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To address the requirements of sonar imaging, such as high receiving sensitivity, a wide bandwidth, and a wide receiving angle, an AlN PMUT with an optimized ratio of 0.6 for the piezoelectric layer diameter to backside cavity diameter is proposed in this paper. A sample AlN PMUT is designed and fabricated with the SOI substrate-based bulk MEMS process. The characterization test result of the sample demonstrates a −6 dB bandwidth of approximately 500 kHz and a measured receiving sensitivity per unit area of 1.37 V/μPa/mm2, which significantly surpasses the performance of previously reported PMUTs. The −6 dB horizontal angles of the AlN PMUT at 300 kHz and 500 kHz are measured as 68.30° and 54.24°, respectively. To achieve an accurate prediction of its characteristics when being packaged and assembled in a receive array, numerical simulations with the consideration of film stress are conducted. The numerical result shows a maximum deviation of ±7% in the underwater receiving sensitivity across the frequency range of 200 kHz to 1000 kHz and a deviation of about 0.33% in the peak of underwater receiving sensitivity compared to the experimental data. By such good agreement, the simulation method reveals its capability of providing theoretical foundation for enhancing the uniformity of AlN PMUTs in future studies.

China has experienced a significant economic growth in recent years. In addition, the country has also built the largest system of Higher Education in the world. However, was the economy that stimulated the advancement of Higher Education? Or was Higher Education that stimulated the advancement of the economy? To answer these questions, this research aimed to understand the role of economy and Projects 211 and 985 for the expansion of Chinese Higher Education. For that, an exploratory and qualitative research was developed, based on interviews with Chinese government managers and questionnaires applied to professors/specialists and to a student leadership. The results showed that investments in Higher Education were preponderant for the country’s economic growth, which was representative from a quantitative perspective. However, also aiming at qualitative growth, projects 211 and 985 were created, allocating a significant amount of resources to the selected institutions. Such positioning makes China an example of benchmarking for other countries that wish to progress economically and intellectually.

This study aims to understand the perceptions of the tuition fees charging in Canada and China and the perspectives of this practice in Brazil, which is a country where society requires access to quality higher education, but which faces large budgetary constraints on its public funding. To understand these questions, a qualitative exploratory multi-case study was carried out with government officials, specialists in higher education, and student leadership from all three countries. In conclusion to this analysis, and considering the benefits provided by the Canadian and Chinese participants, it is suggested for Brazil to perform a reflection on this subject. The study shows that such an initiative can boost public higher education institutions through greater financial availability and democratize access and permanence, as there would be more resources to invest and assist students from underrepresented groups participating in the system.

This study is among the few that attempt to connect two popular topics, the rapid growth of Chinese higher education and the shifting China-US university relations. Now both the Chinese and US higher education are among the top systems in the world--in terms of their sizes and standards. While Chinese and American university ties have been among the most important higher education relations, they now move towards decoupling. Against this backdrop, this study situates the growth of Chinese higher education and China-US university relations in the discourse of a global higher education ecosystem, and explores what China-US university relations would mean to this global ecosystem, how they may evolve, as well as the implications for the global ecosystem. This study draws on Marginson's four heuristic narratives explaining science inquiries as a global space of activity and perception, and develops an analytical lens to apply to data collected from relevant databases and literature in order to reimagine China-US university relations in the various models. Finally, this study maintains that the universities in both countries share the obligation and responsibility to work together for sustaining and nourishing this global higher education ecosystem, particularly in an Anthropocene epoch.

http://dx.doi.org/10.5007/1983-4535.2015v8n4p134 O presente artigo demonstra o processo de massificação da educação superior utilizando como referência a China, que conseguiu se consolidar, em poucos anos, como o maior sistema universitário do mundo. Para tanto, são apresentados no referencial teórico a intervenção estatal e suas responsabilidades econômicas, os principais desafios da educação superior mundial e os efeitos da globalização sobre este nível de educação. No que se refere à metodologia, o presente estudo é delineado sobre os princípios de uma pesquisa explicativa, de abordagem qualitativa. Os dados foram coletados mediante a pesquisa documental e bibliográfica, e posteriormente analisados e interpretados, para realização de fichamentos dos achados que foram correlacionados com os demais dados coletados. A presente pesquisa apresenta, ao seu final, de que forma ocorreu o expansão da educação superior chinesa, que passou de um sistema de elite e se tornou um sistema de massa, se tornando uma referência para outras nações que buscam também a expansão deste nível educacional.

This paper demonstrates the massification process in higher education using as reference China, which reached in a few years the largest university system in the world. To do this, we present in the theoretical reference the Government intervention and its economic responsibilities, the main challenges of global higher education and the effects of globalization on this level of education. As regards the methodology, this study is designed on the principles of explanatory research, with qualitative approach. Data were collected through documentary and bibliographic research, and subsequently analyzed and interpreted to record the findings that were correlated with other data collected. This research shows at its end how was the expansion of Chinese higher education, which was a elite system and became a mass system, becoming a reference for other nations that also seek to expand this educational level.

Canada substantially supported Chinese university development in the 1980s and 1990s, through international aid projects. Since the 2000s, Canadian universities have enjoyed the reciprocal benefits, in terms of an increasing in-bound flow of Chinese students, a pipeline of faculty members of Chinese origin, and growing research collaboration. Nevertheless, now caught in the CanadaChina-US trilateral relations, Canada has followed the US in an attempt to link university collaboration (research in particular) to national security concerns and combat possible intellectual espionage from China. Against such a backdrop, this study aims to spotlight the voices of Canadian university faculty of Chinese descent, concerning how the wider geopolitical circumstances and sociopolitical environment might impact their career development, and lead to racial profiling effect for them. [ABSTRACT FROM AUTHOR]

Our survey reveals that Chinese-origin faculty in Canadian universities used to work in the frontiers of collaborating with China, leveraging their cultural and linguistic competencies, as well as personal networks. Now, they are caught in geopolitical conflicts and even become victims of implicit or explicit racial profiling, as a result of policies that link research collaboration with China to national security concerns. [ABSTRACT FROM AUTHOR]

Based on the thermo-fluid-solid coupling law of coal and gas outburst in deep mining, a numerical model of coal and gas outburst is established, and the response of multi-physical parameters in the whole process of coal and gas outburst under high stress condition is analyzed. The results show that the response rule of the stress field around the outburst hole is initial vibration-sudden attenuation-late stability. The decreasing rate of gas pressure is negatively correlated with the length of the outburst hole. In the outburst process, the adsorbed gas contained in the crushed coal quickly desorbed and expanded to do work, resulting in a decrease in temperature; the areas with significant changes in permeability after outburst can be divided into sudden increase area, medium increase area and increase area. With the increase of stress, the proportion of elastic potential in total coal and gas outburst energy increases, and the proportion of elastic potential is positively correlated with stress.

Coal and gas outburst is one of the most serious kinetic disasters in coal mines, and the use of gas hydrate curing technology to reduce the gas pressure and its gradient in the coal body can reduce the probability of coal and gas outburst accidents. In order to investigate the influence of driving force on the growth kinetics of CH4 hydrate in coal medium, the experimental study on the growth kinetics of gas hydrate in coal medium under three driving force conditions was carried out by using the experimental system of gas hydrate growth kinetics, and the influence of the driving force on the parameters such as gas consumption and growth rate during the synthesis process of gas hydrate in coal medium was discussed. The results show that: within the same particle size range, the nucleation time of hydrate in each particle size range does not completely follow the law of subsequent shortening when the driving force is increased, and the nucleation of CH4 hydrate in coal medium has a certain degree of randomness; the phenomenon of multiple nucleation occurs in the synthesis process; the gas consumption of CH4 hydrate in the coal medium increases with the increase of the driving force; the growth rate of gas hydrate in coal medium is increased with the increase of the driving force, and the growth rate of gas hydrate in coal medium is improved with the increase of driving force under the condition of unchanged temperature and particle size. The effect of driving force on the average growth rate at the early stage of synthesis is more significant.

Early cancer diagnosis from bisulfite‐treated cell‐free DNA (cfDNA) fragments requires tedious data analytical procedures. Here, we present a deep‐learning‐based approach for early cancer interception and diagnosis (DECIDIA) that can achieve accurate cancer diagnosis exclusively from bisulfite‐treated cfDNA sequencing fragments. DECIDIA relies on transformer‐based representation learning of DNA fragments and weakly supervised multiple‐instance learning for classification. We systematically evaluate the performance of DECIDIA for cancer diagnosis and cancer type prediction on a curated dataset of 5389 samples that consist of colorectal cancer (CRC; n = 1574), hepatocellular cell carcinoma (HCC; n = 1181), lung cancer (n = 654), and non‐cancer control (n = 1980). DECIDIA achieved an area under the receiver operating curve (AUROC) of 0.980 (95% CI, 0.976–0.984) in 10‐fold cross‐validation settings on the CRC dataset by differentiating cancer patients from cancer‐free controls, outperforming benchmarked methods that are based on methylation intensities. Noticeably, DECIDIA achieved an AUROC of 0.910 (95% CI, 0.896–0.924) on the externally independent HCC testing set in distinguishing HCC patients from cancer‐free controls, although there was no HCC data used in model development. In the settings of cancer‐type classification, we observed that DECIDIA achieved a micro‐average AUROC of 0.963 (95% CI, 0.960–0.966) and an overall accuracy of 82.8% (95% CI, 81.8–83.9). In addition, we distilled four sequence signatures from the raw sequencing reads that exhibited differential patterns in cancer versus control and among different cancer types. Our approach represents a new paradigm towards eliminating the tedious data analytical procedures for liquid biopsy that uses bisulfite‐treated cfDNA methylome.

Abstract Background Intestinal parasitic infections are still a serious public health problem in developing countries, and the diagnosis of parasitic infections requires the first step of parasite/egg detection of samples. Automated detection can eliminate the dependence on professionals, but the current detection algorithms require large computational resources, which increases the lower limit of automated detection. Therefore, we have designed a lightweight deep-learning model, YAC-Net, to achieve rapid and accurate detection of parasitic eggs and reduce the cost of automation. Methods This paper uses the ICIP 2022 Challenge dataset for experiments, and the experiments are conducted using fivefold cross-validation. The YOLOv5n model is used as the baseline model, and then two improvements are made to the baseline model based on the specificity of the egg data. First, the neck of the YOLOv5n is modified to from a feature pyramid network (FPN) to an asymptotic feature pyramid network (AFPN) structure. Different from the FPN structure, which mainly integrates semantic feature information at adjacent levels, the hierarchical and asymptotic aggregation structure of AFPN can fully fuse the spatial contextual information of egg images, and its adaptive spatial feature fusion mode can help the model select beneficial feature and ignore redundant information, thereby reducing computational complexity and improving detection performance. Second, the C3 module of the backbone of the YOLOv5n is modified to a C2f module, which can enrich gradient information, improving the feature extraction capability of the backbone. Moreover, ablation studies are designed by us to verify the effectiveness of the AFPN and C2f modules in the process of model lightweighting. Results The experimental results show that compared with YOLOv5n, YAC-Net improves precision by 1.1%, recall by 2.8%, the F1 score by 0.0195, and mAP_0.5 by 0.0271 and reduces the parameters by one-fifth. Compared with some state-of-the-art detection methods, YAC-Net achieves the best performance in precision, F1 score, mAP_0.5, and parameters. The precision, recall, F1 score, mAP_0.5, and parameters of our method on the test set are 97.8%, 97.7%, 0.9773, 0.9913, and 1,924,302, respectively. Conclusions Compared with the baseline model, YAC-Net optimizes the model structure and simplifies the parameters while ensuring the detection performance. It helps to reduce the equipment requirements for performing automated detection and can be used to realize the automatic detection of parasite eggs under microscope images. Graphical Abstract

Abstract Objective To explore the clinical efficacy of monolayer suture combined with a hem-o-lok clip during partial nephrectomy among patients with renal cell carcinoma (RCC). Methods Eighty patients with RCC underwent laparoscopic partial nephrectomy from January to October 2021. They were assigned into a control group and an intervention group, each with 40 cases using random number table. The control group received double-layer sutures on the wound, while the intervention group had single-layer sutures with a hem-o-lok clip for hemostasis. The study compared operative indexes and postoperative recovery of the two groups. Results Intraoperative bleeding and warm ischemia time in the intervention group were significantly shorter than that in the control group. There were no significant differences in operation time, drainage volume on the first day after operation, and hospital stay between the two groups. Before operation, there were no significant differences in serum creatinine and blood urea nitrogen between the two groups. However, 24 h post-operation, both groups experienced a significant increase in these levels, with the intervention group showing lower levels than the control group. Changes in glomerular filtration rate were significantly lower in the intervention group than the control group. Complication rates were similar, with 7.5% in the research group and 10.0% in the control group. Conclusion Monolayer suture combined with a hem-o-lok clip can shorten the time of warm ischemia, reduce intraoperative bleeding and the loss of normal renal parenchyma in patients undergoing laparoscopic partial nephrectomy. More studies with larger sample size are needed to confirm the results.

Abstract Background The biological significance of cancer-associated fibroblasts (CAFs) in bladder urothelial carcinoma (BUC) warrants further investigation. There is an urgent need to explore the predictive utility of CAF-related genes for prognosis in BUC. Methods The transcriptome and clinical data of 407 BUC patients in The Cancer Genome Atlas (TCGA) database were analyzed and a prognostic model was established. A total of 476 BUC cases from the E-MTAB-4321 database were used for validation. A risk model was constructed utilizing CAF-related genes through LASSO Cox regression, investigating its association with prognosis, gene mutations, immune cell infiltration, and drug sensitivity in BUC. Results We identified five CAF-related genes (EGFL6, NRSN2, SEMA3D, TM4SF1 and TPST1) in both the TCGA and E-MTAB-4321 datasets, and established a prognostic model using LASSO Cox regression. The high-risk group showed a significant correlation with poor survival. Furthermore, the low-risk group exhibited higher tumor mutational burden and lower levels of immune cell infiltration, and this model holds promise for guiding drug selection in BUC patients. Conclusions These findings underscore the pivotal role of CAF-related genes in prognostic prediction for BUC patients. Clinical decision-making and tailored therapeutics stand to benefit from these results, providing a valuable reference for future research endeavors.

Abstract Background During the COVID-19 pandemic, non-therapeutic interventions (NPIs), such as traffic restrictions, work stoppages, and school suspensions, have led to a sharp decline in the concentration of air pollutants in the epidemic sites. However, few studies focused on the impact of air pollutant changes on the risk of nonaccidental death. Method We selected Yancheng City, China, as the study site and applied a Generalized Additive Model (GAM) based on the quasi-Poisson distribution to evaluate the impact of atmospheric pollutants exposure on the nonaccidental death of local residents. The time span of this study was set from January 1, 2013, to December 21, 2022, that is, before and after the outbreak of COVID-19. Results The concentration of some air pollutants has greatly varied after the outbreak of COVID-19, with a significant decline for PM2.5 (− 43.4%), PM10 (− 38.5%), SO2 (− 62.9%), and NO2 (− 22.6%), but an increase for O3 (+ 4.3%). Comparative analysis showed that PM2.5 contributed to an increased risk of nonaccidental death after the outbreak of COVID-19. With an increase in PM2.5 by 10 µg/m³, the excess relative risks (ER) of nonaccidental death of residents increased by 1.01% (95%CI: 0.19%,1.84%). The stratified analysis revealed that air pollutants impacted nonaccidental deaths in both men and women before the outbreak of COVID-19. After the outbreak of COVID-19, PM10 had a significant effect on male nonaccidental deaths. The concentrations of PM2.5, PM10, and SO2 increased by 10 µg/m³, the ER of PM2.5, PM10, and SO2 on female nonaccidental death increased by 1.52% (0.38%,2.67%), 0.58% (0.02%,1.13%), and 15.09% (5.73%,25.28%), respectively. Before the outbreak of COVID-19, five air pollutants had an impact on the death of residents from cardiovascular disease (CVD). After the outbreak of COVID-19, only PM10 significantly affected the death risk of CVD. In addition, we discovered that PM2.5, PM10, and SO2 significantly impacted the risk of death due to respiratory diseases before and after the outbreak of COVID-19. Conclusions Air pollutants have different effects on nonaccidental deaths before and after the COVID-19 outbreak. A decrease in air pollutant concentration due to the NPIs for COVID-19 had a significant effect on the reduction of the risk of nonaccidental death.

Abstract. Background:. Thyroid cancer (TC) is the most common malignancy of the endocrine system. This study aimed to assess the global distribution of TC incidence and mortality in 2022, as well as to predict the burden for the year 2050. Methods:. Data from the GLOBOCAN 2022 database were used to analyze the age-standardized incidence and mortality rates of TC by sex, age group (

Abstract This work investigates the impact of different ultrasonic treatment durations on the synthesis and electrochemical performance of NiZnCo2O4 (NZC) supercapacitor electrodes. Optimizing treatment to 20 min resulted in a uniform, compact NiZnCo2O4 layer with improved nanostructures, which increased the surface area and active sites for electrochemical reactions. X-ray diffraction (XRD) confirmed successful NiZnCo2O4 synthesis, revealing distinct crystalline phases of NiO, ZnCo2O4, and Co3O4, with improved crystallinity. Electrochemical tests, conducted using a 1.0 M KOH electrolyte, demonstrated that the NZC-2 electrode treated for 20 min achieved the highest 5.678 F/cm3 volumetric capacitance at 0.5 mA/cm2 current density along with 70.5 Wh/kg an energy density at 260 W/kg power density. The galvanostatic charge-discharge and cyclic voltammetry tests revealed that NZC-2 maintained superior charge-discharge efficiency, showing the longest discharge time at 1 mA/cm². Electrochemical impedance spectroscopy (EIS) measurements demonstrated that NZC-2 exhibited the lowest total impedance, thereby enhancing ion transport efficiency. The NZC-2/AC asymmetric supercapacitor showed excellent long-term stability, retaining 64.2% of its capacity after 20,000 charge-discharge cycles. It successfully powered a 1.2 V small fan, demonstrating its practical applicability. The results highlight the crucial importance of ultrasonic treatment in greatly improving the structural and electrochemical characteristics of NiZnCo2O4 electrodes, which opens up possibilities for the advancement of high-performance supercapacitors.

ObjectiveThis paper seeks to solve the problem of the partial failure of the actuator of an underwater salvage robot caused by a decrease in the shipborne power supply voltage or corrosion of the control system circuit. Methods Considering the influence of complex ocean conditions on deep-sea torpedoes, cargo shipwrecks, and other engineering salvage operations, the terminal sliding mode observer is used to observe the uncertain disturbance of the system, while the fault-tolerant control method and finite-time control method are used to estimate the fault coefficient of the actuator on-line, and a finite-time trajectory tracking fault-tolerant control scheme with a terminal sliding mode observer is designed. ResultThe system output of this scheme is smooth, stable, and can reach the desired trajectory quickly. At the same time, compared with the traditional fault-tolerant control scheme, the steady-state time of the underwater salvage robot's control system is reduced (the lateral displacement is reduced by 10 s and the longitudinal displacement by 15 s).ConclusionThis study has practical engineering significance and can provide theoretical references for the trajectory tracking of underwater construction machinery.

Bromate–thiourea coordinated leaching of gold sulfide ore for gold sulfide ore as leaching object. The effects of leaching reagent, stirring speed, and leaching time on gold leaching were investigated in this article. The results showed that the optimum leaching conditions were potassium bromate 0.1 M, thiourea 0.6 g·L−1, hydrochloric acid 0.2 M, agitation speed 250 rpm, ratio of liquid to solid 4, and leaching time 10 min. Under these conditions, high efficiency and rapid leaching of gold can be achieved, and reagent consumption is reduced. The research results have theoretical and practical significance for expanding new green gold extraction technology.

Abstract This study evaluated the reliability and validity of the Chinese version of the “Motivational Climate in Physical Education Scale” (MCPES) among middle school students. Data were collected from 1,008 students, with 473 completing the MCPES, the Physical Needs Support in Physical Education Scale (PNS-PE), and the Youth Sports Friendship Quality Scale (YSFQS). Additionally, 437 students completed only the MCPES, and 200 valid retest questionnaires were gathered three weeks later. Exploratory factor analysis identified four factors: perceived mastery climate, perceived performance climate, perceived autonomy support, and perceived relatedness support with a total of 16 items. Confirmatory factor analysis supported the four-factor structure (χ2/df = 3.38, GFI = 0.92, NFI = 0.90, RMSEA = 0.07, CFI = 0.93, IFI = 0.93, SRMR = 0.05). The scale exhibited strict measurement invariance across genders and strong invariance across grade levels. It was positively correlated with teacher autonomy support (r = 0.34–0.53) and with each dimension and total score of sports friendship (r = 0.21–0.61). Cronbach’s α coefficients for the MCPES and its dimensions were 0.75, 0.82, 0.79, 0.80, and 0.88, respectively. Intraclass correlation coefficients (ICCs) for the three-week retest were 0.64, 0.63, 0.72, and 0.76. In conclusion, the Chinese version of the MCPES demonstrates robust reliability and validity for use with middle school students.

Abstract There is a significant interrelationship between cardiovascular disease and obstructive sleep apnea (OSA), as they share common risk factors and comorbidities. This study aimed to investigate the knowledge, attitude, and practice (KAP) of inpatients with cardiovascular disease towards OSA. This cross-sectional study was conducted between January, 2022 and January, 2023 at Zhongda Hospital Affiliated to Southeast University among inpatients with cardiovascular disease using a self-administered questionnaire. A self-designed questionnaire was used to assess KAP, and the STOP-Bang questionnaire was applied to evaluate participants’ OSA risk. Spearman correlation and path analyses were conducted to explore relationships among KAP scores and high OSA risk. Subgroup analyses were conducted within the high-risk population identified by the STOP-Bang questionnaire. In a study analyzing 591 questionnaires, 66.33% were males. Mean scores were 6.81 ± 4.903 for knowledge, 26.84 ± 4.273 for attitude, and 14.46 ± 2.445 for practice. Path analysis revealed high risk of OSA positively impacting knowledge (β = 2.351, P

Objectives: The guidelines recommend fractional flow reserve-guided coronary artery bypass grafting (CABG) during primary valve surgery without evidence. Quantitative flow ratio (QFR) is a novel coronary angiography (CAG)-based fractional flow reserve measurement. We aimed to compare the early clinical outcomes between QFR-guided and CAG-guided CABG in these patients. Methods: This observational study screened all 2081 patients admitted to our institution for elective primary mitral and/or aortic valve surgery from January 2017 to September 2020. Of them, all 188 patients with comorbid coronary artery lesions (visual estimated stenosis ≥50%) were included. Sixty-nine patients with QFR analysis received bypasses only for lesions with QFR ≤0.80 (QFR-guided group). The remaining 119 patients without QFR analysis received bypasses for all stenosis ≥50% (CAG-guided group). Propensity overlap weighting was used to neutralize the intergroup imbalance. The primary end point was major adverse cardiovascular events. Results: After propensity score weighting, the baseline characteristics were comparable. Concomitant coronary artery bypass grafting was performed 58.1% versus 100% in the QFR-guided and CAG-guided groups, respectively. The mean number of grafts was significantly lower in QFR-guided group than in the CAG-guided group (0.9 ± 0.7 vs 1.6 ± 0.5 [P

Abstract Background To clarify the fat attenuation index (FAI) change trend of peri-saphenous vein graft (SVG) and determine the association between FAI and graft disease progression based on CCTA images. Methods Patients with venous coronary artery bypass grafts (CABGs) were consecutively enrolled in this retrospective study. In study 1, 72 patients who had undergone 1, 3, and 5 years of CCTA examinations without graft occlusion were recruited, and generalized estimation equation was used to analyze the peri-SVG FAI change trend over time. In study 2, 42 patients with graft disease progression and 84 patients as controls were propensity score-matched. Generalized linear mixed model and continuous net reclassification improvement (NRI) were used for assessing the associations with graft disease progression. Multivariable Cox regression analysis was used for assessing risk factors predicting cardiac events. Results In study 1, both the FAI of proximal right coronary artery and SVG decreased over time. In study 2, the 1-year CTA-derived FAI of grafts and graft anastomosis were independent indicators of graft disease progression at the 3-year CCTA follow-up (graft: odds ratio [OR] = 1.106; 95% confidence interval [CI] = 1.030–1.188, P = 0.006; graft anastomosis: OR = 1.170, 95% CI = 1.091–1.254, P

Abstract In multi-criteria decision-making and model evaluation, determining the weight of criteria is crucial. With the rapid development of information technology and the advent of the big data era, the need for complex problem analysis and decision-making has intensified. Traditional CRiteria Importance Through Intercriteria Correlation (CRITIC) methods rely on Pearson correlation, which may not adequately address nonlinearity in some scenarios. This study aims to refine the CRITIC method to better accommodate nonlinear relationships and enhance its robustness. We have developed a novel method named CRiteria Importance Through Intercriteria Dependence (CRITID), which leverages cutting-edge independence testing methods such as distance correlation among others. This approach enhances the assessment of intercriteria relationships. Upon application across diverse data distributions, the CRITID method has demonstrated enhanced rationality and robustness relative to the traditional CRITIC method. These improvements significantly benefit multi-criteria decision-making and model evaluation, providing a more accurate and dependable framework for analyzing complex datasets.

Abstract Background Neuroblastoma exhibits substantial heterogeneity, which is intricately linked to various genetic alterations. We aimed to explore immune status in the peripheral blood and prognosis of patients with neuroblastoma with different genetic characteristics. Methods We enrolled 31 patients with neuroblastoma and collected samples to detect three genetic characteristics. Peripheral blood samples were tested for immune cells and cytokines by fluorescent microspheres conjugated with antibodies and flow cytometry. Event-free survival (EFS) was analyzed using the Kaplan‒Meier method. Results Twenty-two patients had genetic aberrations, including MYCN amplification in 6 patients, chromosome 1p deletion in 9 patients, and chromosome 11q deletion in 14 patients. Two genetic alterations were present in seven patients. The EFS was worse in patients with MYCN amplification or 1p deletion than in the corresponding group, whereas 11q deletion was a prognostic factor only in patients with unamplified MYCN. Changes in immune status revealed a decrease in the proportion of T cells in blood, and an increase in regulatory T cells and immunosuppression-related cytokines such as interleukin (IL)-10. The EFS of the IL-10 high-level group was lower than that of the low-level group. Patients with concomitant genetic alterations and a high level of IL-10 had worse EFS than other patients. Conclusions Patients with neuroblastoma characterized by these genetic characteristics often have suppressed T cell response and an overabundance of immunosuppressive cells and cytokines in the peripheral blood. This imbalance is significantly associated with poor EFS. Moreover, if these patients show an elevated levels of immunosuppressive cytokines such as IL-10, the prognosis will be worse.

Abstract Impact ionization effect has been demonstrated in transistors to enable sub-60 mV dec−1 subthreshold swing. However, traditionally, impact ionization in silicon devices requires a high operation voltage due to limited electrical field near the device drain, contradicting the low energy operation purpose. Here, we report a vertical subthreshold swing device composed of a graphene/silicon heterojunction drain and a silicon channel. This structure creates a low voltage avalanche impact ionization phenomenon and leads to steep switching of the silicon-based device. Experimental measurements reveal a small average subthreshold swing of 16 µV dec−1 over 6 decades of drain current and nearly hysteresis-free, and the operating voltage at which a vertical subthreshold swing occurs can be as low as 0.4 V at room temperature. Furthermore, a complementary silicon-based logic inverter is experimentally demonstrated to reach a voltage gain of 311 at a supply voltage of 2 V.

Abstract Aim To explore the topological organization alterations of functional connectomes in type 2 diabetes (T2DM) patients with and without mild cognitive impairment (MCI), and compare these with structural connectomes changes. Methods Twenty-six T2DM patients with MCI (DM-MCI), 26 without cognitive impairment (DM-NC), and 28 healthy controls were included. Diffusion tensor imaging (DTI) and resting-state functional MRI images were acquired. Networks were constructed and graph-theory based network measurements were calculated. The global network parameters and nodal efficiencies were compared across the three groups using one-way ANOVA and a false-discovery rate correction was applied for multiple comparisons. Partial correlation analyses were performed to investigate relationships between network parameters, cognitive performance and clinical variables. Results In the structural connectome, the DM-MCI group exhibited significantly decreased global efficiency (Eglob) and local efficiency (Eloc) compared to the DM-NC and control groups. In the functional connectome, the DM-MCI group exhibited increased Eloc and clustering coefficient (Cp) compared to the controls. No significant differences were found in Eglob, Eloc, or Cp between the DM-NC and the control group, both in structural and functional connectomes. Nodal efficiencies decreased in some brain regions of structural and functional networks in the DM-MCI and DM-NC groups, but increased in five regions in functional network, some of which were involved in the default-mode network. Conclusion Unlike the consistently decreased global properties and nodal efficiencies in the structural connectome of T2DM patients, increases in Eloc, Cp, and nodal efficiencies in the functional connectome may be viewed as a compensatory mechanism due to functional plasticity and reorganization. Altered nodal efficiency can hint at cognitive decrements at an early stage in T2DM patients.

Abstract PROteolysis TArgeting Chimeras (PROTACs) have been considered the next blockbuster therapies. However, due to their inherent limitations, the efficacy of PROTACs is frequently impaired by limited tissue penetration and particularly insufficient cellular internalization into their action sites. Herein, based on the ultra-pH-sensitive and enzyme-sensitive nanotechnology, a type of polymer PROTAC conjugated and pH/cathepsin B sequential responsive nanoparticles (PSRNs) are deliberately designed, following the construction of the PROTAC for Cyclin-dependent kinase 4 and 6 (CDK4/6). Colorectal cancer (CRC) which hardly responds to many treatments even immune checkpoint blockades was selected as the tumor model in this study. As a result, PSRNs were found to maintain nanostructure (40 nm) in circulation and efficiently accumulated in tumors via enhanced permeation and retention effect. Then, they were dissociated into unimers (

In articular cartilage, zone-specific cellular morphology is a typical characteristic of cartilage tissue, which is related with chondrocyte function, inflammation and osteoarthritis (OA). Chondrocyte hypertrophic phenotype is a criticle physiological process which indicates a hallmark of chondrocyte terminal differentiation and bone formation. Thus, developing a in vitro cell culture system for dynamic regulation of single chondrocyte volume at a three-dimensional (3D) level is particularly necessary for understanding how physical cues of matrix microenvironment regulate chondrocyte fate and the degeneration of articular cartilage. Here, based on the soft lithography techniques, we have constructed well-defined single-cell 3D dynamic volume control system to recapitulate the physiological matrix microenvironment of single chondrocyte niche. The results of finite element analysis indicated that the stress and strain distribution in the cell culture region is homogeneous during the stretching process. Additionally, 3D dynamic volume expansion and compression of single cells in physiological or hyperphysiological can be realized in this cell culture system. Our device for single-cell 3D dynamic culture provides a microphysiological culture system for chondrocytes to explore the mechanisms of cartilage hypertrophy, as well as develops a new paradigm for functional cartilage tissue engineering and regenerative medicine.

Abstract Background Innovative attempt to explore the feasibility and accuracy of using indocyanine green fluorescence (ICGF) to identify the intersegmental plane by the target segmental veins preferential ligation during thoracoscopic segmentectomy. Methods A retrospective analysis was conducted on clinical data of 32 consecutive patients who underwent thoracoscopic segmentectomy with intersegmental plane identification using both ICGF and inflation-deflation method after target segmental veins prioritized blocking at Nanjing Chest Hospital from December 2022 to June 2023. Preoperative three-dimensional reconstruction was used to identify the target segment and the anatomical structure of the arteries, veins, and bronchi. After ligating the target segmental veins during surgery, the first intersegmental plane was immediately identified and marked with an electrocoagulation device using an inflation-deflation method. Subsequently, the second intersegmental plane was determined using the ICGF method. Finally, the consistency of the two intersegmental planes was evaluated. Results All the 32 patients successfully completed thoracoscopic segmentectomy without ICG-related complications and perioperative death. The average operation time was (98.59 ± 20.72) min, the average intraoperative blood loss was (45.31 ± 35.65) ml, and the average postoperative chest tube removal time was (3.5 ± 1.16) days. The average postoperative hospital stay was (4.66 ± 1.29) days, and the average tumor margin width was (26.96 ± 5.86) mm. The intersegmental plane determined by ICGF method was basically consistent with inflation-deflation method in all patients. Conclusion The ICGF can safely and accurately identify the intersegmental plane by target segmental veins preferential ligation during thoracoscopic segmentectomy, which is a beneficial exploration and important supplement to the simplified thoracoscopic anatomical segmentectomy.

Abstract Neuroinflammation is an emerging clinical feature in spinal muscular atrophy (SMA). Characterizing neuroinflammatory cytokines in cerebrospinal fluid (CSF) in SMA and their response to nusinersen is important for identifying new biomarkers and understanding the pathophysiology of SMA. We measured twenty-seven neuroinflammatory markers in CSF from twenty SMA children at different time points, and correlated the findings with motor function improvement. At baseline, MCP-1, IL-7 and IL-8 were significantly increased in SMA1 patients compared to SMA2, and were significantly correlated with disease severity. After six months of nusinersen treatment, CSF levels of eotaxin and MIP-1β were markedly reduced, while IL-2, IL-4 and VEGF-A were increased. The decreases in eotaxin and MIP-1β were associated with changes in motor scores in SMA1. We also detected a transient increase in MCP-1, MDC, MIP-1α, IL-12/IL-23p40 and IL-8 after the first or second injection of nusinersen, followed by a steady return to baseline levels within six months. Our study provides a detailed profile of neuroinflammatory markers in SMA CSF. Our data confirms the potential of MCP-1, eotaxin and MIP-1β as new neuroinflammatory biomarkers in SMA1 and indicates the presence of a subtle inflammatory response to nusinersen during the early phase of treatment.

Abstract Background Lung cancer remains a leading cause of cancer-related mortality worldwide. Autotransplantation has emerged as a potential surgical intervention in select cases, with the aim of achieving curative outcomes. This case report describes a novel approach combining lung autotransplantation with postoperative chemotherapy and immunotherapy, delineating the patient's journey over a period of three years. Case presentation We report on a 37-year-old patient with stage IIIA non-small cell lung cancer (NSCLC) who underwent lung autotransplantation. Despite the complexity of the procedure, the patient had a favorable postoperative course. Adjuvant therapy included a PD-1 inhibitor and a standard chemotherapy regimen. The patient’s follow-up involved regular clinical assessment, imaging, and functional status evaluation, demonstrating a remarkable disease-free survival at the three-year mark postoperatively. Conclusion This case highlights the potential for lung autotransplantation coupled with immunotherapy and chemotherapy to yield significant long-term survival benefits in patients with NSCLC. The favorable outcome suggests that this integrative treatment strategy warrants further investigation and may offer hope to patients with similarly advanced lung cancer.

Abstract Promoters play a crucial role in regulating gene transcription. However, our understanding of how genetic variants influence alternative promoter selection is still incomplete. In this study, we implement a framework to identify genetic variants that affect the relative usage of alternative promoters, known as promoter usage quantitative trait loci (puQTLs). By constructing an atlas of human puQTLs across 49 different tissues from 838 individuals, we have identified approximately 76,856 independent loci associated with promoter usage, encompassing 602,009 genetic variants. Our study demonstrates that puQTLs represent a distinct type of molecular quantitative trait loci, effectively uncovering regulatory targets and patterns. Furthermore, puQTLs are regulating in a tissue-specific manner and are enriched with binding sites of epigenetic marks and transcription factors, especially those involved in chromatin architecture formation. Notably, we have also found that puQTLs colocalize with complex traits or diseases and contribute to their heritability. Collectively, our findings underscore the significant role of puQTLs in elucidating the molecular mechanisms underlying tissue development and complex diseases.

Abstract Objective With the progress of economic globalization and food diversification, foodborne parasitic diseases pose a significant public health challenge in China. This study aimed to explore the knowledge, attitudes, and practices regarding foodborne parasitic diseases among the Chinese population via WeChat, which is a promising tool for disease surveillance and health education. Methods Using a questionnaire, this cross-sectional study was conducted on September 25, 2023. Participants completed a structured questionnaire by scanning a QR code provided in a tweet from the WeChat official account of the Jiangsu Institute of Parasite Disease. Multivariable logistic regression analysis was employed to explore potential independent determinants of adequate knowledge of foodborne parasitic diseases, and the positive attitude and good practice rates of the participants were calculated. Results In total, 5,675 valid questionnaires were collected via the WeChat official account. Most participants (79.91%) fell within the age range of 20–40 years, with a higher representation of males (53.18%), and 89.80% were of Han Chinese ethnicity. It was found that 76.65% of the participants had adequate level of knowledge. Multivariable logistic regression analysis revealed that individuals of Hui nationality (OR = 0.57, 95% CI: 0.40–0.81, p = 0.002), clinicians (OR = 0.13, 95% CI: 0.09–0.19, p

Abstract Introduction HIV is widely prevalent in all regions of the world. The use of antiretroviral drugs has dramatically reduced the mortality rate of HIV-related diseases, but correspondingly increased the incidence of chronic complications in HIV-positive people. Related studies have found that the incidence of osteonecrosis of the femoral head is higher in HIV-positive people, but the co-occurrence of femoral head necrosis, acetabular necrosis and hip joint dislocation in HIV-positive patients is rare. Methods We report a 50-year-old man with a 15-month history of progressively worsening right hip pain with movement restriction. According to the CT findings of the other hospital, the patient was admitted to the hospital with femoral head necrosis. After the admission, the relevant X-ray, CT and MRI examinations showed that the right femoral head collapsed and deformed, with the surrounding bone sclerosis, bone fragments, loose body of the joint, right hip subluxation, acetabular marginal osteogeny, and local microcystic degeneration. The left femoral head was in good shape, and cystic degeneration can be seen under the articular surface. The patient was finally diagnosed with femoral head necrosis and acetabular necrosis combined with hip subluxation. Results The pain of the patient was significantly relieved after the operation, and the patient was discharged from the hospital one week after the start of treatment to continue rehabilitation training. During the follow-up one month after the operation, the self-reported pain disappeared completely, and the limitation of activity was significantly improved.

Achieving robust joint utilization of multidomain characteristics and deep-network features while maintaining a high jamming-recognition accuracy with limited samples is challenging. To address this issue, this paper proposes a multidomain characteristic-guided multimodal contrastive recognition method for active radar jamming. This method involves first thoroughly extracting the multidomain characteristics of active jamming and then designing an optimization unit to automatically select effective characteristics and generate a text modality imbued with implicit expert knowledge. The text modality and involved time-frequency transformation image are separately fed into text and image encoders to construct multimodal-feature pairs and map them to a high-dimensional space for modal alignment. The text features are used as anchors and a guide to time-frequency image features for aggregation around the anchors through contrastive learning, optimizing the image encoder’s representation capability, achieving tight intraclass and separated interclass distributions of active jamming. Experiments show that compared to existing methods, which involve directly combining multidomain characteristics and deep-network features, the proposed guided-joint method can achieve differential feature processing, thereby enhancing the discriminative and generalization capabilities of recognition features. Moreover, under extremely small-sample conditions (2～3 training samples for each type of jamming), the accuracy of our method is 9.84% higher than those of comparative methods, proving the effectiveness and robustness of the proposed method.

Some core designs integrate high-enriched fuel and moderator materials to enhance neutron utilization. This combination results in a broad spectrum within the system, posing challenges in resonance calculation. This paper introduces a general framework to realize resonance self-shielding treatment in broad-spectrum fuel lattice problems. The framework consists of three components. First, a new energy group structure is devised to support resonance calculation in the entire energy range and capture spectral transition and thermalization effects during eigenvalue calculation. Second, the subgroup method based on narrow approximation is selected as a universal method to perform resonance calculation. Finally, transport equations for each fissionable region are solved for neutron flux to collapse the fission spectrum. The proposed method is verified against fast, intermediate, and thermal spectrum pin cell problems and an assembly problem featuring a fast-thermal coupled spectrum. Numerical results affirm the accuracy of the proposed method in handling these scenarios, with eigenvalue errors below 154 pcm for pin cell problems and 106 pcm for the assembly problem. The verification results revealed that the proposed method enables accurate resonance self-shielding treatment for broad-spectrum problems.

Abstract Brain injury is the leading cause of mortality among patients who survive cardiac arrest (CA). Clinical studies have shown that the presence of post-CA hypoxic hepatitis or pre-CA liver disease is associated with increased mortality and inferior neurological recovery. In our in vivo global cerebral ischemia model, we observed a larger infarct area, elevated tissue injury scores, and increased intravascular CD45+ cell adhesion in reperfused brains with simultaneous hepatic ischemia than in those without it. In the ex vivo brain normothermic machine perfusion (NMP) model, we demonstrated that addition of a functioning liver to the brain NMP circuit significantly reduced post-CA brain injury, increased neuronal viability, and improved electrocortical activity. Furthermore, significant alterations were observed in both the transcriptome and metabolome in the presence or absence of hepatic ischemia. Our study highlights the crucial role of the liver in the pathogenesis of post-CA brain injury.

Remote sensing images often need to be merged into a larger mosaic image to support analysis on large areas in many applications. However, the performance of the mosaic imagery may be severely restricted if there are many areas with cloud coverage or if these images used for merging have a long-time span. Therefore, this paper proposes a method of image selection for full coverage image (i.e. a mosaic image with no cloud-contaminated pixels) generation. Specifically, a novel High-Frequency-Aware (HFA)-Net based on Swin-Transformer for region quality grading is presented to provide a data basis for image selection. Spatiotemporal constraints are presented to optimize the image selection. In the temporal dimension, the shortest-time-span constraint shortens the time span of the selected images, obviously improving the timeliness of the image selection results (i.e. with a shorter time span). In the spatial dimension, a spatial continuity constraint is proposed to select data with better quality and larger area, thus improving the radiometric continuity of the results. Experiments on the GF-1 images indicate that the proposed method reduces the averages by 76.1% and 38.7% in terms of the shortest time span compared to the Improved Coverage-oriented Retrieval algorithm (MICR) and Retrieval Method based on Grid Compensation (RMGC) methods, respectively. Moreover, the proposed method also reduces the residual cloud amount by an average of 91.2%, 89.8%, and 83.4% when compared to the MICR, RMGC, and Pixel-based Time-series Synthesis Method (PTSM) methods, respectively.

Abstract This study aims to objectively assess the effect of three surgical approaches for posterior uterine fibroid resection: transumbilical laparoendoscopic single-site surgery (LESS), vaginal natural orifice transluminal endoscopic surgery (vNOTES) in prone position (vNOTES-P), and vNOTES in the lithotomy position (vNOTES-L). A retrospective analysis was conducted on data pertaining to all patients who underwent vNOTES and LESS for single posterior fibroids at our institution from January 2023 to July 2023. Patients were categorized into three groups based on the surgical approach: vNOTES-P group (n = 30), vNOTES-L group (n = 17), and LESS group (n = 32). Comparative analysis was performed on the demographic characteristics and perioperative outcomes among the three groups of patients. All 79 patients underwent surgery without the need for conversion to laparotomy. There were no statistically significant differences among the LESS group, vNOTES-P group, and vNOTES-L group in terms of operative time, intraoperative blood loss, and perioperative complication rates. In the vNOTES-L group, two patients required conversion to LESS during surgery. Patients had faster return of bowel function (less time to flatus) in the vNOTES group compared to the LESS group (P

Abstract Background Low back pain has become a globally challenging health problem, and about 90% of cases are nonspecific. Due to the risks associated with opioid use and the limited effectiveness of drug treatment, acupuncture and other non-drug methods have become the first-line treatment for this disease. However, the best acupuncture method has not yet been determined. In this study, the effects of different acupuncture methods on chronic nonspecific low back pain (CNLBP) were compared by network meta-analysis, aiming at identifying the best option and providing a basis for precise treatment of CNLBP. Methods Clinical randomized controlled trials (RCTs) on acupuncture in the treatment of NSLBP were searched in eight databases including PubMed, Embase, Cochrane Library, Web of Science, Sinomed, CNKI, Wanfang Data and VIP from the inception of databases to January 21, 2024. The Cochrane risk-of-bias tool 2.0 (RoB 2.0) and Stata 15.0 (Stata Corp, College Station, Texas, USA) were used to evaluate the literature quality and meta-analysis, and the evidence quality was assessed based on GRADE guidelines. This systematic review was registered at the International Prospective Register of Systematic Reviews. Results A total of 27 articles were included, involving 2579 patients. The results of the network meta-analysis showed that the top three treatment schemes were warm needle acupuncture, intensive silver needle therapy and meridian-sinew theory-based treatment. In terms of relieving pain, the top three treatments were electrical warm needling, intensive silver needle therapy and warm needle acupuncture. In improving mobility, the top three were meridian-sinew theory-based treatment, routine acupuncture and electroacupuncture. Conclusion For CNLBP patients, warm needle acupuncture, electrical warm needling and meridian-sinew theory-based treatment are mainly recommended. If patients have significant pain, electroacupuncture is strongly suggested. On the contrary, for patients with decreased joint mobility, meridian-sinew theory-based treatment is advocated.