To assess the effectiveness of a comprehensive rehabilitation approach combining Traditional Chinese Medicine Daoyin with lower limb robotics during the recovery phase of stroke patients. Stroke patients meeting the specified criteria were randomly assigned to one of four groups using a random number table: Control group, Daoyin group, lower limb robot group (LLR group), and Daoyin and lower limb robot group (DLLR group). Each group received distinct treatments based on conventional rehabilitation training. The treatment duration spanned two weeks with two days of rest per week. Pre- and post-intervention assessments included various scales: Fugl-Meyer Assessment (FMA), Berg balance scale (BBS), Barthel index (BI), Fatigue Scale-14 (FS-14), Pittsburgh sleep quality index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD). Statistically significant differences were observed in the lower limb function measured by FAM between the Control group (15 ± 5) and the DLLR group (18 ± 5) (P = 0.049). In the Barthel index, a statistically significant difference was noted between the Control group (54 ± 18) and the DLLR group (64 ± 11) (P = 0.041). Additionally, significant differences were found in the Berg balance scale between the Control group (21 ± 10) and the DLLR group (27 ± 8) (P = 0.024), as well as between the Control group (21 ± 10) and the LLR group (26 ± 10) (P = 0.048). The findings of this study suggest that the combined use of Daoyin and robotics not only enhances motor function in stroke patients but also has a positive impact on fatigue, sleep quality, and mood. This approach may offer a more effective rehabilitation strategy for stroke patients.

To investigate the spiritual well-being and self-efficacy levels in patients with intestinal stomas. For this descriptive study, researchers conducted face-to-face interviews with 51 participants. Data were analyzed using a descriptive characteristics questionnaire, the Stoma Self-efficacy Scale (SSES), and the Three-Factor Spiritual Well-being Scale (TF-SWBS). Participants had a mean SSES score of 56.98 ± 21.24. Education level and stoma type affected the SSES scores. Income level affected TF-SWBS scores. There was no correlation between SSES and TF-SWBS total scores. There was a positive correlation between TF-SWBS scores and stoma duration and age. Nurses should provide trainings to develop self-efficacy among and enhance psychosocial and spiritual support for patients with a stoma.

Purpose: To construct a fusion model for predicting CDKN2A/B homozygous deletion status in patients with isocitrate dehydrogenase (IDH)-mutant diffuse astrocytoma by combining the radiomics features and deep learning (DL). Methods: A total of 200 IDH-mutant astrocytoma (103 CDKN2A/B homozygous deletion (HD) and 97 CDKN2A/B non-homozygous deletion (NHD)) patients were retrospectively enrolled in the training cohort (n = 140) and the external test cohort (n = 60) for the prediction of CDKN2A/B homozygous deletion status in patients with IDH-mutant astrocytoma. DL model was constructed by SE-Net model, radiomics features of different regions (edema, tumor and overall lesion) were extracted using Pyradiomics, and radiomics model was built by selecting 4 features in the edema region and 7 features in the tumor region by the least absolute shrinkage and selection operator (LASSO). Finally, a fusion model was jointly constructed by the DL model, radiomics model, and clinical features. The predictive performance of the 3 models was evaluated using calibration curves and decision curves, and compared with the fusion model. Results: Based on the results of the different models, we finally selected a fusion model consisting of DL model, radiomics model, and clinical features. The fusion model showed the best performance with an area under the curve (AUC) of 0.958 in the training cohort and 0.914 in the test cohort. Conclusions: The clinical fusion model based on radiomics features and DL features showed good performance in predicting CDKN2A/B homozygous deletion status in patients with IDH-mutant diffuse astrocytoma. Key Points: 1) Used DL and radiomics to non-invasively predict the CDKN2A/B homozygous deletion status. 2) The model can predict CDKN2A/B homozygous deletion status in IDH-mutant astrocytoma patients. 3) Our result improved classification accuracy and demonstrated better performance in the fusion model.

In this study, GH4099 alloys with over 99.99% density were produced by laser powder bed fusion (LPBF) and followed by hot isostatic pressing (HIP) and heat treatment (HT). The effects of HIP and HT on the microstructure evolution and mechanical properties of the additively manufactured GH4099 superalloy were examined systematically. The as-deposited columnar crystals were effectively transformed into equiaxed crystals via HIP and HT. During HIP, the elimination of defects and elemental segregation in the deposited samples occurs. However, uneven precipitation of the γ′ phase within grains causes the emergence of minor gaps in the γ matrix, which adversely affects mechanical properties. The microstructure resulting from HIP+solution treatment (ST) consists entirely of equiaxed recrystallized grains. The presence of twin and long-period stacking-ordered (LPSO) phases at twin boundaries strongly hinders dislocation behavior, and the remelting of precipitates and carbides greatly improves plasticity. Moreover, during the loading process at 900°C, γ′ phase and carbides were re-precipitated, and the strain concentration was minimized during the precipitation process, resulting in the highest high-temperature strength. Conversely, in the HIP+solution and aging treatment (SAT) process, the progression of γ′ phase precipitation, condensation, annexation, and growth contributes to a reduction in strength. Coupled with an increase in the plasticity of the LPBF GH4099 alloy.

Cardiovascular disorders are the leading cause of death in the world. Many organ diseases (kidney, heart, and brain) are substantially more prone to develop in people with hypertension. In the treatment of hypertension, first-line medications are recommended, while imidazoline receptor agonists are not first-line antihypertensives. Our goal was to conduct a network meta-analysis to assess the efficacy and safety of imidazoline receptor agonists. The meta-analysis was performed following the PRISMA guidelines using the PICOS format, considering the CONSORT recommendations. Studies were collected from four databases: PubMed, Cochrane Library, Web of Science, and Embase. A total of 5960 articles were found. After filtering, 27 studies remained eligible for network meta-analysis. Moxonidine reduced blood pressure in sitting position statistically significantly after 8 weeks of treatment (SBP MD: 23.80; 95% CI: 17.45-30.15; DBP MD: 10.90; 95% CI: 8.45-13.35) compared to placebo. Moreover, moxonidine reduced blood pressure more effectively than enalapril; however, this difference was not significant (SBP MD: 3.10; 95% CI: -2.60-8.80; DBP MD: 1.30; 95% CI: -1.25-3.85). Dry mouth was experienced as a side effect in the case of all imidazoline receptor agonists. After 8 weeks of treatment, the appearance of dry mouth was highest with clonidine (OR: 9.27 95% CI: 4.70-18.29) and lowest with rilmenidine (OR: 6.46 95% CI: 0.85-49.13) compared to placebo. Somnolence was less frequent with moxonidine compared to rilmenidine (OR: 0.63 95% CI: 0.17-2.31). Imidazoline receptor agonists were nearly as effective as the first-line drugs in the examined studies. However, their utility as antihypertensives is limited due to their side effects. As a result, they are not first-line antihypertensives and should not be used in monotherapy. However, in the case of resistant hypertension, they are a viable option. According to our findings, from the point of view of safety and efficacy, moxonidine appears to be the best choice among imidazoline receptor agonists.