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Abstract Aims To explore rare and difficult cases of undifferentiated embryonal sarcoma of the liver (UESL) in children in a single centre, summarize the diagnosis and treatment experience and analyse the role of a computer-assisted surgery system (Hisense CAS), thus providing a new global vision and three-dimensional perspective. Methods We retrospectively collected the clinical data including the diagnoses and treatment processes, of children with UESL confirmed by histopathological examination in our hospital from January 2009 to December 2020. The relationship between the tumour volume and important blood vessels and between the liver volume and tumour volume, as well as other three-dimensional characteristics in the reconstructed three-dimensional model were analysed using Hisense CAS. The findings from this analysis can be used to aid in surgical decision-making and preoperative planning. Results Four children—3 girls and 1 boy—with UESL were included in the study. The age at onset ranged from 6 to 8 years. All four children presented with symptoms of abdominal discomfort, and abdominal masses were detected during physical examination. Owing to the wishes of their parents and the possibility that the disease was benign, all four children underwent one-stage radical surgery. For patient 1, a three-dimensional reconstruction was created during the initial diagnosis, which made accurate evaluation and planning of the preoperative procedure challenging. In patient 2, the tumour was located in the middle lobe of the liver and involved the first and second hepatic hilum. For patient 3, the pathological diagnosis of the tumour after surgery was challenging, but eventually, the diagnosis was confirmed through histochemistry and consultation with higher-level hospitals. Patient 4 had a giant tumour, which had a preoperative simulated future liver remnant volume (FLV) that was 21.0% of the total volume of the liver and tumour (TLTV). According to the standard liver volume (SLV) for children, the FLV was 77.0% of the SLV, making surgery feasible. All four children underwent complete resection, and only patient 4 experienced recurrence below the diaphragm 19 months after surgery. Currently, the 3-year overall survival rate is 100%, and the 3-year event-free survival rate is 75%. Conclusion UESL in children is rare, and the key to diagnosis and treatment is complete surgical resection. Through individualized three-dimensional surgical planning, accurate and complete resection of difficult and complex UESL in children can be achieved, leading to a favourable prognosis.

The assessment of urban renewal (UR) potential aims to prioritize areas for UR, which are essential for sustainable urban revitalization. However, conventional data sources often fall short in encompassing diverse urban characteristics in the evaluation process, such as urban three-dimensional (3D) building information and the intensity of human activities. To address this gap, this study integrated 3D building data and geographic data to create a comprehensive set of 28 indicators spanning four dimensions: natural environmental conditions, land use, socio-economic factors, and building conditions. These indicators take into account vertical dimensions, dynamic aspects, and fine-scale details. Leveraging the existing UR practices as a positive example, we established an UR potential assessment model at street block scale using Presence and Background Learning combined with extreme gradient boosting algorithms (PBLXGBoost). Our findings revealed that the highest accuracy in evaluating industrial UR potential was achieved in Shenzhen (Fpb_avg = 0.80, RMSEavg = 0.21), followed by residential and commercial UR potential assessments. Conversely, other type UR exhibit lower accuracy. Street blocks with significant UR potential are predominantly located in Bao’an, Longgang, and Longhua Districts. Furthermore, employing the SHAP model to elucidate the evaluation results uncovered intricate hierarchical, positive-negative, and overlapping relationships among various factors and different UR types, where geographic big data and 3D building information showed strong correlations. The methodology proposed in this study enables objective and precise assessments of UR potential, offering valuable support for UR practice and sustainable urban development.

Congenital portosystemic shunts (CPSS) are rare pediatric vascular malformations characterized by abnormal development of the portal vein, which is attributed to incomplete embryonic remodeling of the hepatic and surrounding vasculature. CPSS manifests in two main forms: intrahepatic and extrahepatic. This study details the management of a pediatric patient diagnosed with Congenital Intrahepatic Portosystemic Shunt (CIPS) who was referred to our institution. By using a computer-assisted surgical system, the right hepatectomy was successfully performed, guided by precise intraoperative navigation based on three-dimensional reconstructions of enhanced CT imagery. The patient exhibited a favorable postoperative recovery trajectory, with the absence of complications or recurrence throughout the monitoring period.

Hepatoblastoma (HB) is the most common liver malignancy in children, accounting for approximately 60 % of liver tumors in this population. However, the exact cause of HB remains unclear. The combination of surgery and neoadjuvant chemotherapy has significantly improved the overall survival rate of children with HB, increasing it from 40 % in the past to over 70 %. The concept of precise hepatectomy, which aims to achieve the best rehabilitation outcomes with minimal trauma and maximum liver protection, has been widely accepted by hepatobiliary surgeons. This article provides a comprehensive review of the recent advancements in surgical treatment of HB, focusing on digital surgery and minimally invasive techniques.

Sjögren's syndrome (SS) is an autoimmune disease in which the salivary glands (SGs) and the lacrimal glands (LGs) are affected by lymphocytic infiltration and inflammation. It has been reported that interferon-α (IFN-α) released by plasmacytoid dendritic cells (pDCs) contribute to the pathology of SS, and ART has been shown to effectively ameliorates SS. Despite the current research endeavors, the mechanism of how ART works in the treatment of SS remains to be fully elucidated. Whether ART can treat SS by inhibiting IFN-α remains unclear. This hypothesis was tested both in vivo and in vitro settings during the study. The SS model mice, which were treated with ART, showed amelioration in symptoms related to dryness. RNA-seq analysis revealed strong anti-IFN-α signaling response upon ART treatment. Additional in vitro studies provided further confirmation that the application of ART inhibits the MyD88 protein expression and the nuclear translocation of IRF7. This suggests that the intervention of ART in the TLR-MyD88-IRF7 pathway plays a role in the therapeutic approach for SS. In summary, this study highlighted the therapeutic potential of ART in SS and ART inhibited the IFN-α signaling in pDCs via the TLR-MyD88-IRF7 pathway.

Urban regeneration (UR) can improve the physical, social, economic, and ecological environment of urban areas, which is the key path to achieving Sustainable Development Goals (SDGs). However, quantitative assessments of the SDGs dynamics before and after UR process are rarely studied. Taking Shenzhen, China, as a practical example, this study combined multi-source geographic data to proposed a fine-scale SDGs assessment index framework applicable to UR (URSDGi). A comprehensive index of urban regeneration SDGs (URSDGs) was then constructed to evaluate the SDGs performance for four types of UR (industrial, residential, commercial and other types) at street block scale. Results showed that Shenzhen’s 392 blocks underwent UR practice between 2012–2020. The industrial UR exhibited the highest degree of SDGs realization with an increase of 962.29 points in the URSDGs score between 2012 and 2020, followed by residential UR with an increase of 126.41 points, whereas commercial and other types of UR exhibited lower degrees of SDGs realization with an increase of 42.23 and 58.39 points, respectively. In addition, studies have found that all types of UR can obviously promote mixed land use (URSDG5) and improve land use efficiency (URSDG3), with an increase of at least 111.10 points in the URSDGi score between 2012 and 2020. Nevertheless, UR can impose additional pressures on residential housing (URSDG1) and lead to a reduction in urban green space (URSDG4), with a decrease of at least −0.66 points in the URSDGi score. The findings can enrich the research methods of SDGs performance assessment at finer scale and help to guide future UR practices.

Human pose estimation is a hot research in the field of computer vision. Existing algorithms perform well in normal scenarios but struggle in occlusion environments. In order to address occlusion problems, we firstly design a multi-scale feature reinforcement backbone (MFRI) to obtain accurate features, which contains three sub-modules. The first sub-module reinforces detailed keypoint features and eliminates redundant background, The second sub-module assigns different weights to different scale information based on importance. The fourth sub-module integrates different scale feature information using a cascaded method. In addition, we design an occlusion handling method. To begin with, we design a multi-scale feature extractor (MSFE) to construct human topological feature, and propose a feature similarity matching method between keypoint detail features and topological features to identify occluded keypoints and eliminate obstacle features. Based on similarity, we design a feature compensation method to extract common attributes among all keypoints and unique features of each keypoint from multiple aspects to compensate for occluded features. Finally, we propose an adjacency matrix improvement method to enhance its ability for describing node relationships. We conduct comparative experiments on the COCO2017 dataset, COCO-Wholebody dataset, and CrowdPose dataset, achieving accuracy of 78.8%, 66.3%, and 77.8%, respectively. Additionally, we design a series of ablation experiments and visualizations. The results show that our method has better performance in handling occlusions.

Abstract Various post-stroke dysfunctions often result in poor long-term outcomes for stroke survivors, but the effect of conventional treatments is limited. In recent years, lots of studies have confirmed the effect of repetitive transcranial magnetic stimulation (rTMS) in stroke rehabilitation. As a new pattern of rTMS, theta burst stimulation (TBS) was proved recently to yield more pronounced and long-lasting after-effects than the conventional pattern at a shorter stimulation duration. To explore the role of TBS in stroke rehabilitation, this review summarizes the existing evidence from all the randomized controlled trials (RCTs) so far on the efficacy of TBS applied to different post-stroke dysfunctions, including cognitive impairment, visuospatial neglect, aphasia, dysphagia, spasticity, and motor dysfunction. Overall, TBS promotes the progress of stroke rehabilitation and may serve as a preferable alternative to traditional rTMS. However, it’s hard to recommend a specific paradigm of TBS due to the limited number of current studies and their heterogeneity. Further high-quality clinical RCTs are needed to determine the optimal technical settings and intervention time in stroke survivors.

An urban growth boundary (UGB) is an important policy tool used to control urban sprawl, which can effectively balance the urban construction needs, residents’ quality of life, and urban ecological protection. Current studies of UGB delineation and its indicators have paid little attention to human factors, such as human activities and economic vitality, and weights for evaluation indicators have been determined highly subjectively. In response to these problems, this article integrated multisource geographic Big Data to construct a total of 30 natural, human, and ecological evaluation indicators. The GIS technology and machine-learning (ML) approach were combined to determine indicator weights with an officially manually drawn 2035 UGB as the reference, aiming to reduce the subjectivity. The suitability score was then calculated from indicator grading 4–1 and related weights, and high suitability (>2.15) regions were eventually delineated as the UGB. Results showed a delineated UGB of 1528.06 km2 with an overall accuracy of over 93% and high consistence with reference data for 2035 in the Chinese city of Changsha. The geographic Big Data totally contributed more than 33.72%, which mainly characterized role of human elements, and a 5–6 percentage point reduction in accuracy was found without these data. Compared with existing articles, our delineated UGB had higher accuracy and closer spatial pattern to the reference data, verifying the effectiveness and reasonability of ML-based weight setting approach and index system with geographic Big Data. The proposed method can provide scientific and accurate framework for UGB delineation, which can promote the territorial spatial planning and sustainable urban development.

Background & Aims: Hepatic ischemia-reperfusion injury is a significant complication of partial hepatic resection and liver transplantation, impacting the prognosis of patients undergoing liver surgery. The protein proprotein convertase subtilisin/kexin type 9 (PCSK9) is primarily synthesized by hepatocytes and has been implicated in myocardial ischemic diseases. However, the role of PCSK9 in hepatic ischemia-reperfusion injury remains unclear. This study aims to investigate the role and mechanism of PCSK9 in hepatic ischemia-reperfusion injury. Methods: We first examined the expression of PCSK9 in mouse warm ischemia-reperfusion models and AML12 cells subjected to hypoxia/reoxygenation. Subsequently, we explored the impact of PCSK9 on liver ischemia-reperfusion injury by assessing mitochondrial damage and the resulting inflammatory response. Results: Our findings reveal that PCSK9 is up-regulated in response to ischemia-reperfusion injury and exacerbates hepatic ischemia-reperfusion injury. Blocking PCSK9 can alleviate hepatocyte mitochondrial damage and the consequent inflammatory response mediated by ischemia-reperfusion. Mechanistically, this protective effect is dependent on mitophagy. Conclusions: Inhibiting PCSK9 in hepatocytes attenuates the inflammatory responses triggered by reactive oxygen species and mitochondrial DNA by promoting PINK1-Parkin–mediated mitophagy. This, in turn, ameliorates hepatic ischemia-reperfusion injury.

Cell alignment plays a vital role in tissue regeneration, especially for neural cells like neurons. Recent progress in biomaterial technologies has enabled the creation of various approaches for engineering neural cell alignment, which has demonstrated significant effectiveness in several biomedical applications. This review primarily concentrates on the latest advancements for in vitro engineering of neural cell alignment. We also summarized their applications in biomedical research, particularly their potential in addressing nervous system injuries. Finally, we analyze the current challenges associated with engineering neural cell alignment and provide insights into future perspectives in this field.

For a long time, human activities have been prohibited in ecologically protected areas in the Ebinur Lake Wetland National Nature Reserve (ELWNNR). The implementation of total closure is one of the main methods for ecological protection. For arid zones, there is a lack of in-depth research on whether this measure contributes to ecological restoration in the reserve. The Normalized Difference Vegetation Index (NDVI) is considered to be the best indicator for ecological monitoring and has a key role to play in assessing the ecological impacts of total closure. In this study, we used Sentinel-2, Landsat-8, and Moderate Resolution Imaging Spectroradiometer (MODIS) remote sensing data to select optimal data and utilized Sen slope estimation, Mann-Kendall statistical tests, and the geographical detector model to quantitatively analyze the normalized difference vegetation index (NDVI) dynamics and its driving factors. Results were as follows: (1) The vegetation distribution of the Ebinur Lake Wetland National Nature Reserve (ELWNNR) had obvious spatial heterogeneity, showing low distribution in the middle and high distribution in the surroundings. The correlation coefficients of Landsat-8 and MODIS, Sentinel-2 and MODIS, and Sentinel-2 and Landsat-8 were 0.952, 0.842, and 0.861, respectively. The NDVI calculated from MODIS remote sensing data was higher than the value calculated by Landsat-8 and Sentinel-2 remote sensing images, and Landsat-8 remote sensing data were the most suitable data. (2) NDVI indicated more degraded areas on the whole, but the ecological recovery was obvious in the localized areas where anthropogenic closure was implemented. The ecological environment change was the result of the joint action of man and nature. Man-made intervention will change the local ecological environment, but the overall ecological environment change was still dominated by natural environmental factors. (3) Factors affecting the distribution of NDVI in descending order were as follows: precipitation > evapotranspiration > land use type > elevation > vegetation type > soil type > soil erosion > slope > temperature > slope direction. Precipitation was the main driver of vegetation change in ELWNNR. The synergistic effect of the factors showed two-factor enhancement and nonlinear enhancement, and the combined effect of the driving factors would increase the influence on NDVI.

Abstract Standing posteroanterior radiographs have been the golden standard to quantify the severity of scoliosis deformity. However, it exposes ionizing radiation to scoliosis patients, and cannot be used for routine screening and monitoring. This study aimed to develop a protocol of measuring postural indexes by using the noninvasive and radiation-free two-dimensional (2D) photogrammetry method and identify its clinical value in scoliosis screening and monitoring. The five postural indexes were measured from the posterior view of 110 participants. One-way ANOVA with post hoc Tukey HSD/Games–Howell analysis was used to compare the differences between the participants in the scoliosis group and the non-scoliosis group. Pearson coefficients of correlation were analyzed to identify the relationships between Cobb angles and each of the five quantitative postural indexes. Based on 2D photogrammetry, the postural indexes of C7 deviation (p = 0.02), shoulder alignment (p

Abstract Objective The indocyanine green retention rate at 15 min (ICG-R15) is a useful tool to evaluate the functional liver reserve before hepatectomy for liver cancer. Taking ICG-R15 as criteria, we investigated the ability of a machine learning (ML)-based radiomics model produced by Gd-EOB-DTPA-enhanced hepatic magnetic resonance imaging (MRI) or contrast-enhanced computed tomography (CT) image in evaluating functional liver reserve of hepatocellular carcinoma (HCC) patients. Methods A total of 190 HCC patients with CT, among whom 112 also with MR, were retrospectively enrolled and randomly classified into a training dataset (CT: n = 133, MR: n = 78) and a test dataset (CT: n = 57, MR: n = 34). Then, radiomics features from Gd-EOB-DTPA MRI and CT images were extracted. The features associated with the ICG-R15 classification were selected. Five ML classifiers were used for the ML-model investigation. The accuracy (ACC) and the area under curve (AUC) of receiver operating characteristic (ROC) with 95% confidence intervals (CI) were utilized for ML-model performance evaluation. Results A total of 107 different radiomics features were extracted from MRI and CT, respectively. The features related to ICG-R15 which was classified into 10%, 20% and 30% were selected. In MRI groups, classifier XGBoost performed best with its AUC = 0.917 and ACC = 0.882 when the threshold was set as ICG-R15 = 10%. When ICG-R15 = 20%, classifier Random Forest performed best with AUC = 0.979 and ACC = 0.882. When ICG-R15 = 30%, classifier XGBoost performed best with AUC = 0.961 and ACC = 0.941. For CT groups, the classifier XGBoost performed best when ICG-R15 = 10% with AUC = 0.822 and ACC = 0.842. When ICG-R15 = 20%, classifier SVM performed best with AUC = 0.860 and ACC = 0.842. When ICG-R15 = 30%, classifier XGBoost performed best with AUC = 0.938 and ACC = 0.965. Conclusions Both the MRI- and CT-based machine learning models are proved to be valuable noninvasive methods for functional liver reserve evaluation.

In order to improve the accuracy of aerial target location and ensure its concealment, a direct location algo-rithm of the aerial target based on external radiation source was proposed.Fixed broadcast signals were used as transmit-ting sources, and the signals scattered by the aerial targets were received by multiple receivers.A direct relationship be-tween the synchronized multi-dimensional baseband signals and the position coordinates of the target was established, and then the spatial cross-spectrum function and joint matching function were constructed.Through iterative spectral peak search, the positioning results of the aerial target could be optimized, and the impact of direct signals and multipath signals on the ground could be effectively suppressed.Simulation results show that the performance of the proposed al-gorithm is better than that of the traditional two-step localization method and other direct localization methods in the case of low signal-to-noise ratio (SNR), and it can achieve high-precision localization of the three-dimensional mobile target.

Abstract Cell sheet technology has emerged as a novel scaffold‐free approach for cell‐based therapies in regenerative medicine. Techniques for harvesting cell sheets are essential to preserve the integrity of living cell sheets. This review provides an overview of fundamental technologies to fabricate cell sheets and recent advances in cell sheet‐based tissue engineering. In addition to the commonly used temperature‐responsive systems, we introduce alternative approaches, such as ROS‐induced, magnetic‐controlled, and light‐induced cell sheet technologies. Moreover, we discuss the modification of the cell sheet to improve its function, including stacking, genetic modification, and vascularization. With the significant advances in cell sheet technology, cell sheets have been widely applied in various tissues and organs, including but not limited to the lung, cornea, cartilage, periodontium, heart, and liver. This review further describes both the preclinical and clinical applications of cell sheets. We believe that the progress in cell sheet technology would further propel its biomedical applications.

BackgroundAccording to epidemiological studies, particulate matter 2.5 (PM2.5) is a significant contributor to cardiovascular disease (CVD). However, making causal inferences is difficult due to the methodological constraints of observational studies. In this study, we used two-sample Mendelian randomization (MR) to examine the causal relationship between PM 2.5 and the risk of CVD.MethodsGenome-wide association study (GWAS) statistics for PM2.5 and CVD were collected from the FinnGen and UK Biobanks. Mendelian randomization analyses were applied to explore the causal effects of PM2.5 on CVD by selecting single-nucleotide polymorphisms(SNP) as instrumental variables.ResultsThe results revealed that a causal effect was observed between PM2.5 and coronary artery disease(IVW: OR 2.06, 95% CI 1.35, 3.14), and hypertension(IVW: OR 1.07, 95% CI 1.03, 1.12). On the contrary, no causal effect was observed between PM2.5 and myocardial infarction(IVW: OR 0.73, 95% CI 0.44, 1.22), heart failure(IVW: OR 1.54, 95% CI 0.96, 2.47), atrial fibrillation(IVW: OR 1.03, 95% CI 0.71, 1.48), and ischemic stroke (IS)(IVW: OR 0.98, 95% CI 0.54, 1.77).ConclusionWe discovered that there is a causal link between PM2.5 and coronary artery disease and hypertension in the European population, using MR methods. Our discovery may have the significance of public hygiene to improve the understanding of air quality and CVD risk.

Accurate information on the spatiotemporal distribution of urban renewal (UR) is important for sustainable urban development. Due to its complexity, existing studies could not completely describe the land cover types after demolition, and lacked the effective conversion rules to monitor the whole process of UR demolition and reconstruction which made it impossible to obtain high-precision UR extent, demolition time, and reconstruction time. This study proposed an UR monitoring framework by combining Point of Interest, nighttime light RS data, time-series RS data from Google Earth high-resolution and Landsat imageries. The urban vacant land was introduced to supplement the land cover classification system for UR monitoring and extracted by DeepLabv3 semantic segmentation model. The new conversion rules were then generated to track the historical changes in urban land types, and the multi-temporal classification model was applied to extract spatial and temporal characteristics of UR process. Results showed a total of 3,525.55 hm2 UR region were identified in Shenzhen during 2012–2020, and the largest demolition and reconstruction areas were both observed in 2019. The F1 and F2 scores of extracted UR extent, UR demolition time, and UR reconstruction time were larger than 0.72, 0.63 and 0.66, respectively, indicating high overall accuracies. Our proposed framework is important for the UR dynamic monitoring and can provide scientific basis for future urban construction.

ABSTRACTLand types visually reflect the comprehensive attributes of land resources, allowing the monitoring of land development dynamics and evaluation of the land use situation. However, existing land type classification systems in urban areas lacked the integrated consideration of human characteristics and natural landscapes. Thus, this study integrated multi-source geospatial data including Weibo check-in, taxi-tracking, building-surveys, and remote sensing images to acquire anthropogenic features including building characteristics and human activities, and natural landscape features including water, vegetation, and urban vacant land. Three-level urban land type classification system was then constructed with two primary categories, six secondary categories, and 17 tertiary categories to reveal integrated characteristics of urban land resources. Based on the extracted urban areas of Shenzhen, urban land types in 2014 were mapped at street block to reveal the distribution and utilization efficiency of land resources in a visual and detailed format, thus guiding land resources optimization.

Abstract The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had and continues to have a significant impact on global public health. One of the characteristics of SARS-CoV-2 is a surface homotrimeric spike protein, which is primarily responsible for the host immune response upon infection. Here we present the preclinical studies of a broadly protective SARS-CoV-2 subunit vaccine developed from our trimer domain platform using the Delta spike protein, from antigen design through purification, vaccine evaluation and manufacturability. The pre-fusion trimerized Delta spike protein, PF-D-Trimer, was highly expressed in Chinese hamster ovary (CHO) cells, purified by a rapid one-step anti-Trimer Domain monoclonal antibody immunoaffinity process and prepared as a vaccine formulation with an adjuvant. Immunogenicity studies have shown that this vaccine candidate induces robust immune responses in mouse, rat and Syrian hamster models. It also protects K18-hACE2 transgenic mice in a homologous viral challenge. Neutralizing antibodies induced by this vaccine show cross-reactivity against the ancestral WA1, Delta and several Omicrons, including BA.5.2. The formulated PF-D Trimer is stable for up to six months without refrigeration. The Trimer Domain platform was proven to be a key technology in the rapid production of PF-D-Trimer vaccine and may be crucial to accelerate the development and accessibility of updated versions of SARS-CoV-2 vaccines.

Background Wilms’ tumor (WT) is one of the most common solid tumors in children with unsatisfactory prognosis, but few molecular prognostic markers have been discovered for it. Many genes are associated with the occurrence and prognosis of WT. This study aimed to explore the key genes and potential molecular mechanisms through bioinformatics and to verify the effects of aquaporin 1 (AQP1) on WT metastasis. Methods Differentially expressed genes (DEGs) were generated from WT gene expression data sets from the Gene Expression Omnibus (GEO) database. Gene functional enrichment analysis was carried out with the Database for Annotation, Visualization and Integrated Discovery (DAVID). A protein–protein interaction network (PPI) was constructed and visualized by the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database and Cytoscape software. Minimal Common Oncology Data Elements (MCODE) was used to detect the important modules in the PPI network, and the important nodes (genes) in the PPI module were sorted by CytoHubba. RT-qPCR was performed to validate the expression of the key genes in WT. Wound healing and Transwell assays were used to detect the cell migration and invasion abilities of AQP1-overexpressing cells. Phalloidin-iFlour 488 was used to stain the cytoskeleton to observe how AQP1 overexpression affects cytoskeletal microfilament structure. Results A total of 73 co-expressed DEGs were chosen for further investigation. The importance of homeostasis and transmembrane transport of ions and water were highlighted by functional analysis. Gene regulatory network and PPI network were predicted. MCODE plug identified two important modules. Finally, top five key genes were identified using CytoHubba, including Renin (REN), nephrosis 2 (NPHS2), Solute Carrier Family 12 Member 3 (SLC12A3), Solute Carrier Family 12 Member 1 (SLC12A1) and AQP1. The five key genes were mainly enriched in cell volume and ion homeostasis. RT-qPCR confirmed the expression of the five key genes in WT. AQP1 was validated to be expressed at significantly lower levels in WT than in normal tissue. AQP1 overexpression significantly reduced the migratory and invasive capacity of Wit-49 cells, as evidenced by reducing the scratch healing rate and the number of perforated control cells by Wit-49 cells. AQP1 overexpression also reduced the expression of biomarkers of epithelial-mesenchymal transformation, decreased levels of vimentin and N-cadherin and increased expression of E-cadherin, resulting in decreased formation of conspicuous lamellipodial protrusions, characteristic of diminished WT cell invasion and migration. Conclusion Our study reveals the key genes of WT. These key genes may provide novel insight for the mechanism and diagnosis of WT. AQP1 overexpression inhibited invasion, migration, EMT, and cytoskeletal rearrangement of WT cells, indicating that AQP1 plays a role in the pathogenesis of WT.

IntroductionMonoecy is usually interpreted as an important evolutionary route of the plant sexual system from hermaphroditism to dioecy. This floral mechanism can effectively reduce self-interference during the reproductive process, and the services provided by pollinators may play an essential role in monoecious species; however, relevant research is still lacking. Thus, we aimed to determine whether monoecious plants could effectively avoid self-interference and promote the evolution of monoecy under the service of pollinators.MethodsHere, we successfully performed manipulation experiments to test self-compatibility, pollinator behavior, and self-interference between male and female functions in Akebia trifoliata, a typical monoecious species.ResultsWe demonstrated that experimental self-pollination did not yield any fruit, and supplemental pollination significantly increased fruit set and fruit weight compared to natural pollination, suggesting that this species is completely self-incompatible and experiences strong pollen limitation. Simultaneous self- and cross-pollination and self-pollination prior to cross-pollination significantly reduced reproductive fitness, but self-pollination after cross-pollination did not, indicating self-interference in this plant. Moreover, both male flower probing preference and switching modes within inflorescences by pollinators successfully reinforced self-interference and were also responsible for decreasing reproductive fitness in A. trifoliata.DiscussionIn summary, pollinator-mediated self-interference significantly reduced selfing, providing potential dynamics for the maintenance and evolution of monoecy.

Xinjiang is located in the northwest of China, with a vast territory and abundant resources, which holds an important strategic position for China. However, the climate in the region is arid and the ecological environment is fragile. In recent years, with the growth of population and the improvement of economic development level, construction and agricultural land in Xinjiang have gradually expanded, and ecological land has been extensively occupied. The competition between land resources is becoming increasingly fierce, leading to some ecological and environmental problems in the region. In this context, understanding the spatiotemporal changes and driving factors of Xinjiang's production space, living space and ecological space (PLES) is of great practical significance for promoting sustainable development in the region, and can also provide reference for the research of PLES in other arid areas at home and abroad. At present, most of the research on PLES is focused on small-scale areas such as urban agglomerations, rural areas, and watersheds, or non arid areas with relatively superior natural conditions, with less research on large-scale arid areas. In this study, the transfer matrix, the center of gravity movement trajectory, Moran's I and the spatial conflict measurement model were used to illustrate the spatial–temporal evolution of PLES in Xinjiang, and the correlation coefficient was used to determine the main factors affecting the change of PLES. Results show that (1) Xinjiang is dominated by ecological space, which accounts for more than 90% of the total area of Xinjiang and has significant continuity. They are mainly distributed in Tarim, Turpan, and the northern Junggar Basin. The production space area accounts for about 5% of the total area of Xinjiang and is distributed in the vicinity of the Tianshan and Kunlun Mountains. Living space accounts for about 1% of Xinjiang's total area and is scattered around cities. (2) From 2000 to 2020, the change degree of PLES in Xinjiang in the last decade is higher than that in the first decade, most of which is the transformation from ecological space to production space. The three types of spaces influence and restrict each other in the development process. (3) Population, crop sown area, natural conditions, policy and the development level of agricultural science and technology are the main factors affecting the spatial distribution of production. Environmental factors such as altitude, soil erosion and temperature have a great influence on ecological space. Population, the output value of various industries and total retail sales of consumer goods are the main factors affecting residential space. The evolution of Xinjiang PLES is the result of multiple factors. (4) The medium spatial conflict dominates, mainly distributed in Tarim Basin and Junggar Basin. The weak and strong space conflicts are concentrated in the oases in the north of the Tianshan and Kunlun Mountains, and the number is small. From 2000 to 2020, the increasing degree of spatial conflicts in Xinjiang is due to land desertification.

Abstract Background Liver metastasis is the leading cause of death in patients with colorectal cancer (CRC). Surgical resection of the liver metastases increases the incidence of long-term survival in patients with colorectal liver metastasis (CRLM). However, many patients experience CRLM recurrence after the initial liver resection. As an unavoidable pathophysiological process in liver surgery, liver ischemia-reperfusion (IR) injury increases the risk of tumor recurrence and metastasis. Methods Colorectal liver metastasis (CRLM) mouse models and mouse liver partial warm ischemia models were constructed. The levels of lipid peroxidation were detected in cells or tissues. Western Blot, qPCR, elisa, immunofluorescence, immunohistochemistry, scanning electron microscope, flow cytometry analysis were conducted to evaluate the changes of multiple signaling pathways during CRLM recurrence under liver ischemia-reperfusion (IR) background, including SGK1/IL-6/STAT3, neutrophil extracellular traps (NETs) formation, polymorphonuclear myeloid-derived suppressor cell (PMN-MDSC) infiltration. Results Hepatocyte serum/glucocorticoid regulated kinase 1 (SGK1) was activated in response to hepatic ischemia-reperfusion injury to pass hepatocyte STAT3 phosphorylation and serum amyloid A (SAA) hyperactivation signals in CRLM-IR mice, such regulation is dependent on SGK-activated IL-6 autocrine. Administration of the SGK1 inhibitor GSK-650394 further reduced ERK-related neutrophil extracellular traps (NETs) formation and polymorphonucler myeloid-derived suppressor cells (PMN-MDSC) infiltration compared with targeting hepatocyte SGK1 alone, thereby alleviating CRLM in the context of IR. Conclusions Our study demonstrates that hepatocyte and immune cell SGK1 synergistically promote postoperative CRLM recurrence in response to hepatic IR stress, and identifies SGK1 as a translational target that may improve postoperative CRLM recurrence.

Abnormal muscle synergies during sit-to-stand (STS) transitions have been observed post-stroke, which are associated with deteriorated lower-limb function and mobility. Although exoskeletons have been used in restoring lower-limb function, their effects on muscle synergies and lower-limb motor recovery remain unclear. Here, we characterized normal muscle synergy patterns during STS activity in ten healthy adults as a reference, comparing with pathological muscle synergy patterns in ten participants with subacute stroke. Moreover, we assessed the effects of a 3-week exoskeleton-assisted STS training intervention on muscle synergies and clinical scores in seven stroke survivors. We also investigated correlations between neuromuscular complexity of muscle synergies and clinical scores. Our results showed that the STS task involved three motor modules representing distinct biomechanical functions among healthy subjects. In contrast, stroke participants showed 3 abnormal modules for the paretic leg and 2 modules for the non-paretic leg. After the intervention, muscle synergies partially shifted towards the normal pattern observed in healthy subjects on the paretic side. On the non-paretic side, the synergy modules increased to three and neuromuscular coordination improved. Furthermore, the significant intervention-induced increases in Fugl-Meyer Assessment of Lower Extremity and Berg Balance Scale scores were associated with improved muscle synergies on the non-paretic side. These results indicate that the paretic side demonstrates abnormal changes in muscle synergies post-stroke, while the non-paretic side can synergistically adapt to post-stroke biomechanical deviations. Our data show that exoskeleton-based training improved lower-limb function post-stroke by inducing modifications in muscle synergies.

Abstract Background This study was aimed to examine the effectiveness of App-assisted self-care in a Beijing community based on intelligent family physician-optimised collaborative model (IFOCM) program. Methods We conducted a survey of 12,050 hypertensive patients between Jan 2014 and Dec 2021. Generalized linear model was used to analyze the covariates that associated with blood pressure (BP) control. Decision tree and random forest algorithm was used to extract the important factors of BP outcome. Results The study included 5937 patients, mean age 66.2 ± 10.8, with hypertension in the baseline; 3108(52.4) were female. The community management resulted in mean systolic BP and diastolic BP reductions of 4.6 mmHg and 3.8 mmHg at follow-up. There were 3661 (61.6%) hypertension patients with BP control, increasing from 55.0% in 2014 to 75.0% in 2021. After adjusted for covariates, antihypertensive medication adherence, diabetes, and APP-assisted self-care were common predictors associated with BP control in GLM model and machine learning algorithm. Conclusion Community management based on IFOCM program significantly improved BP control in hypertensive patients. APP-assisted self-care would be beneficial for the management of chronic disease.

The assembly of atomically precise clusters into ordered superstructures enables new functional material designs. Here, the authors propose a strategy for linear arrangements of AgCu clusters and explore the consequent transfer and coupling of magnetic spins.

ObjectiveThe aim of this study was to evaluate the clinical efficacy of single-incision laparoscopy appendectomy (SILA) and traditional three-hole laparoscopy appendectomy (THLA) for the treatment of acute appendicitis in children.MethodsThe clinical data of children ( 0.05). There was also no significant difference in the average length of hospital stay between the THLA group and the SILA group (6.91 ± 0.24 days vs. 7.16 ± 0.36 days, P > 0.05). However, the FLACC scores of the SILA group (3.71 ± 0.78) were significantly lower than those of the THLA group (3.99 ± 0.56) on the second postoperative day, and the difference was significant (P 0.05).ConclusionSILA is more advantageous in terms of postoperative FLACC scores and cosmetic appearance in children than THLA. There was no significant difference in the incidence of complications or other aspects between the two surgical methods.

Abstract Objective The mechanism by which mesenchymal stem cell (MSC) transplantation alleviates atherosclerosis in systemic lupus erythematosus (SLE) remains elusive. In this study, we aim to explore the efficacy and mechanism of MSC in ameliorating atherosclerosis in SLE. Methods ApoE−/− and Fas−/− mice on the B6 background were cross-bred to generate SLE mice with atherosclerosis. Myeloid-derived suppressor cells (MDSCs) were sorted and quantified. The apoE−/−Fas−/− mice were either treated with anti-Gr antibody or injected with MDSCs. The lupus-like autoimmunity and atherosclerotic lesions were evaluated. Furthermore, the apoE−/−Fas−/− mice were transplanted with MSCs and lupus-like autoimmunity and atherosclerotic lesions were assessed. Results MDSCs in peripheral blood, spleen, draining lymph nodes increased in apoE−/−Fas−/− mice compared with B6 mice. Moreover, the adoptive transfer of MDSCs aggravated both atherosclerosis and SLE pathologies, whereas depleting MDSCs ameliorated those pathologies in apoE−/−Fas−/− mice. MSC transplantation in apoE−/−Fas−/− mice decreased the percentage of MDSCs, alleviated the typical atherosclerotic lesions, including atherosclerotic lesions in aortae and liver, and reduced serum cholesterol, triglyceride and low-density lipoprotein levels. MSC transplantation also reduced SLE pathologies, including splenomegaly, glomerular lesions, anti-dsDNA antibody in serum, urine protein and serum creatinine. Moreover, MSC transplantation regulated the generation and function of MDSCs through secreting prostaglandin E 2 (PGE2). Conclusion Taken together, these results indicated that the increased MDSCs contributed to atherosclerosis in SLE. MSC transplantation ameliorated the atherosclerosis and SLE through reducing MDSCs by secreting PGE2. Graphical Abstract

Introduction: Repetitive peripheral magnetic stimulation (rPMS) can stimulate profound neuromuscular tissues painlessly to evoke action potentials in motor axons and induce muscle contraction for treating neurological conditions. It has been increasingly used in stroke rehabilitation as an easy-to-administer approach for therapeutic neuromodulation. Objective: We performed this meta-analysis of randomized controlled trials to systematically evaluate the effects of rPMS for the upper limb in patients with stroke, including motor impairment, muscle spasticity, muscle strength, and activity limitation outcomes. Methods: The meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. PubMed, EMBASE, Web of Science, Cochrane Library, and Physiotherapy Evidence Database (PEDro) were searched for articles published before June 2022. Forest plots were employed to estimate the pooled results of the included studies, and the I2 statistical analysis was used to identify the source of heterogeneity. Publication bias was examined by Egger’s regression tests or visual inspection of the funnel plots. Results: The database searches yielded 1052 potential eligible literature; of them, five randomized controlled trials met the eligible criteria, involving a total of 188 participants. Patients in the rPMS group showed better improvement in motor impairment as measured by the FM-UE (MD: 5.39 [95% CI, 4.26 to 6.52]; P

BackgroundBecause it is one of the important pathways for promoting motor recovery after cortical injury, the function of the reticulospinal tract (RST) has received increasing attention in recent years. However, the central regulatory mechanism of RST facilitation and reduction of apparent response time is not well understood.ObjectivesTo explore the potential role of RST facilitation in the acoustic startle priming (ASP) paradigm and observe the cortical changes induced by ASP reaching tasks.MethodsTwenty healthy participants were included in this study. The reaching tasks were performed with their left and right hands. Participants were instructed to get ready after the warning cue and complete the reach as soon as they heard the Go cue. Half of the testing trials were set as control trials with an 80-dB Go cue. The other half of the trials had the Go cue replaced with 114-dB white noise to evoke the StartleReact effect, inducing reticulospinal tract facilitation. The response of the bilateral sternocleidomastoid muscle (SCM) and the anterior deltoid was recorded via surface electromyography. Startle trials were labeled as exhibiting a positive or negative StartleReact effect, according to whether the SCM was activated early (30–130 ms after the Go cue) or late, respectively. Functional near-infrared spectroscopy was used to synchronously record the oxyhemoglobin and deoxyhemoglobin fluctuations in bilateral motor-related cortical regions. The β values representing cortical responses were estimated via the statistical parametric mapping technique and included in the final analyses.ResultsSeparate analyses of data from movements of the left or right side revealed significant activation of the right dorsolateral prefrontal cortex during RST facilitation. Moreover, left frontopolar cortex activation was greater in positive startle trials than in control or negative startle trials during left-side movements. Furthermore, decreased activity of the ipsilateral primary motor cortex in positive startle trials during ASP reaching tasks was observed.ConclusionThe right dorsolateral prefrontal cortex and the frontoparietal network to which it belongs may be the regulatory center for the StartleReact effect and RST facilitation. In addition, the ascending reticular activating system may be involved. The decreased activity of the ipsilateral primary motor cortex suggests enhanced inhibition of the non-moving side during the ASP reaching task. These findings provide further insight into the SE and into RST facilitation.

PM2.5 is closely linked to both air quality and public health. Many studies have used models combined with remote sensing and auxiliary data to inverse a large range of PM2.5 concentrations. However, the data's spatial resolution is limited. and better results might have been obtained if higher resolution data had been used. Therefore, this paper establishes a geographical and temporal weighted regression model (GTWR) and estimates the PM2.5 concentration in Xinjiang from 2015 to 2020 using 1 km resolution MCD19A2 (MODIS/Terra+Aqua Land Aerosol Optical Thickness Daily L2G Global 1km SIN Grid V006) data and 9 auxiliary variables. The findings indicate that the GTWR model performs better than the simple linear regression (SLR) and geographically weighted regression (GWR) models in terms of accuracy and feasibility in retrieving PM2.5 concentrations in Xinjiang. Simultaneously, by combining the GTWR model with MCD19A2 data, a spatial distribution map of PM2.5 with better spatial resolution can be obtained. Next, the regional distribution of annual PM2.5 concentrations in Xinjiang is consistent with the terrain from 2015 to 2020. The low value area is primarily found in the mountainous area with higher terrain, while the high value area is primarily in the basin with lower terrain. Overall, the southwest is high and the northeast is low. In terms of time change, the six-year PM2.5 shows a single peak distribution with 2016 as the inflection point. Lastly, from 2015 to 2020, the seasonal average PM2.5 concentration in Xinjiang has a significant difference, thereby showing winter (66.15μg/m3)>spring (52.28μg/m3)>autumn (40.51μg/m3)>summer (38.63μg/m3). The research shows that the combination of MCD19A2 data and GTWR model has good applicability in retrieving PM2.5 concentration.

Summary: Background: The aim of the study is to estimate the incidence of pancreatic cancer among individuals with new-onset type 2 Diabetes (T2DM) and evaluate the relationship of pancreatic cancer risk with age at diabetes onset and diabetes duration. Methods: This longitudinal cohort study included 428,362 new-onset T2DM patients in Shanghai and Mendelian randomization (MR) in the east-Asian population were used to investigate the association. Incidence rates of pancreatic cancer in all patients and by subgroups were calculated and compared to the general population. Findings: A total of 1056 incident pancreatic cancer cases were identified during eight consecutive years of follow-up. The overall pancreatic cancer annual incidence rate was 55·28/100,000 person years in T2DM patients, higher than that in the general population, with a standardized incidence ratio (SIR) of 1·54 (95% confidence interval [CI], 1·45–1·64). The incidence of pancreatic cancer increased with age and a significantly higher incidence was observed in the older groups with T2DM. However, the relative pancreatic cancer risk was inversely related to age of T2DM onset, and a higher SIR of 5·73 (95%CI, 4·49–7·22) was observed in the 20–54 years old group. The risk of pancreatic cancer was elevated at any diabetes duration. Fasting blood glucose ≥10·0 mmol/L was associated with increased risk of pancreatic cancer. MR analysis indicated a positive association between T2DM and pancreatic cancer risk. Interpretation: Efforts toward early and close follow-up programs, especially in individuals with young-onset T2DM, and the improvement of glucose control might represent effective strategies for improving the detection and results of treatment of pancreatic cancer. Funding: Chinese National Natural Science Foundation.

Abstract Liver fibrosis is a danger signal indicating a huge risk of liver cancer occurrence, but there is still no effective clinical means to regulate the progress of liver fibrosis. Although a variety of drugs targeting SYK have been developed for tumors and autoimmune diseases, the mechanism and specific efficacy of SYK’s role in liver fibrosis are not yet clear. Our studies based on chronic CCL4, bile duct ligation, and subacute TAA mouse models show that SYK in monocyte-derived macrophages (MoMFs) is fully dependent on phosphorylation of Erk to up-regulate the expression of Hif1α, thereby forming the crosstalk with SYK to drive liver fibrosis progress. We have evaluated the ability of the small molecule SYK inhibitor GS9973 in a variety of models. Contrary to previous impressions, high-frequency administration of GS9973 will aggravate CCL4-induced liver fibrosis, which is especially unsuitable for patients with cholestasis whose clinical features are bile duct obstruction. In addition, we found that inhibition of MoMFs SYK impairs the expression of CXCL1, on one hand, it reduces the recruitment of CD11bhiLy6Chi inflammatory cells, and on the other hand, it promotes the phenotype cross-dress process of pro-resolution MoMFs, thereby remodeling the chronic inflammatory environment of the fibrotic liver. Our further findings indicate that on the basis of the administration of CCR2/CCR5 dual inhibitor Cenicriviroc, further inhibiting MoMFs SYK may give patients with fibrosis additional benefits.

BackgroundTo explore the geographical pattern and temporal trend of autism spectrum disorders (ASD) epidemiology from 1990 to 2019, and perform a bibliometric analysis of risk factors for ASD.MethodsIn this study, ASD epidemiology was estimated with prevalence, incidence, and disability-adjusted life-years (DALYs) of 204 countries and territories by sex, location, and sociodemographic index (SDI). Age-standardized rate (ASR) and estimated annual percentage change (EAPC) were used to quantify ASD temporal trends. Besides, the study performed a bibliometric analysis of ASD risk factors since 1990. Publications published were downloaded from the Web of Science Core Collection database, and were analyzed using CiteSpace.ResultsGlobally, there were estimated 28.3 million ASD prevalent cases (ASR, 369.4 per 100,000 populations), 603,790 incident cases (ASR, 9.3 per 100,000 populations) and 4.3 million DALYs (ASR, 56.3 per 100,000 populations) in 2019. Increases of autism spectrum disorders were noted in prevalent cases (39.3%), incidence (0.1%), and DALYs (38.7%) from 1990 to 2019. Age-standardized rates and EAPC showed stable trend worldwide over time. A total of 3,991 articles were retrieved from Web of Science, of which 3,590 were obtained for analysis after removing duplicate literatures. “Rehabilitation”, “Genetics & Heredity”, “Nanoscience & Nanotechnology”, “Biochemistry & Molecular biology”, “Psychology”, “Neurosciences”, and “Environmental Sciences” were the hotspots and frontier disciplines of ASD risk factors.ConclusionsDisease burden and risk factors of autism spectrum disorders remain global public health challenge since 1990 according to the GBD epidemiological estimates and bibliometric analysis. The findings help policy makers formulate public health policies concerning prevention targeted for risk factors, early diagnosis and life-long healthcare service of ASD. Increasing knowledge concerning the public awareness of risk factors is also warranted to address global ASD problem.

ObjectiveThis study analyzed the feasibility of upfront surgical resection for pediatric PRETEXT III and IV hepatoblastoma (HB).Summary Background DataNeoadjuvant chemotherapy is recommended for patients with PRETEXT III and IV HB to obtain a chance of curative surgery. However, chemotherapy can cause toxic side effects and adverse outcomes, and the PRETEXT staging system may overstage the patients. Therefore, whether preoperative chemotherapy is necessary for HB patients remains unclear.MethodsThe clinical data of 37 children who underwent surgical resection for PRETEXT III and IV HB at our hospital were obtained retrospectively. Patients were divided into the neoadjuvant chemotherapy group (NCG; n = 19) and the routine surgery group (RSG; n = 18). Clinicopathologic characteristics, treatment regimens, and outcomes were compared between the groups.ResultsThe RSG had a lower incidence of portal vein involvement than the NCG (p

PR domain-containing 1 with zinc finger domain (PRDM1) has been reported as a promoter of inflammation, which is a critical process involved in the pathogenesis of acute gouty arthritis. Herein, we sought to ascertain the function of PRDM1 in the development of acute gouty arthritis and related mechanisms. At first, peripheral blood-derived monocytes from patients with acute gouty arthritis and healthy individuals were collected as experimental samples. Then, macrophages were induced from monocytes using phorbol myristate acetate (PMA). The expression patterns of PRDM1, sirtuin 2 (SIRT2), and NLR family, pyrin domain-containing 3 (NLRP3) were characterized by RT-qPCR and Western blot assay. PMA-induced macrophages were stimulated by monosodium urate (MSU) for in vitro experimentation. Meanwhile, a murine model of MSU-induced acute gouty arthritis was established for in vivo validation. PRDM1 was highly expressed while SIRT2 poorly expressed in patients with acute gouty arthritis. Loss of PRDM1 could reduce NLRP3 inflammasome and mature IL-1β levels and downregulate inflammatory cytokines in macrophages, which contributed to protection against acute gouty arthritis. Furthermore, results showed that PRDM1 could inhibit SIRT2 expression via binding to the deacetylase SIRT2 promoter. Finally, the in vivo experiments demonstrated that PRDM1 increased NLRP3 inflammasome and mature IL-1β through transcriptional inhibition of SIRT2, whereby aggravating MSU-induced acute gouty arthritis. To sum up, PRDM1 increased NLRP3 inflammasome through inhibiting SIRT2, consequently aggravating MSU-induced acute gouty arthritis.

BackgroundPost-stroke spasticity is an important complication that greatly affects survivors' functional prognosis and daily activities. Increasing evidence points to aberrant contralesional neuromodulation compensation after brain injury as a possible culprit for increased spasticity in patients with severe stroke. Hyperactivity of the contralesional premotor area (cPMA) was supposed to be highly correlated with this progression. This study aims to demonstrate the immediate and short-term efficacy of continuous theta-burst stimulation (cTBS) targeting cPMA on upper limb spasticity in severe subacute stroke patients.MethodsThis trial is a single-center, prospective, three-group randomized controlled trial. Forty-five eligible patients will be recruited and randomized into three groups: the sham-cTBS group (sham cTBS targeting contralesional PMA), the cTBS-cM1 group (cTBS targeting contralesional M1), and the cTBS-cPMA group (cTBS targeting contralesional PMA). All subjects will undergo comprehensive rehabilitation and the corresponding cTBS interventions once a day, five times a week for 4 weeks. Clinical scales, neurophysiological examinations, and neuroimaging will be used as evaluation tools in this study. As the primary outcome, clinical performance on muscle spasticity of elbow/wrist flexor/extensors and upper-limb motor function will be evaluated with the modified Ashworth scale and the Fugl-Meyer Assessment of Upper Extremity Scale, respectively. These scale scores will be collected at baseline, after 4 weeks of treatment, and at follow-up. The secondary outcomes were neurophysiological examinations and Neuroimaging. In neurophysiological examinations, motor evoked potentials, startle reflex, and H reflexes will be used to assess the excitability of the subject's motor cortex, reticulospinal pathway, and spinal motor neurons, respectively. Results of them will be recorded before and after the first cTBS treatment, at post-intervention (at 4 weeks), and at follow-up (at 8 weeks). Neuroimaging tests with diffusion tensor imaging for all participants will be evaluated at baseline and after the 4-week treatment.DiscussionBased on the latest research progress on post-stroke spasticity, we innovatively propose a new neuromodulation target for improving post-stroke spasticity via cTBS. We expected that cTBS targeting cPMA would have significant immediate and short-term effects on spasticity and related neural pathways. The effect of cTBS-cPMA may be better than that of cTBS via conventional cM1. The results of our study will provide robust support for the application of cTBS neuromodulation in post-stroke spasticity after a severe stroke.Clinical trial registrationThis trial was registered with chictr.org.cn on June 13, 2022 (protocol version). http://www.chictr.org.cn/showproj.aspx?proj=171759.

Cryptorchidism is a common congenital malformation in pediatric urology. Although there have been many studies on the etiology of the disease, it has not been fully clarified, and while its diagnostic and treatment models have gradually approached standardization and systematization, some controversies regarding treatment remain. Additionally, although ultrasound is a non-invasive examination without ionizing radiation, its role in the evaluation of cryptorchidism remains controversial. The main basis for treating cryptorchidism is orchidopexy, and the main view on treatment age is that treatment should be performed between 6 and 12 months after birth, but no more than 18 months after birth. The view on hormone therapy is still controversial because most scholars believe that early surgery is the key to treatment. There are many surgical treatment methods for cryptorchidism, including traditional open surgery and laparoscopic surgery, which provide satisfactory results. In conclusion, the treatment of undescended testis (UDT) had been largely standardized, apart from the treatment of high intra-abdominal testis (IAT), which remains a matter of debate.

AIM: To investigate the vision-related quality of life after corneal refraction surgery of the new recruits in a navy unit. METHODS:New recruits in a navy unit during 2014-2016 were interviewed druing recheck ophthalmic examination through a questionnaire, including basic data and the Visual Function Questionnaire-25(VFQ), and also checking the visual acuity, contrast sensitivity(CS), optometry.RESULTS: Among 2 760 new recruits, 340 persons(12.32%)had undergone corneal refractive surgeries, which included corneal stroma surgery(89.71%)and corneal surface surgery(10.29%). According to the preoperative myopia spherical equivalent, the subjects were divided into three groups: mild myopia group(≤-3.00D, 134 cases), moderate myopia group(>-3.00 D to < -6.00D, 159 cases), and high myopia group(≥-6.00D, 47 cases). The postoperation spherical equivalent range ±1.0D is 128 cases(95.52%), 153 cases(96.23%), 38 cases(80.85%)in mild myopia group, moderate myopia group and high myopia group respectively. The contrast sensitivity(CS)were statistically significant among three different diopter groups under natural light and glare conditions(P

Abstract Background Stroke produces multiple symptoms, including sensory, motor, cognitive and psychological dysfunctions, among which motor deficit is the most common and is widely recognized as a major contributor to long-term functional disability. Robot-assisted training is effective in promoting upper extremity muscle strength and motor impairment recovery after stroke. Additionally, action observation treatment can enhance the effects of physical and occupational therapy by increasing neural activation. The AOT-EXO trial aims to investigate whether action observation treatment coupled with robot-assisted training could enhance motor circuit activation and improve upper extremity motor outcomes. Methods The AOT-EXO trial is a multicentre, prospective, three-group randomized controlled trial (RCT). We will screen and enrol 132 eligible patients in the trial implemented in the Department of Rehabilitation Medicine of Tongji Hospital, Optical Valley Branch of Tongji Hospital and Hubei Province Hospital of Integrated Chinese & Western Medicine in Wuhan, China. Prior to study participation, written informed consent will be obtained from eligible patients in accordance with the Declaration of Helsinki. The enrolled stroke patients will be randomized to three groups: the CT group (conventional therapy); EXO group (exoskeleton therapy) and AOT-EXO group (action observation treatment-based exoskeleton therapy). The patients will undergo blinded assessments at baseline, post-intervention (after 4 weeks) and follow-up (after 12 weeks). The primary outcome will be the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Secondary outcomes will include the Action Research Arm Test (ARAT), modified Barthel Index (MBI), kinematic metrics assessed by inertial measurement unit (IMU), resting motor threshold (rMT), motor evoked potentials (MEP), functional magnetic resonance imaging (fMRI) and safety outcomes. Discussion This trial will provide evidence regarding the feasibility and efficacy of the action observation treatment-based exoskeleton (AOT-EXO) for post-stroke upper extremity rehabilitation and elucidate the potential underlying kinematic and neurological mechanisms. Trial registration Chinese Clinical Trial Registry ChiCTR1900026656 . Registered on 17 October 2019.

Trem2, a transmembrane protein that is simultaneously expressed in both bone marrow-derived and embryonic-derived liver-resident macrophages, plays a complex role in liver inflammation. The unique role of myeloid Trem2 in hepatic ischemia-reperfusion (IR) injury is not precisely understood. Our study showed that in the early stage of inflammation induction after IR, Deletion of myeloid Trem2 inhibited the induction of iNOS, MCP-1, and CXCL1/2, alleviated the accumulation of neutrophils and mitochondrial damage, and simultaneously decreased ROS formation. However, when inflammatory monocyte-macrophages gradually evolved into CD11bhiLy6Clow pro-resolution macrophages through a phenotypic switch, the story of Trem2 took a turn. Myeloid Trem2 in pro-resolution macrophages promotes phagocytosis of IR-accumulated apoptotic cells by controlling Rac1-related actin polymerization, thereby actively promoting the resolution of inflammation. This effect may be exercised to regulate the Cox2/PGE2 axis by Trem2, alone or synergistically with MerTK/Arg1. Importantly, when myeloid Trem2 was over-expressed, the phenotypic transition of monocytes from a pro-inflammatory to a resolution type was accelerated, whereas knockdown of myeloid Trem2 resulted in delayed upregulation of CX3CR1. Collectively, our findings suggest that myeloid Trem2 is involved in the cascade of IR inflammation in a two-sided capacity, with complex and heterogeneous roles at different stages, not only contributing to our understanding of sterile inflammatory immunity but also to better explore the regulatory strategies and intrinsic requirements of targeting Trem2 in the event of sterile liver injury.

Abstract Background Spinal manipulative therapy is commonly used in the treatment of adolescent idiopathic scoliosis. Some therapists also rely on physiotherapeutic scoliosis-specific exercise (PSSE). Combining these two modalities seems reasonable, but the effectiveness of this combination has never been rigorously tested. Here, a protocol for a pilot study is proposed to determine the feasibility of conducting a larger randomized trial. The pilot study was designed to test the hypothesis that spinal manipulative therapy followed by PSSE is more effective than PSSE alone in improving the Cobb angle, sensorimotor integration, the angle of trunk rotation (ATR), body symmetry, and quality of life. Methods The protocol describes a randomized controlled pilot trial with 40 subjects divided into study and control groups. Both groups will receive 8 weeks of PSSE, but the study group will also receive spinal manipulative therapy during the first 2 weeks before PSSE. The primary outcome will be an estimate of the feasibility of conducting a full-scale experiment. The influencing factors will be the time to complete enrollment, the recruitment rate, subject retention, and adherence to the treatment allocations. The secondary outcomes that will be used to assess the efficacy of treatment will include the Cobb angle, somatosensory evoked potentials, ATR, three-dimensional postural parameters, and scores on the 22-item Scoliosis Research Society outcomes questionnaire. The Cobb angle will be measured at baseline and at the end of 8 weeks of training. The somatosensory evoked potentials will be measured at baseline and at the end of 2 weeks of training. The ATR, three-dimensional postural parameters, and scores on the 22-item Scoliosis Research Society outcomes questionnaire will be measured at baseline and at 2 weeks, 4 weeks, and 8 weeks of treatment. Discussion This study will inform the design of a future full-scale trial. The outcomes will provide preliminary data about the efficacy of the combination of spinal manipulative therapy and exercise in treating scoliosis. Trial registration Prospectively registered at Chinese clinical trial registry, ChiCTR1900027037 . Registered on 29 October 2019. http://www.chictr.org.cn/edit.aspx?pid=44954&htm=4

Mapping fine-scale distribution of the population is essential to the study of human activities, where more reliable open-access big data could be excavated with the help of machine learning models. However, the combination of multisource datasets and multidimensional features for population estimation was still unclear, and different models also needed comparison. Thus, in this study, related features from multisource data were first extracted, including building data, geographic big data, remote sensing data, and basic geographic data. Then, the effective indicators with higher contribution weight were selected from multisource data, which can reduce the noise and unstable model fitting. Finally, the population distribution map for 100-m grid was obtained in Shenzhen in 2019, and estimation results for five tree-based ensemble learning models were also compared at community scale, including random forest (RF), gradient boosted decision tree (GBDT), extreme gradient boosting (XGBoost), light gradient boosting machine (LightGBM), and categorical boosting (CatBoost). Our results showed that: 1) building data and geographic big data could better reflect the spatial heterogeneity of the population; 2) indicators selection could effectively improve the estimation accuracy of the population mapping; and 3) compared with other models, XGBoost had the largest R2 (80%), the smallest RMSE, and MAE, the most percentage of accurate estimation communities (−0.3

Crystallization-induced photoluminescence weakening in ultrasmall metal nanoparticles is not well understood. Here, the authors study conformational isomers of gold nanoclusters to examine the effect of interparticle distance on this phenomenon, and propose a model of distance-dependent non-radiative excitation electron transfer.

Abstract Background Elevated atmospheric CO2 has direct and indirect influences on ecosystem processes. The impact of elevated atmospheric CO2 concentration on carbon and nitrogen transformations, together with the microbial community, was evaluated with water hyacinth (Eichhornia crassipes) in an open-top chamber replicated wetland. The responses of nitrogen and carbon pools in water and wetland soil, and microbial community abundance were studied under ambient CO2 and elevated CO2 (ambient + 200 μL L−1). Results Total biomass for the whole plant under elevated CO2 increased by an average of 8% (p = 0.022). Wetlands, with water hyacinth, showed a significant increase in total carbon and total organic carbon in water by 7% (p = 0.001) and 21% (p = 0.001), respectively, under elevated CO2 compared to that of ambient CO2. Increase in dissolved carbon in water correlates with the presence of wetland plants since the water hyacinth can directly exchange CO2 from the atmosphere to water by the upper epidermis of leaves. Also, the enrichment CO2 showed an increase in total carbon and total organic carbon concentration in wetland soil by 3% (p = 0.344) and 6% (p = 0.008), respectively. The total nitrogen content in water increased by 26% (p = 0.0001), while total nitrogen in wetland soil pool under CO2 enrichment decreased by 9% (p = 0.011) due to increased soil microbial community abundance, extracted by phospholipid fatty acids, which was 25% larger in amount than that of the ambient treatment. Conclusion The study revealed that the elevated CO2 would affect the carbon and nitrogen transformations in wetland plant, water, and soil pool and increase soil microbial community abundance.

Background: Hong Kong's construction industry currently faces a manpower crisis. Blue-collar workers are a disadvantaged group and suffer higher levels of chronic diseases, for example, cancer, than the wider population. Cancer risk factors are likely to cluster together. We documented prevalence of cancer-associated lifestyle risk behaviors and their correlates among Hong Kong construction workers. Methods: Data were collected from workers at 37 railway-related construction worksites throughout Hong Kong during May 2014. Tobacco use, alcohol consumption, unbalanced nutrition intake, and physical inactivity were included in the analysis. Latent class analysis and multivariable logistic regression were performed to identify the patterns of risk behaviors related to cancer, as well as their impact factors among construction workers in Hong Kong. Results: Overall, 1,443 workers participated. Latent class analysis identified four different behavioral classes in the sample. Fully adjusted multiple logistic regression identified age, gender, years of Hong Kong residency, ethnicity, educational level, and living status differentiated behavioral classes. Conclusion: High levels of lifestyle-related cancer-risk behaviors were found in most of the Hong Kong construction workers studied. The present study contributes to understanding how cancer-related lifestyle risk behaviors cluster among construction workers and relative impact factors of risk behaviors. It is essential to tailor health behavior interventions focused on multiple risk behaviors among different groups for further enlarging the effects on cancer prevention. Keywords: Cancer, Construction workers, Prevention, Risk behaviors

In this paper, we prepared doxorubicin-loaded folic acid-functionalized pH-sensitive photothermal therapy (PTT) traceable hollow mesoporous silica nanoparticles (DOX-HPCF) as a drug carrier for liver cancer treatment. According to TEM characterization, hollow mesoporous silica nanoparticles (HMSN) are monodispersed spherical particles with hollow structure. In vitro drug release experiments showed that HPCF exhibited pH-sensitive release. Cell uptake experiments showed that HPCF was successfully absorbed by SMMC-7721 cells. In addition, DOX-HPCF significantly inhibited the proliferation of SMMC-7721 cells, and the near-infrared (NIR) light group showed a more obvious inhibitory effect. In vivo anti-tumor experiments showed that DOX-HPCF-assisted PTT inhibited tumor growth significantly. Therefore, HPCF is a promising photothermotherapy carrier for the treatment of liver cancer.