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Abstract Background Dysregulation of vascular homeostasis can induce cardiovascular diseases and increase global mortality rates. Although lineage tracing studies have confirmed the pivotal role of modulated vascular smooth muscle cells (VSMCs) in the progression of pathological vascular remodeling, the underlying mechanisms are still unclear. Methods The expression of Tudor-SN was determined in VSMCs of artery stenosis, PDGF-BB-treated VSMCs and atherosclerotic plaque. Loss- and gain-of-function approaches were used to explore the role of Tudor-SN in the modulation of VSMCs phenotype both in vivo and in vitro. Results In this study, we demonstrate that Tudor-SN expression is significantly elevated in injury-induced arteries, atherosclerotic plaques, and PDGF-BB-stimulated VSMCs. Tudor-SN deficiency attenuates, but overexpression aggravates the synthetic phenotypic switching of VSMCs and pathological vascular remodeling. Loss of Tudor-SN also reduces atherosclerotic plaque formation and increases plaque stability. Mechanistically, PTEN, the major regulator of the MAPK and PI3K-AKT signaling pathways, plays a vital role in Tudor-SN-mediated regulation on proliferation and migration of VSMCs. Tudor-SN facilitates the polyubiquitination and degradation of PTEN via NEDD4-1, thus exacerbating vascular remodeling under pathological conditions. BpV (HOpic), a specific inhibitor of PTEN, not only counteracts the protective effect of Tudor-SN deficiency on proliferation and migration of VSMCs, but also abrogates the negative effect of carotid artery injury-induced vascular remodeling in mice. Conclusions Our findings reveal that Tudor-SN deficiency significantly ameliorated pathological vascular remodeling by reducing NEDD4-1-dependent PTEN polyubiquitination, suggesting that Tudor-SN may be a novel target for preventing vascular diseases.

Abstract Background Annual epidemics of respiratory syncytial virus (RSV) had consistent timing and intensity between seasons prior to the SARS-CoV-2 pandemic (COVID-19). However, starting in April 2020, RSV seasonal activity declined due to COVID-19 non-pharmaceutical interventions (NPIs) before re-emerging after relaxation of NPIs. We described the unusual patterns of RSV epidemics that occurred in multiple subsequent waves following COVID-19 in different countries and explored factors associated with these patterns. Methods Weekly cases of RSV from twenty-eight countries were obtained from the World Health Organisation and combined with data on country-level characteristics and the stringency of the COVID-19 response. Dynamic time warping and regression were used to cluster time series patterns and describe epidemic characteristics before and after COVID-19 pandemic, and identify related factors. Results While the first wave of RSV epidemics following pandemic suppression exhibited unusual patterns, the second and third waves more closely resembled typical RSV patterns in many countries. Post-pandemic RSV patterns differed in their intensity and/or timing, with several broad patterns across the countries. The onset and peak timings of the first and second waves of RSV epidemics following COVID-19 suppression were earlier in the Southern than Northern Hemisphere. The second wave of RSV epidemics was also earlier with higher population density, and delayed if the intensity of the first wave was higher. More stringent NPIs were associated with lower RSV growth rate and intensity and a shorter gap between the first and second waves. Conclusion Patterns of RSV activity have largely returned to normal following successive waves in the post-pandemic era. Onset and peak timings of future epidemics following disruption of normal RSV dynamics need close monitoring to inform the delivery of preventive and control measures.

Abstract. Background:. Patients who undergo coronary artery bypass grafting (CABG) are known to be at a significant risk of experiencing long-term adverse events, emphasizing the importance of regular assessments. Evaluating health-related quality of life (HRQoL) serves as a direct method to gauge prognosis. Our objective is to ascertain the prognostic significance of consecutive HRQoL assessments using the Physical Component Summary (PCS) and Mental Component Summary (MCS) derived from the Short-Form 36 (SF-36) health survey in CABG patients. Methods:. The study population consisted of 433 patients who underwent isolated elective CABG at Fuwai Hospital between 2012 and 2013. SF-36 assessments were conducted during both the hospitalization period and follow-up. The primary endpoint of the study was all-cause mortality, while the secondary outcome was a composite measure including death, myocardial infarction, stroke, and repeat revascularization. We assessed the relationships between the PCS and MCS at baseline, as well as their changes during the first 6 months after the surgery (referred to as ΔPCS and ΔMCS, respectively), and the observed outcomes. Results:. The patients were followed for an average of 6.28 years, during which 35 individuals (35/433, 8.1%) died. After adjusting for clinical variables, it was observed that baseline MCS scores (hazard ratio [HR] for a 1-standard deviation [SD] decrease, 1.57; 95% confidence interval [CI], 1.07–2.30) and ΔMCS (HR for a 1-SD decrease, 1.67; 95% CI, 1.09–2.56) were associated with all-cause mortality. However, baseline PCS scores and ΔPCS did not exhibit a significant relationship with all-cause mortality. Notably, there was a dose-response relationship observed between ΔMCS and the likelihood of all-cause mortality (HRs for the 2nd, 3rd and 4th quartiles compared to the 1st quartile, 0.33, 0.45 and 0.11, respectively). Conclusions:. Baseline MCS and changes in MCS were independent predictors for long-term mortality of CABG. Better mental health status and recovery indicated better prognosis.

With the massive access to sensing, measuring, and user-side intelligent terminal devices, the functionalities and applications at the edge-side of digital distribution networks have become significantly enriched. However, the limited computation resources of edge computing devices must be utilized efficiently to achieve various functions, presenting challenges to resource scheduling within digital distribution networks. To tackle these challenges, this paper proposes an optimal resource scheduling method for multi-functional edge computing devices. The collaborative processing relationships of multi-functional applications for edge computing devices in digital distribution networks are analyzed to achieve various functions. These applications are further abstracted into computational task models with different characteristics. On this basis, constraints for resource scheduling are established, including the logical relationships between tasks, the multi-core configuration, and the resource limitation of devices. With the proposed scheduling method, computation resources of the edge computing device can be optimally allocated to different tasks, achieving multiple objectives such as reducing the process latency, avoiding task abandonment, and maximizing resource backup. The results of the case study indicate that using the proposed method, the overall task completion time is reduced by 20%, the task processing success rate increases to 95%, and the adequate resource reservation ratio improves to 40%.

ObjectiveThis study aimed to determine if patients with chronic ankle instability (CAI) exhibit biomechanical changes associated with the increased risk of anterior cruciate ligament (ACL) injury during landing tasks.Study DesignThis study was conducted through systematic review and meta-analysis.Data SourcesSearches were conducted in May 2024 across five electronic databases, including Web of Science, Scopus, PubMed, SPORTDiscus, and Cochrane Library.Eligibility CriteriaStudies were included if they (1) involved subjects with CAI and healthy controls and (2) assessed biomechanical variables such as ground reaction forces, joint angles, and joint torques.ResultsOf the 675 identified studies, 171 were included in the review, and 13 were eligible for meta-analysis. The reviewed studies clearly defined research objectives, study populations, consistent participant recruitment, and exposures, and they used valid and reliable measures for outcomes. However, areas such as sample size calculation, study sample justification, blinding in assessments, and addressing confounders were not robust. This meta-analysis involved 542 participants (healthy group: n = 251; CAI group: n = 291). Compared with healthy individuals, patients with CAI exhibited a greater peak vertical ground reaction force (peak VGRF; SMD = 0.30, 95% CI: 0.07–0.53, p = 0.009), reduced hip flexion angles (SMD = −0.30, 95% CI: −0.51 to −0.17, p < 0.0001), increased trunk lateral flexion (SMD = 0.47, 95% CI: 0.05 to 0.9, p = 0.03), greater hip extension moments (SMD = 0.47, 95% CI: 0.09–0.84, p = 0.02), and increased knee extension moments (SMD = 0.39, 95% CI: 0.02–0.77, p = 0.04).ConclusionDuring landing tasks, patients with CAI demonstrate increased hip extension moments and knee extension moments, decreased hip flexion angles, increased peak VGRF, and increased trunk lateral flexion angles. These biomechanical variables are associated with an elevated risk of ACL injuries.Systematic Review Registration: Identifier CRD42024529349.

Background Current approaches for initial coronary artery disease (CAD) assessment rely on pretest probability (PTP) based on risk factors and presentations, with limited performance. Infrared thermography (IRT), a non-contact technology that detects surface temperature, has shown potential in assessing atherosclerosis-related conditions, particularly when measured from body regions such as faces. We aim to assess the feasibility of using facial IRT temperature information with machine learning for the prediction of CAD.Methods Individuals referred for invasive coronary angiography or coronary CT angiography (CCTA) were enrolled. Facial IRT images captured before confirmatory CAD examinations were used to develop and validate a deep-learning IRT image model for detecting CAD. We compared the performance of the IRT image model with the guideline-recommended PTP model on the area under the curve (AUC). In addition, interpretable IRT tabular features were extracted from IRT images to further validate the predictive value of IRT information.Results A total of 460 eligible participants (mean (SD) age, 58.4 (10.4) years; 126 (27.4%) female) were included. The IRT image model demonstrated outstanding performance (AUC 0.804, 95% CI 0.785 to 0.823) compared with the PTP models (AUC 0.713, 95% CI 0.691 to 0.734). A consistent level of superior performance (AUC 0.796, 95% CI 0.782 to 0.811), achieved with comprehensive interpretable IRT features, further validated the predictive value of IRT information. Notably, even with only traditional temperature features, a satisfactory performance (AUC 0.786, 95% CI 0.769 to 0.803) was still upheld.Conclusion In this prospective study, we demonstrated the feasibility of using non-contact facial IRT information for CAD prediction.

Abstract Knowledge distillation can transfer the knowledge from the pre-trained teacher model to the student model, thus effectively accomplishing model compression. Previous studies have carefully crafted knowledge representation, targeting loss function design, and distillation location selection, but there have been few studies on the role of classifiers in distillation. Previous experiences have shown that the final classifier of the model has an essential role in making inferences, so this paper attempts to narrow the gap in performance between models by having the student model directly use the classifier of the teacher model for the final inference, which requires an additional projector to help match features of the student encoder with the teacher's classifier. However, a single projector cannot fully align the features, and integrating multiple projectors may result in better performance. Considering the balance between projector size and performance, through experiments, we obtain the size of projectors for different network combinations and propose a simple method for projector integration. In this way, the student model undergoes feature projection and then uses the classifiers of the teacher model for inference, obtaining a similar performance to the teacher model. Through extensive experiments on the CIFAR-100 and Tiny-ImageNet datasets, we show that our approach applies to various teacher–student frameworks simply and effectively.

Abstract Organic co-crystals offer an opportunity to fabricate organic functional materials. Traditional co-crystals are generally packed following the segregated or mixed stacking mode, leading to the lack of structural and functional diversity. Herein, we report three sets of macrocycle co-crystals with identical co-constitutions. The macrocycle co-crystals differ in the stoichiometric ratios (2:1, 1:1, and 2:3) of the constituents and molecular packing modes. The co-crystals are constructed using triangular pyrene-macrocycle and 1,2,4,5-tetracyanobenzene exploiting exo-wall charge-transfer interactions. Interestingly, the three co-crystals exhibit distinct, tunable emission properties. The corresponding emission peaks appear at 575, 602, and 635 nm, covering yellow via orange to red. The X-ray diffraction analyses and the density functional theory calculations reveal the superstructure-property relationships that is attributed to the formation of different ratios of charge-transfer transition states between the donor and acceptor motifs, resulting in red-shifted luminescence.

The objective of this study was to explore the braking technical characteristics of the swing leg of elite male athletes in long jump take-off and its dependencies on the extension velocity of the support leg and the balance. Two cameras were used to capture 8 elite male long jump athletes (25.88 ± 3.00 years) under competitive conditions at a National Indoor Athletic Championships Final, a 3-D kinematic analysis method was conducted to analyze the take-off technique of the athletes. The results showed that the rapid braking of the swing leg increased the extension velocity of the support leg. Compared to the swing leg that started braking at the moment of maximum knee flexion of the support leg (SPKnee maximum flexion moment), athletes’ performance was greater when swing leg started braking at the moment of maximum ankle flexion of the support leg (SPAnkle maximum flexion moment). Furthermore, the swing leg exhibited an inward movement during its forward swing, and the inward angle was significantly correlated with the balance maintenance (r = - 0.50,P = 0.004). In conclusion, a relatively delayed rapid braking and moderate inward movement of the swing leg during the take-off phase are conducive to achieving a better take-off effect in long jump.

Abstract：: Pearl oyster Pinctada margaritifera is famous for culturing the high-valued round nucleated pearl with prismatic and nacre layer color polymorphism. However, there exists limiting understanding in prismatic and nacre color formation in the species. Herein, we found five colored phenotypes in the Sanya wild population. The five colored phenotypes included black prismatic layer (BP), red prismatic layer (RP), black nacreous layer (BN), red nacreous layer (RN) and golden nacreous layer (GN). The chemical substances and gene expression pattern of five colored phenotypes of P. margaritifera were analyzed. The results showed that the contents of eumelanin, pheomelanin, carotenoids and trace elements (Mn, Mg, Fe) were significantly different between the BP and the RP (P

The blood-brain barrier (BBB) is a selectively semi-permeable layer, crucial in shielding the brain from external pathogens and toxic substances while maintaining ionic homeostasis and sufficient nutrient supply. However, it poses a significant challenge for drugs to penetrate the BBB in order to effectively target brain tumors. Magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT) is a minimally invasive technique that employs thermal energy to cauterize intracranial lesions with the potential to temporarily disrupt the BBB. This further opens a possible therapeutic window to enhance patient outcomes. Here, we review the impact of MRg-LITT on BBB and blood tumor barrier (BTB) and the duration of the BBB disruption. Studies have shown that MRg-LITT is effective due to its minimally invasive nature, precise tumor targeting, and low complication rates. Although the disruption duration varies across studies, the average peak disruption is within the initial two weeks post-ablation period and subsequently exhibits a gradual decline. However, further research involving larger groups with extended follow-up periods is required to determine disruption duration more accurately. In addition, evaluating toxicity and glymphatic system disruption is crucial to circumvent potential risks associated with this procedure.

IntroductionLanguage impairments often result from severe neurological disorders, driving the development of neural prosthetics utilizing electrophysiological signals to restore comprehensible language. Previous decoding efforts primarily focused on signals from the cerebral cortex, neglecting subcortical brain structures’ potential contributions to speech decoding in brain-computer interfaces.MethodsIn this study, stereotactic electroencephalography (sEEG) was employed to investigate subcortical structures’ role in speech decoding. Two native Mandarin Chinese speakers, undergoing sEEG implantation for epilepsy treatment, participated. Participants read Chinese text, with 1–30, 30–70, and 70–150 Hz frequency band powers of sEEG signals extracted as key features. A deep learning model based on long short-term memory assessed the contribution of different brain structures to speech decoding, predicting consonant articulatory place, manner, and tone within single syllable.ResultsCortical signals excelled in articulatory place prediction (86.5% accuracy), while cortical and subcortical signals performed similarly for articulatory manner (51.5% vs. 51.7% accuracy). Subcortical signals provided superior tone prediction (58.3% accuracy). The superior temporal gyrus was consistently relevant in speech decoding for consonants and tone. Combining cortical and subcortical inputs yielded the highest prediction accuracy, especially for tone.DiscussionThis study underscores the essential roles of both cortical and subcortical structures in different aspects of speech decoding.

Background Lipoprotein(a) is a possible causal risk factor for atherosclerosis and related complications. The distribution and prognostic implication of lipoprotein(a) in patients undergoing coronary artery bypass grafting remain unknown. This study aimed to assess the impact of high lipoprotein(a) on the long‐term prognosis of patients undergoing coronary artery bypass grafting. Methods and Results Consecutive patients with stable coronary artery disease who underwent isolated coronary artery bypass grafting from January 2013 to December 2018 from a single‐center cohort were included. The primary outcome was all‐cause death. The secondary outcome was a composite of major adverse cardiovascular and cerebrovascular events. Of the 18 544 patients, 4072 (22.0%) were identified as the high‐lipoprotein(a) group (≥50 mg/dL). During a median follow‐up of 3.2 years, primary outcomes occurred in 587 patients. High lipoprotein(a) was associated with increased risk of all‐cause death (high lipoprotein(a) versus low lipoprotein(a): adjusted hazard ratio [aHR], 1.31 [95% CI, 1.09–1.59]; P=0.005; lipoprotein(a) per 1‐mg/dL increase: aHR, 1.003 [95% CI, 1.001–1.006]; P=0.011) and major adverse cardiovascular and cerebrovascular events (high lipoprotein(a) versus low lipoprotein(a): aHR, 1.18 [95% CI, 1.06–1.33]; P=0.004; lipoprotein(a) per 1‐mg/dL increase: aHR, 1.002 [95% CI, 1.001–1.004]; P=0.002). The lipoprotein(a)‐related risk was greater in patients with European System for Cardiac Operative Risk Evaluation

Background We aimed to develop an administrative model to profile the performance on the outcomes of coronary artery bypass grafting across hospitals in China. Methods and Results This retrospective study was based on the Chinese Hospital Quality Monitoring System (HQMS) from 2016 to 2020. The coronary artery bypass grafting cases were identified by procedure code, and those of 2016 to 2017 were randomly divided into modeling and validation cohorts, while those in other years were used to ensure the model stability across years. The outcome was discharge status as “death or withdrawal,” and that withdrawal referred to discharge without medical advice when patients were in the terminal stage but reluctant to die in the hospital. Candidate covariates were mainly identified by diagnoses or procedures codes. Patient‐level logistic models and hospital‐level hierarchical models were established. A total of 203 010 coronary artery bypass grafts in 699 hospitals were included, with 60 704 and 20 233 cases in the modeling and validation cohorts and 40 423, 42 698, and 38 952 in the years 2018, 2019, and 2020, respectively. The death or withdrawal rate was 3.4%. The areas under the curve were 0.746 and 0.729 in the patient‐level models of modeling and validation cohorts, respectively, with good calibration and stability across years. Hospital‐specific risk‐standardized death or withdrawal rates were 2.61% (interquartile range, 1.87%–3.99%) and 2.63% (interquartile range, 1.97%–3.44%) in the modeling and validation cohorts, which were highly correlated (correlation coefficient, 0.96; P

Abstract Background DCM is a common cardiomyopathy worldwide, which is characterized by ventricular dilatation and systolic dysfunction. DCM is one of the most widespread diseases contributing to sudden death and heart failure. However, our understanding of its molecular mechanisms is limited because of its etiology and underlying mechanisms. Hence, this study explored the underlying molecular mechanism of dilated cardiomyopathy through integrative analysis of data mining, iTRAQ-PRM proteomics and bioinformatics Methods DCM target genes were downloaded from the public databases. Next, DCM was induced in 20 rats by 8 weeks doxorubicin treatment (2.5 mg/kg/week). We applied isobaric tags for a relative and absolute quantification (iTRAQ) coupled with proteomics approach to identify differentially expressed proteins (DEPs) in myocardial tissue. After association analysis of the DEPs and the key target genes, subsequent analyses, including functional annotation, pathway enrichment, validation, were performed. Results Nine hundred thirty-five genes were identified as key target genes from public databases. Meanwhile, a total of 782 DEPs, including 348 up-regulated and 434 down-regulated proteins, were identified in our animal experiment. The functional annotation of these DEPs revealed complicated molecular mechanisms including TCA cycle, Oxidative phosphorylation, Cardiac muscle contraction. Moreover, the DEPs were analyzed for association with the key target genes screened in the public dataset. We further determined the importance of these three pathways. Conclusion Our results demonstrate that TCA cycle, Oxidative phosphorylation, Cardiac muscle contraction played important roles in the detailed molecular mechanisms of DCM.

Abstract Sipuncula is a class of exocoelomic unsegmented animals whose evolutionary relationships are unresolved. The peanut worm Sipunculus nudus is a globally distributed, economically important species belonging to the class Sipuncula. Herein, we present the first high-quality chromosome-level assembly of S. nudus based on HiFi reads and high-resolution chromosome conformation capture (Hi-C) data. The assembled genome was 1,427 Mb, with a contig N50 length of 29.46 Mb and scaffold N50 length of 80.87 Mb. Approximately 97.91% of the genome sequence was anchored to 17 chromosomes. A BUSCO assessment showed that 97.7% of the expectedly conserved genes were present in the genome assembly. The genome was composed of 47.91% repetitive sequences, and 28,749 protein-coding genes were predicted. A phylogenetic tree demonstrated that Sipuncula belongs to Annelida and diverged from the common ancestor of Polychaeta. The high-quality chromosome-level genome of S. nudus will serve as a valuable reference for studies of the genetic diversity and evolution of Lophotrochozoa.

Introduction The implementation of a heart team still faces many challenges which may be facilitated with advanced communication technology. There is a knowledge gap to support the use of an electronic real-time heart team decision-making approach based on communication technology in the real clinical practice and evaluate its safety and feasibility in patients with complex coronary artery disease (CAD).Methods and analysis The EHEART (Electronic HEArt team with Real-Time decision-making) trial is a prospective, multicentre, two-arm, randomised controlled trial that will randomise 490 patients with complex CAD to either an electronic real-time heart team group or conventional heart team group. For patients allocated to the real-time electronic group, heart team meetings will be initiated during the coronary angiography and guided by a supporting system based on communication technology to help with information synchronisation, real-time communication between specialists, meeting process recording and assistance and joint decision-making with patients’ families. The primary and safety endpoint is a composite of all-cause death, myocardial infarction, stroke, revascularisation or re-angina hospital admission at 1 year. The primary secondary outcome is the time interval from the coronary angiography to the final treatment, which is the major indicator of feasibility. We will also compare the practical feasibility from the specialist’s and patient’s perspectives (for example, specialist’s workload and patient’s decision results) between the two groups.Ethics and dissemination The study was approved by the Institutional Review Board (IRB) of Fuwai Hospital (no. 2022-1749). Informed consent will be obtained from all participants. The results of this trial will be disseminated through manuscript publication and national/international conferences, and reported in the trial registry entry.Trial registration number ClinicalTrials.gov Registry (NCT05514210).

Summary: Ebstein’s anomaly is a rare congenital heart disease characterized by tricuspid valve downward displacement and is associated with additional cardiac phenotypes such as left ventricle non-compaction. The genetic basis of Ebstein’s anomaly has yet to be fully elucidated, although several genes (e.g., NKX2-5, MYH7, TPM1, and FLNA) may contribute to Ebstein’s anomaly. Here, in two Ebstein’s anomaly families (a three-generation family and a trio), we identified independent heterozygous nonsense variants in laminin subunit 3 α (LAMA3), cosegregated with phenotypes in families with reduced penetrance. Furthermore, knocking out Lama3 in mice revealed that haploinsufficiency of Lama3 led to Ebstein’s malformation of the tricuspid valve and an abnormal basement membrane structure. In conclusion, we identified a novel gene-disease association of LAMA3 implicated in Ebstein’s anomaly, and the findings extended our understanding of the role of the extracellular matrix in Ebstein’s anomaly etiology.

Abstract Background The optimal glycemic control level in diabetic patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (On-Pump) remains unclear. Therefore, this study aimed to investigate the effect of different blood glucose control levels and glucose fluctuations on in-hospital adverse outcomes in diabetic patients undergoing on-pump CABG. Method A total of 3918 patients with diabetes undergoing CABG were reviewed in this study. A total of 1638 patients were eligible for inclusion and were categorized into strict, moderate and liberal glucose control groups based on post-operative mean blood glucose control levels of

Smart Grid– Grid 2.0, is a promising grid scenario due to its low cost, high reliability, and high security. However, the high-intensity complex task interaction and the differentiated Quality of Service (QoS) requirements pose challenges to the energy orchestration of the dynamic and time-varying smart grid. In addition, Network Virtualization (NV) technology is widely utilized to decouple physical network resources. In this work, based on Virtual Network Embedding (VNE), we propose an energy orchestration strategy to better support the operation and maintenance of Grid 2.0. Specifically, a series of constraint indicators for energy orchestration is first formulated. Second, based on the advantages of Deep Reinforcement Learning (DRL), a five-layer architecture energy orchestration model is proposed. It frequently extracts the grid energy matrix as the state input, adopts two-stage actions to reasonably orchestrate the grid energy, and combines the reward mechanism of DRL to effectively interact with the environment. Finally, we conduct experiments in a simulation environment and demonstrate the advantages of the proposed strategy through analysis and comparison.

The dramatic increase in the volume of users and services makes scheduling network resources for smart grids a key challenge. Network slicing is an important technology to solve this problem. We introduce edge computing networks into the smart grid to intelligently allocate resources based on users’ quality of service (QoS) and available resources. However, existing heuristic resource scheduling algorithms often lead to resource fragmentation and thus fall into local optima. To this end, we propose a deep reinforcement learning (DRL)-based virtual network embedding algorithm to optimize the resource allocation strategy of smart grids from a network virtualization perspective. We extract the network properties of the smart grid to construct a policy network as a training environment for DRL agents. Finally, DRL derives the probability of each node being embedded based on the extracted attributes of edge computing nodes and completes user request (UR) embedding based on this probability. The experimental results show that the algorithm proposed in this paper has excellent performance with guaranteed low latency, 21% improvement in long-term revenue and 5.6% improvement in UR success rate compared with the other two algorithms.

Abstract Purpose To investigate the feasibility of ultra-low-dose CT (ULDCT) reconstructed with the artificial intelligence iterative reconstruction (AIIR) algorithm in total-body PET/CT imaging. Methods The study included both the phantom and clinical parts. An anthropomorphic phantom underwent CT imaging with ULDCT (10mAs) and standard-dose CT (SDCT) (120mAs), respectively. ULDCT was reconstructed with AIIR and hybrid iterative reconstruction (HIR) (expressed as ULDCT-AIIRphantom and ULDCT-HIRphantom), respectively, and SDCT was reconstructed with HIR (SDCT-HIRphantom) as control. In the clinical part, 52 patients with malignant tumors underwent the total-body PET/CT scan. ULDCT with AIIR (ULDCT-AIIR) and HIR (ULDCT-HIR), respectively, was reconstructed for PET attenuation correction, followed by the SDCT reconstructed with HIR (SDCT-HIR) for anatomical location. PET/CT images’ quality was qualitatively assessed by two readers. The CTmean, as well as the CT standard deviation (CTsd), SUVmax, SUVmean, and the SUV standard deviation (SUVsd), was recorded. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated and compared. Results The image quality of ULDCT-HIRphantom was inferior to the SDCT-HIRphantom, but no significant difference was found between the ULDCT-AIIRphantom and SDCT-HIRphantom. The subjective score of ULDCT-AIIR in the neck, chest and lower limb was equivalent to that of SDCT-HIR. Besides the brain and lower limb, the change rates of CTmean in thyroid, neck muscle, lung, mediastinum, back muscle, liver, lumbar muscle, first lumbar spine and sigmoid colon were −2.15, −1.52, 0.66, 2.97, 0.23, 8.91, 0.06, −4.29 and 8.78%, respectively, while all CTsd of ULDCT-AIIR was lower than that of SDCT-HIR. Except for the brain, the CNR of ULDCT-AIIR was the same as the SDCT-HIR, but the SNR was higher. The change rates of SUVmax, SUVmean and SUVsd were within $$\pm$$ ± 3% in all ROIs. For the lesions, the SUVmax, SUVsd and TBR showed no significant difference between PET-AIIR and PET-HIR. Conclusion The SDCT-HIR could not be replaced by the ULDCT-AIIR at date, but the AIIR algorithm decreased the image noise and increased the SNR, which can be implemented under special circumstances in PET/CT examination.

Abstract Background Surveillance for respiratory syncytial virus (RSV) likely captures just a fraction of the burden of disease. Understanding the burden of hospitalizations and disparities between populations can help to inform upcoming RSV vaccine programs and to improve surveillance. Methods We obtained monthly age-, ZIP code- and cause-specific hospitalizations in New York, New Jersey, and Washington from the US State Inpatient Databases (2005–2014). We estimated the incidence of respiratory hospitalizations attributable to RSV by age and by socioeconomic status using regression models. We compared the estimated incidence and the recorded incidence (based on ICD9-CM) of RSV hospitalizations to estimate the under-recorded ratio in different subpopulations. Results The estimated annual incidence of respiratory hospitalizations due to RSV was highest among infants

Abstract Several vaccines and extended half-life monoclonal antibodies (mAbs) against respiratory syncytial virus (RSV) have shown promise in clinical trials. We used age-structured transmission models to predict the possible impact of various RSV prevention strategies including maternal immunization, live-attenuated vaccines, and long-lasting mAbs. Our results suggest that maternal immunization and long-lasting mAbs are likely to be highly effective in preventing RSV hospitalizations in infants under 6 months of age, averting more than half of RSV hospitalizations in neonates. Live-attenuated vaccines could reduce RSV hospitalizations in vaccinated age groups and are also predicted to have a modest effect in unvaccinated age groups because of disruptions to transmission. Compared to year-round vaccination, a seasonal vaccination program at the country level provides at most a minor advantage regarding efficiency. Our findings highlight the substantial public health impact that upcoming RSV prevention strategies may provide.

Summary: Based on high-throughput transcriptomic sequencing, SNHG3 was among the most highly expressed long noncoding RNAs in calcific aortic valve disease. SNHG3 upregulation was verified in human and mouse calcified aortic valves. Moreover, in vivo and in vitro studies showed SNHG3 silencing markedly ameliorated aortic valve calcification. In-depth functional assays showed SNHG3 physically interacted with polycomb repressive complex 2 to suppress the H3K27 trimethylation BMP2 locus, which in turn activated BMP2 expression and signaling pathways. Taken together, SNHG3 promoted aortic valve calcification by upregulating BMP2, which might be a novel therapeutic target in human calcific aortic valve disease.

Abstract Objectives Analysis of FDG‐PET imaging commonly shows that hypometabolism extends into extra‐epileptogenic zones (extra‐EZ). This study investigates the distribution patterns of hypometabolism in frontal lobe epilepsy (FLE) originating in different frontal regions. Methods Sixty‐four patients with FLE were grouped by EZ localization according to Brodmann areas (BAs): Group 1 (the frontal motor and premotor area), BAs 4, 6, and 8; Group 2 (the inferior frontal gyrus and opercular area), BAs 44, 45, and 47; Group 3 (the dorsal prefrontal area), BAs 9, 10, 11, and 46; and Group 4 (the medial frontal and anterior cingulate gyrus), BAs 32 and 24. Regions of extra‐EZ hypometabolism were statistically analyzed between FLE groups and healthy controls. Correlation analysis was performed to identify relationships between the intensity of hypometabolism and clinical characteristics. Results Significant hypometabolism in the ipsilateral (Groups 1 and 4) or bilateral (Groups 2 and 3) anterior insulae was found. Groups 1 and 4 presented with limited distribution of extra‐EZ hypometabolism, whereas Groups 2 and 3 showed widely distributed extra‐EZ hypometabolism in the rectus gyrus, cingulate gyrus, and other regions. Additionally, the intensity of hypometabolism was correlated with epilepsy duration in Groups 2 and 3. Conclusions All FLE groups showed hypometabolism in the anterior insula. In addition, distinct patterns of extra‐EZ hypometabolism were identified for each FLE group. This quantitative FDG‐PET analysis expanded our understanding of the topography of epileptic networks and can guide EZ localization in the future.

Summary: Microplastics (MPs, particle size

Abstract Fast spin manipulation in magnetic heterostructures, where magnetic interactions between different materials often define the functionality of devices, is a key issue in the development of ultrafast spintronics. Although recently developed optical approaches such as ultrafast spin‐transfer and spin–orbit torques open new pathways to fast spin manipulation, these processes do not fully utilize the unique possibilities offered by interfacial magnetic coupling effects in ferromagnetic multilayer systems. Here, ultrafast optically controlled interfacial exchange interactions in the ferromagnetic Co2FeAl/(Ga,Mn)As system at low laser fluence levels are experimentally demonstrated. The excitation efficiency of Co2FeAl with the (Ga,Mn)As layer is 30–40 times higher than the case with the GaAs layer at 5 K due to the modification of exchange coupling interaction via photoexcited charge transfer between the two ferromagnetic layers. In addition, the coherent spin precessions persist to room temperature, excluding the drive of pump‐modulated magnetization in the (Ga,Mn)As layer and indicating a proximity‐effect‐related optical excitation mechanism. The results highlight the importance of interfacial exchange interactions in ferromagnetic heterostructures and how these magnetic coupling effects can be utilized for ultrafast, low‐power spin manipulation.

Due to nonspecific pathological changes and the rapid degradation of insulin in postmortem blood samples, the identification of the cause of death during insulin overdose has always been a difficulty in forensic medicine. At present, there is a lack of studies on the toxicological changes and related mechanisms of an insulin overdose, and the specific molecular markers of insulin overdose are still unclear. In this study, an animal model of insulin overdose was established, and 24 SD rats were randomly divided into a control group, insulin overdose group, and a recovery group (n = 8). We detected the biochemical changes and analyzed the toxicological mechanism of an insulin overdose. The results showed that after insulin overdose, the rats developed irregular convulsions, Eclampsia, Opisthotonos, and other symptoms. The levels of glucose, glycogen, and C-peptide in the body decreased significantly, while the levels of lactate, insulin, and glucagon increased significantly. The decrease in plasma K+ was accompanied by the increase in skeletal muscle K+. The PI3K-AKT signaling pathway was significantly activated in skeletal muscle, and the translocation of GLUT4/Na+-K+-ATPase to sarcolemma was significantly increased. Rare glycogenic hepatopathy occurred in the recovery group after insulin overdose. Our study showed that insulin overdose also plays a role in skeletal muscle cells, mainly through the PI3K-Akt signaling pathway. Therefore, the detection of signaling pathway proteins of the skeletal muscle cell membrane GLUT4 and Na+-K+-ATPase has a certain auxiliary diagnostic value for forensic insulin overdose identification. Glycogen detection in the liver and skeletal muscle is important for the diagnosis of insulin overdose, but it still needs to be differentiated from other causes of death. Skeletal muscle has great potential for insulin detection, and the ratio of insulin to the C-peptide (I:C) can determine whether an exogenous insulin overdose is present.

At present, numerous reflector antennas have been constructed worldwide on land. However, there are few applications of reflector antennas directly set off the coast. To expand the application region of reflector antennas, a floating cylindrical reflector antenna (FCRA) driven by the moving mass was developed to implement the elevation angle adjustment. Firstly, the structure design is introduced in detail. The design parameters are stated and analyzed to obtain the kinematic relationship while considering the water surface constraint. Then, the effects of each variable on the rotation capacity and structural stability are discussed. Further, the feasibility of the elevation angle adjustment process is demonstrated by using a prototype model test and software simulation. Finally, the deformation analyses and shape sensing of the back frame are carried out on the basis of the inverse finite element method (iFEM). We concluded that this new structure is feasible and expected to sit off the coast. In addition, the iFEM algorithm with sub-region reconstruction was proved to be suitable for the shape sensing of the over-constrained FCRA during the angle adjustment process via several quasi-static sampling moments.

Abstract Aims To characterize surgical valvular heart diseases (VHDs) in China and disclose regional variations in VHD surgeries by analyzing the data derived from the Chinese Cardiac Surgery Registry (CCSR). Methods and results From January 2016 to December 2018, we consecutively collected the demographic information, clinical characteristics and outcomes of 38,131 adult patients undergoing valvular surgery in China. We sought to assess the quality of VHD surgery by examining in-hospital deaths of all patients from 7 geographic regions. Using a hierarchical generalized linear model, we calculated the risk-standardized mortality rate (RSMR) of each region. By comparing VHD characteristics and RSMRs, we pursued an investigation into regional variations. The mean age was 54.4 ± 12.4 years, and 47.2% of the patients were females. Among cases, the number of aortic valve surgeries was 9361 (24.5%), which was less than that of mitral valve surgeries (n = 14,506, 38.0%). The number of concurrent aortic and mitral valve surgeries was 6984 (18.3%). A total of 4529 surgical VHD patients (11.9%) also underwent coronary artery bypass grafting (CABG) surgery. The overall in-hospital mortality rate was 2.17%. The lowest RSMR, 0.91%, was found in the southwest region, and the highest RSMR, 3.99%, was found in the northeast. Conclusion Although the overall valvular surgical mortality rate in large Chinese cardiac centers was in line with high-income countries, there were marked regional variations in the characteristics and outcomes of surgical VHD patients across China.

BackgroundThe presence of a high left ventricular end-diastolic diameter (LVEDD) has been linked to a less favorable outcome in patients undergoing coronary artery bypass grafting (CABG) procedures. However, by taking into consideration the reference of left ventricular size and volume measurements relative to the patient's body surface area (BSA), it has been suggested that the accuracy of the predicting outcomes may be improved. ObjectiveWe propose that BSA weighted LVEDD (bLVEDD) is a more accurate predictor of outcomes in patients undergoing CABG compared to simply using LVEDD alone. MethodsThis study was a comprehensive retrospective cohort study that was conducted across multiple medical centers. The inclusion criteria for this study were patients who were admitted for treatment between October 2016 and May 2021. Only elective surgery patients were included in the study, while those undergoing emergency surgery were not considered. All participants in the study received standard care, and their clinical data were collected through the institutional registry in accordance with the guidelines set forth by the Society of Thoracic Surgeons National Adult Cardiac Database. bLVEDD was defined as LVEDD divided by BSA. The primary outcome was in-hospital all-cause mortality (30 days), and the secondary outcomes were postoperative severe adverse events, including use of extracorporeal membrane oxygenation, multiorgan failure, use of intra-aortic balloon pump, postoperative stroke, and postoperative myocardial infarction. ResultsIn total, 9474 patients from 5 centers under the Chinese Cardiac Surgery Registry were eligible for analysis. We found that a high LVEDD was a negative factor for male patients’ mortality (odds ratio 1.44, P

CO2 capture from flue gas is one of the global urgent tasks. Adsorption separation of CO2 is an energy-efficient way as compared to the absorption method. The central issue is to devise efficient adsorbents that work well under flue gas conditions with temperatures of 323–348 K and low CO2 concentrations of 15%. In this work, we targeted this issue and proposed a well-controlled diffusion strategy, which is achieved over a series of poly(furfuryl alcohol)-derived carbons (PFCs) with dense and abundant ultra-micropores. As the adsorption temperature increased from 298 to 348 K, the CO2 capture capacity is 54% kept for PFC-800, which is 1.2 times higher than that for samples without diffusion limitation. The capture of CO2 is kinetics control at ambient temperature, however, at 348 K CO2 with higher kinetic energy can overcome the restriction of the narrow pore entrance and the CO2/N2 selectivity for simulated flue gas composition increases from 20 to 40. Furthermore, the PFCs exhibit a high CO2 volumetric adsorption capacity of 97 cm3 cm−3 at 298 K and 1 bar, benefiting the practical application deployed with an integrated adsorption column. The diffusion kinetics can be further tuned when altering the bulk phase into nanocoating, which would inspire their application in different scenarios.

Background: The choice between bioprosthetic and mechanical valves for aortic valve replacement (AVR) and mitral valve replacement (MVR) among patients aged 50–70 years is controversial. We compared the long-term outcomes of patients using bioprosthetic or mechanical valves to provide clinical evidence for valve selection. Methods: From 2002 to 2007, patients aged 50–70 years who underwent isolated AVR or MVR at the Fuwai Hospital were enrolled. After inverse probability-weighted (IPW) propensity balancing, we evaluated long-term mortality, stroke, and bleeding events between patients receiving mechanical and biological prostheses for MVR or AVR. Results: A total of 1639 patients were included in the study, including 1181 patients undergoing MVR (median follow-up: 11.6 years) and 458 patients undergoing AVR (median follow-up: 11.4 years). After IPW adjustment, there was no significant difference in long-term mortality and stroke rate between patients using bioprosthetic and mechanical valves for MVR [mortality: log-rank p = 0.802; stroke: log-rank p = 0.983] and AVR [mortality: log-rank p = 0.815; stroke: log-rank p = 0.537]. Landmark analysis at 12.5 years yielded significantly lower mortality in the patients receiving mechanical valves compared with bioprosthetic valves in the MVR cohort (p = 0.028). Patients receiving mechanical aortic valves displayed an increased risk of bleeding compared with those who received bioprosthetic aortic valves [Hazard Ratio (95% Confidence interval): 2.51 (1.06–5.93) p = 0.036]. Conclusions: For patients aged 50–70, there was no significant difference in overall long-term mortality between mechanical and bioprosthetic valve recipients. Patients receiving mechanical valves for MVR displayed lower mortality after 12.5 years follow-up. For AVR, bioprosthetic valves were associated with a lower risk of bleeding.

The ability to accurately predict flight time of arrival in real time during a flight is critical to the efficiency and reliability of aviation system operations. This paper proposes a data-light and trajectory-based machine learning approach for the online prediction of estimated time of arrival at terminal airspace boundary (ETA_TAB) and estimated landing time (ELDT), while a flight is airborne. Rather than requiring a large volume of data on aircraft aerodynamics, en-route weather, and traffic, this approach uses only flight trajectory information on latitude, longitude, and speed. The approach consists of four modules: (a) reconstructing the sequence of trajectory points from the raw trajectory that has been flown, and identifying its best-matched historical trajectory which bears the most similarity; (b) predicting the remaining trajectory, based on what has been flown and the best-matched historical trajectory; this is achieved by developing a long short-term memory (LSTM) network trajectory prediction model; (c) predicting the ground speed of the flight along its predicted trajectory, iteratively using the current position and previous speed information; to this end, a gradient boosting machine (GBM) speed prediction model is developed; and (d) predicting ETA_TAB using trajectory and speed prediction from (b) and (c), and using ETA_TAB to further predict ELDT. Since LSTM and GBM models can be trained offline, online computation efforts are kept at a minimum. We apply this approach to real-world flights in the US. Based on our findings, the proposed approach yields better prediction performance than multiple alternative methods. The proposed approach is easy to implement, fast to perform, and effective in prediction, thus presenting an appeal to potential users, especially those interested in flight ETA prediction in real time but having limited data access.

Abstract Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer characterized by high invasiveness, heterogeneity, and mainly occurs in the ultraviolet (UV)-exposed regions of the skin, but its pathogenesis is still unclear. Here, we generated single-cell transcriptome profiles for 350 cells from six primary UV-induced cSCCs, together with matched adjacent skin samples, and three healthy control skin tissues by single-cell RNA-sequencing technology based on Smart-seq2 strategy. A series of bioinformatics analyses and in vitro experiments were used to decipher and validate the critical molecular pattern of cSCC. Results showed that cSCC cells and normal keratinocytes were significantly distinct in gene expression and chromosomal copy number variation. Furthermore, cSCC cells exhibited 18 hallmark pathways of cancer by gene set enrichment analysis. Differential expression analysis demonstrated that many members belonging to S100 gene family, SPRR gene family, and FABP5 were significantly upregulated in cSCC cells. Further experiments confirmed their upregulation and showed that S100A9 or FABP5 knockdown in cSCC cells inhibited their proliferation and migration through NF-κB pathway. Taken together, our data provide a valuable resource for deciphering the molecular pattern in UV-induced cSCC at a single-cell level and suggest that S100A9 and FABP5 may provide novel targets for therapeutic intervention of cSCC in the future.

The application of real-time monitoring has been widely used to detect the safety and stability of the electric power system. Traditional monitoring relies heavily on human judgment and is impossible to detect status in real-time. Recently, with the development of deep learning, the object detection algorithm based on the deep convolutional neural network becomes a great option for realizing real-time monitoring applications of the power system. However, in power system scenarios, failed or unreal-time detection of abnormal conditions may cause a hazardous accident. To apply and optimize the object detection algorithm, issues such as multi-scale objects, class imbalance, and difficulty in balance speed and accuracy need to be addressed to improve the detection performance. Thus, we present a cascaded feature enhancement network model that combining attention mechanism, feature fusion scheme, and Cascaded Refinement Scheme. Attention mechanism and feature fusion scheme can help extract more effective feature information of multi-scale objects. Cascaded Refinement Scheme can effectively solve the problem of class imbalance. The whole model can well balanced in detect speed and accuracy. Experiments are performed on two benchmarks: PSA_Datasets and PASCAL VOC. Our method gets an absolute gain of 1.6% (300×300 input), 2.6% (512×512 input) in terms of mAP result of PSA_Datasets and 1% (300×300 input), 1.6% (512×512 input) in PASCAL VOC Dataset, compared to the best results of other SOTA detectors.

Introduction A multidisciplinary heart team approach has been recommended by revascularisation guidelines, but how to organise and implement the heart team in a standardised way has not been validated. Inter-team and intra-team decision instability existed in the guideline-based heart team protocol, and our standardised heart team protocol based on a mixed method study may improve decision stability. The objective of this study is to evaluate the effect of the standardised heart team protocol versus the guideline-based protocol on decision-making stability in stable complex coronary artery disease (CAD).Methods and analysis Eighty-four eligible interventional cardiologists, cardiac surgeons or non-interventional cardiologists from 26 hospitals in China have been enrolled. They will be randomised to a standardised heart team protocol group or a guideline-based protocol group to make revascularisation decisions for 480 historic cases (from a prospective registry) with stable complex CAD. In the standardised group, we will establish 12 heart teams based on an evidence-based protocol, including specialist selection, specialist training, team composition, team training and a standardised meeting process. In the guideline-based group, we will organise 12 heart teams according to the guideline principles, including team composition and standardised meeting process. The primary outcome is the overall percent agreement in revascularisation decisions between heart teams within a group. To demonstrate the clinical implication of decision-making stability, we will further explore the association between decision stability and 1-year clinical outcomes.Ethics and dissemination The study was approved by the Institutional Review Board (IRB) of Fuwai Hospital (No. 2019-1303). All participants have provided informed consent and all patients included as historic cases provided written informed consent at the time of entry to the prospective registry. The results of this trial will be disseminated through manuscript publication and national/international conferences, and reported in the trial registry entry.Trial registration number NCT05039567.

Introduction Atrial fibrillation (AF) is common in patients with rheumatic mitral valve disease (RMVD) and increase the risk of stroke and death. Bi-atrial or left atrial ablation remains controversial for treatment of AF during mitral valve surgery. The study aims to compare the efficacy and safety of bi-atrial ablation with those of left atrial ablation among patients with RMVD and persistent or long-standing persistent AF.Methods and analysis The ABLATION trial (Bi-atrial vs Left Atrial Ablation for Patients with RMVD and Non-paroxysmal AF) is a prospective, multicentre, randomised controlled study. The trial will randomly assign 320 patients with RMVD and persistent or long-standing persistent AF to bi-atrial ablation procedure or left atrial ablation procedure in a 1:1 randomisation. The primary end point is freedom from documented AF, atrial flutter or atrial tachycardia of >30 s at 12 months after surgery off antiarrhythmic drugs. Key secondary end point is the probability of freedom from permanent pacemaker implantation at 12 months after surgery. Secondary outcomes include the probability of freedom from any recurrence of atrial tachyarrhythmias with antiarrhythmic drugs, AF burden, incidence of adverse events and cardiac function documented by echocardiography at 12 months after operation.Ethics and dissemination The central ethics committee at Fuwai Hospital approved the ABLATION trial. The results of this study will be disseminated through publications in peer-reviewed journals and conference presentations.Trial registration number NCT05021601.

Objective: Deep brain stimulation (DBS) has been used as a treatment of last resort for treatment-resistant depression (TRD) for more than a decade. Many DBS targets have been proposed and tested clinically, but the underlying circuit mechanisms remain unclear. Uncovering white matter tracts (WMT) activated by DBS targets may provide crucial information about the circuit substrates mediating DBS efficacy in ameliorating TRD. Methods: We performed probabilistic tractography using diffusion magnetic resonance imaging datas from 100 healthy volunteers in Human Connectome Project datasets to analyze the structural connectivity patterns of stimulation targeting currently-used DBS target for TRD. We generated mean and binary fiber distribution maps and calculated the numbers of WMT streamlines in the dataset. Results: Probabilistic tracking results revealed that activation of distinct DBS targets demonstrated modulation of overlapping but considerably distinct pathways. DBS targets were categorized into 4 groups: Cortical, Striatal, Thalamic, and Medial Forebrain Bundle according to their main modulated WMT and brain areas. Our data also revealed that Brodmann area 10 and amygdala are hub structures that are associated with all DBS targets. Conclusions: Our results together suggest that the distinct mechanism of DBS targets implies individualized target selection and formulation in the future of DBS treatment for TRD. The modulation of Brodmann area 10 and amygdala may be critical for the efficacy of DBS-mediated treatment of TRD.

Abstract Objectives Low‐grade tumors are the most common neoplasms inducing focal epilepsy; however, the short‐ and medium‐term efficacy of surgery in epilepsy patients with low‐grade tumors remains underappreciated. This study aims to summarize the clinical characteristics of epilepsy patients with low‐grade tumors and to identify factors associated with postsurgical seizure‐free outcomes. Methods We retrospectively reviewed consecutive patients with low‐grade tumors who underwent subsequent epilepsy surgery in our epilepsy center, between 2012 and 2018 with a minimum follow‐up of 1 year. Using Engel’s classification and Kaplan–Meier survival analysis, we assessed postoperative seizure freedom over time. Demographical, electroclinical, and other presurgical evaluations were then evaluated for association with postoperative seizure outcome. Results The cohort included a total of 132 patients: 79 males and 53 females. Among them, 110 (83.33%) were seizure‐free through their last follow‐up. The Engel class I outcomes were 90.15%, 87.76%, 85.53%, 82.46%, and 73.17% at the end of the 1st, 2nd, 3rd, 4th, and 5th postoperative years, respectively. Multivariate logistic analysis revealed that longer epilepsy duration (p

Marine environmental change directly affects bivalve growth and survival. Exoskeleton formation, the main energy dissipation in the physiological metabolism, typically reflects the body growth of the bivalve. However, how bivalves regulate the biomineralization of the exoskeleton under environmental stressors is not yet clear. Long non-coding RNA regulates various life processes through complex mechanisms in vertebrates and invertebrates. In this research, we cloned the complete sequence of a mantle-specific expressed long non-coding RNA (designated as LncMPEG1) from a pearl oyster, Pinctada fucata martensii. A quantitative real-time PCR analysis showed that LncMPEG1 expression was significantly high in early umbo larvae and juveniles, which would be the critical periods of shell development. LncMPEG1 was identified in the outer epithelium of the middle fold from the mantle edge, mantle pallial, and mantle center by using in situ hybridization. Additionally, the expression of LncMPEG1 was stimulated by shell damage, alien invasion, heat and cold temperature stress, and hypoxia stress. In the mantle, a decreased in LncMPEG1 expression was detected by RNA interference, which can cause the irregular growth of crystals on the inner surface of the prismatic layer and nacre in the shells. Therefore, we propose that LncMPEG1 could be a key regulator in biomineralization and responds to environmental stress in the mantle .

In order to save resources and reduce air pollution, human beings have begun to pay attention to the production and use of photovoltaic, wind power and other green power. Due to the difficulty of direct transaction between green power producers and power users, a park-level energy Internet has been proposed and used to connect all kinds of green electricity with power users. Then park users can effectively buy and use green electricity. Taking the park-level energy Internet as the scenario, this paper constructs a transaction model between green power operators and green power producers. The model is a dynamic game of complete and perfect information. The dynamic characteristics of this game model are analyzed by using semi-tensor product method, and corresponding strategies are provided for all players. From the results obtained, it is easy to find that in many cases, the strategy profile of all participants are constantly changing to obtain more profits, rather than stable at some traditional Nash equilibrium.

Tyrosinase is a type-3 copper protein with six conserved histidine residues within the copper-binding sites. It participates in mollusk nacre formation. Here, we identified nacreous-layer-specific tyrosinases (NLSTyr) from Pinctada fucata martensii (PmTyr-4 and PmTyr-6), as well as their homologs in Pinctada maxima (PmaxTyr and PmaxTyr4) and Pinctada margaritifera (PmarTyr and PmarTyr-4), which encoded tyrosinases without the six conserved histidine residues within the copper-binding sites. PmTyr-4 and PmTyr-6 mRNAs were spatially concentrated in the mantle central and pearl sac, which are the organs responsible for nacre formation. During shell regeneration and pearl formation, PmTyr-4 and PmTyr-6 were also significantly highly expressed in the mantle and pearl sac. RNA interference showed that PmTyr-4 participated in nacreous-layer formation. The recombinant protein of PmTyr-4 (rPmTyr-4) inhibited the calcium carbonate precipitation rate. Correspondingly, calcium carbonate crystallization assay showed that the aragonite crystals of the rPmTyr-4 group were smaller than those of the control group. Moreover, the calcite and aragonite morphologies of the rPmTyr-4 group were modified compared with the control group. These results suggested that NLSTyr in pearl oyster inhibited calcium carbonate precipitation and affected crystal morphologies during nacre formation. Our findings provided new insights into the evolution and function gain of tyrosinase in Mollusk.

Intelligent construction (IC) has emerged as a new approach to transforming the architecture, engineering, and construction (AEC) industry through the integration of advanced information technologies such as artificial intelligence (AI) and the Internet of Things (IoT). However, due to its interdisciplinary nature, the relevant documents on IC are diverse and fragmented. To provide a comprehensive understanding of research progress and future opportunities in IC and to offer suggestions for both developing and developed countries, this study employed VOSviewer and Gephi to conduct a comparative review of relevant literature from the 21st century. A keyword search of Web of Science (WOS) identified 2788 relevant documents which were subjected to an overall co-citation and co-authorship analysis. To illustrate the differences between developing and developed countries, China, a representative developing country, was taken as the candidate to be compared with developed countries via a co-occurrence analysis. Differences between China and developed countries in the three sub-directions of IC, research foundation and domain knowledge transformation; information perception, fusion, and decision making; and embodied AI, were qualitatively discussed. Finally, four future research directions were suggested: (1) data fusion and decision-making, (2) improving the accuracy and efficiency of knowledge representation, learning, and utilization, (3) the establishment of large, pre-trained models in the field, and (4) embodied AI for taking actions according to the decisions made. This paper provides an overview of the relevant literature and the IC context for practitioners and scholars in the AEC industry in countries with different levels of development, as well as suggestions for the future development of IC. The findings of this study can serve both academia and industry in promoting IC in the AEC industry.

Tricuspid regurgitation (TR) may occur late after left-sided valve surgery (LSVS). Isolated tricuspid regurgitation after left-sided valve surgery (iTR-LSVS) refers to isolated TR without significant lesions in the mitral and/or aortic position late after mitral and/or aortic replacement or repair. Severe TR has a negative impact on long-term prognosis and requires surgical or transcatheter treatment. However, there is no clear recommendation on when and how intervention should be performed for patients with iTR-LSVS in the current guidelines for the management of valvular heart disease. The historically high operative mortality may be reduced by current minimally invasive techniques and transcatheter therapy. To further understand iTR-LSVS, standardize the treatment, improve the prognosis, and promote the collaboration, the Chinese Minimally Invasive Cardiovascular Surgery Committee (CMICS) wrote this expert consensus on the management of iTR-LSVS from the aspects of etiology, preoperative evaluation, indications for intervention, surgical treatment, transcatheter therapy, and postoperative management.

Pearl color is regulated by genetics, biological pigments, and organic matrices and an important factor that influences the pearl economic value. The epigenetic regulation mechanism underlying pearl pigmentation remains poorly understood. In this study, we collected the mantle pallial (MP) and mantle central (MC) of the golden-lipped strain, and MP of the silver-lipped strain of pearl oyster Pinctada fucata martensii. The whole-genome bisulfite sequencing (WGBS) technology was employed to investigate the possible implication of epigenetic factors regulating nacre color variation. Our results revealed approximately 2.5% of the cytosines in the genome of the P. fucata martensii were methylated, with the CG methylation type was in most abundance. Overall, we identified 12, 621 differentially methylated regions (DMRs) corresponding to 3,471 DMR-associated genes (DMGs) between the two comparison groups. These DMGs were principally enriched into KEGG metabolic pathways including ABC transporters, Terpenoid backbone biosynthesis, and fatty acid degradation. In addition, integrating information about DMGs, DEGs, and function annotation indicated eight genes LDLR, NinaB, RDH, CYP, FADS, fn3, PU-1, KRMP as the candidate genes related to pigmentation of nacre color. A further study proved that the pigment in nacre is violaxanthin. The results of our study provide the support that there is an association between nacre color formation and DNA methylation profiles and will help to reveal the epigenetic regulation of nacre pigmentation formation in pearl oyster P. fucata martensii.

BackgroundThis study aims to correlate the morphological complexity of left atrial appendage (LAA) with thrombosis and stroke in patients with atrial fibrillation (AF).MethodsThe training cohort consisted of 46 patients with AF (age 55.8 ± 7.2 years, 73.9% men) who were referred for radiofrequency catheter ablation. An independent validation cohort consisting of 443 patients with AF was enrolled for further verification. All patients in the training cohort underwent both transesophageal echocardiography (TEE) and enhanced computed tomography (CT). Fractal dimension (FD) analysis was performed to evaluate the morphological complexity of LAAs quantitatively. Clinical and imaging manifestations, FD of LAAs, and diagnostic accuracy were investigated and compared between patients with AF in both training and validation cohorts.ResultsIn the training cohort, LAAs (n = 22) with thrombi had significantly higher FD than those without thrombi (n = 24) h 0.44 ± 0.07 vs. 2.35 ± 0.11, p = 0.003). Receiver-operating characteristic (ROC) analysis suggested that the diagnostic accuracy of FD combined with a CHA2DS2-VaSc score was significantly higher than that of the CHA2DS2-VaSc score alone in low- to moderate-risk patients with AF (area under the curve 0.8479 vs. 0.6958, p = 0.009). The results were also validated in an independent external validation cohort and demonstrated that increased FD was associated with stroke. Hemodynamic analysis revealed that LAAs with thrombi and high FD were prone to blood stasis and lower blood flow rate.ConclusionLAA morphological complexity is closely associated with thrombosis and stroke in patients with paroxysmal AF. A new risk assessment system combining CHA2DS2-VaSc score and FD has a higher diagnostic accuracy in predicting LAA thrombosis.

BackgroundDeep brain stimulation (DBS) has been proposed as a last-resort treatment for major depressive disorder (MDD) and has shown potential antidepressant effects in multiple clinical trials. However, the clinical effects of DBS for MDD are inconsistent and suboptimal, with 30–70% responder rates. The currently used DBS targets for MDD are not individualized, which may account for suboptimal effect.ObjectiveWe aim to review and summarize currently used DBS targets for MDD and relevant diffusion tensor imaging (DTI) studies.MethodsA literature search of the currently used DBS targets for MDD, including clinical trials, case reports and anatomy, was performed. We also performed a literature search on DTI studies in MDD.ResultsA total of 95 studies are eligible for our review, including 51 DBS studies, and 44 DTI studies. There are 7 brain structures targeted for MDD DBS, and 9 white matter tracts with microstructural abnormalities reported in MDD. These DBS targets modulate different brain regions implicated in distinguished dysfunctional brain circuits, consistent with DTI findings in MDD.ConclusionsIn this review, we propose a taxonomy of DBS targets for MDD. These results imply that clinical characteristics and white matter tracts abnormalities may serve as valuable supplements in future personalized DBS for MDD.