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Abstract Background Acute pain is a major concern after arthroscopic shoulder surgery, supraclavicular brachial plexus blockade has shown favorable postoperative analgesic effects. However, its duration of analgesia does not meet clinical needs. We aimed to explore whether the combination of different local anesthetic adjunct can prolong the analgesic duration of supraclavicular brachial plexus block for arthroscopic shoulder surgery. Methods In this prospective randomized controlled trial, we allocated 80 patients into four groups: Group DMD (dexamethasone 10 mg + ropivacaine 100 mg + dexmedetomidine 50 µg + magnesium sulfate 250 mg), Group DM (ropivacaine 100 mg + dexmedetomidine 50 µg + magnesium sulfate 250 mg), Group M (ropivacaine 100 mg + magnesium sulfate 250 mg) and Group D (ropivacaine 100 mg + dexmedetomidine 50 µg). The primary outcome was the time to first request for analgesia. Secondary outcome measures included cumulative opioid consumption at 6, 12, 18, 24, and 48 h postoperatively, VAS scores at 6, 12, 18, 24, and 48 h postoperatively and so on. Results The time to first request for analgesia in Group DMD was significantly longer than Group DM (P = 0.011) and Group M (P = 0.003). The cumulative opioid consumption at 18 h postoperatively in Group DMD was significantly lower than in Group DM (P = 0.002) and Group M (P = 0.007). The cumulative opioid consumption at 24 h postoperatively in Group DMD was significantly lower than in Group DM (P = 0.016). The VAS score at 6 h postoperatively in Group DMD was significantly lower than in Group DM and Group M. The VAS score at 12 h postoperatively in Group DMD was significantly lower than in Group M. For American Shoulder and Elbow Surgeons Score, Group DMD had a better score than Group DM and Group D. Conclusions The analgesic efficacy of supraclavicular brachial plexus blockade combined with dexamethasone, magnesium sulfate, and dexmedetomidine is significantly superior to the combination of magnesium sulfate and dexmedetomidine, and significantly superior to the use of magnesium sulfate alone. Trial registration This trial was registered in Chinese Clinical Trial Registry. (ChiCTR2200061181, Date of registration: June 15, 2022, http://www.chictr.org.cn )

Integrating territorial spatial planning with the spatial autocorrelation of cultivated land quality indices can enhance the optimization of farmland preservation and food security. This study combines the “three lines” demarcation—basic farmland protection line, ecological protection line, and urban development boundary—with farmland spatial autocorrelation to propose an improved model for optimizing farmland layout. We employed a four-dimensional farmland quality evaluation system that includes the natural quality index, utilization management index, ecological environment index, and economic value index. Using Liuhe District as a case study, we applied the optimal combination weighting method for quality assessment and conducted spatial autocorrelation analysis to simulate the indices’ relationships at the plot scale. The results indicate that: (1) The natural quality index is high in the west and low in the east, while the other indices are high in the center and low at the margins. (2) Each quality index exhibits positive geographic autocorrelation, with Moran’s I values of 0.89, 0.67, 0.65, and 0.83, respectively. (3) The optimization scheme increased permanent basic farmland by 123.15 hm² and improved the quality grade by 1.45, classifying land into four primary categories focused on protection and development. The permanent basic farmland protection zone has the highest quality and non-agricultural construction should be prohibited on it. The urban development buffer zone, which has poor farmland quality and a locational advantage, is ideal for urban growth. The ecological environmental protection zone, despite its poor farmland quality, should be focused on conservation. The comprehensive adjustment zone should address land obstructions and facilitate a transition to permanent basic farmland.

IntroductionGenitourinary syndrome of menopause (GSM) describes the symptoms and signs resulting from the effect of estrogen deficiency on the female genitourinary tract, including genital, urinary, and sexual symptoms. However, besides estrogen deficiency, little is known about the etiology of GSM. The objective of this study was to investigate the effects of vaginal microbiota dysbiosis on the occurrence and development of GSM in perimenopausal and postmenopausal women.MethodsIn total, 96 women were enrolled in this cross-sectional study and clinical data were collected. GSM symptoms were divided into three types: genital, urological, and sexual symptoms. Full-length 16S rRNA gene sequencing using the third-generation PacBio sequencing technology was performed to analyze the vaginal microbiome using vaginal swabs of non-GSM and GSM women with different types of GSM symptoms. Live Lactobacillus Capsule for Vaginal Use (LLCVU) treatment was used to verify the effects of Lactobacillus on GSM symptoms.ResultsWe found that 83.58% (56/67) of women experienced GSM symptoms in the perimenopausal and postmenopausal stages. Among these women with GSM, 23.21% (13/56), 23.21% (13/56), and 53.57% (30/56) had one type, two types, and three types of GSM symptoms, respectively. The richness and diversity of vaginal microbiota gradually increased from reproductive to postmenopausal women. There were significant differences in vaginal microbial community among non-GSM women and GSM women with different types of symptoms. Lactobacillus was found to be negatively associated with the onset, severity, and type of GSM while some bacteria, such as Escherichia-shigella, Anaerococcus, Finegoldia, Enterococcus, Peptoniphilus_harei, and Streptococcus, were found to be positively associated with these aspects of GSM, and these bacteria were especially associated with the types of genital and sexual symptoms in GSM women. LLCVU significantly relieved genital symptoms and improved the sexual life of GSM women in shortterm observation.ConclusionsThe onset, severity, and type of GSM symptoms may be associated with changes in vaginal microbiota in perimenopausal and postmenopausal women. Vaginal microbiota dysbiosis probably contributes to the occurrence and development of GSMsymptoms, especially vaginal and sexual symptoms. Lactobacillus used in the vagina may be a possible option for non-hormonal treatment of GSM women with genital and sexual symptoms.Clinical Trial Registrationhttps://www.chictr.org.cn/indexEN.html, identifier ChiCTR2100044237.

[Objective] Examining farming households’ homestead withdrawal willingness by considering the endowment effect and risk coping capacity has great significance for deepening homestead reform in China. [Methods] This study constructed a theoretical framework based on endowment effect, risk coping capacity, and homestead exit willingness, and used a mediation effect model to analyze the mediation effect of endowments on the impact of risk coping capacity on homestead exit willingness, used the threshold model to analyze the double threshold effect of risk coping capacity on homestead exit willingness, and explored the differences in the mediation role of endowments at each level of risk coping capacity. [Results] (1) The endowment effect has a significant negative impact on the willingness to withdraw from the homestead through the three paths of subject attachment, object dependence and uncertainty perception; (2) The impact of risk carrying capacity on the willingness to withdraw from the homestead has a double threshold effect. When the risk carrying capacity is between the two threshold values, the impact on the willingness to withdraw from the homestead is positive, and when it is too low or too high, the impact on the willingness to withdraw from the homestead is negative; (3) Endowment effect plays an intermediary role in the impact of risk carrying capacity on the willingness to withdraw from homestead. Among them, the order of mediating effect from large to small is homestead irreplaceability, psychological ownership and uncertainty perception; (4) In the process of accumulation of risk coping capacity, the mediation effect of endowments experienced the change of complete mediation-partial mediation-non-mediation, indicating that the accumulation of risk coping capacity helps to weaken the mediation effect of endowments. [Conclusion] The government should clarify the group of farmers with moderate risk carrying capacity, improve the mobilization and demonstration mechanism of homestead exit, improve the level of farmers’ policy cognition, improve the guarantee mechanism of farmers’ risk carrying capacity, and promote the transformation of homestead exit to people-oriented.

Advances in deep learning have revolutionized medical image segmentation, facilitating the precise delineation of complex anatomical structures. The scarcity of annotated training samples remains a significant bottleneck. To tackle the data limitation, federated learning (FL) offers the promise of pooling data from multiple healthcare institutions. However, as models grow larger, the increase in communication costs restricts FL to fewer nodes, which constrains the volume of data. This situation necessitates the simultaneous achievement of model lightweighting. To address this problem, this study proposes FKD-Med, a novel framework that integrates FL for privacy-sensitive data amalgamation across multiple healthcare institutions, and uses knowledge distillation (KD) to enhance communication efficiency. The “Med” in FKD-Med refers to medical application computational problems. Our principal contributions encompass the design of an open-source framework that seamlessly blends FL and KD, rendering it applicable to a broad spectrum of medical informatics tasks. Our approach substantially augments the computational data volume, thereby boosting both communication efficiency and training throughput. Tested on two datasets of medical image segmentation using TransUNet and ResUNet as teacher models, FKD-Med achieves data privacy, lowers communication costs, and increases accuracy. The parameters of the student models were reduced to 1/127 and 1/1027 of those in the teacher models. Additionally, the models subjected to KD exhibited accuracy improvements of 0.25%, 0.43%, 1.35%, and 1.46% respectively, given the same parameter volume. This positions FKD-Med not only as a pivotal tool for multi-institutional medical research but also as a versatile platform adaptable to a wide array of real-world medical engineering applications. The code is publicly available at https://github.com/SUN-1024/FKD-Med.

Sarcopenia is a senile disease with high morbidity, serious complications and limited clinical treatments. Menopause increases the risk of sarcopenia in females, while the exact pathogenesis remains unclear. To systematically investigate the development of hormone-related sarcopenia, we established a model of sarcopenia by ovariectomy and recorded successive characteristic changes. Furthermore, we performed the transcriptome RNA sequencing and bioinformatics analysis on this model to explore the underlying mechanism. In our study, we identified an integrated model combining obesity, osteoporosis and sarcopenia. Functional enrichment analyses showed that most of the significantly enriched pathways were down-regulated and closely correlated with endocrine and metabolism, muscle dysfunction, cognitive impairment and multiple important signaling pathways. We finally selected eight candidate genes to verify their expression levels. These findings confirmed the importance of estrogen in the maintenance of skeletal muscle function and homeostasis, and provided potential targets for further study on hormone-related sarcopenia.

Objective: Corticosteroid injection is a common treatment for primary frozen shoulder, but controversy remains regarding whether different injection approaches to the glenohumeral joint have similar clinical benefits. Design: Randomized controlled clinical trial. Patients: A total of 60 patients with primary frozen shoulder were divided randomly into either anterior or posterior approach groups. Methods: Both groups received a 5-mL drug injection, including 1 mL 40 mg/mL triamcinolone acetonide and 4 mL 2% lidocaine. Follow-up time-points were 4, 8 and 12 weeks post-injection. Outcome measures included visual analogue scale score, Constant-Murley score, and passive range of motion of the shoulder joint. Results: All outcome measures improved over the follow-up period compared with those of previous follow-up time-points within the groups. The primary finding was that the visual analogue scale score in the anterior group was better than that in the posterior group at each follow-up time-point (all p < 0.05). In addition, improvement in function score and external rotation was faster and significant in the anterior group in the early stages (p = 0.02). Conclusion: The anterior approach achieves more satisfactory results in pain control and offers better recovery of functional activity than posterior approach in the early period for primary frozen shoulder. LAY ABSTRACT Although many studies have been published in recent years on corticosteroid injection in the glenohumeral joint for primary frozen shoulder, the injection approaches described by current reports are not consistent and not described in detail, which is not conducive for their use to be repeated by clinicians. Meanwhile, controversy remains regarding whether different approaches have similar clinical outcomes. This study used a modified anterior approach based on anatomical landmarks, taking the acromioclavicular joint as a reference, to accurately and quickly complete the injection process. The study showed that the anterior approach could reduce pain severity more significantly than the regular posterior approach, and this advantage can be maintained for 3 months. Meanwhile, the function score of the anterior approach could recover to the maximum more quickly. In addition, recovery of external rotation in the anterior approach was faster and greater that for the posterior approach.

Ginsenoside Rg1 (Rg1) is purified from ginseng with various pharmacological effects, which might facilitate the biological behavior of human amnion-derived mesenchymal stem/stromal cells (hAD-MSCs). This study is aimed at investigating the effects of Rg1 on the biological behavior, such as viability, proliferation, apoptosis, senescence, migration, and paracrine, of hAD-MSCs. hAD-MSCs were isolated from human amnions. The effects of Rg1 on the viability, proliferation, apoptosis, senescence, migration, and paracrine of hAD-MSCs were detected by CCK-8, EdU, flow cytometry, SA-β-Gal staining, wound healing, and ELISA assays, respectively. The protein expression levels were detected by western blot. Cell cycle distribution was evaluated using flow cytometry. We found that Rg1 promoted hAD-MSC cycle progression from G0/G1 to S and G2/M phases and significantly increased hAD-MSC proliferation rate. Rg1 activated PI3K/AKT signaling pathway and significantly upregulated the expressions of cyclin D, cyclin E, CDK4, and CDK2 in hAD-MSCs. Inhibition of PI3K/AKT signaling significantly downregulated the expressions of cyclin D, cyclin E, CDK4, and CDK2, prevented cell cycle progression, and reduced hAD-MSC proliferation induced by Rg1. hAD-MSC senescence rate was significantly increased by D-galactose, while the elevated hAD-MSC senescence rate induced by D-galactose was significantly decreased by Rg1 treatment. D-galactose significantly induced the expressions of senescence markers, p16INK4a, p14ARF, p21CIP1, and p53 in hAD-MSCs, while Rg1 significantly reduced the expressions of those markers induced by D-galactose in hAD-MSCs. Rg1 significantly promoted the secretion of IGF-I in hAD-MSCs. Rg1 reduced the hAD-MSC apoptosis rate. However, the difference was not significant. Rg1 had no influence on hAD-MSC migration. Altogether, our results demonstrate that Rg1 can promote the viability, proliferation, and paracrine and relieve the senescence of hAD-MSCs. PI3K/AKT signaling pathway is involved in the promotive effect of Rg1 on hAD-MSC proliferation. The protective effect of Rg1 on hAD-MSC senescence may be achieved via the downregulation of p16INK4A and p53/p21CIP1 pathway.

Abstract Objectives It remains debatable if early mobilization (EM) yields a better clinical outcome than the late mobilization (LM) in adults with an acute and displaced distal radial fracture (DRF) of open reduction internal fixation (ORIF). Therefore, we aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs), comparing clinical results with the safety of EM with LM following ORIF. Methods Databases such as Medline, Cochrane Central Register, and Embase were searched from Jan 1, 2000, to July 31, 2021, and RCTs comparing EM with LM for DRF with ORIF were included in the analysis. The primary outcome of study included disabilities of the Arm, Shoulder, and Hand (DASH) score at different follow-up times. Wherever the secondary outcomes included patient-rated wrist evaluation (PRWE), grip strength (GS), visual analog scale (VAS), wrist range of motion (WROM), and associated complications, the two independent reviewers did data extraction for the analysis. Effect sizes of outcome for each group were pooled using random-effects models; thereafter, the results were represented in the forest plots. Results Nine RCTs with 293 EM and 303 LM participants were identified and included in the study. Our analysis showed that the DASH score of the EM group was significantly better than LM group at the six weeks postoperatively (− 10.15; 95% CI − 15.74 to − 4.57, P

Premature ovarian insufficiency (POI) can cause multiple sequelae and is currently incurable. Mesenchymal stem cell (MSC) transplantation might provide an effective treatment method for POI. However, the clinical application of systemic MSC transplantation is limited by the low efficiency of cell homing to target tissue in vivo , including systemic MSC transplantation for POI treatment. Thus, exploration of methods to promote MSC homing is necessary. This study was to investigate the effects of low-intensity pulsed ultrasound (LIPUS) on the migration and homing of transplanted human amnion–derived MSCs (hAD-MSCs) to ovaries in rats with chemotherapy-induced POI. For LIPUS treatment, hAD-MSCs were exposed to LIPUS or sham irradiation. Chemokine receptor expressions in hAD-MSCs were detected by polymerase chain reaction (PCR), Western blot, and immunofluorescence assays. hAD-MSC migration was detected by wound healing and transwell migration assays. Cyclophosphamide-induced POI rat models were established to evaluate the effects of LIPUS on the homing of systemically transplanted hAD-MSCs to chemotherapy-induced POI ovaries in vivo . We found that hAD-MSCs expressed chemokine receptors. The LIPUS promoted the expression of chemokine receptors, especially CXCR4, in hAD-MSCs. SDF-1 induced hAD-MSC migration. The LIPUS promoted hAD-MSC migration induced by SDF-1 through SDF-1/CXCR4 axis. SDF-1 levels significantly increased in ovaries induced by chemotherapy in POI rats. Pretreating hAD-MSCs with LIPUS increased the number of hAD-MSCs homing to ovaries in rats with chemotherapy-induced POI to some extent. However, the difference was not significant. Both hAD-MSC and LIPUS-pretreated hAD-MSC transplantation reduced ovarian injuries and improved ovarian function in rats with chemotherapy-induced POI. CXCR4 antagonist significantly reduced the number of hAD-MSCs- and LIPUS-pretreated hAD-MSCs homing to POI ovaries, and further reduced their efficacy in POI treatment. According to these findings, pretreating MSCs with LIPUS before transplantation might provide a novel, convenient, and safe technique to explore for improving the homing of systemically transplanted MSCs to target tissue.

The research progress on determination of free-base nicotine in tobacco and tobacco products in the past 30 years was reviewed and discussed, including solvent extraction method, headspace solid-phase microextraction method, 1H NMR, Henderson-Hasselbalch method and spectroscopy method, etc. Advantages and limitations of each method were summarized and discussed and the development in this field was prospected.

Flatness error is an important factor for effective evaluation of surface quality. The existing flatness error evaluation methods mainly evaluate the flatness error of a small number of data points on the micro scale surface measured by CMM, which cannot complete the flatness error evaluation of three-dimensional point cloud data on the micro/nano surface. To meet the needs of nano scale micro/nano surface flatness error evaluation, a minimum zone method on the basis of improved particle swarm optimization (PSO) algorithm is proposed. This method combines the principle of minimum zone method and hierarchical clustering method, improves the standard PSO algorithm, and can evaluate the flatness error of nano scale micro/nano surface image data point cloud scanned by atomic force microscope. The influence of the area size of micro/nano surface topography data on the flatness error evaluation results is analyzed. The flatness evaluation results and measurement uncertainty of minimum region method, standard least squares method, and standard PSO algorithm on the basis of the improved PSO algorithm are compared. Experiments show that the algorithm can stably evaluate the flatness error of micro/nano surface topography point cloud data, and the evaluation result of flatness error is more reliable and accurate than standard least squares method and standard PSO algorithm.

C30H32N4O8S2Cu2, triclinic, P1̅ (no. 2), a = 8.7209(5) Å, b = 12.9753(7) Å, c = 14.7680(8) Å, α = 84.584(4)°, β = 89.392(4)°, γ = 87.913(4)°, V = 1662.49(16) Å3, Z = 2, Rgt(F) = 0.0469, wRref(F2) = 0.1252, T = 296 K.

In view of problem of incomplete instrument record and lack of maintenance system, a management system for ventilation security instrument was designed. The overall system design, hardware design of collection node and software design of server management were introduced by taking self-rescuer management as an example. The system realizes effective management of ventilation security instrument and consuming staff, which electronizes paper information, systematizes record information and makes equipment maintenance method more reasonable. Meanwhile, it achieves seamless connection among procurement, storage and use of ventilation security instrument.

C20H24N4O14S2Cl2Zn, monoclinic, C2/c (no.15), a = 20.4949(9) Å, b = 9.9752(3) Å, c = 16.8927(6) Å, β = 124.945(4)°, V = 2830.9(2) Å3, Z = 4, Rgt(F) = 0.0406, wRref(F2) = 0.1135, T = 296 K.

We successfully synthesized tetragonal FeS with various Fe:S molar ratios using a hydrothermal method, and the EDS and XRF results confirmed that FeS exhibits superconductivity within the Fe and S element ratio range of 1.155–1.274, rather than a strict stoichiometric ratio. The reaction temperature can not only play a crucial role in determining the purity of the obtained FeS phase but also significantly alter its micromorphology. Significantly, by analyzing the relationship between the Fe:S actual molar ratio and Tc as well as the Fe:S actual molar ratio and unit cell volume, FeS exhibits dome-shaped superconductivity and shows a negative correlation with Tc and chemical pressure. Furthermore, considering the correlation between anion height (hanion) and Tc, Tc reaches the maximum value of 4.53 K for hanion ≈ 1.28 Å, a behavior distinct from that of observed in Fe-pnictide superconductors. In short, our experimental results provide a unique perspective to deepen our understanding of FeS superconductors. [ABSTRACT FROM AUTHOR]