Endovascular revascularization vs. open surgical revascularization for patients with lower extremity artery disease: a systematic review and meta-analysis

BackgroundCurrently, the main treatment for lower extremity artery disease (LEAD) is revascularization, including endovascular revascularization (EVR) and open surgical revascularization (OSR), but the specific revascularization strategy for LEAD is controversial. This review provided the comprehensive and recent evidence for the treatment of LEAD.MethodsMedline, Embase, and the Cochrane Library databases were searched for relevant articles. Randomized controlled trials (RCTs) and cohort studies comparing the short-term or long-term outcomes between EVR and OSR of LEAD were identified. Short-term outcomes were 30-day mortality, major amputation, wound complication, major adverse cardiovascular events (MACEs), and length of hospital stay (LOS), while long-term outcomes included overall survival (OS), amputation-free survival (AFS), freedom from re-intervention (FFR), primary patency (PP), and secondary patency (SP).Results11 RCTs and 105 cohorts involving 750,134 patients were included in this analysis. For the pooled results of cohort studies, EVR markedly decreased the risk of 30-day mortality, wound complication, MACEs, LOS, but increased the risk of OS, FFR, PP, and SP. For the pooled outcomes of RCTs, EVR was associated with obviously lower 30-day mortality, less wound complication and shorter LOS, but higher risk of PP, and SP. However, both RCTs and cohorts did not show obvious difference in 30-day major amputation and AFS.ConclusionsBoth the pooled results of cohorts and RCTs indicated that EVR was associated with a lower short-term risk for LEAD, while OSR was accompanied by a substantially lower long-term risk. Therefore, the life expectancy of LEAD should be strictly considered when choosing the revascularization modality. As the current findings mainly based on data of retrospective cohort studies, additional high-quality studies are essential to substantiate these results.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42022317239

Tourism cloud management system: the impact of smart tourism.

This study investigates the possibility of supporting tourists in a foreign land intelligently, by using the Tourism Cloud Management System (TCMS) to enhance and better their tourism experience. Some technologies allow tourists to highlight popular tourist routes and circuits, through the visualisation of data and sensor clustering approaches. With this, a tourist can access the shared data on a specific location to know the sites of famous local attractions, how other tourists feel about them, and how to participate in local festivities through a smart tourism model. This study surveyed the potential of smart tourism among tourists and how such technologies have developed over time, while proposing a TCMS. Its goals were to make physical/paper tickets redundant via the introduction of a mobile app with eTickets that can be validated using camera-based and QR code technologies, and to enhance the transport network using Bluetooth and GPS for real-time identification of tourists' proximity. The results show that a significant number of participants engage in tourist travels, hence the need for smart tourism and tourist management. It was concluded that smart tourism is very appealing to tourists and can improve the appeal of the destination, if smart solutions are implemented. This study gives a first-hand review of the preference of tourists and the potential of smart tourism

Transcription factor IRF8 directs a silencing programme for TH17 cell differentiation

TH17 cells are recognized as a unique subset of T helper cells that have critical roles in the pathogenesis of autoimmunity and tissue inflammation. Although RORγt is necessary for the generation of TH17 cells, the molecular mechanisms underlying the functional diversity of TH17 cells are not fully understood. Here we show that a member of interferon regulatory factor (IRF) family of transcription factors, IRF8, has a critical role in silencing TH17-cell differentiation. Mice with a conventional knockout, as well as a T cell-specific deletion, of the Irf8 gene exhibited more efficient TH17 cells. Indeed, studies of an experimental model of colitis showed that IRF8 deficiency resulted in more severe inflammation with an enhanced TH17 phenotype. IRF8 was induced steadily and inhibited TH17-cell differentiation during TH17 lineage commitment at least in part through its physical interaction with RORγt. These findings define IRF8 as a novel intrinsic transcriptional inhibitor of TH17-cell differentiation

5-Fluorouracil targets thymidylate synthase in the selective suppression of TH17 cell differentiation

While it is well established that treatment of cancer patients with 5-Fluorouracil (5-FU) can result in immune suppression, the exact function of 5-FU in the modulation of immune cells has not been fully established. We found that low dose 5-FU selectively suppresses TH17 and TH1 cell differentiation without apparent effect on Treg, TH2, and significantly suppresses thymidylate synthase (TS) expression in TH17 and TH1 cells but has a lesser effect in tumor cells and macrophages. Interestingly, the basal expression of TS varies significantly between T helper phenotypes and knockdown of TS significantly impairs TH17 and TH1 cell differentiation without affecting the differentiation of either Treg or TH2 cells. Finally, low dose 5-FU is effective in ameliorating colitis development by suppressing TH17 and TH1 cell development in a T cell transfer colitis model. Taken together, the results highlight the importance of the anti-inflammatory functions of low dose 5-FU by selectively suppressing TH17 and TH1 immune responses

T cell–derived inducible nitric oxide synthase switches off TH17 cell differentiation

RORγt is necessary for the generation of TH17 cells but the molecular mechanisms for the regulation of TH17 cells are still not fully understood. We show that activation of CD4+ T cells results in the expression of inducible nitric oxide synthase (iNOS). iNOS-deficient mice displayed enhanced TH17 cell differentiation but without major effects on either TH1 or TH2 cell lineages, whereas endothelial NOS (eNOS) or neuronal NOS (nNOS) mutant mice showed comparable TH17 cell differentiation compared with wild-type control mice. The addition of N6-(1-iminoethyl)-l-lysine dihydrochloride (L-NIL), the iNOS inhibitor, significantly enhanced TH17 cell differentiation, and S-nitroso-N-acetylpenicillamine (SNAP), the NO donor, dose-dependently reduced the percentage of IL-17–producing CD4+ T cells. NO mediates nitration of tyrosine residues in RORγt, leading to the suppression of RORγt-induced IL-17 promoter activation, indicating that NO regulates IL-17 expression at the transcriptional level. Finally, studies of an experimental model of colitis showed that iNOS deficiency results in more severe inflammation with an enhanced TH17 phenotype. These results suggest that NO derived from iNOS in activated T cells plays a negative role in the regulation of TH17 cell differentiation and highlight the importance of intrinsic programs for the control of TH17 immune responses

Robot-Environment Interaction Control of a Flexible Joint Light Weight Robot Manipulator

This paper presents a weighted path planning approach for a light weight robot coming into compliant contact with the environment, as well as robot-environment interaction enabled impedance control. Using a joint torque sensor, Cartesian impedance control is introduced to realize the manipulator compliance control. Then the weighted path planning approach is developed to detect the contact condition and to control the interaction. Experiments are carried out on a 5-DOF light weight manipulator. The experimental results validate the developed control approach enhanced by the weighted path planning scheme

Immune Regulation and Antitumor Effect of TIM-1

T cells play an important role in antitumor immunity, and the T cell immunoglobulin domain and the mucin domain protein-1 (TIM-1) on its surface, as a costimulatory molecule, has a strong regulatory effect on T cells. TIM-1 can regulate and enhance type 1 immune response of tumor association. Therefore, TIM-1 costimulatory pathways may be a promising therapeutic target in future tumor immunotherapy. This review describes the immune regulation and antitumor effect of TIM-1

Regulation of iNOS on Immune Cells and Its Role in Diseases

In recent years, there have been many studies on the function of nitric oxide synthase (NOS) in experimental animals and humans. This review analyzes and explores the relationship between inducible nitric oxide synthase (iNOS) and T cells, macrophages, and dendritic cell et al. differentiation using data based on laboratory research, highlighting recent NOS laboratory research. Our insights into research prospects and directions are also presented

Video Segment Indexing Through Classification and Interactive View-based Query

As video information proliferates, managing video sources becomes increasingly important. Indices must be constructed to allow any future retrieval. We distinguish two categories of indexing: (i) those that are general-purpose and do not make use of domain-specific knowledge, and (ii) those that are application-dependent. In this paper, we present our work in both categories within the VideoBook project. We discuss how to structure video data into shots (physical parts) and clusters (semantic parts). A video partitioning algorithm is described. Its effectiveness and efficiency lies in the use of both statistical and spatial information in the images without, however, having to examine the entire images. To improve the querying efficiency, we propose to investigate in two directions: deriving higher-level indices through classification and providing a method that finds targets of interest through interactive learning. The first technique takes advantage of domain knowledge of underlyi..