Science Progress最新文献

Flatfoot, a disorder defined by the flattening or loss of the medial longitudinal arch (MLA), affects approximately 15.6% of the child population. It may result from congenital or acquired dysfunction of muscles, tendons, or ligaments in the foot and ankle, as well as skeletal abnormalities. Clinically, this disorder manifests as foot pain, gait abnormalities, and compensatory injuries in lower limb joints (e.g., knee and hip), thereby affecting motor function and quality of life. Short foot exercises (SFE) as a noninvasive rehabilitation strategy enhances arch height and improves dynamic foot support by actively contracting plantar muscles. It has been confirmed to effectively improve foot morphology and alleviate pain. This is a narrative review that summarizes the impact of flatfoot on patient health and the benefits of SFE-based interventions by focusing on the morphological, functional, and biomechanical characteristics of flatfoot, the standardized intervention cycles and assessment approaches for SFE as well as the mechanism(s) by which SFE alleviates flatfoot-related symptoms.

Downhole severe vibration of reamers while drilling is a critical bottleneck restricting drilling safety and efficiency. Existing studies often neglect the coupled effects of cutter dynamic wear on vibration and lack systematic quantitative analysis of the vibration suppression mechanisms of centralizers, resulting in a lack of reliable basis for anti-vibration design. This study innovatively establishes a dynamic model of the "equivalent upper drill string assembly + BHA" that incorporates cutter wear, and systematically reveals the synergistic vibration suppression mechanism of centralizer position, number, and outer diameter. The findings indicate that centralizer position serves as the foundation for vibration suppression: positioning it directly below the reamer provides optimal constraint, reducing the centroid offset area by 92.5%. Increasing the number of centralizers enhances vibration control, with a three-centralizer configuration reducing axial and torsional vibrations by 64.4% and 66.9%, respectively. Moreover, enlarging the centralizer outer diameter further amplifies the suppression effect: increasing the outer diameter from 204 to 214 mm results in additional reductions of 55.4% in axial and 31.6% in torsional vibrations. The proposed "position-number-outer diameter" synergistic design principle provides theoretical support and quantitative guidelines for vibration control in reamers while drilling, offering significant value for improving the reliability of drilling engineering.

In the past decade, convolutional neural networks (CNNs) and transformers have achieved wide application in semantic segmentation tasks. Although CNNs with transformer models greatly improve performance, the global context modeling remains inadequate. Recently, Mamba achieved great potential in vision tasks, showing its advantages in modeling long-range dependency. In this article, we propose a lightweight efficient CNN-Mamba network for semantic segmentation, dubbed as ECMNet. ECMNet combines CNN with Mamba skillfully in a capsule-based framework to address their complementary weaknesses. Specifically, we design an enhanced dual-attention block for a lightweight bottleneck. In order to improve the representation ability of the feature, we devise a multi-scale attention unit to integrate multi-scale feature aggregation, spatial aggregation, and channel aggregation. Moreover, a Mamba enhanced feature fusion module merges diverse level feature, significantly enhancing segmented accuracy. Extensive experiments on two representative datasets demonstrate that the proposed model excels in accuracy and efficiency balance, achieving 70.6% mIoU on Cityscapes and 73.6% mIoU on CamVid test datasets, with 0.87 M parameters and 8.27G FLOPs on a single RTX 3090 GPU platform. Source code will be available at https://github.com/feixiangdu/ECMNet.

This study focuses on the transmission dynamics of anthracnose disease and the effectiveness of treatment strategies designed to limit its spread, particularly under splashing-rain conditions. A mathematical model is developed to investigate the progression of anthracnose in a healthy environment when incorporating control measures such as treatment interventions and systematic removal of infected plants. The model is extended to a fractional-order form using the fractal-fractional operator, allowing continuous monitoring and reliable numerical approximations. A detailed analysis is performed to examine stability, boundedness, and uniqueness, thereby ensuring the validity of the system dynamics. Transmission rates across sub-compartments are derived through global derivatives and verified using Lipschitz and linear growth conditions. Bifurcation analysis is conducted to assess the emergence and control of chaotic behavior within the system. The role of the fractional operator, including the Mittag-Leffler kernel in its generalized form, is studied via a two-step Lagrange polynomial approach. Numerical simulations illustrate the influence of various factors on disease spread and demonstrate the effectiveness of hypersensitive response strategies in controlling infections. The findings contribute to a deeper understanding of anthracnose transmission and support the development of mathematically verified management strategies for improved plant health.

ObjectivesThe COVID-19-associated hyperinflammatory syndrome (cHIS) score has been proposed as a tool for identifying patients at risk of clinical deterioration. This study evaluated the predictive accuracy of the admission cHIS score for invasive mechanical ventilation and ICU mortality in critically ill COVID-19 patients.MethodsWe conducted a single-center retrospective observational study including 85 adults with laboratory-confirmed COVID-19 who were admitted to the ICU. The cHIS score was calculated on admission, and patients were stratified into two groups (<3 and ≥3). Associations with mechanical ventilation and ICU mortality were examined using ROC curve analysis and multivariable logistic regression, adjusted for age and comorbidity burden.ResultsAn admission cHIS score ≥3 demonstrated moderate discrimination for ICU mortality (AUROC = 0.70; sensitivity = 0.76; specificity = 0.66) and mechanical ventilation (AUROC = 0.71; sensitivity = 0.73; specificity = 0.65). Higher cHIS scores were significantly associated with both outcomes in unadjusted analyses. After adjustment, the associations were attenuated and became borderline for mortality and mechanical ventilation, suggesting potential confounding by age and underlying comorbidities. Key inflammatory markers within the cHIS score-CRP, LDH, and D-dimer-showed the strongest individual associations with adverse outcomes. Kaplan-Meier analysis demonstrated significantly reduced survival probabilities in patients with cHIS ≥3.ConclusionThe admission cHIS score reflects the degree of systemic hyperinflammation and is associated with greater illness severity, ICU mortality, and the need for mechanical ventilation. Although its predictive value diminishes after adjusting for age and comorbidities, the score remains a useful adjunct for early risk stratification in critically ill COVID-19 patients. Larger multicenter studies are needed to determine its independent prognostic utility.

Guillain-Barré syndrome (GBS) is a life-threatening acute paralytic neuropathy characterized by rapidly progressive limb weakness and bilateral cranial nerve involvement. We report an early 70s male with no relevant medical history diagnosed with anti-GM3 IgG-positive GBS, who developed unilateral oculomotor nerve palsy and autonomic dysfunction during intravenous immunoglobulin (IVIG) therapy, with spontaneous symptom resolution following IVIG completion. Six-month follow-up assessments confirmed complete remission. This case reinforces the therapeutic value of IVIG in GBS patients with specific autoantibody profiles, even when complicated by transient neurological deterioration during treatment.

ObjectiveThis study aims to systematically review and synthesize the studies on the application of machine learning for classifying infant cry types, identifying pathological cries, and evaluating the accuracy of infant cry recognition.MethodsThis review followed the PRISMA guidelines and was registered in PROSPERO (CRD42024600969). The literature search was conducted on four data sources: PubMed, CINAHL, Embase, and IEEE Xplore. The included studies focused on machine learning-based classification of infants' needs cries or pathological cries. These were published in English between January 1, 2014 and October 31, 2024. Study quality was assessed using the QUADAS-2 tool.ResultsOf 919 studies were identified, 17 were included in the final synthesis. Machine learning can classify infant cries into two main types: infant needs' cries and pathological cries, with some studies addressing both. Needs-related cries comprised nine subtypes, while pathological cries included six subtypes. Classification accuracy varied by machine learning classifier and the features used, ranging from 44.5% to 99.82%. The highest accuracy for infant needs' cries was hunger and pain cries at 99.82% using a Gaussian mixture model (GMM) classifier with constant-Q cepstral coefficients features. For pathological cries, the highest accuracy was for detecting deafness (99.42% to 99.82%), using a genetic selection of Fuzzy Model and a GMM classifier.ConclusionsMachine learning shows strong potential for accurately classifying infant cries and detecting pathologies. Future research should prioritize developing diverse cry datasets to improve model generalizability, evaluating performance in real-world settings, and integrating cry analysis with physiological signals to enhance diagnostic accuracy.

Current guidelines recommend VATS as the first-line treatment for stage II empyema. Patients with concomitant cardiorespiratory failure are considered ineligible for guideline-recommended management. Alternative treatment options are needed. This case report pertains to an obese man in his early 60 s with respiratory failure and decompensated heart failure. He developed an emphyema, which was refractory to the standard antibiotic therapy, thoracocentesis and other chest drainage. As patient was disqualified from surgical treatment, new approach was implemented. Minimally invasive approach of introducing a single-use bronchoscope through an existing chest drain (FOB-VAMT) was performed with support of non-invasive ventilation and analgosedation. Patient's condition improved significantly after the procedure. He remains under regular follow-up at the Pulmonology Outpatient Clinic 2 years after implemented treatment. This case reports that FOB-VAMT may provide an effective therapeutic option for patients disqualified from standard VATS and endotracheal intubation.

BackgroundInflammation is a key component in the pathophysiology of hypertension, in which proinflammatory cytokines interleukin (IL) 1β and IL6 and anti-inflammatory cytokines IL4 and IL10 are involved. Elevated remnant cholesterol (RC) level has emerged as an independent risk factor of incident hypertension, surpassing conventional risk factors based on its strength. Additionally, it has a higher penetration into the arterial wall than conventional lipids and induces arterial wall and systemic inflammations.ObjectiveThis study aimed to investigate the association between cerebrospinal fluid (CSF) ILs, blood pressure (BP), and RC and examine the moderation effects of RC on the relationship between ILs and BP.MethodsThis cross-sectional study included participants (mean age: 31.76 ± 10.22 years) who were divided into RC < 0.8 mmol/L (n = 81) and RC ≥ 0.8 mmol/L (n = 104) groups. BP was measured on the morning before CSF collection, and CSF IL levels were analyzed using ELISA. The linear regression models were constructed to estimate the moderation of RC on the relationship between ILs and BP.ResultsRC may play a moderation role in the relationship between IL10 and BP (R² = 0.11, β = -0.31 for systolic BP [SBP] and R² = 0.11, β = -0.28 for diastolic BP [DBP], both p < 0.001). BMI exhibited a positive correlation with the BP (R² = 0.09, β = 0.28 for SBP and R² = 0.05, β = 0.24 for DBP, both p < 0.05). CSF IL4 exhibited a negative correlation with triglycerides among males in the RC ≥ 0.8 mmol/L group (r = -0.25, p = 0.013).ConclusionsThis study demonstrated previously undocumented evidence regarding the potential protective effect of CSF IL10 on hypertension in individuals with RC ≥ 0.8 mmol/L. This indicates that elevated CSF IL10 levels may aid in maintaining BP for overall health, particularly in individuals with elevated total cholesterol levels.

Congenital absence of the left atrial appendage (LAA) is an exceptionally rare cardiac anomaly. We reported a patient in his 60s with symptomatic persistent atrial fibrillation (AF) and no history of cardiac surgery or other diseases. During preprocedural evaluation for AF cardioversion, transesophageal echocardiography and cardiac computed tomography revealed a complete absence of the LAA. The patient was managed with regular anticoagulation therapy and maintained in sinus rhythm, without recurrence or related complications during a 1-year follow-up.