Search

Introduction Cardiopulmonary complications and cognitive impairment following craniotomy have a significantly impact on the general health of individuals with brain tumours. Observational research indicates that engaging in walking is linked to better prognosis in patient after surgery. This trial aims to explore whether walking exercise prior to craniotomy in brain tumour patients can reduce the incidence of cardiopulmonary complications and preserve patients’ cognitive function.Methods and analysis In this randomised controlled trial, 160 participants with supratentorial brain tumours aged 18–65 years, with a preoperative waiting time of more than 3–4 weeks and without conditions that would interfere with the trial such as cognitive impairment, will be randomly assigned in a ratio of 1:1 to either receive traditional treatment or additional combined with a period of 3–4 weeks of walking exercise of 10 000–15 000 steps per day. Wearable pedometer devices will be used to record step counts. The researchers will evaluate participants at enrolment, baseline, 14 days preoperatively, 3 days prior to surgery and 1 week after surgery or discharge (select which occurs first). The primary outcomes include the incidence of postoperative cardiopulmonary complications and changes in cognitive function (gauged by the Montreal Cognitive Assessment test). Secondary outcomes include the average length of hospital stay, postoperative pain, participant contentment, healthcare-associated costs and incidence of other postoperative surgery-related complications. We anticipate that short-term preoperative walking exercises will reduce the incidence of surgery-related complications in the short term after craniotomy, protect patients’ cognitive function, aid patients’ postoperative recovery and reduce the financial cost of treatment.Ethics and dissemination The study protocol has been approved by Ethics Committee of Xiangya Hospital of Central South University (approval number: 202305117). The findings of the research will be shared via publications that have been reviewed by experts in the field and through presentations at conferences.Trial registration number NCT05930288.

AimsTo evaluate the effectiveness of a multicomponent exercise intervention and to clarify the underlying mechanisms of the program in community-dwelling older adults with cognitive frailty. Additionally, the perception of participants in the program will be explored.DesignA mixed-methods design, including a randomized controlled trial and an exploratory qualitative study, was used.MethodsEach group consists of 41 participants. The experimental group will undergo a 12-week multicomponent exercise intervention, including warm-up, exergaming aerobic exercise, elastic-band resistance exercise, and cool-down. This intervention was developed based on the Health Belief Model (HBM) and Self-Efficacy Model (SEM). The control group will not receive any intervention. Physical frailty and cognitive function will be considered as primary outcomes. Data will be collected both at baseline and at the end of the intervention period. Fisher’s exact test, analysis of covariance, and generalized linear models will be conducted to compare mean changes between the two groups. Additionally, the mediation models will be used to examine whether any intervention effects are mediated through exercise self-efficacy.DiscussionThe findings of this study are anticipated to provide valuable insights for healthcare providers, enabling them to learn about effective strategies to enhance exercise adherence and promote improved functionality, independence, and quality of life for older adults with cognitive frailty.Clinical trial registration: [https://clinicaltrials.gov/], identifier [ChiCTR2200058850].

AbstractStorm surge-induced flooding (SSIF) is a major hazard for coastal areas under intensified typhoons. Therefore, it is essential to assess the potential impacts of SSIF (SSPIA). This study proposes a multidisciplinary framework for refined SSPIA using an ocean model and a refined exposure estimation method. First, a finite-volume coastal ocean model (FVCOM) and a typhoon model were developed and validated. Then, five scenarios of varying intensity were defined and combined with FVCOM to identify inundation scenarios. Subsequently, machine learning was used to obtain the fine-scale gridded population and gross domestic product (GDP) maps based on the census and geospatial data. Finally, we assessed the magnitude of the affected population and GDP based on the inundation scenarios and refined exposure datasets. We selected Zhoushan Island as a study area to implement this framework. Our assessment results show that the lowest scenario (955 hPa) affected 2587 people and 323.745 million CNY of GDP, while the highest scenario (915 hPa) affected 259,516 people and 20,178.898 million CNY of GDP. Therefore, it is imperative to implement effective mitigation and adaptation measures to address the threat of SSIF. This framework will apply to all flood-prone areas for a refined assessment of the potential impacts of SSIF.

Abstract Cancer of unknown primary site(CUPs) is a metastatic syndrome with an unidentifiable primary tumor, even after extensive workup to seek the primary site. CUPs accounts for about 3%-5% of the total number of all cancer diagnoses worldwide. The current precision medicine era has reclassified patients with CUPs into the favorable and unfavorable prognostic subset. In this study clinical characteristics and treatment of patients of CUPs were retropactively analysed. Thirty-two patients treated from July 2016 to October 2021 were included in the Affiliated Tumor Hospital of Tianjin Medical University(Tianjin, China).Common symptoms were anemia, fever, enlarged lymph nodes, abdominal pain, edema/multiple serous cavity effusion. Patients with good prognostic factors achieved good outcomes with treatment, conversely, patients with poor prognosis were generally treated empirically and had poorer outcomes. After anti-tumor treatment, the total effective rate was 41 percent(41% was the percentage of patients who achievedtumour respons). To the end of follow-up, after anti-tumor treatment, the median Overall Survival(OS) of patients was 5.4 months.

IntroductionOur previous studies showed that Xiangya Hospital Circuit Training (X-CircuiT) effectively improved physical fitness and reversed pre-frailty in community-dwelling older adults. This study aimed to explore the generalizability and applicability of X-CircuiT in different aged populations in the context of exercise intensity and energy expenditure.MethodsWe prospectively recruited 72 community-dwelling sedentary adults, twelve adults divided into 6 age groups ranging from 20 to 80 years old and separated by decades. Cardiopulmonary exercise testing was performed to determine peak heart rate (HRpeak). An individual HR-oxygen consumption regression equation was fit for each participant, and then a session of remote heart rate monitored X-CircuiT was performed. Exercise intensity (%HRpeak) and energy expenditure of X-CircuiT among the six age groups were assessed. Further sub-analysis was conducted by dividing the participants by peak metabolic equivalent (MET) values,

BackgroundIrritable bowel syndrome (IBS) is a common disorder of gut-brain interaction with challenging treatment. According to evidence-based studies, acupuncture is likely to be a promising therapy and subservient adjunct for IBS. Mechanism study of acupuncture based on related clinical trials of high quality, nevertheless, is still vacant.AimThis study aims to assess the results and qualities of current clinical evidence and conclude the relevant pathophysiological mechanisms and therapeutic effects of acupuncture on IBS with diarrhea (IBS-D).MethodsLiterature from four databases, namely, PubMed, Cochrane Library, EMBASE, and Web of Science, was systematically searched to obtain eligible randomized controlled trials (RCTs), which contained mechanism research of acupuncture treatment in IBS-D patients. Two independent reviewers completed data extraction and quality evaluation using the RevMan 5.4.1 software.ResultsTen trials that covered 19 items related to mechanism research were included in this review. Acupuncture was reported to improve IBS-D symptoms and quality of life, with positive effects in regulating brain-gut peptides, cerebral activities, neuroendocrine functions, psychological state, and inflammatory GI and hypersensitive intestinal tracts.ConclusionAcupuncture has potential influence on pathophysiology alterations such as regulating brain-gut peptides, altering cerebral connectivity and activity, promoting neuroendocrine functions and mental state, and mitigating inflammation as well as hypersensitivity of bowels in IBS-D patients, but further studies of high quality are still necessary.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022320331].

Objective To investigate the clinical features of AIHA/ES patients with clonal Ig/TCR gene rearrangement. Methods Ig/TCR gene rearrangements were measured by BIOMED-2 PCR. 44 primary AIHA/ES patients were enrolled in the study. Clinical characteristics were analyzed and compared between patients with and without clonal Ig/TCR gene rearrangement. Results Clonal Ig/TCR rearrangements were identified in 34.09% (15/44) patients including 18.18% (8/44) clonal Ig rearrangement and 15.91% (7/44) clonal TCR rearrangement. 11.37% (5/44) patients showed TCR γ rearrangement, and 2.27% (1/44) patient showed β rearrangement. 2.27% (1/44) patient showed both γ and β chain rearrangement. The median ages of patients with Ig/TCR clonality (8 male and 7 female) and without Ig/TCR clonality (10 male and 19 female) were 60 (16 ∼ 81) and 53 (17 ∼ 78) years old, respectively. No significant differences were found in age or gender between the two groups (p = .26, p = .378). Hb and RBC of patients with Ig/TCR clonality [(64.31 ± 5.72) g/L, (1.78 ± 0.22) × 1012/L] were significantly lower than those of patients without Ig/TCR clonality (p = .0053 and p = .0189, respectively). The percentage of reticulocytes of Ig/TCR clonality group was obviously higher than that of patients without Ig/TCR clonality (p = .0248). No significant differences were found in levels of TBIL, IBIL, LDH, FHb, Hp, IgG, IgA, IgM, IgE, C3, C4, CD5+CD19+/CD19+ ratio, and CD3+CD4+/CD3+CD8+ ratio between the two groups. Treatment response of Ig/TCR clonality group occurred significantly later than that of the non-clonality group (p = .0016). There were no differences in relapse rate, time to recurrence, and duration of remission between two groups (p = .083, p = .72, and p = .61, respectively). Conclusion AIHA/ES patients with clonal Ig/TCR gene rearrangement presented more severe haemolysis and anaemia. Longer treatment is needed for these patients to obtain remission.

Inositol polyphosphate-4-phosphatase type II (INPP4B) has been identified as a tumor suppressor, while little is known about its expression and function in multiple myeloma (MM). In this study, we evaluated the expression of INPP4B in 28 cases of newly diagnosed MM patients and 42 cases of extramedullary plasmacytoma (EMP) patients compared with normal plasma cells and found that low INPP4B expression was correlated with poor outcomes in MM patients. Moreover, expression of INPP4B in seven MM cell lines was all lower than that in normal plasma cells. In addition, loss of function of INPP4B promoted cell proliferation in MM cells; however, gain of function suppressed MM cells proliferation and arrested the cell cycle at G0/G1 phage. Meanwhile, knockdown of INPP4B enhanced resistance, but overexpression promoted sensitivity to bortezomib treatment in MM cells. Mechanistically, we found that INPP4B exerted its role via inhibiting the phosphorylation of Akt at lysine 473 but not threonine 308, which attenuated the activation of the PI3K/Akt/mammalian target of rapamycin (mTOR) signaling pathway. Therefore, we identified an inhibitory effect of INPP4B in MM, and our findings suggested that loss of INPP4B expression is a risk factor of aggressive MM.

This paper carries out the transient behaviors of a thin rectangular plate considering different boundary conditions, Pasternak foundation, and thermal environment simultaneously. The governing differential equations of the system are derived by employing the Kirchhoff’s classical plate theory and Hamilton’s principle. This paper proposes a novel semi-analytical methodology, which integrates Laplace transform, the one-dimensional differential quadrature method, Fourier series expansion technique, and Laplace numerical inversion to analyze plates’ transient response. The proposed method can obtain dynamic response of the rectangular efficiently and accurately, which fills the gap of transient behaviors in semi-analytical method. A comparison between semi-analytical results and numerical solutions from the publication on this subject is presented to verify the method. Specifically, the results also agree well with the data generated by the Navier’s method. The convergence tests indicate that the semi-analytical algorithm is a quick convergence method. The effects of various variables, such as geometry, boundary conditions, temperature, and the coefficients of the Pasternak foundation, are further studied. The parametric studies show that geometry and temperature change are significant factors that affect the dynamic response of the plate.

Non-side-looking airborne radar provides important applications on account of its all-round multi-angle airspace coverage. However, it suffers clutter range dependence that makes the samples fail to satisfy the condition of being independent and identically distributed (IID), and it severely degrades traditional approaches to clutter suppression and target detection. In this paper, a novel reweighted extreme learning machine (ELM)-based clutter suppression and range compensation algorithm is proposed for non-side-looking airborne radar. The proposed method involves first designing the pre-processing stage, the special reweighted complex-valued activation function containing an unknown range compensation matrix, and two new objective outputs for constructing an initial reweighted ELM-based network with its training. Then, two other objective outputs, a new loss function, and a reverse feedback framework driven by the specifically designed objectives are proposed for the unknown range compensation matrix. Finally, aiming to estimate and reconstruct the unknown compensation matrix, special processes of the complex-valued structures and the theoretical derivations are designed and analyzed in detail. Consequently, with the updated and compensated samples, further processing including space–time adaptive processing (STAP) can be performed for clutter suppression and target detection. Compared with the classic relevant methods, the proposed algorithm achieves significantly superior performance with reasonable computation time. It provides an obviously higher detection probability and better improvement factor (IF). The simulation results verify that the proposed algorithm is effective and has many advantages. [ABSTRACT FROM AUTHOR]

Summary: TET2 is a methylcytosine dioxygenase that regulates cytosine hydroxymethylation. Although there are extensive data implicating a pivotal role of TET2 in hematopoietic stem/progenitor cells (HSPCs), the importance of TET2 in bone marrow mesenchymal stromal cells (BMSCs) remains unknown. In this study, we show that loss of TET2 in BMSCs increases cell proliferation and self-renewal and enhances osteoblast differentiation potential of BMSCs, which may in turn alter their behavior in supporting HSPC proliferation and differentiation. In addition, Tet2 loss alters BMSCs in promoting Tet2-deficiency-mediated myeloid malignancy progression. Tet2 loss in BMSCs also dysregulates hydroxylation of 5-methylcytosine (5mC) and the expression of genes that are key for BMSC proliferation and osteoblast differentiation, leading to alteration of biological characteristics in vivo. These results highlight the critical role of TET2 in the maintenance of BMSC functions and osteoblast differentiation and provide evidence that dysregulation of epigenetic modifiers in BMSCs contributes to the progression of myeloid malignancies.

Bone marrow metastasis (BMM) refers to the metastasis of malignant tumours originating from nonhematopoietic tissues to the bone marrow. The nonhematopoietic malignant tumour cells metastasize to the bone marrow via heterogeneous dissemination or direct invasion to form metastases and the bone marrow is infiltrated by tumour cells, resulting in the destruction of its structure and the development of haematopoietic disorders. In the present study, the clinical characteristics, prognosis and treatment of BMMs were investigated. The main clinical manifestations were moderate anaemia and thrombocytopenia. Out of 52 cases, a total of 18 patients were not treated and the remaining patients underwent chemotherapy, radiotherapy, surgery or autologous stem cell transplantation in the Affiliated Tumour Hospital of Tianjin Medical University from September 2010 to October 2021. The primary tumours of bone marrow metastatic cancer were usually neuroblastoma and tumours originating from the breast and stomach. When bone metastases occur, patients are not necessarily accompanied by BMMs. In the present study, bone metastases occurred mainly in patients with breast and prostate cancers. The median overall survival of patients treated with antitumor therapy was significantly higher than that of untreated patients (11.5 vs. 3.3 months P<0.01). For patients with BMM, it is of great importance to actively evaluate the patient's condition and select the appropriate treatment plan for improving their prognosis. [ABSTRACT FROM AUTHOR]

Moving targets always defocus and shift outside the scene in video synthetic aperture radar (video SAR) image sequences. However, the shadows of moving targets are immune to these issues and can reveal the true position of the moving targets. As such, by tracking the shadows of moving targets in the video SAR image sequence, it becomes feasible to keep track of these targets. Nevertheless, due to the small pixel size and time-varying characteristics of the target shadow, current prevailing tracking methods often prove insufficient for direct tracking of the shadow. In this letter, a shadow-assisted tracking method for moving targets based on a multilevel discriminant correlation filters network (MDCFnet) is proposed. Primarily, we designed a reverse feature pyramid network (RFPN) that integrates multiple high-level features into low-level features to obtain multiple features with higher distinguishability and resolution, thereby enhancing the final tracking accuracy and precision. Furthermore, we devised multilevel discriminant correlation filters (MDCFs) to perform filtering tracking under multiple feature maps. Real dataset processing results are provided to demonstrate that the proposed method outperforms other state-of-the-art methods. [ABSTRACT FROM AUTHOR]

TET1/2/3 are methylcytosine dioxygenases that regulate cytosine hydroxymethylation. Tet1/2 are abundantly expressed in HSC/HPCs and are implicated in hematological malignancies. Tet2 deletion in mice causes myeloid malignancies, while Tet1-null mice develop B cell lymphoma after an extended period of latency. Interestingly, TET1/2 are often concomitantly downregulated in acute B-lymphocytic leukemia. Here, we investigated the overlapping and non-redundant functions of Tet1/2 using Tet1/2 double-knockout (DKO) mice. DKO and Tet2−/− HSC/HPCs show overlapping and unique 5hmC and 5mC profiles. DKO mice exhibit strikingly decreased incidence and delayed onset of myeloid malignancies in comparison to Tet2−/− mice and in contrast develop lethal B cell malignancies. Transcriptome analysis of DKO tumors reveals expression changes in many genes dysregulated in human B cell malignancies, including LMO2, BCL6, and MYC. These results highlight the critical roles of TET1/2 individually and together in the pathogenesis of hematological malignancies.