Multilayer Perceptron-Based Wearable Exercise-Related Heart Rate Variability Predicts Anxiety and Depression in College Students.

(1) Background: This study aims to investigate the correlation between heart rate variability (HRV) during exercise and recovery periods and the levels of anxiety and depression among college students. Additionally, the study assesses the accuracy of a multilayer perceptron-based HRV analysis in predicting these emotional states. (2) Methods: A total of 845 healthy college students, aged between 18 and 22, participated in the study. Participants completed self-assessment scales for anxiety and depression (SAS and PHQ-9). HRV data were collected during exercise and for a 5-min period post-exercise. The multilayer perceptron neural network model, which included several branches with identical configurations, was employed for data processing. (3) Results: Through a 5-fold cross-validation approach, the average accuracy of HRV in predicting anxiety levels was 89.3% for no anxiety, 83.6% for mild anxiety, and 74.9% for moderate to severe anxiety. For depression levels, the average accuracy was 90.1% for no depression, 84.2% for mild depression, and 82.1% for moderate to severe depression. The predictive R-squared values for anxiety and depression scores were 0.62 and 0.41, respectively. (4) Conclusions: The study demonstrated that HRV during exercise and recovery in college students can effectively predict levels of anxiety and depression. However, the accuracy of score prediction requires further improvement. HRV related to exercise can serve as a non-invasive biomarker for assessing psychological health.

Tai Chi Movement Recognition and Precise Intervention for the Elderly Based on Inertial Measurement Units and Temporal Convolutional Neural Networks.

(1) Background: The objective of this study was to recognize tai chi movements using inertial measurement units (IMUs) and temporal convolutional neural networks (TCNs) and to provide precise interventions for elderly people. (2) Methods: This study consisted of two parts: firstly, 70 skilled tai chi practitioners were used for movement recognition; secondly, 60 elderly males were used for an intervention study. IMU data were collected from skilled tai chi practitioners performing Bafa Wubu, and TCN models were constructed and trained to classify these movements. Elderly participants were divided into a precision intervention group and a standard intervention group, with the former receiving weekly real-time IMU feedback. Outcomes measured included balance, grip strength, quality of life, and depression. (3) Results: The TCN model demonstrated high accuracy in identifying tai chi movements, with percentages ranging from 82.6% to 94.4%. After eight weeks of intervention, both groups showed significant improvements in grip strength, quality of life, and depression. However, only the precision intervention group showed a significant increase in balance and higher post-intervention scores compared to the standard intervention group. (4) Conclusions: This study successfully employed IMU and TCN to identify Tai Chi movements and provide targeted feedback to older participants. Real-time IMU feedback can enhance health outcome indicators in elderly males.

Adaptive Weighted Error-Correction Method Based on the Error Distribution Characteristics of Multi-Channel Alignment.

As process nodes of advanced integrated circuits continue to decrease below 10 nm, the requirement for overlay accuracy is becoming stricter. The alignment sensor measures the position of the alignment mark relative to the wafer; thus, sub-nanometer alignment position accuracy is vital. The Phase Grating Alignment (PGA) method is widely used due to its high precision and stability. However, the alignment error caused by the mark asymmetry is the key obstacle preventing PGA technology from achieving sub-nanometer alignment accuracy. This error can be corrected using many methods, such as process verification and multi-channel weighted methods based on multi-diffraction, multi-wavelength and multi-polarization state alignment sensors. However, the mark asymmetry is unpredictable, complex and difficult to obtain in advance. In this case, the fixed-weight method cannot effectively reduce the alignment error. Therefore, an adaptive weighted method based on the error distribution characteristic of a multi-channel is proposed. Firstly, the simulation result proves that the error distribution characteristic of the multi-alignment result has a strong correlation with the mark asymmetry. Secondly, a concrete method of constructing weight values based on error distribution is described. We assume that the relationship between the weight value of each channel and the deviations of all channels' results is second-order linear. Finally, without other prior process correction in the simulation experiment, the residual error's Root Mean Square (RMS) of fixed weighted method is 14.0 nm, while the RMS of the adaptive weighted method is 0.01 nm, when dealing with five typical types of mark asymmetry. The adaptive weighted method exhibits a more stable error correction effect under unpredictable and complicated mark asymmetry.

A Semi-Autonomous Stereotactic Brain Biopsy Robotic System With Enhanced Surgical Safety and Surgeon-Robot Collaboration.

OBJECTIVE: Despite benefits brought by recent neurosurgical robots, surgical safety and surgeon-robot collaboration remain significant challenges. In this article, we analyze and address these problems in the context of brain biopsy, by proposing a semi-autonomous system. METHODS: A robotic module is designed for the automation of all the brain biopsy procedures, and a biopsy cannula with tissue blocker is developed to avoid tissue excess and haemorrhage. In addition, two methods are proposed for surgical safety and surgeon-robot collaboration enhancement. First, a priority-based control framework is proposed for neuronavigation with simultaneous optical tracking line-of-sight maintenance and surgeon avoidance. Second, after neuronavigation, an adaptive reconfiguration method is developed to optimize the arm angle of KUKA robot based on the surgeon's pose, for workspace interference minimization, high robot dexterity, and joint-limit avoidance. RESULT: Effectiveness of the proposed solution demonstrated by simulations and experiments. CONCLUSION: The system can perform automatic navigation with simultaneous optical tracking maintenance and surgeon avoidance, autonomous brain biopsy, and adaptive reconfiguration for workspace interference minimization. SIGNIFICANCE: This work improves existing neurosurgical systems, in terms of autonomy level from mechanical guidance to task autonomy, surgical safety, and surgeon-robot collaboration.

Velocity feedback control method of low-frequency electromagnetic vibration exciter based on Kalman filter estimation.

The absence of an appropriate low-frequency vibration velocity detection method to establish feedback control limits the further improvement of the low-frequency vibration performance of electromagnetic vibration exciters. In this article, a low-frequency vibration velocity feedback control method based on the Kalman filter estimation is proposed for the first time to reduce the total harmonic distortion of the vibration waveform. The rationality of establishing velocity feedback control in the velocity characteristic band of the electromagnetic vibration exciter is analyzed. Based on an identification model of the system and measured vibration displacements, the vibration velocity is estimated with high accuracy through the Kalman filter. The velocity feedback control system is established to suppress the impacts of disturbances effectively. Experimental results show that the method proposed in this paper can reduce the harmonic distortion of vibration waveform by 40%, which is 20% higher than the traditional control method, thoroughly verifying its superiority.

Biosafety protection and workflow of clinical microbiology laboratory under COVID-19: A review.

This paper mainly discusses how to do a good job of daily biosafety protection measures in clinical microbiology laboratories during the epidemic of COVID-19, so as to ensure the safe development of routine clinical microbiology testing items. According to the microbiological and epidemiological characteristics of the novel coronavirus, this paper analyzed the potential risks of the laboratory from the perspective of personal protection before, during, and after testing. Combined with the actual work situation, the improved biosafety protection measures and optimized work flow are introduced to ensure the safety of medical staff and the smooth development of daily work. Danyang People's Hospital of Jiangsu Province, clinical microbiology laboratory of clinical laboratory in strict accordance with the relevant laws and regulations, technical specifications and the expert consensus, combined with their own conditions, the biosafety measures to perfect the working process was optimized, effectively prevent the laboratory exposure, and maintain strict working condition for a long time, continue to improve. We found that the biosafety protection measures of clinical microbiology laboratory have good prevention and control effect on preventing infection of medical staff, which will greatly reduce the risk of infection of medical staff, form good working habits, and provide reference for biosafety protection of microbiology laboratory during the epidemic of COVID-19.

Clinical review considerations of class I PI3K inhibitors in hematolymphatic malignancies by Center for Drug Evaluation.

Several phosphoinositide 3-kinase (PI3K) inhibitors are currently approved to treat hematolymphatic malignant diseases worldwide, and many drugs that have the same target are in the clinical research stage. In March 2022, duvelisib became the first PI3K inhibitor approved in China indicated for the treatment of hematolymphatic malignant diseases. Meanwhile, linperlisib and copanlisib have almost completed the technical review of the clinical specialty. The Center for Drug Evaluation (CDE) of the China National Medical Products Administration (NMPA) found that class I PI3K inhibitors can cause various degrees of immune-related adverse events, which are associated with action mechanisms, affecting the benefit-risk assessment of the drugs. On April 21, 2021, the United States Food and Drug Administration (FDA) convened the Oncologic Drugs Advisory Committee (ODAC) meeting to discuss the safety of PI3K inhibitors indicated for hematolymphatic malignancies and their related risk of death. The hematological tumor group of CDE of the China NMPA summarized and combined the data on PI3K inhibitors listed or under technical review for marketing authorization applications and found that such products may have unique efficacy and safety characteristics in Chinese patients with malignant lymphoma.

Embedded micro-probe fiber optic interferometer with low nonlinearity against light intensity disturbance.

A novel low-nonlinearity Michelson microprobe fiber interferometer against light intensity disturbance for high-precision embedded displacement measurements is introduced. To analyze the influence of light intensity disturbance on the microprobe and measurement accuracy of the integrated fiber interferometer, an equivalent model of micro-probe sensing with the tilted target is established. The proposed PGC demodulation and nonlinearity correction method with simple principle helps avoid DC component varying with light intensity. The experiments show that residual displacement errors of the micro-probe fiber interferometer are reduced from 4.36 nm to 0.46 nm, thus allowing embedded displacement detection with sub-nanometer accuracy under low frequency light intensity disturbance.

[Considerations on Clinical Development and Regulatory of the Oversea License-in 
Anti-tumor Drugs].

With the boom of China's innovative pharmaceutical industry, licensing-in model has gradually become an important research and development model for innovative pharmaceutical companies. The in-licensed drugs at different stages need different research and development (R&D) strategy in China. The pharmaceutical companies take the responsibility to comprehensively collate the oversea clinical data and conduct a detailed analysis of clinical pharmacology, safety, efficacy and ethnic sensitivity. Clinical R&D strategy should be made based on the results of the above data and analysis. We encourage high-quality drugs which fill unmet clinical needs licensed in, and as early as possible, so as to conduct multi-regional clinical trials (MRCTs). The clinical R&D strategy in China is particularly important for the drug's approval. Guidelines published by the National Medical Products Administration (NMPA) and clinical associations should be followed. Communications about clinical R&D strategy with Center of Drug Evaluation (CDE) are encouraged.
.

Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in improving the physical function recovery for patients following minimally invasive esophagectomy: a prospective randomized controlled trial.

BACKGROUND: Perioperative rehabilitation management is essential to enhanced recovery after surgery (ERAS). Limited reports, however, have focused on quantitative, detailed early activity plans for patients receiving minimally invasive esophagectomy (MIE). The purpose of this research was to estimate the effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in the recovery of bowel and physical functions for patients undergoing MIE. METHODS: In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients admitted to the Affiliated Cancer Hospital of Zhengzhou University from June 2019 to February 2020 were selected and randomly assigned to an intervention group (IG) or a control group (CG). The participants in the IG received medical care based on the t-ECRP strategy during perioperative period, and participants in the CG received routine care. The recovery of bowel and physical functions, readiness for hospital discharge (RHD), and postoperative hospital stay were evaluated on the day of discharge. RESULTS: Two hundred and fifteen cases with esophageal cancer (EC) were enrolled and randomized to the IG (n = 107) or CG (n = 108). The mean age was 62.58 years (SD 9.07) and 71.16% were male. For EC, 53.49% were mid-location cancers and 79.07% were classified as pathological stage II and III cancers. There were no significant differences between the two groups in terms of demographic and clinical characteristics and baseline physical functions. Participants in the IG group presented significantly shorter lengths of time to first flatus (P < 0.001), first postoperative bowel movement (P = 0.024), and for up and go test (P < 0.001), and lower scores of frailty (P < 0.001). The analysis also showed that participants in the IG had higher scores of RHD and shorter lengths of postoperative stay than in the CG (P < 0.05). CONCLUSIONS: The t-ECRP appears to improve bowel and physical function recovery, ameliorate RHD, and shorten postoperative hospital stay for patients undergoing MIE. Clinicians should consider prescribing quantitative, detailed, and individualized early activity plans for these patients. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT01998230).

Effectiveness of an early, quantified, modified oral feeding protocol on nutritional status and quality of life of patients after minimally invasive esophagectomy: A retrospective controlled study.

OBJECTIVES: Previous studies confirmed the safety and feasibility of oral feeding on the first postoperative day (POD) for patients with minimally invasive esophagectomy (MIE). Nonetheless, some clinical concern can lead to delays in early oral feeding on POD 1. To our knowledge, few reports have focused on resolving these clinical concerns. The aims of this study were to evaluate the effects of an early, quantified, modified oral feeding protocol for patients after MIE and to explore its effect on nutritional status and quality of life (QoL). METHODS: In this prospective controlled trail, 200 patients were selected as the intervention group (IG) from March 2020 to June 2021; 115 patients hospitalized from June 2019 to February 2020 were assigned to the control group (CG). For 2 wk during the postoperative period, IG participants received an early, quantified, modified oral feeding protocol. The recovery of dietary outcomes, nutritional status, and QoL were evaluated after the intervention. RESULTS: There was no significant difference between the two groups in terms of demographic and clinical characteristics and baseline physical function. After the intervention, patients in the IG showed a more rapid growth in daily total oral caloric intake and the ratio of oral calorie intake to total calorie required by the body (K/R value) from POD 1 to POD 14, and less weight loss (1.5 ± 1 versus 2.1 ± 1.7 kg; P < 0.05), better serum prealbumin (193.0 ± 26.9 versus 139.3 ± 27.2 mg/L; P < 0.05) than the CG with statistical significance. By the second week of the intervention, IG patients reported higher global QoL and function scores and lower symptom scores than patients in the CG. The IG participants presented a shorter time to first flatus and bowel movement (P < 0.001), a shorter postoperative hospital length of stay, and higher activities of daily living scores (P < 0.05) the those in the CG. CONCLUSIONS: The findings demonstrated that the early, quantified, modified oral feeding protocol can alleviate postoperative body weight loss, improve the patient's nutritional status, and have a positive effect on QoL and early recovery for patients undergoing MIE.

Effect of Chin-down-plus-larynx-tightening maneuver on swallowing function after minimally invasive esophagectomy: A randomized controlled trail.

BACKGROUND: The incidence of swallowing abnormality was high after minimally invasive esophagectomy (MIE) for esophageal cancer (EC). Few reports, however, focused on interventions for dysphagia after esophagectomy. AIM: The purpose of this research was to estimate the effect of Chin-down-plus-larynx-tightening maneuver on swallowing function for patients receiving esophagectomy. METHOD: This was a 2-arm, parallel-group, single-blind randomized clinical trial, performed in patients suffered from EC from November 2018 to January 2020. Patients were randomly assigned to the intervention group (IG) or the control group (CG). The participants in CG received routine care, and the IG received Chin-down-plus-larynx-tightening maneuver during feeding. The incidence of choking cough, swallowing function, and dietary outcomes were evaluated before and after intervention for 7 days. RESULTS: A total of 237 EC cases were enrolled and randomized to the IG (n = 118) or CG (n = 119). There was no significant difference between the two groups in terms of demographic and clinical characteristics. Postoperative choking cough occurred in 5 of 118 cases (4.24%) in IG and 18 of 119 cases (19.4%) in CG, the differences showed statistically significant (P < .001). The analysis showed that the participants in the IG compared with the CG have more total caloric intake of 24 hours and higher K/R (the ratio of calories oral achieved to total calories required of body) significantly from D1 to D7 of intervention (P < .05). CONCLUSION: The findings suggest that the Chin-down-plus-larynx-tightening maneuver can improve swallowing function recovery and oral total food intake and calories in EC patients undergoing MIE.

Do Surface Slope and Posture Influence Lower Extremity Joint Kinetics during Cycling?

The purpose of this study was to investigate the effects of surface slope and body posture (i.e., seated and standing) on lower extremity joint kinetics during cycling. Fourteen participants cycled at 250 watts power in three cycling conditions: level seated, uphill seated and uphill standing at a 14% slope. A motion analysis system and custom instrumented pedal were used to collect the data of fifteen consecutive cycles of kinematics and pedal reaction force. One crank cycle was equally divided into four phases (90° for each phase). A two-factor repeated measures MANOVA was used to examine the effects of the slope and posture on the selected variables. Results showed that both slope and posture influenced joint moments and mechanical work in the hip, knee and ankle joints (p < 0.05). Specifically, the relative contribution of the knee joint to the total mechanical work increased when the body posture changed from a seated position to a standing position. In conclusion, both surface slope and body posture significantly influenced the lower extremity joint kinetics during cycling. Besides the hip joint, the knee joint also played the role as the power source during uphill standing cycling in the early downstroke phase. Therefore, adopting a standing posture for more power output during uphill cycling is recommended, but not for long periods, in view of the risk of knee injury.

China National Medical Products Administration approval summary: anlotinib for the treatment of advanced non-small cell lung cancer after two lines of chemotherapy.

BACKGROUND: On May 8, 2018, the China National Medical Products Administration (NMPA) approved anlotinib, an orally administered anti-angiogenesis inhibitor, for the treatment of patients with advanced non-small cell lung cancer (NSCLC) who have progressed after treatment with two or more lines of prior systemic chemotherapy. China NMPA reviewed and inspected a regional double-blinded, placebo-controlled, Phase III trial comparing the overall survival (OS) of NSCLC patients between the anlotinib and placebo arms. A total of 437 patients were randomized (2:1) to receive either anlotinib (n = 294) or placebo (n = 143) once daily on a 2-week on and 1-week off schedule. Patients with epidermal growth factor receptor (EGFR) or activating anaplastic lymphoma kinase (ALK) genomic tumor aberrations should have disease progression on NMPA-approved therapy. Anlotinib is the first NMPA-approved drug for patients with advanced NSCLC who have progressed on at least two lines of prior systemic chemotherapies in China. The approval was based on a statistically and clinically significant improvement in median OS with anlotinib (9.46 months) compared with placebo [6.37 months; hazard ratio (HR]) = 0.70, 95% confidence interval (CI) = 0.55-0.89; two-sided log-rank P = 0.002]. The confirmed objective response rate (ORR) was 9.2% in the anlotinib arm and 0.7% in the placebo arm. The median duration of response (DoR) was 4.83 months, with a 95% CI of 3.31-6.97 months. The toxicity profile of anlotinib was consistent with that of known anti-angiogenesis inhibitors. Common adverse drug reactions (ADRs) in anlotinib-treated patients included hypertension (67.4%), hand-foot syndrome (43.9%), hemoptysis (14.0%), thyroid stimulating hormone (TSH) elevation (46.6%), and corrected QT interval (QTc) prolongation (26.2%). SHORT CONCLUSION: Anlotinib demonstrated a clinically significant OS prolongation as a novel therapeutic option for advanced or metastatic NSCLC following at least two lines of chemotherapy.

The Treatment of Oesophageal Perforation after Anterior Cervical Spinal Surgery.

Oesophageal perforation is a rare complication occurring during or after cervical spine surgery, and the risk factors are not well understood. This study presents a case of a 25-year-old man with oesophageal perforation after anterior cervical spine surgery. It is suggested that four factors (anatomical structure, mechanism of trauma, implant dislodgment, and the operation) could induce postoperative oesophageal perforation after cervical spine surgery performed using the anterior surgical approach. A comprehensive understanding and early management of this complication are necessary for successful therapy.

Two-dimensional displacement measurement based on two parallel gratings.

In this paper, a two-dimensional (2-D) planar encoder based on two parallel gratings, which includes a scanning grating and scale grating, is presented. The scanning grating is a combined transmission rectangular grating comprised of a 2-D grating located at the center and two one-dimensional (1-D) gratings located at the sides. The grating lines of the two 1-D gratings are perpendicular to each other and parallel with the 2-D grating lines. The scale grating is a 2-D reflective-type rectangular grating placed in parallel with the scanning grating, and there is an angular difference of 45° between the grating lines of the two 2-D gratings. With the special structural design of the scanning grating, the encoder can measure the 2-D displacement in the grating plane simultaneously, and the measured interference signals in the two directions are uncoupled. Moreover, by utilizing the scanning grating to modulate the phase of the interference signals instead of the prisms, the structure of the encoder is compact. Experiments were implemented, and the results demonstrate the validity of the 2-D planar grating encoder.

Rapid super-resolution confocal microscopy through virtual structured detection based on serial scanning in array.

To improve the imaging speed of a confocal microscope with virtual structured detection, we have designed an optical system with rigid coordination control of the CCD, galvanometer scanner, and laser diode. In this system, the width of the coherent transfer function expands, which enhances the lateral resolution by a factor of 1.4. Also, the temporal image sequence is transformed to a spatial one so that multiple images can be acquired during a single exposure period of the CCD. This method increases the system imaging speed 25-fold at least, and an even higher speed can be achieved by further increasing the number of spots recorded during a single exposure period.

High-order super-resolution optical fluctuation imaging based on low-pass denoising.

A new scheme of super-resolution optical fluctuation imaging (SOFI) is proposed to broaden its application in the high-order case by separating the elimination of shot noise from the computation of cumulant, applying the low-pass denoising (LPD) operator to SOFI. The high-order cumulants are derived from a basic recursion of moments with the suppression of shot noise by the LPD on raw data. SOFI based on LPD (LPD-SOFI) demonstrates a 10.6-fold lateral resolution enhancement with the cumulant order of the 16th and a seven-fold three-dimensional resolution enhancement with the cumulant order of the 10th in experiments performed on a sparse sample of quantum dots.

Assembled Cantilever Fiber Touch Trigger Probe for Three-Dimensional Measurement of Microstructures.

In this paper, an assembled cantilever fiber touch trigger probe was developed for three-dimensional measurements of clear microstructures. The probe consists of a shaft assembled vertically to an optical fiber cantilever and a probing sphere located at the free end of the shaft. The laser is emitted from the free end of the fiber cantilever and converges on the photosensitive surface of the camera through the lens. The position shift of the light spot centroid was used to detect the performance of the optical fiber cantilever, which changed dramatically when the probing sphere touched the objects being measured. Experimental results indicated that the sensing system has sensitivities of 3.32 pixels/µm, 1.35 pixels/µm, and 7.38 pixels/µm in the x, y, and z directions, respectively, and resolutions of 10 nm, 30 nm, and 5 nm were achieved in the x, y, and z, respectively. An experiment on micro slit measurement was performed to verify the high aspect ratio measurement capability of the assembled cantilever fiber (ACF) probe and to calibrate the effective two-point diameter of the probing sphere. The two-point probe sphere diameter was found to be 174.634 µm with a standard uncertainly of 0.045 µm.