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This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Methods
In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3+, CD4+, and CD8+ were detected from T0 to T5.
Results
Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8+ were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3+ and CD4+/CD8+ values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4+ value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.
Conclusions
Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.
Neural tuning for visual words is essential for fluent reading across various scripts. This study investigated the emergence and development of N170 tuning for Chinese characters and its cognitive–linguistic correlates. Electroencephalogram data from 48 adult L2 learners and 23 native Chinese readers were collected using a color detection task. The N170 for real characters, pseudo-characters, false characters, stroke combinations and line drawings were recorded. We found beginner adult L2 learners showed larger N170 Chinese characters compared to stroke combinations (coarse neural tuning). The intermediate-level L2 Chinese learners demonstrated fine-tuning for Chinese orthographic regularities. Importantly, a clear shift from bilateral to left-lateralized coarse and fine-tuning for print was observed from beginner to intermediate L2 learners as their Chinese reading experience increased. Moreover, individual differences in neural print tuning moderately correlated with word-reading fluency, Chinese vocabulary knowledge and morphological awareness.
In this paper, we propose a novel vision-based adaptive leakage-type (LT) sliding mode admittance control for actuator-constrained collaborative robots to realize the synchronous control of the precise path following and compliant interaction force. Firstly, we develop a vision-admittance-based model to couple the visual feedback and force sensing in the image feature space so that a reference image feature trajectory can be obtained concerning the contact force command and predefined trajectory. Secondly, considering the system uncertainty, external disturbance, and torque constraints of collaborative robots in reality, we propose an adaptive sliding mode controller in the image feature space to perform precise trajectory tracking. This controller employs a leakage-type (LT) adaptive control law to reduce the side effects of system uncertainties without knowing the upper bound of system uncertainties. Moreover, an auxiliary dynamic is considered in this controller to overcome the joint torque constraints. Finally, we prove the convergence of the tracking error with the Lyapunov stability analysis and operate various semi-physical simulations compared to the conventional adaptive sliding mode and parallel vision/force controller to demonstrate the efficacy of the proposed controller. The simulation results show that compared with the controller mentioned above, the path following accuracy and interaction force control precision of the proposed controller increased by 50% and achieved faster convergence.
Adsorption of uranyl (UO22+) ions to mineral surfaces is a potentially effective method for removing this hazardous metal from water, but other toxic trace metal ions (Xn+: Rb+, Sr2+, Cr3+, Mn2+, Ni2+, Zn2+, Cd2+) in uraniferous wastewaters compete with UO22+ for adsorption sites and thus may diminish the capacity of adsorbents to sequester UO22+. A better understanding of competitive adsorption among these metal ions and the development of better adsorbents are, therefore, of critical importance. The purpose of the present study was to synthesize and characterize magnetic adsorbents, consisting of MFe2O4 (M = Mn, Fe, Zn, Co, or Ni) nanoparticles synthesized on montmorillonite (Mnt) edge sites, and to investigate their use as adsorbents for UO22+, including competitive adsorption with trace metal ions. Selective adsorption was studied using Langmuir, Freundlich, and Dubinin-Radushkevich isotherms, and the results showed that Xn+ ions were adsorbed primarily on MFe2O4-montmorillonite surfaces, and the UO22+ ions were adsorbed on the interfaces between montmorillonite edge surfaces and MFe2O4 nanoparticles. Using the Freundlich model, the interface adsorption capacity of UO22+ reached 25.1 mg·g–1 in mixed solution. Further, the UO22+ and Cr3+ ions had a redox reaction on the interfaces with synergistic adsorption. Herein, the adsorption capacity of Cr3+ was 60.2 mg·g–1 using the Freundlich isotherm. The results demonstrated that the MFe2O4-montmorillonite with highly selective adsorption of UO22+ ions is applicable to UO22+ treatment in the presence of toxic trace metal ions.
Retropharyngeal lymphadenectomy is challenging. This study investigated a minimally invasive approach to salvage retropharyngeal lymphadenectomy in patients with nasopharyngeal carcinoma.
Methods
An anatomical study of four fresh cadaveric heads was conducted to demonstrate the relevant details of retropharyngeal lymphadenectomy using the endoscopic transoral medial pterygomandibular fold approach. Six patients with nasopharyngeal cancer with retropharyngeal lymph node recurrence, who underwent retropharyngeal lymphadenectomy with the endoscopic transoral medial pterygomandibular fold technique at the Eye and ENT Hospital of Fudan University from July to December 2021, were included in this study.
Results
The anatomical study demonstrated that the endoscopic transoral medial pterygomandibular fold approach offers a short path and minimally invasive approach to the retropharyngeal space. The surgical procedure was well tolerated by all patients, with no significant post-operative complications.
Conclusion
The endoscopic transoral medial pterygomandibular fold approach is safe and efficient for retropharyngeal lymphadenectomy.
The random distributed-feedback fiber laser (RFL) is a new approach to obtain a high-power stable supercontinuum (SC) source. To consider both structure simplification and high-power SC output, an innovative structure achieving a kilowatt-level SC output in a single-stage RFL with a half-open cavity is demonstrated in this paper. It consists of a fiber oscillator, a piece of long passive fiber and a broadband coupler, among which the broadband coupler acting as a feedback device is crucial in SC generation. When the system has no feedback, the backward output power is up to 298 W under the pump power of 1185 W. When the feedback is introduced before the pump laser, the backward power loss can be reduced and the pump can be fully utilized, which could promote forward output power and conversion efficiency significantly. Under the maximum pump power of 1847 W, a 1300 W SC with spectrum ranging from 887 to 1920 nm and SC conversion efficiency of 66% is obtained. To the best of our knowledge, it is the simplest structure used for high-power SC generation, and both the generated SC output power and the conversion efficiency are highest in the scheme of the half-opened RFL output SC.
The psychological problems of college students are the focus of social concern and hot discussions. Influenced by the epidemic, college students’ study, life and employment have been affected to a certain extent. Schools should strengthen mental health education to improve college students’ ability to resist pressure and help students improve their ability to adapt to society. Positive psychology can help students improve their mental health by guiding their mental activities and tapping their own strengths. In the process of using positive psychological knowledge to intervene with college students, self-help incentive training and personality cultivation can help students understand their own mental health problems. Therefore, in the psychological health education of colleges and universities, we can consider taking these two methods to carry out psychological intervention on college students, so as to improve the students’ ability to withstand pressure.
Subjects and Methods
In the experiment, 360 college students who meet the requirements were randomly selected in colleges and universities through a questionnaire survey as the research objects of mental health problems. There are 187 boys and 173 girls, with an average age of (20 ± 2) years. The 360 college students were randomly divided into the intervention group and the control group, 180 in each. The intervention group used positive psychological thinking for psychological intervention, while the control group did not take any psychological intervention measures. The Perceived Stress Scale (PSS) was selected as the test scale of college students’ compressive capacity, and SPSS23.0 was used to analyze the score results.
Results
The score of the PSS scale is shown in Table 1. It can be seen from the table that after the intervention group received the psychological intervention, their problem-solving and rationalization abilities were significantly improved (P < 0.05), and their withdrawal emotions were significantly reduced (P < 0.05).Table 1.
PSS score
Test content
Before
After
t
P
Solve the problem
0.78±0.21
0.82±0.25
2.091
0.027
Self-reproach
0.80±0.31
0.78±0.15
0.368
0.792
Seek help
0.62±0.18
0.67±0.22
1.682
0.063
Fantasy
0.82±0.21
0.80±0.17
0.78
0.579
Retreat
0.85±0.26
0.75±0.27
2.319
0.013
Rationalization
0.76±0.19
0.88±0.32
3.497
0.005
Conclusions
The results show that after the intervention of positive psychology, the psychological pressure resistance of college students has been significantly improved, which helps to improve the level of mental health of college students, so as to better solve many psychological problems caused by the epidemic.
The rapid and accurate taxonomic identification of fossils is of great significance in paleontology, biostratigraphy, and other fields. However, taxonomic identification is often labor-intensive and tedious, and the requisition of extensive prior knowledge about a taxonomic group also requires long-term training. Moreover, identification results are often inconsistent across researchers and communities. Accordingly, in this study, we used deep learning to support taxonomic identification. We used web crawlers to collect the Fossil Image Dataset (FID) via the Internet, obtaining 415,339 images belonging to 50 fossil clades. Then we trained three powerful convolutional neural networks on a high-performance workstation. The Inception-ResNet-v2 architecture achieved an average accuracy of 0.90 in the test dataset when transfer learning was applied. The clades of microfossils and vertebrate fossils exhibited the highest identification accuracies of 0.95 and 0.90, respectively. In contrast, clades of sponges, bryozoans, and trace fossils with various morphologies or with few samples in the dataset exhibited a performance below 0.80. Visual explanation methods further highlighted the discrepancies among different fossil clades and suggested similarities between the identifications made by machine classifiers and taxonomists. Collecting large paleontological datasets from various sources, such as the literature, digitization of dark data, citizen-science data, and public data from the Internet may further enhance deep learning methods and their adoption. Such developments will also possibly lead to image-based systematic taxonomy to be replaced by machine-aided classification in the future. Pioneering studies can include microfossils and some invertebrate fossils. To contribute to this development, we deployed our model on a server for public access at www.ai-fossil.com.
Patent data have been utilized for engineering design research for long because it contains massive amount of design information. Recent advances in artificial intelligence and data science present unprecedented opportunities to mine, analyse and make sense of patent data to develop design theory and methodology. Herein, we survey the patent-for-design literature by their contributions to design theories, methods, tools, and strategies, as well as different forms of patent data and various methods. Our review sheds light on promising future research directions for the field.
Insulin-like growth factor 1 receptor (IGF1R) is a cell surface receptor, belonging to the tyrosine kinase receptor superfamily. IGF1R plays a role not only in normal cell development but also in malignant transformation, which has become a candidate therapeutic target for the treatment of human cancer. This study aimed to explore insertions and deletions (indels) in IGF1R gene and investigate their association with growth traits in four Chinese cattle breeds (Xianan cattle, Jinnan cattle, Qinchuan cattle and Nanyang cattle). The current paper identified a 28-bp indel by polymerase chain reaction within IGF1R gene. The analysis showed that there was a significant correlation between the locus and the hucklebone width of Nanyang cattle in four periods, in which it was highly correlated at 6, 12 and 18 months. At the age of 6 months, it was also significantly correlated with body height, body weight and body length. Association analysis showed that the locus in Jinnan cattle was extremely significantly correlated with body slanting length and body weight, and significantly correlated with chest circumference. There was no significant correlation between this locus and growth traits of Xianan cattle and Qinchuan cattle. The detected indel in the IGF1R gene was significantly associated with growth traits in Jinnan and Nanyang cattle, and could be used as a molecular marker for growth trait selection.
Previous analyses of grey and white matter volumes have reported that schizophrenia is associated with structural changes. Deep learning is a data-driven approach that can capture highly compact hierarchical non-linear relationships among high-dimensional features, and therefore can facilitate the development of clinical tools for making a more accurate and earlier diagnosis of schizophrenia.
Aims
To identify consistent grey matter abnormalities in patients with schizophrenia, 662 people with schizophrenia and 613 healthy controls were recruited from eight centres across China, and the data from these independent sites were used to validate deep-learning classifiers.
Method
We used a prospective image-based meta-analysis of whole-brain voxel-based morphometry. We also automatically differentiated patients with schizophrenia from healthy controls using combined grey matter, white matter and cerebrospinal fluid volumetric features, incorporated a deep neural network approach on an individual basis, and tested the generalisability of the classification models using independent validation sites.
Results
We found that statistically reliable schizophrenia-related grey matter abnormalities primarily occurred in regions that included the superior temporal gyrus extending to the temporal pole, insular cortex, orbital and middle frontal cortices, middle cingulum and thalamus. Evaluated using leave-one-site-out cross-validation, the performance of the classification of schizophrenia achieved by our findings from eight independent research sites were: accuracy, 77.19–85.74%; sensitivity, 75.31–89.29% and area under the receiver operating characteristic curve, 0.797–0.909.
Conclusions
These results suggest that, by using deep-learning techniques, multidimensional neuroanatomical changes in schizophrenia are capable of robustly discriminating patients with schizophrenia from healthy controls, findings which could facilitate clinical diagnosis and treatment in schizophrenia.
Pancreatic cancer is one of the most malignant tumours with a poor prognosis. In recent years, the incidence of pancreatic cancer is on the rise. Traditional chemotherapy and radiotherapy for pancreatic cancer have been improved, first-line and second-line palliative treatments have been developed, and adjuvant treatments have also been used in clinical. However, the 5-year survival rate is still less than 10% and new treatment methods such as targeted therapy and immunotherapy need to be investigated. In the past decades, many clinical trials of targeted therapies and immunotherapies for pancreatic cancer were launched and some of them showed an ideal prospect in a subgroup of pancreatic cancer patients. The experience of both success and failure of these clinical trials will be helpful to improve these therapies in the future. Therefore, the current research progress and challenges of selected targeted therapies and immunotherapies for pancreatic cancer are reviewed.
The South Qinling block, a segment of the Yangtze craton involved in the Qinling–Dabie orogen, is critical for understanding the tectonic evolution of eastern China. However, the tectonic setting of the South Qinling block and the northern margin of the Yangtze block during middle Neoproterozoic time has long been the subject of debate, with two distinctly different models (continental rift or volcanic arc) proposed. Here, a comprehensive study of zircon U–Pb geochronology and geochemistry has been carried out on the Chengwan granitic pluton from the Suizao terrane in the South Qinling block. The granites are monzogranite and syenogranite in lithology, and are mainly composed of potash feldspar, quartz, plagioclase and biotite. This suite has long been regarded as a Palaeozoic magmatic pluton, but zircon U–Pb ages of 809 ± 9 Ma and 816 ± 4 Ma are obtained in this study. The granites are metaluminous to strongly peraluminous with high alkali contents, and exhibit highly fractionated features, including high SiO2, low Zr/Hf ratios, rare earth element tetrad effects and enrichment of K and Rb. They show Hf–Nd isotopic decoupling, which may be genetically related to their petrogenetic process. Based on the geochemical features and the positive εHf(t) values of the zircons, it is indicated that the granites may have been derived from partial melting of juvenile tonalitic rocks by biotite breakdown under fluid-absent conditions. The Chengwan granite geochemically belongs to the A2-subtype granites, suggesting that it might have formed in a post-orogenic tectonic setting. The highly fractionated A-type granite in this study may represent extensional collapse shortly after the collisional events in the South Qinling block, and thus indicate a tectonic regime switch, from compression to extension, as early as middle Neoproterozoic time. Integrating our new data with documented magmatic, metamorphic and sedimentary events during middle Neoproterozoic time in the region may support a continental rift model, and argues against arc models.
Efficient photosynthesis requires a balance of ATP and NADPH production/consumption in chloroplasts, and the exportation of reducing equivalents from chloroplasts is important for balancing stromal ATP/NADPH ratio. Here, we showed that the overexpression of purple acid phosphatase 2 on the outer membranes of chloroplasts and mitochondria can streamline the production and consumption of reducing equivalents in these two organelles, respectively. A higher capacity of consumption of reducing equivalents in mitochondria can indirectly help chloroplasts to balance the ATP/NADPH ratio in stroma and recycle NADP+, the electron acceptors of the linear electron flow (LEF). A higher rate of ATP and NADPH production from the LEF, a higher capacity of carbon fixation by the Calvin–Benson–Bassham (CBB) cycle and a greater consumption of NADH in mitochondria enhance photosynthesis in the chloroplasts, ATP production in the mitochondria and sucrose synthesis in the cytosol and eventually boost plant growth and seed yields in the overexpression lines.
The objective of this study was to delineate the characteristics and incidence of congenital heart disease (CHD) in patients with isolated microtia and to determine whether the prevalence of CHD among patients with isolated microtia increases with the severity of microtia.
Methods:
A total of 804 consecutive patients had a pre-operative colour Doppler echocardiographic examination. A retrospective study was performed with the clinical and imaging data from November, 2017 to January, 2019. The χ2 test was performed to analyse the interaction between isolated microtia and CHD.
Results:
With the colour Doppler echocardiographic examination’s data from 804 consecutive isolated microtia patients, we found CHD, including atrial septal defect, ventricular septal defect, tetralogy of Fallot, patent ductus arteriosus, and others, occurred in 52 of 804 patients (6.5%). Atrial septal defect prevalence in patients with isolated microtia was significantly higher than ventricular septal defect (24/804 versus 11/804, p < 0.05) and patent ductus arteriosus (24/804 versus 2/804, p < 0.001). Ventricular septal defect prevalence in patients with isolated microtia was significantly higher than patent ductus arteriosus (11/804 versus 2/804, p < 0.05). All four types of microtia (concha-type microtia, small concha-type microtia, lobule-type microtia, and anotia) had similar incidences of CHD with no difference in the incidences among these types (p > 0.05 respectively). Furthermore, there was no significant difference in the incidence of the atrial septal defect among the four subtypes (p > 0.05 respectively). Similarly, ventricular septal defect and patent ductus arteriosus also showed no differences (p > 0.05 respectively).
Conclusions:
The overall incidences of CHD and three most common CHD subtypes (atrial septal defect, ventricular septal defect, and patent ductus arteriosus) in patients with isolated microtia are higher than general population. The prevalence of CHD among patients with isolated microtia does not increase with the severity of microtia. According to our experience in this study, we suggest colour Doppler echocardiographic imaging should be performed for isolated microtia patients soon after birth if possible. Furthermore, for the plastic surgeon and anaesthesiologist, it is important to take pre-operative colour Doppler echocardiographic images which can help evaluate heart function to ensure the safety of the peri-operative period. Future studies when investigating CHDs associated with isolated microtia could focus on genetic and molecular mechanisms.
The aim of this study was to explore the effects and mechanisms of different starvation treatments on the compensatory growth of Acipenser dabryanus. A total of 120 fish (60·532 (sem 0·284) g) were randomly assigned to four groups (fasting 0, 3, 7 or 14 d and then refed for 14 d). During fasting, middle body weight decreased significantly with prolonged starvation. The whole-body and muscle composition, serum biochemical indexes, visceral indexes and digestive enzyme activities had been effected with varying degrees of changes. The growth hormone (GH) level in serum was significantly increased in 14D; however, insulin-like growth factor-1 (IGF-1) showed the opposite trend. The neuropeptide Y (npy) mRNA level in brain was significantly improved in 7D; peptide YY (pyy) mRNA level in intestine was significantly decreased during fasting. After refeeding, the final body weight, percentage weight gain, specific growth rate, feed intake, feed efficiency and protein efficiency ratio showed no difference between 0D and 3D. The changes of whole-body and muscle composition, serum biochemical indexes, visceral indexes and digestive enzyme activities had taken place in varying degrees. GH levels in 3D and 7D were significantly higher than those in the 0D; the IGF-1 content decreased significantly during refeeding. There was no significant difference in npy and pyy mRNA levels. These results indicated that short-term fasting followed by refeeding resulted in full compensation and the physiological and biochemical effects on A. dabryanus were the lowest after 3 d of starvation and 14 d of refeeding. Additionally, compensation in A. dabryanus may be mediated by appetite genes and GH, and the degree of compensation is also affected by the duration of starvation.
The microstructure evolution, dynamic recrystallization (DRX) and precipitation of the ZM61 alloy sheets prepared with different rolling conditions were studied. The DRX grain sizes (dDRX) at four high strain rate rolling (HSRR) temperatures (275–350 °C) are 1.9, 2.3, 2.6 and 3.1 μm, respectively, while the DRX volume fractions (fVDRX) are 69, 73, 76 and 82%, respectively. 300 °C is selected as the optimal HSRR temperature. The dDRX and fVDRX of the alloys prepared by pre-rolling (PR) at 300 °C + HSRR are 1.0 μm and 91%, respectively. The PR treatment does not change the types of the precipitates but promotes the precipitation. The tensile strength (UTS) of 369 MPa and yield strength (YS) of 261 MPa can be achieved by HSRR at 300 °C, while a further increase in both UTS and YS can be obtained by PR treatment.
Heterogeneous magnesium matrix nanocomposites (Hetero-Mg-NCs) exhibited excellent strength–toughness synergy, but their damage behavior and toughness mechanism lacked of investigation. Here, atomic force microscopy was first employed to characterize the microstructure evolution and damage behavior of the Hetero-Mg-NCs after indentation. The heterogeneous structure comprised of pure Mg areas (soft phase) and Mg nanocomposite areas (hard phase) was revealed by the electrostatic force microscopy. Furthermore, the surface morphology and cracks of the deformed area were investigated with high resolution. The results indicated the soft phase undertook most of the deformation and played an important role in capturing and blunting the crack.