Search

Abstract Percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure for removing renal calculi, while a large number of patients experience acute moderate-to-severe pain despite the analgesia provided. This study aimed to explore the risk factors for postoperative pain after PCNL, which may provide a novel perspective to refine the enhanced recovery after surgery (ERAS) program and to improve clinical outcomes. The clinical data of 331 patients who underwent PCNL in our hospital from September 2020 to February 2021 were retrospectively analyzed. The pain intensity was assessed every 4 h until 24 h post-surgery. According to the visual analog scale (VAS) score, patients were divided into two groups: mild or no pain group (VAS score, 0–3) and moderate-to-severe pain group (VAS score, 4–10). The pre-, peri-, and post-operative data were collected and analyzed. The indicators with statistically significant differences were selected, and multivariate logistic regression analysis was employed to determine the risk factors for postoperative pain after PCNL. Among 331 patients, 221 patients had moderate-to-severe pain and the incidence rate was 66.77%. Multivariate logistic regression analysis showed that the independent risk factors for moderate-to-severe pain after PCNL were the diameter of the renal calculus (odds ratio (OR) = 6.23, 95% confidence interval (CI) 2.50–15.56, P = 0.001), the number of renal calculi (OR = 15.892, 95% CI 7.721–32.711, P

Cerebral malaria (CM), as one of the most common complications in severe malaria, has threatened millions of individuals’ neurological health and even their lives. Macrophage migration inhibitory factor (MIF), a pleiotropic proinflammatory factor in humans, seems to be a risk factor for death in patients with CM, but its functional mechanism remains unclear. To verify whether affecting the intestinal microbes of the host was one of the mechanisms by which MIF regulates CM, C57BL/6 mice, including WT + PbA, MIF-KO + PbA and their uninfected controls, were sent for 16S rRNA-based sequencing targeting the V4 region of the intestinal microbiota through the Illumina MiSeq platform. The results showed that OTU clustering, alpha and beta diversity in the four groups involved had evident variation. The relative abundance at different taxonomic levels, especially the dominant intestinal flora, was obviously changed. The LEfSe analysis screened out several biomarkers, including significantly reduced Ligilactobacillus (Lactobacillus murinus) in WPbA mice compared to the WT group and Akkermansia (Akkermansia_muciniphila) in KPbA mice compared to the WPbA group. For MIF KO groups, mice infected with PbA or uninfected showed significant enrichment of producers of short-chain fatty acids, including Dubosiella and Faecalibaculum (Faecalibaculum rodentium) in KPbA, and Lachnospiraceae_NK4A136_group and Firmicutes_bacterium_M10-2 in KO. This study not only further proved the gut microbiota changes in C57BL/6 mice caused by PbA infection, but also found that MIF deletion directly affected the changes in the gut microbiota of C57BL/6 mice before and after PbA infection. This finding reveals a potential mechanism by which MIF regulates CM. Combining MIF with potential microbial biomarkers will provide a promising idea to develop combined drugs for improving CM in the future.

Abstract Background The classic formula has been used to estimate the depth of tracheal tube intubation in children for decades. However, it is unclear whether this formula is applicable when the head and neck position changes intraoperatively. Methods We prospectively reviewed the data of 172 well-developed children aged 2–12 years (64.0% boys) who underwent head and neck surgery under general anesthesia. The distances from the tracheal carina to the endotracheal tube tip (CT), from the superior margin of the endotracheal tube tip to the vocal cord posterior commissure (CV), and from the tracheal carina to the posterior vocal commissure (TV) were measured in the sniffing position (maximum), neutral head, and maximal head flexion positions. Results Average CT and CV in the neutral head position were 4.33 cm and 10.4 cm, respectively. They increased to 5.43 cm and 11.3 cm, respectively, in the sniffing position, and to 3.39 cm and 9.59 cm, respectively, in the maximal flexion position (all P-values

Abstract Anterior talofibular ligament injuries and osteochondral lesions of the talus present unique challenges to orthopedic surgeons. This study aimed to investigate the relevant relationship between them by analyzing the Magnetic resonance imaging (MRI) results of clinical patients and single-cell RNA sequence (scRNA seq) results of healthy talus cartilage to discuss the risk factors. Data from 164 patients from 2018 to 2023 was retrospectively analyzed. The correlation analysis between ATFL injury grade and the Hepple stage of OLT determined by MRI was performed. Publicly available single-cell RNA datasets were collected. Single-cell RNA datasets from five volunteers of healthy talus cartilage were analyzed. ATFL injury grade was relevant with the Hepple stage of OLT (P

Based on electrophysiological activity, neuroprostheses can effectively monitor and control neural activity. Currently, electrophysiological neuroprostheses are widely utilized in treating neurological disorders, particularly in restoring motor, visual, auditory, and somatosensory functions after nervous system injuries. They also help alleviate inflammation, regulate blood pressure, provide analgesia, and treat conditions such as epilepsy and Alzheimer’s disease, offering significant research, economic, and social value. Enhancing the targeting capabilities of neuroprostheses remains a key objective for researchers. Modeling and simulation techniques facilitate the theoretical analysis of interactions between neuroprostheses and the nervous system, allowing for quantitative assessments of targeting efficiency. Throughout the development of neuroprostheses, these modeling and simulation methods can save time, materials, and labor costs, thereby accelerating the rapid development of highly targeted neuroprostheses. This article introduces the fundamental principles of neuroprosthesis simulation technology and reviews how various simulation techniques assist in the design and performance enhancement of neuroprostheses. Finally, it discusses the limitations of modeling and simulation and outlines future directions for utilizing these approaches to guide neuroprosthesis design.

Abstract Objective Chronic subjective tinnitus is a worldwide intractable problem. In our previous studies, customized music therapy combined with a follow‐up system can reduce tinnitus perception and improve anxiety/depression. This study aims to explore which characteristics of tinnitus patients are more likely to benefit from our therapy. Study Design This study included 1031 patients with chronic subjective tinnitus, all of whom completed customized music therapy with the follow‐up system. Population demographics, tinnitus characteristics, and tinnitus‐related scales at pretherapy and posttherapy were collected. Setting Huadong Hospital affiliated Fudan University, Department of Otorhinolaryngology–Head & Neck Surgery from 2018 to 2022. Methods A paired t test and the one‐way analysis of variance were utilized to the overall efficacy and stratified difference based on tinnitus duration/age/tinnitus frequency. Results There were significant statistical differences in the Tinnitus Handicap Inventory (THI), Tinnitus Loudness Visual Analog Scale (VAS), and Hospital Anxiety and Depression Scale (HADS)‐A/D scores between pretherapy and 3 months posttherapy. THI and HADS (A/D) scores decreased the most in the 1‐year duration tinnitus group. The most significant decrease in THI and VAS scores was observed in the 31‐ to 50‐year‐old tinnitus group. Patients with high‐frequency tinnitus and extended high‐frequency tinnitus had greater decreases generally than those with low‐frequency tinnitus though no significance. Conclusion Group with severe and prolonged tinnitus, shorter duration of tinnitus onset, and 31 to 50 years old benefit more from our therapy. Therefore, standardized personalized music and consulting and follow‐up systems while promoting early treatment can reduce tinnitus and its comorbidities.

Crotonylation is a recently discovered protein acyl modification that shares many enzymes with acetylation. However, it possesses a distinct regulatory mechanism and biological function due to its unique crotonyl structure. Since the discovery of crotonylation in 2011, numerous crotonylation sites have been identified in both histones and other proteins. In recent studies, crotonylation was found to play a role in various diseases and biological processes. This paper reviews the initial discovery and regulatory mechanisms of crotonylation, including various writer, reader, and eraser proteins. Finally, we emphasize the relationship of dysregulated protein crotonylation with eight common malignancies, including cervical, prostate, liver, and lung cancer, providing new potential therapeutic targets.

Objectives The role of the distal tibiofibular ligament in the occurrence of high ankle sprain (HAS) has been widely studied. But previous studies have overlooked the physiological and anatomical differences between males and females and have not further refined gender. Therefore, the impact of the anatomical morphology of fibular notch (FN) on HAS in different genders is still unclear. This study aimed to explore the impact of different types of FN on the severity of HAS and to estimate the prognosis of patients with HAS while excluding anatomical differences caused by gender. Methods One hundred and eighty patients with HAS were included in this study as the experimental group (i.e., HAS group). They were further divided into four groups according to gender and FN depth, with deep concave FN ≥ 4 mm and shallow flat FN

Neural interfaces are crucial conduits between neural tissues and external devices, enabling the recording and modulation of neural activity. However, with increasing demand, simple neural interfaces are no longer adequate to meet the requirements for precision, functionality, and safety. There are three main challenges in fabricating advanced neural interfaces: sensitivity, heat management, and biocompatibility. The electrical, chemical, and optical properties of 2D nanomaterials enhance the sensitivity of various types of neural interfaces, while the newly developed interfaces do not exhibit adverse reactions in terms of heat management and biocompatibility. Additionally, 2D nanomaterials can further improve the functionality of these interfaces, including magnetic resonance imaging (MRI) compatibility, stretchability, and drug delivery. In this review, we examine the recent applications of 2D nanomaterials in neural interfaces, focusing on their contributions to enhancing performance and functionality. Finally, we summarize the advantages and disadvantages of these nanomaterials, analyze the importance of biocompatibility testing for 2D nanomaterials, and propose that improving and developing composite material structures to enhance interface performance will continue to lead the forefront of this field.

Abstract Background Syndesmosis injury is proposed to contribute to ankle stability and osteoarthritis (OA). However, whether distal tibiofibular syndesmosis structure is closely related to ankle OA is unclear. We hypothesized that different DTS morphology classifications would affect the biomechanics properties in ankle OA. The study aimed to determine the association between the distal tibiofibular syndesmosis (DTS) morphological classification and ankle OA. Methods This is a retrospective study examining imaging data of 147 patients (87 males and 60 females) with ankle OA. Magnetic resonance imaging was used to access the DTS morphological classification, according to measuring various parameters. Joint space narrowing and osteophytes were measured using ankle weight-bearing radiography. The classification and parameters were analyzed to determine the relationship between the syndesmosis classification and the abnormality of ankle OA. Results Five morphological classifications of the DTS, including Chevron (19.6%), Widow’s peak (16.2%), Flat (22.3%), Trapezoid (32.0%), and Crescent (19.6%), were shown. There were statistical differences between DTS classification and tibial angle surface angle (TAS) (P = .009) and talar tilt angle (TTA) (P = .014). The TAS (degree) of the Crescent (86.47 ± 3.21) was less than Chevron (88.75 ± 2.72) (P = .006), Widow’s peak (89.26 ± 3.15) (P = .001), Flat (88.83 ± 3.62) (P = .003) and Trapezoid (88.11 ± 2.62) (P = .041), respectively. The TTA (degree) of Crescent (86.83 ± 5.30) was less than Chevron (89.28 ± 2.46) and Widow’s peak (89.82 ± 3.41). The men were greater than women for TAS (P = .008) and angle (P = .003), which are consistent with osteophyte (P = .019) and the modified Kellgren–Lawrence grades (P = .041) between gender. Conclusions DTS morphological classification might affect the biomechanics properties in TAS and TTA in ankle OA. In clinical practice, surgeons should pay attention to the effects of DTS on ankle OA. Level of Evidence: Level III, retrospective study.

Abstract Backgrounds Tinnitus is a meaningless sound signal perceived by the patients in the absence of auditory stimuli. Due to the complex etiology and unclear mechanism, specific therapies for tinnitus are still in the exploratory stage. In recent years, personalized and customized music therapy has been proposed as an effective method for tinnitus treatment. The aim of this study was to explore the efficacy of customized therapy with a well-designed follow-up system in the treatment of tinnitus through a large sample one arm study and to identify the relevant factors affecting the treatment outcome. Methods The study investigated a total of 615 patients with unilateral or bilateral chronic tinnitus who received personalized and customized music therapy for 3 months. A complete follow-up system was designed by the professionals. Questionnaires of Tinnitus Handicap Inventory (THI), Hospital Anxiety and Depression Scale (HADS) and Visual Analogue Scale (VAS) were used to evaluate the therapeutic effects and relevant factors affecting the efficacy of therapy. Results The results showed a decreasing trend in THI and VAS scores after 3 months of therapy, with statistically significant differences between pre- and post-therapy time points (P

At the interface of machine learning and quantum computing, an important question is what distributions can be learned provably with optimal sample complexities and with quantum-accelerated time complexities. In the classical case, Klivans and Goel discussed the $Alphatron$, an algorithm to learn distributions related to kernelized regression, which they also applied to the learning of two-layer neural networks. In this work, we provide quantum versions of the Alphatron in the fault-tolerant setting. In a well-defined learning model, this quantum algorithm is able to provide a polynomial speedup for a large range of parameters of the underlying concept class. We discuss two types of speedups, one for evaluating the kernel matrix and one for evaluating the gradient in the stochastic gradient descent procedure. We also discuss the quantum advantage in the context of learning of two-layer neural networks. Our work contributes to the study of quantum learning with kernels and from samples.

In the design of high-speed interconnection systems, it is often necessary to evaluate signal integrity and electromagnetic interference performance by extracting terminal network parameters and differential and common mode network parameters. However, in a multi-conductor transmission line, the characteristic parameters related to different conductors, which named terminal in terminal theory, are couped together in traditional model network parameters and could not be extracted directly. Therefore, in this paper, a three-dimension terminal simulation tool based on transfinite element method is developed to solve this problem. The vector finite element method is combined with the transfinite element method, and the electric field of the truncation surface is approximated by the expansion of the truncation surface mode function. As far as we know, the combination of the transfinite element method and the terminal theory is proposed for the first time. The terminal simulation tool has a human-computer interaction interface, as well as functions such as modeling, mesh generation, solution setting, and post-processing result display, which can accurately obtain the terminal network parameters and differential and common mode network parameters. Numerical examples are given to demonstrate the accuracy and efficiency of the developed tool compared with the results from HFSS.

For a multi-robot system, the accurate global map building based on a local map obtained by a single robot is an essential issue. The map building process is always divided into three stages: single-robot map acquisition, multi-robot map transmission, and multi-robot map merging. Based on the different stages of map building, this paper proposes a multi-stage optimization (MSO) method to improve the accuracy of the global map. In the map acquisition stage, we windowed the map based on the position of the robot to obtain the local map. Furthermore, we adopted the extended Kalman filter (EKF) to improve the positioning accuracy, thereby enhancing the accuracy of the map acquisition by the single robot. In the map transmission stage, considering the robustness of the multi-robot system in the real environment, we designed a dynamic self-organized communication topology (DSCT) based on the master and slave sketch to ensure the efficiency and accuracy of map transferring. In the map merging stage, multi-layer information filtering (MLIF) was investigated to increase the accuracy of the global map. We performed simulation experiments on the Gazebo platform and compared the result of the proposed method with that of classic map building methods. In addition, the practicability of this method has been verified on the Turtlebot3 burger robot. Experimental results proved that the MSO method improves the accuracy of the global map built by the multi-robot system.

This study focuses on the generation of the bubble-free layer during the fabrication of the metal foam using the direct melt foaming method. The theoretical models for the three stages during the foaming process have been established, and the boundary conditions have been discussed. The results from the theoretical study indicated that the bubble number of the liquid foam played a critical role in the generation of the bubble-free layer, thus, improving the bubble number retards the velocity of the bubble-free layer generation. The liquid film rupture led to the expansion of the local cross-sectional area of the Plateau border channel and increased the drainage velocity, thus, resulting in an enhancement in the bubble-free layer. Additionally, the verification experiments were conducted by employing the graphene nanoflakes (GNFs) as the heterogeneous nucleation agent. The findings indicated that the generation of the bubble-free layer was hindered, and the bubble-free layer was altogether absent in case the content of the heterogeneous nucleation agent was enhanced.

In order to solve the problem of slow convergence speed and long planned path when the robot plans a path in unknown environment by using Q-learning algorithm, we propose the Experience-Memory Q-Learning (EMQL) algorithm based on the continuous update of the shortest distance from the current state node to the start point. The autonomous learning ability of the robot is enhanced by the different role assignments of two tables in the proposed algorithm. EM table with $(m*1)$ dimension is designed to record the distance information, reflecting the learning process of the robot. Q table is adopted as an auxiliary guidance for the experience transfer strategy and experience reuse strategy, and these strategies enable the robot accomplish the task even if the destination is changed or the path is blocked. Further, the learning efficiency of the robot in the EMQL algorithm is improved by the dual reward mechanism consisting of static reward and dynamic reward. The static reward is designed to prevent the robot from exploring a state node excessively. The dynamic reward is responsible for helping the robot avoid searching blindly in unknown environment. We test the effectiveness of the proposed algorithm on both grid maps and road network maps. The comparison results in planning time, iteration times and path length show that the performance of the EMQL algorithm is superior to Q-learning algorithm in convergence speed and optimization ability. Additionally, the practicability of the proposed algorithm is validated in a real-world experiment using the Turtlebot3 burger robot.

Magneto-Acousto-Electric Tomography with coil detection, known as Magneto-Acousto-Electric Tomography with Magnetic Induction (MAET-MI), is a non-contact resistivity-based imaging method that employs a coil to detect the induced current generated by the ultrasound in biological tissue, which lie under a static magnetic field. To reconstruct an image of the tissue's conductivity, we propose a reciprocal model to describe the relationship between the inducted voltage of a coil and its conductivity. Previous work on the reciprocal theorem demonstrates that reconstructing conductivity using this method is effective. The forward and inverse problem are usually not verified both numerically and experimentally. In this paper, different approaches are adopted to calculate the forward and the inverse problems for verification of the reciprocal model. This verifies that the reconstruction method based on electrode detection can be applied to MAET-MI. This means that the inverse problem of MAET-MI can be transformed into an inverse source reconstruction of a wave equation based on the coil detection. In the forward problem, the moment method is employed to calculate the Radon transform and generate the ultrasonic signals. For the inverse problem, the filtered back projection method is chosen to reconstruct the ultrasound sources, which are related to the curl of the current density in the reciprocal process. Based on the curl of the current density in the reciprocal process, four sets of correlation coefficients of the original and reconstructed images' model are all greater than 90%. The uniform error criterion is obtained via multiple reconstructions and comparison of multiple models. The reciprocal model exhibits a good uniformity and stability when describing the actual physical process. It also provides additional effective ideas for solving the inverse problem quickly to reconstruct the ultrasonic sources, which is corresponding to the actual distribution of the conductivity.

OBJECTIVES: Hypoxia leads to endothelial cell inflammation, apoptosis, and damage, which plays an important role in the complications associated with ischemic cardiovascular disease. As an oxidoreductase, p66Shc plays an important role in the regulation of reactive oxygen species (ROS) production and apoptosis. Ketamine is widely used in clinics. This study was designed to assess the potential protective effect of ketamine against hypoxia-induced injury in human umbilical vein endothelial cells (HUVECs). Moreover, we explored the potential mechanism by which ketamine protected against hypoxia-induced endothelial injury. METHODS: The protective effects of ketamine against hypoxia-induced injury was assessed using cell viability and adhesion assays, quantitative polymerase chain reaction, and western blotting. RESULTS: Our data showed that hypoxia reduced HUVEC viability, increased the adhesion between HUVECs and monocytes, and upregulated the expression of endothelial adhesion molecules at the protein and mRNA levels. Moreover, hypoxia increased ROS accumulation and upregulated p66Shc expression. Furthermore, hypoxia downregulated sirt1 expression in HUVECs. Alternatively, ketamine was shown to reverse the hypoxia-mediated reduction of cell viability and increase in the adhesion between HUVECs and monocytes, ameliorate hypoxia-induced ROS accumulation, and suppress p66Shc expression. Moreover, EX527, a sirt1 inhibitor, reversed the protective effects of ketamine against the hypoxia-mediated reduction of cell viability and increase in adhesion between HUVECs and monocytes. CONCLUSION: Ketamine reduces hypoxia-induced p66Shc expression and attenuates ROS accumulation via upregulating sirt1 in HUVECs, thus attenuating hypoxia-induced endothelial cell inflammation and apoptosis.