depression. The effects of behavioral activation therapy and interpersonal therapy for the prevention of depression appeared late. All psychological interventions included in the study were more effective than supportive counseling. More evidence is needed from large comparative trials that provide long-term follow-up data.

Abstract Objective Biallelic variants of RARS1, a gene that encodes the cytoplasmic tRNA synthetase for arginine (ArgRS), are associated with central nervous system (CNS) manifestations, such as hypomyelinating leukodystrophy‐9 and developmental and epileptic encephalopathy (DEE). This study aimed to better understand the RARS1 biallelic mutations and the associated phenotypes, particularly in patients with DEE. Methods We identified two patients with RARS1 biallelic mutations and functionally validated these mutations in vitro. Furthermore, we performed a review of the literature. Results Two patients with hypomyelinating leukodystrophy were found to have RARS1 biallelic variants (Patient 1: c.1535G>A (p.Arg512Gln) and c.1382G>A (p.Arg461His); Patient 2: homozygous variants c.5A>T (p.Asp2Val)). Patient 2 had a severe clinical manifestation of DEE. A review of the literature identified 27 patients from five studies. Among the 29 patients, intellectual disability, developmental delay, and hypomyelination were the common symptoms, while 13 of them exhibited DEE and malformations of cortical development. Of the 25 variants identified, c.5A>G (p.Asp2Gly) was identified in 10 patients. ArgRS protein expression and stability were substantially reduced in the two newly identified patients. Significance Patients with RARS1 biallelic mutations frequently exhibit DEE, a severe phenotype, along with hypomyelinating leukodystrophy. Besides its effects on the white matter, this mutation also influences cortical development. Moreover, the variants c.5A>T (p.Asp2Val), c.1382G>A (p.Arg461His), and c.1535G>A (p.Arg512Gln) are pathogenic and affect the expression of ArgRS by reducing the protein stability.

Gear transmission systems are widely used in ship propulsion systems, but, during operations, they produce serious vibration and noise problems, reducing the fatigue life of gears and affecting the performance of ships and the comfort of operators. Taking into account the complex frequencies and vibration components of gear transmission systems, this study conducted wide-band vibration suppression and noise reduction research on a gear transmission system using an integral squeeze film damper (ISFD), providing a novel approach for reducing vibration and noise in gear transmission systems. By conducting a simulation analysis and numerical calculations, the ISFD was analyzed via a static analysis and a dynamic analysis. We developed an experimental platform for reducing vibration and noise in gear transmission systems using sliding bearings, and the experiments were conducted under different speed and load conditions to study the vibration suppression and noise reduction of gears based on the ISFD. The experimental results show that the ISFD has good vibration suppression capabilities for gears at different speeds, with a horizontal vibration reduction of 75.44% and a vertical vibration reduction of 68.48% at 2400 r/min. The ISFD has wide-band vibration suppression capabilities, especially for mesh frequency and twice-mesh frequency, with a vibration reduction of 86.96% or more. Moreover, the ISFD has good vibration suppression capabilities for gears at different load torques, with a reduction of more than 35% in all directions. In addition, the ISFD also has noise reduction capabilities, reducing the gears’ noise by 1.92 dB at different speeds.

Abstract Background Major perioperative complications of stent‐assisted embolization treated for aneurysmal subarachnoid hemorrhage patients include the formation of thromboembolic events (TEs) and hemorrhagic events (HEs), for which antiplatelet protocols play a key role. Methods We conducted a single‐center retrospective analysis to compare the differences between arteriovenous tirofiban administration with traditional oral dual antiplatelet therapy (DAPT). A total of 417 consecutive patients were enrolled. General clinical characteristics, as well as the perioperative ischemic and hemorrhagic events, were retracted in digital documents. Logistic regression was conducted to identify both risk and protective factors of perioperative TEs and HEs. Results Perioperative TEs occurred in 21 patients, with an overall perioperative TEs rate of approximately 5.04%; among these patients, the incidence of perioperative TEs in the tirofiban group was less than that in the DAPT group. Additionally, 66 patients developed perioperative HEs, with an incidence of approximately 15.83%; among these patients, the incidence of perioperative HEs was less than that in the DAPT group. No significant differences were seen between the two groups in terms of the mRS score at the time of discharge. Conclusion This study indicated that an improved perioperative antiplatelet drug tirofiban was an independent protective factor for perioperative TEs in stent‐assisted embolization of ruptured intracranial aneurysms, but it did not impart an elevated risk of perioperative HEs and had no significant effects on the near‐term prognosis of the patients.

HNRNPA2B1 is a member of the HNRNP family, which is associated with telomere function, mRNA translation, and splicing, and plays an important role in tumor development. To date, there have been no pan-cancer studies of HNRNPA2B1, particularly within the TME. Therefore, we conducted a pan-cancer analysis of HNRNPA2B1 using TCGA data. Based on datasets from TCGA, TARGET, Genotype-Tissue Expression, and Human Protein Atlas, we employed a range of bioinformatics approaches to explore the potential oncogenic role of HNRNPA2B1. This included analyzing the association of HNRNPA2B1 expression with prognosis, tumor mutation burden (TMB), microsatellite instability (MSI), immune response, and immune cell infiltration of individual tumors. We further validated the bioinformatic findings using immunohistochemistry techniques. HNRNPA2B1 was found to be differentially expressed across most tumor types in TCGA’s pan-cancer database and was predictive of poorer clinical staging and survival status. HNRNPA2B1 expression was also closely linked to TMB, MSI, tumor stemness, and chemotherapy response. HNRNPA2B1 plays a significant role in the TME and is involved in the regulation of novel immunotherapies. Its expression is significantly associated with the infiltration of macrophages, dendritic cells, NK cells, and T cells. Furthermore, HNRNPA2B1 is closely associated with immune checkpoints, immune-stimulatory genes, immune-inhibitory genes, MHC genes, chemokines, and chemokine receptors. We performed a comprehensive evaluation of HNRNPA2B1, revealing its potential role as a prognostic indicator for patients and its immunomodulatory functions.

ObjectiveTo the literature, variants in the ATP6AP2 gene may cause abnormal nervous system development and associated neurological symptoms.MethodsWe report a patient with developmental and epileptic encephalopathy (DEE) carrying an ATP6AP2 c.858G > A (p.Ala286=) synonymous variant. In addition, an overview of reported patients with the same variant were collected and summarized to compare our findings.ResultsThe patient started experiencing tonic seizures at 3.5 months of age, and magnetic resonance imaging (MRI) indicated impaired brain white matter development and reduced left hippocampal volume. Furthermore, electroencephalography showed multifocal interictal epileptiform discharges. Treatment with various anti-seizure medications yielded unsatisfactory results, and the disorder eventually developed into epileptic spasms. An in vitro splicing assay for the ATP6AP2 gene mRNA revealed that the variant caused a deletion in exon 8 and a corresponding protein truncation. A review of previously reported ATP6AP2-related DEE patients found that synonymous variants in the ATP6AP2 gene can cause early DEE onset, progressive changes in early-life MRI, and exon skipping in all ATP6AP2-related DEE patients.SignificanceWe found that synonymous variants in ATP6AP2 may have significant pathogenicity and are highly correlated with DEE. Due to increased isoform production, ATP6AP2 synonymous variants may cause nervous system developmental disorders by competitively reducing the generation of full-length transcripts, resulting in defects in ATP6AP2-related physiological processes.

Abstract Introduction Sotos syndrome (SS) is an overgrowth disease characterized by distinctive facial features, advanced bone age, macrocephaly, and developmental delay is associated with alterations in the NSD1 gene. Here, we report a case of a 4‐year‐old female child with SS caused by NSD1 gene nonsense mutation. Methods Whole‐exome sequencing (WES) was applied for probands and her parents. Sanger sequencing was used to confirm the mutation. We performed the literature review using PubMed and found 12 articles and 14 patients who presented with SS. Results The patient showed typical facial features of SS, hand deformities, and seizure. WES revealed de novo heterozygous variant: NSD1 (NM_022455.5), c.6095G > A, p.TRP2032*. We also reviewed the phenotype spectrum of 14 patients with SS, who exhibited a variety of clinical phenotypes, including developmental delay, seizures, scoliosis, hearing loss, cardiac and urinary system abnormalities, and so on. Discussion The lack of correlation between mutation sites or types and phenotypes was summarized by literature reviewing. The NSD1 protein contains 14 functional domains and this nonsense mutation was located in SET domain. Early appearance of the termination codon leads to protein truncation. Haploinsufficiency of the NSD1 gene causes the overgrowth disorders.

Abstract The development of fifth‐generation technology has resulted in increased demand for materials with low dielectric losses and superior thermal and mechanical properties. However, ensuring the widespread use of such materials by investigating their aging mechanisms and operating lifetimes remains challenging. In this study, a glass‐fiber (GF)‐reinforced acrylate‐styrene‐acrylonitrile/polycarbonate (ASA/GF/PC) composite is designed and comprehensively investigated its aging behavior, mechanism, and service lifetime under long‐term hygrothermal conditions. Based on the general Peck model, the composite maintains a high level of quality for over 10 years, including under harsh conditions of 40 °C and 80% relative humidity. The aging mechanism is primarily ascribed to cracking between the GF fibers and matrix, the breaking of chemical bonds, the generation of new cross‐linked domains, and physical aging. These findings provide valuable insights into the long‐term utilization of ASA/GF/PC composites in harsh environments.

Steel slag and waste clay bricks are two prevalent solid waste materials generated during industrial production. The complex chemical compositions of these materials present challenges to their utilization in conventional alumina silicate ceramics manufacturing. A new type of ceramic tile, which utilizes steel slag and waste clay brick as raw materials, has been successfully developed in order to effectively utilize these solid wastes. The optimal composition of the ceramic material was determined through orthogonal experimentation, during which the effects of the sample molding pressure, the soaking time, and the sintering temperature on the ceramic properties were studied. The results show that the optimal ceramic tile formula was 45% steel slag, 35% waste clay bricks, and 25% talc. The optimal process parameters for this composition included a molding pressure of 25 MPa, a sintering temperature of 1190 °C, and a soaking time of 60 min. The prepared ceramic tile samples had compositions in which solid waste accounted for more than 76% of the total material. Additionally, they possessed a modulus of rupture of more than 73.2 MPa and a corresponding water absorption rate of less than 0.05%.

BackgroundFocal cortical dysplasia (FCD) IIb and tuberous sclerosis complex (TSC) are common causes of drug-resistant epilepsy in children. However, the etiologies related to the development of FCD IIb and TSC are not fully understood. α-synuclein (α-syn) is a member of synucleins family that plays crucial roles in modulating synaptic transmission in central nervous system. Here, we explored the expression profiles and potential pathogenic functions of α-syn in cortical lesions of epileptic patients with FCD IIb and TSC.MethodsSurgical specimens from epileptic patients with FCD IIb and TSC, as well as FCD rats generated by in utero X-ray-radiation were adopted in this study and studied with immunohistochemistry, immunofluorescence, western blotting, and co-immunoprecipitation etc. molecular biological techniques.ResultOur results showed that α-syn expression was reduced in FCD IIb and TSC lesions. Specifically, α-syn protein was intensely expressed in dysplastic neurons (DNs) and balloon cells (BCs) in FCD IIb lesions, whereas was barely detected in DNs and giant cells (GCs) of TSC lesions. Additionally, p-α-syn, the aggregated form of α-syn, was detected in DNs, BCs, GCs, and glia-like cells of FCD IIb and TSC lesions. We previous showed that the function of N-methyl-D-aspartate receptor (NMDAR) was enhanced in FCD rats generated by X-ray-radiation. Here, we found the interaction between α-syn and NMDAR subunits NMDAR2A, NMDAR2B were augmented in cortical lesions of FCD patients and FCD rats.ConclusionThese results suggested a potential role of α-syn in the pathogenesis of FCD IIb and TSC by interfering with NMDAR.

Abstract Background Postoperative fever is one of the common complications in neurosurgery, and intracranial aseptic inflammation and infection are important risk factors. Continuous drainage of cerebrospinal fluid (CSF) via lumbar drainage (LD) is often used in the treatment of postoperative intracranial infection or aseptic inflammation. Compared with the previously reported placement of LD after the onset of meningitis symptoms, we designed this randomized controlled trial (RCT) to evaluate the effectiveness and safety of early drainage (1st day postoperation) of CSF using the preset lumbar cistern to prevent delayed fever (fever occurred after the third day postoperation) or reduce its treatment time after cerebellopontine angle (CPA) tumour surgery. Methods Patients suffering from CPA tumours and who underwent resection of the tumour with an intraoperative dura opening time > 4 h are recruited for this study. The study is a 2-arm RCT to compare the early LD group and the no early LD group. Postoperative duration and rate of delayed fever and postoperative length of stay (LOS), as the main outcomes, will be compared in the two groups. Discussion Here, we present the study design of a prospective RCT to evaluate the safety and efficacy of using preoperative preset LD to treat or reduce postoperative delayed fever. Trial registration China Clinical Trial Registry ChiCTR2100049057. Registered on July 20, 2021.

Abstract Background The TiRobot is the only robot that has been reported in the literature for posterior pelvic injuries. We aim to compare TiRobot-assisted pelvic screw fixation with the conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation. Methods We conducted a meta-analysis to identify studies involving TiRobot‑assisted versus conventional percutaneous sacroiliac screw fixation for pelvic ring injuries in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and WanFang database, up to April 2022. The following keywords were used: “TiRobot,” “robot,” “robotic,” “pelvic fracture,” “screw fixation,” “percutaneous,” and “pelvic ring injury.” Pooled effects of this meta-analysis were calculated using STATA SE version 15.0. Results Compared with conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation, TiRobot will result in less radiation exposure time of screw implantation (P = 0.000), less frequency of intraoperative fluoroscopy (P = 0.000), fewer guide wire attempts (P = 0.000), less intraoperative blood loss (P = 0.005), better screw accuracy (P = 0.011), better Majeed score (P = 0.031), and higher overall excellent and good rates of Majeed score (P = 0.018). However, there were no significant differences in terms of operative time (P = 0.055), fracture healing time (P = 0.365), and overall excellent and good rate of reduction accuracy (P = 0.426) between the two groups. Conclusion TiRobot-assisted fixation has less intraoperative fluoroscopy and intraoperative blood loss, superior screw accuracy, and Majeed score compared with conventional percutaneous sacroiliac screw fixation. TiRobot has no significant effect on operative time, fracture healing time, and reduction accuracy. Given the relevant possible biases in our meta-analysis, we required more adequately powered and better-designed RCT studies with long-term follow-up to reach a firmer conclusion.

BackgroundThis meta-analysis was dedicated to evaluating the safety and effectiveness of indocyanine green (ICG) -mediated fluorescence molecular imaging (FMI) technology in liver tumors resection.MethodsA literature search of PubMed, Embase databases, Cochrane Library, and Web of Science was performed to identify all clinical controlled studies exploring the effects of fluorescence imaging on liver tumors resection. Quality assessment and data extraction of studies were conducted independently by 3 reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software.Results14 retrospective cohort studies (RCSs) involving a total of 1227 patients were finally included. The results showed that Fluorescence-assisted liver tumors resection could improve the R0 resection rate (OR = 2.63; 95% CI: 1.46~4.73, p = 0.001), reduce overall complications (OR = 0.66; 95% CI: 0.44~0.97, p = 0.04), biliary fistula (OR = 0.20; 95% CI: 0.05~0.77, p = 0.02), intraoperative blood loss (MD = −70.76, 95% CI: −106.11 to −35.41; p < 0.0001), and shortens hospital stay (MD = −1.41, 95% CI: −1.90 to −0.92; p < 0.00001). There were no significant differences in the incidences of operative time (MD = −8.68, 95% CI: −18.59 to −1.22; p = 0.09), complications of grade III or above (OR = 0.73; 95% CI: 0.43~1.25, p = 0.26), liver failure (OR = 0.86; 95% CI: 0.39~1.89, p = 0.71), and blood transfusion (OR = 0.66; 95% CI: 0.42~1.03, p = 0.07).ConclusionCurrent evidence suggests that ICG-mediated FMI technology could enhance the clinical effectiveness of patients with liver tumors resection and is clinically worthy of promotion.Systematic review registrationPROSPERO, identifier CRD42022368387.

Abstract Traditional design, manufacturing and maintenance are run and managed independently under their own rules and regulations in an increasingly time-and-cost ineffective manner. A unified platform for efficient and intelligent design-manufacturing-maintenance of mechanical equipment and systems is highly needed in this rapidly digitized world. In this work, the definition of digital twin and its research progress and associated challenges in the design, manufacturing and maintenance of engineering components and equipment were thoroughly reviewed. It is indicated that digital twin concept and associated technology provide a feasible solution for the integration of design-manufacturing-maintenance as it has behaved in the entire lifecycle of products. For this aim, a framework for information-physical combination, in which a more accurate design, a defect-free manufacturing, a more intelligent maintenance, and a more advanced sensing technology, is prospected.

BackgroundFecal microbiota transplantation (FMT) may be helpful in the treatment of autism spectrum disorder (ASD) as rebalancing the gut microbiome has been shown to potentially improve behavioral symptoms in children with ASD.MethodsThis systematic review was conducted to assess the effect of FMT for children with ASD. The Embase, PubMed, Web of Science, and Cochrane Library databases were searched for articles published from inception to October 6, 2022. Two reviewers independently screened the identified records and undertook data extraction.ResultsThe search identified a total of five studies: two prospective open-label studies, two retrospective observational studies, and a case report; however, no randomized controlled trial was identified. All five studies reported a significant post-FMT-treatment improvement in neuropsychological assessment of ASD. The two prospective open-label studies suggested that the Autism Behavior Checklist (ABC) score, and the Social Responsiveness Scale (SRS) score at the posttreatment assessment decreased from the baseline (Wilcoxon signed-rank test; all p < 0.01]). The two retrospective observational studies suggested that FMT helped to improve the ASD symptoms. One observational study reported that the Childhood Autism Rating Scale (CARS) score and ABC score of the constipation group decreased from the baseline after the second course assessment (CARS [baseline: mean 35.25 ± standard deviation 4.36, second course: 32.5 ± 3.1, p = 0.015]; ABC [baseline: 56.21 ± 16.08, second course: 46.54 ± 16.54, p = 0.046]). Another observational study found that both ABC and CARS scores decreased as the number of FMT courses increased, and significant differences were found at the end of each course as compared with the baseline.ConclusionCompared with the baseline, FMT significantly improved symptoms of autism in children with ASD in observational studies. However, rigorously designed randomized controlled clinical trials are needed to establish the safety and efficacy of FMT as a treatment for ASD.

Abstract Introduction Pelvic fracture is a severe high-energy injury with the highest disability and mortality of all fractures. Traditional open surgery is associated with extensive soft tissue damages and many complications. Minimally invasive surgery potentially mitigates the risks of open surgical procedures and is becoming a new standard for pelvic fracture treatment. The accurate reduction has been recognized as the cornerstone of minimally invasive surgery for pelvic fracture. At present, the closed reduction in pelvic fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces of soft tissue involved in the fragment manipulation, which might result in fracture malreduction. To overcome these shortcomings and facilitate pelvic fracture reduction, we developed an intelligent robot-assisted fracture reduction (RAFR) system for pelvic fracture. Methods The presented method is divided into three parts. The first part is the preparation of 20 pelvic fracture models. In the second part, we offer an automatic reduction algorithm of our robotic reduction system, including Intraoperative real-time 3D navigation, reduction path planning, control and fixation, and robotic-assisted fracture reduction. In the third part, image registration accuracy and fracture reduction accuracy were calculated and analyzed. Results All 20 pelvic fracture bone models were reduced by the RAFR system; the mean registration error E1 of the 20 models was 1.29 ± 0.57 mm. The mean reduction error E2 of the 20 models was 2.72 ± 0.82 mm. The global error analysis of registration and reduction results showed that higher errors are mainly located at the edge of the pelvis, such as the iliac wing. Conclusion The accuracy of image registration error and fracture reduction error in our study was excellent, which could reach the requirements of the clinical environment. Our study demonstrated the precision and effectiveness of our RAFR system and its applicability and usability in clinical practice, thus paving the way toward robot minimally invasive pelvic fracture surgeries.

Nowadays, digital images are widely used in various services. The emergence of more and more image editing algorithms has made image forensic approaches to be severely challenged. Driven by the emergence of forged images, more and more image forensic methods are proposed to evaluate the authenticity of digital images. However, in some privacy-related image forensics areas, the scarcity of data affects their development. In this paper, we investigate a document image generation scheme based on face swapping and distortion generation to generate document image databases at a low cost. First, we propose an IDNet for editing face content and text content in digital document images. Second, we propose a Distortion Simulation Network (DSNet) for simulating print-and-scan distortion, and the generated data can be used to study a novel document attack type called recapture attack. Third, we use the database generated by our proposed method to assist in training document image recapture forensic networks. A qualitative comparison with existing methods illustrates that the image content generated by our proposed method maintains more complete semantic information and higher image quality. Quantitative results have confirmed that with the addition of the generated database, the performance of the model improves by about 8% measured in AUC.

The purpose of this study was to examine the efficacy of ICG-mediated fluorescence molecular imaging (FMI) in debridement of necrotic tissue. 96 wound-infected rats were randomly divided into control group, ICG group, excitation light (EL)group and FMI group for debridement of necrotic tissue (n = 24). (I) Control group: only debridement; (II) ICG group: ICG injection before debridement; (III) EL group: Debridement under EL; (IV) FMI group: Debridement guided by ICG-mediated FMI. On the 3rd, 6th, and 9th days, the wound tissues of the rats in each group were collected for histological examination, and the levels of serum interleukin-4 (IL-4) and interferon-γ (INF-γ) were analyzed. The wound healing rate, wound score and body weight of the rats in each group were followed up until the wound healed. The results showed that the infected wounds of the rats in the FMI group had significant fluorescence development. The level of serum IL-4 in the FMI group was higher than that in the other three groups on the 6th day (p

The "3S" technology and soil chemical methods were used to study the change and ecological restored effect of sandy desertification land in Yulin City of Mu Us sandy land during the past 45 years. The results show that: the intensity of sandy desertification land in the study area was mainly mild and moderate, and the restored mode was mainly artificial restoration; the distributed area and the intensity of sandy desertification land from 1975 to 2019 showed the desertification developed rapidly and then deteriorated, the development of sandy desertification from 1975 to 2007 was closely related to human activities such as overgrazing, wasteland reclamation and mineral resources development, and the reversal from 2007 to 2019 was closely related to the implementation of ecological control policies and control projects; the soil nutrient content of the artificial restored area was better than the natural restored area, the different causes of sandy desertification land was very different under the same natural restored conditions; combined the artificial restored method and the natural restored method, artificial vegetation construction is proved to be a effective way to promote natural vegetation restoring and ecological restoration in the study area.

Purpose: Rapid decompressive craniectomy (DC) was the most effective method for the treatment of hypertensive intracerebral hemorrhage (HICH) with cerebral hernia, but the mortality and disability rate is still high. We suspected that hematoma puncture drainage (PD) + DC may improve the therapeutic effect and thus compared the combined surgery with DC alone. Methods: From December 2013 to July 2019, patients with HICH from Linzhi, Tibet and Honghe, Yunnan Province were retrospectively analyzed. The selection criteria were as follows: (1) altitude ≥1500 m; (2) HICH patients with cerebral hernia; (3) Glascow coma scale score of 4–8 and time from onset to admission ≤3 h; (4) good liver and kidney function; and (5) complete case data. The included patients were divided into DC group and PD + DC group. The patients were followed up for 6 months. The outcome was assessed by Glasgow outcome scale (GOS) score, Kaplan-Meier survival curve and correlation between time from admission to operation and prognosis. A good outcome was defined as independent (GOS score, 4-5) and poor outcome defined as dependent (GOS score, 3-1). All data analyses were performed using SPSS 19, and comparison between two groups was conducted using separate t-tests or Chi-square tests. Results: A total of 65 patients was included. The age ranged 34-90 years (mean, 63.00 ± 14.04 years). Among them, 31 patients had the operation of PD + DC, whereas 34 patients underwent DC. The two groups had no significant difference in the basic characteristics. After 6 months of follow-up, in the PD + DC group there were 8 death, 4 vegetative state, 4 severe disability (GOS score 1-3, poor outcome 51.6 %); 8 moderate disability, and 7 good recovery (GOS score 4-5, good outcome 48.4 %); while in the DC group the result was 15 death, 6 vegetative state, 5 severe disability (poor outcome 76.5 %), 4 moderate disability and 4 good recovery (good outcome 23.5 %). The GOS score and good outcome were significantly less in DC group than in PD + DC group (Z = −1.993, p = 0.046; χ2 = 4.38, p = 0.043). However, there was no significant difference regarding the survival curve between PD + DC group and DC group. The correlation between the time from admission to operation and GOS at 6 months (r = −0.41, R2 = 0.002, p = 0.829) was not significant in the PD + DC group, but significant in the DC group (r = −0.357, R2 = 0.128, p = 0.038). Conclusion: PD + DC treatment can improve the good outcomes better than DC treatment for HICH with cerebral hernia at a high altitude.

Based on conventional meteorological observations, observational data from the regional automatic weather stations, NCEP reanalysis data with spatial resolution of 1°×1° and temporal resolution of 6 h, satellite images, Doppler weather radar and wind profiler data, as well as the retrieval results from BeijingVariational Doppler Radar Analysis System (VDRAS), we have conducted analysis of the precipitation characteristics, atmospheric circulation, mesoscale system evolution features and the causes of a regional warm-sector torrential rain event in the Beijing-Tianjin-Hebei region on 12 August 2020. The results show that the event occurs in the warm air mass below 500 hPa at the edge of the subtropical high, and the main influencing systems are the low-level jet and the warm shear line at the 850 hPa. The whole severe precipitation event presented clearly the phased characteristics; it can be divided into two stages corresponding to the two different rainstorm areas, i.e., the southern Hebei and the north part of the Beijing-Tianjin-Hebei region with different formation mechanisms. The severe precipitation in the first stage is caused by a meso-α-scale convective system (MαCS), which is triggered by the surface convergence line. Before the precipitation starts, the local water vapor and unstable energy is rich. When the surface convergence line triggers the release of unstable energy, a strong linear echo is formed. The severe precipitation is mainly caused by the continuous development of convective cells in the spiral echo corresponding to the surface cyclonic circulation. The severe precipitation in the second stage is generated by several β-scale cloud clusters, and the southerly low-level jet strengthened northward provides sufficient water vapor and better dynamic conditions for the occurrence of torrential rain. The low-level jet in the boundary layer and the mesoscale low vortex system are the crucial influence systems at the second stage of this event. The hourly extremely severe precipitation of 125.9 mm at a station in Xiongan New Area is caused jointly by the warm cloud precipitation at the tail of comma-shaped radar echo and the "train effect".

Abstract Background Focal cortical dysplasia type IIb (FCDIIb) and tuberous sclerosis complex (TSC) show persistent neuroinflammation, which promotes epileptogenesis and epilepsy progression, suggesting that endogenous resolution of inflammation is inadequate to relieve neuronal network hyperexcitability. To explore the potential roles of formyl peptide receptor 2 (FPR2), which is a key regulator of inflammation resolution, in epilepsy caused by FCDIIb and TSC, we examined the expression and cellular distribution of FPR2. Method The expression of FPR2 and nuclear factor‐κB (NF‐κB) signaling pathway was examined by real‐time PCR, western blots, and analyzed via one‐way analysis of variance. The distribution of FPR2 was detected using immunostaining. The expression of resolvin D1 (RvD1, the endogenous ligand of FPR2) was observed via enzyme‐linked immunosorbent assay. Pearson's correlation test was used to evaluate the correlation between the expression levels of FPR2 and RvD1 and the clinical variants. Results The expression of FPR2 was significantly lower in FCDIIb (p = .0146) and TSC (p = .0006) cortical lesions than in controls, as was the expression of RvD1 (FCDIIb: p = .00431; TSC: p = .0439). Weak FPR2 immunoreactivity was observed in dysmorphic neurons (DNs), balloon cells (BCs), and giant cells (GCs) in FCDIIb and TSC tissues. Moreover, FPR2 was mainly distributed in dysplastic neurons; it was sparse in microglia and nearly absent in astrocytes. The NF‐κB pathway was significantly activated in patients with FCDIIb and TSC, and the protein level of NF‐κB was negatively correlated with the protein level of FPR2 (FCDIIb: p = .00395; TSC: p = .0399). In addition, the protein level of FPR2 was negatively correlated with seizure frequency in FCDIIb (p = .0434) and TSC (p = .0351) patients. Conclusion In summary, these results showed that the expression and specific distribution of FPR2 may be involved in epilepsy caused by FCDIIb and TSC, indicating that downregulation of FPR2 mediated the dysfunction of neuroinflammation resolution in FCDIIb and TSC.

ObjectivesTraumatic intracerebellar hematoma (TICH) is a very rare entity with a high morbidity and mortality rate, and there is no consensus on its optimal surgical management. In particular, whether and when to place external ventricle drainage in TICH patients without acute hydrocephalus pre-operation is still controversial.MethodsA single-institutional, retrospective analysis of total of 47 TICH patients with craniectomy hematoma evacuation in a tertiary medical center from January 2009 to October 2020 was performed. Primary outcomes were mortality in hospital and neurological function evaluated by GOS at discharge and 6 months after the ictus. Special attention was paid to the significance of external ventricular drainage (EVD) in TICH patients without acute hydrocephalus on admission.ResultsAnalysis of the clinical characteristics of the TICH patients revealed that the odds of use of EVD were seen in patients with IVH, fourth ventricle compression, and acute hydrocephalus. Placement of EVD at the bedside can significantly improve the GCS score before craniotomy, as well as the neurological score at discharge and 6 months. Compared with the only hematoma evacuation (HE) group, there is a trend that EVD can reduce hospital mortality and decrease the occurrence of delayed hydrocephalus, although the difference is not statistically significant. In addition, EVD can reduce the average NICU stay time, but has no effect on the total length of stay. Moreover, our data showed that EVD did not increase the risk of associated bleeding and intracranial infection. Interestingly, in terms of neurological function at discharge and 6 month after the ictus, even though without acute hydrocephalus on admission, the TICH patients can still benefit from EVD insertion.ConclusionFor TICH patients, perioperative EVD is safe and can significantly improve neurological prognosis. Especially for patients whose GCS dropped by more than 2 points before the operation, EVD can significantly improve the patient's GCS score, reduce the risk of herniation, and gain more time for surgical preparation. Even for TICH patients without acute hydrocephalus on admission CT scan, EVD placement still has positive clinical significance.

The isoleucine–glutamine (IQ) motif and Sec7 domain-containing protein 2 (IQSEC2) gene, located at Xp11. 2, are associated with nervous system diseases, such as epilepsy, autism, and intellectual disabilities. Gender-related differences in the severity of phenotype severity have been described previously. Here, we report the details of seven male children with IQSEC2 mutations from different families. During this investigation, we explored the relationship between the genotype and phenotype of IQSEC2 mutations; to do so, we recruited seven children with pathogenic/likely pathogenic IQSEC2 mutations who were diagnosed with global developmental delay and/or epilepsy. Their clinical features were assessed, and Trio-based whole-exome sequencing (trio WES) was conducted in seven pedigrees. A variety of algorithms and computational tools were used to calculate the pathogenicity, protein stability, conservation, side chain properties, and protein-protein interactions of mutated proteins. The seven patients ranged in age from 18 months to 5 years. Among them, six children were found to have both developmental delay and epilepsy, and one child only exhibited developmental delay. Four novel mutations (c.316C > T, c.443_4 44dup, c.3235T > C, and c.1417G > T) were newly reported. Two patients did not have truncated aberrant proteins caused by missense mutations. Still, they did have severe phenotypes, such as early-onset epilepsy in infancy, because the mutations were located in domains like the pleckstrin homology and IQ calmodulin-binding motif domains. The bioinformatics analysis also proved that missense mutations may be located in the functional region, which affects protein stability and is harmful. In summary, severe phenotypes, such as early-onset epilepsy in infancy, occur in male patients with a missense mutation in specific domains (e.g., pleckstrin homology and IQ calmodulin-binding motif domains). Some female individuals with IQSEC2 mutations may be asymptomatic because of the skewed inactivation of the X chromosome.

Background and purposeFollowing mechanical thrombectomy (MT), patients with large artery occlusive acute ischemic stroke (LAO-AIS) often have cerebral herniation due to its complications, resulting in poor prognosis. Decompressive craniectomy (DC) can markedly improve patient prognosis. This study aimed to verify the predictive value of clinical parameters such as the systemic immune-inflammatory index (SII) for DC in patients with LAO-AIS after MT.MethodsClinical data of a total of 173 patients with LAO-AIS treated with MT between January 2020 and January 2022 were retrospectively analyzed. Patients receiving DC were grouped into an experimental group or a control group (no DC). The patients were randomly divided into the training set (n = 126, 75%) and validation set (n = 43, 25%). Multivariate logistic regression was used to construct a nomogram predictive model.ResultsThe SII value in the experimental group (median: 2851.1×109/L) was significantly higher than that in the control group (median: 1898.6 × 109/L) (P = 0.019). Receiver operating characteristic (ROC) analyses showed that the best cutoff value of the SII was 2505.7 × 109/L with a sensitivity of 55%, a specificity of 75.8%, and an area under the curve (AUC) of 0.649. Multivariate logistic regression indicated that the SII was an independent predictor for performing DC in patients with LAO-AIS after MT (OR = 3.579, 95% CI = 1.360–9.422, P = 0.01). The AUC was 0.728 in the training set and 0.583 in the validation set. The average error of the calibration curve was 0.032 in the training set and 0.023 in the validation set. The average error was relatively small and consistent in the training set and validation set. The C-index of the nomogram was 0.804 suggesting good accuracy.ConclusionsThe SII at admission is an independent predictor for the requirement of DC in patients with LAO-AIS after MT. The SII-based nomogram helps doctors make decisions on whether DC is needed timely and rationally, and thereby may improve the prognosis of these patients.

Bimetallic catalysts, especially non-noble metals, hold great potential for substituting for noble metals in catalytic hydrogenation. In present study, a series of CoxNiy (x + y = 6) bimetallic catalysts were prepared through the impregnation–reduction method and cyclohexene was chosen as probe-molecule to study the promotion effect of Co on the catalytic olefin hydrogenation reactions. Meanwhile, density functional theory (DFT) was utilized to investigate the formation energies and the charge distribution of CoNi bimetals, as well as the transition state (TS) searches for hydrogen dissociation and migration. The results suggest that bimetals tend to have superior catalytic performance than pure metals, and Co3Ni3 shows the highest catalytic activity on the cyclohexene hydrogenation. It was found that the charge transfer from Co to Ni and the alloying give rise to the refinement of CoNi grains and the improvement of its catalytic activity and stability. Thus, it may be possible to obtain better catalytic performance by tuning the metal/metal atomic ratio of bimetals.

Background and Objective: The guidelines on the factors to determine whether a patient with concomitant stroke and hip fracture is a good candidate for surgical hip repair are still debatable. This study was carried out to investigate the relationship between the management of acute hip fracture and the recovery of neurological function and prognosis in patients with concomitant acute cerebral infarction. Methods: Thirty patients with acute cerebral infarction combined with acute hip fracture, who were hospitalized and did not accept surgical treatment, and matched 60 cases as control group having acute cerebral infarction without hip fracture admitted in the same period were selected. The neurological function recovery, hospitalization period, 6 months recovery rate, frequency of complications, and 1 year mortality rate between the groups were compared. Results: Compared with common acute cerebral infarction patients, the NIH Stroke Scale/Score of acute cerebral infarction group with hip fracture was higher (7.2 ± 5.4 vs. 5.6 ± 4.3, p = 0.034). The hospitalization period was prolonged (16.1 ± 8.9 vs. 12.2 ± 5.3, p = 0.041), and 6 months recovery rate was lower (26.7% vs. 53.3%, p = 0.016), the frequency of pulmonary infection and lower extremity deep vein thrombosis was higher (30% vs. 11.7%, p = 0.03; 6.7% vs. 0, p = 0.043). The 1-year mortality rate in patients with combined hip fracture was higher than in patients with cerebral infarction only. Conclusion: Acute cerebral infarction combined with hip fracture lead to worse neurological recovery, prolonged hospitalization period, increased complications, decreased patient prognosis, and increased 1 year mortality. Surgical treatment of hip fracture with concomitant acute cerebral infarction may improve the prognosis of patients. According to the statistics of neurological function and mortality after 1 year of follow-up, the prognosis of patients with Modified Rankin Scale below 3 was considered good.

We report a rare case of spontaneous biliary pleural fistula in a patient whose diagnosis was aided by the use of near-infrared I/II fluorescence imaging. When both 99mTc-mebrofenin hepatobiliary scintigraphy and CT examination were diagnostically difficult, we found strong fluorescent signals in the patient’s pleural drainage fluid and sputum using NIR I/II fluorescence imaging, and therefore diagnosed the patient with a biliary pleural fistula. This provides a safe and effective test for diagnosing biliary pleural fistulas.

The aim of this study was to develop a brief version of cognitive assessment test for evaluating the efficacy of treatments targeting cognitive impairments in Chinese schizophrenia patients, to examine its reliability, and establish normative data. Stratified according to age, gender, and educational level, healthy adult subjects were recruited from fifteen institutions in seven administrative regions of China and 723 valid samples were obtained, of which 50 were retested. Generalized Linear Models were conducted to analyze the effects of age, sex, and education. There was no significant difference between genders, while significant effects were demonstrated respectively among age and education on the normative data of C-BCT. The Cronbach α of C-BCT is 0.75, and the test-retest reliability (ICC) ranged from 0.62 to 0.76. Normative data of C-BCT were generated by gender, age and education, and the effects of these demographic factors were analyzed. It revealed good internal consistency and test-retest reliability of C-BCT.

Abstract Background Sleep disturbance and executive function impairment are common in patients with major depressive disorder (MDD), though the relationship between the two remains unclear. We investigated this association in first-episode, treatment-naïve patients with MDD. Methods We analyzed data from 242 patients with MDD. We divided the patients into 2 groups based on sleep disturbance severity and compared the executive function odds ratios between the groups. Results A total of 121 pairs of patients were matched (age 39.4 ± 10.1, 70.2% female). After propensity score matching, the odds ratios for cognitive impairment in patients with MDD and severe sleep disturbance were 1.922 (1.068–3.459, P = 0.029, q = 0.044) in executive functioning; 2.023 (1.211–3.379, P = 0.007, q = 0.021) in executive shifting. Conclusions Sleep disturbance is associated with executive functioning impairment in first-episode, treatment-naïve patients with MDD. Severe sleep disturbance can be a marker and aid in recognizing executive function impairment in patients with first-episode treatment-naïve MDD. Severe sleep disturbance can be a potential modifiable factor to improve executive function in MDD, as well as an effective measurement to improve cognition for sleep symptom management that should be enforced at initial treatment of first-episode MDD. Further study is required to confirm our results. Trial registration ClinicalTrials.gov: NCT02023567 ; registration date: December 2013.

Abstract Background Despite advances in decompressive craniectomy (DC) for the treatment of traumatic brain injury (TBI), these patients are at risk of having a poor long-term prognosis. The aim of this study was to predict 1-year mortality in TBI patients undergoing DC using logistic regression and random tree models. Methods This was a retrospective analysis of TBI patients undergoing DC from January 1, 2015, to April 25, 2019. Patient demographic characteristics, biochemical tests, and intraoperative factors were collected. One-year mortality prognostic models were developed using multivariate logistic regression and random tree algorithms. The overall accuracy, sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs) were used to evaluate model performance. Results Of the 230 patients, 70 (30.4%) died within 1 year. Older age (OR, 1.066; 95% CI, 1.045–1.087; P < 0.001), higher Glasgow Coma Score (GCS) (OR, 0.737; 95% CI, 0.660–0.824; P < 0.001), higher d-dimer (OR, 1.005; 95% CI, 1.001–1.009; P = 0.015), coagulopathy (OR, 2.965; 95% CI, 1.808–4.864; P < 0.001), hypotension (OR, 3.862; 95% CI, 2.176–6.855; P < 0.001), and completely effaced basal cisterns (OR, 3.766; 95% CI, 2.255–6.290; P < 0.001) were independent predictors of 1-year mortality. Random forest demonstrated better performance for 1-year mortality prediction, which achieved an overall accuracy of 0.810, sensitivity of 0.833, specificity of 0.800, and AUC of 0.830 on the testing data compared to the logistic regression model. Conclusions The random forest model showed relatively good predictive performance for 1-year mortality in TBI patients undergoing DC. Further external tests are required to verify our prognostic model.

Abstract Background Cerebral fat embolism (CFE) syndrome at high altitude was rare complicated with paroxysmal sympathetic hyperactivity (PSH) syndrome and septic shock. It is a challenge to differential diagnosis and treatment at high altitude. Case presentation This case presents a CFE with PSH and septic shock of a 23-year-old man occurred at high altitude of 3800 m above sea level, transferred by airplane successfully and cured in the department of neurosurgery, Xi’an Tangdu Hospital. Conclusions It is key that CFE with PSH can be rapid diagnosed and treatment bundles of septic shock should be initiated as soon as possible. Early neurological rehabilitation played an important role for good outcome.

Dimensionality reduction is a hot research topic in pattern recognition. Traditional dimensionality reduction methods can be separated into linear dimensionality reduction methods and nonlinear dimensionality reduction methods. Linear dimensionality reduction methods usually utilize Euclidean distances to explore global geometric structures, and nonlinear dimensionality reduction methods can preserve local manifold structures in learned low-dimensional subspaces. However, redundant information and noises of the raw high-dimensional data restrict the classification performance of these methods. To solve the problem, we propose a novel orthogonal dimensionality reduction method based on twin eigen decomposition called orthogonal locality and globality preserving projections (OLGPP). Orthogonality, as a commonly used criterion in pattern recognition, is insensitive to the redundant information and the noises. OLGPP not only combines the advantages of global Euclidean structures and local manifold structures, but also is insensitive to the redundant information and noises of the raw high-dimensional data by embedding the orthogonality criterion. Additionally, the objective function based on twin eigen decomposition can be solved sequentially to obtain analytical solutions. On four well-known datasets, we design extensive experiments to evaluate the performance of OLGPP. From the experimental results, OLGPP has the optimal experimental results, and its average recognition rates are about 10% higher than the classic local dimensionality reduction method (i.e., locality preserving projection), which proves OLGPP is an effective dimensionality reduction method.

TiO₂-Ta₂O₅-CaCO₃ varistor ceramics were prepared by hot isostatic pressing (HIP) and annealed in oxygen and nitrogen, respectively. The nonlinear coefficient α, the breakdown voltage EB and the leakage current JL of samples were tested using a varistor dc parameter meter. The average barrier height ΦB of the unannealed samples and the samples annealed in oxygen and nitrogen was calculated. The microstructure of samples was analyzed by STEM-EDS, XRD and SEM. TiO₂-Ta₂O₅-CaCO₃ varistor ceramics with uniform microstructure, fine grains and low porosity was obtained by HIP. By annealing, α increases, while EB and JL decrease. When annealing is performed in oxygen, the oxygen enrichment at the grain boundaries is also helpful to increase α and reduce JL. TiO₂-Ta₂O₅-CaCO₃ varistor ceramics with Ta₂O₅ and CaCO₃ contents of 0.20mol% sintered at 1200°C and annealed at 700°C for 3h in oxygen possesses best varistor performance with α =11.2, EB =22.6V.mm-1 and JL =8.7μA.cm-2.

Bipolar disorders (BDs) have high morbidity. The first onset of 27.7% of BDs occurs in children under 13 years and of 37.6% occurs in adolescents between 13 and 18 years. However, not all of the pediatric and adolescent patients with BD receive therapy in time. Therefore, studies about pediatric and adolescent patients with disorders have aroused increased attention in the scientific community. Pediatric and adolescent patients with BD present with a high prevalence rate (0.9–3.9%), and the pathogenic factors are mostly due to genetics and the environment; however, the pathological mechanisms remain unclear. Pediatric and adolescent patients with BD manifest differently from adults with BDs and the use of scales can be helpful for diagnosis and treatment evaluation. Pediatric and adolescent patients with BDs have been confirmed to have a high comorbidity rate with many other kinds of disorders. Both medication and psychological therapies have been shown to be safe and efficient methods for the treatment of BD. This review summarizes the research status related to the epidemiology, pathogenic factors, clinical manifestations, comorbidities, diagnostic and treatment scales, medications, and psychological therapies associated with BDs.

Pelvic fracture is among the most complicated fractures in traumatic orthopedics, with high mortality and morbidity rates. The main difficulty associated with the reduction surgery is significant muscle resistance. It then becomes necessary to decrease the reduction force against this strong muscle resistance, for improving surgical safety. Here, we propose a novel traction method for decreasing the reduction force during pelvic reduction, and investigate the performance of the elastic traction method on decreasing the reduction force using experimental tests and simulation-based analyses. From the experimental results, the reduction force decreased by 59.2% when 10 ​kg of elastic traction was applied. We also establish a musculoskeletal model of the pelvic fracture reduction, for analyzing the muscle resistance and the optimal traction force applied in reduction surgeries. The elastic traction method can counteract the muscle resistance increase in the non-traction direction owing to its flexibility. We conclude that the optimal traction force applied should be in the 10–15 ​kg range, and recommend adopting a dynamic traction strategy rather than continuous traction in clinical settings. Elastic traction is very promising for various surgeries that require traction, including pelvic reduction. It significantly reduces force, which can significantly reduce the physical exertion of the operating surgeon, the possibility of additional injuries to the operated patient, and promotes robot-assisted reduction surgeries.

This paper studies the stabilization problem for the non-diagonal inertia and damping matrices underactuated unmanned surface vessels (USVs) in the presence of unknown time varying environment disturbances and state constraints. In this framework, we first convert the mathematical model into a form of two subsystems, which is easier amenable for stabilization, by applying several transformations. It is proved that the investigated problem can be reduced to one of the second subsystem. A novel time-varying state feedback control scheme based on backstepping method and prescribed Lyapunov function is proposed to ensure state constraints and guarantee the global stability of the reduced control system, as well as sufficient conditions to ensure controller feasibility are given. With adaptive neural networks (NNs), the controller can be easily extended to compensate uncertainty induced by unknown time-varying external disturbances (e.g., wind, waves, and currents). It is proved that all the states and stabilization functions in the overall closed-loop are globally uniformly bounded. Finally, simulation results demonstrate the effectiveness of the proposed control scheme.

In this article, we analyze the signal-to-interference ratio (SIR) coverage probability of a multi-cell downlink system with random traffic arrivals. Based on a theoretical model, in which the base stations (BSs) and devices are deployed as independent Poisson point processes (PPPs), we first present the sufficient and necessary conditions of the ε-stable region for the queueing system. Then, by taking into account the impact of spatially queueing interactions among BSs, we focus on the steady status of the queues and introduce a two-queue-length approximated model for the system. Specifically, in the studied new model, the BSs are separated into two sets in the steady state: the long-queue BS set and the short-queue BS set. The locations of the former are modeled by a Neyman-Scott process and those of the latter are modeled as a residual hole process. By applying the first-order statistic approximation, we further approximate the hole process by a homogeneous PPP with the same density. To model the deployment of the BSs precisely, the related parameters in the approximated model are fitted. Using tools from stochastic geometry and queueing theory, we derive the SIR coverage probability in the steady state. An iterative algorithm is proposed to calculate the active probability of the BSs. To reduce the computational complexity, Beta distribution is applied to approximate the probability density function of the service rate in each iteration of the algorithm. Finally, the effect of the fitting parameters and the accuracy of our analysis are presented via Monte Carlo simulations.

This paper proposes a method for optimizing unbalanced force and unbalanced moment of the multistage disk based on sequence quadratic program algorithm to solve the vibration problem of gas turbine tie rod rotor. This method guides the assembly phase of the multistage disks. The influence of unbalanced force and unbalanced moment on the vibration of the tie rod rotor are analyzed based on the characteristics of rotor structure and assembly process. A dynamic model of the unbalanced force and unbalanced moment of the tie rod rotor is established. The sequence quadratic program algorithm is used to optimize multi-dimension of unbalanced force and moment, so the global optimal solution can be obtained. In order to verify the effectiveness of the optimization method proposed in this paper, vibration control experiments are carried out for traditional tie rod rotor and gas turbine tie rod rotor structure. The results show that both unbalanced force optimization and unbalanced moment optimization can control the tie rod rotor vibration effectively, and unbalanced moment optimization is better. Unbalanced moment optimization is used to perform constant speed and speed-up experiment on the gas turbine tie rod rotor structure. At 1200r/min, the maximum vibration reduction of the system is 76.68%. And the vibration has a decrease of 43.3% at the first-order critical speed. The proposed method in this paper can be used not only for the guidance of tie rod rotor assembly of gas turbine, but also for the vibration control during operation.

Objective The effects of Pleurotus ostreatus on the feed utilization of broad bean stalks (BBS), rape straw (RS), paddy straw (PS), and corn stalk (CS) was examined. Methods The four roughages were co-cultured with Pleurotus ostreatus. The chemical composition; enzyme activities of laccase, carboxymethylcellulase (CMCase) and xylanase; carbohydrate and protein fractions (based on The Cornell Net Carbohydrate and Protein System [CNCPS]) were assessed at different days after inoculation (7, 14, 21, 28 d) and un-inoculated roughages (control, 0 d). The digestibility of nutrient components and the gas production of roughage with various incubation times were monitored at 0, 2, 4, 6, 9, 12, 24, 36, 48, 60, and 72 h using an in vitro ruminal fermentation method. Results A higher CMCase activity (0.1039 U/mL) and earlier time to peak (14 d) were detected in Pleurotus ostreatus cultured with CS (p0.05) in slowly-degradable carbohydrate (CB2) at different incubation times (p