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In general multiple medical devices orthogonal frequency-division multiplexing (OFDM) communication systems, all the interfering medical users are legitimate but will cause disturbance to the desired user. In this work, we evaluate three deep learning (DL) algorithms: fully connected deep neural networks, convolutional neural networks, and long short-term memory neural networks for signal processing and detection in uncoded multiple medical devices OFDM communications systems. The bit error rates (BER) of these DL methods are compared with the conventional linear minimum mean squared error (LMMSE) detector. Additionally, the relationships between the BER and signal-to-interference ratio, signal-to-noise ratio, the number of interferences, and modulation type are investigated. Numerical results show that DL methods outperform LMMSE under different multiple medical device interference situations and are robust when the wireless channel has high variability. Also, DL methods are proven to have strong anti-interference ability and are useful in multiple medical devices OFDM systems.

Objective. This study explored the 10-year efficacy, safety, and prognostic factors of low-dose collagenase chemonucleolysis (CCNL) combined with radiofrequency (RF) in the treatment of lumbar disc herniation (LDH). Methods. The data of 167 LDH patients were collected. Modified MacNab criteria, Numerical Rating Scale (NRS), and Japanese Orthopedic Association (JOA) scores were, respectively, used to evaluate patients’ excellent and good rates, pain degree, and nerve function. The preoperative and 10-year postoperative patients’ pain, numbness, and muscle weakness were compared. Patients’ complications in perioperative period, recurrent/reappeared LDH, and reoperations were recorded. Finally, the independent risk factors affecting the long-time efficacy were assessed. Results. A total of 126 patients were included. The patients’ excellent and good rates were 86.51%–92.86% with no significant difference P>0.05. Postoperative NRS and JOA scores significantly improved P<0.01, most obvious within 6 months postoperatively. At 10 years postoperatively, 65.08%, 83.95%, and 93.02% of patients’ pain, numbness, and muscle weakness were completely relieved P<0.05. Perioperative complications occurred in three patients with the rate of 2.38%. Recurrent/reappeared LDH patients were 11 with the ratio of 8.73%; nine of them underwent reoperations with the rate of 7.14%. And patients’ probability of fair and poor efficacy at 10 years postoperatively with the course of disease >12 months and the responsibility disc ≥2 were, respectively, 6.005 and 4.227 times that of patients with the course of disease ≤12 months and the responsibility disc = 1 P<0.05. Conclusion. The combined treatment is effective and safe in the long term. A course of disease >12 months and responsibility disc ≥2 independently reduce efficacy, and a course of disease >12 months has a more significant impact.

•We report a case of cervical epidural abscess that developed after acupuncture and wet-cupping therapy in China for the first time.•Acupuncture and wet-cupping therapy should be taken into consideration as a cause of spinal epidural abscesses.•Acupuncture and wet-cupping practitioners should pay attention to hygienic measures. Report of an uncommon complication of acupuncture and wet cupping. A 54-year-old man presented with neck pain and fever. Magnetic resonance imaging of the cervical spine revealed an epidural abscess at C4 to T2. The symptoms related to epidural abscess resolved partially after treatment with antibiotics. Acupuncture and wet-cupping therapy should be taken into consideration as a cause of spinal epidural abscesses in patients who present with neck pain and fever. Furthermore, acupuncture and wet-cupping practitioners should pay attention to hygienic measures.

Evacuated tube transportation (ETT) will be one of the ultra-large-scale vacuum application areas. This paper lists some key vacuum technology issues in ETT: (1) how to construct ultra-large-scale vacuum chamber with lower cost and high reliability, (2) how to evacuate gas out of the ETT tube in short time, (3) how to release heat or reduce temperature in the vacuum tube, (4) how to avoid vacuum discharge, (5) how to make vehicles with airproof shells and life support system, and (6) how to detect leaks and find leak positions efficiently. At the same time, some solutions are proposed.

Reliable projections of wildfire and associated socioeconomic risks are crucial for the development of efficient and effective adaptation and mitigation strategies. The lack of or limited observational constraints for modeling outputs impairs the credibility of wildfire projections. Here, we present a machine learning framework to constrain the future fire carbon emissions simulated by 13 Earth system models from the Coupled Model Intercomparison Project phase 6 (CMIP6), using historical, observed joint states of fire-relevant variables. During the twenty-first century, the observation-constrained ensemble indicates a weaker increase in global fire carbon emissions but higher increase in global wildfire exposure in population, gross domestic production, and agricultural area, compared with the default ensemble. Such elevated socioeconomic risks are primarily caused by the compound regional enhancement of future wildfire activity and socioeconomic development in the western and central African countries, necessitating an emergent strategic preparedness to wildfires in these countries. A new study develops a machine learning framework to observationally constrain CMIP6-simulated fire carbon emissions, finding a weaker increase in 21st-century global fires but higher increase in their socioeconomic risks than previously thought.

Esophageal squamous cell carcinoma (ESCC) ranks fourth among cancer-related deaths in China due to the lack of actionable molecules. We performed whole-exome and T-cell receptor (TCR) repertoire sequencing on multi-regional tumors, normal tissues and blood samples from 39 ESCC patients. The data revealed 12.8% of ERBB4 mutations at patient level and functional study supported its oncogenic role. 18% of patients with early BRCA1 /2 variants were associated with high-level contribution of signature 3, which was validated in an independent large cohort ( n  = 508). Furthermore, knockdown of BRCA1 /2 dramatically increased sensitivity to cisplatin in ESCC cells. 5% of patients harbored focal high-level amplification of CD274 that led to massive expression of PD-L1, and might be more sensitive to immune checkpoint blockade. Finally, we found a tight correlation between genomic and TCR repertoire intra-tumor heterogeneity (ITH). Collectively, we reveal high-level ITH in ESCC, identify several potential actionable targets and may provide novel insight into ESCC treatment. Esophageal squamous cell carcinoma (ESCC) is highly prevalent in China. Here, the authors carry out multi-region sampling of Chinese ESCC samples, and find recurrent ERBB4 mutations, BRCA1/2 variants, and amplification of CD274 ; together with high levels of genomic and T-cell receptor heterogeneity.

Objective This population-based study investigated longitudinal changes in the prevalence and genotype distribution of HPV across the pre-pandemic (2017-2019), pandemic (2020-2022), and post-pandemic (2023-2024) periods in Western China. Methods We conducted a retrospective cohort analysis of 129,585 women, stratified into three chronological cohorts: pre-pandemic (n=40,044), pandemic (n=43,717), and post-pandemic (n=45,824) cohorts. Cervicovaginal specimens were analyzed via real-time PCR-based genotyping to detect 16 high-risk and 7 low-risk genotypes. Age-specific prevalence patterns were evaluated across six demographic strata (<20 to ≥60 years). Age-standardized prevalence rates were calculated using 2020 Chinese census data as a reference population. Results The total HPV prevalence decreased from 31.59% before the pandemic to 23.28% during the pandemic, stabilizing at 21.45% after the pandemic. Nonvaccine-targeted HR-HPV subtypes (HPV-52, HPV-58) maintained persistent dominance across all phases, with the prevalence of HPV-52 decreasing from 6.00% before the pandemic to 3.00% after the pandemic. Adolescents (<20 years) presented the lowest infection rates, whereas peak rates were reported for women aged 40-49 years. Conclusions The sustained reduction in total HPV prevalence is potentially associated with pandemic-related behavioral modifications and healthcare disruptions. The persistent circulation of nonvaccine-targeted subtypes highlights gaps in current prevention strategies. These findings emphasize the need for comprehensive surveillance integrating catch-up screening and genotype-specific vaccine development to address post-pandemic HPV transmission dynamics.

Africa contains some of the most vulnerable ecosystems to fires. Successful seasonal prediction of fire activity over these fire-prone regions remains a challenge and relies heavily on in-depth understanding of various driving mechanisms underlying fire evolution. Here, we assess the seasonal environmental drivers and predictability of African fire using the analytical framework of Stepwise Generalized Equilibrium Feedback Assessment (SGEFA) and machine learning techniques (MLTs). The impacts of sea-surface temperature, soil moisture, and leaf area index are quantified and found to dominate the fire seasonal variability by regulating regional burning condition and fuel supply. Compared with previously-identified atmospheric and socioeconomic predictors, these slowly evolving oceanic and terrestrial predictors are further identified to determine the seasonal predictability of fire activity in Africa. Our combined SGEFA-MLT approach achieves skillful prediction of African fire one month in advance and can be generalized to provide seasonal estimates of regional and global fire risk. Fire is an important component of many African ecosystems, but prediction of fire activity is challenging. Here, the authors use a statistical framework to assess the seasonal environmental drivers of African fire, which allow for a better prediction of fire activity.

With the increasing proportion of the aging population, neurodegenerative diseases have become one of the major health issues in society. Neurodegenerative diseases (NDs), including multiple sclerosis (MS), Alzheimer’s disease (AD), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS), are characterized by progressive neurodegeneration associated with aging, leading to a gradual decline in cognitive, emotional, and motor functions in patients. The process of aging is a normal physiological process in human life and is accompanied by the aging of the immune system, which is known as immunosenescence. T-cells are an important part of the immune system, and their senescence is the main feature of immunosenescence. The appearance of senescent T-cells has been shown to potentially lead to chronic inflammation and tissue damage, with some studies indicating a direct link between T-cell senescence, inflammation, and neuronal damage. The role of these subsets with different functions in NDs is still under debate. A growing body of evidence suggests that in people with a ND, there is a prevalence of CD4+ T-cell subsets exhibiting characteristics that are linked to senescence. This underscores the significance of CD4+ T-cells in NDs. In this review, we summarize the classification and function of CD4+ T-cell subpopulations, the characteristics of CD4+ T-cell senescence, the potential roles of these cells in animal models and human studies of NDs, and therapeutic strategies targeting CD4+ T-cell senescence.

Objective To evaluate the impact of preoperative pleural effusion on the ultrasound visualization of the paravertebral space (PVS), thoracic paravertebral nerve block administered by anesthesiologists, and to investigate whether ultrasound combined with pressure guidance can assist in locating the paravertebral space in patients with pleural effusion. Methods This prospective observational study enrolled patients undergoing thoracic surgery at Beijing Jishuitan Hospital between September 2021 and September 2022. Patients were categorized into two groups based on preoperative CT findings: the pleural effusion group ( n  = 40) and the non-pleural effusion group ( n  = 40). Prior to the induction of general anesthesia, all patients were placed in a lateral position. Thoracic paravertebral nerve block (TPVB) was administered using ultrasound guidance combined with pressure monitoring, with a 20 ml of 0.5% ropivacaine. Results Parameters recorded included the duration of puncture and ultrasound pre-scan for TPVB, the ultrasound image definition score of the PVS, the pressure in the external intercostal muscle and PVS, and additional relevant indicators. Mean arterial pressure (MAP) and heart rate (HR) were measured before anesthesia induction, post-induction, and during skin incision. Compared to the non-pleural effusion group, the pleural effusion group demonstrated prolonged ultrasound pre-scan and puncture durations. The PVS definition score, the ventral displacement of the pleura, and the accuracy of resident anesthesiologists in identifying the PVS were all significantly lower in the pleural effusion group ( p  < 0.05). Compared to non-pleural effusion group, the pleural effusion group had significantly higher pressure in PVS. In the pleural effusion group, the pressure in PVS was significantly lower than that in external intercostal muscle ( p  < 0.05). No significant differences were observed in MAP and HR between the two groups before anesthesia induction, post-induction and during skin incision ( p  > 0.05). Conclusion Preoperative pleural effusion is associated with reduced clarity of ultrasound visualization of the PVS, and extended procedural durations for anesthesiologists, thereby increasing the complexity of TPVB. Pressure detection during TPVB implementation can assist in locating the position of the puncture needle. For anesthesiologists with less experience, TPVB should be carefully performed in patients with preoperative pleural effusion. Trial registration The trial was prospectively registered with the Chinese Clinical Trial Registry under registration number ChiCTR2100050582, on August 30, 2021.