Perforating cutaneous vessels: A key feature of acupoints - Anatomical evidence from five-Shu acupoints in the upper limbs.

Acupuncture has been proven an effective clinical treatment for numerous pathological conditions and malfunctions. However, substantial anatomical evidence for acupuncture points (APs) and meridians is still lacking, so the location of APs is relatively subjective and understanding of the biological mechanisms of acupuncture is limited. All these problems hinder the clinical applications and worldwide acceptance of acupuncture. Our long-term microsurgery experience has indicated that Perforating Cutaneous Vessels (PCVs) are highly relevant to APs but the anatomical evidence is insufficient. To address this lack, two specimens of fresh adult human upper limbs were dissected using an advanced vascular perfusion-fixation method and then examined. The results show that all 30 five-Shu APs in the upper limbs have corresponding PCVs. Both specimens showed a 100% coincidence rate between APs and PCVs, indicating that PCVs could be critical anatomical features of APs. This study also provides an anatomical basis for locating APs objectively via preliminary detection of PCVs. The findings could lead to a better theoretical understanding of mechanisms of acupuncture and the essence of meridians.

Prognostic factor analysis in patients with early-stage nasopharyngeal carcinoma in the USA.

Aim: To evaluate independent risk factors specific for early-stage nasopharyngeal carcinoma (NPC). Methods: A total of 566 patients with early-stage NPC from 2004 to 2019 were identified using the Surveillance, Epidemiology and End Results database. Results: Older ages (70-79 and >80 years) were independent risk factors, with hazard ratios of 1.961 and 5.011, respectively. The hazard ratio for early-stage NPC in Asian and Pacific Islander residents (0.475) was lower than that for White residents. A tumor size <3 cm was a protective factor for overall and cancer-specific survival in the current study. Conclusion: In patients with early-stage NPC, age >70 years, race and tumor size were independent prognosticators for cancer-specific survival.

Accuracy analysis of traditional acupoint location and the coincidence of cutaneous arterial perforators and acupoints.

Several reports have shown a coincidence relationship between perforators and acupoints. However, there have been few previous reports of objective experimental methods to verify the reliability of the accuracy of acupoint location (APL) with nearby perforators. This research aimed to determine the internal agreement of the APL of five acupuncturists and to analyze the coincidence rate of acupoints with nearby perforators. Three two healthy volunteers were recruited with the inclusion and exclusion criteria. Three TCM clinical physicians determined acupoints in areas of the lower limb of participants. Two microsurgeons sketched corresponding regions based on the most common skin flap operation sites, located bone markers, and drew the skin flap axis. Doppler ultrasound was used to mark the perforator point and the distances measured for both points. There is no significant difference in the distance between the acupoints and perforators localization in different groups, and there are significant differences between the angle formed by acupoints and penetrators in all groups. All the points located by the traditional Chinese medicine (TCM) therapists are distributed around the dot. The distance between the coordinate point (A-B) of Wenliu (LI7) localization is the largest, reaching 16.6 mm. The accuracy of the acupoint location of each physician is limited by the clinical experience of physicians, and the difference among them is significant. There is a certain correspondence between the location of acupoints and perforators, which needs further studies to confirm.

Electron mean-free-path filtering in Dirac material for improved thermoelectric performance.

Recent advancements in thermoelectric materials have largely benefited from various approaches, including band engineering and defect optimization, among which the nanostructuring technique presents a promising way to improve the thermoelectric figure of merit (zT) by means of reducing the characteristic length of the nanostructure, which relies on the belief that phonons' mean free paths (MFPs) are typically much longer than electrons'. Pushing the nanostructure sizes down to the length scale dictated by electron MFPs, however, has hitherto been overlooked as it inevitably sacrifices electrical conduction. Here we report through ab initio simulations that Dirac material can overcome this limitation. The monotonically decreasing trend of the electron MFP allows filtering of long-MFP electrons that are detrimental to the Seebeck coefficient, leading to a dramatically enhanced power factor. Using SnTe as a material platform, we uncover this MFP filtering effect as arising from its unique nonparabolic Dirac band dispersion. Room-temperature zT can be enhanced by nearly a factor of 3 if one designs nanostructures with grain sizes of ∼10 nm. Our work broadens the scope of the nanostructuring approach for improving the thermoelectric performance, especially for materials with topologically nontrivial electronic dynamics.

Topological Singularity Induced Chiral Kohn Anomaly in a Weyl Semimetal.

The electron-phonon interaction (EPI) is instrumental in a wide variety of phenomena in solid-state physics, such as electrical resistivity in metals, carrier mobility, optical transition, and polaron effects in semiconductors, lifetime of hot carriers, transition temperature in BCS superconductors, and even spin relaxation in diamond nitrogen-vacancy centers for quantum information processing. However, due to the weak EPI strength, most phenomena have focused on electronic properties rather than on phonon properties. One prominent exception is the Kohn anomaly, where phonon softening can emerge when the phonon wave vector nests the Fermi surface of metals. Here we report a new class of Kohn anomaly in a topological Weyl semimetal (WSM), predicted by field-theoretical calculations, and experimentally observed through inelastic x-ray and neutron scattering on WSM tantalum phosphide. Compared to the conventional Kohn anomaly, the Fermi surface in a WSM exhibits multiple topological singularities of Weyl nodes, leading to a distinct nesting condition with chiral selection, a power-law divergence, and non-negligible dynamical effects. Our work brings the concept of the Kohn anomaly into WSMs and sheds light on elucidating the EPI mechanism in emergent topological materials.

[Predictive value of global longitudinal strain in patients with cardiomyopathy without hypertrophic change but variants of susceptibility genes].

OBJECTIVE: To explore the predictive value of overall longitudinal strain for the development of cardiomyopathy without hypertrophic changes. METHODS: Sixty five patients with suspected hypertrophic cardiomyopathy (HCM) but without hypertrophic changes were selected. Genetic variant, overall longitudinal strain, left ventricular ejection fraction, end diastolic volume, end systolic volume, interventricular septal thickness, left ventricular diameter and end diastolic diameter were detected. The risk factors of HCM were analyzed. RESULTS: Forty four variants of 16 genes were identified, among which MYBPC3 13659G>A was the commonest (73.20%) and MYH7 13252C>T was the second (31.25%). MYBPC3 GG genotype, overall longitudinal strain and apical longitudinal strain were correlated with HCM (P<0.05). CONCLUSION: The increase of longitudinal strain is of great value in predicting the occurrence of HCM.

Phonon Hydrodynamic Heat Conduction and Knudsen Minimum in Graphite.

In the hydrodynamic regime, phonons drift with a nonzero collective velocity under a temperature gradient, reminiscent of viscous gas and fluid flow. The study of hydrodynamic phonon transport has spanned over half a century but has been mostly limited to cryogenic temperatures (∼1 K) and more recently to low-dimensional materials. Here, we identify graphite as a three-dimensional material that supports phonon hydrodynamics at significantly higher temperatures (∼100 K) based on first-principles calculations. In particular, by solving the Boltzmann equation for phonon transport in graphite ribbons, we predict that phonon Poiseuille flow and Knudsen minimum can be experimentally observed above liquid nitrogen temperature. Further, we reveal the microscopic origin of these intriguing phenomena in terms of the dependence of the effective boundary scattering rate on momentum-conserving phonon-phonon scattering processes and the collective motion of phonons. The significant hydrodynamic nature of phonon transport in graphite is attributed to its strong intralayer sp2 hybrid bonding and weak van der Waals interlayer interactions. More intriguingly, the reflection symmetry associated with a single graphene layer is broken in graphite, which opens up more momentum-conserving phonon-phonon scattering channels and results in stronger hydrodynamic features in graphite than graphene. As a boundary-sensitive transport regime, phonon hydrodynamics opens up new possibilities for thermal management and energy conversion.

Whole exome sequencing identifies a novel variant in an apoptosis-inducing factor gene associated with X-linked recessive hearing loss in a Chinese family.

We report on the genetic analysis of a Chinese family in which four male patients presented with postlingual progressive hearing loss, associated with distal muscle wasting and unsteady ataxic gait. Using whole exome sequencing, we identified a new pathogenic variant (c.1463C>T, p.Pro488Leu) in the AIFM1 gene, which encodes the apoptosis-inducing factor mitochondrion-associated 1 precursor. AIFM1 is involved in the mitochondrial respiratory chain and cellular caspase-independent apoptosis pathway and has been reported to cause multiple phenotypes including hearing loss. The p.Pro488Leu missense variant segregated with symptoms in the pedigree. It was not found in the dbSNP database, databases of genomes and SNPs in the Chinese population, in 74 patients with sporadic hearing loss, or in 108 normal individuals.We also verified that this AIFM1variant enhanced cell apoptosis rates compared in 293T cells transfected with wild-type AIFM1. Different variations of AIFM1 give rise to different phenotypes in patients, and this is the second reported family with a variant in the C-terminal domain of AIFM1 showing the phenotype of hearing loss and peripheral neuropathy.

Nonperturbative Quantum Nature of the Dislocation-Phonon Interaction.

Despite the long history of dislocation-phonon interaction studies, there are many problems that have not been fully resolved during this development. These include an incompatibility between a perturbative approach and the long-range nature of a dislocation, the relation between static and dynamic scattering, and their capability of dealing with thermal transport phenomena for bulk material only. Here by utilizing a fully quantized dislocation field, which we called a "dislon", a phonon interacting with a dislocation is renormalized as a quasi-phonon, with shifted quasi-phonon energy, and accompanied by a finite quasi-phonon lifetime, which are reducible to classical results. A series of outstanding legacy issues including those above can be directly explained within this unified phonon renormalization approach. For instance, a renormalized phonon naturally resolves the decade-long debate between dynamic and static dislocation-phonon scattering approaches, as two limiting cases. In particular, at nanoscale, both the dynamic and static approaches break down, while the present renormalization approach remains valid by capturing the size effect, showing good agreement with lattice dynamics simulations.

Thermal stability and thermal conductivity of phosphorene in phosphorene/graphene van der Waals heterostructures.

Phosphorene, a new two-dimensional (2D) semiconducting material, has attracted tremendous attention recently. However, its structural instability under ambient conditions poses a great challenge to its practical applications. A possible solution for this problem is to encapsulate phosphorene with more stable 2D materials, such as graphene, forming van der Waals heterostructures. In this study, using molecular dynamics simulations, we show that the thermal stability of phosphorene in phosphorene/graphene heterostructures can be enhanced significantly. By sandwiching phosphorene between two graphene sheets, its thermally stable temperature is increased by 150 K. We further study the thermal transport properties of phosphorene and find surprisingly that the in-plane thermal conductivity of phosphorene in phosphorene/graphene heterostructures is much higher than that of the free-standing one, with a net increase of 20-60%. This surprising increase in thermal conductivity arises from the increase in phonon group velocity and the extremely strong phonon coupling between phosphorene and the graphene substrate. Our findings have an important meaning for the practical applications of phosphorene in nanodevices.

In-plane and cross-plane thermal conductivities of molybdenum disulfide.

We investigate the in-plane and cross-plane thermal conductivities of molybdenum disulfide (MoS2) using non-equilibrium molecular dynamics simulations. We find that the in-plane thermal conductivity of monolayer MoS2 is about 19.76 W mK(-1). Interestingly, the in-plane thermal conductivity of multilayer MoS2 is insensitive to the number of layers, which is in strong contrast to the in-plane thermal conductivity of graphene where the interlayer interaction strongly affects the in-plane thermal conductivity. This layer number insensitivity is attributable to the finite energy gap in the phonon spectrum of MoS2, which makes the phonon-phonon scattering channel almost unchanged with increasing layer number. For the cross-plane thermal transport, we find that the cross-plane thermal conductivity of multilayer MoS2 can be effectively tuned by applying cross-plane strain. More specifically, a 10% cross-plane compressive strain can enhance the thermal conductivity by a factor of 10, while a 5% cross-plane tensile strain can reduce the thermal conductivity by 90%. Our findings are important for thermal management in MoS2 based nanodevices and for thermoelectric applications of MoS2.

Analysis of network patterns and its influencing factors in Chengdu-Chongqing urban agglomeration based on multi-flow.

With the strengthening of the cross-regional flows of the economy, information, innovation, and population, this paper constructs a network model of multi-flow integration and analyzes the spatial pattern and influencing factors of urban networks in Chengdu-Chongqing Urban Agglomeration using social network analysis and spatial analysis technology. The main conclusions are as follows. (1) The density and efficiency are in the transition stage from the primary level to the medium level in the comprehensive network. (2) The overall pattern keeps a polyhedral pyramid structure with Chengdu ↔ Chongqing as the core axis, and the grade of each axis has been significantly raised. (3) Four groups are formed using the social network method and show a geographic proximity effect. In addition, the connections within each group are relatively close, but the connections between the groups are significantly different. (4) Location conditions, economic development level, enterprise development level, scientific research investment, scientific and technological development level, and government support have a greater impact on the formation of the comprehensive network of Chengdu-Chongqing urban agglomeration. Information application level and transportation accessibility show a small impact and human capital level has not yet produced a significant impact.

Spatial-temporal differentiation pattern and influencing factors of land economic density at the township scale in Zhejiang Province.

Based on the land economic density of 892 town units, the spatial pattern of the land economic density in Zhejiang Province is analyzed using the coefficient of variation, spatial classification, and spatial correlation methods, and the influencing factors are analyzed using a spatial regression model. The results are as follows: (1) The coefficients of variation were 2.6 and 3.1 in 2014 and 2019, respectively, indicating that the degree of imbalance of the town's industrial economy at the county level increased. (2) The distribution of the high-level agglomeration areas was characterized by one core area and two sub-core areas. The main core area was located at the junction of Hangzhou City, Shaoxing City, and Jiaxing City, and the two sub-core areas were located in Yuyao City and the main urban area of Ningbo City. In addition, several small-scale agglomeration areas composed of medium and high-level units were distributed in Wenzhou City. (3) The high-value agglomeration and low-value agglomeration distribution in the spatial correlation patterns was identified using the spatial auto-correlation method. The hot spots and sub-hot spots were distributed in Northern Zhejiang, and the cold spots formed a large-scale agglomeration in Quzhou City, Lishui City, Taizhou City, and several other cities in Southern Zhejiang. (4) Compared with the county scale, the spatial scope of the high-level areas in Northern Zhejiang shrunk significantly at the township scale, and the high-level agglomeration areas along the southeast coast changed into a cluster of several townships. (5) According to the geographically weighted regression (GWR) model, the importance of influencing factors is as follows: population density > regional area > industrial output value per capita > total population > proportion of secondary and tertiary personnel > total employees.

Spatial pattern of China's rural digital economy based on subjective-Objective evaluation: Evidence from 2085 counties.

The rural digital economy plays an essential role in China's industrial upgrading, transformation, and urban-rural integration. To determine the state of China's rural digital economy, we constructed a county-level evaluation system using the subjective-objective evaluation method and calculated the digital economic levels of 2085 counties. Then, we analyzed the spatial distribution characteristics, spatial autocorrelation pattern, spatial disequilibrium degree, and spatial driving force of the rural digital economy at the county level using spatial analysis technology and a self-organizing feature mapping model. The results are as follows: 1) Compared with the real economy, the agglomeration effect of the digital economy was more obvious, and the economic gradient was more significant. Specifically, the dense high-value regions formed a continuous belt on the eastern coast from the Beijing-Tianjin area to the Pearl River Delta, opposite the dense low-value regions in the west. 2) There were significant differences in the rural digital economy within cities or provinces. Intraregional differences were not necessarily linked to the overall digital economy level because central and northeastern China presented a more balanced rural digital economy. 3) Digital network performance, e-commerce level, and economic vitality were identified as the core factors influencing the rural digital economy.

Pain relief effect of angiopuncture therapy on patients with postoperative pain: A clinical trial.

BACKGROUND: The objective of this study is to study the pain relief effects of angiopuncture therapy in patients with postoperative pain. METHODS: Forty-one patients were randomly selected based on the inclusion and exclusion criteria. Doppler imaging was performed to locate the cutaneous perforator. Angiopuncture was performed on the first postoperative day. A Numerical Rating Scale was used to evaluate the degree of pain before and after angiopuncture. Utilizing the paired t test or Wilcoxon signed rank test, all pre- and post-data were examined, and further subgroup analysis based on time was performed. RESULTS: Variance analysis revealed a significant difference before and after angiopuncture (P < .05). The results of the subgroup analysis showed the pain-relieving effect of angiopuncture for postoperative pain patients at the time points of 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours was apparent (P < .05). CONCLUSION: The angiopuncture therapy approach may assist in pain relief in patients with postoperative pain.

Transcriptional-profile changes in the medial geniculate body after noise-induced tinnitus.

Tinnitus is a disturbing condition defined as the occurrence of acoustic hallucinations with no actual sound. Although the mechanisms underlying tinnitus have been explored extensively, the pathophysiology of the disease is not completely understood. Moreover, genes and potential treatment targets related to auditory hallucinations remain unknown. In this study, we examined transcriptional-profile changes in the medial geniculate body after noise-induced tinnitus in rats by performing RNA sequencing and validated differentially expressed genes via quantitative polymerase chain reaction analysis. The rat model of tinnitus was established by analyzing startle behavior based on gap-pre-pulse inhibition of acoustic startles. We identified 87 differently expressed genes, of which 40 were upregulated and 47 were downregulated. Pathway-enrichment analysis revealed that the differentially enriched genes in the tinnitus group were associated with pathway terms, such as coronavirus disease COVID-19, neuroactive ligand-receptor interaction. Protein-protein-interaction networks were established, and two hub genes (Rpl7a and AC136661.1) were identified among the selected genes. Further studies focusing on targeting and modulating these genes are required for developing potential treatments for noise-induced tinnitus in patients.

The Association Between Tinnitus Sensation-Level Loudness and Sleep Quality in Patients With Subjective Consecutive Tinnitus: A Mediation Analysis.

PURPOSE: So far, there have been no in-depth analyses of the connection between tinnitus sensation-level loudness and sleep quality. Accordingly, the present study was formulated as a mediation analysis focused on exploring this relationship. METHOD: Overall, 1,255 adults with consecutive subjective tinnitus who had sought outpatient treatment were enrolled in the present study. RESULTS: Direct effects of tinnitus sensation-level loudness on sleep quality were not statistically significant (95% confidence intervals [CI] include zero), as measured by the point estimate, -0.016. However, the 95% CI for indirect effects did not include zero when assessing the Self-Rating Anxiety Scale (SAS) scores, the Self-Rating Depression Scale (SDS) scores, the visual analogue scale (VAS) scores, and self-reported tinnitus annoyance. CONCLUSIONS: These results suggest that tinnitus sensation-level loudness does not directly have an effect on sleep quality. However, it indirectly impacts sleep quality, mediated by SAS scores, SDS scores, the impact of tinnitus on life measured using the VAS, and self-reported tinnitus annoyance. As such, alleviating anxiety and depression in patients with tinnitus may result in reductions in their insomnia even if there is no reduction in tinnitus loudness. Importantly, otolaryngologists and other clinicians treating tinnitus should refer patients with tinnitus suffering from insomnia with comorbid depression or anxiety for appropriate psychological and/or psychiatric treatment.

Most discriminative stimuli for functional cell type clustering.

Identifying cell types and understanding their functional properties is crucial for unraveling the mechanisms underlying perception and cognition. In the retina, functional types can be identified by carefully selected stimuli, but this requires expert domain knowledge and biases the procedure towards previously known cell types. In the visual cortex, it is still unknown what functional types exist and how to identify them. Thus, for unbiased identification of the functional cell types in retina and visual cortex, new approaches are needed. Here we propose an optimization-based clustering approach using deep predictive models to obtain functional clusters of neurons using Most Discriminative Stimuli (MDS). Our approach alternates between stimulus optimization with cluster reassignment akin to an expectation-maximization algorithm. The algorithm recovers functional clusters in mouse retina, marmoset retina and macaque visual area V4. This demonstrates that our approach can successfully find discriminative stimuli across species, stages of the visual system and recording techniques. The resulting most discriminative stimuli can be used to assign functional cell types fast and on the fly, without the need to train complex predictive models or show a large natural scene dataset, paving the way for experiments that were previously limited by experimental time. Crucially, MDS are interpretable: they visualize the distinctive stimulus patterns that most unambiguously identify a specific type of neuron.

Biology-Informed Recurrent Neural Network for Pandemic Prediction Using Multimodal Data.

In the biomedical field, the time interval from infection to medical diagnosis is a random variable that obeys the log-normal distribution in general. Inspired by this biological law, we propose a novel back-projection infected-susceptible-infected-based long short-term memory (BPISI-LSTM) neural network for pandemic prediction. The multimodal data, including disease-related data and migration information, are used to model the impact of social contact on disease transmission. The proposed model not only predicts the number of confirmed cases, but also estimates the number of infected cases. We evaluate the proposed model on the COVID-19 datasets from India, Austria, and Indonesia. In terms of predicting the number of confirmed cases, our model outperforms the latest epidemiological modeling methods, such as vSIR, and intelligent algorithms, such as LSTM, for both short-term and long-term predictions, which shows the superiority of bio-inspired intelligent algorithms. In general, the use of mobility information improves the prediction accuracy of the model. Moreover, the number of infected cases in these three countries is also estimated, which is an unobservable but crucial indicator for the control of the pandemic.

Outcomes of cochlear implantation in 75 patients with auditory neuropathy.

Background: Cochlear implantation (CI) outcomes in patients with auditory neuropathy (AN) are variable, which hampers patients' decisions on CI. Objective: This study aims to assess the outcomes of CI in individuals diagnosed with AN and to examine the various factors that may influence the effectiveness of this intervention. Methods: A total of 75 patients diagnosed with AN were included in the study. The hearing threshold, the score of categories of auditory performance (CAP), speech intelligibility rating (SIR), and speech audiometry were tested. Genetic testing was conducted by medical exome sequencing in 46 patients. Results: After CI, the average aided hearing threshold for patients with prelingual and post-lingual onset was 38.25 ± 6.63 dB and 32.58 ± 9.26 dB, respectively; CAP score improved to 5.52 ± 1.64 (p < 0.001) and 6.00 ± 0.96 (p < 0.001), respectively; SIR score increased to 3.57 ± 1.22 (p < 0.001) and 4.15 ± 0.95 (p < 0.001), respectively. Maximum speech recognition ranged from 58 to 93% for prelingual onset patients and 43 to 98% for those with post-lingual onset. Speech outcomes of CI in cases with cochlear nerve (CN) deficiency were significantly poorer (p = 0.008). Molecular etiologies, including TWIST1, ACTG1, m.A7445G, and a copy-number variant (CNV) carrying ACTB, were related to AN here. Conclusion: CI is a viable therapy option for patients with AN; CN deficiency might impact outcomes of CI.