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AimThis study aimed to predict the formation of OBL during femtosecond laser SMILE surgery by employing deep learning technology.MethodsThis was a cross-sectional, retrospective study conducted at a university hospital. Surgical videos were randomly divided into a training (3,271 patches, 73.64%), validation (704 patches, 15.85%), and internal verification set (467 patches, 10.51%). An artificial intelligence (AI) model was developed using a SENet-based residual regression deep neural network. Model performance was assessed using the mean absolute error (EMA), Pearson’s correlation coefficient (r), and determination coefficient (R2).ResultsFour distinct types of deep neural network models were established. The modified deep residual neural network prediction model with channel attention built on the PyTorch framework demonstrated the best predictive performance. The predicted OBL area values correlated well with the Photoshop-based measurements (EMA = 0.253, r = 0.831, R2 = 0.676). The ResNet (EMA = 0.259, r = 0.798, R2 = 0.631) and Vgg19 models (EMA = 0.31, r = 0.758, R2 = 0.559) both displayed satisfactory predictive performance, while the U-net model (EMA = 0.605, r = 0.331, R2 = 0.171) performed poorest.ConclusionWe used a panoramic corneal image obtained before the SMILE laser scan to create a unique deep residual neural network prediction model to predict OBL formation during SMILE surgery. This model demonstrated exceptional predictive power, suggesting its clinical applicability across a broad field.

ABSTRACTThe African swine fever virus (ASFV) structural protein pA104R is the only histone-like protein encoded by eukaryotic viruses. pA104R is an essential DNA-binding protein required for DNA replication and genome packaging of ASFV, which are vital for pathogen survival and proliferation. pA104R is an important target molecule for diagnosing, treating, and immune prevention of ASFV. This study characterized monoclonal antibodies (mAbs) against pA104R and found them to recognize natural pA104R in ASFV strains with different genotypes, showing high conservation. Confirmation analyses of pA104R epitopes using mAbs indicated the presence of immunodominant B-cell epitopes, and further characterization showed the high antigenic index and surface accessibility coefficients of the identified epitope. Furthermore, the pA104R protein functions through the polar interactions between the binding amino acid sites; however, these interactions may be blocked by the recognition of generated mAbs. Characterizing the immunodominant B-cell epitope of the ASFV critical proteins, such as pA104R, may contribute to developing sensitive diagnostic tools and vaccine candidate targets.IMPORTANCEAfrican swine fever (ASF) is a highly pathogenic, lethal, and contagious viral disease affecting domestic pigs and wild boars. As no effective vaccine or other treatments have been developed, the control of African swine fever virus (ASFV) relies heavily on virus detection and diagnosis. A potential serological target is the structural protein pA104R. However, the molecular basis of pA104R antigenicity remains unclear, and a specific monoclonal antibody (mAb) against this protein is still unavailable. In this study, mAbs against pA104R were characterized and found to recognize natural pA104R in ASFV strains with different genotypes. In addition, confirmation analyses of pA104R epitopes using mAbs indicated the presence of immunodominant B-cell epitopes, and further characterization showed the high antigenic index and surface accessibility coefficients of the identified epitope. Characteristics of the immunodominant B-cell epitope of ASFV proteins, such as pA104R, may contribute to developing sensitive diagnostic tools and identifying vaccine candidate targets.

Traumatic heterotopic ossification (HO) represents an intractable sequela following trauma with no currently effective prophylaxis or treatment. Photodynamic therapy (PDT) is a non-invasive treatment for various proliferative diseases. However, the specific effects of PDT on HO development remain unclear. In this study, the therapeutic potential of a near-infrared (NIR) probe-WL-808, composed of type II collagen-binding peptide (WYRGRL) and a PDT photosensitizer (IR-808), was evaluated for the innovative HO-targeted PDT approach. In vitro studies indicated that WL-808 could induce chondrocyte apoptosis and inhibit cell viability through ROS generation under NIR excitation. In vivo, the efficacy of WL-808-mediated PDT was tested on the tenotomy HO model mice. WL-808 specifically targeted the type II collagen cartilaginous template of HO, promoting cell apoptosis and enhancing extracellular matrix (ECM) degradation under 808 nm NIR excitation, which inhibited the final ectopic bone formation. Moreover, no obvious toxicity or side effects were detected after treatment with WL-808. Taken together, WL-808-mediated PDT significantly diminished ectopic cartilage and subsequent bone formation, providing a new perspective for HO prophylaxis and treatment.

Lanthanum (La) compounds have attracted much attention because of low toxicity and biocompatibility. In this study, a series of La-doped magnesium phosphate composites bone repair materials (LMPCs) were prepared by the precursor method, in which the molar ratio of lanthanum was 1%, 3% and 5%, respectively. The results of X-ray powder diffraction, scanning electron microscope and compressive strength test show that La-doped magnesium phosphates (LMPs) synthesized by the precursor method have uniform particle distribution, high purity and excellent degradability. In vitro research results show that LMPCs exhibited reliable biosafety and excellent bioactivity. The introduction of lanthanum enhances the antibacterial activity of Escherichia coli and Staphylococcus aureus of the composite. Furthermore, the combined system of released La3+ and Mg2+ is more conducive to promoting the proliferation of mesenchymal stromal cells (MSC) and angiogenesis of human umbilical vein endothelial cells (HUVECs) when the content of lanthanum is 3% (referred to as LMPC-2). By up-regulating the expression of alkaline phosphatase (ALP) and Runt-related transcription factor 2 (RUNX2), LMPC-2 is prominent in promoting osteogenic differentiation, and mineralized calcium deposition in vitro. Moreover, the results of micro-CT, H&E and Masson staining confirmed the beneficial effect of the combined system of La3+ and Mg2+ on the repair of rat skull defects in vivo. These achievements will provide new strategies for improving the biological activity of LMPCs and provide reference value for bone repairing in the clinic.

BackgroundChronic ankle instability (CAI) is a common sports injury disease and characterized by limited mobility, perceived instability and muscle weakness, combined treatment of hip-knee-ankle is a common rehabilitation method. Tuina, as a traditional Chinese manual therapy, is usually used for CAI, but many of them only focus on the local ankle joint rather than the combination of hip and knee joint. Therefore, we have designed a randomized controlled trial (RCT) to investigate the effects of Tuina base on the concept of hip-knee-ankle conjugation on the stability and balance of lower limbs and ankle function in patients with CAI.MethodsWe have designed a randomized controlled trial. A total of 72 participants with CAI will be randomly divided into functional training groups and hip-knee-ankle Tuina combined with functional training group in a 1:1 ratio. Participants in control group will receive 8 sessions of functional training (30 min per session, twice a week for 4 weeks). Participants in intervention group will receive 8 sessions of Tuina combined with functional training (twice a week for 4 weeks). The primary outcomes include the Y-Balance Test (YBT) and Cumberland Ankle Instability Tool (CAIT). The Secondary outcomes include the Foot and Ankle Ability Measure (FAAM) and ankle range of motion (ROM). The outcome assessments will be conducted before the first intervention and after the last intervention.DiscussionThe aim of this study is to explore a safe and effective manipulation program and serve as reference for clinical treatment of CAI and expect to provide the necessary theoretical and practical support to our future research.Clinical Trial RegistrationChinese Clinical Trail Registry ChiCTR2300068274.

The present study was conducted to evaluate the efficacy of phytogenic extract on growth and health of tilapia. Three experimental diets were designed as the basal diet (Con) and phytogenic extract (Flourishing, F) supplemented diets at 0.5 and 1 g/kg inclusion (F-1 and F-2), which the phytogenic additive was extracted from Eucommia ulmoides, Astragalus membranaceus, Lonicera japonica and Codonopsis pilosula. The three diets were fed to juvenile tilapia (14.0 ± 0.1 g) with 30 fish per cage, and three replicate cages from the three groups were placed in one indoor concrete pool (a total of three pools were used). After 8 weeks of feeding, the weight gain was significantly increased, and feed conversion ratio was decreased in F-2 group (P < 0.05) when compared to the control. Both levels of phytogenic extract significantly promoted the retentions of protein and lipid and the apparent digestibility coefficient of dry matter and protein (P < 0.05). The activity of superoxide dismutase and the levels of white blood cells, haemoglobin and glutamic pyruvic transaminase were also significantly increased by the supplementation of phytogenic extract (P < 0.05). The villus height in anterior intestine was significantly enhanced in F-1 and F-2 groups (P < 0.05). After challenging with Aeromonas hydrophila, the cumulative mortality was significantly declined in F-1 and F-2 groups (P < 0.05). In summary, the dietary supplementation of phytogenic extract at 1 g/kg feed could provide positive efficiency on growth, nutrient utilization, immunity, gut morphology and disease resistance of tilapia under the present conditions.

Abstract To solve the problem of tendon adhesion after an operation, an anti‐adhesion membrane is designed, which can inhibit the exogenous healing of tendons and promote endogenous healing. Here, poly[3(S)‐methyl‐morpholine‐2,5‐dione‐co‐lactic acid] P(MMD‐co‐LA) containing alanine units is obtained by melt ring‐opening polymerization (ROP). It can effectively reduce the production of acidic degradation products that cause aseptic inflammation. Then a kind of oriented P(MMD‐co‐LA)/deferoxamine (DFO) anti‐adhesion membrane with good mechanical properties, cell adhesion properties, and induced macrophage polarization properties is constructed by electrospinning. In vitro and in vivo studies have shown that oriented fibrous membranes can down‐regulate the expression of inflammatory cytokines. In addition, the fibrous membrane can up‐regulate the expression of angiogenesis‐related genes, namely HIF1‐α, SDF‐1α, and VEGF, by releasing DFO in situ, thus promoting the revascularization of tendon defects and providing nutritional support for endogenous tendon healing. This method provides a new barrier strategy to reduce tendon adhesion through anti‐inflammation combined with vascularization to inhibit exogenous tendon healing while promoting tendon endogenous healing. The results provide essential insights into the corresponding regulation of the tendon healing microenvironment.

Abstract Background Cutaneous Melanoma (CM) is a malignant disease with increasing incidence and high mortality. Ferroptosis is a new kind of cell death and related to tumor blood and lymphatic metastasis. This study aims at using bioinformatics technology to construct a prognostic signature and identify ferroptosis-related biomarkers to improve the prognosis and treatment of cutaneous melanoma. Methods We used bioinformatics tools to analyze RNA sequencing expression data with clinical information from multiple databases, utilized varieties of statistical methods to construct a ferroptosis-related prognostic signature of cutaneous melanoma and screened out specific genes with independent prognostic ability. Results We obtained 22 ferroptosis-related (P

The provision of cultural and tourism public services in tourism destinations exerts a substantial influence on visitor experience and their overall quality of life. The current study applied structural equation modeling to empirically investigate the relationship between perceived cultural and tourism public services of visitors and their quality of life. Additionally, the mediating effects of perceived value, expectancy disconfirmation, and satisfaction in the above-mentioned influence relationship was also explored. In order to collect data, a field survey was conducted in a world heritage site located in Nanjing, Jiangsu Province, China. A total of 550 questionnaires were delivered, out of which 518 valid questionnaires were retained for subsequent analysis. The results demonstrate that perceived cultural and tourism public services of visitors have significant and positive influence on their perceived value, and visitors’ perceived value has a positive effect on their expectancy disconfirmation. Moreover, there is a strong and positive relationship between visitors’ expectancy disconfirmation and their satisfaction and quality of life. Additionally, the mediating effect of perceived value, expectancy disconfirmation, and satisfaction exist, and these three mediating variables serve as full mediators. The present study addresses the theoretical and practical implications, limitations, and potential areas for further research.

In microsurgery, it is always difficult to accurately identify the blood supply with ease, such as vascular anastomosis, digit replantation, skin avulsion reconstruction and flap transplantation. Near-infrared window I (NIR-I, 700—900 nm) imaging has many clinical applications, whereas near-infrared window II (NIR-II, 1,000–1700 nm) imaging has emerged as a highly promising novel optical imaging modality and used in a few clinical fields recently, especially its penetration distance and noninvasive characteristics coincide with the needs of microsurgery. Therefore, a portable NIR-II imaging instrument and the Food and Drug Administration (FDA) approved indocyanine green (ICG) were used to improve the operation efficiency in microsurgery of 39 patients in this study. The anastomotic vessels and the salvaged distal limbs were clearly visualized after intravenous injection of ICG. The technique enabled identification of perforator vessels and estimation of perforator areas prior to the flap obtention and made it easier to monitor the prognosis. Overall, this study highlights the use of the portable NIR- II imaging with ICG as an operative evaluation tool can enhance the safety and accuracy of microsurgery.

Diabetes mellitus is a metabolic disorder that increases fracture risk and interferes with bone formation and impairs fracture healing. Genomic studies on diabetes and fracture healing are lacking. We used a weighted co-expression network analysis (WGCNA) method to identify susceptibility modules and hub genes associated with T2DM and fracture healing. First, we downloaded the GSE95849, GSE93213, GSE93215, and GSE142786 data from the Gene Expression Omnibus (GEO) website, analyzed differential expression genes and constructed a WGCNA network. Second, we screened out 30 hub genes, which were found to be enriched in neutrophil activation, translational initiation, RAGE receptor binding, propanoate metabolism, and other pathways through Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) analyses. Third, we searched for genes related to bone metabolism and fracture healing in the published genome-wide single nucleotide polymorphism (SNP) data, built a protein-protein interaction (PPI) network with hub genes, and found that they were associated with metabolic process, blood vessel development, and extracellular matrix organization. ANXA3 was identified as the biomarker based on gene expression and correlation analysis. And the AUC value of it was 0.947. Fourth, we explored that ANXA3 was associated with neutrophils in fracture healing process by single-cell RNA sequencing analysis. Finally, we collected clinical patient samples and verified the expression of ANXA3 by qRT-PCR in patents with T2DM and fracture non-union. In conclusion, this is the first genomics study on the effect of T2DM on fracture healing. Our study identified some characteristic modules and hub genes in the etiology of T2DM-associated fracture non-union, which may help to further investigate the molecular mechanisms. Up-regulated ANXA3 potentially contributed to fracture non-union in T2DM by mediating neutrophils. It can be a prognostic biomarker and potential therapeutic target.

Nonunion and delayed union are common complications of diabetes mellitus that pose a serious health threat to people. There are many approaches that have been used to improve bone fracture healing. Recently, exosomes have been regarded as promising medical biomaterials for improving fracture healing. However, whether exosomes derived from adipose stem cells can promote bone fracture healing in diabetes mellitus remains unclear. In this study, adipose stem cells (ASCs) and exosomes derived from adipose stem cells (ASCs-exos) are isolated and identified. Additionally, we evaluate the in vitro and in vivo effects of ASCs-exos on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and bone repair and the regeneration in a rat model of nonunion via Western blotting, immunofluorescence assay, ALP staining, alizarin red staining, radiographic examination and histological analysis. Compared with controls, ASCs-exos promoted BMSC osteogenic differentiation. Additionally, the results of Western blotting, radiographic examination and histological analysis show that ASCs-exos improve the ability for fracture repair in the rat model of nonunion bone fracture healing. Moreover, our results further proved that ASCs-exos play a role in activating the Wnt3a/β-catenin signaling pathway, which facilitates the osteogenic differentiation of BMSCs. All these results show that ASCs-exos enhance the osteogenic potential of BMSCs by activating the Wnt/β-catenin signaling pathway, and also facilitate the ability for bone repair and regeneration in vivo, which provides a novel direction for fracture nonunion in diabetes mellitus treatment.

Recent studies have documented life satisfaction of people have changed during the COVID-19 pandemic. However, it is unknown about the influential factors and mechanisms of life satisfaction of postgraduate medical students during the COVID-19 pandemic. There is a strong link among life satisfaction and individual quality of life and achievement, so it is important to explore the influence mechanism of life satisfaction of postgraduate medical students and explore ways to improve life satisfaction for the development of postgraduate medical students. The current study was based on the Circumplex Model of Marital and Family System, The Theory of Family Functioning, The Meaning Maintenance Model, The Theory of Personal Meaning and Existential Theory to construct theoretical framework and examine whether meaning in life and depression would mediate the link between family function and postgraduate medical students’ life satisfaction. By convenient sampling method, a total of 900 postgraduate medical students (Mage = 27.01 years, SD = 3.33) completed questionnaires including Family APGAR Scale, Chinese Version of Meaning In Life Questionnaire, Patient Health Questionnaire, and Satisfaction With Life Scale. In this study, SPSS 25.0 was used for correlation analysis, regression analysis and common method bias test, and AMOS 23.0 was used for structural equation modeling analysis. The results showed that (a) family function could predict life satisfaction of postgraduate medical students significantly; (b) both meaning in life and depression mediated the association between family function and life satisfaction in a parallel manner; (c) meaning in life and depression sequentially mediated the link between family function and life satisfaction of postgraduate medical students. The study illuminates the role of meaning in life and depression in improving life satisfaction and implies that it is necessary to focus on the changes of life satisfaction of postgraduate medical students during the COVID-19 pandemic, and medical educator can improve the sense of meaning in life of postgraduate medical students through improving their family function, further decreasing the risk of depression, finally improving their life satisfaction.

Objective: To compare the biomechanical characteristics of two transforaminal thoracic interbody fusion cages based on the Chinese population thoracic anatomy. Method: Computed tomography scans of the thoracic spine of 150 patients from our institution were collected and analysed. Two cages were designed based on the anatomical parameters of these patients. Further, we used 3D finite element analysis models to compare the stability of two cages by using Mimics 17.0 and ANSYS 15.0 software. Result: Two kinds of thoracic cages (box and kidney-shaped) were designed. Under the displacement working condition, the two new fusion cages could achieve immediate postoperative stability, but the kidney-shaped cage was better than the box-shaped cage. Under the stress working condition, no highly focused stress area was found in either cages, but the kidney-shaped cage experienced less stress than the box-shaped cage. Conclusion: The kidney-shaped cage is more stable and experiences lesser stress than the box-shaped cage after thoracic intervertebral fusion, and it is more suitable for Chinese transforaminal thoracic interbody fusion. The translational potential of this article: This article is about thoracic fusion cage design and finite element analysis (FEA) analysis based on the thoracic anatomy parameters. For there is currently no suitable thoracic fusion cage for transforaminal thoracic interbody fusion, the results in this article may have the potential of transferring the two designed cages into clinical use. Keywords: Anatomy parameters, Finite element analysis, Thoracic interbody cage

Background. Postoperative ileus (POI) is an important complication after elective colorectal surgery, which prolongs hospital stay and increases hospital costs. Coffee has been reported to be beneficial for the recovery of gastrointestinal function. We aimed to investigate the effectiveness of coffee consumption in the treatment of POI, following elective colorectal surgery. Methods. A comprehensive literature search for medical subject heading (MeSH) terms, including coffee, caffeine, colon, rectum, and colorectal surgery was conducted in PubMed, Embase, and Cochrane Library until November 2021. A meta-analysis of postoperative outcomes was conducted to assess the effectiveness of coffee consumption on POI after colorectal surgery. Results. 726 articles were identified and six RCTs that captured 416 patients were included. The time to first defecation was reduced with postoperative coffee consumption compared to the control group (mean difference=−15.03 h; 95% confidence interval: -17.79, -12.26; P

Our previous studies have shown that the environmental contaminant bisphenol A (BPA) exhibits strong intestinal toxicity and can readily cause intestinal barrier dysfunction. However, the causal relationship between adverse biological processes of BPA-induced intestinal tissue and the role of key signaling molecules in it requires further investigation. In this study, we established a mouse and intestinal epithelial cell model of BPA treatment to determine the underlying molecular mechanisms of BPA-induced intestinal injury. The results showed that the BPA treatment increased the intestinal permeability and disrupted the barrier function by increasing the chemical marker content and tight junction expression in intestinal tissues and blood circulation. BPA also altered the oxidative and antioxidant status of intestinal epithelial cells by increasing ROS and RNS contents and decreasing the activity levels of SOD, GPx, CAT, and T-AOC. BPA further induced inflammatory responses by upregulating the gene abundance of key factors of the innate immune system (TLR2, TLR4, MyD88, and NF-κB), the transcriptional activity of NF-kB, and the secretion of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α). Moreover, apoptosis was activated by BPA, whereas cell proliferation was inhibited by BPA. Mechanistically, co-treatment of intestinal epithelial cells with BPA using the oxidative stress scavenger NAC, the NF-κB-specific inhibitor JSH-23, and the apoptosis inhibitor Z-VAD-FMK, respectively, showed that BPA activates the innate immune response by inducing oxidative stress. Consequently, apoptosis is promoted, and cell proliferation is inhibited, ultimately disrupting the intestinal barrier function. Our findings provide insight into the pathogenesis of BPA-induced gut injury.

Dye-sensitized solar cells (DSSC) attracted widespread attention for its low cost, being easy to manufacture, large-scale production and environmentally friendly features. Sensitizer is a core component of the DSSC which plays a role in collecting sunlight and injecting excited state electron into the conduction band of the semiconductor, which is crucial to the photo-electric conversion efficiency. Organic dyes have a number of advantages such as easy synthesizing and tuning of photo-physical and electrochemical properties through molecular design. Triphenylamine is a strong electron donating group, and its non-planar spatial structure makes the degree of the dye molecules aggregation to be decreased. These properties are conducive to improve the absorption properties of the dye and the electron transport efficiency. In recent years, triphenylamine or substituted triphenylamine as electron donor of organic sensitizers becomes the research focus for improving the photoelectric conversion efficiency of solar cells. In this paper, the progress of triphenylamine photosensitive dyes is described.

In this paper, we prove that any nonconstant, $C^2$ solution of the infinity Laplacian equation $u_{x_i}u_{x_j}u_{x_ix_j}=0$ can not have interior critical points. This result was first proved by Aronsson [2] in two dimensions. When the solution is $C^4$, Evans [6] established a Harnack inequality for $|Du|$, which implies that non-constant $C^4$ solutions have no interior critical points for any dimension. Our method is strongly motivated by the work in [6].

In the title compound, C17H19N3O6, the dihedral angle between the two aromatic rings is 45.9 (1)°. The crystal structure is stabilized through intermolecular N—H...O hydrogen bonds and intramolecular O—H...O hydrogen bonds are also present.

We study the effective fronts of first order front propagations in two dimensions (n = 2) in the periodic setting. Using PDE-based approaches, we show that for every a G (0,1), the class of centrally symmetric polygons with rational vertices (i.e., vectors in Uagr AZ2) and nonempty interior is admissible as effective fronts for front speeds in C1,a(T2, (0, oo)). This result can also be formulated in the language of stable norms corresponding to periodic metrics in T2. Similar results were known long ago when n > 3 for front speeds in Cco(Tn, (0, oo)). The two-dimensional case is much more subtle due to topological restrictions. In fact, for given C1,1(T2, (0, oo)) front speeds, the effective front is C1 and hence cannot be a polygon. Our regularity requirements on front speeds are hence optimal. To the best of our knowledge, this is the first time that polygonal effective fronts have been constructed in two dimensions. [ABSTRACT FROM AUTHOR]