BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints...BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.展开更多
Because of the challenge of compounding lightweight,high-strength Ti/Al alloys due to their considerable disparity in properties,Al 6063 as intermediate layer was proposed to fabricate TC4/Al 6063/Al 7075 three-layer ...Because of the challenge of compounding lightweight,high-strength Ti/Al alloys due to their considerable disparity in properties,Al 6063 as intermediate layer was proposed to fabricate TC4/Al 6063/Al 7075 three-layer composite plate by explosive welding.The microscopic properties of each bonding interface were elucidated through field emission scanning electron microscope and electron backscattered diffraction(EBSD).A methodology combining finite element method-smoothed particle hydrodynamics(FEM-SPH)and molecular dynamics(MD)was proposed for the analysis of the forming and evolution characteristics of explosive welding interfaces at multi-scale.The results demonstrate that the bonding interface morphologies of TC4/Al 6063 and Al 6063/Al 7075 exhibit a flat and wavy configuration,without discernible defects or cracks.The phenomenon of grain refinement is observed in the vicinity of the two bonding interfaces.Furthermore,the degree of plastic deformation of TC4 and Al 7075 is more pronounced than that of Al 6063 in the intermediate layer.The interface morphology characteristics obtained by FEM-SPH simulation exhibit a high degree of similarity to the experimental results.MD simulations reveal that the diffusion of interfacial elements predominantly occurs during the unloading phase,and the simulated thickness of interfacial diffusion aligns well with experimental outcomes.The introduction of intermediate layer in the explosive welding process can effectively produce high-quality titanium/aluminum alloy composite plates.Furthermore,this approach offers a multi-scale simulation strategy for the study of explosive welding bonding interfaces.展开更多
软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一...软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一种基于时差的多输出tri-training异构软测量方法。通过构建一种新的tri-training框架,采用多输出的高斯过程回归(multi-output Gaussian process regression,MGPR)、相关向量机(multi-output relevance vector machine,MRVM)、最小二乘支持向量机(multi-output least squares support vector machine,MLSSVM)三种模型作为基线监督回归器,使用标记数据进行训练和迭代;同时,引入时间差分(time difference,TD)改进模型的动态特性,并通过卡尔曼滤波(Kalman filtering,KF)优化模型的参数,提高其预测性能;最后通过模拟污水处理平台(benchmark simulation model 1,BSM1)和实际污水处理厂对该模型进行了验证。结果表明,与传统的软测量建模方法相比,该模型能显著提高数据分布不平衡下软测量模型的自适应性和预测性能。展开更多
Improving the volumetric energy density of supercapacitors is essential for practical applications,which highly relies on the dense storage of ions in carbon-based electrodes.The functional units of carbon-based elect...Improving the volumetric energy density of supercapacitors is essential for practical applications,which highly relies on the dense storage of ions in carbon-based electrodes.The functional units of carbon-based electrode exhibit multi-scale structural characteristics including macroscopic electrode morphologies,mesoscopic microcrystals and pores,and microscopic defects and dopants in the carbon basal plane.Therefore,the ordered combination of multi-scale structures of carbon electrode is crucial for achieving dense energy storage and high volumetric performance by leveraging the functions of various scale structu re.Considering that previous reviews have focused more on the discussion of specific scale structu re of carbon electrodes,this review takes a multi-scale perspective in which recent progresses regarding the structureperformance relationship,underlying mechanism and directional design of carbon-based multi-scale structures including carbon morphology,pore structure,carbon basal plane micro-environment and electrode technology on dense energy storage and volumetric property of supercapacitors are systematically discussed.We analyzed in detail the effects of the morphology,pore,and micro-environment of carbon electrode materials on ion dense storage,summarized the specific effects of different scale structures on volumetric property and recent research progress,and proposed the mutual influence and trade-off relationship between various scale structures.In addition,the challenges and outlooks for improving the dense storage and volumetric performance of carbon-based supercapacitors are analyzed,which can provide feasible technical reference and guidance for the design and manufacture of dense carbon-based electrode materials.展开更多
Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesit...Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight,body fat,fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024.Risk of bias assessment was performed with RoB 2.0,and the GRADE approach assessed the certainty of evidence(CoE)of each main outcome.We included four publications summing up 202 patients.Two publications used orlistat as an anti-obesity drug treatment,while the other two adopted GLP-1 receptor agonist(liraglutide or tirzepatide)as a pharmacotherapy for weight management.Orlistat combined with exercise was superior to change body weight(mean difference(MD):−2.27 kg;95%CI:−2.86 to−1.69;CoE:very low),fat mass(MD:−2.89;95%CI:−3.87 to−1.91;CoE:very low),fat-free mass(MD:0.56;95%CI:0.40–0.72;CoE:very low),and VO_(2)Peak(MD:2.64;95%CI:2.52–2.76;CoE:very low).GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight(MD:−3.96 kg;95%CI:−5.07 to−2.85;CoE:low),fat mass(MD:−1.76;95%CI:−2.24 to−1.27;CoE:low),fat-free mass(MD:0.50;95%CI:−0.98 to 1.98;CoE:very low)and VO_(2)Peak(MD:2.47;95%CI:1.31–3.63;CoE:very low).The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.展开更多
Convolutional neural networks(CNNs)-based medical image segmentation technologies have been widely used in medical image segmentation because of their strong representation and generalization abilities.However,due to ...Convolutional neural networks(CNNs)-based medical image segmentation technologies have been widely used in medical image segmentation because of their strong representation and generalization abilities.However,due to the inability to effectively capture global information from images,CNNs can easily lead to loss of contours and textures in segmentation results.Notice that the transformer model can effectively capture the properties of long-range dependencies in the image,and furthermore,combining the CNN and the transformer can effectively extract local details and global contextual features of the image.Motivated by this,we propose a multi-branch and multi-scale attention network(M2ANet)for medical image segmentation,whose architecture consists of three components.Specifically,in the first component,we construct an adaptive multi-branch patch module for parallel extraction of image features to reduce information loss caused by downsampling.In the second component,we apply residual block to the well-known convolutional block attention module to enhance the network’s ability to recognize important features of images and alleviate the phenomenon of gradient vanishing.In the third component,we design a multi-scale feature fusion module,in which we adopt adaptive average pooling and position encoding to enhance contextual features,and then multi-head attention is introduced to further enrich feature representation.Finally,we validate the effectiveness and feasibility of the proposed M2ANet method through comparative experiments on four benchmark medical image segmentation datasets,particularly in the context of preserving contours and textures.展开更多
Prediction of production decline and evaluation of the adsorbed/free gas ratio are critical for determining the lifespan and production status of shale gas wells.Traditional production prediction methods have some sho...Prediction of production decline and evaluation of the adsorbed/free gas ratio are critical for determining the lifespan and production status of shale gas wells.Traditional production prediction methods have some shortcomings because of the low permeability and tightness of shale,complex gas flow behavior of multi-scale gas transport regions and multiple gas transport mechanism superpositions,and complex and variable production regimes of shale gas wells.Recent research has demonstrated the existence of a multi-stage isotope fractionation phenomenon during shale gas production,with the fractionation characteristics of each stage associated with the pore structure,gas in place(GIP),adsorption/desorption,and gas production process.This study presents a new approach for estimating shale gas well production and evaluating the adsorbed/free gas ratio throughout production using isotope fractionation techniques.A reservoir-scale carbon isotope fractionation(CIF)model applicable to the production process of shale gas wells was developed for the first time in this research.In contrast to the traditional model,this model improves production prediction accuracy by simultaneously fitting the gas production rate and δ^(13)C_(1) data and provides a new evaluation method of the adsorbed/free gas ratio during shale gas production.The results indicate that the diffusion and adsorption/desorption properties of rock,bottom-hole flowing pressure(BHP)of gas well,and multi-scale gas transport regions of the reservoir all affect isotope fractionation,with the diffusion and adsorption/desorption parameters of rock having the greatest effect on isotope fractionation being D∗/D,PL,VL,α,and others in that order.We effectively tested the universality of the four-stage isotope fractionation feature and revealed a unique isotope fractionation mechanism caused by the superimposed coupling of multi-scale gas transport regions during shale gas well production.Finally,we applied the established CIF model to a shale gas well in the Sichuan Basin,China,and calculated the estimated ultimate recovery(EUR)of the well to be 3.33×10^(8) m^(3);the adsorbed gas ratio during shale gas production was 1.65%,10.03%,and 23.44%in the first,fifth,and tenth years,respectively.The findings are significant for understanding the isotope fractionation mechanism during natural gas transport in complex systems and for formulating and optimizing unconventional natural gas development strategies.展开更多
BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential t...BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.展开更多
In recent years,gait-based emotion recognition has been widely applied in the field of computer vision.However,existing gait emotion recognition methods typically rely on complete human skeleton data,and their accurac...In recent years,gait-based emotion recognition has been widely applied in the field of computer vision.However,existing gait emotion recognition methods typically rely on complete human skeleton data,and their accuracy significantly declines when the data is occluded.To enhance the accuracy of gait emotion recognition under occlusion,this paper proposes a Multi-scale Suppression Graph ConvolutionalNetwork(MS-GCN).TheMS-GCN consists of three main components:Joint Interpolation Module(JI Moudle),Multi-scale Temporal Convolution Network(MS-TCN),and Suppression Graph Convolutional Network(SGCN).The JI Module completes the spatially occluded skeletal joints using the(K-Nearest Neighbors)KNN interpolation method.The MS-TCN employs convolutional kernels of various sizes to comprehensively capture the emotional information embedded in the gait,compensating for the temporal occlusion of gait information.The SGCN extracts more non-prominent human gait features by suppressing the extraction of key body part features,thereby reducing the negative impact of occlusion on emotion recognition results.The proposed method is evaluated on two comprehensive datasets:Emotion-Gait,containing 4227 real gaits from sources like BML,ICT-Pollick,and ELMD,and 1000 synthetic gaits generated using STEP-Gen technology,and ELMB,consisting of 3924 gaits,with 1835 labeled with emotions such as“Happy,”“Sad,”“Angry,”and“Neutral.”On the standard datasets Emotion-Gait and ELMB,the proposed method achieved accuracies of 0.900 and 0.896,respectively,attaining performance comparable to other state-ofthe-artmethods.Furthermore,on occlusion datasets,the proposedmethod significantly mitigates the performance degradation caused by occlusion compared to other methods,the accuracy is significantly higher than that of other methods.展开更多
Coral reef limestone(CRL)constitutes a distinctive marine carbonate formation with complex mechanical properties.This study investigates the multiscale damage and fracture mechanisms of CRL through integrated experime...Coral reef limestone(CRL)constitutes a distinctive marine carbonate formation with complex mechanical properties.This study investigates the multiscale damage and fracture mechanisms of CRL through integrated experimental testing,digital core technology,and theoretical modelling.Two CRL types with contrasting mesostructures were characterized across three scales.Macroscopically,CRL-I and CRL-II exhibited mean compressive strengths of 8.46 and 5.17 MPa,respectively.Mesoscopically,CRL-I featured small-scale highly interconnected pores,whilst CRL-II developed larger stratified pores with diminished connectivity.Microscopically,both CRL matrices demonstrated remarkable similarity in mineral composition and mechanical properties.A novel voxel average-based digital core scaling methodology was developed to facilitate numerical simulation of cross-scale damage processes,revealing network-progressive failure in CRL-I versus directional-brittle failure in CRL-II.Furthermore,a damage statistical constitutive model based on digital core technology and mesoscopic homogenisation theory established quantitative relationships between microelement strength distribution and macroscopic mechanical behavior.These findings illuminate the fundamental mechanisms through which mesoscopic structure governs the macroscopic mechanical properties of CRL.展开更多
The fusion of infrared and visible images should emphasize the salient targets in the infrared image while preserving the textural details of the visible images.To meet these requirements,an autoencoder-based method f...The fusion of infrared and visible images should emphasize the salient targets in the infrared image while preserving the textural details of the visible images.To meet these requirements,an autoencoder-based method for infrared and visible image fusion is proposed.The encoder designed according to the optimization objective consists of a base encoder and a detail encoder,which is used to extract low-frequency and high-frequency information from the image.This extraction may lead to some information not being captured,so a compensation encoder is proposed to supplement the missing information.Multi-scale decomposition is also employed to extract image features more comprehensively.The decoder combines low-frequency,high-frequency and supplementary information to obtain multi-scale features.Subsequently,the attention strategy and fusion module are introduced to perform multi-scale fusion for image reconstruction.Experimental results on three datasets show that the fused images generated by this network effectively retain salient targets while being more consistent with human visual perception.展开更多
A nonlinear multi-scale interaction(NMI)model was proposed and developed by the first author for nearly 30 years to represent the evolution of atmospheric blocking.In this review paper,we first review the creation and...A nonlinear multi-scale interaction(NMI)model was proposed and developed by the first author for nearly 30 years to represent the evolution of atmospheric blocking.In this review paper,we first review the creation and development of the NMI model and then emphasize that the NMI model represents a new tool for identifying the basic physics of how climate change influences mid-to-high latitude weather extremes.The building of the NMI model took place over three main periods.In the 1990s,a nonlinear Schr?dinger(NLS)equation model was presented to describe atmospheric blocking as a wave packet;however,it could not depict the lifetime(10-20 days)of atmospheric blocking.In the 2000s,we proposed an NMI model of atmospheric blocking in a uniform basic flow by making a scale-separation assumption and deriving an eddyforced NLS equation.This model succeeded in describing the life cycle of atmospheric blocking.In the 2020s,the NMI model was extended to include the impact of a changing climate mainly by altering the basic zonal winds and the magnitude of the meridional background potential vorticity gradient(PVy).Model results show that when PVy is smaller,blocking has a weaker dispersion and a stronger nonlinearity,so blocking can be more persistent and have a larger zonal scale and weaker eastward movement,thus favoring stronger weather extremes.However,when PVy is much smaller and below a critical threshold under much stronger winter Arctic warming of global warming,atmospheric blocking becomes locally less persistent and shows a much stronger westward movement,which acts to inhibit local cold extremes.Such a case does not happen in summer under global warming because PVy fails to fall below the critical threshold.Thus,our theory indicates that global warming can render summer-blocking anticyclones and mid-to-high latitude heatwaves more persistent,intense,and widespread.展开更多
In this paper,we propose a new method to achieve automatic matching of multi-scale roads under the constraints of smaller scale data.The matching process is:Firstly,meshes are extracted from two different scales road ...In this paper,we propose a new method to achieve automatic matching of multi-scale roads under the constraints of smaller scale data.The matching process is:Firstly,meshes are extracted from two different scales road data.Secondly,several basic meshes in the larger scale road network will be merged into a composite one which is matched with one mesh in the smaller scale road network,to complete the N∶1(N>1)and 1∶1 matching.Thirdly,meshes of the two different scale road data with M∶N(M>1,N>1)matching relationships will be matched.Finally,roads will be classified into two categories under the constraints of meshes:mesh boundary roads and mesh internal roads,and then matchings between the two scales meshes will be carried out within their own categories according to the matching relationships.The results show that roads of different scales will be more precisely matched using the proposed method.展开更多
Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improvin...Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improving survival,even though the underlying mechanisms remain unclear.Preclinical and clinical evidence shows that the acute effects of a single exercise session can suppress the growth of various cancer cell lines in vitro.This suppression is potentially due to altered concentrations of hormones(e.g.,insulin)and cytokines(e.g.,tumor necrosis factor alpha and interleukin 6)after exercise.These factors,known to be involved in tumorigenesis,may explain why exercise is associated with reduced cancer incidence,recurrence,and mortality.However,the effects of short-(<8 weeks)and long-term(≥8 weeks)exercise programs on cancer cells have been reported with mixed results.Although more research is needed,it appears that interventions incorporating both exercise and diet seem to have greater inhibitory effects on cancer cell growth in both apparently healthy subjects as well as in cancer patients.Although speculative,these suppressive effects on cancer cells may be driven by changes in body weight and composition as well as by a reduction in low-grade inflammation often associated with sedentary behavior,low muscle mass,and excess fat mass in cancer patients.Taken together,such interventions could alter the systemic levels of suppressive circulating factors,leading to a less favorable environment for tumorigenesis.While regular exercise and a healthy diet may establish a more cancer-suppressive environment,each acute bout of exercise provides a further“dose”of anticancer medicine.Therefore,integrating regular exercise could potentially play a significant role in cancer management,highlighting the need for future investigations in this promising area of research.展开更多
Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount im...Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount importance for residents,as it fosters critical thinking,problem-solving abilities,and a deeper understanding of applying scientific principles to clinical practice.This paper explores the necessity and significance of integrating research training into residency programs,emphasizing its role in cultivating well-rounded physicians capable of advancing medical knowledge.This study proposes a competency-based research training model that encompasses research literacy,study design,biostatistics,and scientific writing.Additionally,online asynchronous training modules,robust mentorship,and balanced time management strategies are recommended to enhance residents’research engagement without compromising clinical training.By implementing these measures,residency programs can improve residents’research capabilities,contributing to both individual professional growth and the broader advancement of medical science.展开更多
Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhan...Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms.This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture,electrical stimulation,and biofeedback therapy versus conventional therapy consisting of electroacupuncture,electrical stimulation,and biofeedback alone in women with SUI,and to explore the role of PFPT in improving symptom and functional outcomes.Methods:In this randomized controlled trial,72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital,Central South University,between December 2021 and October 2023.Participants were randomly assigned to an experimental group(n=36)or a control group(n=36).Both groups received health education.The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy,while the experimental group additionally received PFPT 3 times per week for 4 weeks.The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF).Secondary outcomes included pelvic floor muscle strength,bladder neck mobility,and balance ability.The ICIQ-SF was reassessed at 1,3,6,and 12 months post-treatment.Results:Both groups showed statistically significant improvements in all parameters after treatment(all P<0.05).However,there were no statistically significant differences between groups in most measures(all P>0.05).The experimental group demonstrated longer singleleg stance duration with eyes closed than the control group(left leg:P=0.026;right leg:P=0.006),with a significant increase from baseline(P<0.001).At 6 months post-treatment,the cure rate in the experimental group was significantly higher than that in the control group(P=0.037).Conclusion:Conventional therapy effectively improves SUI symptoms,but adding PFPT provides notable additional benefits,including enhanced balance ability and sustained midterm cure rates.These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.展开更多
Purpose We aimed to determine:(a)the chronic effects of interval training(IT)combined with blood flow restriction(BFR)on physiological adaptations(aerobic/anaerobic capacity and muscle responses)and performance enhanc...Purpose We aimed to determine:(a)the chronic effects of interval training(IT)combined with blood flow restriction(BFR)on physiological adaptations(aerobic/anaerobic capacity and muscle responses)and performance enhancement(endurance and sprints),and(b)the influence of participant characteristics and intervention protocols on these effects.Methods Searches were conducted in PubMed,Web of Science(Core Collection),Cochrane Library(Embase,ClinicalTrials.gov,and International Clinical Trials Registry Platform),and Chinese National Knowledge Infrastructure on April 2,with updates on October 17,2024.Pooled effects for each outcome were summarized using Hedge's g(g)through meta-analysis-based random effects models,and subgroup and regression analyses were used to explore moderators.Results A total of 24 studies with 621 participants were included.IT combined with BFR(IT+BFR)significantly improved maximal oxygen uptake(VO2_(max))(g=0.63,I^(2)=63%),mean power during the Wingate 30-s test(g=0.70,I^(2)=47%),muscle strength(g=0.88,I^(2)=64%),muscle endurance(g=0.43,I^(2)=0%),time to fatigue(g=1.26,I^(2)=86%),and maximal aerobic speed(g=0.74,I^(2)=0%)compared to IT alone.Subgroup analysis indicated that participant characteristics including training status,IT intensity,and IT modes significantly moderated VO2_(max)(subgroup differences:p<0.05).Specifically,IT+BFR showed significantly superior improvements in VO2_(max)compared to IT alone in trained individuals(g=0.76)at supra-maximal intensity(g=1.29)and moderate intensity(g=1.08)as well as in walking(g=1.64)and running(g=0.63)modes.Meta-regression analysis showed cuff width(β=0.14)was significantly associated with VO2_(max)change,identifying 8.23 cm as the minimum threshold required for significant improvement.Subgroup analyses regarding muscle strength did not reveal any significant moderators.Conclusion IT+BFR enhances physiological adaptations and optimizes aspects of endurance performance,with moderators including training status,IT protocol(intensity,mode,and type),and cuff width.This intervention addresses various IT-related challenges and provides tailored protocols and benefits for diverse populations.展开更多
This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessmen...This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessment Form has been assessed as severe articulation disorder.The patient has significantly improved his speech function and quality of life after systematic head control training,respiratory function training,articulation motor training,and articulation training.In the course of treatment,emphasis was placed on head postural control training and respiratory function training,and emphasis was placed on the strength and coordination training of articulatory organs,and the results were remarkable.After the patient was discharged from the hospital,the follow-up of basic daily life communication was not limited.展开更多
Mental health problems and potential psychological crises affect the healthy growth and learning performance of college students.Effective and suitable prevention of psychological crises among college students is a co...Mental health problems and potential psychological crises affect the healthy growth and learning performance of college students.Effective and suitable prevention of psychological crises among college students is a continuous challenge university managers face.To explore a method of preventing psychological crises among college students,we measured 38661 students by using SCL-90(symptom check list-90)and screened out 5790 students with positive results.Then,we measured 33188 students by using PHQ-9(patient health questionnaire-9)and screened out 603 students with suicidal ideation or behavior;we interviewed 392 students by using GAQ(growth adversity questionnaire).The number of students who had positive results at both phases is 155.As a result,we obtained a data set(N=76)by integrating the students who tested positive on the PHQ-9(i.e.total score≥20)with those who completed the PHQ-9 and GAQ.In addition,we obtained a data set(N=50)by excluding the cases in which the GAQ score is 0.With regard to QCA(qualitative comparative analysis)results,the data set(N=76)exhibits 5 constellations of solutions with a coverage rate greater than 0.7,and the first eight indicators of the PHQ-9 constitute the explanatory variables in the combined solutions.About the data set(N=50),the combined solutions are extremely complicated and the explanatory variables encompass indicators from both the PHQ-9 and GAQ.All these mean that the multi-scale could more comprehensively reflect mental health states of college students,thus enhance the accuracy and effectiveness of the corresponding hierarchical intervention,and finally provide support for preventing psychological crises in universities.展开更多
文摘BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.
基金Opening Foundation of Key Laboratory of Explosive Energy Utilization and Control,Anhui Province(BP20240104)Graduate Innovation Program of China University of Mining and Technology(2024WLJCRCZL049)Postgraduate Research&Practice Innovation Program of Jiangsu Province(KYCX24_2701)。
文摘Because of the challenge of compounding lightweight,high-strength Ti/Al alloys due to their considerable disparity in properties,Al 6063 as intermediate layer was proposed to fabricate TC4/Al 6063/Al 7075 three-layer composite plate by explosive welding.The microscopic properties of each bonding interface were elucidated through field emission scanning electron microscope and electron backscattered diffraction(EBSD).A methodology combining finite element method-smoothed particle hydrodynamics(FEM-SPH)and molecular dynamics(MD)was proposed for the analysis of the forming and evolution characteristics of explosive welding interfaces at multi-scale.The results demonstrate that the bonding interface morphologies of TC4/Al 6063 and Al 6063/Al 7075 exhibit a flat and wavy configuration,without discernible defects or cracks.The phenomenon of grain refinement is observed in the vicinity of the two bonding interfaces.Furthermore,the degree of plastic deformation of TC4 and Al 7075 is more pronounced than that of Al 6063 in the intermediate layer.The interface morphology characteristics obtained by FEM-SPH simulation exhibit a high degree of similarity to the experimental results.MD simulations reveal that the diffusion of interfacial elements predominantly occurs during the unloading phase,and the simulated thickness of interfacial diffusion aligns well with experimental outcomes.The introduction of intermediate layer in the explosive welding process can effectively produce high-quality titanium/aluminum alloy composite plates.Furthermore,this approach offers a multi-scale simulation strategy for the study of explosive welding bonding interfaces.
文摘软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一种基于时差的多输出tri-training异构软测量方法。通过构建一种新的tri-training框架,采用多输出的高斯过程回归(multi-output Gaussian process regression,MGPR)、相关向量机(multi-output relevance vector machine,MRVM)、最小二乘支持向量机(multi-output least squares support vector machine,MLSSVM)三种模型作为基线监督回归器,使用标记数据进行训练和迭代;同时,引入时间差分(time difference,TD)改进模型的动态特性,并通过卡尔曼滤波(Kalman filtering,KF)优化模型的参数,提高其预测性能;最后通过模拟污水处理平台(benchmark simulation model 1,BSM1)和实际污水处理厂对该模型进行了验证。结果表明,与传统的软测量建模方法相比,该模型能显著提高数据分布不平衡下软测量模型的自适应性和预测性能。
基金funded by the Joint Fund for Regional Innovation and Development of National Natural Science Foundation of China(U21A20143)the National Science Fund for Excellent Young Scholars(52322607)the Excellent Youth Foundation of Heilongjiang Scientific Committee(YQ2022E028)。
文摘Improving the volumetric energy density of supercapacitors is essential for practical applications,which highly relies on the dense storage of ions in carbon-based electrodes.The functional units of carbon-based electrode exhibit multi-scale structural characteristics including macroscopic electrode morphologies,mesoscopic microcrystals and pores,and microscopic defects and dopants in the carbon basal plane.Therefore,the ordered combination of multi-scale structures of carbon electrode is crucial for achieving dense energy storage and high volumetric performance by leveraging the functions of various scale structu re.Considering that previous reviews have focused more on the discussion of specific scale structu re of carbon electrodes,this review takes a multi-scale perspective in which recent progresses regarding the structureperformance relationship,underlying mechanism and directional design of carbon-based multi-scale structures including carbon morphology,pore structure,carbon basal plane micro-environment and electrode technology on dense energy storage and volumetric property of supercapacitors are systematically discussed.We analyzed in detail the effects of the morphology,pore,and micro-environment of carbon electrode materials on ion dense storage,summarized the specific effects of different scale structures on volumetric property and recent research progress,and proposed the mutual influence and trade-off relationship between various scale structures.In addition,the challenges and outlooks for improving the dense storage and volumetric performance of carbon-based supercapacitors are analyzed,which can provide feasible technical reference and guidance for the design and manufacture of dense carbon-based electrode materials.
基金supported by Brazilian agencies CAPES(Finance Code 001)CNPq through PQ productivity scholarship.
文摘Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight,body fat,fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024.Risk of bias assessment was performed with RoB 2.0,and the GRADE approach assessed the certainty of evidence(CoE)of each main outcome.We included four publications summing up 202 patients.Two publications used orlistat as an anti-obesity drug treatment,while the other two adopted GLP-1 receptor agonist(liraglutide or tirzepatide)as a pharmacotherapy for weight management.Orlistat combined with exercise was superior to change body weight(mean difference(MD):−2.27 kg;95%CI:−2.86 to−1.69;CoE:very low),fat mass(MD:−2.89;95%CI:−3.87 to−1.91;CoE:very low),fat-free mass(MD:0.56;95%CI:0.40–0.72;CoE:very low),and VO_(2)Peak(MD:2.64;95%CI:2.52–2.76;CoE:very low).GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight(MD:−3.96 kg;95%CI:−5.07 to−2.85;CoE:low),fat mass(MD:−1.76;95%CI:−2.24 to−1.27;CoE:low),fat-free mass(MD:0.50;95%CI:−0.98 to 1.98;CoE:very low)and VO_(2)Peak(MD:2.47;95%CI:1.31–3.63;CoE:very low).The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.
基金supported by the Natural Science Foundation of the Anhui Higher Education Institutions of China(Grant Nos.2023AH040149 and 2024AH051915)the Anhui Provincial Natural Science Foundation(Grant No.2208085MF168)+1 种基金the Science and Technology Innovation Tackle Plan Project of Maanshan(Grant No.2024RGZN001)the Scientific Research Fund Project of Anhui Medical University(Grant No.2023xkj122).
文摘Convolutional neural networks(CNNs)-based medical image segmentation technologies have been widely used in medical image segmentation because of their strong representation and generalization abilities.However,due to the inability to effectively capture global information from images,CNNs can easily lead to loss of contours and textures in segmentation results.Notice that the transformer model can effectively capture the properties of long-range dependencies in the image,and furthermore,combining the CNN and the transformer can effectively extract local details and global contextual features of the image.Motivated by this,we propose a multi-branch and multi-scale attention network(M2ANet)for medical image segmentation,whose architecture consists of three components.Specifically,in the first component,we construct an adaptive multi-branch patch module for parallel extraction of image features to reduce information loss caused by downsampling.In the second component,we apply residual block to the well-known convolutional block attention module to enhance the network’s ability to recognize important features of images and alleviate the phenomenon of gradient vanishing.In the third component,we design a multi-scale feature fusion module,in which we adopt adaptive average pooling and position encoding to enhance contextual features,and then multi-head attention is introduced to further enrich feature representation.Finally,we validate the effectiveness and feasibility of the proposed M2ANet method through comparative experiments on four benchmark medical image segmentation datasets,particularly in the context of preserving contours and textures.
基金supported by the Natural Science Foundation of China(Grant No.42302170)National Postdoctoral Innovative Talent Support Program(Grant No.BX20220062)+3 种基金CNPC Innovation Found(Grant No.2022DQ02-0104)National Science Foundation of Heilongjiang Province of China(Grant No.YQ2023D001)Postdoctoral Science Foundation of Heilongjiang Province of China(Grant No.LBH-Z22091)the Natural Science Foundation of Shandong Province(Grant No.ZR2022YQ30).
文摘Prediction of production decline and evaluation of the adsorbed/free gas ratio are critical for determining the lifespan and production status of shale gas wells.Traditional production prediction methods have some shortcomings because of the low permeability and tightness of shale,complex gas flow behavior of multi-scale gas transport regions and multiple gas transport mechanism superpositions,and complex and variable production regimes of shale gas wells.Recent research has demonstrated the existence of a multi-stage isotope fractionation phenomenon during shale gas production,with the fractionation characteristics of each stage associated with the pore structure,gas in place(GIP),adsorption/desorption,and gas production process.This study presents a new approach for estimating shale gas well production and evaluating the adsorbed/free gas ratio throughout production using isotope fractionation techniques.A reservoir-scale carbon isotope fractionation(CIF)model applicable to the production process of shale gas wells was developed for the first time in this research.In contrast to the traditional model,this model improves production prediction accuracy by simultaneously fitting the gas production rate and δ^(13)C_(1) data and provides a new evaluation method of the adsorbed/free gas ratio during shale gas production.The results indicate that the diffusion and adsorption/desorption properties of rock,bottom-hole flowing pressure(BHP)of gas well,and multi-scale gas transport regions of the reservoir all affect isotope fractionation,with the diffusion and adsorption/desorption parameters of rock having the greatest effect on isotope fractionation being D∗/D,PL,VL,α,and others in that order.We effectively tested the universality of the four-stage isotope fractionation feature and revealed a unique isotope fractionation mechanism caused by the superimposed coupling of multi-scale gas transport regions during shale gas well production.Finally,we applied the established CIF model to a shale gas well in the Sichuan Basin,China,and calculated the estimated ultimate recovery(EUR)of the well to be 3.33×10^(8) m^(3);the adsorbed gas ratio during shale gas production was 1.65%,10.03%,and 23.44%in the first,fifth,and tenth years,respectively.The findings are significant for understanding the isotope fractionation mechanism during natural gas transport in complex systems and for formulating and optimizing unconventional natural gas development strategies.
文摘BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
基金supported by the National Natural Science Foundation of China(62272049,62236006,62172045)the Key Projects of Beijing Union University(ZKZD202301).
文摘In recent years,gait-based emotion recognition has been widely applied in the field of computer vision.However,existing gait emotion recognition methods typically rely on complete human skeleton data,and their accuracy significantly declines when the data is occluded.To enhance the accuracy of gait emotion recognition under occlusion,this paper proposes a Multi-scale Suppression Graph ConvolutionalNetwork(MS-GCN).TheMS-GCN consists of three main components:Joint Interpolation Module(JI Moudle),Multi-scale Temporal Convolution Network(MS-TCN),and Suppression Graph Convolutional Network(SGCN).The JI Module completes the spatially occluded skeletal joints using the(K-Nearest Neighbors)KNN interpolation method.The MS-TCN employs convolutional kernels of various sizes to comprehensively capture the emotional information embedded in the gait,compensating for the temporal occlusion of gait information.The SGCN extracts more non-prominent human gait features by suppressing the extraction of key body part features,thereby reducing the negative impact of occlusion on emotion recognition results.The proposed method is evaluated on two comprehensive datasets:Emotion-Gait,containing 4227 real gaits from sources like BML,ICT-Pollick,and ELMD,and 1000 synthetic gaits generated using STEP-Gen technology,and ELMB,consisting of 3924 gaits,with 1835 labeled with emotions such as“Happy,”“Sad,”“Angry,”and“Neutral.”On the standard datasets Emotion-Gait and ELMB,the proposed method achieved accuracies of 0.900 and 0.896,respectively,attaining performance comparable to other state-ofthe-artmethods.Furthermore,on occlusion datasets,the proposedmethod significantly mitigates the performance degradation caused by occlusion compared to other methods,the accuracy is significantly higher than that of other methods.
基金National Key Research and Development Program of China (No.2021YFC3100800)the National Natural Science Foundation of China (Nos.42407235 and 42271026)+1 种基金the Project of Sanya Yazhou Bay Science and Technology City (No.SCKJ-JYRC-2023-54)supported by the Hefei advanced computing center
文摘Coral reef limestone(CRL)constitutes a distinctive marine carbonate formation with complex mechanical properties.This study investigates the multiscale damage and fracture mechanisms of CRL through integrated experimental testing,digital core technology,and theoretical modelling.Two CRL types with contrasting mesostructures were characterized across three scales.Macroscopically,CRL-I and CRL-II exhibited mean compressive strengths of 8.46 and 5.17 MPa,respectively.Mesoscopically,CRL-I featured small-scale highly interconnected pores,whilst CRL-II developed larger stratified pores with diminished connectivity.Microscopically,both CRL matrices demonstrated remarkable similarity in mineral composition and mechanical properties.A novel voxel average-based digital core scaling methodology was developed to facilitate numerical simulation of cross-scale damage processes,revealing network-progressive failure in CRL-I versus directional-brittle failure in CRL-II.Furthermore,a damage statistical constitutive model based on digital core technology and mesoscopic homogenisation theory established quantitative relationships between microelement strength distribution and macroscopic mechanical behavior.These findings illuminate the fundamental mechanisms through which mesoscopic structure governs the macroscopic mechanical properties of CRL.
基金Supported by the Henan Province Key Research and Development Project(231111211300)the Central Government of Henan Province Guides Local Science and Technology Development Funds(Z20231811005)+2 种基金Henan Province Key Research and Development Project(231111110100)Henan Provincial Outstanding Foreign Scientist Studio(GZS2024006)Henan Provincial Joint Fund for Scientific and Technological Research and Development Plan(Application and Overcoming Technical Barriers)(242103810028)。
文摘The fusion of infrared and visible images should emphasize the salient targets in the infrared image while preserving the textural details of the visible images.To meet these requirements,an autoencoder-based method for infrared and visible image fusion is proposed.The encoder designed according to the optimization objective consists of a base encoder and a detail encoder,which is used to extract low-frequency and high-frequency information from the image.This extraction may lead to some information not being captured,so a compensation encoder is proposed to supplement the missing information.Multi-scale decomposition is also employed to extract image features more comprehensively.The decoder combines low-frequency,high-frequency and supplementary information to obtain multi-scale features.Subsequently,the attention strategy and fusion module are introduced to perform multi-scale fusion for image reconstruction.Experimental results on three datasets show that the fused images generated by this network effectively retain salient targets while being more consistent with human visual perception.
基金supported by the National Natural Science Foundation of China(Grant Nos.42150204 and 2288101)supported by the China National Postdoctoral Program for Innovative Talents(BX20230045)the China Postdoctoral Science Foundation(2023M730279)。
文摘A nonlinear multi-scale interaction(NMI)model was proposed and developed by the first author for nearly 30 years to represent the evolution of atmospheric blocking.In this review paper,we first review the creation and development of the NMI model and then emphasize that the NMI model represents a new tool for identifying the basic physics of how climate change influences mid-to-high latitude weather extremes.The building of the NMI model took place over three main periods.In the 1990s,a nonlinear Schr?dinger(NLS)equation model was presented to describe atmospheric blocking as a wave packet;however,it could not depict the lifetime(10-20 days)of atmospheric blocking.In the 2000s,we proposed an NMI model of atmospheric blocking in a uniform basic flow by making a scale-separation assumption and deriving an eddyforced NLS equation.This model succeeded in describing the life cycle of atmospheric blocking.In the 2020s,the NMI model was extended to include the impact of a changing climate mainly by altering the basic zonal winds and the magnitude of the meridional background potential vorticity gradient(PVy).Model results show that when PVy is smaller,blocking has a weaker dispersion and a stronger nonlinearity,so blocking can be more persistent and have a larger zonal scale and weaker eastward movement,thus favoring stronger weather extremes.However,when PVy is much smaller and below a critical threshold under much stronger winter Arctic warming of global warming,atmospheric blocking becomes locally less persistent and shows a much stronger westward movement,which acts to inhibit local cold extremes.Such a case does not happen in summer under global warming because PVy fails to fall below the critical threshold.Thus,our theory indicates that global warming can render summer-blocking anticyclones and mid-to-high latitude heatwaves more persistent,intense,and widespread.
基金The National Natural Science Foundation of China(Nos.4110136241471386)。
文摘In this paper,we propose a new method to achieve automatic matching of multi-scale roads under the constraints of smaller scale data.The matching process is:Firstly,meshes are extracted from two different scales road data.Secondly,several basic meshes in the larger scale road network will be merged into a composite one which is matched with one mesh in the smaller scale road network,to complete the N∶1(N>1)and 1∶1 matching.Thirdly,meshes of the two different scale road data with M∶N(M>1,N>1)matching relationships will be matched.Finally,roads will be classified into two categories under the constraints of meshes:mesh boundary roads and mesh internal roads,and then matchings between the two scales meshes will be carried out within their own categories according to the matching relationships.The results show that roads of different scales will be more precisely matched using the proposed method.
文摘Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improving survival,even though the underlying mechanisms remain unclear.Preclinical and clinical evidence shows that the acute effects of a single exercise session can suppress the growth of various cancer cell lines in vitro.This suppression is potentially due to altered concentrations of hormones(e.g.,insulin)and cytokines(e.g.,tumor necrosis factor alpha and interleukin 6)after exercise.These factors,known to be involved in tumorigenesis,may explain why exercise is associated with reduced cancer incidence,recurrence,and mortality.However,the effects of short-(<8 weeks)and long-term(≥8 weeks)exercise programs on cancer cells have been reported with mixed results.Although more research is needed,it appears that interventions incorporating both exercise and diet seem to have greater inhibitory effects on cancer cell growth in both apparently healthy subjects as well as in cancer patients.Although speculative,these suppressive effects on cancer cells may be driven by changes in body weight and composition as well as by a reduction in low-grade inflammation often associated with sedentary behavior,low muscle mass,and excess fat mass in cancer patients.Taken together,such interventions could alter the systemic levels of suppressive circulating factors,leading to a less favorable environment for tumorigenesis.While regular exercise and a healthy diet may establish a more cancer-suppressive environment,each acute bout of exercise provides a further“dose”of anticancer medicine.Therefore,integrating regular exercise could potentially play a significant role in cancer management,highlighting the need for future investigations in this promising area of research.
基金Research on the Construction of a Course Ideological and Political Education System and Evaluation Framework for the“Traditional Chinese Medicine Internal Medicine”Course(Project No.:2025J0459)Open Research Fund Program of Yunnan Key Laboratory of Integrated Traditional Chinese(Project No.:CWCD2023-002,CWCD2023-003&CWCD2023-009)+2 种基金Western Medicine for Chronic Disease in Prevention and TreatmentYunnan 047 Key Laboratory of Yi Dai Medicine and Yi Medicine(Project No.:2024SS24047)Yunnan 025 Key Laboratory of Yi Dai Medicine and Yi Medicine(Project No.:2024SS24025)。
文摘Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount importance for residents,as it fosters critical thinking,problem-solving abilities,and a deeper understanding of applying scientific principles to clinical practice.This paper explores the necessity and significance of integrating research training into residency programs,emphasizing its role in cultivating well-rounded physicians capable of advancing medical knowledge.This study proposes a competency-based research training model that encompasses research literacy,study design,biostatistics,and scientific writing.Additionally,online asynchronous training modules,robust mentorship,and balanced time management strategies are recommended to enhance residents’research engagement without compromising clinical training.By implementing these measures,residency programs can improve residents’research capabilities,contributing to both individual professional growth and the broader advancement of medical science.
基金supported by the Natural Science Foundation of Hunan Province(2024JJ8121,2024JJ6626)the Hunan Provincial Key Research and Development Program(2023SK2038),China.
文摘Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms.This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture,electrical stimulation,and biofeedback therapy versus conventional therapy consisting of electroacupuncture,electrical stimulation,and biofeedback alone in women with SUI,and to explore the role of PFPT in improving symptom and functional outcomes.Methods:In this randomized controlled trial,72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital,Central South University,between December 2021 and October 2023.Participants were randomly assigned to an experimental group(n=36)or a control group(n=36).Both groups received health education.The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy,while the experimental group additionally received PFPT 3 times per week for 4 weeks.The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF).Secondary outcomes included pelvic floor muscle strength,bladder neck mobility,and balance ability.The ICIQ-SF was reassessed at 1,3,6,and 12 months post-treatment.Results:Both groups showed statistically significant improvements in all parameters after treatment(all P<0.05).However,there were no statistically significant differences between groups in most measures(all P>0.05).The experimental group demonstrated longer singleleg stance duration with eyes closed than the control group(left leg:P=0.026;right leg:P=0.006),with a significant increase from baseline(P<0.001).At 6 months post-treatment,the cure rate in the experimental group was significantly higher than that in the control group(P=0.037).Conclusion:Conventional therapy effectively improves SUI symptoms,but adding PFPT provides notable additional benefits,including enhanced balance ability and sustained midterm cure rates.These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
文摘Purpose We aimed to determine:(a)the chronic effects of interval training(IT)combined with blood flow restriction(BFR)on physiological adaptations(aerobic/anaerobic capacity and muscle responses)and performance enhancement(endurance and sprints),and(b)the influence of participant characteristics and intervention protocols on these effects.Methods Searches were conducted in PubMed,Web of Science(Core Collection),Cochrane Library(Embase,ClinicalTrials.gov,and International Clinical Trials Registry Platform),and Chinese National Knowledge Infrastructure on April 2,with updates on October 17,2024.Pooled effects for each outcome were summarized using Hedge's g(g)through meta-analysis-based random effects models,and subgroup and regression analyses were used to explore moderators.Results A total of 24 studies with 621 participants were included.IT combined with BFR(IT+BFR)significantly improved maximal oxygen uptake(VO2_(max))(g=0.63,I^(2)=63%),mean power during the Wingate 30-s test(g=0.70,I^(2)=47%),muscle strength(g=0.88,I^(2)=64%),muscle endurance(g=0.43,I^(2)=0%),time to fatigue(g=1.26,I^(2)=86%),and maximal aerobic speed(g=0.74,I^(2)=0%)compared to IT alone.Subgroup analysis indicated that participant characteristics including training status,IT intensity,and IT modes significantly moderated VO2_(max)(subgroup differences:p<0.05).Specifically,IT+BFR showed significantly superior improvements in VO2_(max)compared to IT alone in trained individuals(g=0.76)at supra-maximal intensity(g=1.29)and moderate intensity(g=1.08)as well as in walking(g=1.64)and running(g=0.63)modes.Meta-regression analysis showed cuff width(β=0.14)was significantly associated with VO2_(max)change,identifying 8.23 cm as the minimum threshold required for significant improvement.Subgroup analyses regarding muscle strength did not reveal any significant moderators.Conclusion IT+BFR enhances physiological adaptations and optimizes aspects of endurance performance,with moderators including training status,IT protocol(intensity,mode,and type),and cuff width.This intervention addresses various IT-related challenges and provides tailored protocols and benefits for diverse populations.
基金Teaching and Research Project of Anhui Urban Management Vocational College(Project No.:2024kfkc001)。
文摘This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessment Form has been assessed as severe articulation disorder.The patient has significantly improved his speech function and quality of life after systematic head control training,respiratory function training,articulation motor training,and articulation training.In the course of treatment,emphasis was placed on head postural control training and respiratory function training,and emphasis was placed on the strength and coordination training of articulatory organs,and the results were remarkable.After the patient was discharged from the hospital,the follow-up of basic daily life communication was not limited.
文摘Mental health problems and potential psychological crises affect the healthy growth and learning performance of college students.Effective and suitable prevention of psychological crises among college students is a continuous challenge university managers face.To explore a method of preventing psychological crises among college students,we measured 38661 students by using SCL-90(symptom check list-90)and screened out 5790 students with positive results.Then,we measured 33188 students by using PHQ-9(patient health questionnaire-9)and screened out 603 students with suicidal ideation or behavior;we interviewed 392 students by using GAQ(growth adversity questionnaire).The number of students who had positive results at both phases is 155.As a result,we obtained a data set(N=76)by integrating the students who tested positive on the PHQ-9(i.e.total score≥20)with those who completed the PHQ-9 and GAQ.In addition,we obtained a data set(N=50)by excluding the cases in which the GAQ score is 0.With regard to QCA(qualitative comparative analysis)results,the data set(N=76)exhibits 5 constellations of solutions with a coverage rate greater than 0.7,and the first eight indicators of the PHQ-9 constitute the explanatory variables in the combined solutions.About the data set(N=50),the combined solutions are extremely complicated and the explanatory variables encompass indicators from both the PHQ-9 and GAQ.All these mean that the multi-scale could more comprehensively reflect mental health states of college students,thus enhance the accuracy and effectiveness of the corresponding hierarchical intervention,and finally provide support for preventing psychological crises in universities.
