Standard System Research Articles

Comparative analysis of morphologival parameters in isolated and fused L5 spondylolysis patients on the basis of CT features

Background and objectiveThe classification of lumbar spondylolysis varies, and there is currently no clear consensus on a standardized system. This study examines the morphological characteristics and parameter differences of the L5 vertebra in patients with isolated versus fused spondylolysis using CT measurements. It also proposes a preliminary classification system based on the separation distance at the fracture site and explores its clinical significance.MethodsA total of 117 young male patients with L5 spondylolysis related to high-intensity physical activity were enrolled. Patients with a pars interarticularis separation distance ≥ 2 mm were classified into the isolated group (Group A, 66 patients), while those with a separation distance < 1 mm were classified into the fused group (Group B, 51 patients).Additionally, 117 patients without spondylolysis but experiencing lower back pain were included as the control group (group C). Multislice spiral computed tomography (MSCT) was used to measure the morphological parameters of the L5 vertebra in all three groups, including the sagittal pedicle height (SPH), transverse pedicle width (TPW), transverse pedicle vertical length (TPVL), pedicle screw trajectory length (PSTL), pedicle angle of attack (PAA), frontal vertebral body height (FVH), posterior vertebral body height (PVH), sagittal midline intervertebral space height (SMISH), horizontal vertebral body angle (HVA), and vertical vertebral body angle (VVA). Differences in the morphological imaging parameters of the L5 vertebrae and pedicles among the three groups were compared.ResultsThere were no significant differences in age, height, weight, body mass index (BMI), or Pfirrmann grade among the three groups. No significant differences were observed in any of the pedicle parameters between the left and right sides within the groups. Group A showed significantly greater TPVL and PSTL values compared to Group B, while TPW and PAA were significantly lower. No significant difference in SPH was observed between Group A and Group B. When compared to Group C, Group A exhibited significant differences in SPH, TPW, TPVL, and PSTL, but not in PAA. Group B, compared to Group C, demonstrated significant differences in SPH and PAA, but no significant differences were observed in TPW, TPVL, or PSTL. Significant differences were also found in FVH, HVA, and VVA between Group A and Group B, with Group A showing a smaller PVH. No significant difference in SMISH was observed between the two groups. Compared to Group C, Group A showed significant differences in PVH, HVA, and VVA, but no significant differences were found in FVH or SMISH. In Group B, significant differences were noted in FVH and HVA compared to Group C, but no differences were observed in PVH, SMISH, or VVA.ConclusionDifferences in the sagittal morphological parameters of the pedicles and vertebral bodies can be observed between the two types of spondylolysis patients. In the isolated spondylolysis pattern, the pedicles exhibit a "thin, long, and contracted" morphology, while the vertebral bodies present a "stuffed bun" shape, both anteriorly, posteriorly, and superiorly. In contrast, the fused type is characterized by "short, thick, and expanded" pedicles, with the vertebral bodies showing a "less pronounced stuffed bun" shape in the anterior–posterior direction. These morphological differences indicate that spondylolysis separation may involve adaptive stress-induced bone remodeling. Surgeons must pay special attention when choosing surgical techniques, as isolated spondylolysis may present a tendency toward slippage. Caution is advised in performing isolated pars repair surgeries, especially during the placement of pedicle screws, where special attention must be given to the length and direction of the screws to avoid additional damage.

Enhancing Long-Term Viability of Energy Pile with Heat Sink Systems in Tropical Monsoon Climates: Implementation Strategies and Performance Analysis

Energy piles, a form of ground-source heat pump system integrated into building foundations, show great potential for reducing building energy consumption associated with fossil fuels. While it excels in climates where cooling demand matches heating, its effectiveness faces challenges in tropical monsoon regions characterized by hot summers and cool winters. In such climates, cooling demand dominates, leading to significant thermal accumulation over time, which diminishes the long-term viability of energy pile systems. This study focuses on the long-term thermal behavior analysis of an energy pile system installed in a representative office building. Our approach begins with an examination of short-term behavior, followed by the creation of a simplified model. Using this model, we analyze the long-term behavior of different systems, including the standard energy pile and combinations with various solutions: natural groundwater flow and synthetic heat sink systems. Key outcomes are evaluated based on entering water temperature (EWT), soil temperature, and energy efficiency ratio (EER), while also comparing energy savings with conventional air conditioning systems. Major findings include: (1) Standard energy pile systems without any mitigation measures achieve only a 15.3% energy savings initially and may cease functioning after approximately 10 years, (2) Energy pile systems using specific solutions can achieve a maximum saving ratio of 50%, typically ranging from 30% to 45%, while maintaining stability over the designated lifespan, (3) Higher EER and saving ratios correlate with increased groundwater flow and larger heat sink systems, however, the relationship is nonlinear, emphasizing the need for tailored design under varying geology and climate conditions. This study provides essential insights into energy pile systems design and practical guidance, along with expected energy savings in tropical monsoon climates for future application.

Intraoperative ABR measurements via the active middle ear implant vibrant soundbridge using different types of couplers.

The Vibrant Soundbridge active middle ear implant is indicated for the treatment of different types of hearing loss. Recently, a novel system for determining implant performance based on auditory brainstem response (ABR) was developed. A reference value for the expected ABR hearing thresholds is determined on the base of a substantial number of measurements in this work. ABRs were recorded in patients following VSB surgery. A standard ABR system was employed, utilizing an implemented optimized chirp stimulus, which was transmitted directly to the VSB via the AcoustiAP transmission unit (MED-EL). The study included 104 subjects with different types of hearing loss. Six distinct VSB couplers were utilized in this cohort. ABR were recorded in all patients. The intraoperative ABR thresholds were 20.1 dB higher compared to the preoperative BC thresholds, 15.9 dB higher compared to the postoperative vibrogram, and 13.4 dB higher compared with the vibrogram thresholds determined at the first fitting. No significant differences were observed between the different couplers in either the investigated methods. It can be posited that the presented intraoperative measurement reference value enhances the interpretability of ABR in VSB and should be considered, when using this method in VSB surgery.

Injectable cell-laden gelatin-chondroitin sulphate hydrogels for liver in vitro models.

Liver extracellular matrix-based models that precisely reproduce liver physiology and functions are required as 3D culture microenvironments for multiple applications in toxicology and metabolism, or for understanding the mechanisms implicated in liver disease. We introduced injectable gelatin-chondroitin sulphate (Gel/CS) hydrogels for culturing HepG2 cells, and evaluated the mechanical properties and functionality of cells in different Gel/CS compositions. The Gel/CS hydrogels exhibited soft mechanical properties and allowed the HepG2 culture. The characterisation and comparison of 3D cultures to standard monolayer systems revealed the regulation of key hepatic markers (i.e. CYP3A4, GSTA1) when cells were cultured in the Gel/CS hydrogels compared to 2D cultures, and also enhanced urea and albumin production, which would indicate increased cells functionality. This study underpins 3D in vitro models based on the Gel/CS hydrogels that can be used for different hepatology applications by offering increased predictivity and physiological relevance compared to current in vitro models.

Temporal trends in biosecurity in Irish pig herds using a standardized scoring system

BackgroundBiosecurity measures are crucial to the introduction and spread of pathogens both within and between farms. External biosecurity focuses on preventing pathogens from entering or leaving the farm, while internal biosecurity aims to limit or stop the spread of pathogens within the farm. Implementing biosecurity measures not only protects animals from disease but also has positive effects on productivity, welfare and farm profitability. By reducing the need for antimicrobials, biosecurity measures also contribute to combating antimicrobial resistance. To assess and improve biosecurity, tools like Biocheck.UGent have been developed. In Ireland, the Biocheck.UGent tool has been widely used in pig farms since 2018. The aims of this study were firstly to assess temporal trends on biosecurity scores in Irish pig farms from 2018 to 2023 using the Biocheck.UGent tool and secondly to identify areas for improvement.ResultsThere was an increase in the number of annual assessments over the study period, with the majority of farms being assessed multiple times. Overall, external biosecurity scores were higher than internal scores. Improvements in the scores were observed over time for most of the subcategories for external and internal biosecurity and across the different farm types. Analysis of the subcategories within the scoring system revealed areas with lower scores, including disease management, cleaning and disinfection, and measures between compartments. Weaner-to-finisher farms tended to have lower scores compared to other farm types.ConclusionsWhile external biosecurity in Irish pig farms is generally high, there is room for improvement in internal biosecurity. This study highlights the importance of continuous efforts to improve biosecurity. The data obtained will aid in estimating the cost–benefit of implementing biosecurity measures, crucial for decision-making and better returns on investments.

Artificial intelligence for segmentation and classification in lumbar spinal stenosis: an overview of current methods.

Lumbar spinal stenosis (LSS) is a frequently occurring condition defined by narrowing of the spinal or nerve root canal due to degenerative changes. Physicians use MRI scans to determine the severity of stenosis, occasionally complementing it with X-ray or CT scans during the diagnostic work-up. However, manual grading of stenosis is time-consuming and induces inter-reader variability as a standardized grading system is lacking. Machine Learning (ML) has the potential to aid physicians in this process by automating segmentation and classification of LSS. However, it is unclear what models currently exist to perform these tasks. A systematic review of literature was performed by searching the Cochrane Library, Embase, Emcare, PubMed, and Web of Science databases for studies describing an ML-based algorithm to perform segmentation or classification of the lumbar spine for LSS. Risk of bias was assessed through an adjusted version of the Newcastle-Ottawa Quality Assessment Scale that was more applicable to ML studies. Qualitative analyses were performed based on type of algorithm (conventional ML or Deep Learning (DL)) and task (segmentation or classification). A total of 27 articles were included of which nine on segmentation, 16 on classification and 2 on both tasks. The majority of studies focused on algorithms for MRI analysis. There was wide variety among the outcome measures used to express model performance. Overall, ML algorithms are able to perform segmentation and classification tasks excellently. DL methods tend to demonstrate better performance than conventional ML models. For segmentation the best performing DL models were U-Net based. For classification U-Net and unspecified CNNs powered the models that performed the best for the majority of outcome metrics. The number of models with external validation was limited. DL models achieve excellent performance for segmentation and classification tasks for LSS, outperforming conventional ML algorithms. However, comparisons between studies are challenging due to the variety in outcome measures and test datasets. Future studies should focus on the segmentation task using DL models and utilize a standardized set of outcome measures and publicly available test dataset to express model performance. In addition, these models need to be externally validated to assess generalizability.

Characterization of Optokinetic Nystagmus in Healthy Participants With a Novel Oculography Device.

To develop a proof-of-concept smart-phone-based eye-tracking algorithm to assess non-pathologic optokinetic (OKN) nystagmus in healthy participants. Current videonystagmography (VNG) is typically restricted to in-office use, and advances in portable vestibular diagnostics would yield immense public health benefits. Prospective cohort study. Tertiary academic medical center. Healthy participants (n = 39) without dizziness or vertigo were recruited. A smart-phone attached to a custom head stabilization device illuminated by a white LED circuit was used to record nystagmus induced with a 30 frames per second OKN stimulus over a 60-second period. A centroid tracking algorithm was created to detect slow-phase velocity (SPV) of horizontal nystagmus in a diverse subject cohort in a variety of lighting conditions. Nystagmus recordings were compared to those obtained with a standard VNG system. Non-pathologic nystagmus from an OKN stimulus was measured across multiple lighting conditions, with high signal-to-noise ratios (SNR) and mean SPV 22.13 ± 5.26°/s. Nystagmus SPV was not significantly different between the device and standard VNG system (t = -0.5, P = .6). Lighting conditions produced SNRs of 57.30 (ideal), 50.59 (backlit), 51.33 (side-lit), 49.28 (dark), 54.52 (outdoor lighting). We demonstrate the feasibility of a novel portable oculography system in the detection of non-pathologic nystagmus in healthy subjects. Future applications of this system include: (1) to obtain real-time measurements of nystagmus during an acute vertigo attack; (2) to test patients unable or unwilling to present to a specialized vestibular laboratory; (3) to efficiently repeat testing overtime; (4) to improve accessibility of vestibular testing.

P-1562. Epidemiology, Management, and Outcomes of a Novel Complex Urologic Infections Interdisciplinary Clinic

Abstract Background Urinary tract infections (UTIs) are the most common bacterial infections, yet patients with recurrent infection are often not offered effective preventative therapies, patients with bacterial persistence may have a urologic nidus of infection, and patients with non-infectious syndromes are often over-treated with antibiotics. Methods We developed a Complex Urologic Infections Interdisciplinary Clinic comprised of infectious diseases and urology physicians as well as antimicrobial stewardship pharmacists. We categorized patients as complicated (defined as abnormal urinary tract predisposing to infection) or uncomplicated and describe the first 237 patients seen 16 months after clinic initiation. Results Most of our patients were female (69%) and white (67%) with a mean age of 61 and a mean Charlson score of 3.3 (Table 1). Most (58%) had complicated urologic tracts with overall higher Charlson comorbidity scores. Based on a standardized clinical classification system, most presented with recurrent/reinfection (38%), but we also identified patients with isolated and intermittent infection, bacterial persistence, and non-infectious syndromes (Table 2). We started 75/89 (84%) patients with recurrent infections on prevention therapy, and 14 declined. Vaginal estrogen or methenamine monotherapy had an efficacy of 57% and 70% at a mean follow up of 4.2 and 4.6 months, respectively (Figure 1). All five patients on vaginal estrogen plus continuous prophylaxis were UTI free at a mean follow up of 5 months. We identified 20 patients with urinary bacterial persistence, ordered imaging of the urologic tract, and identified an infected urologic nidus and cured or suppressed the infection in 95%. Thirty-two percent of patients referred for UTI were found to have non-infectious syndromes, including asymptomatic bacteriuria (19%) and lower urinary tract symptoms (10%) (Figure 2). Multi-drug resistant organisms were found in 25%, 30% of which were in patients with non-infectious syndromes. Conclusion Complex Urologic Infections Interdisciplinary Clinics can provide expertise to prevent recurrent UTIs, identify a urologic nidus of infection in patients with persistence, and potentially reduce antimicrobial burden and resistance in patients without true infection. Disclosures All Authors: No reported disclosures

High-dimensional coherent one-way quantum key distribution

High-dimensional quantum key distribution (QKD) offers secure communication with key rates that surpass those of QKD protocols utilizing two-dimensional encoding. However, existing high-dimensional QKD protocols require additional experimental resources, such as multiport interferometers and multiple detectors, thereby increasing the cost of high-dimensional systems and limiting their use. We introduce and analyze a high-dimensional QKD protocol that requires only standard two-dimensional hardware. We provide security analysis against individual and coherent attacks, establishing upper and lower bounds on the secure key rates. We tested our protocol on a standard two-dimensional QKD system over a 40 km fiber link, achieving a twofold increase in secure key rate compared to the standard two-dimensional coherent one-way protocol, without any hardware modifications. This work offers a significant improvement in the performance of already deployed QKD systems through simple software updates and holds broad applicability across various QKD schemes, making high-dimensional QKD practical for widespread use.

Construction and demonstrative application of an evaluation indicator system for the distinction of ancient books of traditional chinese medicine based on the delphi method and analytic hierarchy process

Objective: To construct a scientific and standardized evaluation indicator system for the distinction of ancient books of Traditional Chinese Medicine, aiming to provide a scientific basis for their cascade protection. Methods: The Delphi method was applied to establish the evaluation indicator system for the distinction of ancient books of Traditional Chinese Medicine, and the Analytic Hierarchy Process (AHP) was used to determine the weight of each indicator. Results: An evaluation indicator system for the distinction of ancient books of Traditional Chinese Medicine was developed, including 4 first-level indicators and 15 second-level indicators. The experts’ enthusiasm, authority, and coordination of opinions were all satisfactory. Conclusion: A evaluation indicator system for the distinction of ancient books of Traditional Chinese Medicine was preliminary constructed. The system is targeted, well-structured, and exhibits strong scientific and practical significance.

Stability of Second‐Order Discrete Linear Switching Systems: The Case of All Subsystems With Eigenvalue Modulus &gt;1$$ &gt;1 $$ Under State‐Dependent Switching

ABSTRACTThis article investigates the asymptotic stability of discrete‐time switching systems in which the modulus of all subsystem eigenvalues are greater than one. The study begins by constructing an energy function with practical physical meaning for each discrete‐time subsystem. Specifically, a standard linear discrete system is derived by discretizing a single‐degree‐of‐freedom vibratory model, with its energy function defined as the sum of the model's kinetic and potential energies. An invertible transform is then applied to convert a general linear discrete system into standard form, enabling the construction of a general energy function based on that of a standard one. Since the construction of subsystem energy functions depends on the choice of invertible transform, which is not unique, the resulting energy functions for different subsystems under distinct transforms cannot be directly compared. To address this issue, an intermediate subsystem is introduced to define a relative energy ratio function between two subsystems. Using this relative energy ratio function, a state‐dependent switching rule is developed to maximize energy loss within a switch circuit, thereby achieving rapid asymptotic stability of the discrete switching system. Finally, numerical examples are provided to validate the effectiveness of the proposed method.

Major Depressive Disorder as a Condition Negatively Impacting Both Mental and Physical Functioning. What to Do When There Is Treatment Resistance?

The objective of this article is to assess the efficacy and safety of diverse therapeutic strategies for treatment-resistant depression (TRD), encompassing both pharmacological and non-pharmacological interventions. Additionally, the review identifies potential avenues for future research within this domain. The article compares the results of selected studies. We conducted a literature search in November of 2024, using PubMed. Six studies were identified, chosen, and appraised. Among these studies, three are systematic reviews and three are narrative literature reviews. If it comes to treatment efficacy studies have demonstrated the effectiveness of several strategies. Ketamine and esketamine have shown rapid and substantial efficacy in mitigating the symptoms of TRD. Augmentation with aripiprazole and quetiapine has also been found to enhance the response to antidepressant treatment. The combination of olanzapine and fluoxetine is effective for treating TRD, however, it may be associated with metabolic side effects. Augmentation with lithium, triiodothyronine (T3), and lamotrigine shows promising results, though further research is required to fully evaluate their efficacy and safety in TRD management. The management of TRD is associated with several challenges. These include the absence of a standardized definition and grading system, which impedes the comparison of research outcomes. The multifactorial nature of TRD further complicates the development of a universal treatment strategy. Summarizing, there are several treatment strategies available for TRD, however, the most effective approach should be personalized for each patient. Ongoing research is critical to advancing our understanding of TRD and developing more effective therapeutic options.

Nanoscale Cellular Traction Force Quantification: CRISPR-Cas12a Supercharged DNA Tension Sensors in Nanoclustered Ligand Patterns.

High-throughput measurement of cellular traction forces at the nanoscale remains a significant challenge in mechanobiology, limiting our understanding of how cells interact with their microenvironment. Here, we present a novel technique for fabricating protein nanopatterns in standard multiwell microplate formats (96/384-wells), enabling the high-throughput quantification of cellular forces using DNA tension gauge tethers (TGTs) amplified by CRISPR-Cas12a. Our method employs sparse colloidal lithography to create nanopatterned surfaces with feature sizes ranging from sub 100 to 800 nm on transparent, planar, and fully PEGylated substrates. These surfaces allow for the orthogonal immobilization of two different proteins or biomolecules using click-chemistry, providing precise spatial control over cellular signaling cues. We demonstrate the robustness and versatility of this platform through imaging techniques, including total internal reflection fluorescence microscopy, confocal laser scanning microscopy, and high-throughput imaging. Applying this technology, we measured the early stage mechanical forces exerted by 3T3 fibroblasts across different nanoscale features, detecting forces ranging from 12 to 56 pN. By integrating the Mechano-Cas12a Assisted Tension Sensor (MCATS) system, we achieved rapid and high-throughput quantification of cellular traction forces, analyzing over 2 million cells within minutes. Our findings reveal that nanoscale clustering of integrin ligands significantly influences the mechanical responses of cells. This platform offers a powerful tool for mechanobiology research, facilitating the study of cellular forces and mechanotransduction pathways in a high-throughput manner compatible with standard cell culture systems.

Concurrent validity of single- and dual-beam timing systems for linear and change of direction speed testing in youth soccer players

This study investigates the concurrent validity of the Sportreact single-beam timing system with a standard dual-beam system for the evaluation of linear and change of direction speed. Forty-two youth soccer players (age = 12.9 ± 1.1 years) performed linear sprints (10 and 30 m splits) and 505 Agility Test. The times were measured by both systems simultaneously. The single-beam timing system was set at a height of 64 cm from the ground, while the dual-beam system was set at 67 and 90 cm for the lower and upper beam, respectively. The results showed very high intraclass correlation coefficients for the 10 m sprint (ICC (95% CI); 0.95 (0.93–0.98)), 30 m sprint (0.99 (0.98–0.99)), and 505 Agility Test (0.98 (0.98–0.99)), with a low typical error of estimates (TEEs (%) = 2.16%, 1.12%, and 1.05%, respectively). However, TEE of 0.046 s in the 10 m sprint test overlapped the smallest worthwhile change (≈0.030 s). Bland-Altman analyses showed 95% LoA ranging from −0.086 to 0.093 s for the 10 m sprint, −0.115 to 0.106 s for the 30 m sprint, and −0.055 to 0.049 for 505 agility tests. The Sportreact single-beam timing system provides a useful tool for linear sprint (≥30 m) and change of direction speed tests only when considering heterogeneous groups but not individual athletes. However, this system should not be used interchangeably with a dual-beam systems for the assessment of linear and change of direction sprint tests in youth team sport players.

A Focused Review on Upper and Lower Limb Joint Torque Estimation via Neural Networks

Joint torque estimation is an essential aspect of the control architecture in assistive devices for rehabilitation and aiding movement impairments. Healthy adult torque trajectories serve as a baseline for controllers to determine the level of assistance required by patients, evaluate impaired motion, understand biomechanics, and design treatment plans. Currently, methods of torque estimation include inverse dynamics using gold standard motion capture systems, generic mathematical models based on joint torque-angle relationships, neuromusculoskeletal modelling using surface electromyography, and neural networks. As such, this review provides a focused overview of the recent and existing neural networks tailored for upper and lower limb joint torque estimation. Dataset preparation, data preprocessing, and evaluation metrics are presented along with a detailed description of the developed networks, which are classified by model architecture. It includes artificial neural networks (ANNs), convolution neural networks (CNNs), long short-term memory (LSTM) networks, and hybrid and alternate architectures such as wavelet or explainable convolution (XCM). The performance, benefits, and limitations of the models are discussed, highlighting CNNs and LSTMs as the current optimal models for time series prediction of joint torque. This is due to their ability to capture spatial and temporal dependencies in the data. Additionally, joint kinematics such as angles, angular velocities, and accelerations are considered optimal input parameters due to their ease of measurement using wearable sensors and integration with wearable assistive technology.

Grading scales for vitreous haze

Background: Grading scales for vitreous haze are crucial for the diagnosis, monitoring, and management of uveitis. The presence of inflammatory cells within the vitreous cavity is widely recognized as a key indicator of disease activity and severity, offering valuable insights into the underlying inflammatory processes. This mini-review aims to explore the evolution of vitreous haze grading scales systematically, emphasizing conventional grading methods, advances in imaging technologies, and the integration of artificial intelligence (AI) into the grading process. Methods: The PubMed/MEDLINE database was comprehensively searched for studies published between 1959 and 2024, using keywords such as “AI-based grading systems,” “artificial intelligence,” “automated grading,” “grading scales for vitreous cells,” “inflammation,” “uveitis,” and “vitreous haze.” Relevant studies were identified, and additional articles were selected by reviewing the reference lists of the included publications. The selection of articles for inclusion in the mini-review was limited to those written in English. Results: In the current literature, two grading methods are used: the National Institutes of Health (NIH) scale and the Miami scale. Despite their widespread utilization, both scales entail subjective assessments of vitreous haze, which renders them susceptible to observer bias and interobserver variability. The NIH scale uses six levels, while the Miami scale employs nine levels, both of which require subjective assessments of vitreous haze. Recent advances in objective imaging technologies, namely ultrawide-field fundus photography and advanced optical coherence tomography-based analysis, have given rise to increasingly consistent and standardized grading systems, which may enhance the reliability of these assessments. Innovative techniques have been developed to enhance accuracy and sensitivity, thereby facilitating the early detection and precise monitoring of vitreous inflammation. Despite these advances, challenges remain, including the difficulty of distinguishing subtle variations in vitreous haze and the variability of inflammatory presentations. The incorporation of AI-driven tools and state-of-the-art imaging technologies into the vitreous cell grading signifies a substantial advance in the evaluation and management of uveitis. Conclusions: The development of more objective, reproducible, and quantitative grading scales is imperative for optimizing uveitis evaluation and grading vitreous haze in clinical settings and clinical trials. These innovations will also provide robust endpoints for clinical studies, ultimately improving patient care. Moreover, objective grading criteria will enhance diagnostic precision, facilitate better management of ocular inflammatory diseases, and promote further advances in uveitis research and treatment.

Research on the life stress and hypertension among young couples of childbearing age

Objective: To investigate the current status of life stress and hypertension among couples of childbearing age across diverse economic regions in China, and to explore relevant influencing factors. Methods: This study was a cross-sectional study, with subjects from the "Research on the standardized system of comprehensive prevention and control of birth defects based on preconception-prenatal-postnatal whole chain". From February to May 2021, urban and rural couples of childbearing age (18-49 years old) from Beijing, Henan, and Gansu provinces were enrolled, representing the eastern, central, and western regions of China, respectively. The detection rate, cognition and control of hypertension in the general population, as well as the detection rate of hypertension in different genders and regions were analyzed. Subjects were divided into hypertensive group and non-hypertensive group based on whether their blood pressure was≥140/90 mmHg (1 mmHg=0.133 kPa), and the general clinical data of the two groups were compared. Subjects were also divided into prehypertension and hypertension group and normal blood pressure group based on whether their blood pressure was≥130/80 mmHg, and the general clinical data of the two groups were compared, with subgroup analyses conducted by gender. Multifactorial logistic regression model was applied to identify factors associated with prehypertension and hypertension in both males and females. Results: A total of 1 942 couples of childbearing age, comprising 3 884 individuals, aged (29.8±5.2) years were enrolled, with 1 942 males (50.0%). The overall hypertension detection rate was 6.3% (246/3 884), with a detection rate of 10.5% (203/1 942) in males and 2.2% (43/1 942) in females. The hypertension detection rates in Beijing, Henan, and Gansu were 6.2% (92/1 482), 11.6% (139/1 200), and 1.2% (15/1 202), respectively. The overall detection rate of prehypertension and hypertension was 40.5% (1 574/3 884). Multifactorial logistic regression analysis showed that life pressure factors had no effect on female blood pressure levels (P>0.05), while a significant or high level of life/work pressure was a risk factor for prehypertension and hypertension in males (OR=2.30, 95%CI 1.06-4.99, P<0.05). Conclusion: The detection rate of prehypertension and hypertension among young couples of childbearing age in China is high, with poor awareness and control of hypertension. There are sex differences in the relationship between life pressure and blood pressure levels. Comprehensive consideration of individual living environments and mental health factors is crucial in blood pressure management. Measures to reduce life stress and enhance mental resilience should be implemented to address this public health issue.

Forensic pathology standards in China: a 30-year retrospective study.

China's forensic pathology standardization has accumulated more than 30 years of experience, but there is limited research summarizing the features and detailed information concerning these standards. In this paper, we collected documents on forensic pathology standards and statistically analyzed their types, effective scopes, drafting units, authorization departments, promulgation times, revision cycles, and other information. All of the standards information was obtained from standardization websites and databases. Since the first national standardization committee of forensic science established in 1991, a total of thirty-six forensic pathology standards have been published, including one national standard, thirty-one sector standards, and four enterprise standards. Among them, twenty-four standards were currently valid, while another twelve had been repealed. There were two management standards and thirty-four technical standards. The minimum revision cycle for standards was nine years, and the maximum cycle was twenty-three years. The standards system of forensic pathology had been primarily established, and the public welfare attributes of standardization were strengthened. However, some challenges still await positive actions, such as resolving the relative deficiencies of basic and management standards, satisfying the requirements for national standards, and advancing the delayed revisions of standards. In the future, we should continue to promote national standards for forensic pathology, actively absorb advanced international experience, strengthen the construction of basic and management standards, and fully encourage the flexibility, efficiency, and pioneer of standards dominated by associations, enterprises, and other organizations.

PRRSV-2 variant classification: a dynamic nomenclature for enhanced monitoring and surveillance.

Existing genetic classification systems for porcine reproductive and respiratory syndrome virus type 2 (PRRSV-2), such as restriction fragment length polymorphisms and sub-lineages, are unreliable indicators of close genetic relatedness or lack sufficient resolution for epidemiological monitoring routinely conducted by veterinarians. Here, we outline a fine-scale classification system for PRRSV-2 genetic variants in the United States. Based on >25,000 U.S. open reading frame 5 (ORF5) sequences, sub-lineages were divided into genetic variants using a clustering algorithm. Through classifying new sequences every 3 months and systematically identifying new variants across 8 years, we demonstrated that prospective implementation of the variant classification system produced robust, reproducible results across time and can dynamically accommodate new genetic diversity arising from virus evolution. From 2015 to 2023, 118 variants were identified, with ~48 active variants per year, of which 26 were common (detected >50 times). Mean within-variant genetic distance was 2.4% (max: 4.8%). The mean distance to the closest related variant was 4.9%. A routinely updated webtool (https://stemma.shinyapps.io/PRRSLoom-variants/) was developed and is publicly available for end users to assign newly generated sequences to a variant ID. This classification system relies on U.S. sequences from 2015 onward; further efforts are required to extend this system to older or international sequences. Finally, we demonstrate how variant classification can better discriminate between previous and new strains on a farm, determine possible sources of new introductions into a farm/system, and track emerging variants regionally. Adoption of this classification system will enhance PRRSV-2 epidemiological monitoring, research, and communication, and improve industry responses to emerging genetic variants.IMPORTANCEThe development and implementation of a fine-scale classification system for PRRSV-2 genetic variants represent a significant advancement for monitoring PRRSV-2 occurrence in the swine industry. Based on systematically applied criteria for variant identification using national-scale sequence data, this system addresses the shortcomings of existing classification methods by offering higher resolution and adaptability to capture emerging variants. This system provides a stable and reproducible method for classifying PRRSV-2 variants, facilitated by a freely available and regularly updated webtool for use by veterinarians and diagnostic labs. Although currently based on U.S. PRRSV-2 ORF5 sequences, this system can be expanded to include sequences from other countries, paving the way for a standardized global classification system. By enabling accurate and improved discrimination of PRRSV-2 genetic variants, this classification system significantly enhances the ability to monitor, research, and respond to PRRSV-2 outbreaks, ultimately supporting better management and control strategies in the swine industry.

VIEWER: an extensible visual analytics framework for enhancing mental healthcare.

A proof-of-concept study aimed at designing and implementing Visual & Interactive Engagement With Electronic Records (VIEWER), a versatile toolkit for visual analytics of clinical data, and systematically evaluating its effectiveness across various clinical applications while gathering feedback for iterative improvements. VIEWER is an open-source and extensible toolkit that employs natural language processing and interactive visualization techniques to facilitate the rapid design, development, and deployment of clinical information retrieval, analysis, and visualization at the point of care. Through an iterative and collaborative participatory design approach, VIEWER was designed and implemented in one of the United Kingdom's largest National Health Services mental health Trusts, where its clinical utility and effectiveness were assessed using both quantitative and qualitative methods. VIEWER provides interactive, problem-focused, and comprehensive views of longitudinal patient data (n = 409870) from a combination of structured clinical data and unstructured clinical notes. Despite a relatively short adoption period and users' initial unfamiliarity, VIEWER significantly improved performance and task completion speed compared to the standard clinical information system. More than 1000 users and partners in the hospital tested and used VIEWER, reporting high satisfaction and expressed strong interest in incorporating VIEWER into their daily practice. VIEWER provides a cost-effective enhancement to the functionalities of standard clinical information systems, with evaluation offering valuable feedback for future improvements. VIEWER was developed to improve data accessibility and representation across various aspects of healthcare delivery, including population health management and patient monitoring. The deployment of VIEWER highlights the benefits of collaborative refinement in optimizing health informatics solutions for enhanced patient care.