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The efficacy of artificial neural network (ANN) models employing laboratory variables for predicting fatty liver disease (FLD) remains inadequately established. The study aimed to develop ANN models to precisely predict FLD.

Objetivo: Relatar um caso de mielofibrose primária com apresentação clínica de tromboses em sítios diferentes. Métodos: Coleta de dados através de entrevista, registro fotográficoe revisão do prontuário. Relato de caso: Paciente masculino, 61 anos, em investigação de anemia normo-normocom eritroblastose. História de perda ponderal de 8 kg em 30 dias, astenia, dispneia e dor abdominal. Negava sangramentos, equimoses, alterações de hábitos intestinais, cirurgias, história familiar de trombofilias ou neoplasias. Possuía antecedente recente de múltiplas tromboses. Há 3 meses quadro deTEP bilateraleTVP extensa de membro inferior esquerdo. Angio-TCtórax comembolia pulmonar de artérias segmentares de lobos inferiores mais extensa à direita; Doppler venoso de membro inferior esquerdocom trombose de veiaspoplítea, femoral comum, superficial e profunda. Em investigação complementar com TC de abdome apresentou sinais de trombose de veia porta com transformação cavernomatosa extensa e esplenomegalia 18,4 cm. Laboratório inicial: Hemoglobina 8.9 g/dL, Hematócrito de 28%, normocrômica e normocítica, com presença de anisocitose +/4+, poiquilocitose +/4+, dacriócitos ++/4+, policromasia +/4+ e eritroblastos 2%, leucócitos totais 11.590/mm3 e plaquetas em 421.000/mm3, índice de saturação de transferrina30%, ferro sérico 86 μg/dL e ácido fólico 13,9 ng/mL, sorologias para hepatite B, Hepatite C, Sífilis e HIV negativas. Demais investigação: provas de hemólise imune negativas, porém com DHL 1523U/L, fator reumatoide e fator antinuclear negativos, e trombofilias não identificadas. Prosseguiu-se com coleta de mielograma e biópsia de medula óssea em crista ilíaca póstero superior direita, além de avaliação genética das mutações JAK2, CALR e MPL. Resultado de AP compatível com neoplasia mieloproliferativa crônica (mielofibrose primária): celularidade de 60%, aumento da megacariopoiese com atipias e alto pleomorfismo, “clusters”, diminuição da hematopoiese com hemossiderose moderada e fibrose medular grau III. As três mutações foram negativas. O paciente foi encaminhado à onco-hemalogia para tratamento seguimento. Discussão: A mielofibrose primária é rara e resulta de transformação neoplásica de células hematopoiéticas, com mutação (JAK-2, CALR, MPL); que causam alterações intensas do estroma medular gerando fibrose, osteosclerose e angiogênese. Até 25% são assintomáticos, o restante pode apresentar sintomas de anemia, dor abdominal crônica, perda de peso, alterações ósseas, eritropoiese extramedular, sangramentos, anormalidades imunológicas, e muito raramente alterações trombóticas. O diagnostico depende de 3 critérios maiores (fibrose ou megacariocitoseem AP, ausência de outras síndromes mielodisplásicas, mutação JAK2 ou ausência de outra etiologia para fibrose) e ao menos 1 critério menor (leucoeritroblastoste, DHL sérico aumentado, anemia, esplenomegalia). Cerca de 5 a 10% dos pacientes são triplo negativos. O transplante de células tronco hematopoiético é a única opção curativa, há outras opções terapêuticas como hidroxiuréia, prednisona, talidomida e ruxolitinibe. Conclusão: Demonstra-se apresentação de quadro clínico trombótico exuberante associado à mielofibrose primária, etiologia rara, mas cujo diagnóstico deve ser lembrado perante quadros de trombose, principalmente de sítio abdominal.

Abstract The posterolateral tibial plateau fracture is a special type of intra-articular fracture, for which there is no simple, safe, and effective standardized procedure. In this paper, we evaluate the clinical efficacy and the advantages of the treatment of posterolateral tibial plateau fracture by using our designed proximal lateral tibial rim plate for the posterolateral condyle of the tibial plateau via the space above the fibula head. Thirty-eight patients with posterolateral tibial plateau fractures from June 2018 to June 2021 were retrospectively analyzed. CT scans were used to classify the degree of injury in the included patients. All of them were fixed with reduction using an approach above the fibula head combined with a homemade anatomical plate. The regular postoperative review was performed to instruct functional knee exercises. Postoperative complications were observed and follow-up visits were performed to assess the functional outcome. A total of 38 patients with posterolateral tibial plateau fractures, 13 males and 25 females were included in the study. All patients were followed up for 13–26 months, with a mean of 15.3 months. There were no postoperative complications such as numbness of the limb, knee joint instability, etc. X-ray review showed that the fractures were all healed, and the healing time was 10–16 weeks, with an average of 12.1 weeks; none of the internal fixation loosening and loss of articular surface occurred during the follow-up period. At the last follow-up, according to the HSS knee function score criteria, the scores were 79–98, with an average of 91.3. The HSS score presented excellent in 34 cases (89%) and good in 4 cases (11%). The Rasmussen score was graded as excellent in 29 cases (76%) and good in 9 cases (24%). In conclusion, The treatment of posterolateral tibial plateau fractures by an approach above the fibula head has the advantages of simplicity and safety, small trauma, and no risk of vascular and nerve injuries, and the anatomical proximal lateral tibial rim plate can play a direct and effective supporting role for the bone fragments of the posterolateral condyle, and the combination of both of them has obvious advantages in the treatment of posterolateral condylar fracture of the tibial plateau, and it is a method worth borrowing and popularizing.

For the collaborative treatment and resource utilization of an industrial coke oven on municipal solid waste (MSW), this study used MSW to prepare refuse-derived fuel (RDF). The influence of different mix ratio between RDF and coal on coking products was considered, and technical and economic analyses were conducted. The results showed that under the low mixture ratio (3%), the pyrolytic carbon obtained basically met the class III standard of metallurgical carbon. In the experiment of medium mixture ratio (25%, 30%, 35%), the product contained a certain amount of calorific value, lower than that of the metallurgical coke. It might be that the ash content increased, and such product can be used for civil coke or chemical coke. When the mixture ratio was 100%, the calorific value of pyrolysis carbon was 7.53 MJ/kg, representing 25.7% of the calorific value of ordinary coke. The gas production rate of the discharged gas was 0.35, and the calorific value is 14.0 MJ/kg, reaching 73.6% of the coke oven gas. Under the condition of no coal input, the MSW was converted into usable energy. The results demonstrated that coke oven pyrolysis with 100% RDF addition is the most feasible way to recycle resources and energy.

Zhenjie Teng,1– 3 Jing Feng,4 Xiaohua Xie,2 Jing Xu,2 Xin Jiang,2 Peiyuan Lv1– 3 1Department of Neurology, Hebei Medical University, Shijiazhuang, People’s Republic of China; 2Department of Neurology, Hebei General Hospital, Shijiazhuang, People’s Republic of China; 3Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, People’s Republic of China; 4Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of ChinaCorrespondence: Peiyuan Lv, Department of Neurology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, Hebei Province, 050051, People’s Republic of China, Tel/Fax +86 31185988906, Email peiyuanlu2@163.comBackground: Total cerebral small vessel disease (CSVD) burden score is an important predictor of vascular cognitive impairment (VCI). However, few predictive models of VCI in type 2 diabetes mellitus (T2DM) patients have included the total CSVD burden score, especially in the early stage of VCI.Objective: To develop and validate a nomogram that includes the total CSVD burden score to predict mild VCI in patients with T2DM.Methods: A total of 322 eligible participants with T2DM who were divided into mild and normal cognitive groups were enrolled in this retrospective study. Demographic data, laboratory data and imaging markers of CSVD were collected. The total CSVD burden score was calculated by combining the different CSVD markers. Step-backward multivariable logistic regression analysis with the Akaike information criterion was applied to select significant predictors and develop a best-fit predictive nomogram. The performance of the nomogram was assessed in terms of discriminative ability, calibrated ability, and clinical usefulness.Results: The nomogram model consisted of five variables: age, education, hemoglobin A1c level, serum homocysteine level, and total CSVD burden score. A nomogram with these variables showed good discriminative ability (area under the receiver operating characteristic curve was 0.801 in internal verification). In addition, the Hosmer-Lemeshow test (χ2 =9.226, P=0.417) and bootstrap-corrected calibration plot indicated that the nomogram had good calibration. The Brier score of the predictive model was 0.178. Decision curve analysis demonstrated that when the threshold probability ranged between 16% and 98%, the use of the nomogram to predict mild VCI in patients with T2DM provide a greater net benefit.Conclusions: The nomogram, composed of age, education, stroke, HbA1c level, Hcy level, and total CSVD burden score, had good predictive accuracy and may provide clinicians with a practical tool for predicting the risk of mild VCI in T2DM patients.Keywords: vascular cognitive impairment, mild cognitive impairment, cerebral small vessel disease, type 2 diabetes mellitus, nomogram

Ci Lu,1,* Panpan Lv,2,* Xiaoying Zhu,1 Yongmei Han1 1Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Department of Ultrasound, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaoying Zhu; Yongmei Han, Department of Rheumatology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3# Qingchun East Road, Hangzhou, 310016, People’s Republic of China, Email 3202091@zju.edu.cn; 3408235@zju.edu.cnAbstract: Cogan’s syndrome (CS) is a rare chronic inflammatory disease, characterized by interstitial keratitis and vestibular auditory dysfunction. Hypertrophic pachymeningitis (HP) is a rare chronic aseptic inflammatory disease of the central nervous system. This article reports a patient with CS coexisting with HP. The patient was a 66-year-old male with fever, headache, red eyes, hearing loss, and significantly elevated inflammatory markers. Cerebrospinal fluid examination, blood culture, and tests for autoantibodies such as antinuclear antibodies were negative. Pure tone audiology (PTA) indicated bilateral sensorineural deafness. Both Positron emission tomography–computed tomography (PET/CT) and vascular color Doppler ultrasound suggest the presence of vasculitis. Considering Cogan’s syndrome, the patient received 40 mg of methylprednisolone intravenously once daily. The brain’s magnetic resonance imaging (MRI) revealed slightly thickened and enhanced dura mater, suggesting HP. The dose of methylprednisolone was increased to 40 mg intravenously every 8 hours, leading to the patient’s improved symptoms and decreased inflammatory markers. Both CS and HP are rare chronic inflammatory diseases, and their coexistence is even rarer, with only two reported cases in literature up to date. The coexistence of CS and HP should be considered when the CS patients with headaches do not respond well to treatment.Keywords: Cogan’s syndrome, hypertrophic pachymeningitis, vasculitis

Abstract Background There are many difficulties in the reduction and fixation of the tibial plateau fractures involving posterolateral quadrant using general plates via traditional approaches. By imaging the area above the fibulae capitulum, this study was performed to investigate the feasibility of the trans-fibular-head approach and to design an ideal anatomical plate. Methods MRI and CT scans of the knee joint were collected from 205 healthy volunteers (103 males, 102 females). Gender and height were used to divide the volunteers into groups separately: (1) A1 group and A2 group according to gender, (2) B1 group and B2 group according to height. Based on the images, several parameters were defined and measured to describe the space above the head of the fibula. In addition, differences in these parameters between genders and height were compared. Results The narrowest distance in the bony region was (10.96 ± 1.39) mm, (5.41 ± 0.97 mm) in the bone-ligament region. The narrowest distance of bony region in the A1 group was more than that in the A2 group (11.21 ± 1.62 mm, 10.85 ± 1.47 mm, p = 0.029). The narrowest distance of the bony region was (10.21 ± 1.42) mm and (11.65 ± 1.39) mm in the B1 group and B2 group, respectively (p = 0.002). The narrowest distance of the bone-ligament region was (5.39 ± 0.78) mm and (5.22 ± 1.21) mm in the A1 group and A2 group, respectively. No statistically significant differences were observed between the A1 group and the A2 group in terms of the narrowest distance of the bone-ligament region. In the B1 group, the narrowest distance of the bone-ligament region (5.18 ± 0.71 mm) was not significantly less than that (5.31 ± 0.91 mm) in the B2 group. Conclusion The space above the fibular capitellum was ample enough to place the plate for treating tibial plateau fractures involving posterolateral quadrant. The divisions of the lateral tibial plateau by 3-dimensional CT and the parameters of each region were crucial for providing guidance for designing the anatomical plate for the trans-fibular-head approach.

The Internet background and the rapid change in science and technology promote the innovation of traditional college physical education, and the study uses the OpenPose method to detect the key points of students’ bodies in physical education and evaluate their postures. Meanwhile, based on the extraction of feature information of students’ movement postures, the DTW algorithm solves the problem of the inconsistent length of the video sequence of movement postures, matches students’ movement postures, and determines whether the activities of various joints are standardized during students’ movement. The evaluation index system of college physical education is constructed to evaluate the college physical education teaching method proposed in this paper. Apply the method of this paper in practice, using the method of comparing and analyzing the students’ academic interest, physical fitness, motor skills and motor posture before and after the experiment to explore the effectiveness of this paper’s method. The evaluation of the physical education method scored the highest on the secondary index of technology application, the lowest on learning resources, and the highest on the tertiary index of “the ability to use modern educational technology” and “timely and accurate student feedback”. The lowest scores were for “reasonable layout of learning space” and “completeness of facilities”. Before the experiment, the P value of the tennis program of the two groups of male and female students in the 10 dimensions of academic interest, physical fitness and motor skills and the mobility specification of 4 types of joints was greater than 0.05. After the experiment, the two groups of male and female students performed better than the control group in academic interest, physical fitness, motor skills and the mobility specification of joints, and the P value of the two groups of male and female students was less than 0.05. This paper shows that the OpenPose-based approach to physical education in higher education has yielded positive outcomes.

Taking visual art intelligence as an entry point, this paper describes the transformation brought by the information age to the expression of visual art. Based on VR technology to build a practice system of visual art intelligence, VR positioning technology is used to locate the three-dimensional coordinates of the operator in order to realize the independent positioning of multiple operators in a large space and avoid positioning interference. Through the eye movement multi-channel interaction algorithm based on head-eye synergy, the two-dimensional interaction task in flow field visualization is completed, and then gesture interaction is added to complete the three-dimensional interaction task. The constructed system was implemented in the teaching of art majors at College Z, and the data were analyzed. The results show that the total average scores of innovative theoretical ideas, interactive experience feeling, symbolic integration of creative content and infinite extension of the multidimensional spatial field are 82.42, 83.57, 80.84 and 80.28, respectively. The data show that teachers, students and parents recognize the intelligent system of visual arts and believe that it improves students’ innovative ability in art creation, enhances the interactive experience feeling of visual arts, and provides data support for the continuous research and exploration of contemporary visual arts.

The Kirchhoff model is derived from the vibration problem of stretchable strings. This article focuses on the long-time dynamics of a class of higher-order coupled Kirchhoff systems with nonlinear strong damping. The existence and uniqueness of the solutions of these equations in different spaces are proved by prior estimation and the Faedo-Galerkin method. Subsequently, the family of global attractors of these problems is proved using the compactness theorem. In this article, we systematically propose the definition and proof process of the family of global attractors and enrich the related conclusions of higher-order coupled Kirchhoff models. The conclusions lay a theoretical foundation for future practical applications.

Based on a large amount of energy consumption, performance indicators and base station configuration data that can be collected in the 5G network management system, this paper uses machine learning algorithms to establish an energy consumption calculation model for common AAU equipment on the existing network, and verifies the accuracy of the model. The test results show that the accuracy of the energy consumption calculation models established by this scheme for several common AAU devices in the existing network has reached more than 97%, which fully proves that the energy consumption modeling method has high practicability and promotion value.

Separation among rubidium and potassium ions from salt lake brines remains challenging. In this work, a typical room temperature ionic liquid 1-ethyl-3-metyhlimidazaolium bis(trifluoromethylsulfonyl)imide ([C2mim+][NTf2–]) was used as diluent and synergistic extractant, dicyclohexano-18-crown-6 (DCH18C6) was used as extractant to extract rubidium ions from brine solutions which contain high concentrations of potassium ions was investigated. Under the optimal conditions, the single extraction efficiency of rubidium ions was up 93.63%. The thermodynamic parameters of the rubidium ion extraction were obtained. Based on the slope analysis method, the extracted species in the organic phase were ascertained as 1:1 complex. UV-visible has been performed to investigate the ion concentration of ionic liquid before and after the interaction of metal ions and ligands. Rubidium ions in [Rb · DCH18C6]+ complex were stripped by 2.5 mol · L–1 NH4NO3. The extraction system offers high efficiency, simplicity and environmentally friendly application prospect to separate rubidium from brine solutions.

Jiangxia Huang,1 Qianru Yang,1 Pan Lv,1 Xiaoyan Xiong,2 Ougen Liu1 1Department of Dermatology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 2Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of ChinaCorrespondence: Ougen Liu, Department of Dermatology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, Jiangxi, 330006, People’s Republic of China, Email 13576296646@163.comAbstract: Cutaneous pili migrans is a rare condition caused by embedded hair shafts or fragments which presents as a mobile black linear rash and is easily confused with cutaneous larva migrans. “Ingrowing hair”, in which the hair shaft grows inside the skin and burrows into the uppermost dermis rather than exiting the skin, is much rarer, and only 8 cases have been reported thus far, all in Asian men. We report a case of a 22-year-old Chinese male with a 4 cm-long black linear rash that migrated from the anterior abdomen to the left lower abdomen. The black lines represented hair shafts with follicular structures. The lesion disappeared immediately after hair removal. No recurrence occurred in 4 weeks of follow-up. To our knowledge, this is the first description of ingrowing hair occurring in the abdomen.Keywords: cutaneous pili migrans, ingrowing hair, creeping hair

Yining Xiao,1– 3 Zhenjie Teng,1– 3 Jing Xu,2,3 Qianqian Qi,2 Tianyuan Guan,1,2 Xin Jiang,2,3 Huifang Chen,2 Xiaohua Xie,2 Yanhong Dong,2,3 Peiyuan Lv1– 3 1Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 3Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People’s Republic of ChinaCorrespondence: Peiyuan Lv, Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email peiyuanlu2@163.comObjective: This study sought to explore the associations of the systemic immune-inflammation index (SII) with total cerebral small vessel disease (CSVD) burden and cognitive impairment.Methods: We enrolled 201 patients in the retrospective study with complete clinical and laboratory data. The SII was calculated as platelet count × neutrophil count/lymphocyte count. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE). Total CSVD burden was assessed based on magnetic resonance imaging. We performed logistic regression models, Spearman correlation, and mediation analysis to evaluate the associations of SII with CSVD burden and cognitive impairment.Results: After adjustment for confounding factors in the multivariate binary logistic regression model, elevated SII (odds ratio [OR], 3.263; 95% confidence interval [CI], 1.577– 6.752; P = 0.001) or severe CSVD burden (OR, 2.794; 95% CI, 1.342– 5.817; P = 0.006) was significantly associated with the risk of cognitive impairment. Correlation analyses revealed that SII levels were negatively associated with MMSE scores (rs = − 0.391, P < 0.001), and positively associated with the total CSVD burden score (rs = 0.361, P < 0.001). Moreover, SII was significantly related to the severity of the CSVD burden (OR, 2.674; 95% CI, 1.359– 5.263; P = 0.004). The multivariable-adjusted odds ratios (95% CI) in highest tertile versus lowest tertile of SII were 8.947 (3.315– 24.145) for cognitive impairment and 4.945 (2.063– 11.854) for severe CSVD burden, respectively. The effect of higher SII on cognitive impairment development was partly mediated by severe CSVD burden.Conclusion: Elevated SII is associated with severe CSVD burden and cognitive impairment. The mediating role of severe CSVD burden suggests that higher SII may contribute to cognitive impairment through aggravating CSVD burden.Keywords: systemic immune-inflammation index, inflammation, cognitive impairment, cerebral small vessel disease, total burden

Yuyuan Zhang,1,&ast; Zaoqu Liu,1,&ast; Jie Li,1 Xin Li,1 Mengjie Duo,2 Siyuan Weng,1 Peijie Lv,3 Guozhong Jiang,4 Caihong Wang,5 Yan Li,6 Shichao Liu,6 Zhen Li1 1Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3Department of Radiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, People’s Republic of China; 4Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 5Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 6Department Cardiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhen Li, Email lzlyct620@163.comIntroduction: Mutation patterns have been extensively explored to decipher the etiologies of hepatocellular carcinoma (HCC). However, the study and potential clinical role of mutation patterns to stratify high-risk patients and optimize precision therapeutic strategies remain elusive in HCC.Methods: Using exon-sequencing data in public (n=362) and in-house (n=30) cohorts, mutation signatures were extracted to decipher relationships with the etiology and prognosis in HCC. The proteomics (n=159) and cell-line transcriptome data (n=1019) were collected to screen the implication of sensitive drugs. A novel multi-step machine-learning framework was then performed to construct a classification predictor, including recognizing stable reversed gene pairs, establishing a robust prediction model, and validating the robustness of the predictor in five independent cohorts (n=900).Results: Two heterogeneous mutation signature clusters were identified, and a high-risk prognosis cluster was recognized for further analysis. Notably, mutation signature cluster 1 (MSC1) was featured by activated anti-tumor immune and metabolism dysfunctional states, higher genomic instability (high TMB, SNV neoantigen, indel neoantigens, and total neoantigens), and a dismal prognosis. Notably, MSC performed as an independent risk factor than clinical traits (eg, stage, vascular invasion). Additionally, afatinib and canertinib were recognized which might have potential therapeutic implications in MSC1, and the targets of these drugs presented a higher expression in both gene and protein levels in HCC.Discussion: Our studies may provide a promising platform for improving prognosis and tailoring therapy in HCC.Keywords: hepatocellular carcinoma, mutation signature, gene pairs, precision therapy, machine learning, prognosis

Zhenjie Teng,1– 3,&ast; Jing Feng,4,&ast; Peiyuan Lv1– 3 1Department of Neurology, Hebei Medical University, Shijiazhuang, People’s Republic of China; 2Department of Neurology, Hebei General Hospital, Shijiazhuang, People’s Republic of China; 3Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, People’s Republic of China; 4Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Peiyuan Lv, Department of Neurology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, Hebei Province, 050051, People’s Republic of China, Tel/Fax +86 31185988906, Email peiyuanlu2@163.comObjective: To investigate the association between subclinical hypothyroidism (SCH) and cognitive function in patients with cerebral small vessel disease (CSVD).Methods: We evaluated 528 patients with CSVD in this retrospective study. SCH was defined as elevated levels of thyroid stimulating hormone with normal concentrations of free thyroxine. Magnetic resonance imaging was performed to assess the total CSVD burden score and the Montreal Cognitive Assessment was used to measure the cognitive function. Participants were grouped based on cognitive function or total CSVD burden score. Multivariate logistic regression and mediation analysis models were used to estimate the association of SCH with cognitive function and CSVD burden.Results: SCH was an independent risk factor for cognitive impairment in patients with CSVD after adjustment for potential confounding factors (OR: 1.939; 95% CI: 1.170 to 3.213; P=0.010). Additionally, SCH was independently associated with severe CSVD burden after adjustment for potential confounding factors (OR: 1.668; 95% CI: 1.085 to 2.564; P=0.020). Mediation analysis found a significant moderating effect (P=0.021) of the severe CSVD burden on the relation between SCH and cognitive impairment after adjustment for potential confounding factors. A 30.1% of the total effect between this relation was attributable to the presence of severe CSVD burden.Conclusion: SCH was associated with an increased risk of cognitive impairment in patients with CSVD. The mediating role of severe CSVD burden suggests that SCH may lead to cognitive impairment through the presence of severe CSVD burden. These findings may suggest strategies for screening for SCH in the context of cognitive impairment in patients with severe CSVD.Keywords: subclinical hypothyroidism, cognitive function, cerebral small vessel disease

Zhenjie Teng,1,2 Jing Feng,3 Ronghui Liu,4 Yanhong Dong,2 Huifang Chen,2 Jing Xu,2 Xin Jiang,2 Rui Li,2 Peiyuan Lv1,2 1Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei Province, People’s Republic of China; 2Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China; 3Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of China; 4Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei Province, People’s Republic of ChinaCorrespondence: Peiyuan Lv, Department of Neurology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, Hebei Province, 050051, People’s Republic of China, Tel/Fax +86 31185988906, Email peiyuanlu2@163.comObjective: Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment, but the underlying cerebral small vessel disease (CSVD)-related structural brain correlates are unclear. The aim of this study was to investigate the relationship between various imaging markers of CSVD and mild cognitive impairment (MCI) in patients with T2DM.Methods: A total of 228 eligible participants with T2DM who were divided into MCI group and normal cognitive group based on neuropsychological assessment were enrolled in this retrospective study. White matter hyperintensity (WMH), lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces (EPVS) were evaluated based on brain magnetic resonance imaging (MRI). The total CSVD burden score was calculated by combining the above four markers of CSVD. Binary logistic regression analysis was used to evaluate the relationship between different imaging markers of CSVD and MCI in patients with T2DM. Kruskal–Wallis test and Jonckheere–Terpstra test were used to compare mean MoCA scores among individuals with varying CSVD markers.Results: In the multivariate binary logistic regression analyses, moderate or severe total CSVD burden (OR: 3.29, 95% CI: 1.63– 7.38, P=0.004; OR: 10.97, 95% CI: 4.94– 24.34, P< 0.001, respectively), moderate dWMH (OR: 3.26, 95% CI: 1.43– 7.41, P=0.005), extensive lacunes (OR: 4.97, 95% CI: 1.79– 13.81, P=0.002), and moderate BG-EPVS (OR: 3.84, 95% CI: 1.81– 8.13, P< 0.001) were associated with MCI in patients with T2DM related to MCI after adjusting for potential confounders. There was a trend for significant decrease in MoCA scores with increase severity of dWMH, pWMH, lacunes, BG-EPVS, deep CMBs, or total CSVD burden (P for trend < 0.05).Conclusion: Different imaging markers of CSVD, particularly total CSVD burden, were associated with an increased risk of MCI and decline in MoCA scores in patients with T2DM. These findings may provide clues for future studies to explore early diagnostic imaging markers of cognitive impairment in relation to T2DM.Keywords: type 2 diabetes mellitus, mild cognitive impairment, cerebral small vessel disease

Abstract Intravenous thrombolysis is the preferred treatment modality for acute ischemic stroke. In China, written informed consent from patients or proxies must be obtained before intravenous thrombolysis is performed, which always leads to in-hospital delay of thrombolysis. To explore the relationship between characteristics of thrombolysis decision-making and psychological states of proxies of AIS patients. This was a pilot study. 231 proxies of AIS patients were recruited, including 147 males and 84 females. STAI, WFPTS, CAOT, CPS, C-DCS and time-consuming of decision-making were collected by trained nurses during the period from signing informed consent to thrombolysis finished. The general information was collected within 24 h after admission. Pearson correlation analysis and the Ridge regression analysis were used to explore the correlation and causality between psychological indicators (STAI, WFPTS, CAOT, CPS) and decision-making characteristics (C-DCS, Time consuming). Structural equation modeling was used to explore the direct and indirect effect of psychological factors on decision-making characteristics. The mean of anxiety, trust in physicians, and decision conflict were 49.20 ± 9.50, 37.83 ± 6.63 and 30.60 ± 14.77, respectively. The CAOT was associated with C-DCS through the mediation of STAI and WFPTS (p

Foxtail millet, a high-quality coarse cereal, is generally used to cook porridge. Cooked foxtail millet is another food product of this cereal. However, a systematic evaluation method for the eating quality of cooked foxtail millet has not yet been established. In this study, heater type, millet-to-water mass ratio, water type, and soaking time affecting the edible quality of cooked foxtail millet (Variety: Zhangzagu 13) were investigated. The hardness viscometer, colorimeter and sensory evaluation were used to comprehensively evaluate the edible quality of millet. The optimal cooking method was determined as follows: Firstly, put 300 g of millet in an electric cooker and wash twice with deionized water quickly. Secondly, add deionized water in a mass ratio of millet to water 1.0∶2.0 and soak for 30 min. Finally, cook millet for about 45 minutes in the essence rice mode. After cooking, stir well and stew for 20 min. This research provides an important scientific basis for foxtail millet cooking and edible quality evaluation.

Dan Mu,1,&ast; Xin Wang,1,&ast; Huiting Wang,1 Xuan Sun,2 Qing Dai,2 Pin Lv,1 Renyuan Liu,1 Yu Qi,2 Jun Xie,2 Biao Xu,2,3 Bing Zhang1,4 1Department of Radiology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People’s Republic of China; 2Department of Cardiology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People’s Republic of China; 3State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, Jiangsu, 210023, People’s Republic of China; 4Institute of Brain Science, Nanjing University, Nanjing, Jiangsu, 210008, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Biao Xu; Bing Zhang, Email xubiao62@nju.edu.cn; zhangbing_nanjing@nju.edu.cnBackground: Photodynamic therapy (PDT) has achieved continued success in the treatment of tumors, but its progress in the treatment of atherosclerosis has been limited, mainly due to the low tissue-penetration ability of the excitation light for photosensitizers.Methods: In this study, we designed a chemiexcited system producing singlet oxygen in an attempt to apply PDT for the treatment of atherosclerosis without the irradiation of external light. The system designed was polymeric nanoparticles (NPs) equipped with chemical fuel and photosensitizers, cross-linked with an Fe3+–catechol complex for stabilization and magnetic resonance imaging (MRI).Results: The system (FeCNPs for short) accumulated effectively in plaques, providing persistent and enhanced T1-weighted contrast ability. FeCNPs also prevented progression of atherosclerosis via macrophage elimination, and obviously reduced plaque size and thickness revealed by T1-weighted MRI. Expression of CD68, MCP1, and TNFα was significantly reduced after treatment. However, low doses of FeCNPs exhibited better therapeutic efficacy than high doses. Furthermore, low-dose FeCNPs exhibited effective macrophage elimination in aortic arches and abdominal aortae, but inefficiency in the thoracic aorta, aortic hiatus, and aorta–iliac bifurcation.Conclusion: This study provides the first example of a combination of MRI and chemiexcited PDT for atherosclerosis, evidencing the effectiveness of PDT and providing significant pointers for developing nanotherapy on atherosclerosis.Keywords: photodynamic therapy, atherosclerosis, chemi-excited, macrophages, MRI

Xiaofang Dong,1 Sen Yang,2 Yuanli Guo,1 Peihua Lv,1 Yanjin Liu1 1Neurology Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 2Orthopedics Department, The Seventh People’s Hospital of Zhengzhou, Zhengzhou, Henan Province, People’s Republic of ChinaCorrespondence: Yanjin Liu, Neurology Department, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan, 450052, People’s Republic of China, Tel +86 13523548732, Email luomeiruxue139@sina.com; liu-yanjin@126.comPurpose: To identify latent classes of acute stroke patients with distinct experiences with the symptom clusters of depression, anxiety, fatigue, sleep disturbance, and pain symptoms and assess, if the selected variables determine a symptom-cluster experience in acute stroke patients.Participants and Methods: A sample of 690 participants were collected from July 2020 to December 2020 in a cross-sectional descriptive study. Latent class analysis was conducted to distinguish different clusters of acute stroke participants who experienced five patient-reported symptoms. Furthermore, multinomial logistic regression was selected to verify the influencing indicators of each subgroup, with selected socio-demographic variables, clinical characteristics, self-efficacy, and perceived social support as independent variables and the different latent classes as the dependent variable.Results: Three latent classes, named “all high symptom,” “high psychological disorder,” and “all low symptom,” were identified, accounting for 9.6%, 26.3%, and 64.1% of symptom clusters, respectively. Patients in the “all high symptom” and “high psychological disorder” classes reported significantly lower quality of life (F=40.21, p < 0.05). Female gender, younger age, higher National Institutes of Health Stroke Scale scores, and lower self-efficacy and perceived social support were risk factors associated with the “high psychological disorder” class. Younger patients with lower self-efficacy and perceived social support were more likely to be in the “all high symptom” class.Conclusion: This study identified latent classes of acute stroke patients that can be used in predicting symptom-cluster experiences following a stroke. Also, the ability to characterize subgroups of patients with distinct symptom experiences helps identify high-risk patients. Focusing on symptom clusters in clinical practice can inspire us to create effective targeted interventions for subgroups of stroke patients suffering from the same symptom cluster.Keywords: pain, fatigue, sleep disturbance, anxiety, depression

In this paper, the stochastic asymptotic behavior of the nonautonomous stochastic higher-order Kirchhoff equation with variable coefficients is studied. By using the Galerkin method, the solution of this kind of equation is obtained, and stochastic dynamical system under this kind of equation is obtained; by using the uniform estimation, the existence of the family of Dk{{\mathcal{D}}}_{k}-absorbing sets of the stochastic dynamical system Φk{\Phi }_{k} is obtained, and the asymptotic compactness of Φk{\Phi }_{k} is proved by the decomposition method. Finally, the Dk{{\mathcal{D}}}_{k}-stochastic attractor family of the stochastic dynamical system Φk{\Phi }_{k} in Vm+k(Ω)×Vk(Ω){V}_{m+k}\left(\Omega )\times {V}_{k}\left(\Omega ) is obtained.

Accurate calculation of the mode shape and natural frequency of the motor stator is the basis for reducing motor noise and vibration. At present, scholars have disputes about the setting of stator core and winding material property parameters. In this paper, the modal simulation analysis and experimental test of a 2.2 kW permanent magnet brushless DC motor stator system are carried out. First, to give the stator core and the winding materials, The finite element software is used to analyze the relationship between the motor modal frequency and the parameters of the anisotropic materials. According to the modal frequency variation law, a method for correcting the parameters of the anisotropic materials based on the modal frequency is proposed. The method can complete the finite element model parameter correction of the stator. Secondly, the modal experiment is carried out by hammering method to verify the accuracy of the finite element model and determine the effectiveness of the method for correcting the equivalent material parameters. And by this method, the stator material parameters of the stator can be quickly determined. The error of this experiment and simulation is within 3%, achieving the purpose of experiment and simulation benchmarking.