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Background: Retroperitoneal leiomyomas are rare benign smooth muscle tumours. Diagnosing these tumours is often challenging due to their unique growth site and nonspecific clinical manifestations. There are a few reports of leiomyomas with intratumoral bleeding. Case presentation: A patient with a giant retroperitoneal leiomyoma presented with multiple-organ dysfunction syndrome accompanied by a progressive decrease in haemoglobin. Computed tomography (CT) revealed two cystic tumours in the abdominal cavity. The patient was underwent transabdominal retroperitoneal tumour resection. During surgery, we found two retroperitoneal tumours—one contained approximately 9000 mL of dark red fluid and the other contained 1000 mL of light brown fluid. She has recovered well without any complications. Conclusions: There have been only a few reports of retroperitoneal leiomyomas with intratumoral bleeding. This case highlights the importance of recognizing intratumoral haemorrhage in patients with large leiomyomas and a progressive decrease in haemoglobin after ruling out external haemorrhage. If necessary, dynamic monitoring via CT may help clarify the diagnosis.

This paper proposes a novel optimization scheme to support stable and reliable vehicle-to-everything connections in two-tier networks, where the uplink channel of the cellular user is reused by underlay vehicle-to-vehicle communications. However, considering complex channel fading and high-speed vehicle movement, the certainty assumption is impractical and fails to maintain power control strategy in reality in the traditional statical vehicular networks. Rather than the perfect channel state information assumption, the first-order Gauss-Markov process which is a probabilistic model affected by vehicle speed and fading is introduced to describe imperfect channel gains. Moreover, interference management is a major challenge in reusing communications, especially in uncertain channel environments. Power control is an effective way to realize interference management, and optimal power allocation can ensure that interference of the user meets the communication requirements. In this study, the sum-rate-oriented power control scheme and minimum-rate-oriented power control scheme were implemented to manage interference and satisfy different design objectives. Since both of these schemes are non-convex and intractable, the Bernstein approximation and successive convex approximation methods were adopted to transform the original problems into convex ones. Furthermore, a novel distributed robust power control algorithm was developed to determine the optimal solutions. The performance of the algorithm was evaluated through numerical simulations, and the results indicate that the proposed algorithm is effective in vehicular communication networks with uncertain channel environments.

IntroductionWhite matter hyperintensities (WMHs) are a common age- and vascular risk factor-related disease and have been recognized to play an important role in cognitive impairment. However, it is still unclear what the mechanism of this effect is. In this study, intravoxel incoherent motion (IVIM) was employed to assess the microvasculature and parenchymal microstructure changes of WMHs and explore their relationship with cognitive function.MethodsForty-nine WMH patients and thirty-one healthy controls underwent IVIM imaging, a diffusion technique that provides parenchymal diffusivity D, intravascular diffusivity D*, and perfusion fraction f . The IVIM dual exponential model parameters were obtained in specific regions of interest, including deep white matter hyperintensities (DWMHs), periventricular white matter hyperintensities (PWMHs), and normal-appearing white matter (NAWM). The independent-sample t-test or Mann–Whitney U-test was utilized to compare IVIM parameters between patients and controls. The Kruskal–Wallis test or one-way analysis of variance was used to compare IVIM parameters among DWMH, PWMH, and NAWM for patients. The Wilcoxon two-sample test or independent-sample t-test was used to assess the differences in IVIM parameters based on the severity of WMH. The multivariate linear regression analysis was conducted to explore the factors influencing cognitive scores.ResultsWMH patients exhibited significantly higher parenchymal diffusivity D than controls in DWMH, PWMH, and NAWM (all p < 0.05). IVIM parameters in the three groups (DWMH, PWMH, and NAWM) were significantly different for patients (all p < 0.001). The severe WMH group had a significantly higher parenchymal diffusivity D (DWMH and PWMH) than mild WMH (both p < 0.05). The multiple linear regression analysis identified D in DWMH and PWMH as influencing cognitive function scores (all p < 0.05).ConclusionIVIM has the potential to provide a quantitative marker of parenchymal diffusivity for assessing the severity of WMH and may serve as a quantitative marker of cognitive dysfunction in WMH patients.

Summary: Background: Convincing clinical evidence regarding completely opioid-free postoperative pain management using erector spinae plane block (ESPB) in patients undergoing open major hepatectomy (OMH) is lacking. Herein, we aimed to compare the postoperative analgesic efficacy of the visualised continuous opioid-free ESPB (VC-ESPB) and conventional intravenous opioid-based postoperative pain management in hepatocellular carcinoma (HCC) patients undergoing OMH. Methods: This open-label, randomised, controlled, non-inferiority trial enrolled patients with HCC undergone open major hepatectomy in Fujian Provincial Hospital and compared the postoperative analgesic efficacy of VC-ESPB (VC-ESPB group) and conventional intravenous opioid-based pain management regimen (conventional group). Patients were randomly assigned (1:1) to VC-ESPB group and conventional group. Patients were not masked to treatment allocation. The VC-ESPB group was treated with intermittent injections of 0.25% ropivacaine (bilateral, 30 mL each side) given every 12 h through catheters placed in the space of erector spinae and an opioid-free intravenous pump (10-mg tropisetron diluted to 100 mL with 0.9% normal saline [NS]) for postoperative pain management. The conventional group did not receive ESPB and was treated with a conventional intravenous opioid-based pump (2.5-μg/kg sufentanil and 10-mg tropisetron diluted to 100 mL with 0.9% NS). Patients in the VC-ESPB group underwent magnetic resonance imaging (MRI) to identify local anaesthetic diffusion after ESPB was performed under ultrasound guidance. The primary outcome was postoperative analgesic efficacy, which was indicated by the cumulative area under the curve (AUC) of the pain visual analogue scale scores (range, 0–10; a higher score indicates more pain) obtained at rest and at movement until 48 h postoperatively after leaving the post-anaesthesia care unit (PACU). Herein, an AUC of 26.5 was set as the noninferiority margin, which needed to be satisfied for both cumulative AUCPACU-48 h at rest and cumulative AUCPACU-48 h at movement. Per protocol participants were included in primary and safety analyses. This trial was registered with ChiCTR.org.cn (ChiCTR1900026583). Findings: Between October 30, 2019, and May 1, 2023, 106 patients were enrolled and randomly assigned to the VC-ESPB group (n = 53) and the conventional group (n = 53). After the dropout (n = 5), a total of 101 patients (VC-ESPB group, n = 50; conventional group, n = 51) were analysed. Both the level of cumulative AUCPACU-48 h (at rest: 160.08 ± 38.00 vs. 164.94 ± 31.00; difference [90% CI], −4.861 [−16.308, 6.585]) and cumulative AUCPACU-48 h (at movement: 209.64 ± 28.98 vs. 212.59 ± 33.11; difference [90% CI], −2.948 [−13.236, 7.339]) were similar between the VC-ESPB and control groups within the first postoperative 48 h. The upper limit of the 90% CIs for the difference in cumulative ACUPACU-48 h at rest and at movement did not reach the upper inferiority margin (26.5). During the first postoperative 48 h, the rate of nonsteroidal anti-inflammatory drug rescue analgesia was similar between the VC-ESPB group and conventional group (n = 16, 32.0% vs. n = 11, 21.6%; P = 0.236). Treatment-related death was not observed in the VC-ESPB group (n = 0, 0%) and conventional group (n = 0, 0%). In VC-ESPB group, local site paralysis (n = 1, 2.0%) was observed in one patient and rash (n = 1, 2.0%) was observed in another patient. One patient in the conventional group was observed with rash preoperatively (n = 1, 2.0%). The VC-ESPB group had significantly lower rates of postoperative nausea (n = 2, 4.0%, vs. n = 9, 17.6%, P = 0.028), vomiting (n = 1, 2.0% vs. n = 8, 15.7%, P = 0.031) and lower incidence of major complications (n = 4, 8.0% vs. n = 6, 11.8%; P = 0.033). Interpretation: This study demonstrates the noninferiority of VC-ESPB when compared with the conventional opioid-based approach for postoperative pain management after OMH, suggesting that it is feasible to achieve opioid-free postoperative pain management for OMH. Funding: The Joint Funds for the Innovation of Science and Technology, Fujian Province, China; the Youth Scientific Research Project of Fujian Provincial Health Commission; the Fujian Research and Training Grants for Young and Middle-aged Leaders in Healthcare; and the Key Clinical Specialty Discipline Construction Program of Fujian, China.

Background Iliac vein compression syndrome (IVCS) diagnosis heavily relies on an imaging test. However, non-invasive and contrast-free imaging test for the diagnosis of IVCS remains a big challenge. To address this issue, this prospective study aimed to assess the image quality and diagnostic performance of a magnetic resonance imaging technique, black-blood venous imaging (BBVI), in detecting IVCS by comparing it with contrast-enhanced computed tomography venography (CTV) and using invasive digital subtraction angiography (DSA) as the reference. Methods We enrolled 105 patients, and all patients underwent BBVI, CTV, and DSA examinations. We compared the consistency of CTV and BBVI image quality and their consistency in diagnosing the rate of iliac vein stenosis in IVCS patients. Using the consensus DSA as a reference, the sensitivity, specificity, positive and negative predictive values, and accuracy of BBVI and CTV and their diagnostic agreement with DSA were calculated. Results BBVI demonstrated high sensitivity, specificity, and accuracy for the diagnosis of IVCS, without contrast agents. BBVI and CTV are quite in diagnosis IVCS. Quite SE (67.8% vs 68.3%), SP (94.8% vs 94.8%), PPV (98.0% vs 98.0%), NPV (46.2% vs 46.9%) and ACC (75.3% vs 75.7%) were obtained by BBVI in comparison with CTV. Conclusion BBVI has comparable diagnostic performance with CTV. It may be a viable alternative to CTV techniques in screening the IVCS without contrast agents and free of ionizing radiation.

Abstract Background This study aimed to develop and validate an ultrasound radiomics model for distinguishing invasive ductal carcinoma (IDC) from ductal carcinoma in situ (DCIS) by combining intratumoral and peritumoral features. Methods Retrospective analysis was performed on 454 patients from Chengzhong Hospital. The patients were randomly divided in accordance with a ratio of 8:2 into a training group (363 cases) and validation group (91 cases). In addition, 175 patients from Yanghu Hospital were used as the external test group. The peritumoral ranges were set to 2, 4, 6, 8, and 10 mm. Mann–Whitney U-test, recursive feature elimination, and a least absolute shrinkage and selection operator were used to in the dimension reduction of the radiomics features and clinical knowledge, and machine learning logistic regression classifiers were utilized to construct the diagnostic model. The area under the curve (AUC) of the receiver operating characteristics, accuracy, sensitivity, and specificity were used to evaluate the model performance. Results By combining peritumoral features of different ranges, the AUC of the radiomics model was improved in the validation and test groups. In the validation group, the maximum increase in AUC was 9.7% (P = 0.031, AUC = 0.803) when the peritumoral range was 8 mm. Similarly, when the peritumoral range was only 8 mm in the test group, the maximum increase in AUC was 4.9% (P = 0.005, AUC = 0.770). In this study, the best prediction performance was achieved when the peritumoral range was only 8 mm. Conclusions The ultrasound-based radiomics model that combined intratumoral and peritumoral features exhibits good ability to distinguish between IDC and DCIS. The selection of peritumoral range size exerts an important effect on the prediction performance of the radiomics model.

Currently, the rapid development of the industrial Internet has led to the creation of a massive number of intelligent agents that are widely and distributively applied in various edge scenarios. The work conditions in these edge scenarios are complex, uncertain, and random. Traditional manual updates or human judgments are used for task decision-making in large-scale distributive intelligent agent edge work scenarios, which lack dynamic perception and autonomous recognition capabilities for edge work conditions. This inevitably leads to low decision-making accuracy, poor reliability, and ultimately, task failure. To address this issue, this study proposes an adaptive task identification strategy based on cloud-edge collaboration. This method utilizes a cloud-edge collaborative industrial intelligent application architecture to achieve cloud-based training and encapsulation of the task model, with online calling at the edge-end. Then, edge-end intelligent agents identify edge work conditions through multi-source data fusion, enabling accurate task decision-making. Finally, the edge-end requests the cloud for task model matching. The effectiveness of the proposed method is validated in an industrial safety situation virtual detection system.

Abstract Background Bacterial small regulatory RNA (sRNA) plays a crucial role in cell metabolism and could be used as a new potential drug target in the treatment of pathogen-induced disease. However, experimental methods for identifying sRNAs still require a large investment of human and material resources. Methods In this study, we propose a novel sRNA prediction model called sRNAdeep based on the DistilBERT feature extraction and TextCNN methods. The sRNA and non-sRNA sequences of bacteria were considered as sentences and then fed into a composite model consisting of deep learning models to evaluate classification performance. Results By filtering sRNAs from BSRD database, we obtained a validation dataset comprised of 2438 positive and 4730 negative samples. The benchmark experiments showed that sRNAdeep displayed better performance in the various indexes compared to previous sRNA prediction tools. By applying our tool to Mycobacterium tuberculosis (MTB) genome, we have identified 21 sRNAs within the intergenic and intron regions. A set of 272 targeted genes regulated by these sRNAs were also captured in MTB. The coding proteins of two genes (lysX and icd1) are implicated in drug response, with significant active sites related to drug resistance mechanisms of MTB. Conclusion In conclusion, our newly developed sRNAdeep can help researchers identify bacterial sRNAs more precisely and can be freely available from https://github.com/pyajagod/sRNAdeep.git .

Inherent low strength is the major limitation of Mg-Li alloys. Through precise control of precipitates, the cast Mg-8Li-3Al-2Zn alloy obtained a high specific ultimate tensile strength of 213 kN·m·kg−1. Precipitates evolution during non-isothermal aging was investigated: strip-like Mg3(Al, Zn) in β-Li → globular Mg3(Al, Zn) in β-Li →Mg/Li(Al, Zn) core–shell and nanoscale rod-like Mg3(Al, Zn) in β-Li + Laves phase in α-Mg. The short-term high-temperature aging results in the precipitation of Laves phase in α-Mg and the formation of nanoscale rod-like Mg3(Al, Zn) and Mg/Li(Al, Zn) core–shell phase in β-Li, achieving synergistic strengthening of the dual matrix phases.

A novel Mg-10Li-3Al (wt.%, LA103) matrix composite reinforced by ex situ micron TiB2 particles was developed in the present study. The ball milling and cold pressing pretreatment of the reinforcements made it feasible to prepare this material under stir casting conditions with good dispersion. The microstructure and mechanical properties of the composites prepared by different pretreatment methods were analyzed in detail. The TiB2 particles in the Al-TiB2/LA103 composite using the pretreatment process were uniformly distributed in the microstructure due to the formation of highly wettable core-shell units in the melt. Compared with the matrix alloys, the Al-TiB2/LA103 composite exhibited effective strength and elastic modulus improvements while maintaining acceptable elongation. The strengthening effect in the composites was mainly attributed to the strong grain refining effect of TiB2. This work shows a balance of high specific modulus (36.1 GPa·cm3·g-1) and elongation (8.4%) with the conventional stir casting path, which is of considerable application value.

Abstract Omniphobic membranes, due to their exceptional properties, have drawn significant attention for overcoming the bottleneck in membrane distillation (MD) technology. This study demonstrates an innovative method for fabricating an omniphobic membrane that is simple and facile compared to other methods such as wet/dry etching and photolithography. The surface morphology of springtails was imitated using electrospraying technique to coat a polyvinylidene fluoride substrate with concave-shaped polystyrene beads that were successfully developed by controlling the electrical traction (voltage) and air resistance (humidity). Then, the lipid coating of springtail surfaces was mimicked by dip-coating the membrane in a low-toxicity short-chain perfluoropolyether lubricant. The concave structure’s tiny air pockets increased membrane hydrophobicity significantly, indicated by the fact that the first round of water bouncing took only 16.3 ms. Finally, in MD treatment of seawater containing 1.0 mM sodium dodecyl sulfate, the optimized omniphobic membrane maintained a stable 99.9% salt rejection rate.

In this paper, (0.2–1 wt%) Yb was added to improve the tensile properties and high-cycle fatigue behavior of the as-cast and as-extruded Mg-10Li-5Zn-0.5Er alloys. It is found that Yb mainly affects the mechanical properties of the alloy by changing the grain size, type and morphology of the second phases. Yb mainly exists in the formation of Mg2Yb and Mg-Zn-Yb phases in the metallographic structure. With the addition of Yb, the grains are refined and these Yb-containing phases replace the large-sized MgLiZn phase to be enriched at the grain boundaries. While the addition of excess Yb reduces the number of small-sized MgLiZn phases in the grain, thus reducing the alloys’ mechanical performance. After extrusion, the small-sized MgLiZn phase is refined and the number increases, which effectively improves the tensile and fatigue strength of the alloy. The fatigue strength is mainly affected by the number and morphology of the second phase, positively correlated with the strength. Balanced in grain size and number and size of second phases, the extruded alloy with 0.2Yb added exhibits excellent mechanical properties with the yield strength, ultimate tensile strength and elongation of 292 MPa, 303 MPa and 11.7%, and an fatigue strength of 130 MPa.

Abstract Background Computed tomography (CT) is widely in clinics and is affected by metal implants. Metal segmentation is crucial for metal artifact correction, and the common threshold method often fails to accurately segment metals. Purpose This study aims to segment metal implants in CT images using a diffusion model and further validate it with clinical artifact images and phantom images of known size. Methods A retrospective study was conducted on 100 patients who received radiation therapy without metal artifacts, and simulated artifact data were generated using publicly available mask data. The study utilized 11,280 slices for training and verification, and 2,820 slices for testing. Metal mask segmentation was performed using DiffSeg, a diffusion model incorporating conditional dynamic coding and a global frequency parser (GFParser). Conditional dynamic coding fuses the current segmentation mask and prior images at multiple scales, while GFParser helps eliminate high-frequency noise in the mask. Clinical artifact images and phantom images are also used for model validation. Results Compared with the ground truth, the accuracy of DiffSeg for metal segmentation of simulated data was 97.89% and that of DSC was 95.45%. The mask shape obtained by threshold segmentation covered the ground truth and DSCs were 82.92% and 84.19% for threshold segmentation based on 2500 HU and 3000 HU. Evaluation metrics and visualization results show that DiffSeg performs better than other classical deep learning networks, especially for clinical CT, artifact data, and phantom data. Conclusion DiffSeg efficiently and robustly segments metal masks in artifact data with conditional dynamic coding and GFParser. Future work will involve embedding the metal segmentation model in metal artifact reduction to improve the reduction effect.

The confined aquifer dewatering for long-deep excavations usually encounters challenges due to complicated geotechnical conditions, large excavation sizes, and high hydraulic pressures. To propose the most efficient scheme of confined aquifer dewatering for long-deep excavations, dewatering optimizations were performed using the simulation–optimization method. An open cut tunnel of the Jiangyin-Jingjiang Yangtze River Tunnel Project was taken as an example. The methods of finite element and linear programming (LP) were combined to optimize the dewatering process. A three-dimensional finite element model was developed. After simulating the pumping tests, hydraulic conductivity was inverted. Then, necessary parameters in the LP method were determined by simulating dewatering with each pumping well, and various LP models were developed based on some important influence factors such as dewatering sequence, considered pumping wells, and pumping rate limitation. Finally, the optimal pumping rates were solved and applied to the numerical model, with induced drawdown and ground settlement computed for comparison. The results indicate that the optimization can significantly reduce the required wells in the original design. Dewatering in the deepest zone exhibits the highest efficiency for long-deep excavations with gradually varying depths. For the dewatering sequence from the shallowest to the deepest zone, more pumping wells are required but less energy is consumed. Higher quantity and more advantageous locations of pumping wells in the LP model usually result in lower total pumping rate, drawdown, and ground settlement. If more pumping wells are considered in the deepest zone, pumping rate limitation of single well will only slightly increase the total pumping rate, number of required pumping wells, drawdown, and ground settlement.

Ethylene serves a pivotal function in plant growth, development, and stress responses. Initially received by receptors, ethylene signals the journey to nuclear transcription factors via downstream elements, prompting the expression of relevant genes and engaging in diverse physiological and biochemical processes. Over the preceding decades, the bulk of research efforts concentrated on unraveling the components of ethylene signaling and deciphering their molecular regulations. Remarkably less attention, however, was devoted to scrutinizing the role of ethylene signaling in fostering salt stress tolerance in plants. Crucial questions, such as whether ethylene positively or negatively impacts salt tolerance, remain insufficiently explored. Similarly, the precise role of ethylene signaling in orchestrating the SOS pathway for salt tolerance is not comprehensively understood. Hence, this article seeks to narrow this knowledge gap by exploring the latest breakthroughs in comprehending how ethylene signaling contributes to plants' responses when encountering salt stress. It will explore ethylene synthesis's role, the functions of ethylene signaling components, and the intricate molecular interplay between ethylene signaling and other pathways during salt stress responses. These studies not only deepen our comprehension of ethylene's involvement in salt stress responses but also offer valuable insights for leveraging this knowledge to develop new plant varieties resilient to salt stress.

Abstract Objectives Accurate segmentation of the clinical target volume (CTV) of CBCT images can observe the changes of CTV during patients' radiotherapy, and lay a foundation for the subsequent implementation of adaptive radiotherapy (ART). However, segmentation is challenging due to the poor quality of CBCT images and difficulty in obtaining target volumes. An uncertainty estimation- and attention-based semi-supervised model called residual convolutional block attention-uncertainty aware mean teacher (RCBA-UAMT) was proposed to delineate the CTV in cone-beam computed tomography (CBCT) images of breast cancer automatically. Methods A total of 60 patients who undergone radiotherapy after breast-conserving surgery were enrolled in this study, which involved 60 planning CTs and 380 CBCTs. RCBA-UAMT was proposed by integrating residual and attention modules in the backbone network 3D UNet. The attention module can adjust channel and spatial weights of the extracted image features. The proposed design can train the model and segment CBCT images with a small amount of labeled data (5%, 10%, and 20%) and a large amount of unlabeled data. Four types of evaluation metrics, namely, dice similarity coefficient (DSC), Jaccard, average surface distance (ASD), and 95% Hausdorff distance (95HD), are used to assess the model segmentation performance quantitatively. Results The proposed method achieved average DSC, Jaccard, 95HD, and ASD of 82%, 70%, 8.93, and 1.49 mm for CTV delineation on CBCT images of breast cancer, respectively. Compared with the three classical methods of mean teacher, uncertainty-aware mean-teacher and uncertainty rectified pyramid consistency, DSC and Jaccard increased by 7.89–9.33% and 14.75–16.67%, respectively, while 95HD and ASD decreased by 33.16–67.81% and 36.05–75.57%, respectively. The comparative experiment results of the labeled data with different proportions (5%, 10% and 20%) showed significant differences in the DSC, Jaccard, and 95HD evaluation indexes in the labeled data with 5% versus 10% and 5% versus 20%. Moreover, no significant differences were observed in the labeled data with 10% versus 20% among all evaluation indexes. Therefore, we can use only 10% labeled data to achieve the experimental objective. Conclusions Using the proposed RCBA-UAMT, the CTV of breast cancer CBCT images can be delineated reliably with a small amount of labeled data. These delineated images can be used to observe the changes in CTV and lay the foundation for the follow-up implementation of ART.

Abstract Lensless fiber endomicroscopy, an emergent paradigm shift for minimally-invasive microscopic optical imaging and targeted light delivery, holds transformative potential, especially in biomedicine. Leveraging holographic detection and physical or computational wavefront correction, it enables three-dimensional imaging in an unprecedentedly small footprint, which is crucial for various applications such as brain surgery. This perspective reviews the recent breakthroughs, highlighting potential emerging applications, and pinpointing gaps between innovation and real-world applications. As the research in this realm accelerates, the novel breakthroughs and existing frontiers highlighted in this perspective can be used as guidelines for researchers joining this exciting domain.

Abstract Aims Bariatric surgery results in rapid recovery of glucose control in subjects with type 2 diabetes mellitus. However, the underlying mechanisms are still largely unknown. The present study aims to clarify how bariatric surgery modifies pancreatic cell subgroup differentiation and transformation in the single‐cell RNA level. Methods Male, 8‐week‐old Zucker diabetic fatty (ZDF) rats with obesity and diabetes phenotypes were randomized into sleeve gastrectomy (Sleeve, n = 9), Roux‐en‐Y gastric bypass (RYGB, n = 9), and Sham (n = 7) groups. Two weeks after surgery, the pancreas specimen was further analyzed using single‐cell RNA‐sequencing technique. Results Two weeks after surgery, compared to the Sham group, the metabolic parameters including fasting plasma glucose, plasma insulin, and oral glucose tolerance test values were dramatically improved after RYGB and Sleeve procedures (p