Flammable ionic liquids exhibit high conductivity and a broad electrochemical window,enabling the generation of combustible gases for combustion via electrochemical decomposition and thermal decomposition.This charact...Flammable ionic liquids exhibit high conductivity and a broad electrochemical window,enabling the generation of combustible gases for combustion via electrochemical decomposition and thermal decomposition.This characteristic holds significant implications in the realm of novel satellite propulsion.Introducing a fraction of the electrical energy into energetic ionic liquid fuels,the thermal decomposition process is facilitated by reducing the apparent activation energy required,and electrical energy can trigger the electrochemical decomposition of ionic liquids,presenting a promising approach to enhance combustion efficiency and energy release.This study applied an external voltage during the thermal decomposition of 1-ethyl-3-methylimidazole nitrate([EMIm]NO_(3)),revealing the effective alteration of the activation energy of[EMIm]NO_(3).The pyrolysis,electrochemical decomposition,and electron assisted enhancement products were identified through Thermogravimetry-Differential scanning calorimetry-Fourier transform infrared-Mass spectrometry(TG-DSC-FTIR-MS)and gas chromatography(GC)analyses,elucidating the degradation mechanism of[EMIm]NO_(3).Furthermore,an external voltage was introduced during the combustion of[EMIm]NO_(3),demonstrating the impact of voltage on the combustion process.展开更多
In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operati...In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operations.However,several challenges have emerged within the high-speed railway dispatching and command system,including the heavy workload faced by dispatchers,the difficulty of quantifying subjective expertise,and the need for effective training of professionals.Amid the growing application of artificial intelligence technologies in railway systems,this study leverages Large Language Model(LLM)technology.LLMs bring enhanced intelligence,predictive capabilities,robust memory,and adaptability to diverse real-world scenarios.This study proposes a human-computer interactive intelligent scheduling auxiliary training system built on LLM technology.The system offers capabilities including natural dialogue,knowledge reasoning,and human feedback learning.With broad applicability,the system is suitable for vocational education,guided inquiry,knowledge-based Q&A,and other training scenarios.Validation results demonstrate its effectiveness in auxiliary training,providing substantial support for educators,students,and dispatching personnel in colleges and professional settings.展开更多
The unmanned aerial vehicle(UAV)-assisted mobile edge computing(MEC)has been deemed a promising solution for energy-constrained devices to run smart applications with computationintensive and latency-sensitive require...The unmanned aerial vehicle(UAV)-assisted mobile edge computing(MEC)has been deemed a promising solution for energy-constrained devices to run smart applications with computationintensive and latency-sensitive requirements,especially in some infrastructure-limited areas or some emergency scenarios.However,the multi-UAVassisted MEC network remains largely unexplored.In this paper,the dynamic trajectory optimization and computation offloading are studied in a multi-UAVassisted MEC system where multiple UAVs fly over a target area with different trajectories to serve ground users.By considering the dynamic channel condition and random task arrival and jointly optimizing UAVs'trajectories,user association,and subchannel assignment,the average long-term sum of the user energy consumption minimization problem is formulated.To address the problem involving both discrete and continuous variables,a hybrid decision deep reinforcement learning(DRL)-based intelligent energyefficient resource allocation and trajectory optimization algorithm is proposed,named HDRT algorithm,where deep Q network(DQN)and deep deterministic policy gradient(DDPG)are invoked to process discrete and continuous variables,respectively.Simulation results show that the proposed HDRT algorithm converges fast and outperforms other benchmarks in the aspect of user energy consumption and latency.展开更多
BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the p...BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the patient,operators,and the tools used.The use of artificial intelligence(AI)in colonoscopy has gained popularity by assisting endoscopists in the detection and characterization of polyps.AIM To evaluate the diagnostic performance of AI-assisted colonoscopy[computer assisted diagnosis(CAD)eye function]for colorectal polyp characterization.METHODS This study used a cross-sectional design conducted at the Gastrointestinal Endoscopy Center of Dr.Cipto Mangunkusumo Hospital in January-May 2024 on adult patients with suspected colorectal polyps.RESULTS A total of 60 patients with 100 polyps were involved in this study.Based on the results of the examination,it was found that the AI CAD eye function examination had a sensitivity of 79.17%,specificity of 75.00%,positive predictive value(PPV)of 89.06%,negative predictive value(NPV)of 58.33%,and accuracy of 78.00%.In polyps with diminutive size,sensitivity was 86.27%,specificity was 60.00%,PPV was 95.65%,NPV was 30.00%,and accuracy was 83.93%.Meanwhile,in polyps with non-diminutive size,sensitivity was 61.90%,specificity was 78.26%,PPV was 72.22%,NPV was 69.23%,and accuracy was 70.45%.In polyps on the left side of the colon,sensitivity was 78.85%,specificity was 81.25%,PPV was 93.18%,NPV was 54.17%,and accuracy was 79.41%.Meanwhile,in rightsided polyps the sensitivity was 80.00%,specificity was 66.67%,PPV was 80.00%,NPV was 66.67%,and accuracy was 75.00%.In sessile polyps the sensitivity was 81.54%,specificity was 50.00%,PPV was 91.38%,NPV was 29.41%,and accuracy was 77.33%.Meanwhile,in non-sessile polyps,the sensitivity was 57.14%,specificity was 88.89%,PPV was 66.67%,NPV was 84.21%,and accuracy was 80.00%.CONCLUSION AI CAD eye function examination had a high sensitivity value in diminutive,sessile polyps and right-sided polyps and a high specificity in non-diminutive,non-sessile polyps and left-sided polyps.展开更多
Precise control and measurement of nanoparticles using low-power optical tweezers are pivotal for advancing single-particle analysis,nanoscale sensing,and energy transport research.In this work,we present the tipassis...Precise control and measurement of nanoparticles using low-power optical tweezers are pivotal for advancing single-particle analysis,nanoscale sensing,and energy transport research.In this work,we present the tipassisted nanoparticle capture system that simultaneously achieves localized temperature probing and nanoparticle trapping,significantly lowering the required laser power input.Unlike traditional metal-tip plasmonic techniques that predominantly rely on intense electric field gradients,our approach employs a silicon nanotip under resonant laser excitation,uniquely integrating optical forces,thermophoretic forces,and interatomic interactions for stable nanoparticle confinement.This synergistic collaboration mechanism enables approximately a 42%reduction in laser power density compared to conventional bowtie nanoaperture methods.This experimental method achieved direct and simultaneous Raman-based measurements of localized thermal dynamics,providing new insights into nanoscale thermodynamics during optical trapping.Additionally,the silicon nanotip demonstrates reduced thermal transport due to its confined nanoscale geometry,aligning closely with our theoretical predictions.Our integrated strategy of efficient nanoparticle manipulation coupled with precise thermal probing not only enhances overall energy efficiency but also broadens the scope of potential applications in cutting-edge nanoscience and nanotechnology.展开更多
1.Introduction.Cold Spray(CS)is a highly advanced solid-state metal depo-sition process that was first developed in the 1980s.This innovative technique involves the high-speed(300-1200 m/s)impact deposition of micron-...1.Introduction.Cold Spray(CS)is a highly advanced solid-state metal depo-sition process that was first developed in the 1980s.This innovative technique involves the high-speed(300-1200 m/s)impact deposition of micron-sized particles(5-50μm)to fabricate coatings[1-3].CS has been extensively used in a variety of coating applications,such as aerospace,automotive,energy,medical,marine,and others,to provide protection against high temperatures,corrosion,erosion,oxidation,and chemicals[4,5].Nowadays,the technical interest in CS is twofold:(i)as a repair process for damaged components,and(ii)as a solid-state additive manufacturing process.Compared to other fusion-based additive manufacturing(AM)technologies,Cold Spray Additive Manufacturing(CSAM)is a new member of the AM family that can enable the fabrication of deposits without undergoing melting.The chemical composition has been largely preserved from the powder to the deposit due to the minimal oxidation.The significant advantages of CSAM over other additive manufacturing processes include a high production rate,unlimited deposition size,high flexibility,and suitability for repairing damaged parts.展开更多
BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking rec...BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking recovery.OBJECTIVE:To determine whether early suspension-protected training with a personal assistant machine for stroke patients enhances walking ability and prevents muscle spasms.METHODS:Thirty-two early-stage stroke patients from Shenzhen University General Hospital and the China Rehabilitation Research Center were randomly assigned to the experimental group(n=16)and the control group(n=16).Both groups underwent 4 weeks of gait training under the suspension protection system for 30 minutes daily,5 days a week.The experimental group used the personal assistant machine during training.Three-dimensional gait analysis(using the Cortex motion capture system),Brunnstrom staging,Fugl-Meyer Assessment for lower limb motor function,Fugl-Meyer balance function,and the modified Ashworth Scale were evaluated within 1 week before the intervention and after 4 weeks of intervention.RESULTS AND CONCLUSION:After the 4-week intervention,all outcome measures showed significant changes in each group.The experimental group had a small but significant increase in the modified Ashworth Scale score(P<0.05,d=|0.15|),while the control group had a large significant increase(P<0.05,d=|1.48|).The experimental group demonstrated greater improvements in walking speed(16.5 to 38.44 cm/s,P<0.05,d=|4.01|),step frequency(46.44 to 64.94 steps/min,P<0.05,d=|2.32|),stride length(15.50 to 29.81 cm,P<0.05,d=|3.44|),and peak hip and knee flexion(d=|1.82|to|2.17|).After treatment,the experimental group showed significantly greater improvements than the control group in walking speed(38.44 vs.26.63 cm/s,P<0.05,d=|2.75|),stride length,peak hip and knee flexion(d=|1.31|to|1.45|),step frequency(64.94 vs.59.38 steps/min,P<0.05,d=|0.85|),and a reduced support phase(bilateral:24.31%vs.28.38%,P<0.05,d=|0.88|;non-paretic:66.19%vs.70.13%,P<0.05,d=|0.94|).For early hemiplegia,personal assistant machine-assisted gait training under the suspension protection system helps establish a correct gait pattern,prevents muscle spasms,and improves motor function.展开更多
This study analyzed how impressions are formed online depending on the type of social media and the implications that may come from the over-disclosure of information. Using a Qualtrics survey, 97 participants viewed ...This study analyzed how impressions are formed online depending on the type of social media and the implications that may come from the over-disclosure of information. Using a Qualtrics survey, 97 participants viewed the profile of a female teaching assistant on Twitter and Facebook. While there was little difference between the two social media, the use of self-disclosure on Twitter seemed slightly more inappropriate for sharing personal information.展开更多
Background:This study evaluates the ability of mobile AI voice assistants(AI-VAs)to provide accurate medical advice for early knee osteoarthritis(KOA)and compares their performance with conventional web searches and h...Background:This study evaluates the ability of mobile AI voice assistants(AI-VAs)to provide accurate medical advice for early knee osteoarthritis(KOA)and compares their performance with conventional web searches and human clinicians.Methods:From September to October 2024,two AI-VAs(Apple’s Siri and Huawei’s Xiaoyi)were tested on 15 KOA-related questions in Chinese and English.The assessment focused on the accuracy of voice recognition,response capabilities,and medical advice.Siri was further tested in four international regions(USA,UK,Germany,Hong Kong)using localized languages.Results:In Chinese-language tests,Siri and Xiaoyi showed comparable voice recognition(recognition accuracy:95.6%vs.93.3%)and response ability(speech response:88.9%vs.85.7%).However,Siri provided significantly more accurate medical advice(medical advice:95.6%vs.53.3%;Z=2.762,P<0.001).External validation via Global Quality Score further confirmed Siri’s superiority(mean Global Quality Score=4.0 vs.Xiaoai=0.9).Siri outperformed Xiaoyi in English-language tests(53.3%vs.0%).While Siri’s medical advice accuracy(95.6%)surpassed non-specialist clinicians(Z=2.685,P=0.007),it primarily reflects filtered search results(Baidu/Google)rather than clinical synthesis.Claims of equivalence to junior surgeons(98.2%)must be interpreted cautiously,as AI-VAs lack diagnostic reasoning capabilities.This distinction is critical to avoid overstating their role in clinical decision-making.Conclusion:Current AI-VAs offer limited value in providing precise medical advice for KOA,primarily serving as intermediaries for web search results.Their performance varies across languages,regions,and search engines.展开更多
This research investigates the effectiveness of climate-related development aid in Indonesia’s climate mitigation.Specific objectives include assessing the contribution of official development assistance(ODA)to reduc...This research investigates the effectiveness of climate-related development aid in Indonesia’s climate mitigation.Specific objectives include assessing the contribution of official development assistance(ODA)to reducing CO_(2) emissions and evaluating the implementation of the Busan Principles of aid effectiveness to achieve Indonesia’s mitigation priorities and targets.We utilize a new primary dataset based on interviews with the most knowledgeable stakeholders of ODA on climate change mitigation.Additionally,we use secondary data from the annual Rio Marker and the Common Reporting Standard data of the Organization for Economic Co-operation and Development.The results show a significant correlation between climate-related development aid and CO_(2) emission reduction in Indonesia.Additionally,the implementation of the Busan Principles enhances aid management by fostering project ownership and increasing the involvement of civil society and private sector.The study has implications for devising an effective climate change mitigation strategy for Indonesia.It is suggested that the government of Indonesia exercise greater flexibility and dynamism in engaging with development partners.展开更多
Background:Work engagement(WE)is critical to quality primary healthcare delivery.However,limited research has explored its levels and determinants among healthcare professionals in low-and middle-income countries.This...Background:Work engagement(WE)is critical to quality primary healthcare delivery.However,limited research has explored its levels and determinants among healthcare professionals in low-and middle-income countries.This study assessed the levels and correlates of work engagement among physician assistants(PAs)in Ghana.Methods:A cross-sectional study was conducted among 439 PAs from October to December 2024.Participants were recruited via emails,social media platforms,and posters featuring study links and scannable questionnaire codes.WE was measured using the validated Utrecht Work Engagement Scale questionnaire.Results:Overall,WE levels were average,with similar trends across the three subdomains.In the bootstrapped multivariate linear regression model,anxiety was negatively associated with WE(β=-0.49,95%confidence interval[CI]:-0.77 to-0.21).Conversely,working in an urban area(β=0.36,95%CI:0.05 to 0.67),holding the rank of PA/Senior PA(β=0.27,95%CI:0.03 to 0.52),reporting good self-rated health(β=0.54,95%CI:0.19 to 0.88),and working at health centers(β=0.86,95%CI:0.22 to 1.50)were positively associated with WElevels.Conclusion:WE levels are average in the study sample,highlighting the need for strategic interventions to improve and sustain the healthcare workforce's motivation and performance.Addressing workplace stressors,enhancing professional development opportunities,and fostering supportive work environments could improve engagement among PAs and healthcare professionals in general.Strengthening WE is essential for ensuring resilient quality primary healthcare systems and achieving the goals of universal health coverage.展开更多
With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.I...With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.It is urgent to develop a power-assisted exoskeleton robot suitable for individual combat.In the past,most power-assisted exoskeleton robots were driven by motors.This driving method has an excellent power-assisted effect,but the endurance is often insufficient.In view of this shortcoming,this study designed an ankle exoskeleton robot based on an active-passive combined drive through simulation analysis of human motion.It used OpenSim software to simulate and verify that the addition of spring could achieve a good effect.At the same time,according to the gait characteristics of the human body,the gait planning of an exoskeleton robot was carried out.Afterwards,theoretical analysis explained that the cooperation among spring,motor and wearer could be realized in this gait.Finally,the assisting ability and driving coordination of the active-passive combination driven ankle exoskeleton robot were verified through experiments.展开更多
Mg-Li alloys hold significant potential for applications in aerospace,automotive manufacturing,military weaponry,and biomedical implants,due to their excellent recyclability,high specific strength,biocompatibility,and...Mg-Li alloys hold significant potential for applications in aerospace,automotive manufacturing,military weaponry,and biomedical implants,due to their excellent recyclability,high specific strength,biocompatibility,and superior electromagnetic shielding properties.However,their poor corrosion resistance and high susceptibility to environmentally assisted cracking(EAC)significantly limit broader application.In recent years,growing attention has been directed toward understanding the corrosion and EAC behavior of Mg-Li alloys,as localized corrosion areas and hydrogen generated during the corrosion process can serve as crack initiation points and promote crack propagation.A comprehensive understanding of these mechanisms is essential for enhancing the reliability and performance of Mg-Li alloys in practical environments.This paper presents a detailed review of corrosion and EAC in Mg-Li alloys,focusing on corrosion behavior,crack initiation and propagation mechanisms,and the key factors influencing these processes.It summarizes recent advances in alloying,heat treatment,mechanical processing,microstructural control,environmental influences,mechanical loading,and surface treatments.In addition,the paper explores future research directions,highlights emerging trends,and proposes strategies to improve the durability and service performance of Mg-Li alloys.展开更多
Segmentation of demonstration trajectories and learning the contained motion primitives can effectively enhance the assistive robot's intelligence to flexibly reproduce learnt tasks in an unstructured environment....Segmentation of demonstration trajectories and learning the contained motion primitives can effectively enhance the assistive robot's intelligence to flexibly reproduce learnt tasks in an unstructured environment.With the aim to conveniently and accurately segment demonstration trajectories,a novel demonstration trajectory segmentation approach is proposed based on the beta process autoregressive hidden Markov model(BP-ARHMM)algorithm and generalised time warping(GTW)algorithm aiming to enhance the segmentation accuracy utilising acquired demonstration data.This approach first adopts the GTW algorithm to align the multiple demonstration trajectories for the same task.Then,it adopts the BP-AR-HMM algorithm to segment the demonstration trajectories,acquire the contained motion primitives,and establish the related task library.This segmentation approach is validated on the 6-degree-of-freedom JACO robotic arm by assisting users to accomplish a holding water glass task and an eating task.The experimental results show that the motion primitives within the trajectories can be correctly segmented with a high segmentation accuracy.展开更多
Solid-state precipitation is an effective strategy for tuning the mechanical and functional properties of ad-vanced alloys.Structure design and modification necessitate good knowledge of the kinetic evolution of preci...Solid-state precipitation is an effective strategy for tuning the mechanical and functional properties of ad-vanced alloys.Structure design and modification necessitate good knowledge of the kinetic evolution of precipitates during fabrication,which is strongly correlated with defect concentration.For Fe-Ga alloys,giant magnetostriction can be induced by the precipitation of the nanoscale tetragonal L60 phase.By introducing quenched-in vacancies,we significantly enhance the magnetostriction of the aged Fe81Ga19 polycrystalline alloys to~305 ppm,which is close to the level of single crystals.Although vacancies were found to facilitate the generation of the L60 phase,their impact on the precipitation mechanism and kinetics has yet to be revealed.This study combined transmission electron microscopy(TEM)and time-resolved small-angle neutron scattering(SANS)to investigate the precipitation of the L60 phase during the isothermal aging at 350 and 400℃,respectively.The evolution of L60 nanophase in morphology and number density in as-cast(AC)and liquid nitrogen quenched(LN)Fe81Ga19 alloys with aging time were quantitatively compared.Interestingly,the nucleation of the L60 phase proceeds progressively in AC while suddenly in LN specimens,indicating the homogenous to heterogeneous mechanism switching in-duced by concentrated vacancies.Moreover,excess vacancies can change the shape of nanoprecipitates and significantly accelerate the growth and coarsening kinetics.The magnetostrictive coefficient is opti-mized when the size(long-axis)of L60 precipitates lies between 100 and 110Åwith a number density between 3.2-4.3×10-7Å-3.Insight from this study validates the feasibility of achieving high magnetoe-lastic properties through precise manipulation of the nanostructure.展开更多
In complex environments such as high dynamics and weak signals,a satellite signal compensation method based on prefabricated trajectory assistance and an improved adaptive Kalman filter is proposed for a 155 mm differ...In complex environments such as high dynamics and weak signals,a satellite signal compensation method based on prefabricated trajectory assistance and an improved adaptive Kalman filter is proposed for a 155 mm differential rotating rear-body control-guided projectile to address the situation of satellite signal flickering and loss in projectile navigation systems due to environmental limitations.First,establish the system state and measurement equation when receiving satellite signals normally.Second,a seven-degree-of-freedom external ballistic model is constructed,and the ideal trajectory output from the ballistic model is used to provide the virtual motion state of the projectile,which is input into a filter as a substitute observation when satellite signals are lost.Finally,an adaptive Kalman filter(AKF)is designed,the proposed adaptive Kalman filter can accurately adjust the estimation error covariance matrix and Kalman gain in real-time based on information covariance mismatch.The simulation results show that compared to the classical Kalman filter,it can reduce the average positioning error by more than 38.21%in the case of short-term and full-range loss of satellite signals,providing a new idea for the integrated navigation of projectiles with incomplete information under the condition of satellite signal loss.展开更多
BACKGROUND Acupuncture,an ancient practice,is gaining recognition as a complementary and alternative medicine,especially in assisted reproductive technology.It plays a crucial role in enhancing embryo transfer success...BACKGROUND Acupuncture,an ancient practice,is gaining recognition as a complementary and alternative medicine,especially in assisted reproductive technology.It plays a crucial role in enhancing embryo transfer success rates.Research indicates that acupuncture can improve blood flow,increase endometrial receptivity regulate pressure,and affect neuroendocrine activities in the ovaries and uterus during embryo implantation,therefore improving pregnancy outcomes.AIM To highlight recent developments related to acupuncture's influence on embryo transfer and elucidating the precise mechanisms by which acupuncture influences embryo transfer.METHODS We searched database including PubMed,Cochrane Library up to September 2024 for relevant studies and patents to evaluate the effects of acupuncture on women undergoing in vitro fertilization(IVF).The experimental design included an intervention group using needling,and a control group consisting of no needling or sham needling.The main outcome is clinical pregnancy rate(CPR),while secondary includes live birth rate(LBR)and biochemical pregnancy rate(BPR).We examined the influence of adjunctive needling on pregnancy outcomes by analyzing variations in the main outcomes.RESULTS A total of 145 randomized controlled trials involving 27748 participants were analyzed.Data revealed that the overall CPR was significantly elevated in all acupuncture cohorts compared to the control group[relative risk(RR):1.21,95%CI:1.07-1.38,P=0.01].In contrast,the aggregated LBR did not exhibit a corresponding increase,and notable statistical heterogeneity was observed among the studies.Acupuncture-assisted frozen-thawed embryo transfer enhanced the BPR(RR:1.51,95%CI:1.21-1.89,P=0.03)and improved endometrial morphology(RR:1.41,95%CI:1.13-1.75,P=0.01).Furthermore,IVF outcomes were significantly superior in the acupuncture group when acupuncture was administered during controlled ovarian hyperstimulation(RR:1.71,95%CI:1.08-2.13,95%CI:1.08-4.21,P=0.03).CONCLUSION We find that acupuncture positively influences pregnancy rates in women receiving IVF treatment.Nonetheless,there are no established guidelines for optimal acupuncture protocols.Considering the methodological limitations identified in current research,there is a need for larger,methodologically rigorous studies.展开更多
Left ventricular assist devices (LVADs) represent a cornerstone therapy foradvanced heart failure. However, their efficacy in patients with type 2 diabetesmellitus (T2DM) is challenged by diabetes-exacerbated complica...Left ventricular assist devices (LVADs) represent a cornerstone therapy foradvanced heart failure. However, their efficacy in patients with type 2 diabetesmellitus (T2DM) is challenged by diabetes-exacerbated complications. To determineoptimal pharmacological strategies to mitigate major LVAD-relatedcomplications in patients with T2DM. This review provides evidence for pharmacologicalstrategies to mitigate major LVAD-related complications in T2DM, inwhich endothelial dysfunction (via impaired PI3K/Akt-NO signaling), chronicinflammation, and diabetic nephropathy amplify the risk of thrombosis, bleeding,infection, and right ventricular (RV) failure. For thromboembolism prevention,individualized warfarin management (international normalized ratio: 2.0-3.0)with intensified monitoring is essential, while aspirin omission in magneticallylevitated devices (2 trials) reduces bleeding. Phosphodiesterase-5 inhibitors showpromise for thrombosis reduction, but require bleeding risk assessment. Glycemiccontrol necessitates the proactive de-escalation of insulin/sulfonylureas post-LVAD owing to improved insulin sensitivity and hypoglycemia risks, favoringSGLT-2 inhibitors/GLP-1 receptor agonists for cardiometabolic benefits. Drivelineinfection management requires renal-adjusted antimicrobial prophylaxis, culturedirectedtherapy, and novel approaches for drug-resistant cases. The preventionof RV failure depends on preoperative hemodynamic optimization and postoperativeinotropic support. A multidisciplinary approach integrating anticoagulationprecision, infection control, glycemic tailoring, and hemodynamic stabilizationis critical to counter T2DM-pathophysiology interactions.展开更多
基金supported by the National Natural Science Foundation of China(Grant No.52206165)。
文摘Flammable ionic liquids exhibit high conductivity and a broad electrochemical window,enabling the generation of combustible gases for combustion via electrochemical decomposition and thermal decomposition.This characteristic holds significant implications in the realm of novel satellite propulsion.Introducing a fraction of the electrical energy into energetic ionic liquid fuels,the thermal decomposition process is facilitated by reducing the apparent activation energy required,and electrical energy can trigger the electrochemical decomposition of ionic liquids,presenting a promising approach to enhance combustion efficiency and energy release.This study applied an external voltage during the thermal decomposition of 1-ethyl-3-methylimidazole nitrate([EMIm]NO_(3)),revealing the effective alteration of the activation energy of[EMIm]NO_(3).The pyrolysis,electrochemical decomposition,and electron assisted enhancement products were identified through Thermogravimetry-Differential scanning calorimetry-Fourier transform infrared-Mass spectrometry(TG-DSC-FTIR-MS)and gas chromatography(GC)analyses,elucidating the degradation mechanism of[EMIm]NO_(3).Furthermore,an external voltage was introduced during the combustion of[EMIm]NO_(3),demonstrating the impact of voltage on the combustion process.
基金the Talent Fund of Beijing Jiaotong University(Grant No.2024XKRC055).
文摘In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operations.However,several challenges have emerged within the high-speed railway dispatching and command system,including the heavy workload faced by dispatchers,the difficulty of quantifying subjective expertise,and the need for effective training of professionals.Amid the growing application of artificial intelligence technologies in railway systems,this study leverages Large Language Model(LLM)technology.LLMs bring enhanced intelligence,predictive capabilities,robust memory,and adaptability to diverse real-world scenarios.This study proposes a human-computer interactive intelligent scheduling auxiliary training system built on LLM technology.The system offers capabilities including natural dialogue,knowledge reasoning,and human feedback learning.With broad applicability,the system is suitable for vocational education,guided inquiry,knowledge-based Q&A,and other training scenarios.Validation results demonstrate its effectiveness in auxiliary training,providing substantial support for educators,students,and dispatching personnel in colleges and professional settings.
基金supported by National Natural Science Foundation of China(No.62471254)National Natural Science Foundation of China(No.92367302)。
文摘The unmanned aerial vehicle(UAV)-assisted mobile edge computing(MEC)has been deemed a promising solution for energy-constrained devices to run smart applications with computationintensive and latency-sensitive requirements,especially in some infrastructure-limited areas or some emergency scenarios.However,the multi-UAVassisted MEC network remains largely unexplored.In this paper,the dynamic trajectory optimization and computation offloading are studied in a multi-UAVassisted MEC system where multiple UAVs fly over a target area with different trajectories to serve ground users.By considering the dynamic channel condition and random task arrival and jointly optimizing UAVs'trajectories,user association,and subchannel assignment,the average long-term sum of the user energy consumption minimization problem is formulated.To address the problem involving both discrete and continuous variables,a hybrid decision deep reinforcement learning(DRL)-based intelligent energyefficient resource allocation and trajectory optimization algorithm is proposed,named HDRT algorithm,where deep Q network(DQN)and deep deterministic policy gradient(DDPG)are invoked to process discrete and continuous variables,respectively.Simulation results show that the proposed HDRT algorithm converges fast and outperforms other benchmarks in the aspect of user energy consumption and latency.
文摘BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the patient,operators,and the tools used.The use of artificial intelligence(AI)in colonoscopy has gained popularity by assisting endoscopists in the detection and characterization of polyps.AIM To evaluate the diagnostic performance of AI-assisted colonoscopy[computer assisted diagnosis(CAD)eye function]for colorectal polyp characterization.METHODS This study used a cross-sectional design conducted at the Gastrointestinal Endoscopy Center of Dr.Cipto Mangunkusumo Hospital in January-May 2024 on adult patients with suspected colorectal polyps.RESULTS A total of 60 patients with 100 polyps were involved in this study.Based on the results of the examination,it was found that the AI CAD eye function examination had a sensitivity of 79.17%,specificity of 75.00%,positive predictive value(PPV)of 89.06%,negative predictive value(NPV)of 58.33%,and accuracy of 78.00%.In polyps with diminutive size,sensitivity was 86.27%,specificity was 60.00%,PPV was 95.65%,NPV was 30.00%,and accuracy was 83.93%.Meanwhile,in polyps with non-diminutive size,sensitivity was 61.90%,specificity was 78.26%,PPV was 72.22%,NPV was 69.23%,and accuracy was 70.45%.In polyps on the left side of the colon,sensitivity was 78.85%,specificity was 81.25%,PPV was 93.18%,NPV was 54.17%,and accuracy was 79.41%.Meanwhile,in rightsided polyps the sensitivity was 80.00%,specificity was 66.67%,PPV was 80.00%,NPV was 66.67%,and accuracy was 75.00%.In sessile polyps the sensitivity was 81.54%,specificity was 50.00%,PPV was 91.38%,NPV was 29.41%,and accuracy was 77.33%.Meanwhile,in non-sessile polyps,the sensitivity was 57.14%,specificity was 88.89%,PPV was 66.67%,NPV was 84.21%,and accuracy was 80.00%.CONCLUSION AI CAD eye function examination had a high sensitivity value in diminutive,sessile polyps and right-sided polyps and a high specificity in non-diminutive,non-sessile polyps and left-sided polyps.
基金supported by the National Natural Science Foundation of China(Grant No.52206107)the National Key R&D Program of China(Grant No.2023YFE0120200)。
文摘Precise control and measurement of nanoparticles using low-power optical tweezers are pivotal for advancing single-particle analysis,nanoscale sensing,and energy transport research.In this work,we present the tipassisted nanoparticle capture system that simultaneously achieves localized temperature probing and nanoparticle trapping,significantly lowering the required laser power input.Unlike traditional metal-tip plasmonic techniques that predominantly rely on intense electric field gradients,our approach employs a silicon nanotip under resonant laser excitation,uniquely integrating optical forces,thermophoretic forces,and interatomic interactions for stable nanoparticle confinement.This synergistic collaboration mechanism enables approximately a 42%reduction in laser power density compared to conventional bowtie nanoaperture methods.This experimental method achieved direct and simultaneous Raman-based measurements of localized thermal dynamics,providing new insights into nanoscale thermodynamics during optical trapping.Additionally,the silicon nanotip demonstrates reduced thermal transport due to its confined nanoscale geometry,aligning closely with our theoretical predictions.Our integrated strategy of efficient nanoparticle manipulation coupled with precise thermal probing not only enhances overall energy efficiency but also broadens the scope of potential applications in cutting-edge nanoscience and nanotechnology.
基金supported by the National Natural Science Foundation of China(No.52061135101 and 52001078)the German Research Foundation(DFG,No.448318292)+3 种基金the Technology Innovation Guidance Special Foundation of Shaanxi Province(No.2023GXLH-085)the Fundamental Research Funds for the Central Universities(No.D5000240161)the Project of Key areas of innovation team in Shaanxi Province(No.2024RS-CXTD-20)The author Yingchun Xie thanks the support from the National Key R&D Program(No.2023YFE0108000).
文摘1.Introduction.Cold Spray(CS)is a highly advanced solid-state metal depo-sition process that was first developed in the 1980s.This innovative technique involves the high-speed(300-1200 m/s)impact deposition of micron-sized particles(5-50μm)to fabricate coatings[1-3].CS has been extensively used in a variety of coating applications,such as aerospace,automotive,energy,medical,marine,and others,to provide protection against high temperatures,corrosion,erosion,oxidation,and chemicals[4,5].Nowadays,the technical interest in CS is twofold:(i)as a repair process for damaged components,and(ii)as a solid-state additive manufacturing process.Compared to other fusion-based additive manufacturing(AM)technologies,Cold Spray Additive Manufacturing(CSAM)is a new member of the AM family that can enable the fabrication of deposits without undergoing melting.The chemical composition has been largely preserved from the powder to the deposit due to the minimal oxidation.The significant advantages of CSAM over other additive manufacturing processes include a high production rate,unlimited deposition size,high flexibility,and suitability for repairing damaged parts.
文摘BACKGROUND:Hemiplegia,a prevalent stroke-related condition,is often studied for motor dysfunction;however,spasticity remains under-researched.Abnormal muscle tone significantly hinders hemiplegic patients’walking recovery.OBJECTIVE:To determine whether early suspension-protected training with a personal assistant machine for stroke patients enhances walking ability and prevents muscle spasms.METHODS:Thirty-two early-stage stroke patients from Shenzhen University General Hospital and the China Rehabilitation Research Center were randomly assigned to the experimental group(n=16)and the control group(n=16).Both groups underwent 4 weeks of gait training under the suspension protection system for 30 minutes daily,5 days a week.The experimental group used the personal assistant machine during training.Three-dimensional gait analysis(using the Cortex motion capture system),Brunnstrom staging,Fugl-Meyer Assessment for lower limb motor function,Fugl-Meyer balance function,and the modified Ashworth Scale were evaluated within 1 week before the intervention and after 4 weeks of intervention.RESULTS AND CONCLUSION:After the 4-week intervention,all outcome measures showed significant changes in each group.The experimental group had a small but significant increase in the modified Ashworth Scale score(P<0.05,d=|0.15|),while the control group had a large significant increase(P<0.05,d=|1.48|).The experimental group demonstrated greater improvements in walking speed(16.5 to 38.44 cm/s,P<0.05,d=|4.01|),step frequency(46.44 to 64.94 steps/min,P<0.05,d=|2.32|),stride length(15.50 to 29.81 cm,P<0.05,d=|3.44|),and peak hip and knee flexion(d=|1.82|to|2.17|).After treatment,the experimental group showed significantly greater improvements than the control group in walking speed(38.44 vs.26.63 cm/s,P<0.05,d=|2.75|),stride length,peak hip and knee flexion(d=|1.31|to|1.45|),step frequency(64.94 vs.59.38 steps/min,P<0.05,d=|0.85|),and a reduced support phase(bilateral:24.31%vs.28.38%,P<0.05,d=|0.88|;non-paretic:66.19%vs.70.13%,P<0.05,d=|0.94|).For early hemiplegia,personal assistant machine-assisted gait training under the suspension protection system helps establish a correct gait pattern,prevents muscle spasms,and improves motor function.
文摘This study analyzed how impressions are formed online depending on the type of social media and the implications that may come from the over-disclosure of information. Using a Qualtrics survey, 97 participants viewed the profile of a female teaching assistant on Twitter and Facebook. While there was little difference between the two social media, the use of self-disclosure on Twitter seemed slightly more inappropriate for sharing personal information.
文摘Background:This study evaluates the ability of mobile AI voice assistants(AI-VAs)to provide accurate medical advice for early knee osteoarthritis(KOA)and compares their performance with conventional web searches and human clinicians.Methods:From September to October 2024,two AI-VAs(Apple’s Siri and Huawei’s Xiaoyi)were tested on 15 KOA-related questions in Chinese and English.The assessment focused on the accuracy of voice recognition,response capabilities,and medical advice.Siri was further tested in four international regions(USA,UK,Germany,Hong Kong)using localized languages.Results:In Chinese-language tests,Siri and Xiaoyi showed comparable voice recognition(recognition accuracy:95.6%vs.93.3%)and response ability(speech response:88.9%vs.85.7%).However,Siri provided significantly more accurate medical advice(medical advice:95.6%vs.53.3%;Z=2.762,P<0.001).External validation via Global Quality Score further confirmed Siri’s superiority(mean Global Quality Score=4.0 vs.Xiaoai=0.9).Siri outperformed Xiaoyi in English-language tests(53.3%vs.0%).While Siri’s medical advice accuracy(95.6%)surpassed non-specialist clinicians(Z=2.685,P=0.007),it primarily reflects filtered search results(Baidu/Google)rather than clinical synthesis.Claims of equivalence to junior surgeons(98.2%)must be interpreted cautiously,as AI-VAs lack diagnostic reasoning capabilities.This distinction is critical to avoid overstating their role in clinical decision-making.Conclusion:Current AI-VAs offer limited value in providing precise medical advice for KOA,primarily serving as intermediaries for web search results.Their performance varies across languages,regions,and search engines.
文摘This research investigates the effectiveness of climate-related development aid in Indonesia’s climate mitigation.Specific objectives include assessing the contribution of official development assistance(ODA)to reducing CO_(2) emissions and evaluating the implementation of the Busan Principles of aid effectiveness to achieve Indonesia’s mitigation priorities and targets.We utilize a new primary dataset based on interviews with the most knowledgeable stakeholders of ODA on climate change mitigation.Additionally,we use secondary data from the annual Rio Marker and the Common Reporting Standard data of the Organization for Economic Co-operation and Development.The results show a significant correlation between climate-related development aid and CO_(2) emission reduction in Indonesia.Additionally,the implementation of the Busan Principles enhances aid management by fostering project ownership and increasing the involvement of civil society and private sector.The study has implications for devising an effective climate change mitigation strategy for Indonesia.It is suggested that the government of Indonesia exercise greater flexibility and dynamism in engaging with development partners.
文摘Background:Work engagement(WE)is critical to quality primary healthcare delivery.However,limited research has explored its levels and determinants among healthcare professionals in low-and middle-income countries.This study assessed the levels and correlates of work engagement among physician assistants(PAs)in Ghana.Methods:A cross-sectional study was conducted among 439 PAs from October to December 2024.Participants were recruited via emails,social media platforms,and posters featuring study links and scannable questionnaire codes.WE was measured using the validated Utrecht Work Engagement Scale questionnaire.Results:Overall,WE levels were average,with similar trends across the three subdomains.In the bootstrapped multivariate linear regression model,anxiety was negatively associated with WE(β=-0.49,95%confidence interval[CI]:-0.77 to-0.21).Conversely,working in an urban area(β=0.36,95%CI:0.05 to 0.67),holding the rank of PA/Senior PA(β=0.27,95%CI:0.03 to 0.52),reporting good self-rated health(β=0.54,95%CI:0.19 to 0.88),and working at health centers(β=0.86,95%CI:0.22 to 1.50)were positively associated with WElevels.Conclusion:WE levels are average in the study sample,highlighting the need for strategic interventions to improve and sustain the healthcare workforce's motivation and performance.Addressing workplace stressors,enhancing professional development opportunities,and fostering supportive work environments could improve engagement among PAs and healthcare professionals in general.Strengthening WE is essential for ensuring resilient quality primary healthcare systems and achieving the goals of universal health coverage.
基金the National Natural Science Foundation of China(No.52075264)。
文摘With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.It is urgent to develop a power-assisted exoskeleton robot suitable for individual combat.In the past,most power-assisted exoskeleton robots were driven by motors.This driving method has an excellent power-assisted effect,but the endurance is often insufficient.In view of this shortcoming,this study designed an ankle exoskeleton robot based on an active-passive combined drive through simulation analysis of human motion.It used OpenSim software to simulate and verify that the addition of spring could achieve a good effect.At the same time,according to the gait characteristics of the human body,the gait planning of an exoskeleton robot was carried out.Afterwards,theoretical analysis explained that the cooperation among spring,motor and wearer could be realized in this gait.Finally,the assisting ability and driving coordination of the active-passive combination driven ankle exoskeleton robot were verified through experiments.
基金supported by the National Natural Science Foundation of China Projects under Grant(nos.52301112,52331004,U21A2049,and 51871211)Guangdong Basic and Applied Basic Research Foundation(Grant no.2024A1515030065)+4 种基金Basic and Applied Basic Research Project of Guangzhou(Grant no.2024A04J6299)LiaoNing Revitalization Talents Program(XLYC1907062,and XLYC2403026)Shenyang Young and Middle-aged Science and Technology Innovation Talent Support Program(RC231178)the Fundamental Research Funds for the Central Universities(N25GFY002)the Innovation Fund of Institute of Metal Research(IMR),Chinese Academy of Sciences(CAS).
文摘Mg-Li alloys hold significant potential for applications in aerospace,automotive manufacturing,military weaponry,and biomedical implants,due to their excellent recyclability,high specific strength,biocompatibility,and superior electromagnetic shielding properties.However,their poor corrosion resistance and high susceptibility to environmentally assisted cracking(EAC)significantly limit broader application.In recent years,growing attention has been directed toward understanding the corrosion and EAC behavior of Mg-Li alloys,as localized corrosion areas and hydrogen generated during the corrosion process can serve as crack initiation points and promote crack propagation.A comprehensive understanding of these mechanisms is essential for enhancing the reliability and performance of Mg-Li alloys in practical environments.This paper presents a detailed review of corrosion and EAC in Mg-Li alloys,focusing on corrosion behavior,crack initiation and propagation mechanisms,and the key factors influencing these processes.It summarizes recent advances in alloying,heat treatment,mechanical processing,microstructural control,environmental influences,mechanical loading,and surface treatments.In addition,the paper explores future research directions,highlights emerging trends,and proposes strategies to improve the durability and service performance of Mg-Li alloys.
基金Doctoral Research Start-up Fund of Shandong Jiaotong University,Grant/Award Number:BS2024009Natural Science Foundation of Shandong Province of China,Grant/Award Number:ZR2022ME087+1 种基金State Key Laboratory of Robotics and Systems(HIT),Grant/Award Number:SKLRS-2024-KF-09Open Access Publication Fund of Universität Hamburg。
文摘Segmentation of demonstration trajectories and learning the contained motion primitives can effectively enhance the assistive robot's intelligence to flexibly reproduce learnt tasks in an unstructured environment.With the aim to conveniently and accurately segment demonstration trajectories,a novel demonstration trajectory segmentation approach is proposed based on the beta process autoregressive hidden Markov model(BP-ARHMM)algorithm and generalised time warping(GTW)algorithm aiming to enhance the segmentation accuracy utilising acquired demonstration data.This approach first adopts the GTW algorithm to align the multiple demonstration trajectories for the same task.Then,it adopts the BP-AR-HMM algorithm to segment the demonstration trajectories,acquire the contained motion primitives,and establish the related task library.This segmentation approach is validated on the 6-degree-of-freedom JACO robotic arm by assisting users to accomplish a holding water glass task and an eating task.The experimental results show that the motion primitives within the trajectories can be correctly segmented with a high segmentation accuracy.
基金supported by the National Natural Science Foundation of China(Grant No.12275154)the Guangdong Basic and Applied Basic Research Foundation,China(Project No.2021B1515140028)+1 种基金the Youth Innovation Promotion Association,CAS(No.2020010)the National Key Research and Development Program of China,grant number(Nos.2021YFA1600701 and 2021YFB3501201).
文摘Solid-state precipitation is an effective strategy for tuning the mechanical and functional properties of ad-vanced alloys.Structure design and modification necessitate good knowledge of the kinetic evolution of precipitates during fabrication,which is strongly correlated with defect concentration.For Fe-Ga alloys,giant magnetostriction can be induced by the precipitation of the nanoscale tetragonal L60 phase.By introducing quenched-in vacancies,we significantly enhance the magnetostriction of the aged Fe81Ga19 polycrystalline alloys to~305 ppm,which is close to the level of single crystals.Although vacancies were found to facilitate the generation of the L60 phase,their impact on the precipitation mechanism and kinetics has yet to be revealed.This study combined transmission electron microscopy(TEM)and time-resolved small-angle neutron scattering(SANS)to investigate the precipitation of the L60 phase during the isothermal aging at 350 and 400℃,respectively.The evolution of L60 nanophase in morphology and number density in as-cast(AC)and liquid nitrogen quenched(LN)Fe81Ga19 alloys with aging time were quantitatively compared.Interestingly,the nucleation of the L60 phase proceeds progressively in AC while suddenly in LN specimens,indicating the homogenous to heterogeneous mechanism switching in-duced by concentrated vacancies.Moreover,excess vacancies can change the shape of nanoprecipitates and significantly accelerate the growth and coarsening kinetics.The magnetostrictive coefficient is opti-mized when the size(long-axis)of L60 precipitates lies between 100 and 110Åwith a number density between 3.2-4.3×10-7Å-3.Insight from this study validates the feasibility of achieving high magnetoe-lastic properties through precise manipulation of the nanostructure.
基金funded by the National Natural Science Foundation of China (Grant No. 62471048)Open Fund Project of Beijing Key Laboratory of High Dynamic Navigation TechnologyKey Laboratory Fund Project of Modern Measurement and Control Technology, Ministry of Education
文摘In complex environments such as high dynamics and weak signals,a satellite signal compensation method based on prefabricated trajectory assistance and an improved adaptive Kalman filter is proposed for a 155 mm differential rotating rear-body control-guided projectile to address the situation of satellite signal flickering and loss in projectile navigation systems due to environmental limitations.First,establish the system state and measurement equation when receiving satellite signals normally.Second,a seven-degree-of-freedom external ballistic model is constructed,and the ideal trajectory output from the ballistic model is used to provide the virtual motion state of the projectile,which is input into a filter as a substitute observation when satellite signals are lost.Finally,an adaptive Kalman filter(AKF)is designed,the proposed adaptive Kalman filter can accurately adjust the estimation error covariance matrix and Kalman gain in real-time based on information covariance mismatch.The simulation results show that compared to the classical Kalman filter,it can reduce the average positioning error by more than 38.21%in the case of short-term and full-range loss of satellite signals,providing a new idea for the integrated navigation of projectiles with incomplete information under the condition of satellite signal loss.
基金Supported by Funding from the Jiangsu Provincial Science and Technology Plan Special Foundation,No.BE2022712The Special Research Project on The Development Plan of Traditional Chinese Medicine Technology in Jiangsu Province,No.ZT202120.
文摘BACKGROUND Acupuncture,an ancient practice,is gaining recognition as a complementary and alternative medicine,especially in assisted reproductive technology.It plays a crucial role in enhancing embryo transfer success rates.Research indicates that acupuncture can improve blood flow,increase endometrial receptivity regulate pressure,and affect neuroendocrine activities in the ovaries and uterus during embryo implantation,therefore improving pregnancy outcomes.AIM To highlight recent developments related to acupuncture's influence on embryo transfer and elucidating the precise mechanisms by which acupuncture influences embryo transfer.METHODS We searched database including PubMed,Cochrane Library up to September 2024 for relevant studies and patents to evaluate the effects of acupuncture on women undergoing in vitro fertilization(IVF).The experimental design included an intervention group using needling,and a control group consisting of no needling or sham needling.The main outcome is clinical pregnancy rate(CPR),while secondary includes live birth rate(LBR)and biochemical pregnancy rate(BPR).We examined the influence of adjunctive needling on pregnancy outcomes by analyzing variations in the main outcomes.RESULTS A total of 145 randomized controlled trials involving 27748 participants were analyzed.Data revealed that the overall CPR was significantly elevated in all acupuncture cohorts compared to the control group[relative risk(RR):1.21,95%CI:1.07-1.38,P=0.01].In contrast,the aggregated LBR did not exhibit a corresponding increase,and notable statistical heterogeneity was observed among the studies.Acupuncture-assisted frozen-thawed embryo transfer enhanced the BPR(RR:1.51,95%CI:1.21-1.89,P=0.03)and improved endometrial morphology(RR:1.41,95%CI:1.13-1.75,P=0.01).Furthermore,IVF outcomes were significantly superior in the acupuncture group when acupuncture was administered during controlled ovarian hyperstimulation(RR:1.71,95%CI:1.08-2.13,95%CI:1.08-4.21,P=0.03).CONCLUSION We find that acupuncture positively influences pregnancy rates in women receiving IVF treatment.Nonetheless,there are no established guidelines for optimal acupuncture protocols.Considering the methodological limitations identified in current research,there is a need for larger,methodologically rigorous studies.
文摘Left ventricular assist devices (LVADs) represent a cornerstone therapy foradvanced heart failure. However, their efficacy in patients with type 2 diabetesmellitus (T2DM) is challenged by diabetes-exacerbated complications. To determineoptimal pharmacological strategies to mitigate major LVAD-relatedcomplications in patients with T2DM. This review provides evidence for pharmacologicalstrategies to mitigate major LVAD-related complications in T2DM, inwhich endothelial dysfunction (via impaired PI3K/Akt-NO signaling), chronicinflammation, and diabetic nephropathy amplify the risk of thrombosis, bleeding,infection, and right ventricular (RV) failure. For thromboembolism prevention,individualized warfarin management (international normalized ratio: 2.0-3.0)with intensified monitoring is essential, while aspirin omission in magneticallylevitated devices (2 trials) reduces bleeding. Phosphodiesterase-5 inhibitors showpromise for thrombosis reduction, but require bleeding risk assessment. Glycemiccontrol necessitates the proactive de-escalation of insulin/sulfonylureas post-LVAD owing to improved insulin sensitivity and hypoglycemia risks, favoringSGLT-2 inhibitors/GLP-1 receptor agonists for cardiometabolic benefits. Drivelineinfection management requires renal-adjusted antimicrobial prophylaxis, culturedirectedtherapy, and novel approaches for drug-resistant cases. The preventionof RV failure depends on preoperative hemodynamic optimization and postoperativeinotropic support. A multidisciplinary approach integrating anticoagulationprecision, infection control, glycemic tailoring, and hemodynamic stabilizationis critical to counter T2DM-pathophysiology interactions.
