Role of diaphragmatic ultrasound in patients with acute exacerbation of chronic obstructive pulmonary disease

Assessing diaphragm function status is vital for diagnosing and treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Diaphrag-matic ultrasound has become increasingly important due to its non-invasive nature,absence of radiation exposure,widespread availability,prompt results,high accuracy,and repeatability at the bedside.The diaphragm is a crucial respiratory muscle.Decline or dysfunction of the diaphragm can lead to dyspnea and even respiratory failure in AECOPD patients.In this editorial,we comment on an article,retrospectively analyzed ninety-four acute exacerbations of chronic obstructive pulmonary disease patients who received mechanical ventilation from January 2022 to December 2023.The study found that the diaphragm thickening fraction,an index from diaphragm ultrasound,can better predict the outcome of non-invasive ventilation in patients with AECOPD.The value of non-invasive ventilation in treating respiratory failure caused by AECOPD has been widely acknowledged.Diaphragmatic dysfunction diagnosed with ultrasound is asso-ciated with prolonged mechanical ventilation and weaning times and higher mortality.

Star Movement Is Not Predicted Two-Compartment Model of the Universe

A two-compartment model of the universe is proposed to further refine Albert Einstein’s insight into curvature of space and the energy tensor. The two compartments are energy contained by a shell prism. The model allows for a non-unification of fundamental forces with gravity resulting from the curvature of a space-time prism. Carrier forces travel within the prism and particles emerge from the prism. Giving a thickness to the manifold negates infinity and will allow solutions at both microscopic and cosmic levels. Geometry is the link between quantum mechanics and general relativity. Negative entropy, as proposed by Erwin Schrödinger, gives order to particles and the cosmic. The source of this energy is in the shell of the containment vessel. The acceleration of the expansion of the universe occurred when energy within the container transformed into mass, warping the space-time container and causing an explosion of the container. Star movement is explained by the surface tension of the prism of space-time.

HIPPO artificial intelligence:Correlating automated radiographic femoroacetabular measurements with patient-reported outcomes in developmental hip dysplasia

BACKGROUND Hip dysplasia(HD)is characterized by insufficient acetabular coverage of the femoral head,leading to a predisposition for osteoarthritis.While radiographic measurements such as the lateral center edge angle(LCEA)and Tönnis angle are essential in evaluating HD severity,patient-reported outcome measures(PROMs)offer insights into the subjective health impact on patients.AIM To investigate the correlations between machine-learning automated and manual radiographic measurements of HD and PROMs with the hypothesis that artificial intelligence(AI)-generated HD measurements indicating less severe dysplasia correlate with better PROMs.METHODS Retrospective study evaluating 256 hips from 130 HD patients from a hip preservation clinic database.Manual and AI-derived radiographic measurements were collected and PROMs such as the Harris hip score(HHS),international hip outcome tool(iHOT-12),short form(SF)12(SF-12),and Visual Analogue Scale of the European Quality of Life Group survey were correlated using Spearman's rank-order correlation.RESULTS The median patient age was 28.6 years(range 15.7-62.3 years)with 82.3%of patients being women and 17.7%being men.The median interpretation time for manual readers and AI ranged between 4-12 minutes per patient and 31 seconds,respectively.Manual measurements exhibited weak correlations with HHS,including LCEA(r=0.18)and Tönnis angle(r=-0.24).AI-derived metrics showed similar weak correlations,with the most significant being Caput-Collum-Diaphyseal(CCD)with iHOT-12 at r=-0.25(P=0.042)and CCD with SF-12 at r=0.25(P=0.048).Other measured correlations were not significant(P>0.05).CONCLUSION This study suggests AI can aid in HD assessment,but weak PROM correlations highlight their continued importance in predicting subjective health and outcomes,complementing AI-derived measurements in HD management.

Transcranial photobiomodulation with near-infrared light:a promising therapeutic modality for Alzheimer's disease

Transcranial photobiomodulation(tPBM) is a noninvasive neuromodulation technique that delivers near-infrared(NIR) light with low irradiance(i.e.,power density in mW/cm2) in the wavelength range of 800-1070 nm.Several recently published books or collected literature(Hamblin,2019;GonzalezLima,2021) and papers(Nizamutdinov et al. 2022)offer comprehensive reviews of the mechanism of action and potential clinical translations of tPBM for the treatment of a variety of diseases,including neurodegenerative diseases(Alzheimer’s disease(AD),and Parkinson’s disease),traumatic brain injury.

Color Doppler ultrasound imaging in varicoceles: Is the difference in venous diameter encountered during Valsalva predictive of palpable varicocele grade?

Objective:The clinical grading system for varicoceles is subjective and dependent on clinician experience.Color Doppler ultrasound(US)has not been standardized in the diagnosis of varicoceles.We aimed to determine if US measurement of varicocele could be predictive of World Health Organization(WHO)varicocele grade.Methods:Men who presented for either scrotal pain or infertility to a tertiary men’s health clinic underwent physical examination,and varicoceles were graded following WHO criteria(0Zsubclinical,1,2,3).US was used to measure largest venous diameter in the pampiniform plexus bilaterally at rest and during Valsalva maneuver.Receiver operator characteristic curve analysis was used to determine if resting diameter,diameter during Valsalva,or change in diameter between at rest and during Valsalva provided the highest sensitivity and specificity for determining clinical grade.Threshold values for diameter were determined from these receiver operator characteristic curves.Results:A total of 102 men(50 with clinical varicocele and 52 with subclinical varicocele)were included.Diameter at rest was the best ultrasonographic discriminator between subclinical and clinical varicoceles(area under the curve[AUC]Z0.67)with a diameter threshold of 3.0 mm(sensitivity 79%,specificity 42%).Diameter during Valsalva had the greatest AUC for determining clinical Grades 1 versus 2(AUCZ0.57)with diameter threshold of 5.7 mm(sensitivity 71%,specificity 33%).For differentiating between Grades 2 and 3,diameter at rest had the greatest AUC of 0.65 with a threshold of 3.6 mm(sensitivity 71%,specificity 58%).Conclusion:Our results corroborate other studies that have shown a weak correlation between US and clinical grading.The use of diameter during Valsalva was less predictive than diameter at rest and was only clinically significant in differentiating between Grade 1 and 2 varicocele.A standardized method for determining clinically relevant varicoceles on US would allow for improved patient counseling and clinical decision-making.

The Challenges in Providing Affordable Housing in Nigeria and the Adequate Sustainable Approaches for Addressing Them

Despite multiple schemes implemented by various governments around the country, affordable housing remains elusive to the average Nigerian. Because the situation is comparable to that of other developing nations, it remains a key concern in these countries’ socioeconomic development. Over 52% of Nigeria’s population has been claimed to live in shanties, squatter communities, and informal settlements. This article, therefore, reviews the challenges to the provision of affordable housing in Nigeria and the Sustainable approaches to address them. The article’s findings were based on a thorough examination of the literature. The article’s findings indicated that sustainable approaches for addressing Nigeria’s affordable housing barriers may best be examined through the economic, ecological, social, institutional, and technical factors. The paper urges the present regime, investors, lawmakers, and private developers in Nigeria to implement these approaches for affordable housing provision. The findings from this article will add to the current body of knowledge by providing important information on affordable housing provision and re-directing research interest towards affordable housing in Nigeria and other developing countries.

The Benefits of Solar Energy on the Provision of Sustainable Affordable Housing in Nigeria

Solar energy is the most abundant form of energy on Earth. Solar energy brings impactful benefits and products that are expected to make homes more reliable, sustainable, and affordable. Thanks to technological advancements like the solar cell, we can gather this energy and turn it into electricity. The construction industry has an exceptional chance of benefiting from this sustainable energy. Many recognised benefits have been spelled forth in the construction industry, such as providing homes with clean energy with no trace of ozone depleting material emission. There are many people in Nigeria who are not linked to the public electric grid, and the energy sector produces and generates less than 58% of the entire amount of energy required. As stated in the Nigeria’s National Energy General Plan, the Sustainable Energy programme aims to enhance the country’s use of solar electricity. This paper focuses on the role of solar energy in the provision of sustainable affordable housing in Nigeria. It considers the description, method, and utilisation of solar energy with a focus on residential and commercial buildings.

高光谱遥感在农作物长势监测中的应用

该研究是加拿大Saskatchewan Scott农作物轮作系统(ACS)研究的一部分。研究始于1994年,历时18a,评价9个可耕种农作物产量系统的可靠性。由3种处理水平(organic,reduced,high)和3种作物多样性水平(low,diversified annual grains,diversified annual perennials)结合而产生的9个农作物产量系统,被用于监测和评价加拿大牧场不同处理和不同作物种植轮作下可耕种农作物的产量。在2003年生长季共收集了3次叶面积指数和光谱反射率的数据:生长季前期(6月)、生长季旺盛期(7月)、生长季后期(8月)。叶面积指数是由LAI-2000植物冠层分析仪监测的,光谱测量是由覆盖了350-2500 nm波长范围共2215个波段的ADS便携式高光谱仪完成的。结果显示,光学测量可以用于监测农作物生长状况的差异。从生长季的早期到中期,光谱和叶面积指数在不同处理下有显著差异。7月中期是用遥感资料监测农作物长势的最佳季节;红光波段与近红外波段反射率的比值和基于这两个波段构造的归一化植被指数,是检测农作物长势的最佳植被指数。

SEC准则下基于R3软件的煤层气、致密气上市储量评估方法初探

为合理评估煤层气、致密气资产价值,本文基于R3评估软件,以沁水盆地潘河、寿阳南燕竹煤层气区块、临兴中致密气区块为案例,对不同类型的煤层气藏、致密气藏上市储量评估提出了相应的评估思路和方法。研究结果表明:煤层气、致密气藏SEC储量评估主要包含三大步骤:一是确定储量级别,二是计算单井技术可采储量,三是经济评价。煤层气藏的评估主要采用动态法、静态法及概率法;致密气藏的评估主要采用动态法和概率法。

FLT3在急性白血病靶向治疗中的研究进展

FMS-like Tyrosine Kinase 3(FLT3)是一种受体酪氨酸激酶,在造血干细胞、前体B细胞等的增殖、分化以及存活中具有重要作用。急性白血病的发病往往伴随着FLT3的异常活化,FLT3突变是造成其异常活化的主要原因,且FLT3突变的患者往往具有较差的预后。FLT3抑制剂的研究为白血病靶向治疗提供了广阔的前景。

肠道子宫内膜异位症诊断和治疗的新观点

子宫内膜异位症是一种主要影响育龄妇女的慢性疾病。部分肠道子宫内膜异位症患者可能是无症状的,除了不孕之外,有部分患者表现为各种各样的症状,如排便习惯改变(便秘或腹泻)、排便困难、痛经和性交痛等。迄今为止,对于疑似有肠道受累的子宫内膜异位症患者,尚无明确的评估指南。目前的检查手段包括经阴道或经直肠超声检查、核磁共振成像和气钡双重对比造影。不同的检查方法可提供更多的信息,包括是否存在病灶、病灶的位置和累及的范围等,确保患者充分了解病情,同时也可对术前计划进行优化。如需手术治疗,应由经验丰富的医生在有多学科护理条件的中心进行手术。治疗应根据患者的症状和意愿进行调整,目的是尽可能切除所有病灶的同时保留器官的功能。本综述将讨论肠道子宫内膜异位症诊断和处理的最新观点。

Review of endoscopic techniques in the diagnosis and management of cholangiocarcinoma

Cholangiocarcinoma is a rare malignancy of the biliary tract. Key factors in determining therapeutic options include knowledge of tumor extent, anatomy and obtaining tissue diagnosis. Endoscopically, there are three modalities available to make the diagnosis of cholangiocarcinoma. These include endoscopic retrograde cholangiopancreatography, endoscopic ultrasound with fine needle aspiration and cholangioscopy. Management of cholangiocarcinoma endoscopically is typically confined to stent placement for palliative purposes or as a bridge to surgery. In this article, we will review the endoscopic techniques available for the diagnosis and management of cholangiocarcinoma.

c-Met targeted therapy of cholangiocarcinoma

Cholangiocarcinoma continues to be a challenging disease to treat. Systemic therapy is used in unresectable disease, disease progression after surgery, and in the palliative setting. Unfortunately, results of multiple phase Ⅱ trials have rarely yielded positive results. As data on the molecular carcinogenesis of cholangiocarcinoma is developing, we are more able to understand the disease process and can use this understanding to create unique targeted therapies. We reviewed the role of c-Met/ hepatocyte growth factor (HGF) in the development of cholangiocarcinoma. Furthermore, we explored the use of the c-Met guided cascade as a target to treat cholangiocarcinoma. We reviewed the current use and options for future development of c-Met agents to treat this disease.

Androgen receptor signaling and mutations in prostate cancer

Normal and neoplastic growth of the prostate gland are dependent on androgen receptor （AR） expression and function. Androgenic activation of the AR, in association with its coregulatory factors, is the classical pathway that leads to transcriptional activity of AR target genes. Alternatively, cytoplasmic signaling crosstalk of AR by growth factors, neurotrophic peptides, cytokines or nonandrogenic hormones may have important roles in prostate carcinogenesis and in metastatic or androgen-independent （AI） progression of the disease. In addition, cross-modulation by various nuclear transcription factors acting through basal transcriptional machinery could positively or negatively affect the AR or AR target genes expression and activity. Androgen ablation leads to an initial favorable response in a significant number of patients; however, almost invariably patients relapse with an aggressive form of the disease known as castration-resistant or hormone-refractory prostate cancer （PCa）. Understanding critical molecular events that lead PCa cells to resist androgen-deprivation therapy is essential in developing successful treatments for hormone-refractory disease. In a significant number of hormone-refractory patients, the AR is overexpressed, mutated or genomically amplified. These genetic alterations maintain an active presence for a highly sensitive AR, which is responsive to androgens, antiandrogens or nonandrogenic hormones and collectively confer a selective growth advantage to PCa cells. This review provides a brief synopsis of the AR structure, AR coregulators, posttranslational modifications of AR, duality of AR function in prostate epithelial and stromal cells, AR-dependent signaling, genetic changes in the form of somatic and germline mutations and their known functional significance in PCa cells and tissues.

Saposin C stimulates growth and invasion,activates p42/44 and SAPK/JNK signaling pathways of MAPK and upregulates uPA/uPAR expression in prostate cancer and stromal cells

Aim:To determine the effect of saposin C (a known trophic domain of prosaposin) on proliferation,migration and invasion,as well as its effect on the expression of urokinase plasmonogen activator (uPA),its receptor (uPAR) and matrix metalloproteinases (MMP)-2 and -9 in normal and malignant prostate cells.In addition,we tested whether saposin C can activate p42/44 and stress-activated protein kinase/c-Jun NH_2-terminal kinase (SAPK/JNK) signal transduction pathways of the mitogen-activated protein kinase (MAPK) superfamily.Methods:We employed West- ern blot analysis,phospho-specific antibodies,cell proliferation assay,reverse transcriptase-polymerase chain reaction, in vitro kinase assays and migration and invasion to determine the effect of saposin C on various biological behaviors of prostate stromal and cancer cells.Results:Saposin C,in a cell type-specific manner,upregulates uPA/uPAR and immediate early gene c-Jun expression,stimulates cell proliferation,migration and invasion and activates p42/44 and SAPK/JNK MAPK pathways in prostate stromal and cancer cells.Normal prostate epithelial cells were not responsive to saposin C treatment in the above studies.Conclusion:Saposin C functions as a multipotential modulator of diverse biological activities in prostate cancer and stromal cells.These results strongly suggest that saposin C functions as a potent growth factor for prostatic cells and may contribute to prostate carcinogenesis and/or the development of hormone-refractory prostate cancer.

An update–tissue engineered nerve grafts for the repair of peripheral nerve injuries

Peripheral nerve injuries（PNI） are caused by a range of etiologies and result in a broad spectrum of disability. While nerve autografts are the current gold standard for the reconstruction of extensive nerve damage, the limited supply of autologous nerve and complications associated with harvesting nerve from a second surgical site has driven groups from multiple disciplines, including biomedical engineering, neurosurgery, plastic surgery, and orthopedic surgery, to develop a suitable or superior alternative to autografting. Over the last couple of decades, various types of scaffolds, such as acellular nerve grafts（ANGs）, nerve guidance conduits, and non-nervous tissues, have been filled with Schwann cells, stem cells, and/or neurotrophic factors to develop tissue engineered nerve grafts（TENGs）. Although these have shown promising effects on peripheral nerve regeneration in experimental models, the autograft has remained the gold standard for large nerve gaps. This review provides a discussion of recent advances in the development of TENGs and their efficacy in experimental models. Specifically, TENGs have been enhanced via incorporation of genetically engineered cells, methods to improve stem cell survival and differentiation, optimized delivery of neurotrophic factors via drug delivery systems（DDS）, co-administration of platelet-rich plasma（PRP）, and pretreatment with chondroitinase ABC（Ch-ABC）. Other notable advancements include conduits that have been bioengineered to mimic native nerve structure via cell-derived extracellular matrix（ECM） deposition, and the development of transplantable living nervous tissue constructs from rat and human dorsal root ganglia（DRG） neurons. Grafts composed of non-nervous tissues, such as vein, artery, and muscle, will be briefly discussed.

Involvement of cholangiocyte proliferation in biliary fibrosis

Cholangiocytes are the epithelial cells that line the biliary tree.In the adult liver,they are a mitotically dormant cell population,unless ductular reaction is triggered by injury.The ability of cholangiocytes to proliferate is important in many different human pathological liver conditions that target this cell type,which are termed cholangiopathies(i.e.primary biliary cirrhosis,primary sclerosing cholangitis and biliary atresia).In our article,we provide background information on the morphological and functional heterogeneity of cholangiocytes,summarize what is currently known about their proliferative processes,and briefly describe the diseases that target these cells.In addition,we address recent findings that suggest cholangiocyte involvement in epithelial-to-mesenchymal transformation and liver fibrosis,and propose directions for future studies.

The effects of advanced paternal age on fertility

Modern societal pressures and expectations over the past several decades have resulted in the tendency for couples to delay conception. While women experience a notable decrease in oocyte production in their late thirties, the effect of age on spermatogenesis is less well described. While there are no known limits to the age at which men can father children, the effects of advanced paternal age are incompletely understood. This review summarizes the current state of knowledge regarding advanced paternal age and its implications on semen quality, reproductive success and offspring health. This review will serve as a guide to physicians in counseling men about the decision to delay paternity and the risks involved with conception later in life.

Human benign prostatic hyperplasia heterotransplants as an experimental model

Benign prostatic hyperplasia is a nonmalignant adenomatous enlargement of the pefiurethral prostate gland. It is a common disease in older men. In addition to man,spontaneous benign prostatic hyperplasia occurs in chimpanzee and the dog. Alternatives to these spontaneous models are induced benign prostatic hyperplasia,xenografts and in vitro models. Xenografts may be induced by cells cultured in vitro or by the heterotransplantation of primary surgical specimens into immunosuppressed mice. The purpose of this review is to integrate data from more than 30 years of heterotransplantation research in the study of benign hyperplasia of the prostate. Heterotransplantation has provided data regarding the histopathology,morphology,tissue markers,androgen receptor expression,tissue kinetics,take rate and tissue vasculature for this prostate disease.There are advantages,as well as limitations,that have been identified for human prostate disease heterotransplants versus xenotransplantation of cultured cells.Overall,heterotransplanted tissue is better at retaining tissue morphology,pathology,secretory activity,expression of tissue markers and human vasculature of the patient＇s original specimen. Furthermore,heterotransplanted tissue preserves the three-dimensional tissular architecture of the prostate to maintain critical stromal-epithelial cell interactions.

Semen analysis in 21st century medicine： the need for sperm function testing

Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology （ART）, has fallen out of favour in many reproductive medicine centers throughout the world. Indeed, the most recent addition of the ＇World Health Organisation （WHO） Laboratory Manual for the Examination and Processing of Hu- man Semen＇ now groups many of these procedures into a section termed Research Procedures. In large part, this reflects the current clinical practice of bypassing the in-depth evaluation of the male partner, while assuming that if a spermatozoon can be found for intracytoplasmic sperm injection （ICSI）, it must be a healthy cell capable of achieving fertilization. Never- theless, sperm function testing can provide valuable clinical insights into defects causing male infertility. Admittedly, in some cases, functional sperm deficiencies can be overcome using an ART. In other cases, couples will be empowered by the knowledge of the cause of their infertility, and for some couples, perhaps even the likelihood of ICSI success （relative to the spermatozoa）. The knowledge allows them to make truly informed reproductive decisions, including （perhaps） the de- cision to seek donor insemination, to adopt or to remain childless. Knowledge of the cause of their infertility may provide closure for couples and a sense of confidence regarding their choice of reproductive treatment.