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Low back pain is one of the most prevalent pain conditions worldwide. Virtual reality-based training has been used for low back pain as a new treatment strategy. Present evidence indicated that the effectiveness of virtual reality-based training for people with chronic low back pain is inconclusive. This study conducted a meta-analysis to evaluate the immediate- and short-term effects of virtual reality-based training on pain, pain-related fear, and disability in people with chronic low back pain. We searched the PubMed, Embase, Web of Science, PEDro, CENTRAL, and CINAHL databases from inception until January 2024. Only randomized controlled trials assessing the effects of virtual reality-based training on individuals with chronic low back pain were selected. The outcomes were focused on pain, pain-related fear measured by the Tampa Scale of Kinesiophobia, and disability measured by the Oswestry Disability Index. The immediate term was defined as the immediate period after intervention, and the short term was defined as 3 to 6 months after intervention. The Cochrane Risk of Bias tool and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach were used to evaluate the quality of the methodology and evidence, respectively. In total, 20 randomized controlled trials involving 1059 patients were eligible for analysis. Virtual reality-based training showed significant improvements in pain (mean difference [MD] -1.43; 95% CI -1.86 to -1.00; I =95%; P<.001), pain-related fear using the Tampa Scale of Kinesiophobia (MD -5.46; 95% CI -9.40 to 1.52; I =90%; P=.007), and disability using the Oswestry Disability Index (MD -11.50; 95% CI -20.00 to -3.01; I =95%; P=.008) in individuals with chronic low back pain immediately after interventions. However, there were no significant differences observed in pain (P=.16), pain-related fear (P=.10), and disability (P=.43) in the short term. These findings indicated that virtual reality-based training can be used effectively for individuals with chronic low back pain in the immediate term, especially to reduce pain, alleviate pain-related fear, and improve disability. However, the short-term benefits need more high-quality trials to be demonstrated. PROSPERO CRD42021292633; http://tinyurl.com/25mydxpz.

Mesozoic contraction deformation in the Yanshan and Taihang mountains is characterized by basement-involved thrust tectonics,basement-cored buckling anticlines and ductile thrust and nappe tectonics.Most of these deformations are orientated west-east,west-northwest and northeast to north-northeast.The contraction deformations began in the Permian,continued through the Triassic and Jurassic and terminated in the Early Cretaceous,and constitute an important part of the destruction of the North China Craton.It is estimated,from balanced cross-section reconstructions,that the north-south shortening of the central part of the Yanshan belt before 135 Ma was around 38%.The initial crust thickness,pre-dating the major contraction deformation in late Paleozoic and early Mesozoic,was estimated to be around 35 km based on paleogeographic characteristics.Assuming that the inferred depth of ductile thrusting deformation,20-25 km,was the crust thickness involved in the contraction deformation,and also assuming that the N-S contraction deformation was accommodated by vertical crust thickening,the thickness of the crust after the contraction deformation was expected to be around 47-50 km.This was the approximate crust thickness required for the eclogitization of the lower crust for delamination.The gravity potential accumulated by the isostatic uplift of the thickened crust,together with the decrease in crustal strength caused by the coeval magmatisms associated with the contraction deformation,led to the subsequent extensional collapse of the middle and upper crust although the regional stress regime associated with the plate interactions remained constant.It is inferred that the Mesozoic contraction deformations in the Yanshan and Taihang mountains were not only a significant tectonic process contributing to the destruction of the craton in middle and upper crust but also stimulated delamination at a deep level and the extension of the shallow crust.In other words,both the suspected delamination of the lower crust and upper mantle and the well constrained extension deformations of the shallow crust in the eastern North China Craton during the late Mesozoic are a consequence of crust thickening due to previous contractions.Extensional deformations could be expected to occur independently in the shallow crust,and are not necessarily associated with or responding to delamination at a deep level.

Background: With the incidence of cardiovascular disease (CVD) escalating annually, the significance of investigating the correlation between inflammatory markers and lipid‐related indices, notably the neutrophil‐to‐lymphocyte ratio (NLR) and atherogenic index of plasma (AIP), is increasingly paramount. This study aimed to elucidate the distinct and combined roles of NLR and AIP concerning the incidence of CVD. Methods: Diagnoses of CVD were established based on self‐reported standardized medical condition questionnaires from participants. NLR was computed by dividing the peripheral blood neutrophil count by the lymphocyte count. AIP was calculated as log [triglyceride (TG, mg/dL)/high‐density lipoprotein cholesterol (HDL‐C, mg/dL)]. The study’s primary outcome was the incidence of CVD. To ensure the reliability and accuracy of the results, the analysis incorporated sample weights and complex survey designs. Results: The final analysis included 13,184 individuals. Higher levels of NLR and AIP were independently associated with CVD. After adjusting for all variables, compared to Q1 of AIP or NLR, Q4 of AIP (OR 1.54, 95% CI: 1.19–1.98) and NLR (OR 1.54, 95% CI: 1.19–1.98) was significantly associated with CVD. The joint effects showed that participants with higher levels of NLR and AIP had a significantly higher OR of 1.41(1.06, 1.87). The combination of NLR and AIP has better predictive efficacy (AUC: 0.629) for CVD than alone. Conclusion: This cohort suggests combined effects between the NLR and AIP on CVD. Our findings provide clinical implications for monitoring and managing NLR and AIP levels to mitigate the development of CVD.

Background Metabolic syndrome (MetS) is a cluster of risk factors including increased triglycerides, insulin resistance, and hypertension, posing increasing public health challenges. Both cardiorespiratory fitness (CRF) and the Triglyceride-Glucose (TyG) index have been associated with MetS risk independently. However, their combined predictive value remains unclear. This study aims to assess the combined influence of CRF and TyG index on MetS risk in a survey sample. Methods Data from 3742 participants in the National Health and Nutrition Examination Survey (NHANES) in year cycle of 1999–2004 were analyzed. Logistic regression and restricted cubic spline (RCS) analyses were used to evaluate the associations of CRF and TyG index with MetS risk. Subgroup analyses by different CRF, TyG, and disease conditions were conducted to explore interaction effects across different populations. Sensitivity analysis was implemented to verify the robustness of the results. Predictive value was assessed using net reclassification improvement (NRI), integrated discrimination improvement (IDI), and area under the curve (AUC) of receiver operating characteristic (ROC) curve. Results Logistic regression showed that impaired CRF was associated with a 73% higher risk of MetS (Odds Ratio (OR) 1.73; 95% Confidence Interval (CI), 1.23–2.42), while elevated TyG index was associated with a 6.84-fold increased risk (OR 6.84; 95% CI, 2.71–17.29). The combination of impaired CRF and high TyG index showed the highest risk of MetS (OR 11.99; 95% CI, 3.79–37.98). In sensitivity analysis, the results remained similar. Subgroup and interaction analyses further confirmed these findings, showing consistent results across demographic groups and under various analytical conditions. The combined use of CRF and TyG index significantly enhanced the predictive performance (AUC 0.871; 95% CI, 0.856–0.886) and improved model classification capabilities (NRI 0.393; 95% CI, 0.309–0.476; IDI 0.020; 95% CI, 0.014–0.025). Conclusions This study reveals that CRF and TyG index independently predict MetS risk, while their combination demonstrates superior predictive accuracy compared to using either parameter alone. These findings indicate that integrating both CRF and TyG into clinical practice may improve early detection and preventive strategies for MetS.

Background As cardiovascular disease (CVD) morbidity and mortality increase yearly, this study aimed to explore the potential of the weight-adjusted-waist index (WWI) and its relation to long-term mortality in patients with CVD. Methods The diagnosis of CVD was based on standardized medical condition questionnaires that incorporated participants’ self-reported physician diagnoses. WWI (cm/√kg) is a continuous variable and calculated as waist circumference (WC, cm) divided by square root of body weight (kg). For analysis purposes, the participants were divided into four groups based on the quartiles (Q1 – Q4) of the WWI. The study’s primary outcome was all-cause mortality in patients with CVD, with cardiovascular mortality as the secondary outcome, and sample weights and complex survey designs were used to ensure reliable, accurate results. Results The final analysis included 4,445 study participants. In the fully adjusted model, the highest quartile (WWI > 12.05 cm/√ kg) showed a higher all-cause mortality rate compared with the lowest quartile (WWI < 11.03 cm/√ kg) (HR = 1.37, 95% CI: 1.03, 1.82, P  < 0.05). The risk of all-cause mortality increased with WWI and showed a linear association in patients with congestive heart failure, heart attack ( P -overall < 0.05, P  − nonlinear > 0.05); WWI was nonlinearly associated with the risk of all-cause mortality in patients with coronary heart disease and angina ( P -overall < 0.05, P  − nonlinear < 0.05). Survival curve analysis further showed that all cause and cardiovascular mortality were higher in the high WWI group (Q4) ( P  < 0.001). The time-dependent receiver operating characteristic (ROC) curve showed that WWI’s area under the curves (AUC) for 5- and 10-year survival rates were 0.76 and 0.792 for all-cause mortality and 0.734 and 0.757 for CVD mortality. WWI’s AUC were higher than those of body mass index (BMI) and WC (all P  < 0.01). Conclusion Our findings indicate that a high WWI is positively associated with an increased risk of all-cause mortality. Additionally, the high AUC values for WWI strengthen its potential as a meaningful prognostic marker, underscoring its utility in clinical practice for assessing long-term survival risk in patients with CVD.

The increasing use of large external hanging jib tower cranes in super‐tall building construction necessitates a deeper understanding of their anchorage systems to ensure structural safety and efficiency. Conventional design assumes uniform force distribution, but actual load patterns during crane operation are uncertain. This study bridges this gap through an integrated approach combining field monitoring and numerical simulation, focusing on the ZSL1700 tower crane in the 428‐m Greenland Shandong International Financial Center (IFC). Field strain data under varying crane rotation angles were compared with 3D3S simulations. The resulting stress differential errors were below 15%, validating the model. The study highlights nonuniform stress distribution at anchorage interfaces, with localized stress concentrations during specific operational phases. The lower attachment frame bears significantly larger forces than the upper frame, and critical stress peaks occur at rotation angles of 0°, 135°, and 180°. Vertical forces on the lower frame create unfavorable bending moments at the tower base, while wind direction parallel to the crane’s jib increases forces by ~22%, underscoring the importance of wind considerations in design. These findings provide essential theoretical insights for optimizing anchorage systems and enhancing structural safety in super‐tall building construction.

Aficamten is a next‐in‐class, cardiac myosin inhibitor in development as a potential chronic oral treatment for patients with hypertrophic cardiomyopathy (HCM). A population pharmacokinetic (PK) model was developed using data from nine clinical studies to characterize aficamten PK and identify covariates that may alter aficamten exposure. Aficamten PK was best described by a 2‐compartment model with linear elimination and first‐order absorption following a time lag (Tlag). Population parameter estimates for a typical male participant with obstructive HCM (oHCM) and weighing 80 kg were: apparent clearance (CL/F), 2.62 L/h; apparent volume of the central compartment (Vc/F), 18.1 L; apparent intercompartmental clearance (Q/F), 57.6 L/h; and apparent volume of the peripheral compartment (Vp/F), 295 L. Estimated interindividual variability on CL/F and overall residual error (includes within‐subject variability) was low; the coefficient of variation was 28.7% and 20.3%, respectively. Body weight on volume and clearance, population and sex on CL/F and Vp/F were identified as statistically significant covariates. A male patient with a baseline body weight of 56 kg (5th percentile of the population) exhibited a 23% higher AUCtau compared with a male patient with a typical body weight of 80 kg. Female patients demonstrated a 14.7% higher AUCtau than male patients of the same body weight. Healthy participants had a 23% lower AUCtau compared with participants with oHCM. This population PK analysis demonstrated that aficamten has a linear and predictable PK profile, with a favorable half‐life and time‐to‐steady state, and low interindividual variability on CL/F and overall residual error (includes within‐subject variability).

Purpose To characterize the population pharmacokinetics (PK) of pertuzumab across clinical trials in a variety of solid tumors, evaluate the potential impact of patient characteristics on PK, and confirm the appropriateness of the fixed (non-weight-based) dose. Methods Pertuzumab concentration data collected following intravenous administration during eleven phase I/II studies and the pivotal phase III trial CLEOPATRA were analyzed using nonlinear mixed-effects modeling. The potential impact of patient and laboratory characteristics and HER2 target-related variables on pertuzumab PK were investigated in a covariate analysis. The final model was used to confirm selection of fixed, non-weight-based dosing of pertuzumab, and to compare pertuzumab PK in CLEOPATRA with the other studies. Results The analysis included 4,525 serum concentration measurements from 481 patients with solid tumors. Pertuzumab PK in the 2–25 mg/kg dose range was described by a two-compartment linear model with first-order elimination. The elimination clearance and central compartment volume were 0.235 L/day, and 3.11 L, respectively, and the terminal elimination half-life was 18.0 days. Baseline serum albumin and lean body weight had statistically significant effects on pertuzumab clearance; however, simulations showed that the magnitude of their effects on pertuzumab exposure was minimal compared with overall variability and was not clinically relevant. Thus, variations in these factors do not require dose adjustments. Conclusions The fixed, non-weight-based dosing of pertuzumab, 840 mg loading dose followed by a 420 mg maintenance dose every 3 weeks, in patients with the solid tumors in this analysis is well supported by the population pharmacokinetic modeling and simulation results.

Atherosclerosis serves as the core pathological basis of cardiovascular, cerebrovascular, and peripheral arterial diseases, posing a serious threat to human health. However, current mainstream treatments such as statin drugs and stent implantation are associated with significant side effects or limited efficacy, highlighting the urgent need for new therapeutic strategies. Pulsed electromagnetic fields (PEMFs), due to their noninvasive nature and anti-inflammatory properties, show potential in the treatment of atherosclerosis. This study utilized ApoE-/- mice, ApoE-/-NLRP3-/- knockout mice, human umbilical vein endothelial cells (HUVECs), human aortic endothelial cells (HAECs), and human plasma samples for experiments, revealing significant endothelial cell (EC) inflammation and pyroptosis during the progression of atherosclerosis. PEMFs were found to effectively inhibit the activation of the NLRP3 inflammasome, reduce plaque formation, and delay the progression of atherosclerosis. Proteomic analysis of plasma from atherosclerosis patients further indicated elevated expression levels of proteins related to inflammation and pyroptosis, with particularly notable changes in membrane proteins. Mechanistic studies demonstrated that PEMFs improve mitochondrial dysfunction in ECs by regulating membrane tension and the mechanosensitive tension-mediated transient receptor potential vanilloid 4 (TRPV4) channels, thereby reducing pyroptosis. This discovery not only reveals a novel mechanobiological pathway but also provides a solid theoretical foundation for the development of PEMF-based therapies for atherosclerosis. Schematic diagram of the mechanism by which PEMFs treat atherosclerosis (created in BioRender). Wei, B. (2025) https://BioRender.com/undefined ).

Water molecules and cations with mono, binary, and triple valences have been intercalated into V2O5 to significantly improve its electrochemical properties as a cathode material of zinc-ion batteries. Sn as a tetravalent element is supposed to interact aggressively with the V2O5 layer and have a significant impact on the electrochemical performance of V2O5. However, it has been rarely investigated as a pre-intercalated ion in previous works. Hence, it is intriguing and beneficial to develop water molecules and Sn co-doped V2O5 for zinc-ion batteries. Herein, Sn-doped hydrated V2O5 nanosheets were prepared by a one-step hydrothermal synthesis, and they demonstrated that they had a high specific capacity of 374 mAh/g at 100 mA/g. Meanwhile, they also showed an exceptional rate capability with 301 mAh/g even at a large current density of 10 A/g, while it was only 40 mAh/g for the pristine hydrated V2O5, and an excellent cycling life (87.2% after 2500 cycles at 5 A/g), which was far more than the 25% of the pure hydrated V2O5. The dramatic improvement of the rate and cycling performance is mainly attributed to the faster charge transfer kinetics and the enhanced crystalline framework. The remarkable electrochemical performance makes the Sn-doped hydrate V2O5 a potential cathode material for zinc-ion batteries.