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Background Postoperative nausea and vomiting (PONV) is significantly associated with intraoperative opioid use. Oliceridine, a μ-opioid receptor agonist with G protein bias, exhibits fewer opioid-related adverse events (ORAEs) than morphine. This study aims to evaluate the effect of oliceridine versus fentanyl on the incidence of PONV in female patients undergoing laparoscopic cholecystectomy. Methods This is a single-center, randomized controlled trial conducted at Changshu No. 2 People's Hospital in China. A total of 228 female patients scheduled for elective laparoscopic cholecystectomy will be enrolled in this trial and randomly assigned in a 1:1 ratio to receive either oliceridine (Group O) or fentanyl (Group F) for intraoperative analgesia. The primary endpoint is the incidence of PONV during the first 24 h postoperatively. The secondary endpoints consist of the severity and timing of the initial occurrence of PONV, the requirement for antiemetics and rescue analgesia, postoperative pain assessments, time to first flatus and extubation, postoperative sleep quality, intraoperative consumption of anesthetics and vasopressors, and perioperative adverse effects. Discussion We hypothesize that oliceridine may offer effective analgesia and a lower incidence of PONV than fentanyl in intraoperative pain management for this high-risk group. The findings may provide valuable insights into optimizing perioperative pain management strategies and enhancing patient recovery. Trial registration Chinese Clinical Trial Registry ChiCTR2500096538. Registered on 26 January 2025

Background Tracheal intubation may cause significant hemodynamic responses. Many drugs have been shown to be effective in modifying these cardiovascular responses, including remifentanil, fentanyl, sufentanil, and alfentanil. However, the 90% effect-site concentration (EC90) of remifentanil required to control cardiovascular responses to tracheal intubation when combined with ciprofol remains unclear. The purpose of this study was to determine the EC90 of remifentanil inhibiting cardiovascular responses to tracheal intubation during anesthesia induction with ciprofol using biased-coin design up-and-down sequential method (BC-UDM). Methods This is a prospective sequential allocation dose-finding study. American Society of Anesthesiologists physical status (ASA) I–II elective surgical patients receiving target-controlled infusion (TCI) of remifentanil effect-site concentration (Ce), followed by ciprofol and rocuronium for anesthesia, were enrolled. The cardiovascular response to tracheal intubation was defined as positive when mean arterial pressure (MAP) or heart rate (HR) is 15% higher than the baseline value. Using the BC-UDM, the Ce of remifentanil was determined based on the cardiovascular response to tracheal intubation of the previous patient. The EC90 and 90% confidence intervals (90% CIs) were estimated by R-Foundation centered isotonic regression and the pooled adjacent violators algorithm with bootstrapping. Discussion The results of this study sought to demonstrate EC90 of remifentanil blunting sympathetic responses to tracheal intubation during anesthesia index (Ai)-guided ciprofol anesthesia using BCD-UDM. It may help to minimize the cardiovascular responses to tracheal intubation. Trial registration Chinese Clinical Trial Registry ChiCTR2300078275. Registered on December 3, 2023.

Oliceridine is a μ-opioid receptor agonist that selectively activates the G-protein signaling pathway, offering a potential advantage over traditional opioids by reducing respiratory depression and gastrointestinal reactions. This study aimed to determine the 90% effective dose (ED90) of oliceridine for inhibiting responses to laryngeal mask airway (LMA) insertion under etomidate anesthesia in patients of different ages. This prospective Biased-Coin Sequential Allocation Dose-Finding Trial initially enrolled 120 patients scheduled for LMA anesthesia, divided into two age groups: young-to-middle-aged (Group A, 18-64 years) and elderly (Group B, 65-79 years). The initial dose of oliceridine was 0.02 mg/kg, with dose spacing of 0.002 mg/kg. Dose adjustments for subsequent patients were based on the previous subject's response. If movement, frowning, tearing, coughing, or hemodynamic parameters exceeding 20% above baseline occurred during LMA insertion, the dose was considered inadequate, and the dose for the next patient was increased. Otherwise, biased-coin randomization was applied to the next patient, with an 89% probability of maintaining the same dose and an 11% probability of reducing the dose. The primary outcome was the ED90 and 95% confidence intervals (CIs) for oliceridine combined with etomidate in inhibiting responses to LMA insertion. A total of 113 patients met the study criteria and were included in the final analysis (58 in the group A and 55 in the group B). The ED90 of Oliceridine was 0.0246 mg/kg (95% CI: 0.0215-0.0320 mg/kg) and 0.0229 mg/kg (95% CI: 0.0199-0.0298 mg/kg), respectively. No significant difference in ED90 was observed between the two groups ( > 0.05). The ED90 of oliceridine for inhibiting LMA insertion responses, when combined with 0.25 mg/kg etomidate, was 0.0246 mg/kg in young-to-middle-aged patients and 0.0229 mg/kg in elderly patients. The study was registered with the Chinese Clinical Trial Registry (ChiCTR2500095893) on January 25, 2025.

BackgroundEarly detection of lung cancer to allow curative treatment remains challenging. Cell-free circulating tumour (ct) DNA (ctDNA) analysis may aid in malignancy assessment and early cancer diagnosis of lung nodules found in screening imagery.MethodsThe multicentre clinical study enrolled 192 patients with operable occupying lung diseases. Plasma ctDNA, white cell count genomic DNA (gDNA) and tumour tissue gDNA of each patient were analysed by ultra-deep sequencing to an average of 35 000× of the coding regions of 65 lung cancer-related genes.ResultsThe cohort consists of a quarter of benign lung diseases and three quarters of cancer patients with all histopathology subtypes. 64% of the cancer patients are at stage I. Gene mutations detection in tissue gDNA and plasma ctDNA results in a sensitivity of 91% and specificity of 88%. When ctDNA assay was used as the test, the sensitivity was 69% and specificity 96%. As for the lung cancer patients, the assay detected 63%, 83%, 94% and 100%, for stages I, II, III and IV, respectively. In a linear discriminant analysis, combination of ctDNA, patient age and a panel of serum biomarkers boosted the overall sensitivity to 80% at a specificity of 99%. 29 out of the 65 genes harboured mutations in the patients with lung cancer with the largest number found in TP53 (30% plasma and 62% tumour tissue samples) and EGFR (20% and 40%, respectively).ConclusionPlasma ctDNA was analysed in lung nodule assessment and early cancer detection, while an algorithm combining clinical information enhanced the test performance.Trial registration number NCT03081741.

Bone homeostasis only exists when the physical function of osteoblast and osteoclast stays in the balance between bone formation and resorption. Bone resorption occurs when the two processes are uncoupled, shifting the balance in favour of bone resorption. Excessive activation of osteoclasts leads to a range of osteolytic bone diseases including osteoporosis, aseptic prosthesis loosening, rheumatoid arthritis, and osteoarthritis. Receptor activator of nuclear factor kappa-B ligand (RANKL) and its downstream signaling pathways are recognized as key mediators that drive the formation and activation of osteoclastic function. Hence, osteoclast formation and/or its function remain as dominant targets for research and development of agents reaching the treatment towards osteolytic diseases. Chrysin (CHR) is a flavonoid with a wide range of anti-inflammatory and anti-tumor effects. However, its effect on osteoclasts remains unknown. In this study, we found the effects of CHR on inhibiting osteoclast differentiation which were assessed in terms of the number and size of TRAcP positive multinucleated osteoclasts (OCs). Further, the inhibitory effects of CHR on bone resorption and osteoclast fusion of pre-OC were assessed by hydroxyapatite resorption pit assay and F-actin belts staining; respectively. Western blotting analysis of RANKL-induced signaling pathways and immunofluorescence analysis for p65 nuclear translocation in response to RANKL-induced osteoclasts were used to analyze the mechanism of action of CHR affecting osteoclasts. Lastly, the murine calvarial osteolysis model revealed that CHR could protect against particle-induced bone destruction in vivo . Collectively, our data strongly suggested that CHR with its promising anti-tumor effects would also be a potential therapeutic agent for osteolytic diseases.

In this study, we developed a method for coordinating and optimizing the train connection plans of different lines under the conditions of urban rail transit (URT) network operation. The method allows trains of different lines to form good connections at transfer stations, which can shorten the waiting time of passengers for transfers and reduce passenger retention. A mathematical model was developed to simulate the interaction between passengers and trains. Two optimization models were developed for the train connection plan of network transfer stations based on different optimization objectives during peak and off-peak hours. Subsequently, a corresponding solution method based on a genetic algorithm and simulation was designed. Finally, the Suzhou URT network was used as a case study, and the passenger flow of the transfer station was simulated and calculated using relevant automatic fare collection (AFC) data. The results indicated that the average waiting time and the number of passengers stranded were reduced using the proposed method. The calculation example demonstrated the effectiveness of the model and algorithm, which can guide the coordinated preparation of a network train connection plan.

This study presents a wafer-level sealed silicon cavity (SSC) microacoustic integration platform to address the limitations in the cavity Silicon-on-Insulator (C-SOI) wafers for the 5G/6G wireless communication system. The proposed SSC platform features an extremely smooth suspended membrane with adjustable thickness, flexible cavity shapes with high density, self-formed acoustic wave confinement steps, stable temperature coefficient of frequency (TCF), and highly integrated compatibility with complementary metal-oxide semiconductor (CMOS). A surface smoothing method based on wet oxidation for SSC wafers is presented, which achieves a root mean square (RMS) roughness on the cavity surface of 1.5 nm for the first time. Based on the presented SSC platform, an Al 0.75 Sc 0.25 N sealed cavity bulk acoustic wave resonator (S-BAR) is designed, fabricated, and characterized. The experimental results show that the asymmetric second-order (A2) Lamb mode of S-BAR is enhanced for higher frequency with a maximum piezoelectric coupling coefficient ( k t 2 ) of 9.53%, a maximum quality factor (Q) of 439, and a TCF of −11.44 ppm/K. Different designs’ piezoelectric coupling coefficient distribution is consistent with the theoretical prediction. The proposed smoothing process increases the S-BARs’ quality factor by ~400%. The frequency shift caused by the temperature (absolute value of TCF) is reduced by 62% compared with the traditional Al 0.75 Sc 0.25 N thin film bulk acoustic wave resonator (without temperature compensation). The enhanced performances demonstrated the potential of SSC in the next-generation highly integrated RF communication systems.

The train operation plan plays an essential role in metro systems and directly affects transportation organization efficiency and passenger service level. In metro systems, passengers have paid more attention to the travel time reliability (TTR), reflecting the reliability of metro operation management. This article proposes an analysis method of train operation plan based on TTR in the station dimension. First, an automated fare collection (AFC) data-driven framework is established to calculate the station travel time reliability (STTR) and analyze the train operation plan at different periods. The framework structure consists of four steps: AFC data preprocessing, STTR calculation and assignment, clustering algorithm design based on SOM neural network, and train operation plan analysis and optimization. Second, the proposed method is applied to the Beijing metro network as a case study. Several promising results are analyzed that allow the optimization of the existing train operation plan. Our research shows that STTR is a good supplement for the existing metro operation assignment studies, which can help analyze and optimize the train operation plan effectively. This study is also applicable to other metro networks with AFC systems.

Lubrication is a critical process in cold strip rolling, and the accurate characterization of lubrication characteristics is an essential factor affecting the strip quality. The roll bending and tilting roll in the flatness actuators change the loaded roll gap profile and affect the lubrication characteristics by flatness dynamic correction, thus the mismatch between the actual and setting values of the lubrication status factor. Firstly, the flatness deviation correction model of roll bending and tilting roll based on the key information of the rolling process is established according to the high-order flatness target. Secondly, the characterization of the instantaneous oil film thickness in the work zone based on the loaded roll gap profile is derived from Reynolds’ equation. Finally, the explicit characterization method of the lubrication status factor in the rolling force model of the final stand is established with the work roll bending, tilting roll, and instantaneous oil film thickness of the work zone as variables, relying on the UCM five-stand, six-roll tandem cold rolling mill. The statistical evaluation and application results show that the mentioned optimization method can improve the setting accuracy of the rolling force by about 60% and the after-rolling gauge accuracy by about 50%.

Macroalgal biomass blooms, including those causing the green and golden tides, have been rising along Chinese coasts, resulting in considerable social impacts and economic losses. To understand the links between the ongoing climate changes (ocean warming and acidification) and algal tide formation, the effects of temperature (20 and 24 °C), pCO2 concentration (Partial Pressure of Carbon Dioxide, 410 ppm and 1000 ppm) and their interaction on the growth of Ulva prolifera and Ulva lactuca (green tide forming species), as well as Sargassum horneri (golden tide forming species) were investigated. The results indicate that the concurrent rises in temperature and pCO2 level significantly boosted the growth and nutrient uptake rates of U. lactuca. For U. prolifera, the heightened growth and photosynthetic efficiency under higher CO2 conditions are likely due to the increased availability of inorganic carbon. In contrast, S. horneri exhibited negligible responsiveness to the individual and combined effects of the increased temperature and CO2 concentration. These outcomes indicate that the progressive climate changes, characterized by ocean warming and acidification, are likely to escalate the incidence of green tides caused by Ulva species, whereas they are not anticipated to precipitate golden tides.