Towards Understanding Formation Mechanism of Cellular Structures in Laser Powder Bed Fused AlSi10Mg.

A new approach is proposed that identifies three different zones of the Si-rich network structure (the cellular structure) in laser powder bed fused (LPBF) AlSi10Mg alloy, based on the variation in morphology, grain growth transition, and melt pool solidification conditions. The three identified zones are denoted in the present work as the liquid solidification zone (LSZ), the mushy solidification zone (MSZ), and the heat affected zone (HAZ). The LSZ is the result of liquid-solid transformation, showing small planar growth at the boundary and large cellular growth in the center, while the MSZ is related to a semisolid reaction, and the HAZ arises from a short-time aging process. The boundary between the LSZ and MSZ is identified by the change of grain growth direction and the Si-rich network advancing direction. The boundary between MSZ and HAZ is identified by the start of the breakdown of the Si-rich network. In addition, it is found that the fracture is generated in and propagates along the HAZ during tensile tests.

Spontaneous intestinal perforation among very preterm infants in China: a multicenter cohort study.

Background: Spontaneous intestinal perforation (SIP) is one of the most serious surgical bowel conditions affecting preterm infants. There are limited data on the mortality and morbidities of very preterm infants [VPIs, <32 weeks' gestational age (GA)] with SIP in China. The study aimed to describe the prevalence, treatment, and outcomes of SIP among VPIs in China. Methods: This retrospective cohort study included all infants born at 24+0-31+6 weeks GA from January 1, 2019, to December 31, 2020, and admitted within seven days after birth to the neonatal intensive care units in the Chinese Neonatal Network. The primary outcome was survival without major morbidities. The association between SIP and neonatal outcomes was evaluated using multivariate logistic regression controlling for possible confounders. Results: Out of the 15,814 enrolled infants, 150 (1.0%) developed SIP with a median onset age of four (IQR 2-6) days. Infants with GA 24+0-25+6 weeks had the highest incidence of SIP (13/532, 2.4%), followed by those with GA 26+0-27+6 weeks (22/2,005, 1.1%), 28+0-29+6 weeks (44/5,269, 0.8%) and 30+0-31+6 weeks (71/8,008, 0.9%). Ten SIP cases were lost to follow-up with unknown survival status and 41 (29.3%) of the remaining 140 infants with SIP died during hospitalization. Only 29.3% of infants with SIP survived without major morbidities, significantly lower than those without SIP (59.2%; P<0.01). Multivariate analysis revealed SIP was associated with a higher risk of overall death (adjusted OR 3.36; 95% CI: 1.85 to 6.08), late-onset sepsis (adjusted OR 2.10; 95% CI: 1.02 to 4.31), and bronchopulmonary dysplasia (adjusted OR 2.49; 95% CI: 1.44 to 4.30). Among all infants with SIP, 28 (18.7%) did not receive any surgical intervention. Laparotomy was provided to 113 (92.6%) of the remaining 122 infants, solely (84/122, 68.9%) or following peritoneal drainage (29/122, 23.8%), while nine (7.4%) infants underwent peritoneal drainage only. Conclusions: Around 1% of VPIs in China developed SIP, associated with increased risk of mortality and morbidities. Over 90% of VPIs with SIP underwent laparotomy as initial or subsequent surgical treatment. Effective and evidence-based strategies are needed for the prevention and management of SIP.

Focus on brain-lung crosstalk: preventing or treating the pathological vicious circle between the brain and the lung.

Recently, there has been increasing attention to bidirectional information exchange between the brain and lungs. Typical physiological data is communicated by channels like the circulation and sympathetic nervous system. However, communication between the brain and lungs can also occur in pathological conditions. Studies have shown that severe traumatic brain injury(TBI), cerebral hemorrhage, subarachnoid hemorrhage(SAH), and other brain diseases can lead to lung damage. Conversely, severe lung diseases such as acute respiratory distress syndrome(ARDS), pneumonia, and respiratory failure can exacerbate neuroinflammatory responses, aggravate brain damage, deteriorate neurological function, and result in poor prognosis. A brain or lung injury can have adverse effects on another organ through various pathways, including inflammation, immunity, oxidative stress, neurosecretory factors, microbiome and oxygen. Researchers have increasingly concentrated on possible links between the brain and lungs. However, there has been little attention given to how the interaction between the brain and lungs affects the development of brain or lung disorders, which can lead to clinical states that are susceptible to alterations and can directly affect treatment results. This review described the relationships between the brain and lung in both physiological and pathological conditions, detailing the various pathways of communication such as neurological, inflammatory, immunological, endocrine, and microbiological pathways. Meanwhile, this review provides a comprehensive summary of both pharmacological and non-pharmacological interventions for diseases related to the brain and lungs. It aims to support clinical endeavors in preventing and treating such ailments and serve as a reference for the development of relevant medications.

A method for separating tonoplast from wheat.

Vacuoles account for 90% of plant cell volume and play important roles in maintaining osmotic pressure, storing metabolites and lysosomes, compartmentalizing harmful ions, and storing and reusing minerals. These functions closely relay on the ion channels and transporters located on the tonoplast. The separation of intact vacuoles from plant cells is the key technology utilized in the study of tonoplast-located ion channels and transporters. However, the current vacuole separation methods are available for Arabidopsis and some other dicotyledons but are lacking for monocot crops. In this study, we established a new method for the vacuole separation from wheat mesophyll cells and investigated the transmembrane proton flux of tonoplasts with non-invasive micro-test technology (NMT). Moreover, our study provides a technology for the study of vacuole functions in monocot crops.

Analysis of quality evaluation and optimal harvest period of Aurantii Fructus from different sources using UHPLC-Q-TOF-MS/MS.

INTRODUCTION: The active constituents in Aurantii Fructus sourced from different regions within Hunan Province exhibit variations, with certain samples demonstrating substandard quality. OBJECTIVES: The aim of this study is to conduct a comparative analysis of the chemical composition and quality of Aurantii Fructus from various sources, establish a robust methodology for quality evaluation, and determine the optimal harvesting period. MATERIALS AND METHODS: The components of Aurantii Fructus were qualitatively analyzed using a non-targeted metabolomics approach. Multivariate statistical analyses were conducted to identify potential markers, enabling qualitative and quantitative evaluation of the quality and optimal harvest period of Aurantii Fructus. RESULTS: Overall, 155 compounds were identified in Aurantii Fructus, with Huangpi exhibiting the highest number of components. Eleven potential markers were selected to assess the quality of Aurantii Fructus. The average content of Huangpi was the highest, indicating a high level of similarity. The samples' overall scores were ordered as follows: Huangpi > Xiangcheng > Choucheng > Daidai. Anren and Changde's Huangpi exhibited high contents, being rich in chemical components, resulting in favorable scores. Similarly, Changde's Xiangcheng displayed significant medicinal value. As the harvest time was delayed, there was an increase in fruit size, accompanied by thinner peels and a continuous decrease in the contents of potential markers. The best harvest period of Aurantii Fructus was within 1 week before and after the Lesser Heat. CONCLUSION: The present study establishes a precise and efficient method for evaluating the quality of Aurantii Fructus, thereby providing more comprehensive insights into its composition. This research lays the foundation for subsequent development and utilization of Aurantii Fructus.

The clinical use of remote parameter testing during cardiac implantable electronic devices implantation procedures: a single center, randomized, open-label, non-inferiority trial.

Background: A novel non-contact system for remote parameter testing and reprogramming offers an alternative method for assessing device parameters during cardiac implantable electronic devices (CIEDs) implantation without the need for physical contact with the manufacturer's clinical service technician. The safety and feasibility of using this system in CIEDs implantation procedures remains to be determined. Objective: Evaluate the safety and feasibility of remote parameter testing in CIEDs implantation procedures. Methods: A single center, randomized, open-label, non-inferiority trial (ChiCTR2200057587) was conducted to compare the two approaches for interrogating CIEDs during implantation procedures: routine interrogation performed by on-site technicians or remote interrogation performed by technicians using the 5G-Cloud Technology Platform. Patients aged ≥18 years and elected to receive CIEDs were eligible for inclusion. The primary endpoint was the completion rate of the parameter test. Safety and efficiency were evaluated in all randomly assigned participants. Results: A total of 480 patients were finally enrolled and were randomly assigned to routine group (n = 240) or remote group (n = 240). The primary endpoint was achieved by 100% in both groups (P = 0.0060 for noninferiority). The parameters of sensing, threshold, and impedance regarding the right atrium, right ventricle, and left ventricle had no statistical significance between the two groups (P > 0.05). Procedure time, parameter testing time, and both duration and dose of x-ray irradiation were not significantly different between the two groups (P > 0.05). Shut-open door frequency was significantly higher in the routine group than the remote group [6.00 (4.00, 8.00) vs. 0, P < 0.0001]. Notably, no clinical or technical complications were observed in the remote group. Conclusions: Remote parameter testing is safe and feasible across various devices implantation procedures. The utilization of remote parameter testing and reprogramming could represent an innovative approach to improve healthcare accessibility and unlock the full potential of secondary centers in managing CIEDs. The Registration Identification: ChiCTR2200057587.

Appendiceal intussusception complicated by adenocarcinoma of the cecum: A case report.

BACKGROUND: Appendiceal intussusception is a pathological condition in which the appendix is inverted into the cecum, which may cause symptoms that resemble those of other gastrointestinal disorders and may induce intestinal obstruction. The rarity of this case presentation is the co-occurrence of appendiceal intussusception and cecal adenocarcinoma, a combination that to our knowledge has not previously been reported in the medical literature. This case provides new insights into the complexities of diagnosing and managing overlapping pathologies. CASE SUMMARY: A 25-year-old woman presented with persistent periumbilical pain and bloody stools. An initial biopsy showed cecal cancer; however, subsequent colonoscopy and computed tomography findings raised the suspicion of appendiceal intussusception, which was later confirmed postoperatively. This unique case was characterized by a combination of intussusception and adenocarcinoma of the cecum. The intervention included a laparoscopic right hemicolectomy, which led to the histopathological diagnosis of mucinous adenocarcinoma with appendiceal intussusception. The patient recovered well postoperatively and was advised to initiate adjuvant chemotherapy. This case highlights not only the importance of considering appendiceal intussusception in the differential diagnosis, but also the possibility of appendicitis and the atypical presentation of neoplastic lesions. CONCLUSIONS: Physicians should consider the possibility of appendiceal intussusception in cases of atypical appendicitis, particularly when associated with neoplastic presentation.

Method of generating speckle patterns for digital image correlation based on modified Conway's Game of Life.

The measurement accuracy of digital image correlation (DIC) is influenced by the quality of the speckle pattern. Although various models for generating random speckle patterns have been well discussed, obtaining appropriate speckle images with isotropic quality and performance could be a challenging issue in DIC. In this paper, we propose a novel (to our knowledge) method for generating speckle patterns based on modified Conway's game of life (GoL). By sequentially assembling the speckle patterns generated from the modified GoL, we produced the GoL speckle image. Then, verification and comparison experiments were conducted through pure in-plane translations. The results show that the generated speckle image which was resized with k s=6& k r=2 processing and subsequently fuzzified using a Gaussian filter, produces the best accuracy for DIC measurement. Furthermore, based on the rigid body in-plane rotation displacement tests in the physical experimental results of three different speckle images, the GoL speckle generated from our proposed method shows the smallest measurement error. This indicates that the proposed speckle patterns generating method could provide a new type of speckle pattern with better quality and accuracy.

Efficacy and safety of prophylactic balloon occlusion in the management of placenta accreta spectrum disorder: a retrospective cohort study.

OBJECTIVE: Placenta accreta spectrum disorder (PAS) is a serious obstetric complication associated with significant maternal morbidity and mortality. Prophylactic balloon occlusion (PBO), as an intravascular interventional therapies, has emerged as a potential management strategy for controlling massive hemorrhage in patients with PAS. However, current evidence about the clinical application of PBO in PAS patients are still controversial. This study aimed to evaluate the effectiveness and safety of PBO in the management of PAS. METHODS: A retrospective cohort study including PAS patients underwent cesarean delivery was conducted in a tertiary hospital from January 2015 to March 2022. Included PAS patients were further divided into balloon and control groups by whether PBO was performed. Groups were compared for demographic characteristics, intraoperative and postoperative parameters, maternal and neonatal outcomes, PBO-related complication and follow up outcomes. Additionally, multivariate-logistic regression analysis was performed to determine the definitive associations between PBO and risk of massive hemorrhage and hysterectomy. RESULTS: A total of 285 PAS patients met the inclusion criteria were included, of which 57 PAS patients underwent PBO (PBO group) and 228 women performed cesarean section (CS) without PBO (control group). Irrespective of the differences of baseline characteristics between the two groups, PBO intervention did not reduce the blood loss, hysterectomy rate and postoperative hospital stay, but it prolonged the operation time and increased the cost of hospitalization (All P < 0.05) Additionally, there were no significant differences in postoperative complications, neonatal outcomes, and follow-up outcomes(All P > 0.05). In particular, patients undergoing PBO were more likely to develop the venous thrombosis postoperatively (P = 0.001). However, multivariate logistic regression analysis showed that PBO significantly decreased the risk of massive hemorrhage (OR 0.289, 95%CI:0.109-0.766, P = 0.013). The grade of PAS and MRI with S2 invasion were the significant risk factors affecting massive hemorrhage(OR:6.232 and OR:5.380, P<0.001). CONCLUSION: PBO has the potential to reduce massive hemorrhage in PAS patients undergoing CS. Obstetricians should, however, be aware of potential complications arising from the PBO. Additionally, MRI with S2 invasion and PAS grade will be useful to identify PAS patients who at high risk and may benefit from PBO. In brief, PBO seem to be a promising alternative for management of PAS, yet well-designed randomized controlled trials are needed to convincingly demonstrate its benefits and triage the necessity of PBO.

The potassium transporter TaNHX2 interacts with TaGAD1 to promote drought tolerance via modulating stomatal aperture in wheat.

Drought is a major global challenge in agriculture that decreases crop production. γ-Aminobutyric acid (GABA) interfaces with drought stress in plants; however, a mechanistic understanding of the interaction between GABA accumulation and drought response remains to be established. Here we showed the potassium/proton exchanger TaNHX2 functions as a positive regulator in drought resistance in wheat by mediating cross-talk between the stomatal aperture and GABA accumulation. TaNHX2 interacted with glutamate decarboxylase TaGAD1, a key enzyme that synthesizes GABA from glutamate. Furthermore, TaNHX2 targeted the C-terminal auto-inhibitory domain of TaGAD1, enhanced its activity, and promoted GABA accumulation under drought stress. Consistent with this, the tanhx2 and tagad1 mutants showed reduced drought tolerance, and transgenic wheat with enhanced TaNHX2 expression had a yield advantage under water deficit without growth penalty. These results shed light on the plant stomatal movement mechanism under drought stress and the TaNHX2-TaGAD1 module may be harnessed for amelioration of negative environmental effects in wheat as well as other crops.

Heterogeneous reaction of NO2 with hematite: The effects of UV irradiation, O2 and relative humidity.

Heterogeneous reactions on mineral dust surfaces are increasingly considered important in the removal of gaseous pollutants and the formation of secondary aerosols. Although the heterogeneous reaction of NO2 on the hematite surface has been investigated in many previous studies, little is known about the reaction of NO2 with hematite under ambient conditions. In this work, heterogeneous reactions of NO2 with hematite at 298 K were investigated via a coated-wall flow tube reactor and in situ diffuse reflectance Fourier transformed infrared spectroscopy (DRIFTS). The influence of UV illumination, relative humidity (RH) and O2 on the uptake coefficients and adsorption amount of NO2, as well as the nitrate formation on the hematite surface, has been analyzed comprehensively. UV irradiation shows a significant effect on the true uptake coefficient (γBET), which increases from 2.00 × 10-6 to 4.76 × 10-6 in the N2 stream and 1.32 × 10-6 to 4.07 × 10-6 in the air stream under dry conditions (∼0.3 % RH). RH (in the range of 0-67 %) exhibits an inhibitory effect on the adsorption of NO2 on the hematite surface because of the competition between NO2 and water molecules, that is, γBET and adsorption amount of NO2 decrease with an increase in RH under both the dark and light reaction conditions. Meanwhile, both the γBET and adsorption amount of NO2 on hematite decrease in the air stream compared to those in N2 conditions. In addition, the results from the DRIFTS experiments indicate that the presence of UV irradiation promotes the conversion of NO2 to nitrate and both the RH and O2 suppress the nitrate formation. From this research, the heterogeneous reactions between NO2 with mineral dust under ambient conditions will be better understood.

Enabling an Inorganic-Rich Interface via Cationic Surfactant for High-Performance Lithium Metal Batteries.

An anion-rich electric double layer (EDL) region is favorable for fabricating an inorganic-rich solid-electrolyte interphase (SEI) towards stable lithium metal anode in ester electrolyte. Herein, cetyltrimethylammonium bromide (CTAB), a cationic surfactant, is adopted to draw more anions into EDL by ionic interactions that shield the repelling force on anions during lithium plating. In situ electrochemical surface-enhanced Raman spectroscopy results combined with molecular dynamics simulations validate the enrichment of NO3-/FSI- anions in the EDL region due to the positively charged CTA+. In-depth analysis of SEI structure by X-ray photoelectron spectroscopy and time-of-flight secondary ion mass spectrometry results confirmed the formation of the inorganic-rich SEI, which helps improve the kinetics of Li+ transfer, lower the charge transfer activation energy, and homogenize Li deposition. As a result, the Li||Li symmetric cell in the designed electrolyte displays a prolongated cycling time from 500 to 1300 h compared to that in the blank electrolyte at 0.5 mA cm-2 with a capacity of 1 mAh cm-2. Moreover, Li||LiFePO4 and Li||LiCoO2 with a high cathode mass loading of > 10 mg cm-2 can be stably cycled over 180 cycles.

Clinical value of endoscopic ultrasound sound speed in differential diagnosis of pancreatic solid lesion and prognosis of pancreatic cancer.

BACKGROUND: Differential diagnosis of pancreatic solid lesion (PSL) and prognosis of pancreatic cancer (PC) is a clinical challenge. We aimed to explore the differential diagnostic value of sound speed (SS) obtained from endoscopic ultrasonography (EUS) in PSL and the prognostic value of SS in PC. METHODS: Patients with PSL in The Third Xiangya Hospital of Central South University from March 2019 to October 2019 were prospectively enrolled, who obtained SS from PSL. Patients were divided into the PC group and the pancreatic benign lesion (PBL) group. SS1 is the SS of lesions and SS2 is the SS of normal tissues adjacent to lesions. Ratio1 is equal to SS1 divided by SS2 of PSL (ratio1 = SS1/SS2). RESULTS: Eighty patients were enrolled (24 PBL patients, 56 PC patients). SS1 and ratio1 in PC group were higher compared with PBL group (SS1:1568.00 vs. 1550.00, Z = -2.066, p = 0.039; ratio1: 1.0110 vs. 1.0051, Z = -3.391, p = 0.001). The SS1 in PC (Z = -6.503, p < 0.001) was higher compared to SS2. In the nonsurgical group of PC, low ratio1 predicted high overall survival (OS) (7.000 months vs. 4.000 months; p = 0.039). In the surgical group of PC, low SS1 was associated with low median OS (4.000 months vs. 12.000 months; p = 0.033). CONCLUSIONS: SS plays a vital role in distinguishing between PBL and PC. Higher SS1 and ratio1 obtained by EUS are more related to PC than PBL. In PC patients, high SS1 may predict pancreatic lesions. In the nonsurgical group of PC, low ratio1 may predict high OS. However, in the surgical group of PC, low SS1 may predict low OS.

Uncovering lupus nephritis-specific genes and the potential of TNFRSF17-targeted immunotherapy: a high-throughput sequencing study.

Introduction: Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE). This study aimed to identify LN specific-genes and potential therapeutic targets. Methods: We performed high-throughput transcriptome sequencing on peripheral blood mononuclear cells (PBMCs) from LN patients. Healthy individuals and SLE patients without LN were used as controls. To validate the sequencing results, qRT-PCR was performed for 5 upregulated and 5 downregulated genes. Furthermore, the effect of the TNFRSF17-targeting drug IBI379 on patient plasma cells and B cells was evaluated by flow cytometry. Results: Our analysis identified 1493 and 205 differential genes in the LN group compared to the control and SLE without LN groups respectively, with 70 genes common to both sets, marking them as LN-specific. These LN-specific genes were significantly enriched in the 'regulation of biological quality' GO term and the cell cycle pathway. Notably, several genes including TNFRSF17 were significantly overexpressed in the kidneys of both LN patients and NZB/W mice. TNFRSF17 levels correlated positively with urinary protein levels, and negatively with complement C3 and C4 levels in LN patients. The TNFRSF17-targeting drug IBI379 effectively induced apoptosis in patient plasma cells without significantly affecting B cells. Discussion: Our findings suggest that TNFRSF17 could serve as a potential therapeutic target for LN. Moreover, IBI379 is presented as a promising treatment option for LN.

Adsorption of Phosphate by Two-Step Synthesis of Ceramsite from Electrolytic Manganese Residue/Dredged Sludge.

Carrying out research on the management of electrolytic manganese residue (EMR) is necessary to maintain the environment and human health. The dredged sludge (DS) and water hyacinth (WH) generated from dredging projects are potential environmental threats, and therefore suitable methods need to be found for their treatment. In this study, ceramsite was prepared by a two-step low-temperature firing method using DS and EMR as raw materials, WH as a pore-forming additive, and aluminate cement as a binder for the adsorption of phosphorus from wastewater. The optimal ratio and process parameters of the ceramsite were determined by mechanical and adsorption properties. The static adsorption experiments were conducted to study the effect of ceramsite dosage and solution pH on the removal of phosphorus. At the same time, dynamic adsorption experiments were designed to consider the influence of flow rate on its actual absorption effect, to explore the actual effect of ceramsite in wastewater treatment, and to derive a dynamic adsorption model that can provide technical support and theoretical guidance for environmental management.

Effects of meteorological factors on influenza transmissibility by virus type/subtype.

BACKGROUND: Quantitative evidence on the impact of meteorological factors on influenza transmissibility across different virus types/subtypes is scarce, and no previous studies have reported the effect of hourly temperature variability (HTV) on influenza transmissibility. Herein, we explored the associations between meteorological factors and influenza transmissibility according to the influenza type and subtype in Guangzhou, a subtropical city in China. METHODS: We collected influenza surveillance and meteorological data of Guangzhou between October 2010 and December 2019. Influenza transmissibility was measured using the instantaneous effective reproductive number (Rt). A gamma regression with a log link combined with a distributed lag non-linear model was used to assess the associations of daily meteorological factors with Rt by influenza types/subtypes. RESULTS: The exposure-response relationship between ambient temperature and Rt was non-linear, with elevated transmissibility at low and high temperatures. Influenza transmissibility increased as HTV increased when HTV < around 4.5 °C. A non-linear association was observed between absolute humidity and Rt, with increased transmissibility at low absolute humidity and at around 19 g/m3. Relative humidity had a U-shaped association with influenza transmissibility. The associations between meteorological factors and influenza transmissibility varied according to the influenza type and subtype: elevated transmissibility was observed at high ambient temperatures for influenza A(H3N2), but not for influenza A(H1N1)pdm09; transmissibility of influenza A(H1N1)pdm09 increased as HTV increased when HTV < around 4.5 °C, but the transmissibility decreased with HTV when HTV < 2.5 °C and 3.0 °C for influenza A(H3N2) and B, respectively; positive association of Rt with absolute humidity was witnessed for influenza A(H3N2) even when absolute humidity was larger than 19 g/m3, which was different from that for influenza A(H1N1)pdm09 and influenza B. CONCLUSIONS: Temperature variability has an impact on influenza transmissibility. Ambient temperature, temperature variability, and humidity influence the transmissibility of different influenza types/subtypes discrepantly. Our findings have important implications for improving preparedness for influenza epidemics, especially under climate change conditions.

MTD-YOLOv5: Enhancing marine target detection with multi-scale feature fusion in YOLOv5 model.

Underwater light attenuation leads to decreased image contrast. This reduction in contrast subsequently decreases target visibility. Additionally, marine target detection is challenging due to multi-scale problems from varying target-to-device distances, complex target clustering, and noise from waterborne particulates.To address these issues, we propose MTD-YOLOv5.Initially, we enhance image contrast with grayscale equalization and mitigate color shift issues through color space transformation.We then introduce a novel feature extraction module, PCBR, combining max pooling and convolution layers for more effective target feature extraction from the background.Furthermore, we present the Multi-Scale Perceptual Hybrid Pooling (MHP) module.This module integrates horizontal and vertical receptive fields to establish long-range dependencies, thereby capturing hidden target information in deep network feature maps. In the Labeled Fishes in the Wild test datasets, MTD-YOLOv5 achieves a precision of 88.1% and a mean Average Precision (mAP[0.5:.95]) of 49.6%.These results represent improvements of 2.6% in precision and 0.4% in mAP over the original YOLOv5.

Dexmedetomidine and acute kidney injury after non-cardiac surgery: A meta-analysis with trial sequential analysis.

BACKGROUND: Acute kidney injury (AKI) is a common complication after surgery and is associated with detrimental outcomes. This systematic review and meta-analysis evaluated perioperative dexmedetomidine on AKI and renal function after non-cardiac surgery. METHODS: PubMed, Embase, and Cochrane Library databases were searched until August 2023 for randomised trials comparing dexmedetomidine with normal saline on AKI and renal function in adults undergoing non-cardiac surgery. The primary outcome was the incidence of AKI (according to Kidney Disease Improving Global Outcomes or Acute Kidney Injury Network criteria). Meta-analysis was performed using a random-effect model. We conducted sensitivity analysis, trial sequential analysis (TSA), and Grading of Recommendations Assessment, Development and Evaluation level of evidence. RESULTS: Twenty-three trials involving 2440 patients were included. Dexmedetomidine administration, as compared to normal saline, significantly reduced the incidence of AKI (7.4% vs. 13.2%; risk ratio = 0.57, 95% CI = 0.40-0.83, P = 0.003, I2 = 0%; a high level of evidence); TSA and sensitivity analyses suggested the robustness of this outcome. For the renal function and inflammation parameters, dexmedetomidine decreased serum creatinine, blood urea nitrogen, cystatin C, tumour necrosis factor-α, and interleukin-6, and increased urine output and estimated glomerular filtration rate. Additionally, dexmedetomidine reduced postoperative nausea and vomiting and length of hospital stay. Dexmedetomidine was associated with an increased rate of bradycardia, but not hypotension. CONCLUSION: Dexmedetomidine administration reduced the incidence of AKI and improved renal function after non-cardiac surgery. Based on a high level of evidence, dexmedetomidine is recommended as a component of perioperative renoprotection. REGISTRATION: International Prospective Register of Systematic Reviews; Registration number: CRD42022299252.

[Effect of Family Functioning on Adolescents' Internalizing and Externalizing Problem Behaviors: The Multiple Mediating Roles of Empathy and Emotional Competence]. / å®¶åº­åŠŸèƒ½å¯¹é’å°‘å¹´å† å¤–åŒ–é—®é¢˜è¡Œä¸ºçš„å½±å“ï¼šå ±æƒ å’Œæƒ ç»ªèƒ½åŠ›çš„å¤šé‡ä¸­ä»‹ä½œç”¨.

Objective: To examine the mediating role of empathy and emotional competence in the association between family functioning and internalizing and externalizing problem behaviors among adolescents in China. Methods: In this study, we used the data from the June-July 2022 survey of Chengdu Positive Child Development (CPCD) cohort. All respondents were 5th-9th graders from six primary or secondary schools in Chengdu. The Achenbach Child Behavior Checklist (CBCL), the Chinese Family Assessment Instrument (C-FAI), the empathy subscale of the Chinese version of the Interpersonal Reactivity Index (C-IRI), and the emotional competence (EC) subscale of the Chinese Positive Youth Development Scale (CPYD) were used to evaluate the respondents' internalizing and externalizing problem behaviors, family functioning, empathy, and emotional competence, respectively. The average score derived from the total score of a scale divided by the number of entries in each dimension was used as the final score of the scale. Independent samples t-tests or one-way analysis of variance (ANOVA) were performed to examine the differences in family functioning, empathy, emotional competence, and internalizing and externalizing problem behaviors across student groups with different demographic characteristics (sex, grade, and region). Pearson correlation analysis was conducted to examine the relationship between family functioning, empathy, emotional competence, and internalizing and externalizing problem behaviors. AMOS 24.0 was used to validate the hypothesized model and structural equation modeling was used to analyze the mediating effects of empathy and emotional competence between family functioning and internalizing and externalizing problem behaviors among adolescents. Results: A total of 3026 eligible participants were included, including 1548 (51.16%) male students and 1478 (48.84%) female students. Among the respondents, 798 (26.37%) were 5th graders, 738 (24.39%) were 6th graders, 567 (18.74%) were 7th graders, 614 (20.29%) were 8th graders, and 309 (10.21%) were 9th graders. In addition, 2064 (68.21%) of all respondents were from urban areas and 962 (31.79%) were from rural areas. The results of the difference analysis showed that the differences in adolescents' internalizing and externalizing problem behaviors were statistically significant between students of different grades (P=0.004), and that the differences in family functioning and empathy scores were also statistically significant between students of different grades (all P<0.001), whereas the differences in adolescents' internalizing and externalizing problem behaviors were not statistically significant between sexes and regions (P=0.919, 0.959). The results of correlation analysis showed that family functioning scores (the higher the score, the worse the family functioning) were significantly negatively correlated with empathy and emotional competence (r=-0.482, -0.432, P<0.01), and significantly positively correlated with internalizing and externalizing problem behaviors (r=0.220, P<0.01). Empathy was significantly positively correlated with emotional competence (r=0.402, P<0.01). Empathy and emotional competence were significantly negatively correlated with all the dimensions of internalizing and externalizing problem behaviors (r=-0.115, -0.305, P<0.01). Emotional competence partially mediated the relationship between family functioning and adolescents' internalizing and externalizing problem behaviors, with a mediation effect value being 0.042 (95% [confidence interval] CI: 0.031-0.057). Empathy and emotional competence had chain mediation effect between family functioning and adolescents' internalizing and externalizing problem behaviors, with the value of the mediation effect being 0.010 (95% CI: 0.007-0.014). Conclusion: Family functioning influences adolescents' internalizing and externalizing problem behaviors in a direct way and through the chain-mediating roles of empathy and emotional competence.