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Aiming at the problem of serious loss of accuracy in the lightweighting process of the current human pose estimation model, a lightweight human pose estimation model that introduces cascaded channel attention is proposed using the high resolution network (HRNet) as a baseline. Firstly, a cascading channel attention that maintains internal high-resolution features is constructed so as to learn the importance of each channel of the input features to improve the model representation. Secondly, the residual module with high arithmetic complexity in HRNet stages 2, 3, and 4 is replaced by designing a lightweight deepwise convolutional transform module based on the structure of the MetaFormer. Furthermore, a multi-scale feature fusion method is designed to reduce the loss of semantic information of multi-dimensional features in the original fusion method of HRNet. Finally, unbiased data processing is used to eliminate offset errors caused by the process of encoding the heat map at key points. Experimental results from the COC02017 validation set show that the pro-posed model reduces the number of model parameters and floating-point operations by 90.2% and 83.1%, respectively, compared to the benchmark model with a 2 percentage points decrease in AP, and achieves the optimal accuracy among the lightweight models with an AP of 71.4%. [ABSTRACT FROM AUTHOR]

To investigate the effect of gastrointestinal function on the incidence of ventilator-associated pneumonia (VAP) in critically ill patients.

Introduction Thyroid carcinoma is one of the most common endocrine malignancies. Based on the origin and histopathological features, thyroid carcinoma can be classified as papillary, follicular, medullary, and anaplastic (Hundahl [...], Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy involving local and distant metastasis. It is known that CXC chemokine ligand 12 (CXCL12) interacts specifically with CXC chemokine receptor 4 (CXCR4) to guide the migration of PTC cells. However, the signaling pathway downstream of the CXCL12-CXCR4 axis in PTC is not fully understood. In the present study, high expression of CXCR4 was detected in 38 out of 82 specimens of PTC, and the expression level of CXCR4 significantly correlated with the stage of PTC. Additionally, the roles of the CXCL12-CXCR4 axis in the migration, invasion, and epithelial-mesenchymal transition (EMT) of B-CPAP cells were investigated in vitro. The motility and invasiveness were significantly enhanced in CXCR4-overexpressing B-CPAP cells with CXCL12 treatment. Moreover, the CXCL12-CXCR4 axis promoted the EMT process, as evidenced by a decreased level of E-cadherin and increased expressions of N-cadherin and vimentin. Furthermore, the CXCL12-CXCR4 axis activated the nuclear factor kappa-B (NF-[kappa]B) signaling pathway, whereas BAY11-7082, an IKB phosphorylation inhibitor, counteracted CXCL12-CXCR4-induced migration, invasion, and EMT processes in B-CPAP cells. In conclusion, the CXCL12-CXCR4 axis promotes the migration, invasion, and EMT processes in B-CPAP cells, at least partly, by activating the NF-[kappa]B signaling pathway. Key words: papillary thyroid carcinoma, CXCR4, CXCL12, SDF-1, NF-[kappa]B. Le carcinome papillaire de la thyroide (CPT) est la tumeur maligne thyroidienne la plus frequente qui implique des metastases locales et a distance. On sait que la chimiokine CXCL12 interagit specifiquement avec le recepteur CXCR4 pour guider la migration des cellules de CPT. Cependant, la voie de signalisation en aval de l'axe CXCL12-CXCR4 dans le CPT n'est pas pleinement comprise. Dans l'etude presentee ici, une forte expression de CXCR4 a ete detectee chez 38 de 82 specimens de CPT examines et le niveau d'expression de CXCR4 etait significativement correle avec le stade du CPT. Par ailleurs, les roles de l'axe CXCL12-CXCR4 dans la migration, l'invasion et la transition epithelio-mesenchymateuse (TEM) des cellules B-CPAP ont ete examines in vitro. La motilite et le potentiel invasif des cellules B-CPAP dans lesquelles CXCR4 est surexprime etaient significativement accrus par le CXCL12. De plus, l'axe CXCL12-CXCR4 favorisait le processus de TEM, comme le mettait en evidence la diminution de l'expression de la E-cadherine et l'expression accrue de la N-cadherine et de la vimentine. En outre, l'axe CXCL12-CXCR4 activait la voie de signalisation du facteur de transcription NF-[kappa]B, alors que le BAY11-7082, un inhibiteur de la phosphorylation de I[kappa]B, neutralisait la migration, l'invasion et la TEM induites par CXCL12-CXCR4 dans les cellules B-CPAP. En conclusion, l'axe CXCL12-CXCR4 favorise la migration, l'invasion et le processus de TEM chez les cellules B-CPAP, du moins partiellement, en activant la voie de signalisation du NF-[kappa]B. [Traduit par la Redaction] Mots-cles : carcinome papillaire de la thyroide, CXCR4, CXCL12, SDF-1, NF-[kappa]B.

Objectives: To evaluate the accuracy of ultrasound (US) in determining the positions of parametrial implants by comparing US with magnetic resonance imaging (MRI) for advanced cervical cancer. Methods: Patients undergoing brachytherapy with parametrial implantation for cervical cancer from February 2017 to February 2019 were involved in the study. The transverse section of the cervix (surface S1) and the transverse section 1 cm above the external cervix (surface S2) were selected from MRI and US images as the observation planes. In the MRI observation plane, the distances between the uterine titanium needles and the uterine tube/implanter were set as M1 to M4; in the US observation plane, the distances between the uterine titanium needles and the uterine tube/implanter were set as D1 to D4. The differences and consistency in M and D of each group were then compared. Results: There were no significant differences between M and D in each group (P =.058; P =.821; P =.870; and P =.936, respectively). The intraclass correlation coefficients of M and D in each group were 0.970, 0.968, 0.952, and 0.956. A regression analysis showed that the relationships between M and D in each group were as follows: M1 = 0.9449D1 + 0.1812; M2 = 0.9463D2 + 0.0965; M3 = 0.9176D3 + 0.1233; and M4 = 0.9253D4 + 0.1224. Conclusions: In parametrial brachytherapy for cervical cancer, US can accurately determine the positions of parametrial implantation needles, which is already applicable on MRI, and can provide assistance in parametrial brachytherapy for advanced cervical cancer. [ABSTRACT FROM AUTHOR]

The Lachnospiraceae family holds promise as a source of next‐generation probiotics, yet a comprehensive delineation of its diversity is lacking, hampering the identification of suitable strains for future applications. To address this knowledge gap, we conducted an in‐depth genomic and functional analysis of 1868 high‐quality genomes, combining data from public databases with our new isolates. This data set represented 387 colonization‐selective species‐level clusters, of which eight genera represented multilineage clusters. Pan‐genome analysis, single‐nucleotide polymorphism (SNP) identification, and probiotic functional predictions revealed that species taxonomy, habitats, and geography together shape the functional diversity of Lachnospiraceae. Moreover, analyses of associations with atherosclerotic cardiovascular disease (ACVD) and inflammatory bowel disease (IBD) indicated that several strains of potentially novel Lachnospiraceae species possess the capacity to reduce the abundance of opportunistic pathogens, thereby imparting potential health benefits. Our findings shed light on the untapped potential of novel species enabling knowledge‐based selection of strains for the development of next‐generation probiotics holding promise for improving human health and disease management. Highlights: Comprehensive genome analysis reveals underestimated species diversity and distinct functions of Lachnospiraceae.Cataloging 1.5 M genes highlights Lachnospiraceae's significant role in the human gut microbiota, with potential novel species contributing.Lachnospiraceae demonstrates a vast potential for synthesizing short‐chain fatty acid (SCFA), producing secondary metabolites, and forming spores, which is promising for future studies and applications.The abundance of Lachnospiraceae correlates inversely with diseases like atherosclerotic cardiovascular disease (ACVD) and inflammatory bowel disease (IBD), indicating a potential protective role. [ABSTRACT FROM AUTHOR]

In coastal engineering, the cyclic loading caused by traffic, wind, and waves is superimposed on the initial static shear stress in certain infrastructures such as embankments. In some cases, a portion of the subgrade soil is overconsolidated owing to the process of surcharge preloading. Therefore, it is of great practical relevance to study the effects of the initial static shear on the undrained cyclic response of overconsolidated soft marine clay. In this study, a series of monotonic and cyclic triaxial tests were conducted on soft marine clay with a broad range of initial static shear stress ratios (SSRs) and overconsolidation ratios (OCRs) to investigate the pore water pressure response and deformation characteristics. Several useful conclusions were drawn. Importantly, the development and maximum number of cycles of the permanent pore water pressure were found to depend on the SSR and OCR values. Based on the shakedown theory and typical stress–strain relationship, the development of the permanent axial strain was classified into three ranges. [ABSTRACT FROM AUTHOR]

Background: We previously reported a novel clinically distinguishable subtype of congenital scoliosis (CS), namely, TBX6-associated congenital scoliosis (TACS). We further developed the TBX6-associated CS risk score (TACScore), a multivariate phenotype-based model to predict TACS according to the patient's clinical manifestations. In this study, we aimed to evaluate whether using the TACScore as a screening method prior to performing whole-exome sequencing (WES) is more cost-effective than using WES as the first-line genetic test for CS.Methods: We retrospectively collected the molecular data of 416 CS patients in the Deciphering disorders Involving Scoliosis and COmorbidities (DISCO) study. A decision tree was constructed to estimate the cost and the diagnostic time required for the two alternative strategies (TACScore versus WES). Bootstrapping simulations and sensitivity analyses were performed to examine the distributions and robustness of the estimates. The economic evaluation considered both the health care payer and the personal budget perspectives.Results: From the health care payer perspective, the strategy of using the TACScore as the primary screening method resulted in an average cost of $1074.2 (95%CI: $1044.8 to $1103.5) and an average diagnostic duration of 38.7d (95%CI: 37.8d to 39.6d) to obtain a molecular diagnosis for each patient. In contrast, the corresponding values were $1169.6 (95%CI: $1166.9 to $1172.2) and 41.4d (95%CI: 41.1d to 41.7d) taking WES as the first-line test (P < 0.001). From the personal budget perspective, patients who were predicted to be positive by the TACScore received a result with an average cost of $715.1 (95%CI: $594.5 to $835.7) and an average diagnostic duration of 30.4d (95%CI: 26.3d to 34.6d). Comparatively, the strategy of WES as the first-line test was estimated to have significantly longer diagnostic time with an average of 44.0d (95%CI: 43.2d to 44.9d), and more expensive with an average of $1193.4 (95%CI: $1185.5 to $1201.3) (P < 0.001). In 100% of the bootstrapping simulations, the TACScore strategy was significantly less costly and more time-saving than WES. The sensitivity analyses revealed that the TACScore strategy remained cost-effective even when the cost per WES decreased to $8.8.Conclusions: This retrospective study provides clinicians with economic evidence to integrate the TACScore into clinical practice. The TACScore can be considered a cost-effective tool when it serves as a screening test prior to performing WES. [ABSTRACT FROM AUTHOR]