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Background: The aim of this work was to investigate left atrial electrophysiological properties for their ability to predict the recurrence of atrial fibrillation (AF) following pulmonary vein isolation (PVI). Methods: The study comprised 53 patients with AF [62 (interquartile range (IQR): 52–68) years old; 47.2% females]. High-density, three-dimensional electro-anatomic mapping using PentaRay was conducted during sinus rhythm in the left atrium (LA) immediately after PVI. LA conduction time, conduction velocity in predefined anterior and posterior routes, low voltage area percentage and distribution were assessed. Results: The AF recurrence group had longer LA conduction time compared to the non-recurrence group [11 (IQR: 10–12) ms vs. 9 (IQR: 8–10) ms, p = 0.001). The percent low voltage area was greater in the recurrence group than the non-recurrence group [31.2 (IRQ: 7.1–49.3)% vs. 7.7 (IQR: 4.3–15.2)%, p = 0.008]. Multivariate Cox regression revealed that LA conduction time independently predicted AF recurrence following ablation over a median follow-up of 235 days [IQR: 154–382 days; hazard ratio (HR): 2.37, 95% confidence interval (CI): 1.08–5.23, p = 0.031]. The optimal cut-off for LA conduction time was 98 ms [area under curve (AUC): 0.926, sensitivity: 0.833, specificity: 0.894, p < 0.01]. Kaplan–Meier analysis revealed that patients with a conduction time >98 ms had a higher rate of AF recurrence following ablation (p < 0.001). Conclusions: Patients with longer LA conduction time after PVI had more frequent AF recurrence.

Atrial fibrosis is an independent predictor of the recurrence of atrial fibrillation (AF) after catheter ablation. Low-voltage areas (LVA) measured during catheter ablation for AF are a commonly used surrogate for the presence of atrial fibrosis. LVA are associated with clinical outcomes and comorbidities and have links to triggering sites for AF. Several trials have shown promising data of targeting ablation in LVA, however the results have been mixed. This article will review the role of LVA in the prediction of adverse events in AF patients, including stroke, how to predict the presence of LVA, and the impact of LVA ablation on the recurrence of AF.

Based on the electromagnetic induction heating method, heating and curing of Carbon Fiber Reinforced Polymer (CFRP) have the advantages of high energy utilization and no pollution. However, in the heating process, both the material weaving structure and mold material can affect the temperature field. Therefore, in this study, an electromagnetic heating finite element analysis model for CFRP circular tubes was established based on the equivalent electromagnetic thermal characteristics of CFRP. The study investigated the temperature rise mechanism of the material weaving structure under the magnetic field, and explored in-depth the influence of molds made of 45# steel and glass fiber-reinforced plastic (FRP) on the heating process of CFRP. The CFRP circular tubes with weaving structures of 89-degree winding angle, 45-degree winding angle, and plain weave were studied. The study found that when the metal mold was heated, the CFRP structure had almost no effect on the temperature distribution. However, when the glass fiber-reinforced plastic mold was heated, the temperature field changed with the CFRP structure, and the more fiber cross points, the more uniform the temperature field. The accuracy of the finite element model was verified through experiments. The aim of this research is to provide theoretical guidance for actual industrial production.

A kinematics analysis of a new hybrid mechanical leg suitable for bipedal robots was carried out and the gait of the robot walking on flat ground was planned. Firstly, the kinematics of the hybrid mechanical leg were analyzed and the applicable relevant models were established. Secondly, based on the preliminary motion requirements, the inverted pendulum model was used to divide the robot walking into three stages for gait planning: mid-step, start and stop. In the three stages of robot walking, the forward and lateral robot centroid motion trajectories and the swinging leg joint trajectories were calculated. Finally, dynamic simulation software was used to simulate the virtual prototype of the robot, achieving its stable walking on flat ground in the virtual environment, and verifying the feasibility of the mechanism design and gait planning. This study provides a reference for the gait planning of hybrid mechanical legged bipedal robots and lays the foundation for further research on the robots involved in this thesis.

Background: The Brugada Electrocardiographic Indices Registry is a comprehensive data registry composed of patients with Brugada patterns on the electrocardiogram (ECG). The aim is to test the hypotheses that (i) ECG indices combining both depolarization and repolarization abnormalities can better predict spontaneous ventricular arrhythmias than existing ECG markers in Brugada syndrome and (ii) that serial ECG measurements will provide additional information for risk stratification, especially in asymptomatic patients. Methods: Patients with both Brugada pattern ECGs and Brugada syndrome are eligible for inclusion in this registry. Baseline characteristics and ECG variables reflecting depolarization and repolarization will be determined. The primary outcome is spontaneous ventricular tachycardia/ventricular fibrillation or sudden cardiac death. Secondary outcomes are inducible ventricular tachycardia/ventricular fibrillation and syncope. Results: As of November 15, 2019, 39 investigators from 32 cities in 18 countries had joined this registry. As of December 15, 2019, 1383 cases had been enrolled. Conclusions: The Brugada Electrocardiographic Indices Registry will evaluate the disease life course, risk factors, and prognosis in a large series of Brugada patients. It will therefore provide insights for improving risk stratification.

BackgroundThere are many surgical methods of sphincter preservation in treating complex anal fistula, but the therapeutic effects of each operation are different. Therefore, this study aimed to compare the impact of other treatment methods through a network meta-analysis to evaluate the best sphincter preservation method for treating complex anal fistula.MethodsWe searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Journal Database, and the Wanfang Database to collate randomized controlled trials on sphincter-preserving surgery for complex anal fistula.ResultsA total of 29 articles were included in this meta-analysis. The cure rates showed no statistically significant differences between any two interventions (P > 0.05). The recurrence rate results showed that the rate of patients after Fistulectomy was higher than others (P < 0.05). The incidence rate of complications showed that the incidence rate after fistulectomy treatment was higher than that of others (P < 0.05). The surface under the cumulative ranking (SUCRA) was used to arrange their advantages and disadvantages, and a larger SUCRA value indicates that the intervention may be more effective. The results showed that TROPIS may have the highest cure rate (SUCRA = 78.6%), stem cell transplantation (SCT) may have the lowest recurrence rate (SUCRA = 85.5%), and imLIFT may have the least complications (SUCRA = 88.2%).ConclusionAccording to the existing literature data, for patients with complex anal fistula, TROPIS may be the surgical method with the highest cure rate, SCT may be the treatment method with the lowest recurrence rate, and imLIFT may be the surgical method with the lowest incidence of postoperative complications.Systematic Review RegistrationPROSPERO, identifier: CRD42020221907.

Purpose. This study was aimed at investigating whether the platelet-to-neutrophil ratio (PNR) is independently related to the prognosis of patients with ST-elevation myocardial infarction (STEMI) after successful primary percutaneous coronary intervention (pPCI). Methods. This was a secondary analysis of data retrieved from the DATADRYAD database, which was a prospective cohort study. A total of 464 STEMI patients who underwent successful pPCI were recruited between January 2010 and October 2014. The target-independent variable, PNR, was measured at the baseline. The dependent variable in the current study was the occurrence of major adverse cardiovascular events (MACEs) during the 30-month follow-up. Results. Two patients were excluded from the final analysis because their platelet counts were unavailable. The average age of the 462 participants was 63±11.92 years, and approximately 76.6% were male. After adjusting for age, sex, anterior wall myocardial infarction (MI), history of MI, apelin-12, apelin-12 change rate, left ventricular end-diastolic diameter, peak cardiac troponin I, pathological Q wave, Killip classification grade, fasting blood glucose, albumin, GENSINI score, and estimated glomerular filtration rate, a nonlinear relationship was found between the PNR and MACEs in the included cohort. The threshold value of the PNR for MACEs was 23.1. Over this cutoff value, the incidence rate of MACEs increased by 43% per 10-unit change in PNR (95% CI: 1.16–1.75, p=0.0006). Conclusion. There was a threshold relationship between PNR and MACEs in patients with STEMI who underwent successful pPCI. The incidence of MACEs was positively associated with the PNR when the PNR exceeded 23.1.

Based on the digital humanistic perspective, the paper explores the protection and communication strategy of traditional culture, and communication path of innovation of the traditional culture .Digitization is the trend of culture communication, which promotes the development of traditional culture. More and more attention is paid to the combination of technology and product development.Taking the “Digital Dunhuang” project as an example, this paper explores the means of protection, technological path and communication strategies of traditional culture.The research shows that digital humanities innovate the presentation means of traditional culture, and can better achieve the promotion and dissemination of culture.

Introduction This protocol designed a randomised controlled trial (RCT) to evaluate the effectiveness, safety and prognostic outcomes of modified tissue selecting technique (M-TST) combined with complete anal canal epithelial preservation (CACP) among patients with circumferential mixed haemorrhoids.Methods and analysis This study will be single-blinded, and recruit 348 patients who are admitted to the Changshu Hospital Affiliated to Nanjing University of Chinese Medicine and fulfil the inclusion criteria from January 2022 to December 2022. Patients will be randomly assigned to the treatment group and the control group in a 1:1 ratio. The statistician will be blinded for the allocation. The treatment group will receive M-TST combined with CACP (M-TST–CACP), while the control group will receive the procedure for prolapse and haemorrhoids. The two groups will receive the same preoperative and postoperative care. The primary outcome will be recurrence rate. The secondary outcomes will be operation time, intraoperative bleeding, incontinence, pain, postoperative complications (severe bleeding, perianal oedema, urinary retention, faecal urgency, skin tags and anal stenosis), prolapse, recovery time, quality of life, Haemorrhoid Severity Score, and Symptom Severity Score.Ethics and dissemination This protocol has been approved by the Clinical Ethics Committee of the Changshu Hospital Affiliated to Nanjing University of Chinese Medicine (approval no. 202102001).Trial registration number ChiCTR2100042750.

ABSTRACT Background: Varicose veins appear above and below the dentate line in mixed hemorrhoids, which seriously affects anal function and quality of life. Aim: To propose an improvement in tissue-selecting therapy repair of anal pad combined with complete anal canal epithelial retention comparing with Milligan-Morgan surgery. Methods: A prospective randomized controlled study was designed enrolling 200 patients with grade III and IV hemorrhoids. They were divided into control and observation groups. The control received Milligan-Morgan surgery, and the observation the modified tissue-selecting therapy stapler combined with complete anal canal preservation surgery. All patients were followed for six months to evaluate the treatment differences. Results: In final, control group included 82 and observation 87. The average operation time of the control group was significantly lower than that of the observation, while the bleeding volume was significantly lower in control group. The control group VAS score was 3 (1, 4), and observation 4 (2, 5). There was no significant difference in the incidence of urinary retention, bleeding and wound margin edema after surgery at one month postoperatively. Digital incidence of anal stenosis in the observation group was significantly lower than in control; the same occurred with residual anal margins. The postoperative anal canal diameter was significantly larger than the control group. Wexner anal incontinence score showed that no anal incontinence occurred in both groups, and the control group scored was significantly higher than observation. In final six months follow-up, the observation group did not experience any relapse and four cases were found among controls. The treatment satisfaction of the observation group was better. Conclusions: In grades III and IV hemorrhoids, modified tissue-selecting therapy combined with complete anal canal preservation had better prognosis and treatment satisfaction than Milligan-Morgan procedure, and it is a new surgical method for patients with advanced mixed hemorrhoids.

Jinghai Yellow chickens are a new indigenous breed with a dual purpose in China, but their egg laying performance is limited. Compared with white light (WL), exposure to red light (RL) can improve the egg laying performance of hens. Herein, to elucidate the molecular mechanism by which RL affects the egg laying performance, RNA sequencing was used to analyze long noncoding RNAs (lncRNAs) and mRNAs from granulosa cells of small yellow follicles from Jinghai Yellow chickens in RL and WL groups. A total of 12,466 lncRNAs were identified among the assembled transcripts, of which 168 lncRNAs were significantly different between the RL and WL groups (101 downregulated and 67 upregulated). Additionally, 1182 differentially expressed mRNAs were identified (958 downregulated and 224 upregulated). Integrated network analysis demonstrated that numerous differential mRNAs were involved in follicular development through steroid hormone synthesis, oocyte meiosis, and the PI3K-Akt signaling pathway. The impact of lncRNAs on cis and trans target mRNAs indicates that some lncRNAs play important roles in follicular development of small yellow follicles. The results provide a starting point for studies aimed at understanding the molecular mechanisms by which monochromatic light affects follicular development and egg production in hens.

Anaplastic thyroid cancer (ATC) is a highly aggressive and the most lethal type of thyroid cancer. The standard-of-care for unresectable ATC is radiotherapy and chemotherapy, usually based on doxorubicin (Dox). However, most patients develop resistance shortly after treatment. To overcome the drug resistance, we synthesized the mesoporous organosilica nanoparticles (MONPs) loaded with Dox and stabilized the nanocomposites by bovine serum albumin (BSA). The surface area and pore volume of MONPs were 612.653 m2/g and 0.589 cm3/g. The loading capacity of Dox-MONPs reached 47.02%. Compared to Dox-MONPs and free Dox, BSA-Dox-MONPs had more durable tumor-killing power on both drug-sensitive cell line HTh74 and drug-resistant cell line HTh74R. The cellular uptake of BSA-Dox-MONPs was 28.14 and 65.53% higher than that of Dox-MONP in HTh74 and HTh74R. Furthermore, the BSA coating decreased the efflux rate of nanocomposites in HTh74 (from 38.95 to 33.05%) and HTh74R (from 43.03 to 32.07%). In summary, BSA-Dox-MONPs reversed the chemotherapy resistance of ATC cells via increased drug uptake and inhibited drug efflux, offering a promising platform for the treatment of chemo-resistant ATC.

Abstract Background The aim of this study is to investigate the combined value of fT3 and GRACE risk score for cardiovascular prognosis in ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods Three hundred and thirty eight patients with STEMI who received successful primary PCI were enrolled in our study. All patients underwent (33.5 ± 7.1) month’s follow-up. Mace was defined as cardiac death and nonfatal myocardial infarction. Results Multivariate Cox analysis showed that both fT3 (HR = 0.462, 95%CI: 0.364–0.587, P

Energy-efficient microprocessors are essential for a wide range of applications. While near-threshold computing is a promising technique to improve energy efficiency, optimal supply demands from logic core and on-chip memory are conflicting. In this paper, we perform static reliability analysis of 6T SRAM and discover the variance among different sizing configuration and asymmetric minimum voltage requirements between read and write operations. We leverage this asymmetric property i n near-threshold processors equipped with voltage boosting capability by proposing an opportunistic dual-supply switching scheme with a write aggregation buffer. Our results show that proposed technique improves energy efficiency by more than 21.45% with approximate 10.19% performance speed-up.

The CDIO teaching mode is one kind of the engineering education concept, and now it is gradually adopted in English language teaching. Integrated English is one of the basic courses for English major students, and adopting the CDIO teaching mode in this course can improve different abilities of English major students, such as the professional knowledge of English, ability to find and solve the problems, self-learning ability, related employment ability, critical thinking ability, teamwork spirit and innovation ability.

Abstract Background Inflammatory bowel disease (IBD) is a progressive and debilitating inflammatory disease of the gastrointestinal tract (GIT). Despite recent advances, precise treatment and noninvasive monitoring remain challenging. Methods Herein, we developed orally-administered, colitis-targeting and hyaluronic acid (HA)-modified, core-shell curcumin (Cur)- and cerium oxide (CeO2)-loaded nanoprobes (Cur@PC-HA/CeO2 NPs) for computed tomography (CT) imaging-guided treatment and monitoring of IBD in living mice. Results Following oral administration, high-molecular-weight HA maintains integrity with little absorption in the upper GIT, and then actively accumulates at local colitis sites owing to its colitis-targeting ability, leading to specific CT enhancement lasting for 24 h. The retained NPs are further degraded by hyaluronidase in the colon to release Cur and CeO2, thereby exerting anti-inflammatory and antioxidant effects. Combined with the ability of NPs to regulate intestinal flora, the oral NPs result in substantial relief in symptoms. Following multiple treatments, the gradually decreasing range of the colon with high CT attenuation correlates with the change in the clinical biomarkers, indicating the feasibility of treatment response and remission. Conclusion This study provides a proof-of-concept for the design of a novel theranostic integration strategy for concomitant IBD treatment and the real-time monitoring of treatment responses.

Given the characteristics of the flexible job-shop scheduling problem and the practical production of a given enterprise, a flexible job-shop scheduling model was proposed to minimize the maximum completion time. A novel algorithm was proposed to solve the model by integrating the dung beetle optimization algorithm and the simulated annealing algorithm. Algorithmic improvements include the design of a single-layer process encoding scheme with machine selection during decoding to ensure a higher level of the initial population. During population update, the dung beetle optimization algorithm was applied for optimization, followed by simulated annealing operations to enhance the convergence speed and solution quality of the algorithm. Through simulation experiments and comparisons with other algorithms, the effectiveness and superiority of the proposed algorithm were validated. In addition, the feasibility of the algorithm was tested through a real-world factory production case. In conclusion, the improvements made in this paper to the algorithms and scheduling models offer valuable insights into the educational aspects of job-shop scheduling. For instance, the single-layer encoding proposed herein simplifies the coding process, making it more accessible for beginners. Additionally, the accompanying decoding strategy yields relatively higher-quality initial solutions, facilitating subsequent optimization processes by accelerating convergence without compromising solution quality. Students were able to gain a better understanding of real workshop conditions through this project, going beyond the sole goal of minimizing completion time. They began to consider more complex situations in the machining process, such as machine breakdowns, changes in machining schedules, and the load on bottleneck machines and total machine load. This allowed students to have a holistic view of a complex production workshop. In terms of education, the project improved students' ability to consider practical aspects when solving problems and provided them with a way to solve problems.

Abstract Previous prospective memory (PM) studies indicate that PM intentions remain active after completion and result in commission errors. In this study, we aimed to investigate the effect of adding a new PM intention in the finished phase on PM commission errors. Eighty-six participants were randomly allocated to one of three groups: a new PM group, a non-new PM group, and an implementation intention group. In the PM finished phase, the non-new PM group performed the 1-back task only, while the new PM group was asked to complete both the 1-back task and a new PM task simultaneously. The implementation intention group adopted the “if-then” encoding strategy to encode the new PM intention and executed a new PM task while performing an ongoing task. We found no difference in the 1-back task among the three groups, but the main difference was reflected in the commission error rate with the rate being highest in the non-new PM group, followed by the new PM group, and lowest in the implementation intention group. These findings suggest that executing a new PM task after the completion of a PM intention or adopting an implementation intention encoding strategy to form a new intention effectively reduces commission errors. Therefore, in real life, when we form new prospective memory intentions, we can strengthen them through encoding strategies during the encoding stage, in order to avoid the occurrence of commission errors as much as possible.

Abstract Background Prospective memory (PM) refers to the ability to perform planned activities in the appropriate future situations. It needs to be planned in advance and processed through multiple stages such as encoding, retention, retrieval, and execution, which usually require more attention resources. Impulsivity trait individuals are usually characterized by lack of consideration, premature expression, excessive risk-taking and easy to make inappropriate reaction, so they are more likely to show disadvantages in PM. Nevertheless, increasing the importance of PM tasks can promote more adequate and effective cue encoding, and encourage individuals to devote attention to PM tasks, which may change the disadvantage of impulsivity individuals in PM performance. Methods In this study, the between-subjects design of 2 (trait type: high-impulsivity trait, low-impulsivity trait) ×2 (task importance: important, unimportant) was adopted in the experiment, the 2-back task was used for the ongoing task, and the focal cues were used for the PM task cues. Results The results showed that the PM accuracy of high-impulsivity trait individuals was lower than that of low-impulsivity trait individuals under the task unimportant condition, but there was no difference between the two traits groups under the task important condition. Conclusions The results of this study suggested that high-impulsivity trait individuals had a deficit in PM performance, but emphasizing the importance of PM tasks can compensate for their disadvantage in PM performance.