A study on the effect of different channel cues on learning in immersive 360° videos.

Immersive 360° videos are of interest to educators because of their ability to provide immersive sensory experience and other features. This study examined the effects of four cue conditions on 360° video learning performance, attention, cognitive load, and mood using eye-tracking devices, brainwave meters, and subjective questionnaires. The randomly assigned participants (n = 62) did go to the experimental group (visual cues only, auditory cues only, and audiovisual cues) or the control group (no cues). The results showed that visual and audiovisual cues effectively guide learners' attention to the related learning content, reduce cognitive load during learning, and improve retention performance but have no significant effect on knowledge transfer or long-term memory. Auditory cues increase the number of times learners look at the related learning content but do not affect gaze duration and distract their attention, hindering the acquisition of relevant learning content. The study also found that visual cues effectively increase the number of times learners looked at the content. However, they do not affect gaze duration. The study also revealed that visual cues effectively increase learners' relaxation when viewing 360° videos. The study's findings can provide a reference for the instructional processing of information related to 360° video design and its practical application in teaching.

Diosgenin biosynthesis pathway and its regulation in Dioscorea cirrhosa L.

Dioscorea cirrhosa L. (D. cirrhosa) tuber is a traditional medicinal plant that is abundant in various pharmacological substances. Although diosgenin is commonly found in many Dioscoreaceae plants, its presence in D. cirrhosa remained uncertain. To address this, HPLC-MS/MS analysis was conducted and 13 diosgenin metabolites were identified in D. cirrhosa tuber. Furthermore, we utilized transcriptome data to identify 21 key enzymes and 43 unigenes that are involved in diosgenin biosynthesis, leading to a proposed pathway for diosgenin biosynthesis in D. cirrhosa. A total of 3,365 unigenes belonging to 82 transcription factor (TF) families were annotated, including MYB, AP2/ERF, bZIP, bHLH, WRKY, NAC, C2H2, C3H, SNF2 and Aux/IAA. Correlation analysis revealed that 22 TFs are strongly associated with diosgenin biosynthesis genes (-r2- > 0.9, P < 0.05). Moreover, our analysis of the CYP450 gene family identified 206 CYP450 genes (CYP450s), with 40 being potential CYP450s. Gene phylogenetic analysis revealed that these CYP450s were associated with sterol C-22 hydroxylase, sterol-14-demethylase and amyrin oxidase in diosgenin biosynthesis. Our findings lay a foundation for future genetic engineering studies aimed at improving the biosynthesis of diosgenin compounds in plants.

Unveiling and regulating the solvent-polarity-associated excited state intramolecular double proton transfer behavior for 1-bis(benzothiazolyl)naphthalene-diol fluorophore.

Inspired by the regulatory luminescence properties of HBT derivatives, in this work, we mainly conduct a detailed theoretical exploration on the photoinduced excitation behavior of a novel di-proton-transfer type HBT derivative 1-bis(benzothiazolyl)naphthalene-diol (1-BBTND). The intramolecular double hydrogen bonding interaction and the excited state intramolecular double proton transfer (ESDPT) behavior of 1-BBTND fluorophore are investigated in combination with different polar solvent environments. From the structural changes and charge recombination induced by photoexcitation, we can conclude that strong polar solvent environment promotes the excited state dynamical reaction for 1-BBTND compound. By constructing potential energy surfaces (PESs) in S0 and S1 states, we clarify that 1-BBTND fluorophore should undergo a stepwise ESDPT reaction after photoexcitation. Combined with the size of potential energy barriers along with reaction paths in different solvents, we finally propose a new solvent-polarity-dependent stepwise ESDPT for 1-BBTND fluorophore.

Validation of a Wearable System for Lower Extremity Assessment.

OBJECTIVE: Remote assessment and diagnosis of functional impairment caused by osteoarthritis (OA) of the knee can achieve early intervention of patients' functional impairment, prevent the deterioration of OA of the knee, and provide functional remote screening for patients with knee OA. This study introduced an inertial measurement unit (IMU) sensor-based system to assess lower extremity function and perform gait analysis. Then, we compared its accuracy to gold-standard motion capture and gait measurement systems. METHODS: Nine adults were selected to participate in a comparative study of gait assessment outcomes using an IMU sensor-based wearable system, a gold-standard motion capture system, and a pressure-based gait analysis system. The subject walked on a path that incorporated all three systems. Data analysis was performed on spatiotemporal gait parameters, including velocity, cycle time, cadence, and stride length. This was followed by gait phases, including stance, swing, double stance, and single limb support phases. Data were processed using the data processing software of each system. An independent sample t-test was conducted for inter-group comparison to analyze the data. RESULTS: The spatiotemporal gait parameters of the systems demonstrated excellent consistency, and the gait phases showed high consistency. Compared to the gold-standard pressure-based gait analysis system (the GATERite system), the mean gait cycle time results were 1.124 s vs. 1.127 s (p = 0.404); cadence was 93.333 steps/min vs. 94.189 steps/min (p = 0.482); stance phase was 60.89% vs. 63.26% (p < 0.001); swing phase was 39.11% vs. 36.74% (p < 0.001); stride length was 1.404 m vs. 1.420 m (p = 0.743); speed was 1.093 m/s vs. 1.110 m/s (p = 0.725). Compared to the gold-standard video-based motion capture system, the root mean square error was 2.7° for the hip angle and 2.6° for the knee angle. CONCLUSIONS: This IMU-based wearable system delivered precise measuring results to evaluate patients with knee OA. This technology can also be used to guide rehabilitation exercises for patients with knee OA.

The furosemide stress test predicts the timing of continuous renal replacement therapy initiation in critically ill patients with acute kidney injury: a double-blind prospective intervention cohort study.

BACKGROUND: Continuous renal replacement therapy (CRRT) remains a crucial treatment for critically ill patients with acute kidney injury (AKI), although the timing of its initiation is still a matter of contention. Furosemide stress testing (FST) may be a practical and beneficial prediction instrument. This research was meant to examine if FST can be used to identify high-risk patients for CRRT. METHODS: This study is a double-blind, prospective interventional cohort study. For patients with AKI receiving intensive care unit (ICU) income, FST was selected with furosemide 1 mg/kg intravenous (1.5 mg/kg intravenous if a loop diuretic was received within 7 days). Urinary volume more than 200 ml at 2 h after FST was FST-responsive, less than 200 ml was FST-nonresponsive. The FST results are kept strictly confidential from the clinician, who decides whether to initiate CRRT based on laboratory testing and clinical symptoms other than the FST data. The FST data are concealed from both the patients and the clinician. RESULTS: FST was delivered to 187 of 241 patients who satisfied the inclusion and exclusion criteria, with 48 patients responding to the test and 139 patients not responding. 18/48 (37.5%) of the FST-responsive patients received CRRT, while 124/139 (89.2%) of the FST-nonresponsive patients received CRRT. There was no significant difference between the CRRT and non-CRRT groups in terms of general health and medical history (P > 0.05). Urine volume after 2 h of FST was considerably lower in the CRRT group than in the non-CRRT group (35 ml, IQR5-143.75 versus 400 ml, IQR210-890; P = 0.000). FST non-responders were 2.379 times more likely to initiate CRRT than FST responders (95% CI 1.644-3.443, P = 0.000). The area under the curve (AUC) for initiating CRRT was 0.966 (cutoff of 156 ml, sensitivity of 94.85%, specificity of 98.04%, P < 0.001). CONCLUSION: This study demonstrated that FST is a safe and practical approach for predicting the initiation of CRRT in critically ill AKI patients. Trial registration www.chictr.org.cn , ChiCTR1800015734, Registered 17 April 2018.

The effects of total knee arthroplasty on knee proprioception of patients with knee osteoarthritis: a meta-analysis.

BACKGROUND: Studies have given some pieces of evidence for the effect of total knee arthroplasty (TKA) on knee proprioception of patients with knee osteoarthritis (KOA), but their results were conflicting. This review was performed to provide an updated evidence-based meta-analysis investigating the influence of TKA on knee proprioception. METHODS: The electronic databases including PubMed, Google Scholar, and the Cochrane Library were accessed from their inception to March 2020. Two reviewers identified the studies that met the selection criteria for this review. Information on study type, participants, follow-up time, and outcome measures was extracted. Methodological quality was independently assessed by two reviewers using the Cochrane Handbook 5.1.0. Eleven studies with 475 participants were included in the meta-analysis. RESULTS: The I2 index assessed the heterogeneity between studies. The results showed that the pooled standard mean difference of mean angle of error was - 0.58° (95% CI - 1 to - 0.16; P = 0.007; I2 = 69%), and the joint position sense of KOA patients was better after TKA surgery than that before surgery. Pooled standard mean difference of displacement of center of pressure (COP) was - 0.39 (95% CI - 0.72 to - 0.06; P = 0.02; I2 = 51%), and KOA patients had better static balance after TKA surgery than before surgery. CONCLUSIONS: To conclude, no standardized comprehensive evaluation protocol presently exists though different assessment tools are available to measure proprioception. Contrasting results were found in the literature since some studies found that TKA improves proprioception in KOA patients, while others found no difference in proprioception. These differences are seen whether the proprioception was assessed by joint position sense (JPS), or it was indirectly assessed by static balance. However, the lack of sufficient data on the threshold to detect passive movement (TTDPM) and dynamic balance made it difficult to draw a conclusion about whether or not the sense of motion improved after surgery. The method for measuring and evaluating knee joint force sense is worth paying attention, which will make progress with knee proprioception on TKA patients.

Development and validation of outcome prediction models for acute kidney injury patients undergoing continuous renal replacement therapy.

Object: This study aimed to develop and validate a set of practical predictive tools that reliably estimate the 28-day prognosis of acute kidney injury patients undergoing continuous renal replacement therapy. Methods: The clinical data of acute kidney injury patients undergoing continuous renal replacement therapy were extracted from the Medical Information Mart for Intensive Care IV database with structured query language and used as the development cohort. An all-subset regression was used for the model screening. Predictive models were constructed via a logistic regression, and external validation of the models was performed using independent external data. Results: Clinical prediction models were developed with clinical data from 1,148 patients and validated with data from 121 patients. The predictive model based on seven predictors (age, vasopressor use, red cell volume distribution width, lactate, white blood cell count, platelet count, and phosphate) exhibited good predictive performance, as indicated by a C-index of 0.812 in the development cohort, 0.811 in the internal validation cohort and 0.768 in the external validation cohort. Conclusions: The model reliably predicted the 28-day prognosis of acute kidney injury patients undergoing continuous renal replacement therapy. The predictive items are readily available, and the web-based prognostic calculator (https://libo220284.shinyapps.io/DynNomapp/) can be used as an adjunctive tool to support the management of patients.

Concept verification of a Remote Automatic Scoring System for Evaluating Knee Function after Total Knee Arthroplasty.

The Knee Society Score (KSS) is the most commonly used scale for evaluating postoperative pain and physical function after total knee arthroplasty (TKA). However, this scale requires clinic visiting, which is not quite convenient. Our concept verification study demonstrated a remote automatic system for evaluating knee function after TKA using the KSS. The remote scoring system consists of two modules for data acquisition, an application for patients, a cloud server, and an application for doctors. The kinematic data are collected by the data acquisition modules and transmitted to the patient application via Bluetooth. The data acquisition module contains a motion sensor, a microcontroller unit, a power supply, and a Bluetooth module. The motion sensor consists of an accelerometer, a gyroscope, and a geomagnetic sensor, all of which are three-axis instruments. Using the nine-axis data, the three-dimensional (3D) angles are calculated according to the theory of attitude and heading reference system. The KSS score is calculated using a scoring algorithm in the patient application and transmitted to the doctor application through the cloud server. The knee function of 10 patients treated with unilateral TKA was evaluated by both a doctor and the remote scoring system. The consistency in KSS between the doctor and the system was analyzed using the paired t-test. The remote scoring system successfully recorded knee function data and transmitted the scores from the patient application to the doctor application through the cloud server. There was no significant difference in the KSS scores evaluated by the doctor and that by the system (p = 0.326). This remote automatic scoring system provides a reliable and convenient method for evaluating knee function after TKA at home.

Clinical significance of the long non-coding RNA NEAT1/miR-129-5p axis in the diagnosis and prognosis for patients with chronic heart failure.

Chronic heart failure (CHF) is the leading cause of death worldwide. The regulatory interactions of long non-coding RNA (lncRNAs) and microRNAs (miRs) have important roles in multiple diseases. However, the clinical significance of the nuclear-enriched abundant transcript 1 (NEAT1)/miR-129-5p axis in CHF has remained elusive. The present study explored whether the NEAT1/miR-129-5p axis may be a suitable diagnostic and prognostic marker for CHF. The expression of lncRNA NEAT1 and miR-129-5p in the serum of patients with CHF was analyzed by reverse transcription-quantitative PCR. Furthermore, inter-indicator correlations were assessed by Pearson correlation coefficient analysis. Receiver operating characteristic (ROC) curves were generated to evaluate the ability of NEAT1, miR-129-5p and brain natriuretic peptide (BNP) to identify patients with CHF. The prognostic value of the NEAT1/miR-129-5p axis was analyzed by drawing Kaplan-Meier survival curves and by Cox logistic regression analysis. Baseline data were not significantly different between CHF (n=70) and control subjects (n=62). The serum level of NEAT1 was increased and the expression level of miR-129-5p was decreased in patients with CHF (all P<0.001). The ROC curves suggested that serum NEAT1 and miR-129-5p were of diagnostic value in patients with CHF and the combined diagnostic accuracy of NEAT1, miR-129-5p and BNP was significantly improved. Kaplan-Meier and multivariate Cox regression analysis suggested that low NEAT1 and high miR-129-5p were able to predict overall survival of patients with CHF (all P<0.01). In conclusion, the present study indicated that patients with CHF had increased NEAT1 and decreased miR-129-5p expression. The deregulated NEAT1/miR-129-5p axis may provide novel non-invasive biomarkers for the diagnosis and prognosis of CHF.

Clinical Evaluation and Gait Characteristics before and after Total Knee Arthroplasty Based on a Portable Gait Analyzer.

OBJECTIVE: To evaluate the effects of surgery and rehabilitation on patients undergoing total knee arthroplasty (TKA). METHODS: Twelve patients and 12 healthy controls were enrolled and their clinical scores evaluated by a doctor. Gait data, including walking velocity, stride length, single support time, foot fall and swing power, were collected using a portable gait analyzer from 12 patients before and 6 weeks and 6 months after surgery and from 12 healthy controls. The gait data and clinical scores at selected time points were compared and correlations between gait characteristics and clinical scores assessed. RESULTS: Clinical knee and knee function scores increased significantly from before surgery to 6 weeks to 6 months after surgery (P < 0.001). The only significant differences identified were for single support time on the diseased side between before surgery and 6 months after surgery (P = 0.031) and for foot fall with the diseased side between 6 weeks and 6 months after surgery (P = 0.016). Foot fall and speed of the healthy or diseased sides were significantly different in patients at all time points from those of the healthy subjects (P < 0.05). Single support time on the diseased side was significantly different 6 months after surgery (P = 0.035) in patients than in healthy controls. Single support time on the healthy side before surgery was significantly different from that of healthy controls (P = 0.048) and 6 weeks after surgery (P = 0.042). Stride lengths differed significantly between patients and healthy subjects before surgery (healthy side: P = 0.007; diseased side: P = 0.008) and 6 weeks after surgery (healthy side: P = 0.001; diseased side: P = 0.001), but were not different at 6 months after surgery (healthy side: P = 0.088; diseased side: P = 0.077). The only significant correlations identified were between single support time with the diseased side of patients and their knee (r = 0.43, P = 0.032) and knee function scores (r = 0.493, P = 0.012). CONCLUSIONS: A portable gait analyzer appears to be suitable for evaluating the effects of TKA. Single support time on the diseased side may be a sensitive quantitative index for determining the effect of TKA and rehabilitation.

Does tea consumption correlate to risk of fracture? A meta-analysis.

Fractures are important causes of healthy damage and economic loss nowadays. The conclusions of observational studies on tea consumption and fracture risk are still inconsistent. The objective of this meta-analysis is to determine the effect of tea drinking on the risk of fractures. In this study, a comprehensive literature search was conducted in Pubmed, Embase and reference lists of the relevant articles. Observational studies that reported an estimate of the association between tea drinking and incidence of fractures were included. A meta-analysis was conducted by the STATA software. The results indicated that a total of 9 studies involving 147,950 individuals that examined the association between tea consumption and risk of fractures were included in this meta-analysis. The odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. The pooled OR of 9 observational studies for the tea consumption on risk of fracture was 0.89 (95% CI, 0.78-1.04). In the subgroup analyses, no significant association was detected in neither cohort studies (n = 3; OR, 0.97; 95% CI, 0.89-1.06) nor case-control studies (n = 6; OR, 0.91; 95% CI, 0.70-1.19), respectively. Because of the varied and limited data of the included studies, we are not able to conduct the dose-response meta-analysis. In conclusion, tea consumption might be not associated with the risk of fractures. The following large-sample and well-designed studies are required to confirm the existing conclusions.

Lidocaine protects against renal and hepatic dysfunction in septic rats via downregulation of Toll­like receptor 4.

The present study was designed to determine the renoprotective and hepatoprotective effect of lidocaine in septic rats through the Toll­like receptor 4 (TLR4) signaling pathway. Adult male Sprague­Dawley rats were randomly divided into the following three groups: control, sepsis model and 10% lidocaine. A model of sepsis was established by injection of lipopolysaccharide (LPS; 5 mg/kg) into the intraperitoneal cavity of rats. The same volume of saline was injected intraperitoneally into rats of the control group instead of LPS. Light microscopy was used to observe structural changes of the hepatic and nephridial tissues. qPCR was used to measure TLR4 mRNA expression levels and the protein expression was detected by flow cytometry. Western blotting was used to measure myocardial nuclear factor κB (NF­κB) protein levels and ELISA was used to measure the levels of interleukin­6 (IL­6) in hepatic and nephridial tissues. The results demonstrated that 10% lidocaine treatment markedly decreased hepatic and nephridial injury in septic rats and inhibited the expression levels of TLR4, NF­κB and IL­6, which were upregulated in the sepsis model. In addition, the results indicated that lidocaine protects against renal and hepatic dysfunction in septic rats, which may be mediated by the downregulation of TLR4 and associated signaling molecules and inhibition of the inflammatory response.