Multilayer Perceptron-Based Wearable Exercise-Related Heart Rate Variability Predicts Anxiety and Depression in College Students.

(1) Background: This study aims to investigate the correlation between heart rate variability (HRV) during exercise and recovery periods and the levels of anxiety and depression among college students. Additionally, the study assesses the accuracy of a multilayer perceptron-based HRV analysis in predicting these emotional states. (2) Methods: A total of 845 healthy college students, aged between 18 and 22, participated in the study. Participants completed self-assessment scales for anxiety and depression (SAS and PHQ-9). HRV data were collected during exercise and for a 5-min period post-exercise. The multilayer perceptron neural network model, which included several branches with identical configurations, was employed for data processing. (3) Results: Through a 5-fold cross-validation approach, the average accuracy of HRV in predicting anxiety levels was 89.3% for no anxiety, 83.6% for mild anxiety, and 74.9% for moderate to severe anxiety. For depression levels, the average accuracy was 90.1% for no depression, 84.2% for mild depression, and 82.1% for moderate to severe depression. The predictive R-squared values for anxiety and depression scores were 0.62 and 0.41, respectively. (4) Conclusions: The study demonstrated that HRV during exercise and recovery in college students can effectively predict levels of anxiety and depression. However, the accuracy of score prediction requires further improvement. HRV related to exercise can serve as a non-invasive biomarker for assessing psychological health.

Tai Chi Movement Recognition and Precise Intervention for the Elderly Based on Inertial Measurement Units and Temporal Convolutional Neural Networks.

(1) Background: The objective of this study was to recognize tai chi movements using inertial measurement units (IMUs) and temporal convolutional neural networks (TCNs) and to provide precise interventions for elderly people. (2) Methods: This study consisted of two parts: firstly, 70 skilled tai chi practitioners were used for movement recognition; secondly, 60 elderly males were used for an intervention study. IMU data were collected from skilled tai chi practitioners performing Bafa Wubu, and TCN models were constructed and trained to classify these movements. Elderly participants were divided into a precision intervention group and a standard intervention group, with the former receiving weekly real-time IMU feedback. Outcomes measured included balance, grip strength, quality of life, and depression. (3) Results: The TCN model demonstrated high accuracy in identifying tai chi movements, with percentages ranging from 82.6% to 94.4%. After eight weeks of intervention, both groups showed significant improvements in grip strength, quality of life, and depression. However, only the precision intervention group showed a significant increase in balance and higher post-intervention scores compared to the standard intervention group. (4) Conclusions: This study successfully employed IMU and TCN to identify Tai Chi movements and provide targeted feedback to older participants. Real-time IMU feedback can enhance health outcome indicators in elderly males.

Adaptive Weighted Error-Correction Method Based on the Error Distribution Characteristics of Multi-Channel Alignment.

As process nodes of advanced integrated circuits continue to decrease below 10 nm, the requirement for overlay accuracy is becoming stricter. The alignment sensor measures the position of the alignment mark relative to the wafer; thus, sub-nanometer alignment position accuracy is vital. The Phase Grating Alignment (PGA) method is widely used due to its high precision and stability. However, the alignment error caused by the mark asymmetry is the key obstacle preventing PGA technology from achieving sub-nanometer alignment accuracy. This error can be corrected using many methods, such as process verification and multi-channel weighted methods based on multi-diffraction, multi-wavelength and multi-polarization state alignment sensors. However, the mark asymmetry is unpredictable, complex and difficult to obtain in advance. In this case, the fixed-weight method cannot effectively reduce the alignment error. Therefore, an adaptive weighted method based on the error distribution characteristic of a multi-channel is proposed. Firstly, the simulation result proves that the error distribution characteristic of the multi-alignment result has a strong correlation with the mark asymmetry. Secondly, a concrete method of constructing weight values based on error distribution is described. We assume that the relationship between the weight value of each channel and the deviations of all channels' results is second-order linear. Finally, without other prior process correction in the simulation experiment, the residual error's Root Mean Square (RMS) of fixed weighted method is 14.0 nm, while the RMS of the adaptive weighted method is 0.01 nm, when dealing with five typical types of mark asymmetry. The adaptive weighted method exhibits a more stable error correction effect under unpredictable and complicated mark asymmetry.

Embedded micro-probe fiber optic interferometer with low nonlinearity against light intensity disturbance.

A novel low-nonlinearity Michelson microprobe fiber interferometer against light intensity disturbance for high-precision embedded displacement measurements is introduced. To analyze the influence of light intensity disturbance on the microprobe and measurement accuracy of the integrated fiber interferometer, an equivalent model of micro-probe sensing with the tilted target is established. The proposed PGC demodulation and nonlinearity correction method with simple principle helps avoid DC component varying with light intensity. The experiments show that residual displacement errors of the micro-probe fiber interferometer are reduced from 4.36 nm to 0.46 nm, thus allowing embedded displacement detection with sub-nanometer accuracy under low frequency light intensity disturbance.

Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in improving the physical function recovery for patients following minimally invasive esophagectomy: a prospective randomized controlled trial.

BACKGROUND: Perioperative rehabilitation management is essential to enhanced recovery after surgery (ERAS). Limited reports, however, have focused on quantitative, detailed early activity plans for patients receiving minimally invasive esophagectomy (MIE). The purpose of this research was to estimate the effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in the recovery of bowel and physical functions for patients undergoing MIE. METHODS: In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients admitted to the Affiliated Cancer Hospital of Zhengzhou University from June 2019 to February 2020 were selected and randomly assigned to an intervention group (IG) or a control group (CG). The participants in the IG received medical care based on the t-ECRP strategy during perioperative period, and participants in the CG received routine care. The recovery of bowel and physical functions, readiness for hospital discharge (RHD), and postoperative hospital stay were evaluated on the day of discharge. RESULTS: Two hundred and fifteen cases with esophageal cancer (EC) were enrolled and randomized to the IG (n = 107) or CG (n = 108). The mean age was 62.58 years (SD 9.07) and 71.16% were male. For EC, 53.49% were mid-location cancers and 79.07% were classified as pathological stage II and III cancers. There were no significant differences between the two groups in terms of demographic and clinical characteristics and baseline physical functions. Participants in the IG group presented significantly shorter lengths of time to first flatus (P < 0.001), first postoperative bowel movement (P = 0.024), and for up and go test (P < 0.001), and lower scores of frailty (P < 0.001). The analysis also showed that participants in the IG had higher scores of RHD and shorter lengths of postoperative stay than in the CG (P < 0.05). CONCLUSIONS: The t-ECRP appears to improve bowel and physical function recovery, ameliorate RHD, and shorten postoperative hospital stay for patients undergoing MIE. Clinicians should consider prescribing quantitative, detailed, and individualized early activity plans for these patients. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT01998230).

Clinical review considerations of class I PI3K inhibitors in hematolymphatic malignancies by Center for Drug Evaluation.

Several phosphoinositide 3-kinase (PI3K) inhibitors are currently approved to treat hematolymphatic malignant diseases worldwide, and many drugs that have the same target are in the clinical research stage. In March 2022, duvelisib became the first PI3K inhibitor approved in China indicated for the treatment of hematolymphatic malignant diseases. Meanwhile, linperlisib and copanlisib have almost completed the technical review of the clinical specialty. The Center for Drug Evaluation (CDE) of the China National Medical Products Administration (NMPA) found that class I PI3K inhibitors can cause various degrees of immune-related adverse events, which are associated with action mechanisms, affecting the benefit-risk assessment of the drugs. On April 21, 2021, the United States Food and Drug Administration (FDA) convened the Oncologic Drugs Advisory Committee (ODAC) meeting to discuss the safety of PI3K inhibitors indicated for hematolymphatic malignancies and their related risk of death. The hematological tumor group of CDE of the China NMPA summarized and combined the data on PI3K inhibitors listed or under technical review for marketing authorization applications and found that such products may have unique efficacy and safety characteristics in Chinese patients with malignant lymphoma.

High-order super-resolution optical fluctuation imaging based on low-pass denoising.

A new scheme of super-resolution optical fluctuation imaging (SOFI) is proposed to broaden its application in the high-order case by separating the elimination of shot noise from the computation of cumulant, applying the low-pass denoising (LPD) operator to SOFI. The high-order cumulants are derived from a basic recursion of moments with the suppression of shot noise by the LPD on raw data. SOFI based on LPD (LPD-SOFI) demonstrates a 10.6-fold lateral resolution enhancement with the cumulant order of the 16th and a seven-fold three-dimensional resolution enhancement with the cumulant order of the 10th in experiments performed on a sparse sample of quantum dots.

Rapid super-resolution confocal microscopy through virtual structured detection based on serial scanning in array.

To improve the imaging speed of a confocal microscope with virtual structured detection, we have designed an optical system with rigid coordination control of the CCD, galvanometer scanner, and laser diode. In this system, the width of the coherent transfer function expands, which enhances the lateral resolution by a factor of 1.4. Also, the temporal image sequence is transformed to a spatial one so that multiple images can be acquired during a single exposure period of the CCD. This method increases the system imaging speed 25-fold at least, and an even higher speed can be achieved by further increasing the number of spots recorded during a single exposure period.

Lateral resolution enhancement of confocal microscopy based on structured detection method with spatial light modulator.

Lateral resolution in confocal microscope is limited by the size of pinhole. In this paper, we attempt to introduce a new method to achieve structured detection through using spatial light modulator (SLM) to improve it. SLM modulates the Airy disk amplitude distribution according to the detection function in collection arm. Instead of using CCD to capture spot images and modulate them with numerical analysis in virtual structured detection (VSD), this method uses SLM to accomplish these aims with higher imaging rates. Based on simulation and the experiment results, it can be found that coherent transfer function expands and the resolution is 1.6 times as large as that of conventional confocal microscope.

Elliptical mirror-based TIRF microscopy with shadowless illumination and adjustable penetration depth.

We propose an elliptical mirror-based total-internal-reflection fluorescence (e-TIRF) microscopy with shadowless illumination and adjustable penetration depth. The elliptical mirror is used to produce a hollow-cone illumination with all azimuthal directions and a large range of incident angle, so as to attenuate the potential shadow effects when utilizing a single-direction illumination, such as asymmetries and low contrast. The experiment demonstrates that the e-TIRF method can realize shadowless imaging with symmetric intensity distribution. Meanwhile, the penetration depth of e-TIRF can be theoretically adjusted from 58 nm to 250 nm by adjusting the size of the aperture or the position of an opaque mask. This method extends the minimum penetration depth, which is useful for high axial resolution.

Assembled Cantilever Fiber Touch Trigger Probe for Three-Dimensional Measurement of Microstructures.

In this paper, an assembled cantilever fiber touch trigger probe was developed for three-dimensional measurements of clear microstructures. The probe consists of a shaft assembled vertically to an optical fiber cantilever and a probing sphere located at the free end of the shaft. The laser is emitted from the free end of the fiber cantilever and converges on the photosensitive surface of the camera through the lens. The position shift of the light spot centroid was used to detect the performance of the optical fiber cantilever, which changed dramatically when the probing sphere touched the objects being measured. Experimental results indicated that the sensing system has sensitivities of 3.32 pixels/µm, 1.35 pixels/µm, and 7.38 pixels/µm in the x, y, and z directions, respectively, and resolutions of 10 nm, 30 nm, and 5 nm were achieved in the x, y, and z, respectively. An experiment on micro slit measurement was performed to verify the high aspect ratio measurement capability of the assembled cantilever fiber (ACF) probe and to calibrate the effective two-point diameter of the probing sphere. The two-point probe sphere diameter was found to be 174.634 µm with a standard uncertainly of 0.045 µm.

Influences of fatigue and anticipation on female soccer players' biomechanical characteristics during 180° pivot turn: implication for risk and prevention of anterior cruciate ligament injury.

Introduction: Athletes' capability to perform activities with body rotation could be weakened by fatigue accumulation. Making pivot turning in unanticipated scenarios after fatigue may greatly challenge athletes' ability to adapt rational motion strategies, elevating the risk of anterior cruciate ligament (ACL) injury. This study aimed to investigate the effects of fatigue and anticipation on biomechanical risk factors of ACL injury during 180° pivot turns in female soccer players. Methods: Twenty-one female soccer players were selected as participants. The participants performed anticipated turning maneuver before the fatigue intervention. The participants sprinted along the runway, decelerated and planted their foot on the force plate, and then executed a 180° pivot turn. For unanticipated tests, the pivot turn was mixed with side/cross-cuts, which were indicated to the participant using a custom-designed light system. The tests were repeated by the participant after receiving a fatigue intervention. Lower-limb joint angles and moments were characterized. Peak ground reaction forces (GRFs) and GRF loading rates were determined. Two-way repeated measures analysis of variance was applied to examine the effects of fatigue and anticipation on the variables of interest. Results: Compared to the anticipated conditions, the approach speed was significantly lower in the unanticipated tests (P < 0.0001). Lower-limb kinematics showed varied angular patterns across conditions: greater hip joint variations in flexion, abduction, and internal rotation during unanticipated turns; consistent knee joint flexion and ankle plantarflexion with dorsiflexion observed mid-turn. Significant interactions (P = 0.023 to P = 0.035) between fatigue and anticipation influenced hip joint angles. Anticipation effects were notable at initial contact and peak ground reaction force, increasing hip, knee, and ankle joint angles (P < 0.0001 to P = 0.012). Participants showed consistent ground reaction force (GRF) patterns during pivot turns across fatigue and anticipation conditions, with the first peak occurring approximately 10% into the turn period. Significant interaction effects (P = 0.016) between fatigue and anticipation were observed for knee flex/extension moments at the first peak vertical GRF. Anticipation significantly increased first peak vertical (P < 0.0001), anteroposterior (P < 0.0001), and mediolateral (P < 0.0001) GRFs. Fatigue increased first peak vertical (P = 0.022), anteroposterior (P = 0.018), and mediolateral (P = 0.019) GRFs. Post-fatigue, participants exhibited reduced first peak GRFs and loading rates compared to pre-fatigue conditions, with higher rates observed in unanticipated turns (vertical GRF: P = 0.030; anteroposterior GRF: P < 0.0001). Conclusion: Female soccer players' lower-limb Biomechanical characterization could be greatly affected by the change of anticipatory scenarios. With the associated increase of GRF, the risk of their ACL injury might be elevated. Fatigue affected female soccer players' abilities on movement performances, but the interaction of these two factors could potentially weaken their knee's functions during pivot turns. Cognitive training on unanticipated tasks may be important for rehabilitation training after ACL injury.

Velocity feedback control method of low-frequency electromagnetic vibration exciter based on Kalman filter estimation.

The absence of an appropriate low-frequency vibration velocity detection method to establish feedback control limits the further improvement of the low-frequency vibration performance of electromagnetic vibration exciters. In this article, a low-frequency vibration velocity feedback control method based on the Kalman filter estimation is proposed for the first time to reduce the total harmonic distortion of the vibration waveform. The rationality of establishing velocity feedback control in the velocity characteristic band of the electromagnetic vibration exciter is analyzed. Based on an identification model of the system and measured vibration displacements, the vibration velocity is estimated with high accuracy through the Kalman filter. The velocity feedback control system is established to suppress the impacts of disturbances effectively. Experimental results show that the method proposed in this paper can reduce the harmonic distortion of vibration waveform by 40%, which is 20% higher than the traditional control method, thoroughly verifying its superiority.

A Semi-Autonomous Stereotactic Brain Biopsy Robotic System With Enhanced Surgical Safety and Surgeon-Robot Collaboration.

OBJECTIVE: Despite benefits brought by recent neurosurgical robots, surgical safety and surgeon-robot collaboration remain significant challenges. In this article, we analyze and address these problems in the context of brain biopsy, by proposing a semi-autonomous system. METHODS: A robotic module is designed for the automation of all the brain biopsy procedures, and a biopsy cannula with tissue blocker is developed to avoid tissue excess and haemorrhage. In addition, two methods are proposed for surgical safety and surgeon-robot collaboration enhancement. First, a priority-based control framework is proposed for neuronavigation with simultaneous optical tracking line-of-sight maintenance and surgeon avoidance. Second, after neuronavigation, an adaptive reconfiguration method is developed to optimize the arm angle of KUKA robot based on the surgeon's pose, for workspace interference minimization, high robot dexterity, and joint-limit avoidance. RESULT: Effectiveness of the proposed solution demonstrated by simulations and experiments. CONCLUSION: The system can perform automatic navigation with simultaneous optical tracking maintenance and surgeon avoidance, autonomous brain biopsy, and adaptive reconfiguration for workspace interference minimization. SIGNIFICANCE: This work improves existing neurosurgical systems, in terms of autonomy level from mechanical guidance to task autonomy, surgical safety, and surgeon-robot collaboration.

Biosafety protection and workflow of clinical microbiology laboratory under COVID-19: A review.

This paper mainly discusses how to do a good job of daily biosafety protection measures in clinical microbiology laboratories during the epidemic of COVID-19, so as to ensure the safe development of routine clinical microbiology testing items. According to the microbiological and epidemiological characteristics of the novel coronavirus, this paper analyzed the potential risks of the laboratory from the perspective of personal protection before, during, and after testing. Combined with the actual work situation, the improved biosafety protection measures and optimized work flow are introduced to ensure the safety of medical staff and the smooth development of daily work. Danyang People's Hospital of Jiangsu Province, clinical microbiology laboratory of clinical laboratory in strict accordance with the relevant laws and regulations, technical specifications and the expert consensus, combined with their own conditions, the biosafety measures to perfect the working process was optimized, effectively prevent the laboratory exposure, and maintain strict working condition for a long time, continue to improve. We found that the biosafety protection measures of clinical microbiology laboratory have good prevention and control effect on preventing infection of medical staff, which will greatly reduce the risk of infection of medical staff, form good working habits, and provide reference for biosafety protection of microbiology laboratory during the epidemic of COVID-19.

[Considerations on Clinical Development and Regulatory of the Oversea License-in 
Anti-tumor Drugs].

With the boom of China's innovative pharmaceutical industry, licensing-in model has gradually become an important research and development model for innovative pharmaceutical companies. The in-licensed drugs at different stages need different research and development (R&D) strategy in China. The pharmaceutical companies take the responsibility to comprehensively collate the oversea clinical data and conduct a detailed analysis of clinical pharmacology, safety, efficacy and ethnic sensitivity. Clinical R&D strategy should be made based on the results of the above data and analysis. We encourage high-quality drugs which fill unmet clinical needs licensed in, and as early as possible, so as to conduct multi-regional clinical trials (MRCTs). The clinical R&D strategy in China is particularly important for the drug's approval. Guidelines published by the National Medical Products Administration (NMPA) and clinical associations should be followed. Communications about clinical R&D strategy with Center of Drug Evaluation (CDE) are encouraged.
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Effectiveness of an early, quantified, modified oral feeding protocol on nutritional status and quality of life of patients after minimally invasive esophagectomy: A retrospective controlled study.

OBJECTIVES: Previous studies confirmed the safety and feasibility of oral feeding on the first postoperative day (POD) for patients with minimally invasive esophagectomy (MIE). Nonetheless, some clinical concern can lead to delays in early oral feeding on POD 1. To our knowledge, few reports have focused on resolving these clinical concerns. The aims of this study were to evaluate the effects of an early, quantified, modified oral feeding protocol for patients after MIE and to explore its effect on nutritional status and quality of life (QoL). METHODS: In this prospective controlled trail, 200 patients were selected as the intervention group (IG) from March 2020 to June 2021; 115 patients hospitalized from June 2019 to February 2020 were assigned to the control group (CG). For 2 wk during the postoperative period, IG participants received an early, quantified, modified oral feeding protocol. The recovery of dietary outcomes, nutritional status, and QoL were evaluated after the intervention. RESULTS: There was no significant difference between the two groups in terms of demographic and clinical characteristics and baseline physical function. After the intervention, patients in the IG showed a more rapid growth in daily total oral caloric intake and the ratio of oral calorie intake to total calorie required by the body (K/R value) from POD 1 to POD 14, and less weight loss (1.5 ± 1 versus 2.1 ± 1.7 kg; P < 0.05), better serum prealbumin (193.0 ± 26.9 versus 139.3 ± 27.2 mg/L; P < 0.05) than the CG with statistical significance. By the second week of the intervention, IG patients reported higher global QoL and function scores and lower symptom scores than patients in the CG. The IG participants presented a shorter time to first flatus and bowel movement (P < 0.001), a shorter postoperative hospital length of stay, and higher activities of daily living scores (P < 0.05) the those in the CG. CONCLUSIONS: The findings demonstrated that the early, quantified, modified oral feeding protocol can alleviate postoperative body weight loss, improve the patient's nutritional status, and have a positive effect on QoL and early recovery for patients undergoing MIE.

Characteristics of heavy metals and Pb isotopic signatures in sediment cores collected from typical urban shallow lakes in Nanjing, China.

To investigate the contamination levels and sources for heavy metals that have occurred during the development of cities, sediment cores collected from typical urban shallow lakes (Xuanwu Lake and Mochou Lake) in Nanjing, China were analyzed for Cu, Pb, Zn, Cd, Cr, Ni, and for Pb stable isotopic ratios. No significant differences were found in the concentrations of Cu, Ni and Cd among sediment layers from Xuanwu or in the levels of Cr and Ni among sediment layers from Mochou. However, there were significant differences among the layers in the concentrations of Cr, Zn and Pb in Xuanwu and Cu, Zn, Cd and Pb in Mochou. Based on geoaccumulation indexes and enrichment factors, Cd was the primary pollutant at all depths in the sediment cores. The ratios of (206)Pb/(207)Pb and (208)Pb/(206)Pb differ significantly among sediment layers in Xuanwu. No significant differences were found on the ratios of (208)Pb/(206)Pb in Mochou, but the ratios of (206)Pb/(207)Pb differ significantly among some of the sediment layers in Mochou. The range of (208)Pb/(206)Pb and (206)Pb/(207)Pb ratios was found to be 2.098-2.106 and 1.170-1.176, respectively, for sediment cores from Mochou Lake and 2.091-2.104 and 1.168-1.183, respectively, for cores from Xuanwu Lake. The differences in heavy metal concentrations and the Pb isotopic ratios with depth for the cores from Xuanwu and Mochou confirmed that the contamination sources changed during the formation of the different sediment layers. Furthermore, the ratios of (206)Pb/(207)Pb demonstrated that gasoline and vehicular Pb were not the primary sources of Pb contamination at different depths in the sediment cores in Xuanwu Lake and Mochou Lake.

Do Surface Slope and Posture Influence Lower Extremity Joint Kinetics during Cycling?

The purpose of this study was to investigate the effects of surface slope and body posture (i.e., seated and standing) on lower extremity joint kinetics during cycling. Fourteen participants cycled at 250 watts power in three cycling conditions: level seated, uphill seated and uphill standing at a 14% slope. A motion analysis system and custom instrumented pedal were used to collect the data of fifteen consecutive cycles of kinematics and pedal reaction force. One crank cycle was equally divided into four phases (90° for each phase). A two-factor repeated measures MANOVA was used to examine the effects of the slope and posture on the selected variables. Results showed that both slope and posture influenced joint moments and mechanical work in the hip, knee and ankle joints (p < 0.05). Specifically, the relative contribution of the knee joint to the total mechanical work increased when the body posture changed from a seated position to a standing position. In conclusion, both surface slope and body posture significantly influenced the lower extremity joint kinetics during cycling. Besides the hip joint, the knee joint also played the role as the power source during uphill standing cycling in the early downstroke phase. Therefore, adopting a standing posture for more power output during uphill cycling is recommended, but not for long periods, in view of the risk of knee injury.

Effect of Chin-down-plus-larynx-tightening maneuver on swallowing function after minimally invasive esophagectomy: A randomized controlled trail.

BACKGROUND: The incidence of swallowing abnormality was high after minimally invasive esophagectomy (MIE) for esophageal cancer (EC). Few reports, however, focused on interventions for dysphagia after esophagectomy. AIM: The purpose of this research was to estimate the effect of Chin-down-plus-larynx-tightening maneuver on swallowing function for patients receiving esophagectomy. METHOD: This was a 2-arm, parallel-group, single-blind randomized clinical trial, performed in patients suffered from EC from November 2018 to January 2020. Patients were randomly assigned to the intervention group (IG) or the control group (CG). The participants in CG received routine care, and the IG received Chin-down-plus-larynx-tightening maneuver during feeding. The incidence of choking cough, swallowing function, and dietary outcomes were evaluated before and after intervention for 7 days. RESULTS: A total of 237 EC cases were enrolled and randomized to the IG (n = 118) or CG (n = 119). There was no significant difference between the two groups in terms of demographic and clinical characteristics. Postoperative choking cough occurred in 5 of 118 cases (4.24%) in IG and 18 of 119 cases (19.4%) in CG, the differences showed statistically significant (P < .001). The analysis showed that the participants in the IG compared with the CG have more total caloric intake of 24 hours and higher K/R (the ratio of calories oral achieved to total calories required of body) significantly from D1 to D7 of intervention (P < .05). CONCLUSION: The findings suggest that the Chin-down-plus-larynx-tightening maneuver can improve swallowing function recovery and oral total food intake and calories in EC patients undergoing MIE.