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Background: In the recent decade, there has been substantial progress in the technologies and philosophies associated with diagnosing and treating anterior cruciate ligament (ACL) injuries in China. The therapeutic efficacy of ACL reconstruction in re-establishing the stability of the knee joint has garnered widespread acknowledgment. However, the path toward standardizing diagnostic and treatment protocols remains to be further developed and refined. Objective: In this context, the Chinese Association of Orthopaedic Surgeons (CAOS) and the Chinese Society of Sports Medicine (CSSM) collaboratively developed an expert consensus on diagnosing and treating ACL injury, aiming to enhance medical quality through refining professional standards. Methods: The consensus drafting team invited experts across the Greater China region, including the mainland, Hong Kong, Macau, and Taiwan, to formulate and review the consensus using a modified Delphi method as a standardization approach. As members of the CSSM Lower Limb Study Group and the CAOS Arthroscopy and Sports Medicine Study Group, invited experts concentrated on two pivotal issues: “Graft Selection” and “Clinical Outcome Evaluation” during the second part of the consensus development. Results: This focused discussion ultimately led to a strong consensus on nine specific consensus terms. Conclusion: The consensus clearly states that ACL reconstruction has no definitive “gold standard” graft choice. Autografts have advantages in healing capability but are limited in availability and have potential donor site morbidities; allografts reduce surgical trauma but incur additional costs, and there are concerns about slow healing, quality control issues, and a higher failure rate in young athletes; synthetic ligaments allow for early rehabilitation and fast return to sport, but the surgery is technically demanding and incurs additional costs. When choosing a graft, one should comprehensively consider the graft's characteristics, the doctor's technical ability, and the patient's needs. When evaluating clinical outcomes, it is essential to ensure an adequate sample size and follow-up rate, and the research should include patient subjective scoring, joint function and stability, complications, surgical failure, and the return to sport results. Medium and long-term follow-ups should not overlook the assessment of knee osteoarthritis.

Abstract In-vehicle information system (IVIS) use is prevalent among young adults. However, their interaction with IVIS needs to be better understood. Therefore, an on-road study aims to explore the effects of input modalities and secondary task types on young drivers' secondary task performance, driving performance, and visual glance behavior. A 2 × 4 within-subject design was undertaken. The independent variables are input modalities (auditory-speech and visual-manual) and secondary task types (calls, music, navigation, and radio). The dependent variables include secondary task performance (task completion time, number of errors, and SUS), driving performance (average speed, number of lane departure warnings, and NASA-TLX), and visual glance behavior (average glance duration, number of glances, total glance duration, and number of glances over 1.6 s). The statistical analysis result showed that the main effect of input modalities is significant, with more distraction during visual-manual than auditory-speech. The main impact of secondary task types was also substantial across most metrics, aside from average speed and average glance duration. Navigation and music were the most distracting, followed by calls, and radio came in last. The distracting effect of input modalities is relatively stable and generally not moderated by the secondary task types, except radio tasks. The findings practically benefit the driver-friendly human–machine interface design, preventing IVIS-related distraction.

Abstract Background This study explored the relationship between inflammatory markers and glucocorticoid dosage upon admission. Methods We conducted a retrospective analysis of 206 patients with refractory Mycoplasma pneumoniae pneumonia (RMPP) admitted to a Children’s Hospital from November 2017 to January 2022. Patients were categorized into three groups based on their methylprednisolone dosage: low-dose (≤ 2 mg/kg/d), medium-dose (2–10 mg/kg/d), and high-dose (≥ 10 mg/kg/d). We compared demographic data, clinical manifestations, laboratory findings, and radiological outcomes. Spearman’s rank correlation coefficient was used to assess relationships between variables. Results The median age was highest in the low-dose group at 7 years, compared to 5.5 years in the medium-dose group and 6 years in the high-dose group (P

Abstract Background Mycoplasma pneumoniae pneumonia is a common respiratory infection among children. However, the occurrence of thromboembolism with plastic bronchitis in association with Mycoplasma pneumoniae pneumonia is extremely rare. This case series presents five cases of children with Mycoplasma pneumoniae pneumonia who developed thromboembolism and plastic bronchitis. The clinical presentation, diagnostic approach, and management strategies are discussed. Methods A retrospective analysis was conducted on medical records from a pediatric hospital. Patient demographics, clinical features, laboratory findings, imaging results, treatment modalities, and outcomes were collected. Results The patients in our case series presented with varying degrees of respiratory distress, cough, and fever. Imaging studies revealed evidence of thromboembolism based on pulmonary artery occlusion. Bronchial casts were observed by bronchoscopy. Laboratory tests demonstrated elevated D-dimer levels and fibrinogen degradation products. All patients received a combination of low molecular weight heparin anticoagulation and supportive care. Conclusion Thromboembolism with plastic bronchitis associated with Mycoplasma pneumoniae pneumonia is a rare but potentially serious complication in children. Prompt recognition and management are crucial for improving patient outcomes. This case series highlights the diverse clinical presentations, diagnostic challenges, and treatment strategies for this unique clinical entity. Further research is needed to better understand the pathogenesis and optimal management of this condition.

Abstract Hematopoiesis ensures tissue oxygenation, and remodeling as well as immune protection in vertebrates. During embryogenesis, hemangioblasts are the source of all blood cells. Gata1a and pu.1 are co-expressed in hemangioblasts before hemangioblasts are differentiated into blood cells. However, the genes that determine the differentiation of hemangioblasts into myeloid or erythroid cell lineages have not been fully uncovered. Here we showed that miRNA-7145, a miRNA with previously unknown function, was enriched in erythrocytes at the definitive wave, but not expressed in myeloid cells. Overexpression and loss-of-function analysis of miRNA-7145 revealed that miRNA-7145 functions as a strong inhibitor for myeloid progenitor cell differentiation while driving erythropoiesis during the primitive wave. Furthermore, we confirmed that cuedc2 is one of miRNA-7145 targeted-genes. Overexpression or knock-down of cuedc2 partially rescues the phenotype caused by miRNA-7145 overexpression or loss-of-function. As well, overexpression and loss-of-function analysis of cuedc2 showed that cuedc2 is required for myelopoiesis at the expense of erythropoiesis. Finally, we found that overexpression of zebrafish cuedc2 in 293 T cell inhibits the JAK1/STAT3 signaling pathway. Collectively, our results uncover a previously unknown miRNA-7145-cuedc2 axis, which regulate hematopoiesis through inhibiting the JAK1/STAT3 signaling pathway.

Abstract Background This study investigated clinical and laboratory characteristics of human bocavirus type 1 (HBoV1)‐plastic bronchiolitis (PB), Mycoplasma pneumoniae (MP)‐associated plastic bronchitis (PB) and MP‐NPB in children, highlighting inflammation, coagulation, and bronchoscopic needs. Methods Data on preschool children with PB during HBoV1 or MP infection were collected, comparing MP‐PB to severe Mycoplasma pneumoniae pneumonia. Result Compared with the MP‐PB group, the HBoV1‐PB group, with younger children, had significantly milder clinical symptoms but higher WBC counts (p = .028). The MP‐PB group exhibited notably elevated Fibrinogen (p = .045) and d‐dimer levels (p

Abstract The inefficiency of electrocatalysts for water splitting in neutral media stems from a comprehensive impact of poor intrinsic activity, a limited number of active sites, and inadequate mass transport. Herein, hierarchical ultrathin NiCo2Se4 nanosheets are synthesized by the selenization of NiCo2O4 porous nanoneedles. Theoretical and experimental investigations reveal that the intrinsic hydrogen evolution reaction (HER) activity primarily originate from the NiCo2Se4, whereas the high oxygen evolution reaction (OER) performance is related to the NiCoOOH due to the structural reconstruction. The abundant Se and O vacancies introduced by atomically thin nanostructure modulate the electronic structure of NiCo2Se4 and NiCoOOH, thereby improving the intrinsic HER and OER activities, respectively. COMSOL simulation demonstrate the edges of extended nanosheets from the main body significantly promote the charge aggregation, boosting the reduction and oxidation current during HER/OER process. This charge aggregation effect notably exceeds the tip effect for the nanoneedle, highlighting the unique advantage of the hierarchical nanosheet structure. Benefiting from abundant vacancies and unique nanostructure, the hierarchical ultrathin nanosheet simultaneously improve the thermodynamics and kinetics of the electrocatalyst. The optimized samples display an overpotential of 92 mV for HER and 214 mV for OER at 100 mA cm−2, significantly surpassing the performance of currently reported HER/OER catalysts in neutral media.

Abstract Objective The aim of this study was to analyze the clinical characteristics and treatment of children with Mycoplasma pneumoniae pneumonia (MPP) who also present with pulmonary embolism (PE). Methods This retrospective analysis examined the demographic data, clinical manifestations, laboratory tests, imaging characteristics, therapy, and prognosis of nine cases of children with Mycoplasma pneumoniae pneumonia (MPP) complicated by pulmonary embolism (PE). The study focused on patients admitted to the respiratory department of Tianjin Children’s Hospital between January 2018 and December 2021. Results The age range of the patients was 3 to 8 years old, with a median age of 7.5 years. The median number of days from pulmonary infection to the diagnosis of embolism was 14 days. All patients had refractory Mycoplasma pneumoniae pneumonia (RMPP). Among them, three patients reported chest pain, one of whom had hemoptysis, while five patients had dyspnea, and six patients experienced radiating pain at unusual sites. Five out of the nine children tested positive for lupus anticoagulant (LA), five for anticardiolipin antibody (ACA), three for anti-2-glycoprotein antibody IgM, four for reduced protein S or protein C activity, and three for elevated coagulation factor VIII. Moreover, six out of the nine children tested positive for antinuclear antibodies. All the children underwent CT pulmonary angiograms, which revealed filling defects. After sequential low-molecular heparin anticoagulation with rivaroxaban, nine children in this study showed a good prognosis, with two of them receiving thrombolytic therapy for combined cardiac embolism. Follow-up at 0.5-9 months showed the gradual resolution of the emboli in all 9 children, with no thrombotic recurrences and normalized autoantibodies and thrombophilia markers. Conclusions The majority of cases involving Mycoplasma pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) were diagnosed with refractory MPP (RMPP). However, PE did not always occur in the advanced stages of the disease. Most patients presented with transient autoantibody positivity, abnormal coagulation, and fibrinolytic balance. With timely treatment, the prognosis of MPP combined with PE is generally good. Additionally, rivaroxaban treatment has been shown to be safe and effective.

Walking is an indispensable mode of transportation for human survival. Gait is a characteristic of walking. In the clinic, patients with different diseases exhibit different gait characteristics. Gait analysis describes the specific situation of human gait abnormalities by observing and studying the kinematics and dynamics of limbs and joints during human walking and depicting the corresponding geometric curves and values. In foot and ankle diseases, gait analysis can evaluate the degree and nature of gait abnormalities in patients and provide an important basis for the diagnosis of patients’ diseases, the correction of abnormal gait and related treatment methods. This article reviews the relevant literature, expounds on the clinical consensus on gait, and summarizes the gait characteristics of patients with common ankle and foot diseases. Starting from the gait characteristics of individuals with different diseases, we hope to provide support and reference for the diagnosis, treatment and rehabilitation of clinically related diseases.

Abstract Background Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and is related to the severity of the disease. This study aimed to develop and validate a nomogram for predicting severe bronchiolitis in infants and young children with RSV infection. Methods A total of 325 children with RSV-associated bronchiolitis were enrolled, including 125 severe cases and 200 mild cases. A prediction model was built on 227 cases and validated on 98 cases, which were divided by random sampling in R software. Relevant clinical, laboratory and imaging data were collected. Multivariate logistic regression models were used to determine optimal predictors and to construct nomograms. The performance of the nomogram was evaluated by the area under the characteristic curve (AUC), calibration ability and decision curve analysis (DCA). Results There were 137 (60.4%) mild and 90 (39.6%) severe RSV-associated bronchiolitis cases in the training group (n = 227) and 63 (64.3%) mild and 35 (35.7%) severe cases in the validation group (n = 98). Multivariate logistic regression analysis identified 5 variables as significant predictive factors to construct the nomogram for predicting severe RSV-associated bronchiolitis, including preterm birth (OR = 3.80; 95% CI, 1.39–10.39; P = 0.009), weight at admission (OR = 0.76; 95% CI, 0.63–0.91; P = 0.003), breathing rate (OR = 1.11; 95% CI, 1.05–1.18; P = 0.001), lymphocyte percentage (OR = 0.97; 95% CI, 0.95–0.99; P = 0.001) and outpatient use of glucocorticoids (OR = 2.27; 95% CI, 1.05–4.9; P = 0.038). The AUC value of the nomogram was 0.784 (95% CI, 0.722–0.846) in the training set and 0.832 (95% CI, 0.741–0.923) in the validation set, which showed a good fit. The calibration plot and Hosmer‒Lemeshow test indicated that the predicted probability had good consistency with the actual probability both in the training group (P = 0.817) and validation group (P = 0.290). The DCA curve shows that the nomogram has good clinical value. Conclusion A nomogram for predicting severe RSV-associated bronchiolitis in the early clinical stage was established and validated, which can help physicians identify severe RSV-associated bronchiolitis and then choose reasonable treatment.

In this paper, two experimental procedures are reported, namely electro-deposition in the ultrathin liquid layer and chemical micro-etching. Firstly, a large area quasi-two-dimensional periodic membrane with adjustable density is deposited on a Si substrate driven by half-sinusoidal voltage, which is composed of raised ridges and a membrane between the ridges. The smaller the voltage frequency is, the larger the ridge distance is. The height of a raised ridge changes synchronously with the amplitude. The grain density distribution of membrane and raised ridge is uneven; the two structures change alternately, which is closely related to the change of growth voltage and copper ion concentration during deposition. The structural characteristics of membrane provide favorable conditions for micro-etching; stable etching speed and microscope real-time monitoring are the keys to achieve accurate etching. In the chemical micro-etching process, the membrane between ridges is removed, retaining the raised ridges, thus a large scale ordered micro-nano wires array with lateral growth was obtained. This method is simple and controllable, can be applied to a variety of substrates, and is the best choice for designing and preparing new functional materials. This experiment provides a basis for the extension of this method.

The proposed “Guanlan” ocean science satellite, led by China’s Laoshan Laboratory, includes an interferometric radar altimeter (IRA) as a key payload. As an integral part of its development, an airborne IRA experiment was conducted on 6 November 2021, with a flight path of approximately 90 km in the South China Sea. This study investigates the IRA’s ability to observe ocean sea surface height (SSH) across scales ranging from meters to mesoscale. The sea surface height anomaly (SSHA) of the IRA is aligned with the SSHA of the AVISO at scales greater than 30 km, but also demonstrates the ability to capture small-scale SSHA changes in two dimensions. We analyzed wavenumber spectra of SSHA obtained from the airborne IRA, ICESat-2, and SARAL/AltiKa satellite for this region. The results show a good agreement in power spectral density (PSD) levels between ICESat-2, SARAL/AltiKa and IRA at scales larger than 30 km. Within the submesoscale range of 1–10 km, the IRA SSHA spectrum exhibits a distinctly negative slope and the lowest energy level. The minimum PSD level of the IRA fell in the range of 10−4–10−3 m2/cycle/km, at scales around 1 km, which is more than an order of magnitude lower than that of ICESat-2, forming a spectral gap that is in agreement with the theoretical expectation. Furthermore, IRA-derived wave direction and significant wave height matched well with the MFWAM wave data. The results of this study underscore the considerable potential of airborne IRA in capturing SSHA across a range of scales, from oceanic waves to submesoscale.

Spinal cord injury (SCI) is an incurable central nervous system impairment that lack of efficient treatment. Exosomes derived from mesenchymal stem cells (MSCs) are widely applied in disease treatment. This work aimed to determine the promising therapeutic effects of MSC-derived exosomal miRNA146b on SCI. A rat spinal cord injury (SCI) model and lipopolysaccharide (LPS)-induced PC12 cell model were established. Exosomes were extracted from human umbilical cord mesenchymal stem cells (hUCMSCs). The identification of exosomes was performed by using transmission electronic microscope (TEM) and nanoparticle tracking analysis (NTA). Hematoxylin and eosin (HE) staining and TUNEL assay were performed to assess tissue damage and apoptosis, respectively. ELISA was performed to detect levels of inflammatory cytokines. Cell viability was checked by cell counting kit 8 (CCK-8). Gene expression and protein levels were detected by qPCR and western blotting assay. The interaction between miR-146 b and Toll-like receptor 4 (TLR4) was assessed by luciferase reporter gene assay. The hUCMSC-derived exosomes could notably alleviate the spinal cord injury and cell apoptosis. The exosomal miR-146 b treatment suppressed the release of IL-1 β, IL-6, and TNFα. The miR-146 b suppressed the expression of TLR4, directly interact with the 3′-untranslated region (3′UTR) of TLR4, and inactivated the nuclear factor κB (NF-κB) signaling. The hUCMSCs-derived exosomal miR-146 b protects neurons from spinal cord injury through targeting the TLR4 and inactivating the NF-κB signaling. Our findings supported the application of hUCMSCs-derived exosomal miR-146 b for the protection of SCI.

Abstract Background Rapid and accurate identification of pathogens is very important for the treatment of Severe community-acquired pneumonia (SCAP) in children. Metagenomic Next-generation sequencing (mNGS) has been applied in the detection of pathogenic bacteria in recent years, while the overall evaluation the application of SCAP in children is lacking. Methods In our study, 84 cases of SCAP were enrolled. Bronchoalveolar lavage fluid (BALF) samples were analysed using mNGS; and sputum, blood, and BALF samples were analysed using conventional technology (CT). Results Among the 84 children, 41 were boys, and 43 were girls, with an average age ranging from 2 months to 14 years. The pathogen detection rate of mNGS was higher than that of CT (83.3% [70/84] vs. 63.1% [53/84], P = 0.003). The mNGS was much greater than that of the CT in detecting Streptococcus pneumoniae (89.2% [25/29] vs. 44.8% [13/29], P = 0.001) and Haemophilus influenzae (91.7% [11/12] vs. 33.3% [4/12], P 0.005). Treatment for 26 (31.0%) children was changed based on mNGS results, and their symptoms were reduced; nine patients had their antibiotic modified, five had antibiotics added, nine had their antifungal medication, and seven had their antiviral medication. Conclusion mNGS has unique advantages in the detection of SCAP pathogens in children, especially S. pneumoniae, H. influenzae, and fungi. However, the detection rate of MP using mNGS was lower than that of the CT. Additionally, mNGS can detect pathogens that are not generally covered by CT, which is extremely important for the modification of the treatment strategy.

Abstract In recent years, shutdown accidents caused by thyristor voltage monitoring (TVM) board failure have occurred several times in converter stations. With the increase of operation time, the working reliability problem of TVM board becomes a challenge to the safe operation. This paper studies the effects of pollution severity and relative humidity (RH) on the function of TVM board. The results show that the increase of RH can lead to the advance or even disappearance of check‐back signals. Furthermore, the increase of pollution severity can decrease the failure RH threshold. Through simulation and equivalent experiment, it is verified that the resistance decrease of the voltage balancing resistor under the combined effect of contamination and RH is the main reason for the advance of check‐back signals. According to the experiments, it is found that the upper surface contamination has a greater effect on the function of TVM board than the lower surface contamination, resulting in more decrease of the failure RH threshold. In addition, leakage current at different RH is also measured. Results show that the pulse peak of leakage current is closely related to check‐back signals. When the pulse peak is too small or disappears, check‐back signals also disappear, indicating that the TVM board fails.

Neuropathic pain is a chronic pain state that usually caused by injuries in peripheral or central nerve. Inhibition of spinal microglial response is a promising treatment of neuropathic pain caused by peripheral nerve injury. In recent years, mesenchymal stem cells (MSCs) that characterized with multipotent ability have been widely studied for disease treatment. TGF-β1 is a well-known regulatory cytokine that participate in the response to cell stress and is closely correlated with the function of nerve system as well as MSC differentiation. This work aimed to determine the effects of exosomes that extracted from TGF-β1-induced umbilical mesenchymal stem cells (hUCSMCs) on the neuropathic pain. In this work, we established a rat model of chronic constriction injury (CCI) of the sciatic nerve and LPS-induced microglia cell model. The hUCSMCs cell surface biomarker was identified by flow cytometry. Exosomes that extracted from TGF-β1-treated hUCSMCs were characterized by transmission electron microscopy (TEM) and nanoparticle tracking analysis (NTA) and used for treatment. We observed that TGF-β1 upregulates the level of lncRNA UCA1 (UCA1) in hUCMSC-derived exosomes. Treatment with exosomal lncRNA UCA1 (UCA1) alleviated the neuropathic pain, microgliosis, and production of inflammatory mediator both in vivo and in vitro. UCA1 directly interact with the miR-96-5p, and the miR-96-5p acts as sponge of FOXO3a. Knockdown of UCA1 upregulated the level of miR-96-5p and downregulated the FOXO3a expression, which could be recovered by inhibition of miR-96-5p. In summary, the TGF-β1-stimulated exosomal UCA1 from hUCMSCs alleviates the neuropathic pain and microgliosis. These findings may provide novel evidence for treatment of neuropathic pain caused by chronic constriction injury.

Spinal cord ischemia reperfusion (SCIR) injury leads to spinal cord function injury, neural dysfunction and sometimes paralysis or even paraplegia, which severely impair the physical and mental health of individuals. Mesenchymal stem cells (MSCs) are a group of stem cells that have been widely studied for treatment of various diseases. This work aimed to study the therapeutic potential of hypoxia-induced exosomal circular RNA OXNAD1 from human umbilical cord mesenchymal stem cells (HucMSCs) against SCIR. We established an in vivo rat spinal cord injury (SCI) model and conducted treatment with exosomes that isolated from hypoxia-HucMSCs. Hypoxia-HucMSCs-derived exosomal circOXNAD1 alleviated the spinal cord tissue injury in SCI, improved limb motor function, decreased production of inflammatory factors including the IL-1 β, IL-6, and TNF-α. The in vitro hypoxia and reoxygenation (H/R) model demonstrated that Hypoxia-HucMSCs-derived exosomal circOXNAD1 improved neuron proliferation and alleviated apoptosis. Mechanistically, circOXNAD1 directly interact with miR-29a-3p and miR-29a-3p targets the 3′UTR of FOXO3a in neurons. Inhibition of miR-29a-3p and overexpression of FOXO3a reversed the effects of circOXNAD1 depletion in PC12 cell phenotypes. In conclusion, Hypoxia elevated the level circOXNAD1 in exosomes that derived from HuMSCs. The exosomal circOXNAD1 alleviated SCI through sponging miR-29a-3p and consequently elevated the FOXO3a expression. Our findings provided novel evidence for MSC-derived exosomal circOXNAD1in the treatment of SCI.

The Pacific decadal oscillation (PDO) is often described as a long-lived El Niño-like pattern of Pacific climate variability, and it has widespread climate and ecosystem impacts. PDO forecasts can provide useful information for policymakers on how to handle PDO impacts. Nevertheless, due to the long duration of the PDO cycles and their complex formation mechanisms, it remains a challenge to predict long lead time PDO. In this paper, we propose a transfer-learning-enhanced convolutional neural network (CNN) to tackle complex ocean dynamic forecasting and predict PDO events with up to a one-year lead time. Our method first trains the CNN on historical simulations from Coupled Model Intercomparison Project 6 (CMIP6), covering the period from 1850 to 1972. This prior knowledge is then refined by further training the model with observational data from 1854 to 1972, ensuring robust performance on unseen data. Additionally, k-fold cross-validation is also employed to evaluate the model’s performance across diverse subsets of data, enhancing its reliability. Throughout the testing phase from 1983 to 2022, the CNN model consistently outperforms existing dynamical forecast systems, exhibiting superior correlation skills in predicting annual mean PDO indices and PDO phases, including displaying resilience to seasonal variations. The transferred CNN is thus a powerful method to predict PDO events and is potentially valuable for a wide range of applications. This work directly supports the objectives of the World Climate Research Programme Grand Challenge on Climate Prediction.

Determining the dynamic processes of the subsurface ocean is a critical yet formidable undertaking given the sparse measurement resources available presently. In this study, using the light gradient boosting machine algorithm (LightGBM), we report for the first time a machine learning strategy for retrieving subsurface velocities at 1000 dbar depth in the Southern Ocean from information derived from satellite observations. Argo velocity measurements are used in the training and validation of the LightGBM model. The results show that reconstructed subsurface velocity agrees better with Argo velocity than reanalysis datasets. In particular, the subsurface velocity estimates have a correlation coefficient of 0.78 and an RMSE of 4.09 cm/s, which is much better than the ECCO estimates, GODAS estimates, GLORYS12V1 estimates, and Ora-S5 estimates. The LightGBM model has a higher skill in the reconstruction of subsurface velocity than the random forest and the linear regressor models. The estimated subsurface velocity exhibits a statistically significant increase at 1000 dbar since the 1990s, providing new evidence for the deep acceleration of mean circulation in the Southern Ocean. This study demonstrates the great potential and advantages of statistical methods for subsurface velocity modeling and oceanic dynamical information retrieval.

Abstract Background Mycoplasma pneumoniae pneumonia (MPP) is a prevalent disease in community-acquired pneumonia among children. However, in addition to respiratory manifestations, it may also develop extra-pulmonary complications. Embolism is one of the uncommon extra-respiratory manifestations prone to severe sequelae and even death. This study aims to analyze the clinical features of MPP with embolism in children, and explore the associated risk factors of embolism in MPP patients. Methods A retrospective case–control analysis was performed on 48 children with MPP admitted to our hospital wards between January 2010 and December 2021. Embolism group comprised children with embolism by CTA or MRA results, whereas the non-embolism group comprised children with clinical suspicion of embolism but negative diagnostic imaging support. The clinical features, laboratory findings and imaging were analyzed to explore the risk factors for embolism in children with MPP. Results A total of 48 children with MPP were enrolled in the study (16 cases and 32 controls). In the embolism group, 10 patients (62.5%) had pulmonary embolism, 3 patients (18.75%) presented ventricle embolism, 2 patients (12.5%) presented cerebral and carotid artery embolism, one patient (6.25%) had a cerebral embolism, limb, and spleen, respectively. The univariate analysis revealed the maximum body temperature (Tmax), CRP, D-dimer (closest to CTA/MRA), the percentage of neutrophils (N%), pulmonary consolidation (⩾ 2/3 lobe), pleural effusion and atelectasis have significant differences between the embolism group and non-embolism group (P 3.55 mg/L [OR = 1.255 (95% CI: 1.025—1.537), P

Abstract Background Early identification of plastic bronchitis (PB) is of great importance and may aid in delivering appropriate treatment. This study aimed to develop and validate a nomogram for predicting PB in patients with refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods A total of 547 consecutive children with RMPP who underwent fiberoptic bronchoscopy (FOB) intervention from January 2016 to June 2021 were enrolled in this study. Subsequently, 374 RMPP children (PB: 137, without PB: 237) from January 2016 to December 2019 were assigned to the development dataset to construct the nomogram to predict PB and 173 RMPP children from January 2020 to June 2021 were assigned to the validation dataset. The clinical, laboratory and radiological findings were screened using Least Absolute Shrinkage and Selection Operator (LASSO) regression and logistic regression was applied to construct a nomogram. The performance of the nomogram was evaluated by discrimination, calibration and clinical utility. Comparsion of ROC analysis and decision curve analysis (DCA) between nomogram and other models was performed to evaluate the discrimination ability and clinical utility. Results The development dataset included 374 patients with a mean age of 6.6 years and 185(49.5%) were men. The validation dataset included 173 patients and the mean age of the dataset was 6.7 years and 86 (49.7%) were men. From 26 potential predictors, LASSO regression identified 6 variables as significant predictive factors to construct the nomogram for predicting PB, including peak body temperature, neutrophil ratio (N%), platelet counts (PLT), interleukin-6 (IL-6), actic dehydrogenase (LDH) and pulmonary atelectasis. The nomogram showed good discrimination, calibration and clinical value. The mean AUC of the nomogram was 0.813 (95% CI 0.769–0.856) in the development dataset and 0.895 (95% CI 0.847–0.943) in the validation dataset. Through calibration plot and Hosmer–Lemeshow test, the predicted probability had a good consistency with actual probability both in the development dataset (P = 0.217) and validation dataset (P = 0.183), and DCA showed good clinical utility. ROC analysis indicated that the nomogram showed better discrimination ability compared with model of peak body temperature + pulmonary atelactsis and another model of N% + PLT + IL-6 + LDH, both in development dataset (AUC 0.813 vs 0.757 vs 0.754) and validation dataset (AUC 0.895 vs 0.789 vs 0.842). Conclusions In this study, a nomogram for predicting PB among RMPP patients was developed and validated. It performs well on discrimination ability, calibration ability and clinical value and may have the potential for the early identification of PB that will help physicians take timely intervention and appropriate management.

BackgroundThe purpose of the present study was to assess the prognostic morphological changes of the reconstructed hamstring auto-grafts by using reconstructed three-dimensional MRI (3D-MRI) in adolescent patients with ACLR.Methods22 adolescent patients (less than 17 years old) were retrospective included between January 1, 2018, and October 31, 2020, in our department. The patients were divided into 2 subgroups: subgroup A (

BackgroundTo reduce the costs and financial burden in the ACLR treatment, we compare the early clinical outcomes and Magnetic Resonance Imaging (MRI) results of Delta Medical's PEEK (polyether ether ketone) interference screw and EndoButton with those of Smith & Nephew's PEEK interference screw and EndoButton in patients with arthroscopic anterior cruciate ligament reconstruction.MethodsA total of 104 patients in five different medical centers were randomly allocated into two groups: 1: Delta Medical's PEEK interference screw and EndoButton (53 patients); 2: Smith & Nephew's PEEK interference screw and EndoButton (51 patients). The modified Lysholm knee score, the laxity examination, and clinical and functional range of motion were evaluated at 3 and 6 months postoperatively. The clinical effective rate was calculated and classified as excellent and good at 6 months postoperatively. MRI examinations were performed at 3 and 6 months postoperatively to determine the healing process. Computerized tomography (CT) was performed at 2 weeks and 3 months postoperatively to evaluate the complications.ResultsSignificant improvements in knee function and functional scores were observed in both groups after surgery regardless of the fixation materials applied (P < 0.05). No differences were observed in the functional scores and range of motion. The assessments of Lysholm knee scores at 3 and 6 months produced no statistical differences (both P > 0.05). The clinical effective rate revealed no difference between the groups at 6 months postoperatively (non-inferiority analysis P = 0.0220). The differences of laxity examination between the groups were not statistically significant (Fisher's test, P = 0.6139, 0.2004, respectively). No significant differences in the functional range of motion were found at each follow-up time-point (P > 0.05). No major intra- or postoperative complications, such as infection, and vessel or nerve injury were observed.ConclusionsKnee function and functional scores were improved after ACLR in both groups, regardless of the PEEK interference screw and EndoButton applied. The difference in functional scores and range of motion were not significant in groups 1 and 2. Delta Medical's PEEK interference screw and EndoButton had a non-inferiority effect compared to Smith & Nephew's PEEK interference screw and EndoButton. Delta Medical's PEEK interference screw and EndoButton were suitable for arthroscopic ACLR.

ObjectiveThis study aimed to investigate the efficacy and safety of CO2 cryotherapy for lymph node fistula tracheobronchial tuberculosis (TBTB) in infants.Patients and methodsA retrospective analysis was undertaken on seven patients with lymph node fistula tracheobronchial tuberculosis who underwent fiberoptic bronchoscopy (FB) interventional therapy in the respiratory department of Tianjin Children's Hospital from July 2012 to July 2020. The efficacy, safety, and prognosis of CO2 cryotherapy intervention for the treatment of lymph node fistula TBTB in infants were summarized and analyzed.ResultsSeven patients with lymph node fistula TBTB were included in this study. Their ages ranged from 6–13 months. The course of the disease from onset to TBTB ranged from 20 to 70 days. The pathological diagnoses of seven cases by FB combined with tissue biopsy were lymph node fistula TBTB, of which 28.57% (two cases) were in the early stage of rupture and 71.43% (five cases) were in the rupture stage. All patients were treated with CO2 cryotherapy combined with foreign body forceps and local injection drugs based on systemic antituberculosis chemotherapy. Two patients were treated once with CO2 cryotherapy, and five were treated three times. According to the comparison of the clinical symptoms, imaging results, and endoscopic presentations before and after the intervention, six patients achieved clinical cure, and one achieved clinical improvement. No severe intraoperative or postoperative complications were observed. The clinical symptoms, endoscopic findings, radiological manifestations, and quality of life of all patients showed marked improvement. No recurrence occurred after 3–6 months of follow-up with FB.ConclusionCO2 cryotherapy can improve the treatment effect of lymph node fistula in infants with TBTB and reduce the incidence of complications. This treatment is safe and reliable in infants.

BackgroundMeniscal root tears are one of the common diseases in the field of orthopedics and sports medicine today and are the subject of many current investigative efforts.PurposeThis study aims to identify and evaluate the global trends, hotspots and frontiers in meniscal root tear research using bibliometric analysis.MethodsA bibliometric analysis of research findings related to meniscal root tears over the past three decades was performed. CiteSpace was used to conduct document co-citation and cluster analyses on the collected data. The research was conducted based on the following factors: country and institution distribution, chronological distribution, source journal analysis, keyword co-occurrence analysis, and reference co-citation analysis.ResultsA total of 626 research articles on meniscal root tears in English published from 1989 to 2021 were obtained. There was a significant upward trend in the total number of scientific publications over the past decades, especially in 2015–2020. The most productive countries, institutions, journals and authors are the USA, STEADMAN PHILIPPON, KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, and LAPRADE RF. North America and East Asia made outstanding contributions to the research on meniscal root tears, but cooperation and exchanges between countries and institutions were not close enough. A total of 9 clusters were obtained from the citation analysis, and 8 clusters were obtained from the keyword analysis. The main keywords that ranked first were posterior root tear, medial meniscus, menisci tibial, and ACL reconstruction, and these clusters combined with the corresponding emergence reflected the current status of research at different times.ConclusionResearch in this field over the past 32 years has gone through a phase of exploration in the understanding of the anatomy of the meniscal root and the diagnosis of this disease and a phase of development with in-depth biomechanical studies and improved and innovative surgical techniques. The current research focuses on the innovation of meniscal root tear repair techniques, the long-term efficacy of surgery, the variability in the efficacy of different surgical techniques, and surgical strategies for combined injuries. There will be more breakthroughs in surgical techniques, surgical equipment and surgical materials to resolve meniscal root tears.

Background: Graft choice is an important step in the pre-operative plan of anterior cruciate ligament reconstruction (ACLR). The four-strand hamstring tendon (4SHT) is the most widely used auto-graft, while the Ligament Advanced Reinforcement System (LARS) is the newest typical biomaterial for ACLR. The physical activity level (PAL) before injury can affect the efficacy and outcomes of ACLR. This study aims to compare the efficacy and functional outcomes between ACLR using LARS and 4SHT in patients different PALs.Methods: This was a prospective paired case-control study. ACL rupture patients included from 1 January 2017 to 31 December 2019 were subsequently divided into the high and plain PAL groups, according to their baseline PAL before injury. Clinical assessments included: Lachman test, pivot shift test, ligament laxity, Lysholm and International Knee Documentation Committee (IKDC) scores, and rate of returning to sports. The minimum follow-up was 2 years (y).Results: A total of 58 patients had accomplished the 2 y follow-up (missing rate: 6.5%). In the high PAL group (n = 22), the positive rate of A–P laxity of the LARS subgroup was lower than the 4SHG subgroup (p = 0.138), while the Lysholm score (p = 0.002), IKDC score (p = 0.043), and rate of returning to sports (p = 0.010) of the LARS were higher than the 4SHG at 1 year follow-up; the positive rates of A–P laxity (p = 0.009) and pivot test (p = 0.027) were lower in the LARS than the 4SHG at 2 y follow-up. In the plain PAL group (n = 36), the positive rate of A–P laxity in the LARS subgroup was lower than the 4SHG at 1 year follow-up (p = 0.017); the positive rates of A–P laxity (p = 0.001), Lachman (p = 0.034), and pivot tests (p = 0.034) in the LARS were also lower than the 4SHG at 2 y follow-up, but the IKDC score (p = 0.038) and rate of returning to sports (p = 0.019) in the 4SHG were higher than the LARS.Conclusion: In patients with high PAL, LARS can acquire better knee stability, sooner functional recovery, and returning to sports than 4SHG, while in patients without high PAL, 4SHG acquires better functional outcomes and a higher rate of returning to sports.

Abstract Algae contamination accumulated on the surface of insulators will affect the electrical properties of insulators. At present, the characterization method of algae contamination is the image method, which determines the distribution of algae contamination through colour. The detection results are affected by environmental changes and the growth state of algae. This paper puts forward a method of detecting polluted insulator surface with algae by using laser‐induced breakdown spectroscopy (LIBS) technique, combined with the scanning electron microscope (SEM), inductively coupled plasma emission spectrometer (ICP), analyzed by the spectra of algae contamination. Mg, Ca, Fe are selected as the analytical element. The classification of algae contamination, non‐algae contamination and no contamination are realized with the principal component analysis (PCA). The research results are of great significance for characterization of algal pollution on insulator surface by LIBS.

Summary: The autonomous underwater vehicle has widespread applications in marine resource exploration, seabed search and rescue, underwater military reconnaissance, and marine environmental monitoring. Owing to the limited battery capacity, autonomous underwater vehicles usually only operate for several hours or days at a time. This article presents an extended-range wave-powered autonomous underwater vehicle (WPAUV) for underwater wireless sensor networks. Through theoretical analysis, simulation, dry and field experiments, the power generation performance of the extended-range WPAUV was evaluated. Under different wave amplitudes and wave frequencies, the mechanical efficiency of the extended-range WPAUV ranges from 20.41% to 81.56%. The average efficiency is 45.35%. In the field experiments, under calm ocean conditions, the maximum instantaneous power can reach 67.74W with an average of 10.18W. This high performance manifests that the extended-range WPAUV can effectively scavenge wave energy and converts it into electrical energy for expanding the cruising mileage.

With the rapid increase in the number of infections, children with Staphylococcus aureus (S. aureus) infection secondary to Influenza A virus (IAV), appear to have a great possibility of causing severe complications and illness. Despite some cases and research findings regarding the death of children with IAV and S. aureus, coinfection included, there were few details about successful treatment of pleural empyema and necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) infection following IAV. In this case report, we describe the clinical symptoms and treatment of a teenager with pleural empyema and necrotizing pneumonia related to S. aureus secondary infection who was initially infected by IAV. This case highlights the importance of early recognition and application of thoracoscopy for this potentially fatal pleural empyema caused by MRSA and IAV coinfection. We conclude that this is a significant case that contributes to raising awareness regarding rarely occurring severe respiratory infections by MRSA in a child with normal immune function after IAV. In addition, further studies are needed to explore risk factors for IAV coinfection with S. aureus.

Mycoplasma pneumoniae (MP) is a common pathogen of lower respiratory tract infection in children and adolescents. Some patients with MP infection are self-limiting, while with the increase of severe or refractory Mycoplasma pneumoniae pneumonia (MPP) in recent years, there is a great increase in reports of thromboembolism in multiple organs, including lung, brain, spleen, and peripheral arteries. Cardiac multiple thrombi and pulmonary embolism associated with MP infection have not been reported. The most effective treatment option for cardiac thrombus was surgical resection for fear of thrombus detachment and causing new thromboembolism. Herein, we present a patient with cardiac multiple thrombi and pulmonary embolism in MPP for the first time. In our case, the child recovered after conservative medical treatment, which provides a therapeutic option for children with cardiac multiple thrombi.

Abstract Background Single 6 ml Hylan G-F 20 injection, is indicated for knee osteoarthritis patients who have failed to respond to non-pharmacologic therapy and/or simple analgesics. To obtain more thorough understanding of the clinical efficacy and safety, a randomized clinical trial was conducted comparing intra-articular (IA) administration of single 6 ml Hylan G-F 20 injection versus placebo in knee OA patients of Chinese ethnicity. Methods This was a randomized, multi-center, double-blind, placebo-controlled clinical trial conducted in 21 centers across China. Four hundred forty adults with knee OA received a single 6 ml Hylan G-F 20 or placebo injection and were evaluated for clinical efficacy and safety outcomes over 26 weeks. Western Ontario and McMaster Universities OA (WOMAC) A1 index, treatment-emergent adverse events (TEAEs) and standard safety parameters were measured at pre-injection, and at weeks 1, 4, 8, 12, 16, 20 and 26 post-injection. Results Four hundred forty patients (male: 98 [22.3%]; female: 342 [77.7%]) were randomized. The mean age [standard deviation (SD)] was 61.5 (7.9) years. All patients were of East Asian ethnicity. Mean WOMAC A1 score at baseline was 5.3 (1.2) and 5.2 (1.3) in single 6 ml Hylan G-F 20 injection and placebo groups, respectively. Significant reductions of WOMAC A1 score were observed in both treatment groups when compared to baseline at 26 weeks post-injection, with the mean reduction of [standard error (SE)/percentage] -2.146 (0.108)/− 40.5% and − 2.271 (0.110) /− 43.7% in the single 6 ml Hylan G-F 20 injection and the placebo groups, respectively. Additionally, clinically important reductions in pain at 26 weeks was reported in 67.0 and 68.2% in single 6 ml Hylan G-F 20 injection and placebo groups (p = 0.36). Regarding safety, TEAEs were similar between the two treatment groups (hylan G-F 20 single: 61.5%; placebo: 64.5%). Conclusions While the magnitude of the effect of a single 6 ml Hylan G-F 20 injection in this study is consistent with previously published literature with respect to the efficacy and safety of the drug, the current study shows a strong IA placebo effect and did not established superiority of single 6 ml Hylan G-F 20 injection over IA placebo in Chinese knee OA patients. Trial registration Prospectively registered Jun 16, 2017 at www.clinicaltrials.gov ( NCT03190369 ).

Abstract Background Gout is a metabolic disease characterized by recurrent episodes of acute arthritis. Gout has been reported in many locations but is rarely localized in the shoulder joint. We describe a rare case of gouty arthritis involving bilateral shoulder joints and leading to severe destructive changes in the right shoulder glenoid. Case presentation A 62-year-old male was referred for pain and weakness in the right shoulder joint for two years, and the pain had increased in severity over the course of approximately nine months. A clinical examination revealed gout nodules on both feet and elbows. A laboratory examination showed a high erythrocyte sedimentation rate (ESR), high levels of C-reactive protein and hyperuricemia, and an imaging examination showed severe osteolytic destruction of the right shoulder glenoid and posterior humeral head subluxation. In addition, the left humeral head was involved and had a lytic lesion. Because a definite diagnosis could not be made for this patient, a right shoulder biopsy was performed. The pathological examination of the specimen revealed uric acid crystal deposits and granulomatous inflammation surrounding the deposits. After excluding infectious and neoplastic diseases, the patient was finally diagnosed with gouty shoulder arthritis. Conclusions Gout affecting the bilateral shoulder joints is exceedingly uncommon, and to our knowledge, severe erosion of the glenoid has not been previously reported. When severe erosion is present, physicians and orthopedic surgeons should consider gouty shoulder arthritis according to previous medical history and clinical manifestations.

Abstract Background To observe the effect of corticosteroids in the treatment of children with refractory Mycoplasma pneumoniae pneumonia (RMPP) under different doses, to summarize the clinical features of children treated with glucocorticoid pulse therapy. Methods The clinical data of 125 children with RMPP hospitalized in Tianjin Children’s Hospital from September 2018 to October 2019 were retrospectively analyzed. They were divided into two groups according to the dose of hormone. Compare the clinical features, laboratory findings, and imaging between the two groups, and use meaningful related indicators as ROC curves to find reference indicators for pulse therapy. Results (1) The median age of the group II was older than that of the group I(P

BackgroundFighting skin aging signs is one of the major challenges of the 21st century, recently, mesenchymal stem cells (MSCs) and microneedling (MN) have been applied for anti-aging. This study aims to evaluate the efficacy of the combination of MN and human umbilical cord-derived mesenchymal stem cells conditioned media (hUC-MSCs-CM) in skin brightness and rejuvenation.MethodsThirty volunteers with facial skin aging were recruited for the randomized, controlled split-face study. The left and right sides of the face were randomly applied with saline via MN or hUC-MSCs-CM via MN. Five sessions were performed for each volunteer at 2-week intervals. Two dermatologists evaluated the clinical improvement, in terms of skin brightness and texture. A satisfaction score based on a self-evaluation questionnaire was recorded at 2 weeks after the last treatment. The objective evaluation was recorded before the first treatment, and at 2 weeks after the last treatment.ResultsTwenty-eight volunteers with a mean (SD) age of 41 (6.54) years old completed the trial. The investigator’s assessment for skin brightness and texture, and the self-satisfaction score revealed statistically better effects in hUC-MSCs-CM -plus-MN group than in MN alone (MN saline) group. No severe side effects were reported during the whole study period. Compared to MN alone group, the objective assessment revealed significant improvements in skin brightness (reduced melanin index, ultraviolet spots, and brown spots) and skin texture (reduced wrinkles and pores, and increased skin elasticity) in hUC-MSCs-CM-plus-MN group, while there were no obvious differences in skin hydration, trans-epidermal water loss, and the erythema index.ConclusionThe combination of hUC-MSCs-CM and MN exhibite anti-aging efficacy, and this could be used for facial rejuvenation in the future.

Background: Increasing evidence has revealed that epithelial–mesenchymal transition (EMT) and immunity play key roles in idiopathic pulmonary fibrosis (IPF). However, correlation between EMT and immune response and the prognostic significance of EMT in IPF remains unclear.Methods: Two microarray expression profiling datasets (GSE70866 and GSE28221) were downloaded from the Gene Expression Omnibus (GEO) database. EMT- and immune-related genes were identified by gene set variation analysis (GSVA) and the Estimation of STromal and Immune cells in MAlignant Tumors using Expression data (ESTIMATE) algorithm. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to investigate the functions of these EMT- and immune-related genes. Cox and least absolute shrinkage and selection operator (LASSO) regression analyses were used to screen prognostic genes and establish a gene signature. Gene Set Enrichment Analysis (GSEA) and Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) were used to investigate the function of the EMT- and immune-related signatures and correlation between the EMT- and immune-related signatures and immune cell infiltration. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to investigate the mRNA expression of genes in the EMT- and immune-related signatures.Results: Functional enrichment analysis suggested that these genes were mainly involved in immune response. Moreover, the EMT- and immune-related signatures were constructed based on three EMT- and immune-related genes (IL1R2, S100A12, and CCL8), and the K–M and ROC curves presented that the signature could affect the prognosis of IPF patients and could predict the 1-, 2-, and 3-year survival well. Furthermore, a nomogram was developed based on the expression of IL1R2, S100A12, and CCL8, and the calibration curve showed that the nomogram could visually and accurately predict the 1-, 2-, 3-year survival of IPF patients. Finally, we further found that immune-related pathways were activated in the high-risk group of patients, and the EMT- and immune-related signatures were associated with NK cells activated, macrophages M0, dendritic cells resting, mast cells resting, and mast cells activated. qRT-PCR suggested that the mRNA expression of IL1R2, S100A12, and CCL8 was upregulated in whole blood of IPF patients compared with normal samples.Conclusion: IL1R2, S100A12, and CCL8 might play key roles in IPF by regulating immune response and could be used as prognostic biomarkers of IPF.

Abstract Background To analyze the clinical characteristics of Mycoplasma pneumoniae pneumonia with hypoxia in children, and identify the associated risk factors of hypoxia in MPP. Methods A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) admitted to our hospital wards from January 2017 to June 2019. They were divided into three groups, namely MPP with hypoxia, refractory Mycoplasma pneumoniae pneumonia (RMPP), and general Mycoplasma pneumoniae pneumonia (GMPP). The clinical features, laboratory findings, imaging, and management were collected and compared in the three groups. Results The MPP with hypoxia patients (n = 69) had longer disease duration, a higher extra-pulmonary complications rate, and more severe radiological abnormalities (P 174.15 ng/mL, IL-6 > 25.475 pg/ml, and pleural effusion were significantly associated with the incidence of hypoxia in MPP (P 174.15 ng/mL, IL-6 > 25.475 pg/ml and pleural effusion were related risk factors for hypoxia in MPP.

BackgroundIn children, refractory Mycoplasma pneumoniae pneumonia (RMPP) may result in severe complications and high medical costs. There is research on a simple and easy-to-use nomogram for early prediction and timely treatment of RMPP.MethodsFrom December 2018 to June 2021, we retrospectively reviewed medical records of 299 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in Tianjin Children's Hospital. According to their clinical manifestations, patients were divided into the RMPP group and the general Mycoplasma pneumoniae pneumonia (GMPP) group. The clinical manifestations, laboratory indicators, and radiological data of the two groups were obtained. Stepwise regression was employed for variable selection of RMPP. The predictive factors selected were used to construct a prediction model which presented with a nomogram. The performance of the prediction model was evaluated by C statistics, calibration curve, and receiver operating characteristic (ROC) curve.ResultsThe RMPP group significantly showed a higher proportion of females, longer fever duration, and longer hospital stay than the GMPP group (P < 0.05). Additionally, the RMPP group revealed severe clinical characteristics, including higher incidences of extrapulmonary complications, decreased breath sounds, unilateral pulmonary consolidation >2/3, and plastic bronchitis than the GMPP group (P < 0.05). The RMPP group had higher neutrophil ratio (N%), C-reactive protein (CRP), interleukin-6 (IL-6), lactic dehydrogenase (LDH), and D-dimer than the GMPP group (P < 0.05). Stepwise regression demonstrated that CRP [OR = 1.075 (95% CI: 1.020–1.133), P < 0.001], LDH [OR = 1.015 (95% CI: 1.010–1.020), P < 0.001], and D-dimer [OR = 70.94 (95% CI: 23.861–210.904), P < 0.001] were predictive factors for RMPP, and developed a prediction model of RMPP, which can be visualized and accurately quantified using a nomogram. The nomogram showed good discrimination and calibration. The area under the ROC curve of the nomogram was 0.881, 95% CI (0.843, 0.918) in training cohorts and 0.777, 95% CI (0.661, 0.893) in validation cohorts, respectively.ConclusionC-reactive protein, LDH, and D-dimer were predictive factors for RMPP. The simple and easy-to-use nomogram assisted us in quantifying the risk for predicting RMPP, and more accurately and conveniently guiding clinicians to recognize RMPP, and contribute to a rational therapeutic choice.

Abstract Background Little is known about the changes in allergen sensitization in China secondary to the environmental variations over the past decade. We aimed at investigating the variations in sensitization among asthma and/or rhinitis patients in China between 2008 and 2018. Methods This study analyzed cross‐sectional data from national surveys conducted in China in 2008 and 2018. After finishing the questionnaire, participants underwent serum specific IgE measurements. A total of 2322 and 2798 patients were enrolled in 2008 and 2018, respectively. The significance of differences in sensitization rates among four regions of China were assessed. Correlation analysis was used to identify the associations of sensitization with climate change and planting of Artemisia desertorum between the two surveys. Results Compared with 2008, the general sensitization rate to mites significantly increased in 2018, which ranked highest among all tested allergens. Sensitization to pollens, especially Artemisia vulgaris, showed the greatest increase in the north. The annual mean temperature, rainfall and relative humidity in all four regions, and the Artemisia desertorum coverage in the northeastern area, increased significantly in 2018 as compared with 2008. From 2008 to 2018, an increase in Dermatophagoides pteronyssinus sensitization was significantly associated with an increase in relative humidity (r = 0.54, p = 0.037). The increase in A. vulgaris sensitization was significantly associated with the increase in the A. desertorum planting area (r = 0.67, p = 0.006) and with a decrease in rainfall (r = −0.59, p = 0.021). Conclusions House dust mites remain the most important allergen in Chinese individuals with asthma and/or rhinitis. Pollen sensitization dramatically increased in northern China. Increases in sensitization to dust mites and Artemisia were related to the increases in humidity and planting area of A. desertorum.

Treating bone defects coupled with pathogen infections poses a formidable challenge to clinical medicine. Thus, there is an urgent need to develop orthopedic implants that provide excellent antibacterial and osteogenic properties. Of the various types, copper-based biomaterials capable of both regenerating bone and fighting infections are an effective therapeutic strategy for bone tissue engineering and therefore have attracted significant research interest. This review examines the advantages of copper-based biomaterials for biological functions and introduces these materials’ antibacterial mechanisms. We summarize current knowledge about the application of copper-based biomaterials with antimicrobial and osteogenic properties in the prevention and treatment of bone infection and discuss their potential uses in the field of orthopedics. By examining both broad and in-depth research, this review functions as a practical guide to developing copper-based biomaterials and offers directions for possible future work.

Doppler Centroid Analysis (DCA) technique is one of the major techniques that do permit a direct retrieval of ocean surface velocity from synthetic aperture radar (SAR) data. However, azimuth ambiguities in the SAR images severely restrict the capability of DCA technique to obtain accurate ocean surface Doppler velocities. Therefore, it is necessary to investigate how the azimuth ambiguities impact the Doppler velocity estimation performance and to evaluate how significant the impact is. In this paper, a model for ocean surface Doppler velocity estimation affected by azimuth ambiguities is developed resorting to jointly circular Gaussian processes, and its statistic is derived. The impact of azimuth ambiguities on Doppler velocity estimation performance in terms of Doppler centroid estimation bias and the standard deviation of Doppler centroid estimates is analyzed. The theoretical results are validated through simulation and Doppler velocities retrieved from Chinese Gaofen-3 (GF-3) SAR Doppler centroid estimates affected by azimuth ambiguities. This study will help researchers better understand the impact of azimuth ambiguities on Doppler velocity estimation, and will provide a theoretical reference for subsequent research on how to reduce the impact of azimuth ambiguities more effectively.

Fulminant Mycoplasma pneumoniae pneumonia (FMPP) accounts for 0.5–2% of all MPP cases, which is considered as MPP combined with severe complications such as hypoxemia, acute respiratory distress syndrome, or acute respiratory failure. It primarily affects young adults with no underlying disease. Although some studies have proved the severity of FMPP, the details about clinical diagnosis and treatment of FMPP in children have been rarely reported. In this case study, we described three cases who suffered from FMPP. These children not only developed acute lung injury and multiple organ involvement within 7 days of treatment, but were also found plastic bronchitis by bronchoscopy. Finally, all the patients were treated successfully with azithromycin, glucocorticoid, and bronchoscopy lavage. We conclude that this case study would contribute to raise awareness with respect to FMPP, which may occur at a younger age with faster disease progression and common extrapulmonary manifestations. It also reinforces the importance of early identification and prompt intervention to save life of children and reduces sequelae. Further studies are needed about mechanism of FMPP.

Satellite radar altimeters are advanced remote sensing devices that play an important role in observing the global marine environment. Accurately estimating the noise level of altimeter in-orbit ranging data is crucial for evaluating the payload performance, analyzing sea conditions, and monitoring data quality. In this study, we propose an approach based on the differential processing of along-track odd–even data sequences for altimeter in-orbit range noise-level estimation. Using the long-term along-track data sequence can notably improve the issue in the existing method in that the noise level is underestimated owing to the utilization of a relatively short data segment. On the basis of an analysis of the influence of low-frequency components on noise-level estimation, the mathematical formulas of the above differential method were deduced, and the efficacy of the approach in assessing the noise level of altimeter in-orbit data was demonstrated by simulation experiments. This method was used to estimate the noise levels of the 20 Hz datasets of Jason-3 and Sentinel-6, and the idea of the time-domain difference was extended to the frequency domain. The statistical results showed that the 20 Hz noise levels at the significant wave height (SWH) = 2 m were 7.41 cm (Jason-3 low-resolution (LR) mode), 6.66 cm (Sentinel-6 LR mode), and 3.13 cm (Sentinel-6 high-resolution (HR) mode). The power spectrum density analysis further verified its accuracy. By reprocessing the 20 Hz data of Sentinel-6 into 10, 5, and 1 Hz, the effectiveness of the along-track odd–even differential method to directly evaluate the noise level of 1 Hz data was explored, and the impact of ocean signals such as swells on noise-level estimation in synthetic aperture mode was discussed.

Background: To determine the predictive value of peripheral blood cell parameters for refractory Mycoplasma pneumoniae pneumonia (RMPP) in children over 6 years old.Methods: A retrospective study was conducted in children with RMPP admitted to the respiratory department of Tianjin Children's Hospital from September 2017 to September 2019, and non-refractory Mycoplasma pneumoniae pneumonia (NRMPP) was selected by the propensity score method and matched according to the ratio of 1:1.5. We analyzed the differences in clinical characteristics, peripheral blood cell parameters, imaging findings, and treatments between the two groups, and further determined the predictive value of peripheral blood cell parameters on RMPP.Results: There were 76 patients in the RMPP group and 114 patients in the NRMPP group. We found that the RMPP group has a longer clinical course and a higher incidence of intrapulmonary and extrapulmonary complications (p < 0.01). Moreover, the proportion of children in the RMPP group who received immunotherapy (such as glucocorticoid, gamma immunoglobulin) and fiberoptic bronchoscopy intervention was higher than that in the NRMPP group (p < 0.01). Meanwhile, the level of neutrophil, neutrophil/lymphocyte ratio (NLR), platelet count/lymphocyte ratio (PLR), mean platelet volume/lymphocyte ratio (MPVLR), C-reactive protein (CRP), lactic dehydrogenase (LDH), and interleukin (IL)-6 in the RMPP group was significantly higher (p < 0.01) than those in the NRMPP group. The incidence of pulmonary consolidation, atelectasis, and pleural effusion was also higher in the RMPP group (p < 0.05). ROC curve and binary logistic regression analysis showed that NLR > 3.92 (OR = 3.243; 95% CI = 1.485–7.081; p = 0.003), MPVLR > 5.29 (OR = 2.700; 95% CI = 1.258–5.795; p = 0.011), and pleural effusion (OR = 3.023; 95% CI = 1.424–6.420; p = 0.004) were significant factors in predicting RMPP. Our study showed that NLR had higher accuracy in predicting RMPP than CRP.Conclusions: The parameters of peripheral blood cells might be a predictor of RMPP. NLR > 3.92, MPVLR > 5.29, and pleural effusion might have important predictive value for RMPP in children over 6 years old.

Abstract Pain is a significant problem worldwide that affects the quality of life of patients. Dezocine is a non-addictive analgesic drug with kappa-opioid antagonist activity and has been successfully used to alleviate of postoperative pain. In addition, dezocine has an analgesic effect similar to that of morphine, alleviating moderate to severe pain. Rap guanine nucleotide exchange factor 3 (RAPGEF3) is a guanine nucleotide exchange factor for GTPases Rap1 and Rap2, which could enhance the activity of Rap1 to promote cell adhesion and axon regeneration, as well as promote neurite extension by interacting with nerve growth factors. Here, we first observed that overexpression of RAPGEF3 increased cell viability, as shown by a CCK-8 assay, and recovered brain function in rats. The expression of inflammation-related factors at the mRNA level was detected using qPCR, and the concentration of these factors in a cultured cell medium and rat serum samples were decreased as shown by ELISA after RAPGEF3 overexpression. Through western blotting, we further found that pro-inflammatory proteins were decreased, and these effects might be mediated by inhibition of the Ras/p-38 MAPK signaling pathway. Taken together, we speculated that RAPGEF3overexpression enhances the therapeutic effect of dezocine on neuropathic pain by inhibiting the inflammatory response through inhibition of the Ras/p-38 MAPK signaling pathway.

Trapped space charges in epoxy composite distort the electric field, which will induce the failure of the insulation system, and nano graphene oxide may inhibit the curing behavior of epoxy resin matrix. This paper analyzes how the two interfaces affect the electron traps of epoxy resin/graphene oxide systems with different nanofiller contents. The electron affinity energy of epoxy resin matrix and nano filler molecules in the epoxy resin/graphene oxide system is calculated based on quantum chemistry. It is found that nano graphene oxide has a strong electron affinity energy and is easier to capture electrons. Then the influence of the interface formed by the epoxy resin matrix and the nano graphene oxide on the electron transfer ability is calculated. The epoxy resin matrix contains the electron transfer ability of interfaces formed by nano graphene oxide and the molecular chain is different from that of unreacted molecules. The results can provide a reference for the modification of epoxy resin/graphene oxide nanocomposites.

Abstract Background Selenium (Se), an essential micronutrient in both animals and humans, has various biological functions, and its deficiency can lead to various diseases. The most common method for increasing Se uptake is the consumption of Se-rich plants, which transform inorganic Se into organic forms. Wheat is eaten daily by many people. The Se content of Aegilops tauschii (Ae. tauschii), one of the ancestors of hexaploid common wheat, is generally higher than that of wheat. In this study, two genotypes of Ae. tauschii with contrasting Se-accumulating abilities were subjected to different Se treatments followed by high-throughput transcriptome sequencing. Results Sequencing of 12 transcriptome libraries of Ae. tauschii grown under different Se treatments produced about a total of 47.72 GB of clean reads. After filtering out rRNA sequences, approximately 19.3 million high-quality clean reads were mapped to the reference genome (ta IWGSC_MIPSv2.1 genome DA). The total number of reference genome gene is 32,920 and about 26,407 known genes were detected in four groups. Functional annotation of these mapped genes revealed a large number of genes and some pivotal pathways that may participate in Se metabolism. The expressions of several genes potentially involved in Se metabolism were confirmed by quantitative real-time PCR. Conclusions Our study, the first to examine Se metabolism in Ae. tauschii, has provided a theoretical foundation for future elucidation of the mechanism of Se metabolism in this species.

Scientometric reviews, facilitated by computational and visual analytical approaches, allow researchers to gain a thorough understanding of research trends and areas of concentration from a large number of publications. With the fast development of satellite altimetry, which has been effectively applied to a wide range of research topics, it is timely to summarize the scientific achievements of the previous 50 years and identify future trends in this field. A comprehensive overview of satellite altimetry was presented using a total of 8541 publications from the Web of Science Core Collection covering the years from 1970 to 2021. We begin by presenting the fundamental statistical results of the publications, such as the annual number of papers, study categories, countries/regions, afflictions, journals, authors, and keywords, in order to provide a comprehensive picture of satellite altimetry research. We discuss the co-occurrence of the authors in order to reveal the global collaboration network of satellite altimetry research. Finally, we utilised co-citation networks to detect the development trend and associated crucial publications for various specific topics. The findings show that satellite altimetry research has been changed immensely during the last half-century. The United States, France, China, England, and Germany made the most significant contributions in the field of satellite altimetry. The analysis reveals a clear link between technology advancements and the trend in satellite altimetry research. As a result, wide swath altimetry, GNSS-reflectometry, laser altimetry, terrestrial hydrology, and deep learning are among the most frontier study subjects. The findings of this work could guide a thorough understanding of satellite altimetry’s overall development and research front.

BackgroundAcute myelogenous leukemia (AML) is a common pediatric malignancy in children younger than 15 years old. Although the overall survival (OS) has been improved in recent years, the mechanisms of AML remain largely unknown. Hence, the purpose of this study is to explore the differentially methylated genes and to investigate the underlying mechanism in AML initiation and progression based on the bioinformatic analysis.MethodsMethylation array data and gene expression data were obtained from TARGET Data Matrix. The consensus clustering analysis was performed using ConsensusClusterPlus R package. The global DNA methylation was analyzed using methylationArrayAnalysis R package and differentially methylated genes (DMGs), and differentially expressed genes (DEGs) were identified using Limma R package. Besides, the biological function was analyzed using clusterProfiler R package. The correlation between DMGs and DEGs was determined using psych R package. Moreover, the correlation between DMGs and AML was assessed using varElect online tool. And the overall survival and progression-free survival were analyzed using survival R package.ResultsAll AML samples in this study were divided into three clusters at k = 3. Based on consensus clustering, we identified 1,146 CpGs, including 40 hypermethylated and 1,106 hypomethylated CpGs in AML. Besides, a total 529 DEGs were identified, including 270 upregulated and 259 downregulated DEGs in AML. The function analysis showed that DEGs significantly enriched in AML related biological process. Moreover, the correlation between DMGs and DEGs indicated that seven DMGs directly interacted with AML. CD34, HOXA7, and CD96 showed the strongest correlation with AML. Further, we explored three CpG sites cg03583857, cg26511321, cg04039397 of CD34, HOXA7, and CD96 which acted as the clinical prognostic biomarkers.ConclusionOur study identified three novel methylated genes in AML and also explored the mechanism of methylated genes in AML. Our finding may provide novel potential prognostic markers for AML.

K+ is an essential nutrient for plant growth and is responsible for many important physiological processes. K+ deficiency leads to crop yield losses, and overexpression of K+ transporter genes has been proven to be an effective way to resolve this problem. However, current research on the overexpression of K+ transporter genes is limited to plant sources. TrkH is a bacterial K+ transporter whose function generally depends on the regulation of TrkA. To date, whether TrkH can improve K+ uptake in eukaryotic organisms is still unknown. In this study, a novel MbtrkH gene was cloned from marine microbial metagenomic DNA. Functional complementation and K+-depletion analyses revealed that MbTrkH functions in K+ uptake in the K+-deficient yeast strain CY162. Moreover, K+-depletion assays revealed that MbtrkH overexpression improves plant K+ uptake. K+ hydroponic culture experiments showed that, compared with WT tobacco lines, MbtrkH transgenic tobacco lines had significantly greater fresh weights, dry weights and K+ contents. These results indicate that MbTrkH promotes K+ uptake independently of TrkA in eukaryotes and provide a new strategy for improving K+-use efficiency in plants.

Ultrasound-based navigation, as a non-invasive and non-radiation image guiding system, is becoming a research focus in minimally invasive navigation surgery, and calibration between an ultrasonic probe and a 3D vision device is one of the key technologies for ultrasonic registration-based navigation. In this paper, a phantom model was designed as a benchmark for calibration. Both iterative closet point (ICP) and coherent point drift (CPD) algorithms are chosen as point cloud registration methods to implement calibration between ultrasonic scanned points and original phantom points to set up the relationship between the ultrasonic probe and the 3D vision device. Because of large topological difference between the ultrasound scanned points and the points from model, ICP algorithm cannot complete the registration, but the CPD algorithm could implement the registration automatically. The average errors of the center point position for each cavity were 1.50, 1.31, and 1.19 mm, respectively, and the average errors of the axis for each cavity were 0.85°, 0.61°, and 0.99°, respectively. Experiment results showed that the average error of calibration by this method satisfies acquirements of most orthopedic surgeries, and the fully automatic implementation of ultrasonic image processing and subsequent calculation is suitable for on-line calibration and verification in surgery.