University Shenzhen Research Articles

Protective Strategies for Pituitary Function During Endoscopic Transnasal Pituitary Adenoma Surgery: A Single-center Experience.

This study investigated the impact of endoscopic transnasal pituitary adenoidectomy on function and discussed the factors that contribute to postoperative pituitary function. To provide a foundation for protecting pituitary function and improving the curative effect of pituitary adenoma neuroendoscope resection. From January 2019 to January 2022, in the Neurosurgery Pituitary Tumor Diagnosis and Treatment Research Center, the First Affiliated Hospital of Shenzhen University, the clinical data of 306 patients who underwent endoscopic transnasal pituitary adenoma surgery were analyzed retrospectively. The surgical treatment strategy was discussed and explored, while the factors related to pituitary function were examined based on tumor size and Knosp grade. There were 40 cases (67.8%) of pituitary-thyroid axis, 18 cases (60%) of pituitary-adrenal axis, 25 cases (45.4%) of pituitary-gonad axis, 5 cases (62.5%) of pituitary-growth hormone axis, and 8 cases (72.7%) of diabetes insipidus with postoperative improves of hypopituitarism. Postoperative newly developed hypopituitarism occurred in 20 cases (8.1%) of pituitary-thyroid axis, 15 cases (5.4%) of pituitary-adrenal axis, 10 cases (4.0%) of pituitary-gonad axis, 5 cases (1.7%) of pituitary-growth hormone axis, and 8 cases (2.7%) of new diabetes insipidus. The incidence of pituitary-adrenal axis hypofunction in giant pituitary adenomas was significantly higher than that in microadenomas and macroadenomas (P<0.05). The incidence of hypopituitarism of Knosp grade 4 pituitary adenoma before operation was higher than that of other groups (P<0.05), but there was no significant difference in the incidence of new hypopituitarism after operation (P>0.05). In endoscopic transnasal pituitary adenoma surgery, the incidence of hypothyroidism and adrenal gland dysfunction is higher than in other hormone axes, but the recovery rate is also higher, and the recovery rate of sex hormones is lower. The incidence of postoperative hypothyroidism increases dramatically with tumor size and tumor invasiveness.

Spatial-spectral attention state-space fusion network for tree carbon estimation using multi-source data

Abstract Amid rapid industrialization and urbanization, global warming and the urban heat island effect are intensifying. There is an urgent need for rapid and accurate monitoring of carbon storage in urban vegetation to assess and mitigate these environmental issues. While methods exist for estimating above-ground carbon (AGC) stocks in individual trees using deep learning, fewer studies integrate multi-source remote sensing data with these techniques. This study introduces a network that leverages spatial-spectral attention and state-space models, called the spatial-spectral attention state-space fusion network (S4FNet). S4FNet utilizes UAV hyperspectral imaging (HSI) data, light detection and ranging (LiDAR) data, and RGB data to estimate AGC storage in individual trees. This study conducted experiments at two sites, the South and North areas of Shenzhen University’s Yuehai Campus, Shenzhen City, Guangdong Province, China, and compared S4FNet with eight traditional machine learning methods and a deep learning method. The experimental results demonstrate that S4FNet achieves the best performance across all metrics, confirming its excellent capability in predicting AGC stocks using multi-source remote sensing data.

Relationship between the severity of functional mitral regurgitation at admission and one-year outcomes in patients hospitalized for acute heart failure with mildly reduced ejection fraction

BackgroundThe epidemiological distribution of functional mitral regurgitation (FMR) in heart failure (HF) and mildly reduced ejection fraction (HFmrEF) patients and its impact on outcomes remains unclear. We attempt to investigate the prognosis of FMR in patients with HFmrEF.MethodsThe HF center registry study is a prospective, single, observational study conducted at the Second Affiliated Hospital of Shenzhen University, where 2330 patients with acute HF (AHF) were enrolled and 890 HFmrEF patients were included in the analysis. The patients were stratified into three categories based on the severity of FMR: none/mild, moderate, and moderate-to-severe/severe groups. Subsequently, a comparison of the clinical characteristics among these groups was conducted, along with an assessment of the incidence of the primary endpoint (comprising all-cause mortality and readmission for HF) during a one-year follow-up period.ResultsThe one-year follow-up results indicated that the primary composite endpoint occurrence rates in the three groups were 23.5%, 32.9%, and 36.5%, respectively. The all-cause mortality rates in the three groups were 9.3%, 13.7%, and 16.4% respectively. Survival analysis demonstrated a statistically significant difference in the occurrence rates of the primary composite endpoint and all-cause mortality among the three groups (P < 0.05). Multifactor Cox regression revealed that moderate FMR and moderate-to-severe/severe FMR were independent risk factors for adverse clinical prognosis in HFmrEF patients, with hazard ratios and 95% confidence intervals of 1.382 (1.020–1.872, P = 0.037) and 1.546 (1.092–2.190, P = 0.014) respectively.ConclusionsModerate FMR and moderate-to-severe/severe FMR independently predict an unfavorable prognosis in patients with HFmrEF.

Ultrasound image-based nomogram combining clinical, radiomics, and deep transfer learning features for automatic classification of ovarian masses according to O-RADS.

Accurate and rapid discrimination between benign and malignant ovarian masses is crucial for optimal patient management. This study aimed to establish an ultrasound image-based nomogram combining clinical, radiomics, and deep transfer learning features to automatically classify the ovarian masses into low risk and intermediate-high risk of malignancy lesions according to the Ovarian- Adnexal Reporting and Data System (O-RADS). The ultrasound images of 1,080 patients with 1,080 ovarian masses were included. The training cohort consisting of 683 patients was collected at the South China Hospital of Shenzhen University, and the test cohort consisting of 397 patients was collected at the Shenzhen University General Hospital. The workflow included image segmentation, feature extraction, feature selection, and model construction. The pre-trained Resnet-101 model achieved the best performance. Among the different mono-modal features and fusion feature models, nomogram achieved the highest level of diagnostic performance (AUC: 0.930, accuracy: 84.9%, sensitivity: 93.5%, specificity: 81.7%, PPV: 65.4%, NPV: 97.1%, precision: 65.4%). The diagnostic indices of the nomogram were higher than those of junior radiologists, and the diagnostic indices of junior radiologists significantly improved with the assistance of the model. The calibration curves showed good agreement between the prediction of nomogram and actual classification of ovarian masses. The decision curve analysis showed that the nomogram was clinically useful. This model exhibited a satisfactory diagnostic performance compared to junior radiologists. It has the potential to improve the level of expertise of junior radiologists and provide a fast and effective method for ovarian cancer screening.

Problems and Path Reconstruction of Physical Education Talent Cultivation in the Context of the Digital Economy

The development of the digital economy presents new challenges for the cultivation of talents in physical education programs in higher education institutions. This paper analyzes the requirements for physical education talent cultivation in the context of the digital economy, including solid professional knowledge and skills, proficiency in digital technology application, new media operation capabilities, intelligent equipment operation abilities, innovative thinking and creativity, teamwork and communication skills, and a lifelong learning mindset. The paper also draws on successful applications of digital economy teaching in various Chinese universities, such as Peking University's "Digital Sports" course, Nanjing Sport Institute's "Integration of Sports and Education," Hunan Railway Science and Technology Vocational College's "Campus Sunshine Fitness Run," Beijing Sport University's "Virtual Football Tactical Simulation," Guangzhou Sport University's "Online Sports Dance Competition," and Shenzhen University's "Sports Simulation Game Classroom." The analysis identifies existing problems such as insufficient digitization of teaching resources, lack of digital innovation in practical teaching segments, weak integration of course design with the digital economy, inadequate cultivation of students' digital learning abilities, limited investment in digital equipment and facilities, and knowledge anxiety caused by rapid technological updates. The paper proposes ways to improve the cultivation model for physical education talents in the context of the digital economy: optimizing the curriculum system, enhancing teaching methods and resources, strengthening faculty development, and improving research and innovation capabilities.

Artificial intelligence assistance for fetal development: evaluation of an automated software for biometry measurements in the mid-trimester

BackgroundThis study presents CUPID, an advanced automated measurement software based on Artificial Intelligence (AI), designed to evaluate nine fetal biometric parameters in the mid-trimester. Our primary objective was to assess and compare the CUPID performance of experienced senior and junior radiologists.Materials and methodsThis prospective cross-sectional study was conducted at Shenzhen University General Hospital between September 2022 and June 2023, and focused on mid-trimester fetuses. All ultrasound images of the six standard planes, that enabled the evaluation of nine biometric measurements, were included to compare the performance of CUPID through subjective and objective assessments.ResultsThere were 642 fetuses with a mean (±SD) age of 22 ± 2.82 weeks at enrollment. In the subjective quality assessment, out of 642 images representing nine biometric measurements, 617-635 images (90.65-96.11%) of CUPID caliper placements were determined to be accurately placed and did not require any adjustments. Whereas, for the junior category, 447-691 images (69.63-92.06%) were determined to be accurately placed and did not require any adjustments. In the objective measurement indicators, across all nine biometric parameters and estimated fetal weight (EFW), the intra-class correlation coefficients (ICC) (0.843-0.990) and Pearson correlation coefficients (PCC) (0.765-0.978) between the senior radiologist and CUPID reflected good reliability compared with the ICC (0.306-0.937) and PCC (0.566-0.947) between the senior and junior radiologists. Additionally, the mean absolute error (MAE), percentage error (PE), and average error in days of gestation were lower between the senior and CUPID compared to the difference between the senior and junior radiologists. The specific differences are as follows: MAE (0.36-2.53 mm, 14.67 g) compared to (0.64- 8.13 mm, 38.05 g), PE (0.94-9.38%) compared to (1.58-16.04%), and average error in days (3.99-7.92 days) compared to (4.35-11.06 days). In the time-consuming task, CUPID only takes 0.05-0.07 s to measure nine biometric parameters, while senior and junior radiologists require 4.79-11.68 s and 4.95-13.44 s, respectively.ConclusionsCUPID has proven to be highly accurate and efficient software for automatically measuring fetal biometry, gestational age, and fetal weight, providing a precise and fast tool for assessing fetal growth and development.

A nitrous oxide/oxygen fixed mixture to reduce pain induced by the hypodermic injection: study protocol for a randomized, controlled trial

BackgroundPatients with hematological malignancies received multiple hypodermic injections of recombinant human granulocyte colony-stimulating factor. Procedural pain is one of the most common iatrogenic causes of pain in patients with hematological malignancies. It is also identified as the most commonly occurring problem in clinical care in the Department of Hematology and Oncology at Shenzhen University General Hospital. However, providing immediate relief from pain induced by hypodermic injection of recombinant human granulocyte colony-stimulating factor remains a major challenge. This trial aims to evaluate the safety and analgesic efficacy of a fixed nitrous oxide/oxygen mixture for patients with hematological malignancies and experiencing procedural pain caused by hypodermic injection of recombinant human granulocyte colony-stimulating factor in the department.MethodsThe nitrous oxide/oxygen study is a single-center, randomized, double-blind, placebo-controlled trial involving patients with hematological malignancies who require hypodermic injections of recombinant human granulocyte colony-stimulating factor for treatment. This trial was conducted in the Hematology and Oncology Department of Shenzhen University General Hospital. A total of 54 eligible patients were randomly allocated to either the fixed nitrous oxide/oxygen mixture group (n = 36) or the oxygen group (n = 18). Neither the investigators nor the patients known about the randomization list and the nature of the gas mixture in each cylinder. Outcomes were monitored at the baseline (T0), immediately after hypodermic injection of recombinant human granulocyte colony-stimulating factor (T1), and 5 min after hypodermic injection of recombinant human granulocyte colony-stimulating factor (T2) for each group. The primary outcome measure was the score in the numerical rating scale corresponding to the highest level of pain experienced during hypodermic injection of recombinant human granulocyte colony-stimulating factor. Secondary outcomes included the fear of pain, anxiety score, four physiological parameters, adverse effects, total time of gas administration, satisfaction from both patients and nurses, and the acceptance of the patients.DiscussionThis study focused on the safety and analgesic efficacy during hypodermic injection of recombinant human granulocyte colony-stimulating factor procedure. Data on the feasibility and safety of nitrous oxide/oxygen therapy was provided if proven beneficial to patients with hematological malignancies during hypodermic injection of recombinant human granulocyte colony-stimulating factor and widely administered to patients with procedural pain in the department.Trial registrationChinese Clinical Trial Register, ChiCTR2200061507. Registered on June 27, 2022. http://www.chictr.org.cn/edit.aspx?pid=170573&htm=4

The predictive value of four traumatic hemorrhage scores for early massive blood transfusion in trauma patients in the pre-hospital setting.

We aimed to explore the predictive value of four traumatic hemorrhage scores for early massive blood transfusion in trauma patients in the pre-hospital setting. Trauma patients admitted to Shenzhen University General Hospital from July 2018 to December 2022 were included in this study. They were divided into the massive transfusion group and the non-massive transfusion group according to the blood transfusion volume within 24h. Basic information about patients was collected. Glasgow Coma Scale (GCS), focused assessment with sonography for trauma (FAST), and injury severity score (ISS) were performed. The receiving operating characteristic (ROC) curve was used to compare the predictive value of four trauma transfusion scores for early massive blood transfusion in the pre-hospital setting. A total of 475 patients were enrolled, 43 received massive blood transfusions and 29 died within 24h. The sensitivity and specificity of the four trauma hemorrhage scores in predicting the need for massive blood transfusions in trauma patients at their recommended cutoff points were all high. Among the four scores, the area under the ROC curve was larger for the assessment of blood consumption (ABC) score (0.864) and smaller for the trauma-induced coagulopathy clinical score (TICCS) score (0.795, p > 0.05). All four pre-hospital trauma hemorrhage scores have a high predictive value in assessing massive blood transfusion in trauma patients.

Global research trends in CRISPR-related technologies associated with extracellular vesicles from 2015 to 2022: a bibliometric, dynamic, and visualized study

PurposeThis study aims to explore the emerging trends, dynamic development, and research hotspots of clustered regularly interspaced short palindromic repeats (CRISPR) technology associated with extracellular vesicles during the past 7 years and demonstrate them by visualization.MethodsA total of 219 records related to CRISPR technology associated with extracellular vesicles from 2015 to 2022 in the Web of Science Core Collection (WoSCC) database were collected. R language, VOSviewer, CiteSpace, and GraphpadPrism software packages were used to analyze the history of this research, the general characteristics of the literature, and keywords. Finally, the hotspots and latest trends in CRISPR technology associated with extracellular vesicles are predicted.ResultsA total of 219 articles were collected for this study. The production of publications about CRISPR technology associated with extracellular vesicles has increased annually. Researchers from China, the USA, and Germany made the most important contributions to this trend, while RLUK Research Libraries UK offers the largest amount of literature in this field. Shenzhen University, Nanjing Medicine University, and Peking University exhibited the closest cooperation. Additionally, active topics burst during different periods, as identified according to 317 keywords belonging to 39 disciplines. Keywords were clustered into seven research subareas, namely exosome, nanovesicles, DNA, gene editing, gene therapy, cancer therapy, and endometrial stromal cells. The alluvial map of keywords reveals that the most enduring concepts are gene therapy, nanovesicles, etc., while the emerging keywords are genome, protein delivery, plasma, etc.ConclusionsWe reviewed 219 previous publications and conducted the first bibliometric study of CRISPR technology related to extracellular vesicles from 2015 to 2022. This comprehensive summary constructed a knowledge map and demonstrates the trends in this area. The current trends and potential hotpots for this topic are also identified, which will be a great help for researchers in the future.

Starting a new journey for physics and optoelectronics&amp;mdash;Commemorating the 40th anniversary of Shenzhen University

Starting a new journey for physics and optoelectronics&amp;mdash;Commemorating the 40th anniversary of Shenzhen University

Preface

It is our great pleasure to have you at the 2023 5th International Conference on Artificial Intelligence Technologies and Applications (ICAITA 2023), which took place in Changchun, China from June 30th to July 2nd, 2023 (hybrid conference). ICAITA 2023 was successfully held, and received unanimous praise from various experts and scholars all over the world.ICAITA 2023 existed as an international forum for academic communications between experts and scholars in the fields of artificial intelligence technologies and applications. It promoted the research and developmental activities in related fields and scientific information interchange among all the participants, establishing research connections for them to find global partners for potential collaboration.After months of well preparation and hard work, the Proceedings of ICAITA 2023 covering a bunch of papers, having been checked through rigorous review and processes to meet the requirements of publication, are smoothly published. These papers feature but are not limited to the following topics: Artificial Neural Networks, Computational Theories of Learning, Pervasive Computing and Ambient Intelligence, Fuzzy Logic and Methods, etc.We had about 300 participations both as speakers and participants, including senior experts, research talents, and young scholars from enterprises, research institutes, and universities worldwide. During the keynote speech part, each keynote speaker was given 30–40 minutes for keynote speech. Among them, Professor Philippe Fournier-Viger from Shenzhen University, China performed a keynote speech on Advances and Challenges for the Automatic Discovery of Interesting Patterns in Data. He first briefly reviewed early studies on designing algorithms for identifying frequent patterns. Then, he presented an overview of recent challenges and advances to identify other types of interesting patterns in more complex data. Topics that were discussed included high utility patterns, locally interesting patterns, and periodic patterns. Lastly, the SPMF open-source software was mentioned and opportunities related to the combination of pattern mining algorithms with traditional artificial intelligence techniques for intelligent systems were discussed. The insightful speeches of each keynote speakers triggered interesting discussions and a good number of informal talks between all the participants.We would like to express our gratitude to the organizers, keynote speakers and all the participants of ICAITA 2023, for their fruitful work and contribution to the success of the Conference. We are thankful to all the reviewers for providing constructive criticisms, stimulated comments and suggestions to the authors. Particularly, our special thanks go to Journal of Physics: Conference Series, for the endeavor of all its colleagues in publishing this paper volume.May this event be a spark that ignites many more new inventions in the fields related to artificial intelligence technologies and applications!The Committee of ICAITA 2023List of Committee Member is available in this pdf.

An Artificial Intelligence-Based Method for Crack Detection in Engineering Facilities around Subways

While the construction and operation of subways have brought convenience to commuters, it has also caused ground subsidence and cracks of facilities around subways. The industry mainly adopts traditional manual detection methods to monitor these settlements and cracks. The current approaches have difficulties in achieving all-weather, all-region dynamic monitoring, increasing the traffic burden of the city during the monitoring work. The study aims to provide a large-scale settlement detection approach based on PS-InSAR for the monitoring of subway facilities. Meanwhile, this paper proposes a crack detection method that is based on UAVs and the VGG16 algorithm to quantify the length and width of cracks. The experimental data of Shenzhen University Section of Metro Line 9 are used to verify the proposed settlement model and to illustrate the monitoring process. The developed model is innovative in that it can monitor the settlement of large-scale facilities around the subway with high accuracy around the clock and automatically identify and quantify the cracks in the settled facilities around the subway.

Correlation Analysis between Intrarenal Small Artery Intimal Thickening and Clinicopathological Features and Prognosis in Primary Membranous Nephropathy Patients

Background: Primary membranous nephropathy (PMN) is the most common pathological type of nephrotic syndrome in adults. Intrarenal small artery intimal thickening can be observed in most renal biopsies. The purpose of this study was to investigate the association between intrarenal small artery intimal thickening and clinicopathological features and prognosis in PMN patients. Methods: Data were continuously collected from patients who were diagnosed with PMN in Shenzhen Second People’s Hospital (The First Affiliated Hospital of Shenzhen University) from 2008 to 2021 for a retrospective cohort study. Regression analysis and survival analysis were used to analyze the relationship between intrarenal small artery intimal thickening and renal prognosis in PMN patients. Results: 300 PMN patients were enrolled in this study, including 165 patients (55%) with intrarenal small artery intimal thickening. Patients with intimal thickening were older, with higher BMI, systolic blood pressure and diastolic blood pressure, serum uric acid, a higher proportion of hypertension, acute kidney injury, nephrotic syndrome, more urine protein, and lower eGFR. Multivariate Cox regression analysis showed that after adjusting for age, gender, hypertension, BMI, urine protein, eGFR, and the use of ACEI/ARB and hormone immunosuppressants, intimal thickening was a risk factor for renal prognosis in PMN patients (HR = 3.68, 95% CI 1.36–9.96, p < 0.05). Kaplan-Meier survival curve analysis showed that the incidence of reaching the renal composite outcome was higher in the intimal thickening group (p < 0.05). Conclusion: The prognosis of PMN patients with intrarenal small artery intimal thickening is worse, so early intervention is very important for these patients.

Application of virtual endoscopy in the diagnosis of adenoid hypertrophy and the morphologic classification of adenoid

Objective:To discuss the application of virtual endoscopy in the diagnosis of adenoid hypertrophy and the morphologic classification of adenoid. Methods:The clinical data of 97 children with adenoid hypertrophy admitted to Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University General Hospital from July 2022 to December 2022 were collected. The virtual endoscopic reconstruction of the nasopharynx was performed by cone beam computed tomography. The results of virtual endoscopic adenoid size measurement were compared with the results of nasopharyngeal CT median sagittal position and nasopharyngeal endoscopy. Virtual endoscopic classification of adenoid based on the size of the adenoids and their relationship with the torus tubarius. Results:The t-test results of the size of adenoids measured by virtual endoscopy and nasopharyngeal CT were t=1.699 and P=0.093, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.921 and P<0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal CT was highly consistent. The t-test results of the size of adenoids measured virtual endoscopy and nasopharyngeal endoscopy were t=1.543 and P=0.15, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.900 and P<0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal endoscopy was highly consistent. Among the 97 children, the morphological classification results of adenoids were 48 cases of overall hypertrophy type, 47 cases of central bulge type, and 2 cases of flat thickening type. Conclusion:The diagnosis of adenoid hypertrophy by virtual endoscopy has high accuracy, which not only avoids the invasive operation of traditional nasopharyngeal endoscopy, but also can observe the adenoid condition and its relationship with the torus tubarius from multiple angles. And, the morphological classification of adenoids using virtual endoscopy has guiding significance for perioperative preparation.

Application of U-Net network in automatic image segmentation of adenoid and airway of nasopharynx

Objective:To explore the effect of fully automatic image segmentation of adenoid and nasopharyngeal airway by deep learning model based on U-Net network. Methods:From March 2021 to March 2022, 240 children underwent cone beam computed tomography（CBCT） in the Department of Otolaryngology, Head and Neck Surgery, General Hospital of Shenzhen University. 52 of them were selected for manual labeling of nasopharynx airway and adenoid, and then were trained and verified by the deep learning model. After applying the model to the remaining data, compare the differences between conventional two-dimensional indicators and deep learning three-dimensional indicators in 240 datasets. Results:For the 52 cases of modeling and training data sets, there was no significant difference between the prediction results of deep learning and the manual labeling results of doctors（P>0.05）. The model evaluation index of nasopharyngeal airway volume: Mean Intersection over Union（MIOU） s （86.32±0.54）%; Dice Similarity Coefficient（DSC）: （92.91±0.23）%; Accuracy: （95.92±0.25）%; Precision: （91.93±0.14）%; and the model evaluation index of Adenoid volume: MIOU: （86.28±0.61）%; DSC: （92.88±0.17）%; Accuracy: （95.90±0.29）%; Precision: （92.30±0.23）%. There was a positive correlation between the two-dimensional index A/N and the three-dimensional index AV/（AV+NAV） in 240 children of different age groups（P<0.05）, and the correlation coefficient of 9-13 years old was 0.74. Conclusion:The deep learning model based on U-Net network has a good effect on the automatic image segmentation of adenoid and nasopharynx airway, and has high application value. The model has a certain generalization ability.

The University Students’ Expenditure Level and the Public Trust in E-Donation: A Mix-Method Study in Shenzhen University

The University Students’ Expenditure Level and the Public Trust in E-Donation: A Mix-Method Study in Shenzhen University

5G Key Technologies for Helicopter Aviation Medical Rescue.

Rapid global population growth and urbanization have heightened the demand for emergency medical rescue, with helicopter medical rescue emerging as an effective solution. The advent of 5G communication technology, characterized by large bandwidth, low latency, and high reliability, offers substantial promise in enhancing the efficiency and quality of helicopter rescue operations. However, the full integration of 5G technology into helicopter emergency medical services is still in its nascent stages and requires further development. In this viewpoint, we present our experience from the Shenzhen University General Hospital of the application of 5G low-altitude network communication technology, body area network disease sensing technology, and 5G air-ground collaborative rapid diagnosis and treatment technology in aeromedical rescue. We consider that the 5G air-to-ground collaborative rapid diagnosis and treatment technology enables high-quality remote consultation, enhancing emergency medical rescue and providing strong support for future rescue operations.

A commentary on "Clinical outcomes of different endovenous procedures among patients with varicose veins and iliac vein compression: a retrospective cohort study".

Department of Vascular Surgery, Shenzhen Second Hospital (First Affiliated Hospital of Shenzhen University), Shenzhen 518035, Guangdong, China Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: CHINA. E-mail address: [email protected] (H. Yang). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

Detection rate and shunt grading with synchronous testing of contrast transcranial Doppler and contrast transthoracic echocardiography: Preliminary findings.

Patent foramen ovale, a common congenital atrial septal defect, may lead to cardiac right-to-left shunting (RLS), which has been associated with various diseases. Reliable techniques for detecting RLS are essential for diagnosis and assist with treatment decision-making. Contrast transcranial Doppler (c-TCD), contrast transthoracic echocardiography (c-TTE), and contrast transesophageal echocardiography can be used to detect RLS. However, it is still unclear which ultrasound modalities are the most practical and cost-effective. To evaluate the efficacy of synchronous c-TCD and c-TTE in detecting cardiac RLS. We prospectively designed and continuously recruited 100 patients with cryptogenic stroke, migraines, transient ischemic attack, unexplained syncope, or dizziness admitted at the First Affiliated Hospital of Shenzhen University between February 2020 and August 2020. Ninety-five patients underwent synchronous c-TCD and c-TTE (during a single contrast-enhanced ultrasound session). We compared synchronous test results with the results of c-TCD alone and c-TTE alone. Ninety-five patients successfully underwent synchronous c-TCD and c-TTE, with the data analyzed for each individual. The positive detection rates of Grade I, II, and III shunts with synchronous c-TCD and c-TTE were higher than those with c-TTE or c-TCD alone (P = .047, P = .002, and P = .024, respectively). Overall, the positive detection rates of synchronous tests, c-TCD alone, and c-TTE were 69.5%, 51.6%, and 31.6%, respectively (P = .000, and P = .012). Among the 66 patients who were double-RLS-positive (both c-TTE and c-TCD showed positive results), as detected by the synchronous test, 26 (39.3%) patients who underwent c-TTE alone had higher shunt grades detected than those who underwent c-TCD alone. Conversely, 5 (7.6%) patients who underwent c-TCD alone had higher shunt grades detected than those who underwent c-TTE alone (P = .000). Synchronous c-TCD and c-TTE testing can significantly improve the detection rate, accuracy, and test process efficacy for quantifying RLS, and reduce the testing risk, workload, and medical costs.

A Study of the Effects of Language Transfer on Refusal Strategies for Second Language Acquisition among Chinese English Major Students

Many EFL learners have strong linguistic competence, but lack sufficient pragmatic competence, including the use of politeness strategies. The study aims to explore the effects of language transfer on refusal strategies for Chinese L2 learners with higher English proficiency. To test the common claim that refusal strategies transfer strongly from L1 to L2 and are highly influenced by sociocultural factors, online questionnaires were conducted among 22 female students majoring in English at Shenzhen University. The results indicated a limited effect of L1 on L2 for subjects with high English proficiency and showed that the transfer of refusal strategies may be influenced by the memory connections between knowledge input and transferring subjects in L2 learning, in addition to the sociocultural factors. The result suggests teachers create a more authentic communication environment to encourage students to innovatively create a variety of expressions and strategies based on what they have learned and according to different scenarios.