Lianyang Zhang

Axillary hemorrhage is difficult to control before hospital arrival because effective external compression depends on locating a deep arterial target beneath variable shoulder anatomy. We defined four bilateral body-surface zones for the subclavian-axillary artery and evaluated their estimation from computed tomography angiography (CTA)-derived depth images. Of 456 retrospectively reviewed CTA scans, 230 were technically eligible and 228 cases with paired depth images and labels underwent fixed patient-level five-fold out-of-fold (OOF) evaluation. The selected U-Net used equally weighted cross-entropy and multiclass Dice losses with depth-safe augmentation; comparators were standard U-Net, HRNetV2-W18, nnU-Net v2 2D, and nearest-template affine registration. The selected U-Net achieved overall OOF Dice 0.7397 ± 0.0586, with zone-wise Dice 0.5606, 0.7574, 0.7771, and 0.8637. Relative to standard U-Net, mean paired Dice differences were 0.0122 overall (95% confidence interval [CI], 0.0088–0.0156) and 0.0503 for Zone 1 (95% CI, 0.0391–0.0617). Median Zone 1 centroid distance was 10.86 pixels, and 201/228 cases (88.2%) had an intersection over union (IoU) of at least 0.25. These internal CTA-derived simulations support computational feasibility; prospective external validation with real color-and-depth (RGB-D) image acquisition and clinical outcome assessment remains necessary.

Peer review is fundamental to quality scientific communication, yet reviewer behavior remain underexplored. The impact of emerging large language models (L

Introduction: Staphylococcus aureus infection has long been a serious concern in the medical field, with methicillin-resistant Staphylococcus aureus (MRSA) posing a considerable challenge to public health. Given the escalating bacterial resistance and the favorable biosafety and environmental properties of phages, the resurgence of phage therapy offers a promising alternative to antibiotics.Methods: In this study, we isolated and characterized a MRSA phage named StAP1 from a Chinese hospital. Phenotypic and molecular analyses revealed its broad-spectrum characteristics, genomic background, and potential application in MRSA infection treatment.Results: Morphological examination classified the phage as a member of the Herelleviridae phage family, displaying a typical hexagonal head and a slender fibrous tail. Genomic analysis unveiled a size of ~144,705 bp for the StAP1 genome, encompassing 215 open reading frames (ORFs). The one-step growth curve demonstrated a 20-min incubation period for the phage, with an optimal multiplicity of infection (MOI) of 0.1. Moreover, StAP1 exhibited stability across a wide range of temperatures and pH levels. Further investigation of its broad-spectrum characteristics confirmed its ability to effectively infect all staphylococcal cassette chromosomal mec (SCCmec) types found in MRSA strains, notably displaying a remarkable lysis rate of 76.7% against the prevalent ST239 strain in China. In vivo studies show cased significant efficacy of the StAP1 phage against MRSA infection.Discussion: Overall, StAP1 phage presents a broad infection spectrum and exhibits strong lytic effects on various MRSA strains, highlighting its tremendous potential as a powerful tool for MRSA infection treatment.

Intra‐abdominal hypertension (IAH) has gained increasing attention worldwide because of its prevalence and high mortality rate among intensive care unit (ICU) patients. Most current approaches of measuring intra‐abdominal pressure (IAP) involve the use of sensors inside or attached to the body, which may, however, make daily monitoring inconvenient. This paper proposes a noninvasive and contactless system to learn the relationship between the passive mechanical behavior of the abdominal wall with millimeter‐wave (mm‐wave) frequency‐modulated continuous wave (FMCW) radar and an IAP sensor via a deep learning approach. We correlated the IAP variance with the mobility measures of the abdominal wall and proposed Pearson‐coefficient‐guided domain adversarial neural network (PCG‐DANN) to learn the mapping relationship. To validate the efficacy of our proposed method, a stable intra‐abdominal hypertension/abdominal compartment syndrome (IAH/ACS) model using swine was established to evaluate the mobility of the abdominal wall under different intra‐abdominal pressures with multichannel mm‐wave FMCW radar. The superiority of the proposed method is demonstrated by comparing with other neural network structures and mostly adopted sensor‐based methods. These preliminary results confirm that the new methodology for evaluating IAP nonlinearity is promising and that it can serve as an important diagnostic and treatment reference for patients with IAH.

Objective: Noncompressible torso hemorrhage (NCTH) is a major challenge in prehospital bleeding control and is associated with high mortality. This study was performed to estimate medical knowledge and the perceived barriers to information acquisition among health-care workers (HCWs) regarding NCTH in China.Methods: A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue.Results: A total of 575 HCWs participated in this study. In the knowledge section, the majority (87.1%) denied that successful hemostasis could be obtained by external compression. Regarding attitudes, the vast majority of HCWs exhibited positive attitudes toward the important role of NCTH in reducing prehospital preventable death (90.4%) and enthusiasm for continuous learning (99.7%). For practice, fewer than half of HCWs (45.7%) had heard of NCTH beforehand, only a minority (14.3%) confirmed they had attended relevant continuing education, and 16.3% HCWs had no access to updated medical information. The most predominant barrier to information acquisition was the lack of continuing training (79.8%).Conclusions: Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.

BackgroundAbdominal wall tension (AWT) plays an important role in the pathogenesis of abdominal compliance (AC). This study uses a polynomial regression model to analyze the correlation between intra-vesical pressure(IVP) and AWT in critically ill patients and provides new ideas for the diagnosis and treatment of critically ill patients with intra-abdominal hypertension（IAH）.MethodsA retrospective analysis was conducted in critically ill patients who met the inclusion criteria and were admitted to the Department of intensive care unit of Daping Hospital of Army Medical University from March 14, 2019, to May 23, 2020. According to the IVP on the first day of ICU admission and death within 28 days, the patients were divided into the IAH group (IVP ≥12 mmHg), the non-IAH group, the survival group and the nonsurvival group. The demographic and clinical data, prognostic indicators, AWT and IVP on days 1-7 after entering the ICU, IAH risk factors, and 28-day death risk factors were collected.ResultsA total of 100 patients were enrolled, with an average age of 45.59±11.4 years. There were 55 males (55%), 30 patients from departments of internal medicine (30%), 43 patients from surgery departments (43%), and 27 trauma patients (27%). In the IAH group, there were 50 patients (29 males, 58%), with an average age of 45.28±12.27 years; there were 50 patients (26 males, 52%) in the non-IAH group, with an average age of 45.90±10.58 years. The IVP on the 1^st day and the average IVP within 7 days of the IAH group was 18.99（17.52，20.77）mmHg and 19.43（16.87，22.25）mmHg, respectively, which was higher than that of the non-IAH group [ 6.14（3.48，8.70）mmHg, 6.66（2.74，9.08）mmHg], p＜0.001. The AWT on the 1^st day and the average AWT within 7 days of the IAH group was 2.89±0.32 N/mm and 2.82±0.46 N/mm, respectively, which was higher than that of the non-IAH group [(2.45±0.29)N/mm,(2.43±0.39)N/mm],p＜0.001.The polynomial regression models showed that the average AWT and IVP on the 1^st day and within 7 days were AWT_day1 = -2.450×10^-3IVP²+9.695×10^-2 IVP+2.046，r=0.667（p＜0.0001），and AWT_mean = -2.293×10^-3IVP²+9.273×10^-2 IVP+2.081, respectively. The logistic regression analysis showed that AWT_day1 of 2.73-2.97 N/mm increased the patient's 28-day mortality risk (OR: 6.834; 95%: 1.105-42.266, p=0.010).ConclusionsThere is a nonlinear correlation between AWT and IVP in critically ill patients, and a high AWT may indicate poor prognosis.

Background：In this study, a new measurement device was used to measure the AWT in critically ill patients and a polynomial regression model was applied to analyze the correlation between intra-abdominal hypertension (IAH) and AWT in critically ill patients.Methods: A retrospective analysis was conducted in critically ill patients who were admitted to the Department of Critical Care Medicine of Daping Hospital of Army Medical University from March 13, 2019, to May 23, 2020. According to the intravesical pressure (IVP) on the first day of ICU admission and death within 28 days, the patients were divided into the IAH group (IVP ≥12 mmHg), the non-IAH group, the survival group and the nonsurvival group. The demographic and clinical data, prognostic indicators, AWT and IVP on days 1-7 after entering the ICU, IAH risk factors, and 28-day death risk factors were collected.Results: The AWT on the 1^st and mean 7^th day of the IAH group was (2.89±0.32)N/mm and (2.82±0.46) N/mm, respectively, which was higher than that of the non-IAH group [ (2.45±0.29) N/mm, (2.43±0.39) N/mm], p＜0.001. The average IVP on the 1^st and mean 7^th day of all patients were 12.78 (6.14, 18.99) and 11.49 (6.66, 19.43) mmHg, and the AWT on the 1^st and mean 7^th days were (2.75±0.38) and (2.75±0.47) N/mm, respectively, with significant differences (p< 0.0001). The polynomial regression models showed that the average AWT and IVP on the 1^st and mean 7^th were AWT_day1=-2.450×10^-3, IVP²+9.695×10^-2 IVP+2.046，r=0.667（p＜0.0001），and AWT_mean=-2.293×10^-3, IVP²+9.273×10^-2 IVP+2.081, respectively. The logistic regression analysis showed that AWT_day1 2.73-2.97N/mm increased the patient's 28-day mortality risk (OR: 6.834; 95%: 1.105-42.266, p=0.010).Conclusion: There is a nonlinear correlation between AWT and IVP in critically ill patients, and a high AWT may indicate poor prognosis.Trial registration：ChiCTR，ChiCTR1900020562. Registered 8 January 2019，http://www.chictr.org.cn/showproj.aspx?proj=34441