Microsurgical Anatomy of the Common Tendinous Ring and Its Surgical Implications.

BACKGROUND AND OBJECTIVES: The common tendinous ring (CTR), also known as the common annular tendon or annulus of Zinn, is a critical anatomic structure located at the convergence of the orbital apex, superior orbital fissure (SOF), optic canal, and the anterior aspect of the lateral sellar compartment. It plays a vital role in both neurosurgical and neuro-ophthalmological interventions. The aim of this study was to delineate the complex 3-dimensional (3D) topography of the CTR and explore its implications for surgical procedures. METHODS: Ten formalin-fixed skull base specimens from adult Chinese cadavers were meticulously dissected to investigate the morphology of the CTR, focusing particularly on its relationship with the 4 extraocular rectus tendons, the optic strut, the SOF, and the optic canal. Additional skull base specimens were subjected to 3D surface scanning, computed tomography, and histopathological examinations to deepen our understanding of the CTR's structural complexities. RESULTS: The CTR establishes a spatial, 3D tendinous assembly, encompassing 4 rectus tendons, 2 tendinous connections, and a singular common tendinous root. These components interlink to form a distinctive dual-ring configuration, featuring the optic foramen and the oculomotor foramen. The posterior part of the superior rectus tendon demarcates the common boundary between these 2 foramina. The oculomotor foramen itself serves as the central sector of the SOF. Precise incisions of the medial and lateral tendinous connections and fusions are essential for safely opening the CTR. CONCLUSION: The structural composition, interconnections, and dual-ring configuration of the CTR are crucial for precise and safe surgery of orbital apex and adjacent regions.

Noise-robust Vision-language Pre-training with Positive-negative Learning.

Vision-Language Pre-training (VLP) has shown promising performance in various tasks by learning a generic image-text representation space. However, most existing VLP methods encounter the Noisy Correspondence (NC) problem which refers to wrongly matched image-text pairs harvested from the wild. In this paper, we empirically study the influence of NC on the VLP model and obtain the following two observations. First, the NC will largely degrade the performance in downstream tasks even via fine-tuning, indicating the necessity of handling NC in the pre-training period. Second, the influence of NC varies in different pre-training objectives, suggesting the objective-customized solution for achieving NC robustness. Based on the above observations, we propose a novel NoisE-robust Vision-languagE pRe-training method (NEVER) to endow the VLP model with robustness against NC. In brief, NEVER first divides the training data into clean and noisy subsets in a progressive and adaptive manner. Then NEVER employs the positive learning (PL) and negative learning (NL) on the splits to enjoy model convergence and noise robustness, respectively. To further handle the false negative in PL and NL, NEVER proposes to smoothen and sharpen the training targets with the predictions from a twin momentum model. Extensive experiments on the various V+L tasks verify the effectiveness of the proposed method. The code will be released upon acceptance.

Fluorinated ester additive to regulate nucleation behavior and interfacial chemistry of room temperature sodium-sulfur batteries.

Room temperature sodium-sulfur (RT Na-S) batteries are considered as advanced energy storage technology due to their low cost and high theoretical energy density. However, challenges such as the growth of sodium dendrite and dissolution of sodium polysulfides significantly hinder the electrochemical performance. Herein, we developed a propylene carbonate (PC)-based electrolyte with Methyl 2-Fluoroisobutyrate (MFB) as an additive. The ester group in the MFB additive is capable of participating in and reconfiguring the coordination of their Na+ solvated structures, thereby lowering the desolvation barrier and regulating the Na anode's interfacial reaction and nucleation behavior. The polar C-F bond at the other end helps to reduce the lowest unoccupied molecular orbital (LUMO) energy of the MFB additive, enabling the preferential decomposition of MFB to form the F-rich inorganic phase strong polar solid electrolyte interphase (SEI), contributing to the inhibition of Na dendrite growth, the accumulation of dead Na. In addition, NaF-riched cathode electrolyte interphase (CEI) was also observed on sulfur-based cathode, which can effectively inhibited the shuttle effect. Consequently, the developed RT Na-S battery exhibit excellent electrochemical performance.

Portable detection of Salmonella in food of animal origin via Cas12a-RAA combined with an LFS/PGM dual-signaling readout biosensor.

A highly specific and sensitive rapid two-signal assay was developed for the detection of Salmonella typhimurium in foods of animal origin. The invA gene of Salmonella was used as the biorecognition element and recombinase-assisted amplification (RAA) technology for signal amplification. By utilizing the specific recognition and efficient trans-cleavage activity of CRISPR/Cas12a, point-of-care testing (POCT) for S. typhimurium was achieved via lateral flow strips (LFS) and personal glucometer (PGM) biosensors as dual signal readout systems, with sensitivities of 33 CFU/mL and 20 CFU/mL, respectively. Users can select the appropriate test system on the basis of specific application requirements: LFSs are ideal for rapid onsite screening, whereas glucometer biosensors offer precise quantitative determination. This approach simplifies the use of large instruments and overcomes site constraints, demonstrating good accuracy and applicability in animal-derived samples, with significant potential for the detection of other pathogens and for use in restricted environments.

DES-YOLO: a novel model for real-time detection of casting surface defects.

Surface defect inspection methods have proven effective in addressing casting quality control tasks. However, traditional inspection methods often struggle to achieve high-precision detection of surface defects in castings with similar characteristics and minor scales. The study introduces DES-YOLO, a novel real-time method for detecting castings' surface defects. In the DES-YOLO model, we incorporate the DSC-Darknet backbone network and global attention mechanism (GAM) module to enhance the identification of defect target features. These additions are essential for overcoming the challenge posed by the high similarity among defect characteristics, such as shrinkage holes and slag holes, which can result in decreased detection accuracy. An enhanced pyramid pooling module is also introduced to improve feature representation for small defective parts through multi-layer pooling. We integrate Slim-Neck and SIoU bounding box regression loss functions for real-time detection in actual production scenarios. These functions reduce memory overhead and enable real-time detection of surface defects in castings. Experimental findings demonstrate that the DES-YOLO model achieves a mean average precision (mAP) of 92.6% on the CSD-DET dataset and a single-image inference speed of 3.9 milliseconds. The proposed method proves capable of swiftly and accurately accomplishing real-time detection of surface defects in castings.

Full-wave Image Reconstruction in Transcranial Photoacoustic Computed Tomography using a Finite Element Method.

Transcranial photoacoustic computed tomography presents challenges in human brain imaging due to skull-induced acoustic aberration. Existing full-wave image reconstruction methods rely on a unified elastic wave equation for skull shear and longitudinal wave propagation, therefore demanding substantial computational resources. We propose an efficient discrete imaging model based on finite element discretization. The elastic wave equation for solids is solely applied to the hard-tissue skull region, while the soft-tissue or coupling-medium region that dominates the simulation domain is modeled with the simpler acoustic wave equation for liquids. The solid-liquid interfaces are explicitly modeled with elastic-acoustic coupling. Furthermore, finite element discretization allows coarser, irregular meshes to conform to object geometry. These factors significantly reduce the linear system size by 20 times to facilitate accurate whole-brain simulations with improved speed. We derive a matched forward-adjoint operator pair based on the model to enable integration with various optimization algorithms. We validate the reconstruction framework through numerical simulations and phantom experiments.

Molecular characterization, spatio-temporal expression patterns of crtc2 gene and its immune roles in yellow catfish (Pelteobagrus fulvidraco).

cAMP response element binding (CREB) protein 2 (CRTC2) is a transcriptional coactivator of CREB and plays an important role in the immune system. Thus far, the physiological roles of Crtc2 in teleost are still poorly understood. In this study, the crtc2 gene was identified and characterized from yellow catfish (Pelteobagrus fulvidraco; therefore, the gene is termed as pfcrtc2), and its evolutionary and molecular characteristics as well as potential immunity-related roles were investigated. Our results showed that the open reading frame of pfcrtc2 was 2346 bp in length, encoding a protein with 781 amino acids. Gene structure analysis revealed its existence of 14 exons and 13 introns. A phylogenetic analysis proved that the tree of crtc2 was clustered into five groups, exhibiting a similar evolutionary topology with species evolution. Multiple protein sequences alignment demonstrated high conservation of the crtc2 in various vertebrates with similar structure. Syntenic and gene structural comparisons further established that crtc2 was highly conserved, implying its similar roles in diverse vertebrates. Tissue distribution pattern detected by quantitative real-time PCR showed that the pfcrtc2 gene was almost expressed in all detected tissues except for eyes, with the highest expression levels in the gonad, indicating that Crtc2 may play important roles in various tissues. In addition, pfcrtc2 was transcribed at all developmental stages in yellow catfish, showing the highest expression levels at 12 h after fertilization. Finally, the transcriptional profiles of crtc2 were significantly increased in yellow catfishes injected with Aeromonas hydrophila or Poly I:C, which shared a consistent change pattern with four immune-related genes including IL-17A, IL-10, MAPKp38, and NF-κBp65, suggesting pfCrtc2 may play critical roles in preventing both exogenous bacteria and virus invasion. In summary, our findings lay a solid foundation for further studies on the functions of pfcrtc2, and provide novel genetic loci for developing new strategies to control disease outbreak in teleost.

Utilization of chitosan nanocomposites loaded with quantum dots enables efficient and traceable DNA delivery.

Chitosan is widely employed in gene carriers due to its excellent gene loading capacity, ease of modification, and exceptional biodegradability. However, low gene delivery efficiency, high cytotoxicity, and lack of tracer biomimetic properties limit its clinical use. To address these issues, a novel biomimetic tracking gene delivery carrier, RBCm-C50kQT, was constructed by using the design scheme of cell membrane coated carbon quantum dots/chitosan. This carrier improves stability and tracking performance while embedding the cell membrane enhances biosafety. RBCm-C50kQT effectively carries and protects DNA, improving uptake and transfection efficiency with reduced cytotoxicity. It maintains strong fluorescence tracking and shows high uptake efficiencies of 83.62 % and 77.45 % in 293 T and HeLa cells, respectively, with maximum transfection efficiencies of 68.80 % and 45.47 %. This advancement supports gene therapy improvements and paves the way for future clinical applications.

Beyond weight loss: the potential of glucagon-like peptide-1 receptor agonists for treating heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with various phenotypes, and obesity is one of the most common and clinically relevant phenotypes of HFpEF. Obesity contributes to HFpEF through multiple mechanisms, including sodium retention, neurohormonal dysregulation, altered energy substrate metabolism, expansion of visceral adipose tissue, and low-grade systemic inflammation. Glucagon-like peptide-1 (GLP-1) is a hormone in the incretin family. It is produced by specialized cells called neuroendocrine L cells located in the distal ileum and colon. GLP-1 reduces blood glucose levels by promoting glucose-dependent insulin secretion from pancreatic ß cells, suppressing glucagon release from pancreatic α cells, and blocking hepatic gluconeogenesis. Recent evidence suggests that GLP-1 receptor agonists (GLP-1 RAs) can significantly improve physical activity limitations and exercise capacity in obese patients with HFpEF. The possible cardioprotective mechanisms of GLP-1 RAs include reducing epicardial fat tissue thickness, preventing activation of the renin-angiotensin-aldosterone system, improving myocardial energy metabolism, reducing systemic inflammation and cardiac oxidative stress, and delaying the progression of atherosclerosis. This review examines the impact of obesity on the underlying mechanisms of HFpEF, summarizes the trial data on cardiovascular outcomes of GLP-1 RAs in patients with type 2 diabetes mellitus, and highlights the potential cardioprotective mechanisms of GLP-1 RAs to give a pathophysiological and clinical rationale for using GLP-1 RAs in obese HFpEF patients.

Enhanced pH-sensitive anthocyanin film based on chitosan quaternary ammonium salt: A promising colorimetric indicator for visual pork freshness monitoring.

An intelligent pH response indicator film is an easy-to-use device for the real-time monitoring of meat freshness during transport and storage. Therefore, a novel pH-sensitive anthocyanin indicator film composed of polyvinyl alcohol-blueberry anthocyanin (BA)-2-hydroxypropyltrimethyl ammonium chloride chitosan (HACC) called PAH-2.0 with 1.2 mg/mL HACC to monitor meat freshness using HACC as the colorimetric enhancer has been developed. BA and HACC were mixed and immobilized in the polyvinyl alcohol matrix by hydrogen bonds, as confirmed via Fourier-transform infrared spectroscopy and X-ray diffraction. The inclusion of HACC improved the color stability and antioxidant and antibacterial properties of the PAH-2.0 film. When applied to pork for freshness monitoring at 4 °C, three freshness stages, including fresh, sub-fresh, and spoiled, could be clearly distinguished based on the color variations of the PAH-2.0 film. The distinct hierarchical color change from purple to blue-violet and finally to grayish-blue was highly correlated with the indicators of pork freshness: pH values, total volatile basic nitrogen, and total viable count. This study provides a simple and promising approach for fabricating meat freshness indicator films with high color recognition accuracy, thereby offering new possibilities for visual meat freshness monitoring.

Preoperative low serum albumin increases the rate of perioperative blood transfusion in patients undergoing total joint arthroplasty: propensity score matching.

BACKGROUND: To investigate the relationship between preoperative low serum albumin and perioperative blood transfusion in patients undergoing total joint arthroplasty (TJA). METHODS: We enrolled 2,772 TJA patients from our hospital between January 1, 2017, and January 1, 2022. Clinical data were extracted from electronic medical records, including patient ID, sex, BMI (Body Mass Index), age, and diagnoses. Receiver operating characteristic curves were constructed to establish thresholds for serum albumin levels categorization. Propensity score matching (PSM) was developed with preoperative serum albumin as the dependent variable and perioperative blood transfusion-related factors as covariates, including BMI grade, age grade, sex, diagnosis, hypertension, diabetes, coronary heart disease, chronic obstructive pulmonary disease, chronic bronchitis, cerebral infarction, major surgeries within the last 12 months, renal failure, cancer, depression, corticosteroid use, smoking, drinking, and blood type. The low serum albumin group was matched with the normal albumin group at a 1:2 ratio, employing a caliper value of 0.2. Binary logistic regression was employed to analyze the outcomes. RESULTS: An under the curve of 0.601 was discovered, indicating a cutoff value of 37.3 g/L. Following PSM, 892 cases were successfully paired in the low serum (< 37.3 g/L) albumin group, and 1,401 cases were matched in the normal serum albumin (≥ 37.3 g/L) group. Binary logistic regression in TJA patients showed that the albumin OR was 0.911 with 95%CI 0.888-0.935, P < 0.001. Relative to the preoperative normal serum albumin group, TJA patients in the low serum albumin group experienced a 1.83-fold increase in perioperative blood transfusion rates (95% CI 1.50-2.23, P < 0.001). Compared to the normal serum albumin group, perioperative blood transfusion rates for TJA patients with serum albumin levels of 30-37.3 g/L, 25-30 g/L, and ≤ 25 g/L increased by 1.63 (95% CI 1.37-1.99, P < 0.001), 5.4 (95% CI 3.08-9.50, P < 0.001), and 6.43 times (95% CI 1.80-22.96, P = 0.004), respectively. CONCLUSION: In TJA patients, preoperative low serum albumin levels have been found to be associated with an increased risk of perioperative blood transfusion. Furthermore, it has been observed that the lower the preoperative serum albumin level is, the higher the risk of perioperative blood transfusion. TRIAL REGISTRATION: 28/12/2021, Chinese Clinical Trial Registry, ChiCRT2100054844.

Free-Breathing Non-Contrast T1ρ Dispersion MRI of Myocardial Interstitial Fibrosis in Comparison with Extracellular Volume Fraction.

BACKGROUND: Myocardial fibrosis is a common feature in various cardiac diseases. It causes adverse cardiac remodeling and is associated with poor clinical outcomes. Late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) are the standard MRI techniques for detecting focal and diffuse myocardial fibrosis. However, these contrast-enhanced techniques require the administration of gadolinium contrast agents, which is not applicable to patients with gadolinium contraindications. To eliminate the need of contrast agents, we develop and apply an endogenous free-breathing T1ρ dispersion imaging technique (FB-MultiMap) for diagnosing diffuse myocardial fibrosis in a cohort with suspected cardiomyopathies. METHODS: The proposed FB-MultiMap technique, enabling T2, T1ρ and their difference (myocardial fibrosis index, mFI) quantification in a single scan was developed in phantoms and 15 healthy subjects. In the clinical study, 55 patients with suspected cardiomyopathies were imaged using FB-MultiMap, conventional native T1 mapping, LGE, and ECV imaging. The accuracy of the endogenous parameters for predicting increased ECV was evaluated using receiver operating characteristic (ROC) curve analysis. In addition, the correlation of native T1, T1ρ, and mFI with ECV was respectively assessed using Pearson correlation coefficients. RESULTS: FB-MultiMap showed a good agreement with conventional separate breath-hold mapping techniques in phantoms and healthy subjects. Considering all the patients, T1ρ was more accurate than mFI and native T1 for predicting increased ECV, with area under the curve (AUC) values of 0.91, 0.79 and 0.75, respectively, and showed stronger correlation with ECV (correlation coefficient r: 0.72 vs. 0.52 vs. 0.40). In the subset of 47 patients with normal T2 values, the diagnostic performance of mFI was significantly strengthened (AUC=0.90, r=0.83), outperforming T1ρ and native T1. CONCLUSION: The proposed free-breathing T1ρ dispersion imaging technique enabling simultaneous quantification of T2, T1ρ and mFI in a single scan has shown great potential for diagnosing diffuse myocardial fibrosis in patients with complex cardiomyopathies without contrast agents.

Male sling versus artificial urinary sphincter for the treatment of incontinence after prostate surgery: a systematic review with meta-analysis.

Background: Urinary incontinence following prostate treatment (IPT) represents a significant complication that detrimentally impacts the quality of life for patients who have undergone prostate surgery. Presently, there is a scarcity of evidence regarding the preferred surgical techniques for IPT. We conducted a meta-analysis to compare the outcomes of the male sling and artificial urinary sphincter (AUS) in the treatment of IPT. Methods: Data were extracted through electronic literature searches on PubMed, Web of Science, and Embase databases until September 2023. Eligible studies included patients who underwent AUS or male sling procedures for IPT and had a follow-up duration exceeding 12 months. The primary end point was the success rate, with the secondary outcome focusing on complication rates. A fixed-effects or random-effects models were used to calculate the pooled estimate and its 95% confidence interval (CI). The publication bias was assessed using funnel plots and Egger's regression test. Results: The meta-analysis included nine studies, involving a total of 1,350 participants. No statistically significant difference in success rates was found between AUS and male sling [odds ratio (OR): 0.96, 95% CI: 0.91-1.01]. In terms of the complication rate, there was no significant disparity between the two procedures (OR: 0.87, 95% CI: 0.86-1.12). Conclusions: The findings from this study indicated that male sling surgery yielded success and complication rates comparable to those of AUS. This suggests that male sling could serve as a viable alternative surgical option in the treatment of IPT.

Assessment of hyperacute cerebral ischemia using laser speckle contrast imaging.

Accurate diagnosis of cerebral ischemia severity is crucial for clinical decision-making. Laser speckle contrast imaging based cerebral blood flow imaging can help assess the severity of cerebral ischemia by monitoring changes in blood flow. In this study, we simulated hyperacute ischemia in rats, isolating arterial and venous flow-related signals from cortical vasculature. Pearson correlation was used to examine the correlation between damaged vessels. Granger causality analysis was utilized to investigate causality correlation in ischemic vessels. Resting state analysis revealed a negative Pearson correlation between regional arteries and veins. Following cerebral ischemia induction, a positive artery-vein correlation emerged, which vanished after blood flow reperfusion. Granger causality analysis demonstrating enhanced causality coefficients for middle artery-vein pairs during occlusion, with a stronger left-right arterial effect than that of right-left, which persisted after reperfusion. These processing approaches amplify the understanding of cerebral ischemic images, promising potential future diagnostic advancements.

RoMo: Robust Unsupervised Multimodal Learning With Noisy Pseudo Labels.

The rise of the metaverse and the increasing volume of heterogeneous 2D and 3D data have created a growing demand for cross-modal retrieval, enabling users to query semantically relevant data across different modalities. Existing methods heavily rely on class labels to bridge semantic correlations; however, collecting large-scale, well-labeled data is expensive and often impractical, making unsupervised learning more attractive and feasible. Nonetheless, unsupervised cross-modal learning faces challenges in bridging semantic correlations due to the lack of label information, leading to unreliable discrimination. In this paper, we reveal and study a novel problem: unsupervised cross-modal learning with noisy pseudo-labels. To address this issue, we propose a 2D-3D unsupervised multimodal learning framework that leverages multimodal data. Our framework consists of three key components: 1) Self-matching Supervision Mechanism (SSM) warms up the model to encapsulate discrimination into the representations in a self-supervised learning manner. 2) Robust Discriminative Learning (RDL) further mines the discrimination from the learned imperfect predictions after warming up. To tackle the noise in the predicted pseudo labels, RDL leverages a novel Robust Concentrating Learning Loss (RCLL) to alleviate the influence of the uncertain samples, thus embracing robustness against noisy pseudo labels. 3) Modality-invariance Learning Mechanism (MLM) minimizes the cross-modal discrepancy to enforce SSM and RDL to produce common representations. We conduct comprehensive experiments on four 2D-3D multimodal datasets, comparing our method against 14 state-of-the-art approaches, thereby demonstrating its effectiveness and superiority.

Influence of cascade reservoirs on the distribution, transport, and retention patterns of biogenic elements in the Jinsha River.

Cascade reservoirs construction can greatly alter flow regime and sediment transport of rivers, further affecting migration and transformation processes of biogenic elements. The Jinsha River (JSR) is the China's largest hydropower base and the main runoff, sediment suspension, and nutrient source areas of the Yangtze River. However, the distribution, transport, and retention patterns of biogenic elements in the JSR are still unclear under the influence of cascade reservoirs. Therefore, monthly concentration monitoring work was conducted from November 2021 to October 2023 for various forms of carbon (C), nitrogen (N), phosphorus (P), and silicon (Si). Results showed that the concentrations and fluxes of total phosphorus (TP) and particulate phosphorus (PP) exhibited continuous decreasing trends along the reservoirs cascade, whereas N exhibited contrasting trends. The concentrations of dissolved total carbon (DTC), dissolved inorganic carbon (DIC), and total silicon also showed decreasing trends from upstream to downstream, whereas their fluxes were primarily influenced by runoff and exhibited upward fluctuations. Compared with other biogenic elements, there was a more pronounced retention effect on TP and PP by reservoirs, with average retention rates of 8.29 % and 16.01 %, respectively. Longer hydraulic retention time (HRT) can retain more TP and PP. Meanwhile, the retention rates of DTC, DIC, and particulate silicon were positively correlated with HRT, while the retention rate of dissolved silicon (DSi) showed a positive correlation with reservoir age. Moreover, the higher ratios of dissolved inorganic nitrogen to dissolved inorganic phosphorus (DIP) and DSi to DIP have occurred, resulting in apparent P limitation, particularly during the non-flood season due to lower DIP concentration. Overall, cascade reservoirs construction exists great influences on the spatial allocation, fluxes transport, and biogeochemical cycles of biogenic elements, potentially affecting the stability of rivers ecosystem along the food chain network.

Polysaccharides from Seedless Chestnut Rose (Rosa sterilis) Fruits: Insights into Innovative Drying Technologies and Their Structural Characteristics, Antioxidant, Antiglycation, and α-Glucosidase Inhibitory Activities.

The selection of an optimal drying method is essential for extending the shelf life and enhancing the quality of Rosa sterilis fruits. This study investigated the effects of both innovative (microwave vacuum drying and infrared drying) and traditional (freeze-drying and hot air drying) techniques on the structural characteristics and bioactivities of polysaccharides from R. sterilis fruits (RSPs). Four different RSPs were obtained from fruits dried using these methods. Results demonstrated that the structural characteristics and bioactivities of RSPs varied significantly with the drying method. Notable differences were observed in extraction yield, total sugar, uronic acid content, monosaccharide molar ratios, molecular weight distribution, particle size, thermal stability, and microstructures of RSPs. Despite these variations, the types of constituent monosaccharides and major glycosidic linkages remained consistent across all methods. Notably, RSPs obtained via microwave vacuum drying (RSPs-MVD) showed a higher uronic acid content and lower molecular weight, and exhibited stronger in vitro antioxidant, α-glucosidase inhibitory, and antiglycation activities. These findings suggest that microwave vacuum drying is an effective pre-drying technique for extracting RSPs, making them suitable as bioactive ingredients in functional foods and pharmaceuticals for managing diabetes mellitus and its complications.

From Molecular Design to Practical Applications: Strategies for Enhancing the Optical and Thermal Performance of Polyimide Films.

Polyimide (PI) films are well recognized for their outstanding chemical resistance, radiation resistance, thermal properties, and mechanical strength, rendering them highly valuable in advanced fields such as aerospace, sophisticated electronic components, and semiconductors. However, improving their optical transparency while maintaining excellent thermal properties remains a significant challenge. This review systematically checks over recent advancements in enhancing the optical and thermal performance of PI films, focusing on various strategies through molecular design. These strategies include optimizing the main chain, side chain, non-coplanar structures, and endcap groups. Rigid and flexible structural characteristics in the proper combination can contribute to the balance thermal stability and optical transparency. Introducing fluorinated substituents and bulky side groups significantly reduces the formation of charge transfer complexes, enhancing both transparency and thermal properties. Non-coplanar structures, such as spiro and cardo configurations, further improve the optical properties while maintaining thermal stability. Future research trends include nanoparticle doping, intrinsic microporous PI polymers, photosensitive polyimides, machine learning-assisted molecular design, and metal coating techniques, which are expected to further enhance the comprehensive optical and thermal performance of PI films and expand their applications in flexible displays, solar cells, and high-performance electronic devices. Overall, systematic molecular design and optimization have significantly improved the optical and thermal performance of PI films, showing broad application prospects. This review aims to provide researchers with valuable references, stimulate more innovative research and applications, and promote the deep integration of PI films into modern technology and industry.

Efficacy and safety of combining short-course neoadjuvant chemoradiotherapy with envafolimab in locally advanced rectal cancer patients with microsatellite stability: A phase II PRECAM experimental study.

BACKGROUND: Conventional neoadjuvant chemoradiotherapy (nCRT) yields a pathologic complete response (pCR) rate of 15%-30% for locally advanced rectal cancer (LARC). This study ventures to shift this paradigm by incorporating short-course nCRT with immunotherapy, specifically Envafolimab, to achieve improved treatment efficacy and possibly redefine the standard of care for LARC. MATERIALS AND METHODS: The PRECAM study is a prospective, single-arm, phase 2 clinical trial for LARC in patients with microsatellite stable (MSS) tumors. Participants received short-course radiotherapy (25Gy/5f), followed by two cycles of CAPEOX chemotherapy and six weekly doses of Envafolimab, a PD-L1 antibody, before total mesorectal excision surgery. The primary endpoint was the pCR rate. RESULTS: From April to December 2022, 34 patients were enrolled, of whom 32 completed the study, each diagnosed with an MSS rectal adenocarcinoma. All patients underwent preoperative CRT combined with Envafolimab. Remarkably, a pCR rate of 62.5% (20/32) was attained, and a significant pathologic response rate of 75% (24/32) was achieved. Additionally, 21 of 32 participants achieved a neoadjuvant rectal (NAR) score below 8, suggesting an effective treatment response. Common adverse events included tenesmus (78.1%), diarrhea (62.5%), and leukocyte decrease (40.6%). Two Grade 3 adverse events were noted, one related to liver function abnormality and the other to a decrease in platelet count. Surgical procedures were performed in all cases, with minor complications, including ileus, infections, and anastomotic leakage. As of this report, there have been no reported cases of recurrence or death during the follow-up period, ranging from 12 to 20 months. CONCLUSION: In LARC patients exhibiting MSS tumors, combining short-course nCRT with Envafolimab demonstrated favorable efficacy, leading to a significant pCR rate. Minor adverse effects and surgical complications were observed. These preliminary but promising results underscore the potential of this approach and call for further exploration and validation through a randomized controlled trial.

Angioarchitecture Classification and Treatment Modalities of Craniocervical Junction Arteriovenous Fistulas: A Cohort Study of 155 Patients.

BACKGROUND AND OBJECTIVES: Craniocervical junction (CCJ) arteriovenous fistulas (AVFs) are rare. Variability in clinical manifestations and treatment strategies for CCJ AVFs stems from differences in their angioarchitecture. Our study aims to categorize CCJ AVFs based on their angioarchitecture and explore the associated clinical features and treatment modalities for distinct CCJ AVF types. METHODS: The authors conducted a retrospective analysis of patients with CCJ AVFs treated at a single neurosurgical facility over the past decade. These patients were classified based on the angioarchitecture of their CCJ AVFs. The analysis included an evaluation of angioarchitecture, clinical characteristics, treatment strategies, and outcomes. RESULTS: The study included 155 patients, with a median age of 56 years, collectively manifesting 165 CCJ AVFs. Our classification identified 4 distinct CCJ AVF types: epidural AVFs (19 [11.5%]), dural AVFs (98 [59.4%]), radicular AVFs (33 [20.0%]), and perimedullary AVFs (15 [9.1%]). Further differentiation was applied based on the presence of pial feeders. The predominant fistula location was at cervical-1 (77.0%). Ascending intradural drainage (52.7%) and descending intradural drainage (52.1%) were frequently observed drainage patterns. Patients with dural AVF predominantly presented with venous hypertensive myelopathy, whereas patients with other types of CCJ AVFs showed a higher incidence of subarachnoid hemorrhage (P = .012). Microsurgery was the predominant treatment, applied in the management of 126 (76.4%) AVFs, whereas 8 (4.8%) AVFs exclusively underwent interventional embolization and 25 (15.2%) received a combination of interventional embolization and microsurgical treatment. CONCLUSION: CCJ AVFs can be distinguished based on the fistula location and the arterial feeders. Currently, microsurgery stands as the preferred treatment strategy for CCJ AVFs, whereas interventional embolization plays a distinctive role in cases with specific angioarchitecture or as a pretreatment measure before microsurgery.