KGETCDA: an efficient representation learning framework based on knowledge graph encoder from transformer for predicting circRNA-disease associations.

Recent studies have demonstrated the significant role that circRNA plays in the progression of human diseases. Identifying circRNA-disease associations (CDA) in an efficient manner can offer crucial insights into disease diagnosis. While traditional biological experiments can be time-consuming and labor-intensive, computational methods have emerged as a viable alternative in recent years. However, these methods are often limited by data sparsity and their inability to explore high-order information. In this paper, we introduce a novel method named Knowledge Graph Encoder from Transformer for predicting CDA (KGETCDA). Specifically, KGETCDA first integrates more than 10 databases to construct a large heterogeneous non-coding RNA dataset, which contains multiple relationships between circRNA, miRNA, lncRNA and disease. Then, a biological knowledge graph is created based on this dataset and Transformer-based knowledge representation learning and attentive propagation layers are applied to obtain high-quality embeddings with accurately captured high-order interaction information. Finally, multilayer perceptron is utilized to predict the matching scores of CDA based on their embeddings. Our empirical results demonstrate that KGETCDA significantly outperforms other state-of-the-art models. To enhance user experience, we have developed an interactive web-based platform named HNRBase that allows users to visualize, download data and make predictions using KGETCDA with ease. The code and datasets are publicly available at https://github.com/jinyangwu/KGETCDA.

Real-time stealth optical transmission via dither-remodulation in a bias controller of a Mach-Zehnder modulator.

The physical layer transmission security is a promising technology against security threats. As an effective supplement to the encryption strategy, steganography has received widespread attention. We report a real-time 2 kbps stealth transmission in the 10 Gbps dual polarization QPSK public optical communication. The stealth data is embedded in dither signals via precise and stable bias control technique for a Mach-Zehnder modulator. In the receiver, the stealth data can be recovered from the normal transmission signals by low SNR signal processing and digital down conversion. The stealth transmission has been verified to pose almost no impact on the public channel over a 117 km distance. The proposed scheme is compatible with existing optical transmission systems, so that no new hardware needs to be employed. It can be accomplished and is exceeded economically by adding simple algorithms, which utilizes only a small amount of FPGA resources. The proposed method can cooperate with encryption strategies or cryptographic protocols at different network layers to reduce the communication overhead and improve the overall security of the system.

Preliminary Study of the Treatment Strategy for Retaining Traumatic Foreign Bodies Involving the Carotid Artery.

PURPOSE: Craniomaxillofacial trauma is usually accompanied by indwelling foreign bodies, and some of those are close to the carotid artery, which increases the risks and difficulties of surgical treatment. The introduction of interventional radiology combined with image-guided surgical navigation may be a good solution for precise surgery to remove foreign bodies. PATIENTS AND METHODS: Four patients were included in the study. All patients underwent digital subtraction angiography and enhanced computed tomography before surgery. The patients were divided into 3 categories (A, B, and C) according to the presence of carotid artery damage and its positional relationship with the foreign body, and 3 corresponding treatment strategies were developed. Treatments were completed using interventional radiology and surgical navigation systems. RESULTS: All foreign bodies were completely removed, except for 1 remaining in the jugular foramen in a patient. The prognosis of all patients was good, and no systemic complications occurred. CONCLUSION: The combined interventional radiology and surgical navigation method proposed in this study is an effective method to improve the accuracy and safety of foreign body removal surgery.

Multi-Responsive Molecular Encapsulation and Release Based on Hydrogen-Bonded Azo-Macrocycle.

Research on stimuli-responsive host-guest systems is at the cutting edge of supramolecular chemistry, owing to their numerous potential applications such as catalysis, molecular machines, and drug delivery. Herein, we present a multi-responsive host-guest system comprising azo-macrocycle 1 and 4,4'-bipyridinium salt G1 for pH-, photo-, and cation- responsiveness. Previously, we reported a novel hydrogen-bonded azo-macrocycle 1. The size of this host can be controlled through light-induced E↔Z photo-isomerization of the constituent azo-benzenes. The host is found in this work to be capable of forming stable complexes with bipyridinium/pyridinium salts, and implementing guest capture and release with G1 under light in a controlled manner. The binding and release of the guest in the complexes can also be easily controlled reversibly by using acid and base. Moreover, the cation competition-induced dissociation of the complex 1a2⊃G1 is achieved. These findings are expected to be useful in regulating encapsulation for sophisticated supramolecular systems.

Learning from errors? The impact of erroneous example elaboration on learning outcomes of medical statistics in Chinese medical students.

BACKGROUND: Constructivism theory has suggested that constructing students' own meaning is essential to successful learning. The erroneous example can easily trigger learners' confusion and metacognition, which may "force" students to process the learning material and construct meaning deeply. However, some learners exhibit a low level of elaboration activity and spend little time on each example. Providing instructional scaffolding and elaboration training may be an efficient method for addressing this issue. The current study conducted a randomized controlled trial to examine the effectiveness of erroneous example elaboration training on learning outcomes and the mediating effects of metacognitive load for Chinese students in medical statistics during the COVID-19 pandemic. METHODS: Ninety-one third-year undergraduate medical students were randomly assigned to the training group (n = 47) and the control group (n = 44). Prerequisite course performance and learning motivation were collected as covariates. The mid-term exam and final exam were viewed as posttest and delayed-test to make sure the robustness of the training effect. The metacognitive load was measured as a mediating variable to explain the relationship between the training and academic performance. RESULTS: The training significantly improved both posttest and delayed-test performance compared with no training (Fposttest = 26.65, p < 0.001, Partial η2 = 0.23; Fdelayed test = 38.03, p < 0.001, Partial η2 = 0.30). The variation trend in metacognitive load in the two groups was significantly different (F = 2.24, p < 0.05, partial η2 = 0.20), but metacognitive load could not explain the positive association between the treatment and academic performance (ß = - 0.06, se = 0.24, 95% CI - 0.57 to 0.43). CONCLUSIONS: Erroneous example learning and metacognitive demonstrations are effective for academic performance in the domain of medical statistics, but their underlying mechanism merits further study.

Introduction of Digital-Assisted Multidisciplinary Treatment in the Functional and Morphological Reconstruction of Naso-Orbital-Ethmoid Fractures.

ABSTRACT: This study summarizes the process of digital-assisted multidisciplinary treatment (MDT) of naso-orbital-ethmoid (NOE) fractures and evaluates the treatment outcomes. From October 2018 to December 2020, 39 patients with NOE fractures were treated in our department, 21 of whom were diagnosed and treated by a multidisciplinary team. After preoperative multidisciplinary discussions and personalized virtual surgical planning, they received MDT with the assistance of a surgical navigation system. The other 18 patients received traditional single-disciplinary treatment, that is, no preoperative multidisciplinary discussions. Oral and maxil-lofacial surgeons performed surgical design and digitally-assisted surgery alone. After the operation, treatment outcomes were evaluated in terms of aesthetic appearance and function. The duration of preoperative preparation and postoperative aesthetic outcomes were not significantly different in patients who received single-disciplinary treatment and MDT ( P > 0.05). However, postoperative functional outcomes were significantly better in patients who received MDT ( P < 0.05). Furthermore, no significant complications were found. Digital-assisted MDT has a high application value in repair and appearance reconstruction, especially restoring functionality after NOE fracture; thus, it should be promoted in clinical practice.

Three-Dimensional Printed Customized Surgical Guides for the Precise Correction of Complex Midfacial Post-Traumatic Deformities.

PURPOSE: The introduction of intraoperative computed tomography and image-guided navigation have demonstrated some advantages for the correction of midfacial post-traumatic deformities. However, these methods still do not achieve satisfactory results. The authors sought to describe a novel method for the precise correction of complex midfacial post-traumatic deformities using three-dimensional printing customized surgical guides. METHODS: Ten patients with midfacial post-traumatic deformities admitted between January 15, 2018 and August 20, 2020 were included. To design the surgical guide for each patient, preoperative planning and simulation datasets were used as a virtual template. Each surgical guide comprised three-dimensional printing cutting guides and customized titanium plates to guide the osteotomy and repositioning of the fracture fragments intraoperatively. Reduction and fixation were confirmed by intraoperative navigation. Postoperative deviation chromatography analysis and clinical examination were conducted to evaluate the surgical outcome. All operations were successfully performed. RESULTS: The average difference between the virtual plans and postoperative results was less than 1.5 mm. The 3- to 6-month follow-up evaluation demonstrated that symptoms were alleviated, and postoperative function and esthetics improved considerably. CONCLUSIONS: Three-dimensional-printed customized surgical guides can accurately and effectively transfer the virtual surgical plan to the patient and could be considered an ideal and valuable option for this potentially complicated procedure.

Collaborative Control Method and Experimental Research on Robot-Assisted Craniomaxillofacial Osteotomy Based on the Force Feedback and Optical Navigation.

OBJECTIVE: Surgical robot has advantages in high accuracy and stability. But during the robot-assisted bone surgery, the lack of force information from surgical area and incapability of intervention from surgeons become the obstacle. The aim of the study is to introduce a collaborative control method based on the force feedback and optical navigation, which may optimally combine the excellent performance of surgical robot with clinical experiences of surgeons. MATERIALS AND METHODS: The CMF ROBOT system was integrated with the force feedback system to ensure the collaborative control. Force-velocity control algorithm based on force feedback was designed for this control method. In the preliminary experimental test, under the collaborative control mode based on force feedback and optical navigation, the craniomaxillofacial surgical robot entered the osteotomy line area according to the preoperative surgical plan, namely, right maxillary Le Fort I osteotomy, left maxillary Le Fort I osteotomy, and genioplasty. RESULTS: The force sensor was able to collect and record the resistance data of the cutting process of the robot-assisted craniomaxillofacial osteotomy assisted in real time. The statistical results showed that the repeatability of collaborative control mode was acceptable in bilateral maxillary Le Fort I osteotomies (right, P =0.124>0.05 and left, P =0.183>0.05) and unfavorable in genioplasty ( P =0.048<0.05). CONCLUSION: The feasibility of robot-assisted craniomaxillofacial osteotomy under the collaborative control method based on the force feedback and optical navigation was proved in some extent. The outcome of this research may improve the flexibility and safety of surgical robot to meet the demand of craniomaxillofacial osteotomy.

Dlx5 promotes cancer progression through regulation of CCND1 in oral squamous cell carcinoma (OSCC).

Genetic studies have revealed a critical role of the distal-less homeobox gene 5 (Dlx5) in the pathogenesis of ovarian cancer, lung cancer, and T-cell lymphoma; however, the role and underlying mechanisms of Dlx5 in oral squamous cell carcinoma (OSCC) are largely unknown. In this study, we demonstrated that Dlx5 is up-regulated in OSCC tissues and cell lines, compared with their control groups. The results from our immunohistochemistry (IHC) analyses show that high expression levels of Dlx5 correlated with advanced TNM stages (P = 0.0001), lymph node metastasis (P = 0.0049), poor cellular differentiation (P = 0.0491), location of the tumors (P = 0.0132), and poor prognosis for the patient. We also demonstrated that knockdown of Dlx5 inhibited the viability, proliferation, and colony formation of OSCC cell lines CAL-27 and WSU-HN6 cells, probably by blocking cell cycle in the G1 phase. Furthermore, we revealed that Dlx5 exerts its biological functions via direct regulation of CCND1 in CAL-27 and WSU-HN6 cells. Ultimately, we have demonstrated that silencing of Dlx5 inhibits the growth of xenograft tumors in vivo, and that Dlx5 affects the progression of OSCC both in vitro and in vivo via directly regulating CCND1, providing a potential diagnostic biomarker and therapeutic target for OSCC.

Proposal for the Fusion of Ultrasound and Computed Tomography Images for Image Shift Correction in Craniomaxillofacial Soft Tissue Surgery.

ABSTRACT: Surgical navigation has greatly improved the accuracy of craniomaxillofacial bone surgery and is widely used in the clinic. However, during surgery, craniomaxillofacial soft tissue is always deformed due to traction and compression, which leads to intraoperative image drift. This, in turn, impacts navigation accuracy. In order to improve navigation accuracy, this technical note presents a preliminary proposal for fusion imaging technology, which combines ultrasound and computed tomography to address navigational image drift in craniomaxillofacial soft tissue surgery.

Classifying and standardizing panfacial trauma according to anatomic categories and Facial Injury Severity Scale: a 10-year retrospective study.

BACKGROUND: The purpose of this study was to identify the epidemiologic factors of panfacial fractures (PFs), and to evaluate the significance of anatomic PF categories and the Facial Injury Severity Scale (FISS) in classifying and standardizing panfacial injuries. METHODS: A retrospective review of all patients treated with PFs at our institution between June 2010 and April 2021 was performed. PF was defined as a concurrent fracture in at least 3 of 4 facial subunits (frontal, upper midface, lower midface, and mandible). Data regarding patient demographics, causes of injury, location of fractures, major concomitant injuries, and postinjury complications were collected, and the FISS score was collected from each patient. Statistical analysis was performed using IBM SPSS Statistics version 22.0. RESULTS: A total of 227 patients were enrolled. The most commonly fractured bones were the maxillary sinus wall (92.1%), mandible (82.8%), and zygomatic arch (75.3%), and the most common fracture sites in PFs were graphically presented. Four PF patterns were defined: FULM (n = 60), FUL (n = 39), ULM (n = 127), and FUM (n = 1). There was a significant association between PF patterns and sex (p = 0.018), the number of concomitant injuries (p = 0.014), and early surgical airway management (p = 0.003). Different PF patterns were significantly correlated with different types of concomitant injuries and complications. The FISS score showed a significant difference with PF patterns (p = 0.000) and sex (p = 0.007), and a FISS value of 11 or more is the appropriate cutoff for the prediction of multiple concomitant injuries and complications. CONCLUSIONS: Both the anatomic PF categories and FISS were significantly correlated with various concomitant injuries and complications. The combination of PF categories and FISS provided a better positive and negative prediction of concomitant injuries and complications for PF patients. Patients with FULM and FISS > 11 had an obviously higher proportion of the need for multiprofessional treatment.

Attractiveness-related recognition bias captures the memory of the beholder.

Earlier electroencephalographic studies have compared attractive and unattractive faces and between faces with other objects, such as flowers, without revealing if a recognition memory bias toward faces and flowers exists or whether humans exhibit enhanced specific components toward all attractive objects or only toward attractive faces. For objects with similar degrees of attractiveness, we sought to determine if the N170, P1, and N250 reflect upon the attractiveness of faces and flowers and demonstrated by comparing event-related potentials of humans' different perceptual mechanisms recognizing high attractive faces and high attractive flowers. The repeated high attractive faces tended to elicit a larger N170. Simultaneously, the P1 was preferentially associated with the repeated high attractive flowers, but both indicated that the repetitive enhancement effect only occurred on repeated attractive faces. Thus, differences existed in the perceptual mechanisms for processing repeated high attractive faces and repeated high attractive flowers. However, there was no significant difference in N250 between repeated faces and repeated flowers or between high attractive faces and high attractive flowers. Consequently, high attractive faces and high attractive flowers capture the beholder's memory bias in different processing stages. The N170 and P1 components are affected by attractiveness, thereby demonstrating the differences between human perceptual mechanisms in recognizing high attractive faces and objects.

New Solutions to Improve the Accuracy of the Navigation-Guided Foreign Body Removal in Craniomaxillofacial Deep Space.

OBJECTIVE: Surgical navigation-guided removal of foreign bodies in the craniomaxillofacial region has been proven to be an effective method. However, there have been some unsuccessful patients due to reduced navigation accuracy or complicated and undetectable anatomy. This article summarizes the experience and proposes some solutions to achieve better results. STUDY DESIGN: Two solutions were proposed to optimize the surgical navigation procedure: using a 3-dimensionally printed customized mandible retainer to indirectly maintain the consistency of the foreign body's visual images of preoperative planning and intraoperative navigation and importing real-time endoscopic imaging during surgery to provide vision under complex anatomy. Two patients were selected for each method. RESULTS: The foreign bodies were successfully and minimally invasively removed in all patients assisted by optimized surgical navigation. During follow-up at 3 to 6 months postoperatively, no complications were found. CONCLUSION: Improving navigation accuracy and providing real vision might be effective at compensating for insufficient navigation due to navigation positioning errors or the interference of imperceptible and complicated anatomy.

A Modified Method Using Double Computed Tomography Scan Procedure to Maintain Mandibular Width in Mandibular Reconstruction.

OBJECTIVE: The purpose of this study was to evaluate the use of a modified template system and double computed tomography scan procedure to maintain mandibular width in cases of mandibular reconstruction. STUDY DESIGN: Ten patients who underwent mandibular reconstruction with a fibular flap were enrolled. The surgeries were planned with a computer-aided surgical simulation (CASS) planning method. Following double computed tomography scan procedure, the template system was designed in a computer and was fabricated using a three-dimensional printing technique. The cutting guides were designed with the holes of the conventional reconstruction plate on the remnant mandibular segments. After surgery, the outcome evaluation was compared by first superimposing the post-operative computed tomography model onto the planned model and then measuring the differences between the planned and actual outcomes. RESULTS: All surgeries were completed successfully using the template system. With the use of the templates, the largest linear root-mean-square deviation (RMSD) between the planned and post-operative remnant segments was 1.01 mm, and the largest angular RMSD was 4.05°. CONCLUSIONS: The authors conclude that this template system and double computed tomography scan procedure provides a reliable method to maintain mandibular width in mandibular reconstruction using a fibular flap.

Error Analysis of Robot-Assisted Orthognathic Surgery.

OBJECTIVE: Orthognathic surgery is an effective method to correct the dentomaxillofacial deformities. The aim of the study is to introduce the robot-assisted orthognathic surgery and demonstrate the accuracy and feasibility of robot-assisted osteotomy in transferring the preoperative virtual surgical planning (VSP) into the intraoperative phase. METHODS: The CMF robot system, a craniomaxillofacial surgical robot system was developed, consisted of a robotic arm with 6 degrees of freedom, a self-developed end-effector, and an optical localizer. The individualized end-effector was installed with reciprocating saw so that it could perform osteotomy. The study included control and experimental groups. In control group, under the guidance of navigation system, surgeon performed the osteotomies on 3 skull models. In experimental group, according to the preoperative VSP, the robot completed the osteotomies on 3 skull models automatically with assistance of navigation. Statistical analysis was carried out to evaluate the accuracy and feasibility of robot-assisted orthognathic surgery and compare the errors between robot-assisted automatic osteotomy and navigation-assisted manual osteotomy. RESULTS: All the osteotomies were successfully completed. The overall osteotomy error was 1.07 ±â€Š0.19 mm in the control group, and 1.12 ±â€Š0.20 mm in the experimental group. No significant difference in osteotomy errors was found in the robot-assisted osteotomy groups (P = 0.353). There was consistence of errors between robot-assisted automatic osteotomy and navigation-assisted manual osteotomy. CONCLUSION: In robot-assisted orthognathic surgery, the robot can complete an osteotomy according to the preoperative VSP and transfer a preoperative VSP into the actual surgical operation with good accuracy and feasibility.

Posttraumatic Growth in Tibetan Adolescent Survivors 6 Years After the 2010 Yushu Earthquake: Depression and PTSD as Predictors.

This cross-sectional study explored the prevalence of posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) in Tibetan adolescent survivors (98% Tibetan and 2% Han) 6 years after the 2010 Yushu earthquake to identify the PTG predictors. In 2016, 850 high school students (from 11 to 20 years) in Yushu (N = 850) completed the self-rating depression scale, the PTSD Check List-Civilian version, the exposure degree scale, and the posttraumatic growth inventory. It was found that the PTG and probable PTSD prevalence rates were 49.7% and 8.9% 6 years after the earthquake, and that exposure level, depression level, and PTSD symptoms were all significant negative predictors for PTG in both the junior high school and senior high school students. Specifically, having a lower degree of exposure, a lower PTSD level, and no depression symptoms were associated with higher PTG. There was a significant PTG difference found between males and females; however, this gender difference was not found in the senior high school students. No significant PTG differences were found for the different ethnicities. The implications of the results and the limitations of this study are discussed.

A New Modified Method for Accurate Mandibular Reconstruction.

Mandible plays a pivotal role for both function (mastication, swallowing, and phonation) and aesthetic. Traumas, osteomyelitis, osteoradionecrosis, and benign or malignant neoplasm can cause mandibular defect. Several techniques have been proposed for mandibular reconstruction along the past decades. In this article, we present and discuss a new modified method for accurate mandibular reconstruction. This method is mainly indicated in patients with benign mandibular tumors, where the resection margins can be more often anticipated prior to surgery. However, it is less useful for patients with malignant mandibular tumors, in whom resection margins are often finalized intraoperatively.

Interdisciplinary Surgical Management of Multiple Facial Fractures With Image-Guided Navigation.

PURPOSE: To evaluate the effectiveness of interdisciplinary surgical management of multiple facial fractures with image-guided surgical navigation. PATIENTS AND METHODS: From 2011 through 2014, 36 patients with multiple facial fractures were enrolled in the study. With individual virtual 3-dimensional (3D) modeling, interdisciplinary planning and surgical simulation were carried out on an Accu-Navi software platform. Through an interactive collaboration among specialists, all patients underwent 1-stage open reduction under guidance of the navigation system. The outcome was assessed by superimposing the postoperative 3D computed tomographic (CT) model on the preoperative plan and clinical examination. RESULTS: Through the registration procedure, an accurate match between the actual intraoperative position and the CT images was achieved within a systematic error of 1 mm. The fractured bone segments were released and repositioned according to the preoperative plan and simulation with the aid of instrument- and probe-based navigation. All patients underwent uneventful healing without serious complications. Postoperative assessment of surgical intervention showed a quantitative discrepancy less than 2 mm (1.49 ± 0.27), showing a satisfactory concordance. CONCLUSION: In the interdisciplinary surgical management of multiple facial fractures, image-guided surgical navigation, including preoperative planning, surgical simulation, postoperative assessment, and computer-assisted navigation, proved an optimal strategy and valuable option for this potentially complicated procedure.

Navigation-guided lateral gap arthroplasty as the treatment of temporomandibular joint ankylosis.

PURPOSE: This article presents a novel method of navigation-guided lateral gap arthroplasty (LGA) in the treatment of temporomandibular joint ankylosis (TMJA). MATERIALS AND METHODS: Six patients with unilateral TMJA from 2007 through 2011 were included in this study. Presurgical planning was performed to determine the amount and extent of ankylosed bone to be resected using the simulation platform. Minimum follow-up was 6 months. Patients were monitored for complications and signs of recurrence. Maximum mouth opening (MO) was measured and compared intra- and postoperatively. RESULTS: Preoperative planning was performed at the STN or Accu-Navi workstation. The amount and extent of ankylosed bone to be resected was determined. All 6 LGAs were completed successfully using real-time instrument- and pointer-based navigation. Measurements performed intraoperatively showed that the mean for maximum MO was about 35 to 40 mm and remained the same postoperatively. Follow-up evaluation showed remarkable improvement in function and esthetics, with no signs of recurrence. CONCLUSION: Navigation-guided LGA can be regarded a viable option for performing this delicate and complicated surgical procedure.

Le Fort I osteotomy combined with endoscopic assistance for treatment of compound fracture of maxilla, zygoma, and orbital floor.

PURPOSE: The traditional surgery to reconstruct the compound fracture of the zygoma, maxilla, and orbital floor was usually open reduction and internal fixation using miniplate, and surgeons now can perform the endoscopic repair of relatively simple zygoma or orbital blowout fracture. In this study, we try to reconstruct midfacial complex fracture by combined application of intraoral approach and endoscopic-assisted minimally invasive method. METHODS: Six patients with traumatic midfacial fracture, including maxilla, zygoma, and orbital floor fracture, were selected. Intraoral Le Fort I osteotomy approach and endoscopic-assisted minimally invasive method were combined and applied to treat this complex midfacial fracture. RESULTS: The intraoral incision combined with endoscope offered suitable approach for reduction and fixation of fractured zygoma. The Le Fort I osteotomy could help to effectively reduce the fractured maxilla and offered useful operative approach for endoscope. The endoscope combined with a balloon catheter could successfully reconstruct the orbital floor fracture, and no intraoperative complications were encountered. The balloon catheter was removed 4 to 8 weeks after operation and did not lead to infection and obviously disrupt the healing of bone segments. The postoperative eye and occlusion function, evaluated by clinical examination, was satisfactory at 3 months. CONCLUSIONS: Although there are some limitations and strict indications, the advantages of this method may offer alternative choice for reconstruction of compound midfacial fracture.