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Background: Over the past two decades, modern spine surgery has become increasingly intellectualized and minimally invasive. However, whether using robots in spine surgery results in more accurate pedicle screw placement remains a topic of debate. This study aimed to evaluate the certainty and quality of the available evidence on the efficacy of robot-assisted pedicle screw placement. Methods: We performed an overview of reviews including systematic reviews (SRs) and meta-analyses (MAs) regarding the accuracy of robot-assisted pedicle screw placement. Regarding the SRs/MAs, five electronic databases were searched from inception to 28 April 2023. There were no restrictions on the language or population. The quality and certainty of the evidence were evaluated with PRISMA, AMSTAR-2, ROBIS, Veritas plot, and GRADE tools. Results: Fifteen SRs/MAs were analyzed. The findings indicated that the accuracy of pedicle screw placement in the robot-assisted group was not superior to that in the freehand group. All the SRs/MAs were of low or critically low quality. The main reasons for this include missing data, lack of transparency, lack of sensitivity analysis, and measurement of heterogeneity in the included studies, registration of reporting protocols, and deficiencies in the study inclusion methods and selection criteria. Conclusions: While there is potential for robot-assisted pedicle screw placement to offer superior accuracy compared to conventional surgery, the current evidence is limited by methodological shortcomings. The quality of the studies analyzed was insufficient to provide a robust basis for developing clinical guidelines. Further high-quality research is necessary to confirm the benefits and establish clearer recommendations.

Abstract Background Triple Negative Breast Cancer (TNBC) is a particular type of breast cancer with the highest mortality rate. Essential oils are concerned more and more as potential anti-cancer drugs. Methods TNBC cells were treated with different concentrations of navel orange peel essential oil (NOPEO), and then a variety of experiments were performed to investigate the changes in the growth and progression of TNBC cells. MTT assay was performed to detect the proliferation of TNBC cells. The changes of cell cycle and apoptosis were analyzed by FACS. In order to explored the migration of TNBC cells, scratch wound assay was carried out. Western blotting and qPCR were used to examine the expression of proteins and mRNA of related genes. Furthermore, RNA-seq was used to analyze the altered genes and explored the possible signal pathway. Results NOPEO demonstrated dose- and time-dependent suppression of TNBC cell growth. TNBC cells showed an increased percentage of G2/M-phase cells and the protein levels of CyclinB1 and CyclinD1 were decreased after NOPEO treatment. The apoptotic cells were increased in the NOPEO treated TNBC cells. The migration mobility was significantly inhibited by NOPEO. In total, 1376 genes were found to be up-regulated and 1335 genes were down-regulated after NOPEO treatment. According to KEGG and GO pathways, the differentially expressed genes were related to MAPK, Jak/stat and FoxQ signaling pathways. Conclusion This investigation explored the bio-activity and molecular mechanisms of NOPEO against TNBC cells. These results indicated that NOPEO could suppress TNBC growth and migration perhaps via the MAPK and Jak/stat signaling pathways, which may provide theoretical reference for anticancer drug development. NOPEO may be a potential natural product for the chemotherapeutic of TNBC.

Introduction Overactive bladder (OAB) affects approximately 500 million people worldwide, with a higher prevalence in women than in men, significantly impacting the quality of life of female patients. Treatment options for OAB are currently limited. Previous research has proposed that electroacupuncture could be a viable treatment for OAB in women, but there is a lack of high-quality clinical evidence. This study aims to evaluate the effectiveness of electroacupuncture as a safe and efficient non-pharmacological treatment for female OAB by comparing it with solifenacin succinate.Methods and analysis This study is a multicentre, single-blind, double-dummy randomised controlled non-inferiority clinical trial involving 204 eligible female participants with OAB. Participants will be randomly assigned in a 1:1 ratio to either the electroacupuncture group (receiving electroacupuncture and placebo) or the solifenacin succinate group (receiving sham electroacupuncture and solifenacin succinate). Each participant will undergo 12 sessions of electroacupuncture (or sham electroacupuncture) treatment and solifenacin succinate (or placebo) treatment over a 4-week period. The primary outcome measure will be the percentage change in the number of micturition episodes every 24 hours at week 4 compared with baseline. Secondary outcomes will include a percentage reduction in the number of micturition episodes every 24 hours at 2th, 8th and 16th weeks of the trial, Overactive Bladder Symptom Score, number of urinary incontinence and urgency episodes every 24 hours based on a 3-day voiding diary, OAB Questionnaire, Generalised Anxiety Disorder Scale-7, King’s Health Questionnaire and Participant Self-evaluation of Therapeutic Effects. Adverse events will be monitored throughout the study. Efficacy analyses will be conducted on both the intention-to-treat population and the per-protocol set population.Ethics and dissemination Ethical approval has been obtained from the Medical Ethics Committee of Longhua Hospital Shanghai University of Traditional Chinese Medicine (approval number: 2022LCSY097). Each participant will sign a written informed consent before randomisation. The results of this study will be published in a peer-reviewed journal.Trial registration number NCT05798403.

Background: Spinal cord injury (SCI) is a catastrophic condition associated with spinal nerve damage, which can lead to complete or partial loss of sensory and motor functions. Chinese herbal compound prescriptions (CHCP) have shown varying degrees of therapeutic effects on spinal cord injuries. However, there is a significant lack of clinical evidence-based research to substantiate these effects. Purpose: This study aims to thoroughly assess the viability of CHCPs in postoperative SCI through network meta-analysis. Methods: Computer searches were conducted across multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM, from their inception until May 2024. The meta-analysis adhered to the PRISMA guidelines and was registered in the PROSPERO database (CRD42023462686). A network meta-analysis was performed using the BUGSnet software package via R. Study design: A network meta-analysis of randomized clinical trials (RCTs). Results: A total of 26 RCTs involving 1848 patients were ultimately included. The network meta-analysis revealed the effectiveness in improving ASIA motor score as follows: “HQGZD” > “Other Decoctions” > “BYHWD” > “TDHXD” > “THCQD” > “Surgery”. For ASIA sensory score, the effectiveness ranking was: “HQGZD” > “Other Decoctions” > “BYHWD” > “TDHXD” > “THCQD” > “Surgery”. Additionally, the experimental group had a higher ADL score compared to the control group, with a statistically difference [SMD = 1.08, 95 % CI = (0.88, 1.27), p

BackgroundDepressive symptoms are common among patients with lung cancer. We aimed to assess the effects of esketamine on postoperative depressive symptoms after thoracoscopic lung cancer surgery.MethodsIn this randomized, double-blind, placebo-controlled trial, 156 patients undergoing thoracoscopic lung cancer surgery were randomly allocated in a 1:1 ratio to receive intravenous esketamine (intraoperatively and in patient-controlled analgesia until 48 h postoperatively) or normal saline placebo. The primary outcome was the proportion of patients with depressive symptoms at 1 month postoperatively, assessed using the Beck Depression Inventory-II (BDI-II). Secondary outcomes included depressive symptoms at 48 h postoperatively, hospital discharge and 3 months postoperatively, BDI-II scores, anxious symptoms, Beck Anxiety Inventory scores, Quality of Recovery-15 (QoR-15) scores, and 1- and 3-month mortality.Main resultsA total of 151 patients (75 in the esketamine group and 76 in the normal saline group) completed the 1-month follow-up. The esketamine group had a significantly lower incidence of depressive symptoms at 1 month compared to the normal saline group (1.3% vs. 11.8%; risk difference = -10.5, 95%CI = -19.6% to -0.49%; p = 0.018). After excluding patients without lung cancer diagnosis, the incidence of depressive symptoms was also lower in the esketamine group (1.4% vs. 12.2%; risk difference = -10.8, 95%CI = -20.2% to -0.52%; p = 0.018). The secondary outcomes were similar between groups, except that the esketamine group had higher QoR-15 scores at 1 month postoperatively (median difference = 2; 95%CI = 0 to 5; p = 0.048). The independent risk factors for depressive symptoms were hypertension (odds ratio = 6.75, 95%CI = 1.13 to 40.31; p = 0.036) and preoperative anxious symptoms (odds ratio = 23.83, 95%CI = 3.41 to 166.33; p = 0.001).ConclusionPerioperative administration of esketamine reduced the incidence of depressive symptoms at 1 month after thoracoscopic lung cancer surgery. History of hypertension and preoperative anxious symptoms were independent risk factors for depressive symptoms.Clinical trial registration: Chinese Clinical Trial Registry http://www.chictr.org.cn, Identifier (ChiCTR2100046194).

The phenotypic characteristics (including single fruit mass, longitudinal diameter, transverse diameter, and fruit shape index) of 59 varieties of Chinese olive fruit were assessed and categorized based on probability. 15 Chinese olive varieties with varying fruit shape indexes and genetic backgrounds were selected for analysis of volatile compounds using headspace solid-phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC-MS). The results indicated a wide range of variation in four phenotypic traits, with coefficients of variation (CV) between 10.70% and 26.67%. The Kolmogorov-Smirnov (K-S) test showed that the data of fruit shape index, longitudinal diameter, and transverse diameter followed a normal distribution, allowing for their categorization based on probability. A total of 886 volatile compounds were identified including 186 terpenoids, 157 heterocyclic compounds, 146 esters, 73 ketones, 64 hydrocarbons, 64 alcohols, 53 aldehydes, 51 aromatic hydrocarbons, 21 acids, 21 amines, 20 phenols, and 30 other compounds at concentration levels ranging from 1 881.70 to 6 727.40 μg/g of fresh mass. Terpenes were the dominant volatile compounds in Chinese olive fruit, accounting on average for 52.49% of the total volatile compounds. The most abundant terpene was α-pinene, with a relative content of 7.13% (309.66 μg/g of fresh mass). A total of 181 characteristic aroma components were identified using odor activity value (OAV) analysis, contributing to the overall aroma profile of Chinese olive fruit. Among these components, the heterocyclic compound 5-ethyl-3-hydroxy-4-methyl-2(5H)-furanone was the biggest contributor with the highest OAV of 2 468 148.28, being responsible for sweet aroma. Utilizing principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) analysis, 6 differential characteristic aroma components were identified among different varieties of Chinese olive fruit. Notably, α-farnesene had the highest variable importance in the projection (VIP) value with an OAV of 19.71, being responsible for floral and fruity aromas. These findings serve as a valuable reference for the quality grading of Chinese olive fruit, as well as for future investigations into its aroma formation mechanism and quality improvement.

Abstract Constructing composite solid electrolytes (CSEs) integrating the merits of inorganic and organic components is a promising approach to developing high‐performance all‐solid‐state lithium metal batteries (ASSLMBs). CSEs are now capable of achieving homogeneous and fast Li‐ion flux, but how to escape the trade‐off between mechanical modulus and adhesion is still a challenge. Herein, a strategy to address this issue is proposed, that is, intercalating highly conductive, homogeneous, and viscous‐fluid ionic conductors into robust coordination laminar framework to construct laminar solid electrolyte with homogeneous and fast Li‐ion conduction (LSE‐HFC). A 9 µm‐thick LSH‐HFC, in which poly(ethylene oxide)/succinonitrile is adsorbed by coordination laminar framework with metal–organic framework nanosheets as building blocks, is used here as an example to determine the validity. The Li‐ion transfer mechanism is verified and works across the entire LSE‐HFC, which facilitates homogeneous Li‐ion flux and low migration energy barriers, endowing LSE‐HFC with high ionic conductivity of 5.62 × 10−4 S cm−1 and Li‐ion transference number of 0.78 at 25 °C. Combining the outstanding mechanical strength against punctures and the enhanced adhesion force with electrodes, LSE‐HFC harvests uniform Li plating/stripping behavior. These enable the realization of high‐energy‐density ASSLMBs with excellent cycling stability when being assembled as LiFePO4/Li and LiNi0.6Mn0.2Co0.2O2/Li cells.

Introduction Patients with breast cancer often suffer from depressive symptoms throughout various stages of cancer, significantly impacting their quality of life and treatment outcomes. Non-pharmaceutical interventions such as psychotherapy, mind–body therapies and physical exercise have shown effectiveness in addressing cancer-related depression. However, the efficacy and safety of different non-pharmacological interventions remain a topic of debate. Therefore, to provide an objective assessment and comparison of the impact of different non-pharmaceutical interventions on depression, we will conduct a network meta-analysis (NMA) to explore the effects of different non-pharmaceutical interventions on reducing depressive symptoms among patients with breast cancer.Methods and analysis We will search nine Chinese and English-language databases, from database inception to 31 July 2023, for randomised controlled trials published in Chinese or English. The English-language databases are PubMed, Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials, and the Chinese databases are CBM, CNKI, VIP and Wanfang. Two independent researchers will perform information extraction from eligible articles. The primary outcome will be the changes in depressive symptoms, while the secondary outcome will include adverse events. STATA V.15.0 will be used to conduct paired meta-analysis and NMA. Grading of Recommendations Assessment, Development and Evaluation will be used to assess the quality of evidence, and the Cochrane tool for assessing the risks of bias in randomised trials V.2 will be used for risk of bias assessment.Ethics and dissemination The study does not require ethical approval as it will analyse data from existing studies. It is expected that the results of the study will be published in peer-reviewed journals and presented at relevant conferences.PROSPERO registration number CRD42023450494.

Abstract Background Cancer cachexia is associated with impaired functional and nutritional status and worse clinical outcomes. Global Leadership Initiative in Malnutrition (GLIM) consensus recommended the application of GLIM criteria to diagnose malnutrition in patients with cachexia. However, few previous study has applied the GLIM criteria in patients with cancer cachexia. Methods From July 2014 to May 2019, patients who were diagnosed with cancer cachexia and underwent radical gastrectomy for gastric cancer were included in this study. Malnutrition was diagnosed using the GLIM criteria. Skeletal muscle index was measured using abdominal computed tomography (CT) images at the third lumbar vertebra (L3) level. Hand-grip strength and 6-meters gait speed were measured before surgery. Results A total of 356 patients with cancer cachexia were included in the present study, in which 269 (75.56%) were identified as having malnutrition based on the GLIM criteria. GLIM-defined malnutrition alone did not show significant association with short-term postoperative outcomes, including complications, costs or length of postoperative hospital stays. The combination of low hand-grip strength or low gait speed with GLIM-defined malnutrition led to a significant predictive value for these outcomes. Moreover, low hand-grip strength plus GLIM-defined malnutrition was independently associated with postoperative complications (OR 1.912, 95% CI 1.151–3.178, P = 0.012). GLIM-defined malnutrition was an independent predictive factor for worse OS (HR 2.310, 95% CI 1.421–3.754, P = 0.001) and DFS (HR 1.815, 95% CI 1.186–2.779, P = 0.006) after surgery. The addition of low hand-grip strength or low gait speed to GLIM-defined malnutrition did not increase its predictive value for survival. Conclusion GLIM-defined malnutrition predicted worse long-term survival in gastric cancer patients with cachexia. Gait speed and hand-grip strength added prognostic value to GLIM-defined malnutrition for the prediction of short-term postoperative outcomes, which could be incorporated into preoperative assessment protocols in patients with cancer cachexia.

Purpose: To determine whether using robots in spine surgery results in more clinical advantages and fewer adverse consequences. Methods: Between October 1990 and October 2022, a computer-based search was conducted through the databases of PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, China Biology Medicine, VIP databases, and WAN FANG. The study only included randomized controlled trials (RCTs) comparing the clinical efficacy and safety of robot-assisted surgery with those of conventional spine surgery. The review was conducted following PRISMA 2020, and AMSTAR-2 was used to evaluate the methodological quality. R version 4.2.1 was used in the meta-analysis. The Cochrane Collaboration Tool was used for evaluating the risk of bias. Results: This study analyzed 954 participants from 20 RCTs involving cervical spondylosis, lumbar degenerative disease, scoliosis, etc. The robot-assisted group outperformed the freehand group in terms of intraoperative blood loss, number of screws in grade A position, grade A + B position, radiation dose, and hospital stay. Operation duration, visual analog scale scores of low back pain, Oswestry disability index, and radiation exposure time did not significantly differ between the two groups. Conclusions: Although robotic spine surgery is more accurate in pedicle screw placement than conventional methods, the robot group did not demonstrate an advantage in terms of clinical efficacy. Studies of complications and cost-effectiveness are still very rare.

Tetraarylmethanes (TAMs) contain a carbon atom bound to four aryl groups. They have found diverse applications in chemistry, materials science, chemical biology and medicinal chemistry because of their unique 3-dimensional structures. As a reflection of the high demand for TAMs, over 32,000 unique TAMs have been prepared. The distinct structures of TAMs and the crowded nature of the central carbon atom require different strategies for their syntheses. Herein we present the first review on the synthesis of TAMs, from classical approaches to modern methods, including enantioselective syntheses of TAMs. We provide a critical evaluation of methods and highlight important directions for future research into the synthesis of this aesthetically pleasing and very useful class of spherical structures.

Abstract Background Blastocystis hominis (Bh) is zoonotic parasitic pathogen with a high prevalent globally, causing opportunistic infections and diarrhea disease. Human immunodeficiency virus (HIV) infection disrupts the immune system by depleting CD4+ T lymphocyte (CD4+ T) cell counts, thereby increasing Bh infection risk among persons living with HIV (PLWH). However, the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood. Hence, the purpose of the study was to explore the association between Bh infection risk and CD4+ T cell counts, HIV viral load (VL), and duration of interruption in antiviral therapy among PLWH. Methods A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022. The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction, the CD4+ T cell counts in venous blood was measured using flowcytometry, and the HIV VL in serum was quantified using fluorescence-based instruments. Restricted cubic spline (RCS) was applied to assess the non-linear association between Bh infection risk and CD4+ T cell counts, HIV VL, and duration of interruption in highly active antiretroviral therapy (HARRT). Results A total of 1245 PLWH were enrolled in the study, the average age of PLWH was 43 years [interquartile range (IQR): 33, 52], with 452 (36.3%) being female, 50.4% (n = 628) had no immunosuppression (CD4+ T cell counts > 500 cells/μl), and 78.1% (n = 972) achieved full virological suppression (HIV VL

Study region: Poyang Lake and East Dongting Lake, China. Study focus: On the basis of data on the extent of the inundation of water bodies, the water level, and DEM data, this study constructed an hourly flood inundation dataset (PDFID) for the East Dongting Lake and Poyang Lake regions with a 10 m resolution and a coverage area of >5000 km2 from 2012 to 2022 by using the RFim model and the U-net model. Validation of the results on Sentinel-1 SAR images and Sentinel-2 MSI optical images showed that the overall accuracy of the dataset ranged from 88% to 97%, with a kappa coefficient ranging from 0.601 to 0.932. The accuracy for the East Dongting Lake region ranged from 88% to 97%, with a kappa coefficient of >0.67, and for the Poyang Lake region, the accuracy ranged from 89% to 97%, with a kappa coefficient of >0.6. New hydrological insights for the region: Flood inundation datasets with a high spatiotemporal resolution and long time series enable us to analyze and comprehend floods’ processes, patterns, and dynamics, facilitating the enhanced development and management of flood prevention and mitigation strategies. However, they have yet to be made available. Thus, this study can provide a fundamental data source for analytical mining and predicting the flooding processes in basins.

Introduction: Magnetic Resonance Imaging (MRI) is essential in diagnosing cervical spondylosis, providing detailed visualization of osseous and soft tissue structures in the cervical spine. However, manual measurements hinder the assessment of cervical spine sagittal balance, leading to time-consuming and error-prone processes. This study presents the Pyramid DBSCAN Simple Linear Iterative Cluster (PDB-SLIC), an automated segmentation algorithm for vertebral bodies in T2-weighted MR images, aiming to streamline sagittal balance assessment for spinal surgeons.Method: PDB-SLIC combines the SLIC superpixel segmentation algorithm with DBSCAN clustering and underwent rigorous testing using an extensive dataset of T2-weighted mid-sagittal MR images from 4,258 patients across ten hospitals in China. The efficacy of PDB-SLIC was compared against other algorithms and networks in terms of superpixel segmentation quality and vertebral body segmentation accuracy. Validation included a comparative analysis of manual and automated measurements of cervical sagittal parameters and scrutiny of PDB-SLIC’s measurement stability across diverse hospital settings and MR scanning machines.Result: PDB-SLIC outperforms other algorithms in vertebral body segmentation quality, with high accuracy, recall, and Jaccard index. Minimal error deviation was observed compared to manual measurements, with correlation coefficients exceeding 95%. PDB-SLIC demonstrated commendable performance in processing cervical spine T2-weighted MR images from various hospital settings, MRI machines, and patient demographics.Discussion: The PDB-SLIC algorithm emerges as an accurate, objective, and efficient tool for evaluating cervical spine sagittal balance, providing valuable assistance to spinal surgeons in preoperative assessment, surgical strategy formulation, and prognostic inference. Additionally, it facilitates comprehensive measurement of sagittal balance parameters across diverse patient cohorts, contributing to the establishment of normative standards for cervical spine MR imaging.

Cathode materials have been playing an important role in the development of high-energy, safe and low-cost lithium-ion batteries. However, the widely used single-phase cathode materials are facing great challenges in solving the mileage and safety problems related to electric vehicles due to their inherent structural defects. Intergrown design of bulk structure is believed to be one of the most fundamental ways to improve structural stability and capacity for cathode materials. Due to the diversity of structural configurations, the systematic understanding is still lack for the intergrown structures of different combinations. Therefore, it is very desirable, but also of great importance to summarize the current progress and challenges for intergrown cathodes. In this review, we comprehensively reviewed the design and synthesis methods of intergrown cathodes including layered-spinel intergrown structures, layered-rocksalt intergrown structures, and spinel-rocksalt intergrown structured cathode materials. The charge compensation mechanism of intergrown cathodes with different structural configurations was analyzed in depth, and a targeted optimization schematic diagram was also proposed. Finally, combined with advanced characterization techniques, the understanding of the structural changes has been deepened for the intergrown cathodes during the electrochemical process. It is hoped this review should shed light on the development of advanced cathode materials for the next-generation Li-ion batteries.

Optical lattices have been widely used from classical to quantum physics. The tunable and scalable fabrication of lattices would be of great significance in lattice‐based multipartite applications. This work demonstrates first that a circular Airy beam (CAB), which has the peculiar properties of self‐healing and abrupt autofocusing, can be used to generate two‐dimensional (2D) optical lattices in propagation when encoded by a programmable spatial mask, resulting in the formation of large‐scale and tunable optical lattices with both axis and axial symmetry, and even high‐orbital kaleidoscope shapes. The efficient diffraction of CAB during the spatial crosstalk with the mask enables the realization of tunable lattices with rich periodicity and complexity. The study shows a flexible method to manipulate lattices with large‐scale and versatile structures for potential applications in integrated and scalable optical and photonic devices.

Commercialization of the lithium-sulfur battery is hampered by bottlenecks like low sulfur loading, high cathode porosity, uncontrollable Li2 Sx deposition and sluggish kinetics of Li2 S activation. Herein, we developed a densely stacked redox-active hexaazatrinaphthylene (HATN) polymer with a surface area of 302 m2  g-1 and a very high bulk density of ca. 1.60 g cm-3 . Uniquely, HATN polymer has a similar redox potential window to S, which facilitates the binding of Li2 Sx and its transformation chemistry within the bulky polymer host, leading to fast Li2 S/S kinetics. The compact polymer/S electrode presents a high sulfur loading of ca. 15 mgs  cm-2 (200-μm thickness) with a low cathode porosity of 41 %. It delivers a high areal capacity of ca. 14 mAh cm-2 and good cycling stability (200 cycles) at electrolyte-sulfur (E/S) ratio of 5 μL mgs -1 . The assembled pouch cell delivers a cell-level high energy density of 303 Wh kg-1 and 392 Wh L-1 .