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Abstract Background With existing researches identifying an increased rate of long-term conditions (LTCs) among Inflammatory Bowel Disease (IBD) patients, yet there is a lack of exploration into the patterns of comorbidity and prognostic rates for IBD patients with multiple morbidities. Methods The study included 8,305 participants who self-reported having IBD, comprising ulcerative colitis (UC) and Crohn’s disease (CD). Latent class analysis (LCA) was utilized to create optimal categories of LTC combinations for UC and CD patients with additional long-term conditions. Using Cox proportional hazards models, we compared the all-cause mortality rates over a 16-year follow-up among UC and CD patients within different LTC categories, both without LTCs and with the addition of one LTC, the probability of major adverse cardiovascular events (MACE), and the rates of IBD-related surgeries. Results A total of 5,617 participants reported having two or more LTCs, with the LCA method identifying three prevalence categories among CD patients, and four prevalence categories among UC patients. The highest mortality rate among CD patients was found in category 3: (HR 1.789, 95% CI (1.439–2.224)), and the highest rates of MACE were also in category 3: (HR 11.432, 95% CI (9.332–14.005)), with hypertension being the distinguishing characteristic of this category, and the highest rates of IBD-related surgeries being associated with pain in category 1: (HR 1.217, 95% CI (0.983–1.506)). Among UC patients, the highest mortality rate was in category 3: (HR 2.221, 95% CI (1.837–2.684)), with the highest MACE rates found in category 3: (HR 6.422, 95% CI (5.659–7.288)), and the highest rates of IBD-related surgeries being associated with pain, also in category 3: (HR 1.218, 95% CI (1.041–1.425)). Conclusion The rates of adverse health outcomes in IBD patients is closely associated with multimorbidity patterns, underscoring the need to fully consider multimorbidity patterns in the assessment, management, and treatment strategies for IBD.

Abstract Background Ciprofol, a recently developed anesthetic agent, is not inferior to propofol in terms of efficacy and safety. However, most previous clinical experience with ciprofol was based on a robust population. This study aimed to investigate the efficacy and safety of ciprofol for anesthesia induction in female patients with frailty. Methods This prospective randomized controlled trial included patients with frailty undergoing elective general anesthesia for gynecological surgery. Frailty was assessed using the modified frailty index. The patients were randomly administered propofol (2 mg/kg) or ciprofol (0.5 mg/kg) during anesthesia induction. The depth of anaesthesia was continually monitored by the bispectral index. The primary outcome was the lowest systolic blood pressure (SBP) during anesthesia induction. Secondary outcomes included the incidence of general anesthesia induction failure and adverse events. Results Among the 69 enrolled patients with frailty, 67 were included in the final analysis. The success rate of anesthesia induction was 100% in both groups. The lowest SBP was significantly higher in the ciprofol group than in the propofol group (103 [96–110] vs. 90 [85–98] mmHg, respectively; P

Background: Outpatient hysteroscopic surgery requires patients to be anaesthetised and recover quickly, and the drugs used must be safe and effective. Remifentanil is typically co-administered with propofol as total intravenous anaesthesia (TIVA) for hysteroscopy because of its favourable pharmacokinetic and pharmacodynamic properties. However, the optimal dose of remifentanil when co-administered with propofol without neuromuscular blocking agents (NMBAs) has not been established. Objectives: In this sequential dose-finding study, the 90% effective dose (ED90) of remifentanil effect-site concentration (Ce) combined with propofol without NMBAs during outpatient hysteroscopy was calculated to minimise the side effects of using higher doses. Design: This sequential dose-finding study was conducted in August 2022. Methods: Forty patients who underwent outpatient hysteroscopy under TIVA were included in the study. With a biased coin up-and-down design, the initial remifentanil Ce was established at 2 ng/mL, and the subsequent remifentanil dosage was determined based on the reaction of the previous patient. The primary outcome was a remifentanil Ce that resulted in successful TIVA by maintaining a Narcotrend index

IntroductionInflammatory bowel disease (IBD) is a multi-organ autoimmune disease that commonly affects the gastrointestinal tract, but can also affect other organs throughout the body. Less is known, however, about kidney involvement in IBD. Although IBD has been associated with chronic kidney disease (CKD) and end-stage renal disease (ESRD), these results have been inconsistent. The present study analyzed the prevalence of concurrent CKD and ESRD in patients with IBD.MethodsPubMed, Cochrane, Web of Science, and Embase were searched for studies published through October 2023 on IBD patients with concurrent CKD or ESRD. Outcomes included the incidence rates and odds ratios (OR) of concurrent CKD and ESRD in IBD patients. The quality of included studies was assessed using the Newcastle-Ottawa Scale, and sequential sensitivity was analyzed. Publication bias was evaluated using Egger’s test.ResultsNine studies were included in this meta-analysis. The combined results of eight studies, which included 239,042 IBD patients, showed that the prevalence of CKD in IBD patients was 5% (95% confidence interval [CI]: 1–9%). The combined results of two studies, which included 40,341 IBD patients, showed that the prevalence of ESRD in IBD patients was 0.2% (95% CI: −0.08–0.12%). The combined results of six case–control studies reported that the risk of CKD was significantly higher in patients with than without IBD (OR 1.36, 95% CI: 1.08–1.70, p = 0.008).ConclusionAlthough studies have shown an increased risk of CKD in IBD, due to the small number of included studies and high heterogeneity across studies, it is not enough to definitively conclude that CKD is more common in patients with IBD. But patients with IBD should be regularly monitored for CKD.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/.

Background and aimsInflammatory bowel disease (IBD) is a common chronic inflammatory bowel disease characterized by diarrhea and abdominal pain. Recently human metabolites have been found to help explain the underlying biological mechanisms of diseases of the intestinal system, so we aimed to assess the causal relationship between human blood metabolites and susceptibility to IBD subtypes.MethodsWe selected a genome-wide association study (GWAS) of 275 metabolites as the exposure factor, and the GWAS dataset of 10 IBD subtypes as the outcome, followed by univariate and multivariate analyses using a two-sample Mendelian randomization study (MR) to study the causal relationship between exposure and outcome, respectively. A series of sensitivity analyses were also performed to ensure the robustness of the results.ResultsA total of 107 metabolites were found to be causally associated on univariate analysis after correcting for false discovery rate (FDR), and a total of 9 metabolites were found to be significantly causally associated on subsequent multivariate and sensitivity analyses. In addition we found causal associations between 7 metabolite pathways and 6 IBD subtypes.ConclusionOur study confirms that blood metabolites and certain metabolic pathways are causally associated with the development of IBD subtypes and their parenteral manifestations. The exploration of the mechanisms of novel blood metabolites on IBD may provide new therapeutic ideas for IBD patients.

BackgroundLimited studies have investigated the relationship between systemic oxidative stress and inflammatory bowel disease (IBD). The purpose of this study was to explore the relationship between oxidative balance score (OBS) and IBD.MethodsWe included 175,808 participants from the UK Biobank database from 2006 to 2010. OBS scores were calculated based on 22 lifestyle and dietary factors. Multiple variable Cox proportional regression models, as well as gender stratification and subgroup analysis, were utilized to investigate the relationship between OBS and IBD.ResultsThere is a significant negative correlation between OBS and the occurrence of IBD, ulcerative colitis (UC), and Crohn’s disease (CD). Additionally, OBS is significantly negatively correlated with intestinal obstruction in CD patients. Gender stratified analysis suggest a significant correlation between OBS and CD in female patients, particularly pronounced in those under 60 years old. Sensitivity analysis indicates a significant negative correlation between lifestyle-related OBS and diet-related OBS with the occurrence of CD in females, diet-related OBS is negatively correlated with CD in males.ConclusionOBS showed a significant negative correlation with IBD, especially in female CD patients. This study underscores the importance of antioxidant diet and lifestyle, which may provide a greater advantage for female CD patients.

BackgroundThe Oxidative Balance Score (OBS) is commonly used to assess oxidative stress and provides a comprehensive evaluation of dietary and lifestyle-related exposures. However, there is limited research on the association between OBS and colorectal cancer (CRC), its subsites, and complications. The objective of this study was to assess the relationship between OBS and the risk of CRC, its subsites, and common complications in a large prospective cohort study.MethodsWe included data from 175,808 participants in the UK Biobank data sample repository from 2006 to 2010. We evaluated OBS using a scoring system based on 22 dietary and lifestyle factors. Multiple adjustments, including multivariate Cox proportional hazard regression, gender stratification, subgroup analysis, and sensitivity analysis, were performed to fully explore the relationship between OBS and CRC, its subsites, and complications. The mediation analysis was conducted to investigate whether serum albumin, uric acid, and neutrophil levels mediate the relationship between OBS and CRC.ResultsAfter adjusting for potential confounding factors, a significant negative correlation was found between OBS and the risk of CRC and its subsites (proximal colon cancer, distal colon cancer, and rectal cancer). This correlation was particularly pronounced in male CRC patients. Serum albumin, uric acid, and neutrophil count, which are biomarkers, were found to have a significant mediating effect between OBS and CRC.ConclusionOur study suggests that higher exposure to antioxidants assessed through OBS (diet and lifestyle rich in antioxidants) may decrease the occurrence of CRC and its subsites.

Abstract Objective and design An accumulating body of evidence has shown that gut microbiota is involved in regulating inflammation; however, it remains undetermined if and how gut microbiota plays an important role in modulating deep venous thrombosis (DVT), which is an inflammation-involved thrombotic event. Subjects Mice under different treatments were used in this study. Methods and treatment We induced stenosis DVT in mice by partially ligating the inferior vena cava. Mice were treated with antibiotics, prebiotics, probiotics, or inflammatory reagents to modulate inflammatory states, and their effects on the levels of circulating LPS and DVT were examined. Results Antibiotic-treated mice or germ-free mice exhibited compromised DVT. Treatment of mice with either prebiotics or probiotics effectively suppressed DVT, which was accompanied with the downregulation of circulating LPS. Restoration of circulating LPS in these mice with a low dose of LPS was able to restore DVT. LPS-induced DVT was blocked by a TLR4 antagonist. By performing proteomic analysis, we identified TSP1 as one of the downstream effectors of circulating LPS in DVT. Conclusion These results suggest that gut microbiota may play a nonnegligible role in modulating DVT by leveraging the levels of LPS in circulation, thus shedding light on the development of gut microbiota-based strategies for preventing and treating DVT.

Background and aimsInflammatory bowel disease (IBD), mainly categorized into Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic relapsing gastrointestinal disorder that significantly impairs patients’ quality of life. IBD patients often experience comorbidities such as anxiety and depression, and the underlying mechanisms and treatment strategies remain areas of investigation.MethodsWe conducted a Mendelian randomization(MR) analysis utilizing brain image derived phenotypes (IDP) from the UK Biobank database to investigate the causal relationships between IBD and alterations in brain structural morphology and connectivity of neural tracts. This study aimed to identify biological evidence linking IBD to psychiatric disorders such as anxiety and depression.ResultsSpecifically, the volume of grey matter in the Left Frontal Orbital Cortex exhibited a negative association with the onset of Crohn’s disease (odds ratio (OR) [95% confidence interval (CI)]: 0.315[0.180~0.551], adjusted P=0.001), while the volume of the superior frontal cortex in the right hemisphere showed a positive correlation with the development of Ulcerative colitis (OR [95% CI]: 2.285[1.793~2.911], adjusted P

ObjectiveSignificant differences have been discovered between subtypes of Crohn’s disease (CD) and ulcerative colitis (UC). The role of gut microbiota in promoting the onset of UC and CD is established, but conclusions regarding subtype-specific analyses remain limited.MethodsThis study aims to explore the influence of gut microbiota on subtypes of UC and CD, offering novel insights into the pathogenesis and treatment of UC and CD.Two-sample Mendelian randomization (MR) analysis was employed to examine the causal relationship between subtypes of UC and CD and gut microbiota composition. Gut microbiota data were sourced from the International Consortium MiBioGen, while UC and CD data were obtained from FINNGEN. Eligible single nucleotide polymorphisms (SNPs) were selected as instrumental variables. Multiple analytical approaches such as inverse variance-weighted (IVW), MR-Egger regression, weighted median, weighted mode, and MR-RAPS were utilized. Sensitivity analyses including MR-Egger intercept test, Cochran’s Q test, and leave-one-out analysis were conducted for quality control. Subsequently, we employed multivariable IVW, MR-Egger, weighted median, and LASSO regression methods to identify independently significant genera or families and conducted sensitivity analyses.ResultsWe have determined that Hungatella, Acidaminococcaceae, and 15 other microbial taxa act as protective factors for various CD and UC subtypes, while Terrisporobacter, Anaerostipes, and 23 other microbial taxa are associated with increased risk for different CD and UC subtypes. Furthermore, through multivariable MR analysis, we have identified significant genera or families with independent effects.ConclusionOur study confirms a causal relationship between dysbiosis of gut microbiota and the occurrence of CD and UC subtypes. Furthermore, it validates etiological distinctions among different subtypes of CD and UC. A novel approach to adjunctive therapy involving distinct UC or CD subtypes may involve the use of probiotics and represents a potential avenue for future treatments.

Abstract Background The surgical procedure for laparoscopic right colectomy (LRC) is not standardized. Some published studies show the superiority of ileocolic anastomosis (IIA), but the evidence so far is insufficient. This study aimed to investigate the potential advantages in postoperative recovery and safety of IIA in LRC. Methods A total of 114 patients who underwent LRC with IIA (n = 58) or extracorporeal ileocolic anastomosis (EIA, n = 56) between January 2019 and September 2021 were enrolled. We collected certain factors as clinical features, intraoperative characteristics, oncological outcomes, postoperative recovery, and short-term outcomes. Our primary outcome was time to gastrointestinal (GI) function recovery. Secondary outcomes were postoperative complications within 30 days, postoperative pain, and length of hospital stay. Results Faster GI recovery and less postoperative pain were observed in patients with IIA compared to EIA [time to first flatus: (2.4 ± 0.7) vs (2.8 ± 1.0) days, p

Abstract The accomplishment of condition monitoring and intelligent maintenance for cantilever structure‐based energy harvesting devices remains a challenge. Here, to tackle the problems, a novel cantilever‐structure freestanding triboelectric nanogenerator (CSF‐TENG) is proposed, which can capture ambient energy or transmit sensory information. First, with and without a crack in cantilevers, the simulations are carried out. According to simulation results, the maximum change ratios of natural frequency and amplitude are 1.1% and 2.2%, causing difficulties in identifying defects by these variations. Thus, based on Gramian angular field and convolutional neural network, a defect detection model is established to achieve the condition monitoring of the CSF‐TENG, and the experimental result manifests that the accuracy of the model is 99.2%. Besides, the relation between the deflection of cantilevers and the output voltages of the CSF‐TENG is first built, and then the defect identification digital twin system is successfully created. Consequently, the system is capable of duplicating the operation of the CSF‐TENG in a real environment, and displaying defect recognition results, so the intelligent maintenance of the CSF‐TENG can be realized.

IntroductionThe role of tumour secretory cytokines and peripheral circulatory cytokines in tumour progression has received increasing attention; however, the role of tumour-related inflammatory cytokines in colorectal cancer (CRC) remains unclear. In this study, the concentrations of various cytokines in the peripheral blood of healthy controls and patients with CRC at different stages were compared.MethodsPeripheral blood samples from 4 healthy participants and 22 colorectal cancer patients were examined. Luminex beads were used to evaluate concentration levels of 40 inflammatory cytokines in peripheral blood samples.ResultsIn peripheral blood, compared with healthy controls and early stage (I + II) CRC patients, advanced CRC (III + IV) patients had increased concentrations of mononuclear/macrophage chemotactic-related proteins (CCL7, CCL8, CCL15, CCL2, and MIF), M2 polarization-related factors (IL-1β, IL-4), neutrophil chemotactic and N2 polarization-related cytokines (CXCL2, CXCL5, CXCL6, IL-8), dendritic cells (DCs) chemotactic-related proteins (CCL19, CCL20, and CCL21), Natural killer (NK) cell related cytokines (CXCL9, CXCL10), Th2 cell-related cytokines (CCL1, CCL11, CCL26), CXCL12, IL-2, CCL25, and CCL27, and decreased IFN-γ and CX3CL1 concentrations. The differential upregulation of cytokines in peripheral blood was mainly concentrated in CRC patients with distant metastasis and was related to the size of the primary tumour; however, there was no significant correlation between cytokine levels in peripheral blood and the propensity and mechanism of lymph node metastasis.DiscussionDifferent types of immune cells may share the same chemokine receptors and can co-localise in response to the same chemokines and exert synergistic pro-tumour or anti-tumour functions in the tumour microenvironment. Chemokines and cytokines affect tumour metastasis and prognosis and may be potential targets for treatment.

Abstract Oxaliplatin resistance is a major challenge in the treatment of colorectal cancer (CRC). Many molecular targeted drugs for refractory CRC have been developed to solve CRC drug resistance, but their effectiveness and roles in the progression of CRC and oxaliplatin resistance remain unclear. Here, we successfully constructed CRC PDOs and selected the Kruppel-like factor 5 (KLF5) inhibitor ML264 as the research object based on the results of the in vitro drug screening assay. ML264 significantly restored oxaliplatin sensitivity in CRC PDOs by restoring the apoptotic response, and this effect was achieved by inhibiting the KLF5/Bcl-2/caspase3 signaling pathway. Chromatin immunoprecipitation (ChIP) and luciferase reporter assays verified that KLF5 promoted the transcription of Bcl-2 in CRC cells. KLF5 inhibition also overcame oxaliplatin resistance in xenograft tumors. Taken together, our study demonstrated that ML264 can restore oxaliplatin sensitivity in CRC PDOs by restoring the apoptotic response. KLF5 may be a potential therapeutic target for oxaliplatin-resistant CRC. PDOs have a strong potential for evaluating inhibitors and drug combination therapy in a preclinical environment.

Summary: The electric signals of cantilever energy harvesting devices with/without a crack were mainly obtained by external sensors, so detecting device damage on a large scale is difficult. To tackle the issue, a cantilever-structure freestanding triboelectric nanogenerator (CSF-TENG) device was proposed, which can scavenge ambient energy and act as a self-powered sensor. Firstly, the relation between the peak-to-peak voltage and amplitude of the CSF-TENG was established. Next, the output performance of the CSF-TENG was measured. Then, depending on electric signals output by the CSF-TENG, a cantilever defect identification model was built by using the wavelet packet and long short-term memory (LSTM) algorithms. The experimental results manifest that the accuracy of the model is about 98.6%. Thus, the CSF-TENG with a crack can be detected timely due to its self-monitoring ability, which is of great significance for the development of self-powered sensor networks.

Abstract Background Maternal hypotension after spinal anaesthesia occurs at a high rate during caesarean delivery and can lead to adverse maternal or foetal outcomes. The aim of this study was to determine the optimal dose of spinal ropivacaine for caesarean section with or without intravenous single bolus of S-ketamine and to observe the rates of hypotension associated with both methods. Methods Eighty women undergoing elective caesarean delivery were randomly allocated into either a ropivacaine only or ropivacaine with intravenous S-ketamine group. If the upper sensory level of the patient reached T6 and the visual analogue scale (VAS) scores remained below 3 points before delivery, the next patient had a 1/9th chance of receiving a lower dose or an 8/9th chance of receiving the same dose as the previous patient. If the patient had VAS scores of more than 2 points or needed an extra epidural rescue bolus before delivery, a higher dose was used for the next patient. The primary outcome was the successful use of spinal ropivacaine to maintain patient VAS score of

Colorectal cancer (CRC) is the third most common form of cancer, and the incidence of sporadic young-onset colorectal cancer (yCRC) has been increasing. Microbiota residing in the tumor microenvironment are emerging tumor components. The colonic microbiome differs between patients with CRC and healthy controls; however, few studies have investigated the role of the tumor microbiota in disease diagnosis and tumorigenesis of yCRC. We performed 16S rRNA sequencing analysis to identify the microbiome in CRC and found that tumor microbial diversity decreased in yCRC. Proteobacteria and Firmicutes were the most abundant phyla in all CRC samples, and Actinomyces and Schaalia cardiffensis were the key microbiota in the yCRC group. Correlation analysis revealed that Actinomyces co-occurred with various pro-tumor microbial taxa, including Bacteroidia, Gammaproteobacteria, and Pseudomonas. An independent cohort was used to validate the results. The Actinomyces in CRC was co-localized with cancer-associated fibroblasts and activated the TLR2/NF-κB pathway and reduces CD8+ T lymphocyte infiltration in CRC microenvironment. This study suggests that tumoral microbiota plays an important role in promoting tumorigenesis and therefore has potential as a promising non-invasive tool and intervention target for anti-tumor therapy.

This study proposes an approach to minimize the maximum makespan of the integrated scheduling problem in flexible job-shop environments, taking into account conflict-free routing problems. A hybrid genetic algorithm is developed for production scheduling, and the optimal ranges of crossover and mutation probabilities are also discussed. The study applies the proposed algorithm to 82 test problems and demonstrates its superior performance over the Sliding Time Window (STW) heuristic proposed by Bilge and the Genetic Algorithm proposed by Ulusoy (UGA). For conflict-free routing problems of Automated Guided Vehicles (AGVs), the genetic algorithm based on AGV coding is used to study the AGV scheduling problem, and specific solutions are proposed to solve different conflicts. In addition, sensors on the AGVs provide real-time data to ensure that the AGVs can navigate through the environment safely and efficiently without causing any conflicts or collisions with other AGVs or objects in the environment. The Dijkstra algorithm based on a time window is used to calculate the shortest paths for all AGVs. Empirical evidence on the feasibility of the proposed approach is presented in a study of a real flexible job-shop. This approach can provide a highly efficient and accurate scheduling method for manufacturing enterprises.

Abstract Background Post-spinal anesthesia hypotension during cesarean delivery is caused by decreased systemic vascular resistance due to the blockage of the autonomic nerves, which is further worsened by inferior vena cava (IVC) compression by the gravid uterus. This study aimed to assess whether peak velocity and diameter of the IVC below the xiphoid or right common femoral vein (RCFV) in the inguinal region, as measured on ultrasound, could reflect the degree of IVC compression and further identify parturients at risk of post-spinal hypotension. Methods Fifty-six parturients who underwent elective cesarean section with spinal anesthesia were included in this study; peak velocities and anteroposterior diameters of the IVC and peak velocities and transverse diameters of the RCFV were measured using ultrasound before anesthesia. The primary outcome was the ultrasound measurements of IVC and RCFV acquired before spinal anesthesia and their association with post-spinal hypotension. Hypotension was defined as a drop in systolic arterial pressure by > 20% from the baseline. Multinomial logistic regression analysis was used to identify the association between the measurements of IVC, RCFV, and post-spinal hypotension during cesarean delivery. Receiver operating characteristic curves were used to test the abilities of the identified parameters to predict post-spinal hypotension; the areas under the curve and optimum cut-off values for the predictive parameters were calculated. Results A longer transverse diameter of the RCFV was associated with the occurrence of post-spinal hypotension (odds ratio = 2.022, 95% confidence interval [CI] 1.261–3.243). The area under the receiver operating characteristics curve for the prediction of post-spinal hypotension was 0.759 (95% CI 0.628–0.890, P = 0.001). A transverse diameter of > 12.2 mm of the RCFV could predict post-spinal hypotension during cesarean delivery. Conclusions A longer transverse diameter of RCFV was associated with hypotension and could predict parturients at a major risk of hypotension before anesthesia. Trial registration This study was registered at http://www.chictr.org.cn on 16, May, 2018. No. ChiCTR1800016163 .

Abstract Background The aim of this prospective randomized controlled study was to evaluate whether pretreatment with a small dose of dezocine could prevent remifentanil-induced cough in general anesthesia induction. Trial design a prospective, randomized, controlled study. Methods A total of 210 patients receiving elective operative hysteroscopy from December 2018 to April 2019 were enrolled in the present study. They were randomly equally separated into dezocine group (n = 105) and control group (n = 105). Patients were intravenously pre-administrated with dezocine 0.03 mg/kg (diluted to 5 mL) or the same volume of normal saline 1 min prior to remifentanil infusion. One minute later, intravenous injection of propofol 1.5 mg/kg and cisatracurium 0.1 mg/kg were given to all patients for induction of general anesthesia. The counts of coughs occurred during the anesthesia induction period were recorded and the severity of cough was scaled. Results There were 7 cases of mild cough in dezocine group and 18 cases of mild cough, 12 cases of moderate cough and 4 cases of severe cough in control group. The incidence rate of cough was significantly lower and the severity of cough was obviously relieved in dezocine group compared to control group (6.67% vs. 32.38%, P

Substring searching on gene sequence data is widely used for analyzing the association between a list of gene mutations and a specific disease. As substring search usually has a high computational cost, deploying it in the cloud has become a popular solution. Moreover, the cloud allows easier data sharing among medical organizations. Since the gene data contains private information, medical organizations usually outsource encrypted gene data to the cloud and selectively share with others. Most existing solutions for the privacy-preserving substring search problem are based on searchable encryption. However, they mainly focus on single-source gene data, not suitable for handling multi-source gene data because of some practical weaknesses. In this paper, we propose a cryptographic scheme that supports privacy-preserving substring search on multi-source encrypted gene data. The cloud can authorize queriers with access control and perform substring searches over the multi-source encrypted gene data for them. Despite the outsourced gene data is encrypted with different keys, but the authorized querier can issue a substring search only uses its own key. We adopt the composite order bilinear map as the primary underlying cryptographic primitive of our scheme. We mainly focus on protecting the privacy of the outsourced gene data and the substring queries, and we provide a security analysis under the honest-but-curious model. We also perform experiments on different datasets and analyze the experimental results in terms of computation cost and communication cost. The analyses show that our scheme is secure and efficient for substring search on multi-source encrypted gene data.

Searchable encryption (SE) allows users to search over encrypted data without decrypting. In most existing SE schemes, server returns all matched files without relevance ranking, and the update mechanism are suffering with high communication and computation cost, which are not efficient enough to satisfy the real-life dynamic scenario. Addressing the above issues, we proposed TS-RDSE-a Two-Server Ranked Dynamic Searchable Encryption scheme. We integrate orthogonal vector and efficient homomorphic encryption cryptosystems to build a vector-level dynamic secure index, which simultaneously supports efficient dynamic update operations like deletion and insertion of files flexibly. Moreover, in order to rank the search results by relevance without decryption, we build a secure sorting protocol based on the widely-used tf-idf weighting formula and addition property of partial homomorphic encryption, which achieves accurate sorting for the search results while protecting the privacy of relevance scores. We give a comprehensive analysis of the correctness of TS-RDSE in the aspect of searching and sorting with mathematical proofs. The security analysis shows that TS-RDSE is secure against adaptive dynamic chosen-keyword attacks (CKA2) by honest-but-curious adversaries in random oracle model. The performance analysis shows that TS-RDSE has both a very light user workload and a moderate server workload, and it is superior to the existing approaches in terms of functionalities and expansibility. Extensive experiments on the real-world dataset validate our analysis and show that TS-RDSE is suitable for the real world cloud storage environment.

Every day social multimedia applications generate millions of images. To handle such huge amount of images, an optimal solution is using the public cloud, since it has powerful storage capability. Images usually contain a wealth of sensitive information, therefore social service providers need not only to provide services such as retrieval and sharing but also to protect the privacies of the images. In this paper, we propose a privacy-preserving scheme for content-based image retrieval and sharing in social multimedia applications. First, the users extract visual features from the images, and perform locality-sensitive hashing functions on visual features to generate image profile vectors. We then model the retrieval on the images as the equality search on the image profile vectors. To enable accurate and efficient retrieval, we design the secure index structure based on cuckoo hashing, which has constant lookup time. To meet the requirements of dynamic image updating, we enrich our service with image insertion and deletion. In order to reduce the key management overhead and the access control overhead in social applications, we process keys using secret sharing techniques to enable the users holding similar images to query and decrypt images independently. Finally we implement the prototype of the proposed scheme, and perform experiments over encrypted image databases.

During the assembly process of the rear axle, the assembly quality and assembly efficiency decrease due to the accumulation errors of rear axle assembly torque. To deal with the problem, we proposed a rear axle assembly torque online control method based on digital twin. First, the gray wolf-based optimization variational modal decomposition and long short-term memory network (GWO-VMD-LSTM) algorithm was raised to predict the assembly torque of the rear axle, which solves the shortcomings of unpredictable non-stationarity and nonlinear assembly torque, and the prediction accuracy reaches 99.49% according to the experimental results. Next, the evaluation indexes of support vector machine (SVM), recurrent neural network (RNN), LSTM, and SVM, RNN, and LSTM based on gray wolf optimized variational modal decomposition (GWO-VMD) were compared, and the performance of the GWO-VMD-LSTM is the best. For the purpose of solving the insufficient information interaction capability problem of the assembly line, we developed a digital twin system for the rear axle assembly line to realize the visualization and monitoring of the assembly process. Finally, the assembly torque prediction model is coupled with the digital twin system to realize real-time prediction and online control of assembly torque, and the experimental testing manifests that the response time of the system is about 1 s. Consequently, the digital twin-based rear axle assembly torque prediction and online control method can significantly improve the assembly quality and assembly efficiency, which is of great significance to promote the construction of intelligent production line.

Focusing on the diversified demands of location privacy in mobile social networks (MSNs), we propose a privacy-enhancing k-nearest neighbors search scheme over MSNs. First, we construct a dual-server architecture that incorporates location privacy and fine-grained access control. Under the above architecture, we design a lightweight location encryption algorithm to achieve a minimal cost to the user. We also propose a location re-encryption protocol and an encrypted location search protocol based on secure multi-party computation and homomorphic encryption mechanism, which achieve accurate and secure k-nearest friends retrieval. Moreover, to satisfy fine-grained access control requirements, we propose a dynamic friends management mechanism based on public-key broadcast encryption. It enables users to grant/revoke others’ search right without updating their friends’ keys, realizing constant-time authentication. Security analysis shows that the proposed scheme satisfies adaptive L-semantic security and revocation security under a random oracle model. In terms of performance, compared with the related works with single server architecture, the proposed scheme reduces the leakage of the location information, search pattern and the user–server communication cost. Our results show that a decentralized and end-to-end encrypted k-nearest neighbors search over MSNs is not only possible in theory, but also feasible in real-world MSNs collaboration deployment with resource-constrained mobile devices and highly iterative location update demands.

Cloud storage has been gaining tremendous popularity, which provides facilitative data storage and sharing services for distributed clients. To maximize the availability and reliability, some customers may store multiple replicas of critical data on cloud servers. However, cloud servers may collude to make it look like they are storing multiple copies of data, whereas in fact they only store a single copy. Currently, several multi-replica provable data possession schemes have been proposed to provide verifications to ensure that all the outsourced copies are actually stored and maintained intact. For these schemes with third-party verifications, correctly choosing public keys of data owners relies on the public key infrastructure (PKI), which is complicated and resource consuming. In this paper, we propose a novel identity-based public multireplica provable data possession scheme (IDPMR-PDP) to provide third-party verification of outsourced data with multiple replicas without PKI. We also introduce a formal security model of identity-based public multi-replica PDP schemes and prove that the IDPMR-PDP is secure against malicious cloud servers and privacy-preserving against curious verifiers under this model. Meanwhile, our analyses and simulation results demonstrate that the IDPMR-PDP realizes efficient integrity verification.

Protein arginine methyltransferase-6 participates in a range of biological functions, particularly RNA processing, transcription, chromatin remodeling, and endosomal trafficking. However, it remains unclear whether protein arginine methyltransferase-6 modifies neuropathic pain and, if so, what the mechanisms of this effect. In this study, protein arginine methyltransferase-6 expression levels and its effect on neuropathic pain were investigated in the spared nerve injury model, chronic constriction injury model and bone cancer pain model, using immunohistochemistry, western blotting, immunoprecipitation, and label-free proteomic analysis. The results showed that protein arginine methyltransferase-6 mostly co-localized with β-tubulin III in the dorsal root ganglion, and that its expression decreased following spared nerve injury, chronic constriction injury and bone cancer pain. In addition, PRMT6 knockout (Prmt6–/–) mice exhibited pain hypersensitivity. Furthermore, the development of spared nerve injury–induced hypersensitivity to mechanical pain was attenuated by blocking the decrease in protein arginine methyltransferase-6 expression. Moreover, when protein arginine methyltransferase-6 expression was downregulated in the dorsal root ganglion in mice without spared nerve injury, increased levels of phosphorylated extracellular signal-regulated kinases were observed in the ipsilateral dorsal horn, and the response to mechanical stimuli was enhanced. Mechanistically, protein arginine methyltransferase-6 appeared to contribute to spared nerve injury–induced neuropathic pain by regulating the expression of heterogeneous nuclear ribonucleoprotein-F. Additionally, protein arginine methyltransferase-6-mediated modulation of heterogeneous nuclear ribonucleoprotein-F expression required amino acids 319 to 388, but not classical H3R2 methylation. These findings indicated that protein arginine methyltransferase-6 is a potential therapeutic target for the treatment of peripheral neuropathic pain.

Rocuronium is an acceptable alternative when succinylcholine is contraindicated for facilitating the endotracheal intubation. However, the onset time of rocuronium for good intubation condition is still slower than that condition of succinylcholine. This study systematically investigated the most efficacious pharmacological interventions for accelerating the onset time of rocuronium.Medline, Embase, Cochrane Library databases, www.clinicaltrials.gov, and hand searching from the reference lists of identified papers were searched for randomized controlled trials comparing drug interventions with placebo or another drug to shorten the onset time of rocuronium. Statistical analyses were performed using RevMan5.2 and ADDIS 1.16.5 softwares. Mean differences (MDs) with their 95% confidence intervals (95% CIs) were used to analyze the effects of drug interventions on the onset time of rocuronium.43 randomized controlled trials with 2,465 patients were analyzed. The average onset time of rocuronium was 102.4±24.9 s. Priming with rocuronium [Mean difference (MD) -21.0 s, 95% confidence interval (95% CI) (-27.6 to -14.3 s)], pretreatment with ephedrine [-22.3 s (-29.1 to -15.5 s)], pretreatment with magnesium sulphate [-28.2 s (-50.9 to -5.6 s)] were all effective in reducing the onset time of rocuronium. Statistical testing of indirect comparisons showed that rocuronium priming, pretreatment with ephedrine, and pretreatment with magnesium sulphate had the similar efficacy.Rocuronium priming, pretreatment with ephedrine, and pretreatment with magnesium sulphate were all effective in accelerating the onset time of rocuronium, and furthermore their efficacies were similar. Considering the convenience and efficacy, priming with rocuronium is recommended for accelerating the onset time of rocuronium. However, more strict clinical trials are still needed to reach a more solid conclusion due to the large heterogeneities exist among different studies.

Whether pulse oximeter perfusion index (PI) may be applied to detect the onset of caudal block in pediatric patients under ketamine intravenous basal anesthesia is investigated. 40 ASA I, 2–8-year-old boys scheduled for elective circumcision surgery were randomized into two groups. Group I: 20 patients were anesthetized by 2 mg·kg−1 ketamine intravenous injection (IV) followed by caudal block using 1 mL·kg−1 lidocaine (1%); Group II: 20 patients were anesthetized by 2 mg·kg−1 ketamine IV only. PI on the toe in Group II decreased by 33 ± 12%, 71 ± 9% and 65 ± 8% at 1 min, 15 min, and 30 min after ketamine injection. The maximum increase in MAP and HR after ketamine IV was 11 ± 6% at 3 min and 10 ± 6% at 2 min. Compared to the PI value before caudal injection of lidocaine, PI in Group I increased by 363 ± 318% and 778 ± 578% at 5 min and 20 min after caudal block, while no significant changes in MAP and HR were found compared to the baseline before caudal block. Thus, PI provides an earlier, more objective, and more sensitive indicator to assess the early onset of caudal block under basal ketamine anesthesia.