Search

BACKGROUND: To use adversarial training to increase the generalizability and diagnostic accuracy of deep learning models for prostate cancer diagnosis. METHODS: This multicenter study retrospectively included 396 prostate cancer patients who underwent magnetic resonance imaging (development set, 297 patients from Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and Eighth People’s Hospital; test set, 99 patients from Renmin Hospital of Wuhan University). Two binary classification deep learning models for clinically significant prostate cancer classification [PM1, pretraining Visual Geometry Group network (VGGNet)-16-based model 1; PM2, pretraining residual network (ResNet)-50-based model 2] and two multiclass classification deep learning models for prostate cancer grading (PM3, pretraining VGGNet-16-based model 3; PM4: pretraining ResNet-50-based model 4) were built using apparent diffusion coefficient and T2-weighted images. These models were then retrained with adversarial examples starting from the initial random model parameters (AM1, adversarial training VGGNet-16 model 1; AM2, adversarial training ResNet-50 model 2; AM3, adversarial training VGGNet-16 model 3; AM4, adversarial training ResNet-50 model 4, respectively). To verify whether adversarial training can improve the diagnostic model’s effectiveness, we compared the diagnostic performance of the deep learning methods before and after adversarial training. Receiver operating characteristic curve analysis was performed to evaluate significant prostate cancer classification models. Differences in areas under the curve (AUCs) were compared using Delong’s tests. The quadratic weighted kappa score was used to verify the PCa grading models. RESULTS: AM1 and AM2 had significantly higher AUCs than PM1 and PM2 in the internal validation dataset (0.84 vs. 0.89 and 0.83 vs. 0.87) and test dataset (0.73 vs. 0.86 and 0.72 vs. 0.82). AM3 and AM4 showed higher κ values than PM3 and PM4 in the internal validation dataset {0.266 [95% confidence interval (CI): 0.152–0.379] vs. 0.292 (95% CI: 0.178–0.405) and 0.254 (95% CI: 0.159–0.390) vs. 0.279 (95% CI: 0.163−0.396)} and test set [0.196 (95% CI: 0.029–0.362) vs. 0.268 (95% CI: 0.109–0.427) and 0.183 (95% CI: 0.015–0.351) vs. 0.228 (95% CI: 0.068−0.389)]. CONCLUSIONS: Using adversarial examples to train prostate cancer classification deep learning models can improve their generalizability and classification abilities.

In a periodic system with parity-time (PT) symmetry, spontaneous breaking of PT symmetry occurs when non-Hermiticity exceeds a critical value, thereby dividing the Bloch bands into PT-exact phase and PT-broken phase in two momentum regimes.From another perspective, PT-broken momentum regime can be deemed as a momentum gap if we consider Bloch k as eigenvalue of the problem instead.The topological aspects of such a type of momentum gap (PT-broken regime) remain unexplored. Here, we study the topological properties of momentum bandgap in one-dimensional (1D) PT-symmetric photonic crystals (PCs).k*p analysis shows that reversing the system's non-Hermiticity would lead to a topological phase transition, which is manifested as a local geometric phase along the momentum band.As a consequence of such geometric phase, a temporal boundary state (TBS) exists in the middle of momentum gap. Its robustness against perturbations and disorders is numerically verified by temporal simulations.

Background Thrombus enhancement (TE) in large vessel occlusion in patients with acute ischemic stroke can be visualized with thin-slab maximum intensity projection (TS-MIP) image reconstruction of CT angiograms. Purpose To evaluate whether TE on TS-MIP reconstructed CT angiograms can be used to predict thrombus composition and stroke source. Materials and Methods This retrospective study included consecutive patients with acute ischemic stroke who underwent thrombectomy in the anterior circulation between August 2016 and July 2019. Stroke types were classified according to the Trial of ORG 10172 in Acute Stroke Treatment. TE on TS-MIP reconstructed CT angiograms was evaluated by two readers. Various clinical and interventional parameters and histopathologic thrombi examination results were compared between the TE-positive and TE-negative groups. The associations between TE and thrombus compositions and stroke sources were analyzed by using multivariable linear and logistic regression models. Results A total of 148 patients (mean age, 71 years ± 11 [standard deviation]; 94 men) were included. TE was confirmed in 80% (119 of 148) of the patients. TE-positive thrombi contained a higher fibrin and platelet proportion (mean, 46% ± 16 vs 34% ± 13; P = .02) and fewer erythrocytes (mean, 33% ± 14 vs 48% ± 20, P = .002) than the TE-negative thrombi. The proportion of cardioembolic and cryptogenic strokes in the TE-positive and TE-negative groups was 92% (110 of 119) and 24% (seven of 29), respectively (P < .001). In adjusted analysis, the presence of TE (odds ratio, 155; 95% CI: 17, 1438; P < .001) was associated with a combination of cardioembolic and cryptogenic strokes. A multiple logistic regression model showed that TE (odds ratio, 23; 95% CI: 1.8, 288; P = .02) was significantly associated with cardioembolic stroke. Conclusion Thrombus enhancement on thin-slab maximum intensity projection of CT angiography can be used to predict cardioembolic and cryptogenic strokes and identify thrombi with a higher fibrin-to-platelet fraction and a lower erythrocyte proportion. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Kansagra and Goyal in this issue.

The uniaxial tensile and fracture properties are the basic data for the structural integrity assessment of ductile material. In this study, the stress-strain relations of ductile materials are pred...

In this work, the small lateral-compression testing based on energy equivalent (SLT-EE) method is put forward to determine the stress–strain curves of materials utilizing small disk specimens. Numerical simulations of small lateral-compression testing with imaginary materials are conducted to examine the validity of the SLT-EE method. The results demonstrate that the stress–strain curves determined by the SLT-EE method coincide with the curves input by finite element analysis. In order to predict the stress–strain curves of materials with different dimensions, a modified SLT-EE method is successfully proposed by introducing a correction factor f. Finally, the small disk compression experiments of Q345B, 304, 7075 and 6061 are performed. The stress–strain curves of the four materials predicted by the SLT-EE method show agreement with the tension results. Furthermore, the mechanical properties of in-service hollow components are also determined utilizing the same method successfully.

Based on the density functional theory with hybrid functional approach, we calculated the structural, electronic, and the optical properties of Cu2MgSn(S1-xSex)4 (CMTSSe), an potential photovoltaic material for thin film solar cells. The calculation reveals a phase transition from kesterite to stannite structure when Zn atoms are substituted by Mg atoms. In particular, the S-to-Se ratio can determine the energy splitting between the electronic states at the top of the valence band. The band gaps of CMTSSe can be tuned in the ranges of 1.01-1.58 eV. Calculated optical properties and tunable band gaps make them beneficial for achieving band-gap-graded solar cells.

We investigated lipidomic features from healthy controls (HCs), patients with unruptured cerebral aneurysms (UCAs) and ruptured CAs (RCAs) to analyze their lipidomic profiles and identify a lipid signature associated with CAs. Patients (n = 540) were enrolled from two centers. We identified significantly altered plasma lipids in 2 cohort with the total lipid intensity decreasing from HC to UCA to RCA. Triglycerides comprised the distinct profile of lipids in CAs. A four-lipid signatures showed good calibration and diagnostic prediction for CA vs. HC and UCA vs. RCA, but independent discriminate CA from HC, UCA from RCA, and RCA (RI and RII) or UCA (UI and UII) subtypes, in training and validation cohorts. Comprehensive lipidomic profiles identified decreased lipids as a prominent feature of CA development, and a four-lipid signature could not only better diagnose and predict UCAs/RCAs from HCs, but also predicted patients subtypes with severe RCA or high-risk UCA.

Congenital hypoplasia or aplasia of the A1 segment of the anterior cerebral artery is associated with an increased incidence of berry aneurysms at the anterior communicating artery (ACoA) complex. We analyzed the factors contributing to ACoA aneurysm rupture.We retrospectively analyzed the data of patients with ACoA aneurysms who had undergone cerebral angiography from July 2008 to January 2020. The risk factors for rupture were identified using univariate and multivariate logistic regression models. We used the imaging data of patients without intracranial aneurysms as the control population.We confirmed 253 aneurysms in 253 patients, including 137 men (54.2%) and 116 women (45.8%), with a mean age of 54.6 ± 12.7 years. Of the 253 aneurysms, 218 (86.2%) were ruptured and 35 (13.8%) were unruptured, with a mean diameter of 4.56 ± 1.96 mm and 3.24 ± 1.79 mm, respectively. Of the 253 aneurysms, 176 (69.6%) were5 mm in diameter, 146 (83%) of which were ruptured. Of the 253 patients, 141 (55.7%) exhibited A1 segment hypoplasia or aplasia: 106 (41.9%) on the right side of the circle of Willis and 35 (13.8%) on the left. Multivariate logistic regression analysis identified the aneurysm diameter (odds ratio, 4.11; 95% confidence interval, 1.601-16.07; P = 0.003) and age65 years (odds ratio, 0.17; 95% confidence interval, 0.062-0.48; P0.001) as independent predictors of rupture.ACoA aneurysms are small (5 mm) and have a high risk of rupture. A1 segment hypoplasia or aplasia is a risk factor for ACoA aneurysm formation; however, it was uncorrelated with aneurysm diameter or rupture risk. The strongest independent risk factors for rupture were age65 years and aneurysm diameter.

We study the magnetic moments and transition magnetic moments of $P_c$ and $P_{cs}$ states in the molecular picture. We first revisit the magnetic moments of $P_c$ states as the $S$ wave molecular states without coupled channel effects. The coupled channel effects and the $D$ wave contributions are then investigated carefully. The coupled channel effects contribute to the change of $0.1\sim 0.4$ nuclear magneton $\mu_N$ for most cases while the $D$ wave only induces the variation of less than $0.03 ~\mu_N$. In addition, we obtain the transition magnetic moments between different $P_c$ states and the related electromagnetic decay widths of $P_c'\to P_c\gamma$. The magnetic moments of $P_{cs}$ are much different for the assumption of spin being 1/2 and 3/2. The study of electromagnetic properties will help us disclose further the structure of these unconventional states., Comment: 8 pages, 5 tables; version appeared in Phys. Rev. D

Background Recent studies indicated that majority of stroke with undetermined etiology (SUE) showed strong overlap with cardioembolic stroke (CE). We intended to determine the efficacy of the mono antiplatelet (MA) therapy in both stroke types after receiving successful mechanical thrombectomy (MT) recanalization in the acute stage. Methods 178 consecutive stroke patients who received MT treatment were retrospectively analyzed. For CE and SUE type stroke patients, aspirin 100 mg or clopidogrel 75 mg was added immediate for those didn`t received IV-rtPA and after 24 h for those received IV-rtPA if symptomatic intracranial hemorrhage (sICH) was not found. MA treatment outcomes included recanalized artery patency, subsequent sICH and functional independence (mRS score 0–2) were compared between two stroke types. Results 75 CE and 50 SUE patients were included into final analysis. Target artery was confirmed 100 % patency in the CE group and 97.5 % in the SUE group at 7 days after recanalization. Hemorrhagic transformation after 24 h was found in 10 % patients in the SUE group and in 12 % patients in the CE group (P > 0.05). sICH was confirmed in 1 patient in the SUE group and in 2 patients in the CE group. At 90 days, 45.8 % in the SUE group and 46.5 % in the CE group of patients had achieved good outcomes (P = 1.00). However, accumulative death was higher in the CE group than in the SUE group (21 % vs. 15 %; P = 0.47). Conclusion For patients considered CE or SUE stroke types, mono antiplatelet therapy after good flow restoration by thrombectomy is safe and effective.

Recent advances in neuroimaging have demonstrated significant assessment benefits and appropriate triage of patients based on specific clinical and radiological features in the acute stroke setting. Endovascular thrombectomy is arguably the most important aspect of acute stroke management with an extended time window. Imaging-based physiological information may potentially shift the treatment paradigm from a rigid time-based model to a more flexible and individualized, tissue-based approach, increasing the proportion of patients amenable to treatment. Various imaging modalities are routinely used in the diagnosis and management of acute ischemic stroke, including multimodal computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, these imaging methods should provide information beyond the presence or absence of intracranial hemorrhage as well as the presence and extent of the ischemic core, collateral circulation and penumbra in patients with neurological symptoms. Target mismatch may optimize selection of patients with late or unknown symptom onset who would potentially be eligible for revascularization therapy. The purpose of this study was to provide a comprehensive review of the current evidence about efficacy and theoretical basis of present imaging modalities, and explores future directions for imaging in the management of acute ischemic stroke.

We aimed to compare the efficiency of prostate cancer (PCa) detection using a radiomics signature based on advanced zoomed diffusion-weighted imaging and conventional full-field-of-view DWI. A total of 136 patients, including 73 patients with PCa and 63 without PCa, underwent multi-parametric magnetic resonance imaging (mp-MRI). Radiomic features were extracted from prostate lesion areas segmented on full-field-of-view DWI with b-value = 1500 s/mm2 (f-DWIb1500), advanced zoomed DWI images with b-value = 1500 s/mm2 (z-DWIb1500), calculated zoomed DWI with b-value = 2000 s/mm2 (z-calDWIb2000), and apparent diffusion coefficient (ADC) maps derived from both sequences (f-ADC and z-ADC). Single-imaging modality radiomics signature, mp-MRI radiomics signature, and a mixed model based on mp-MRI and clinically independent risk factors were built to predict PCa probability. The diagnostic efficacy and the potential net benefits of each model were evaluated. Both z-DWIb1500 and z-calDWIb2000 had significantly better predictive performance than f-DWIb1500 (z-DWIb1500 vs. f-DWIb1500: p = 0.048; z-calDWIb2000 vs. f-DWIb1500: p = 0.014). z-ADC had a slightly higher area under the curve (AUC) value compared with f-ADC value but was not significantly different (p = 0.127). For predicting the presence of PCa, the AUCs of clinical independent risk factors model, mp-MRI model, and mixed model were 0.81, 0.93, and 0.94 in training sets, and 0.74, 0.92, and 0.93 in validation sets, respectively. Radiomics signatures based on the z-DWI technology had better diagnostic accuracy for PCa than that based on the f-DWI technology. The mixed model was better at diagnosing PCa and guiding clinical interventions for patients with suspected PCa compared with mp-MRI signatures and clinically independent risk factors. • Advanced zoomed DWI technology can improve the diagnostic accuracy of radiomics signatures for PCa. • Radiomics signatures based on z-calDWIb2000 have the best diagnostic performance among individual imaging modalities. • Compared with the independent clinical risk factors and the mp-MRI model, the mixed model has the best diagnostic efficiency.

Background Periprocedural antithrombotic medication after mechanical thrombectomy (MT) for acute intracranial large vessel occlusion (LVO) is still controversial. Recent studies have indicated that majority of stroke with undetermined etiology (SUE), as defined by the TOAST classification, showed strong overlap with cardioembolic stroke (CE). We intended to determine the efficacy of the mono antiplatelet (MA) therapy in both stroke types after receiving successful MT recanalization in the acute stage. Methods 178 consecutive stroke patients who received MT treatment were retrospectively analyzed. CE and SUE type stroke patients were chosed to received MA therapy. Aspirin 100mg or clopidogrel 75 mg was added immediate for patients who didn`t received intravenously recombinant tissue plasminogen activator (IV-rtPA) and after 24 hours for those received IV-rtPA if symptomatic intracranial hemorrhage (sICH) was not found. MA treatment outcomes included recanalized artery patency, subsequent sICH and functional independence (mRS score of 0-2) were compared between two stroke types. Results Successful recanalization (TICI 2b/3) was achieved in 75 CE stroke patients and 50 SUE patients without hemorrhagic transformation were included into final analysis. Target artery at 7 days after recanalization was confirmed 100% patency in the CE group and 97.5% in the SUE group. Hemorrhagic transformation after 24h was found in 26% patients in the SUE group and in 26.7% patients in the CE group (P > 0.05). sICH was confirmed in 3 patients in the SUE group and in 10 patients in the CE group. At 90 days, 45.8% in the SUE group and 46.5% in the CE group of patients had achieved good outcomes (mRs 0-2) (P=1.00). However, accumulative death was higher in the CE group than in the SUE group (21% vs. 15%; P=0.47) Conclusion Mono antiplatelet strategy for the treatment of accurate stage of cardioembolic stroke received mechanical thrombectomy is safe and effective. Meanwhile, for patients considered SUE stroke type, mono antiplatelet therapy after thrombectomy achieved similar treatment outcomes as compared to cardioembolic stroke patients.

Summary: Increased aerobic glycolysis is a hallmark of cancer metabolism. How cancer cells coordinate glucose metabolism with extracellular glucose levels remains largely unknown. Here, we report that coactivator-associated arginine methyltransferase 1 (CARM1 or PRMT4) signals glucose availability to glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and suppresses glycolysis in liver cancer cells. CARM1 methylates GAPDH at arginine 234 (R234), inhibiting its catalytic activity. Glucose starvation leads to CARM1 upregulation, further inducing R234 hypermethylation and GAPDH inhibition. The re-expression of wild-type GAPDH, but not of its methylation-mimetic mutant, sustains glycolytic levels. CARM1 inhibition increases glycolytic flux and glycolysis. R234 methylation delays tumor cell proliferation in vitro and in vivo. Compared with normal tissues, R234 is hypomethylated in malignant clinical hepatocellular carcinoma samples. Notably, R234 methylation positively correlates with CARM1 expression in these liver cancer samples. Our findings thus reveal that CARM1-mediated GAPDH methylation is a key regulatory mechanism of glucose metabolism in liver cancer. : GAPDH is a critical enzyme in glycolysis. Zhong et al. find that CARM1 methylates GAPDH at R234 and inhibits its activity in an AMPK-dependent manner. R234 methylation inhibits glycolysis and proliferation of liver cancer cell lines. In hepatocellular carcinoma patient samples, GADPH R234 is hypomethylated, and there is a positive correlation between CARM1 levels and R234 methylation. Keywords: GAPDH, CARM1, arginine methylation, coenzyme affinity, glycolysis, AMPK, nutrient sensing, Warburg effect, metabolic reprogramming, liver cancer

Background: To investigate the efficacy of retrograde recanalization for chronic total occlusion (CTO) of femoral-popliteal artery in patients with peripheral arterial disease. Methods: In this single-center retrospective study, all patients who had undergone endovascular recanalization for femoral-popliteal CTOs at our center from June 2011 to October 2014 were included. Patients’ demographics, immediate and follow-up outcomes were analyzed. Results: A total of 205 patients with 238 CTOs were enrolled. In total, successful recanalization was achieved in 228 CTOs (95.8%). The antegrade procedure was successful in 196 CTOs. The retrograde procedure was successfully performed in 32 CTOs after failed antegrade procedure. Ankle-brachial index increased from 0.48±0.18 to 0.79±0.16 in antegrade group vs . 0.41±0.13 to 0.76±0.13 in retrograde group (P=0.438). Pulse score increased from 0.48±0.50 to 2.30±0.76 in antegrade group vs . 0.48±0.51 to 2.30±0.79 in retrograde group (P=0.771). At 12 and 24 months, primary patency rate was 86.2% (169/196) and 51.5% (101/196) in the antegrade group, and 75.0% (24/32) and 43.8% (14/32) in the retrograde group, respectively (P=0.346). Kaplan-Meier analysis showed limb salvage rates of 85.7% in the antegrade group vs . 78.1% in the retrograde group (P=0.198). Conclusions: Retrograde recanalization is effective for CTO of femoral-popliteal artery after the failure of an antegrade procedure; immediate outcomes and mid-term patency and limb salvage rate are comparable with that of antegrade procedure.

Aneurysmal subarachnoid hemorrhage is caused by intracranial aneurysm (IA) rupture and results in high rates of mortality and morbidity. Factors contributing to IA generation, growth and rupture can involve genetics, injury, hemodynamics, environmental factors, and inflammation, in which inflammatory factors are believed to play central roles in the whole natural history. Inflammatory reactions that contribute to IA development may involve synthesis of many functional proteins and expression of genes induced by changes of blood flow, external stimuli such as smoking, internal balance such as hormonal status changes, and blood pressure. Meanwhile, inflammatory reactions itself can evoke inflammatory cytokines release and aggregation such as MMPs, MCP-1, TNF-α and ZO-1, directly or indirectly promoting aneurysm growth and rupture. However, the details of these inflammatory reactions and their action on inflammatory chemokines are still unknown. Moreover, some agents with the function of anti-inflammation, lipid-lowering, antihypertension or inflammatory factor inhibition may have the potential benefit to reduce the risk of aneurysm development or rupture in a group of population despite the underlying mechanism remains unclear. Consequently, we reviewed the potential inflammatory responses and their mechanisms contributing to aneurysm development and rupture and sought intervention targets that may prevent IA rupture or generation.

The original version of this article unfortunately contained mistakes. The legends to Figs. 2-4 were incorrectly interchanged. The correct versions are given below. The original article has been corrected.

BACKGROUND: Diabetes mellitus (DM) is associated with increased prevalence and severity of atherosclerosis. This study aimed to assess the prevalence and location of atherosclerosis in intracranial and extracranial vessels in diabetic patients and to investigate their association with ischemic stroke subtype. METHODS: Diabetes patients (n=128) and nondiabetic patients (n=195) were enrolled. Brain MRI, MR angiography, and digital subtraction angiography (DSA) imaging findings in the two groups were retrospectively compared. The characteristics of atherosclerosis (prevalence, location, severity) and collateral flow in diabetic and nondiabetic patients and their association with stroke subtype were analyzed. RESULTS: Atherosclerosis in extracranial vessels was more common in diabetes patients than in nondiabetic patients (43.8% vs. 23.1%; P65 years (OR, 2.55; 95% CI, 1.24–5.22; P=0.011) were independent risk factors for lacunar infarct. Diabetes patients with symptomatic extracranial stenosis or occlusion, combined with good collateral circulation, had significantly higher risk of lacunar infarction than nondiabetic patients (47.8% vs. 30.5%; P=0.045). CONCLUSIONS: DM aggravates the severity of extracranial atherosclerosis. Lacunar stroke is relatively common in diabetic patients and could even be due to large artery disease (LAD).

To investigate factors predictive of thromboembolic occlusions and evaluate the efficacy of percutaneous aspiration thrombectomy (PAT) for infrainguinal thromboembolic occlusions in patients undergoing endovascular recanalization (EVR).In this single-center retrospective study, 23 patients who underwent PAT for thromboembolism during EVR and 237 patients who underwent successful EVR without thromboembolic occlusions (control group) were enrolled. Immediate posttreatment and follow-up outcomes between groups were compared. Multivariate analysis was performed to identify factors predictive of thromboembolic occlusions. Technical success of PAT was defined as achievement of30% residual stenosis and restoration of modified thrombolysis in myocardial infarction grade 3 flow.The technical success rate was 95.7% in the PAT group. After intervention, ankle brachial index (ABI), restoration of blood flow, and improvement in dorsal/plantar arterial pulse score showed no significant differences between the PAT and control groups. During follow-up, no significant differences were observed between groups in improvement of sustained ABI and maximum walking distance, ulcer healing, restenosis/occlusion and limb salvage rates, and pain relief in patients with critical ischemia. Stenosis greater than 90% with lesion occlusion (odds ratio, 12.891; 95% confidence interval, 1.676-99.161; P = .014) and intraluminal angioplasty (odds ratio, 18.423; 95% confidence interval, 2.408-140.942; P = .005) were associated with a high incidence of thromboembolism.Stenosis greater than 90% with lesion occlusion and intraluminal angioplasty may be factors predictive of thromboembolic occlusions. PAT is a safe and effective treatment for thromboembolism during infrainguinal arterial EVR.

Developed a liver cancer prediction model for type II diabetic patients.Found the risk factors of liver cancer for type II diabetic patients.Built a web-based application for liver cancer prediction for diabetic patient.Provided methods and model facilitating clinicians to remind those diabetic patients prevent liver cancer as early as possible. BackgroundDiabetes mellitus is associated with an increased risk of liver cancer, and these two diseases are among the most common and important causes of morbidity and mortality in Taiwan. PurposeTo use data mining techniques to develop a model for predicting the development of liver cancer within 6 years of diagnosis with type II diabetes. MethodsData were obtained from the National Health Insurance Research Database (NHIRD) of Taiwan, which covers approximately 22 million people. In this study, we selected patients who were newly diagnosed with type II diabetes during the 2000-2003 periods, with no prior cancer diagnosis. We then used encrypted personal ID to perform data linkage with the cancer registry database to identify whether these patients were diagnosed with liver cancer. Finally, we identified 2060 cases and assigned them to a case group (patients diagnosed with liver cancer after diabetes) and a control group (patients with diabetes but no liver cancer). The risk factors were identified from the literature review and physicians' suggestion, then, chi-square test was conducted on each independent variable (or potential risk factor) for a comparison between patients with liver cancer and those without, those found to be significant were selected as the factors. We subsequently performed data training and testing to construct artificial neural network (ANN) and logistic regression (LR) prediction models. The dataset was randomly divided into 2 groups: a training group and a test group. The training group consisted of 1442 cases (70% of the entire dataset), and the prediction model was developed on the basis of the training group. The remaining 30% (618 cases) were assigned to the test group for model validation. ResultsThe following 10 variables were used to develop the ANN and LR models: sex, age, alcoholic cirrhosis, nonalcoholic cirrhosis, alcoholic hepatitis, viral hepatitis, other types of chronic hepatitis, alcoholic fatty liver disease, other types of fatty liver disease, and hyperlipidemia. The performance of the ANN was superior to that of LR, according to the sensitivity (0.757), specificity (0.755), and the area under the receiver operating characteristic curve (0.873). After developing the optimal prediction model, we base on this model to construct a web-based application system for liver cancer prediction, which can provide support to physicians during consults with diabetes patients. ConclusionIn the original dataset (n=2060), 33% of diabetes patients were diagnosed with liver cancer (n=515). After using 70% of the original data to training the model and other 30% for testing, the sensitivity and specificity of our model were 0.757 and 0.755, respectively; this means that 75.7% of diabetes patients can be predicted correctly to receive a future liver cancer diagnosis, and 75.5% can be predicted correctly to not be diagnosed with liver cancer. These results reveal that this model can be used as effective predictors of liver cancer for diabetes patients, after discussion with physicians; they also agreed that model can assist physicians to advise potential liver cancer patients and also helpful to decrease the future cost incurred upon cancer treatment.

Background aims Exosomes, a key component of cell paracrine secretion, can exert protective effects in various disease models. However, application of exosomes in vascular repair and regeneration has rarely been reported. In this study, we tested whether endothelial progenitor cell (EPC)-derived exosomes possessed therapeutic effects in rat models of balloon-induced vascular injury by accelerating reendothelialization. Methods Exosomes were obtained from the conditioned media of EPCs isolated from human umbilical cord blood. Induction of the endothelial injury was performed in the rats' carotid artery, and the pro-re-endothelialization capacity of EPC-derived exosomes was measured. The in vitro effects of exosomes on the proliferation and migration of endothelial cells were investigated. Results We found that the EPC-derived exosomes accelerated the re-endothelialization in the early phase after endothelial damage in the rat carotid artery. We also demonstrated that these exosomes enhanced the proliferation and migration of endothelial cells in vitro . Moreover, endothelial cells stimulated with these exosomes showed increased expression of angiogenesis-related molecules. Conclusions Taken together, our results indicate that exosomes are an active component of the paracrine secretion of human EPCs and can promote vascular repair in rat models of balloon injury by up-regulating endothelial cells function.

Distributed sparse learning with a cluster of multiple machines has attracted much attention in machine learning, especially for large-scale applications with high-dimensional data. One popular way to implement sparse learning is to use $L_1$ regularization. In this paper, we propose a novel method, called proximal \mbox{SCOPE}~(\mbox{pSCOPE}), for distributed sparse learning with $L_1$ regularization. pSCOPE is based on a \underline{c}ooperative \underline{a}utonomous \underline{l}ocal \underline{l}earning~(\mbox{CALL}) framework. In the \mbox{CALL} framework of \mbox{pSCOPE}, we find that the data partition affects the convergence of the learning procedure, and subsequently we define a metric to measure the goodness of a data partition. Based on the defined metric, we theoretically prove that pSCOPE is convergent with a linear convergence rate if the data partition is good enough. We also prove that better data partition implies faster convergence rate. Furthermore, pSCOPE is also communication efficient. Experimental results on real data sets show that pSCOPE can outperform other state-of-the-art distributed methods for sparse learning.

Flap necrosis is generally regarded as the result of vasospasm, thrombosis, and infection.To improve skin flap survival and lower the risk of side effects due to systemic drug delivery, we formulated and evaluated compound gels for transdermal application. The transdermal delivery of 1% azithromycin (AZM), 0.5% amlodipine besylate (AB), and 300 IU/g low molecular weight heparin (LMWH) in compound gels, singly or in combinations, was measured across rat skin in vitro. The effects of AB and LMWH on flap blood circulation was investigated using fluorescein angiography, by transdermally applying the gel onto the surface of an in vivo ischaemic flap rat model; concentrations of the drugs were detected in both blood plasma and flap tissue at assigned timepoints. Finally, infected ischaemic flaps were treated to evaluate their anti-inflammatory effects and sizes of flap survival area.Each drug efficiently penetrated the in vitro skin in a time-dependent manner. In the in vivo ischaemic flaps, AB or LMWH increased the blood supply. All gel formulations that included AZM were associated with less flap inflammation. The surviving areas after treatment with AZM+LMWH or AZM+AB were significantly larger than that treated with the AZM-only gel, and the largest surviving area was that treated with AZM+AB+LMWH. Gels containing no AZM could not decrease flap inflammation or increase flap survival.Transdermal application of a compound gel with AZM, AB, and LMWH combined is a promising method to prevent and treat flap infection, improve blood circulation, and increase the survival of infected ischaemic flaps.

Rationale and Objectives To compare the clinical outcomes of retrograde transplantar arch angioplasty and conventional below-the-knee (BTK) anterograde recanalization. Materials and Methods One hundred twelve limbs in 96 patients underwent attempt at antegrade tibial angioplasty. Among 27 technical failures, retrograde trans-dorsal or -planter percutaneous transluminal angioplasty was attempted in 22 limbs. Ankle–brachial index (ABI), thrombolysis in myocardial infarction (TIMI) flow grade, and dorsal/plantar arterial pulse score improvement were compared immediately after the procedures between patients received successful anterograde angioplasty (anterograde angioplasty group [AAG], 85 limbs in 71 patients) and retrograde angioplasty (retrograde angioplasty group [RAG], 22 limbs in 20 patients). Target vessel restenosis and limb salvage were observed during follow-up. Results Primary technical success rate was 75.9% in the RAG (vs. 74.0% AAG, P > .05). ABI improved from 0.55 ± 0.21 to 0.93 ± 0.19 in the RAG (vs. 0.56 ± 0.14 to 0.89 ± 0.18 AAG, P > .05). TIMI flow grade demonstrated greater reperfusion of distal foot tissue in the RAG (2.3 ± 0.8 vs. 1.0 ± 0.8, P P > .05). Kaplan–Meier analysis after 24 months found limb salvage rates of 93.8% in the RAG and 96.5% in the AAG ( P > .05). Conclusions Retrograde transplantar arch angioplasty achieved better immediate blood flow and similar ABI improvement, primary patency rate, and limb salvage rate compared to conventional transtibial angioplasty for BTK occlusions. This could become a supplementary technique when anterograde angioplasty fails.

Campus energy consumption takes up a large proportion of the total expenses of the campus. At the same time power consumption is emphasis. In the paper design of campus energy monitoring system and key technologies are demonstrated. The above-mentioned scheme is applied in a university in the north of China. The energy-saving measures are studied combined with the characteristics of the specific energy consumption.

To investigate morphological characteristics used to predict recanalisation strategies in long-segment (10 cm) femoral chronic total occlusion (LSF-CTO) angioplasty.We retrospectively evaluated a range of morphological CTA and DSA features in patients who underwent recanalisation of LSF-CTO. The stage of CTO was classified into early (3-12 months) and late (12 months) according to estimated duration. Characteristics including stump morphology, lesion length and calcification, proximal side branches, collaterals circulation, runoff vessels and concomitant arterial occlusion were used as predictors, and multivariate logistic regression analysis was performed to identify variables associated with late-stage CTO and retrograde technique.A total of 119 patients with 137 CTOs in 137 limbs were enrolled. Overall, successful recanalisation was achieved in 122 CTOs (89.1%). Flush occlusion [odds ratio (OR) 2.958; 95% confidence interval (CI) 1.172-7.465; p = 0.022], large collateral (OR 2.778; 95% CI 1.201-6.427; p = 0.017) and TransAtlantic Inter-Society Consensus II class D (TASC D) lesion (OR 1.743; 95% CI 1.019-2.981; p = 0.042) were predictors for late-stage CTO. Flush occlusion (OR 75.278; 95% CI 10.664-531.384; p0.001) and large collateral (OR 23.213; 95% CI 3.236-166.523; p = 0.002) were associated with high likelihood for retrograde approach.Flush occlusion and large collateral were associated with a CTO at late-stage which may require retrograde recanalisation.• CTO morphological characteristics help estimate lesion duration and optimise recanalisation strategies. • Flush occlusion and large collateral is associated with late-stage CTO and retrograde recanalisation. • Application of anterograde and retrograde recanalisation for long-segment femoral CTO is effective.

In this paper, hardware and software of the central air-conditioning control system is researched by STC series of enhanced 8051 microcontroller. The STC11F 08XE is the main control of the hardware part. Temperature and humidity sensor regulating valve and all kinds of motor are used as external equipment to complete the temperature and humidity of building the internal control of central air conditioner. In terms of software, the program is described by protel99SE software. Microcontroller program is compiled by Microcontroller development tools keil u and STC-ISP. The temperature and humidity control and optimization of central air conditioning are completed by PID parameters. Infrared control unit is operated and liquid crystal is displayed to show the operation results.

Our aim was to assess the reliability of detecting distal runoff vessels using contrast-enhanced MR angiography (CE-MRA) that were occult on digital subtraction angiography (DSA) for predicting the outcome of endovascular recanalization (ER). This retrospective analysis comprised 63 patients with diabetes (98 limbs) who underwent ER for infrapopliteal lesions. Before ER, they underwent CE-MRA and DSA for peripheral arterial disease; runoff vessels were detected with CE-MRA, but not with DSA. Immediate and follow-up postoperative outcomes were assessed. Univariate analysis was performed to identify variables associated with successful ER. Successful ER was achieved in 85.7 % of limbs, and runoff score was significantly lower than in failure limbs (5.1 ± 1.1 vs. 6.2 ± 1.3; P

In this paper, hardware and software of the central air-conditioning control system is researched by STC series of enhanced 8051 microcontroller. The STC11F 08XE is the main control of the hardware part. Temperature and humidity sensor regulating valve and all kinds of motor are used as external equipment to complete the temperature and humidity of building the internal control of central air conditioner. In terms of software, the program is described by protel99SE software. Microcontroller program is compiled by Microcontroller development tools keil u and STC-ISP. The temperature and humidity control and optimization of central air conditioning are completed by PID parameters. Infrared control unit is operated and liquid crystal is displayed to show the operation results.

In article number 1805452, Yingsheng Cheng, Minghua Li, Helder A. Santos, Wenguo Cui, and co‐workers give an overview of the advantages and disadvantages of the metal devices used in the treatment of cerebrovascular diseases: embolic devices (coils), stents, flow‐diverting devices, and stent retrievers. They examine promising new developments in biodegradable metal materials and drug‐elution techniques for further clinical applications.

Cerebrovascular disease involves various medical disorders that obstruct brain blood vessels or deteriorate cerebral circulation, resulting in ischemic or hemorrhagic stroke. Nowadays, platinum coils with or without biological modification have become routine embolization devices to reduce the risk of cerebral aneurysm bleeding. Additionally, many intracranial stents, flow diverters, and stent retrievers have been invented with uniquely designed structures. To accelerate the translation of these devices into clinical usage, an in-depth understanding of the mechanical and material performance of these metal-based devices is critical. However, considering the more distal location and tortuous anatomic characteristics of cerebral arteries, present devices still risk failing to arrive at target lesions. Consequently, more flexible endovascular devices and novel designs are under urgent demand to overcome the deficiencies of existing devices. Herein, the pros and cons of the current structural designs are discussed when these devices are applied to the treatment of diseases ranging broadly from hemorrhages to ischemic strokes, in order to encourage further development of such kind of devices and investigation of their use in the clinic. Moreover, novel biodegradable materials and drug elution techniques, and the design, safety, and efficacy of personalized devices for further clinical applications in cerebral vasculature are discussed.

The tensile properties of alloy steel 35CrMoA were measured by dynamic tension experimental apparatus, and the stress-strain curves of the material at strain rate range from 10-2/s to 103/s were obtained. The fracture appearance and metallurgical structure were observed for the recovered specimens. The influence of strain rates on mechanical properties and microstructure of the 35CrMoA steel was analyzed. Based on the experimental data of mechanical properties, the JC constitutive parameters were fitted for 35CrMoA.

Metal magnetic memory (MMM) method is a novel, passive magnetic method for inspecting mechanical degradation of ferromagnetic components. In this paper, the correlation between plastic deformation and the deformation-induced magnetic field was experimentally investigated for the X80 steel. Various tensile plastic deformations are introduced into test pieces with different initial discontinuities. The surface strain distributions and normal natural magnetic fields component are measured after the tensile testings. The results show that the normal natural magnetic fields component are effective in capturing different deformation stages under tensions, the relationship between the intensity of damage-induced magnetization and the maximum plastic strain follows a simple formula proposed in this paper.

Determine the feasibility of and tissue response to biodegradable magnesium–silicone stent insertion into the oesophagus of rabbits. Mechanical compression–recovery and degradation behaviours of the stents were investigated in vitro. Thirty rabbits were randomly divided into a magnesium–silicone stent group (n = 15) that received stent insertion into the lower 1/3 of the oesophagus under fluoroscopic guidance and a control group (n = 15). Oesophagography was performed at 1, 2 and 4 weeks. Five rabbits in each group were euthanized at each time point for histological examination. Magnesium–silicone stents showed good flexibility and elasticity, and degraded more slowly than bare stents at pH 4.0 and 7.4. All stent insertions were well tolerated. The oesophageal diameters at 1, 2 and 4 weeks were 9.7 ± 0.7, 9.6 ± 0.8 and 9.6 ± 0.5 mm, respectively (vs. 9.2 ± 0.8 mm before intervention; P > 0.05). Stent migration occurred in six rabbits (one at 1 week, one at 2 and four at 4). Microscopy demonstrated dilation of the oesophageal wall within 1 week of insertion. Oesophageal injury and collagen deposition following stent insertion were similar to control (P > 0.05). Oesophageal magnesium–silicone stent insertion was feasible and provided reliable support for 2 weeks without causing oesophageal injury or collagen deposition. • Mg stent provided apparently adequate radial force and silicone membrane reduced magnesium biodegradation • Stent insertion provided good support for at least 2 weeks before biodegradation • Stenting effectively resulted in oesophageal wall remodelling, without demonstrable injury.

To determine whether string-like lumina (SLs) on contrast-enhanced magnetic resonance angiography (CE-MRA) predict better outcomes in diabetic patients with below-the-knee (BTK) chronic total occlusions (CTOs). This study involved 317 long-segment (>5 cm) BTK CTOs of 245 patients that were examined using CE-MRA and treated using endovascular angioplasty. An SL with a CTO was slowly filled with blood on conventional CE-MRA. Univariate and multivariate analyses were performed to identify predictors of procedural success, recanalisation method and immediate blood flow restoration. The target-lesion patency and limb-salvage rates were assessed. SL-positive CTOs (n = 60) achieved a higher technique success rate, preferred intraluminal angioplasty and better blood flow restoration than SL-negative CTOs (n = 257, P

The introduction of distributed generation will bring new challenges to the theory of power electricity market. The problem of loss allocation is one of them. In the paper three contents are introduced. Firstly, a loss allocation method is proposed for power distribution network with distributed generation. Secondly, the changes of loss allocation which introduction of distributed generation before and after brings about are analyzed and compared and relevant conclusions are obtained. Lastly, a typical mini-grid with a distributed generation is simulated. Simulation results prove the correctness and feasibility of the method.

A sustained drug release system based on the injectable poly(lactic-co-glycolic acid) (PLGA) microspheres loaded with β-methasone was prepared for localized treatment of rheumatic arthritis. The microscopy and structure of microspheres were characterized by scanning electron microscope (SEM) and Fourier transform infrared (FTIR). The effects of various formulation parameters on the properties of microspheres and in vitro release pattern of β-methasone were also investigated. The results demonstrated that increase in drug/polymer ratio led to increased particle size as well as drug release rate. Increase in PLGA concentration led to increased particle size, but decreased burst release. The drug encapsulation efficiency increased sharply by increasing polyvinyl alcohol (PVA) concentration in the aqueous phase from 1.5 to 2.0%. β-methasone release rate decreased considerately with decreasing OP (organic phase)/AP (aqueous phase) volume ratio. Stirring rate had significantly influence on the particle size and encapsulation efficiency. Independent of formulation parameters, β-methasone was slowly released from the PLGA microspheres over 11 days. The drug release profile of high drug loaded microspheres agree with Higuchi equation with a release mechanism of diffusion and erosion, that of middle drug loaded microspheres best agreed with Hixcon-Crowell equation and controlled by diffusion and erosion as well. The low drug loaded microspheres well fitted to logarithm normal distribution equation with mechanism of purely Fickian diffusion.

Based on the instantaneous reactive power theory, an improving detection method of harmonic current is put forward. In this method, the harmonic current is detected by current average. The method has the characteristics of simple structure, strong real-time and good dynamic response. In the paper, the proposed method is used to carry out simulation of MATLAB and the results show the effectiveness of the method.

Most of fracture processes of carbon/carbon composites (C/Cs) have been found to profoundly affected by their interfacial properties. A fiber-bundle pull-out test is utilized to determine the interface strength between fiber bundles and matrix of two kinds of C/Cs. Pre-fracture observations revealed that amount of voids and gaps existed in the interface, which make the interface strength decreases. The interfacial shear strengths of two kinds of C/Cs were all very low. Post-fracture observations revealed that a shear fracture was successfully induced within the carbon matrices at the loaded fiber bundle interface.

A comparative proteomic approach has been used to identify and analyze proteins related to pancreatic cancer. Proteomes of eight pairs of clinical pancreatic ductal adenocarcinoma (PDAC) tissue samples and samples of normal adjacent tissue were obtained by two-dimensional gel electrophoresis (2DE). Comprehensive analysis of proteins was focused on total protein spots for which there were statistical differences between the two groups. Proteins were identified by peptide mass fingerprinting with tandem mass spectrometry (MS-MS). Western blotting and immunohistochemistry (IHC) were also performed to verify the expression of some candidate proteins. Thirty protein spots were identified, including proteases, antioxidant proteins, signal-transduction proteins, calcium-binding proteins, structural proteins, chaperones, and others. Western blotting and IHC confirmed up-regulated expression of two candidate proteins, nucleotide diphosphatase kinase (NDPK) and annexin II, in tumorous tissues. These results suggest that combination of 2DE with MS is an effective strategy for discovery of differently expressed proteins in PDAC which may be molecular markers for diagnosis or therapeutic targets.

Purpose To assess the technical feasibility and efficacy of the rendezvous technique, a type of subintimal retrograde wiring, for the treatment of long-segmental chronic total occlusions above the knee following unsuccessful standard angioplasty. Methods The rendezvous technique was attempted in eight limbs of eight patients with chronic total occlusions above the knee after standard angioplasty failed. The clinical symptoms and ankle-brachial index were compared before and after the procedure. At follow-up, pain relief, wound healing, limb salvage, and the presence of restenosis of the target vessels were evaluated. Results The rendezvous technique was performed successfully in seven patients (87.5%) and failed in one patient (12.5%). Foot pain improved in all seven patients who underwent successful treatment, with ankle-brachial indexes improving from 0.23 ± 0.13 before to 0.71 ± 0.09 after the procedure ( P Conclusion The rendezvous technique is a feasible and effective treatment for chronic total occlusions above the knee when standard angioplasty fails.

Purpose: To compare the feasibility and efficacy of recanalizing below-the-knee (BTK) chronic total occlusions (CTOs) between patients with good or poor distal runoff based on magnetic resonance angiography (MRA) scans. Methods: Two hundred long-segment BTK CTOs in 171 limbs of 113 diabetic patients (58 men; mean age 69.8±1.9 years) were divided into good distal runoff (GDR: 119 lesions, 98 limbs) or poor distal runoff groups (PDR: 81 lesions, 73 limbs) based on baseline MRA findings. After angioplasty, modified thrombolysis in myocardial ischemia (mTIMI) grades and ankle-brachial index (ABI) were used to assess immediate outcomes. Regularly scheduled duplex or MRA imaging was performed in follow-up. The restenosis and limb salvage rates were compared. Results: The success rates were 93.3% and 87.7% in the GDR and PDR groups, respectively (p=0.21); subintimal angioplasty was more common in the PDR group (93.0% vs. 63.1%, p

To compare the clinical outcomes of retrograde transplantar arch angioplasty and conventional below-the-knee (BTK) anterograde recanalization.One hundred twelve limbs in 96 patients underwent attempt at antegrade tibial angioplasty. Among 27 technical failures, retrograde trans-dorsal or -planter percutaneous transluminal angioplasty was attempted in 22 limbs. Ankle-brachial index (ABI), thrombolysis in myocardial infarction (TIMI) flow grade, and dorsal/plantar arterial pulse score improvement were compared immediately after the procedures between patients received successful anterograde angioplasty (anterograde angioplasty group [AAG], 85 limbs in 71 patients) and retrograde angioplasty (retrograde angioplasty group [RAG], 22 limbs in 20 patients). Target vessel restenosis and limb salvage were observed during follow-up.Primary technical success rate was 75.9% in the RAG (vs. 74.0% AAG, P.05). ABI improved from 0.55 ± 0.21 to 0.93 ± 0.19 in the RAG (vs. 0.56 ± 0.14 to 0.89 ± 0.18 AAG, P.05). TIMI flow grade demonstrated greater reperfusion of distal foot tissue in the RAG (2.3 ± 0.8 vs. 1.0 ± 0.8, P.05). Primary patency rates at 12 and 24 months were 63.6% (14 of 22) and 45.5% (10 of 22) in the RAG and 52.9% (45 of 85) and 37.6% (32 of 85) in the AAG, respectively (P.05). Kaplan-Meier analysis after 24 months found limb salvage rates of 93.8% in the RAG and 96.5% in the AAG (P.05).Retrograde transplantar arch angioplasty achieved better immediate blood flow and similar ABI improvement, primary patency rate, and limb salvage rate compared to conventional transtibial angioplasty for BTK occlusions. This could become a supplementary technique when anterograde angioplasty fails.

Objective To prospectively investigate predictors for good restoration of blood flow of below-the-knee (BTK) chronic total occlusions (CTOs) after endovascular therapy in diabetes mellitus (DM) patients. Materials and Methods A total of 120 long-segmental (≥ 5 cm) BTK, CTOs in 81 patients who underwent recanalization were included in this study. After angioplasty, blood-flow restoration was assessed using modified thrombolysis in myocardial ischemia grades and classified as good flow (grade 3) and poor flow (grade 1/2). One hundred and six CTOs with successful recanalization were divided into a good flow group (GFG; n = 68) and poor flow group (PFG; n = 38). Multivariate logistic regression analyses were undertaken to determine independent predictors of blood-flow restoration. Receiver operating characteristic curves were constructed to determine the best cutoff value. The prevalence of target-lesion restenosis during follow-up was compared between two groups. Results Univariate analyses suggested that CTOs in GFG were characterized by lighter limb ischemia (p = 0.03), shorter course of ischemic symptoms (p < 0.01) and lesion length (p = 0.04), more frequent use of intraluminal angioplasty (p = 0.03), and higher runoff score (p < 0.01) than those in PFG. Multivariate regression analyses suggested that distal runoffs (p = 0.001; odds ratio [OR], 10.32; 95% confidence interval [CI]: 4.082–26.071) and lesion length (p < 0.001; OR, 1.26; 95% CI: 1.091–1.449) were independent predictors for good flow restoration. Kaplan-Meier analyses at 12 months showed a higher prevalence of non-restenosis in GFG (p < 0.01). Conclusion Distal runoffs and lesion length are independent predictors for good flow restoration for long-segmental BTK, CTOs in DM patients who receive endovascular therapy.

本研究制备了具有不同形式棱角的NH 4 H 2 PO 4 (ADP)晶体Z切片样品。通过实验, 观察不同Z切片薄表面层形成及生长特性, 并计算了不同棱角情况下薄表面层的切向生长速度V及其动力学系数β。结果表明, 正常棱角的缺失, 影响Z切片对其原有形态的“判断”, 进而影响薄表面层的形成及生长; 薄表面层在正常棱角处相遇形成相交角后, 将主要在相交角处形成并向棱边扩展生长, 表明棱角可能为薄表面层的主要生长源。此外, 计算结果显示, 正常棱角处薄表面层切向生长的平均生长动力学系数βn为131.8 μm/s, 远大于棱角缺失后薄表面层切向生长的平均生长动力学系数βa=11.6 μm/s, 即正常棱角缺失后, 薄表面层的切向生长速度将大大降低。

The quality of child-care centers and preschools—situated in a mixed market—varies enormously. Advocates for higher quality urge higher subsidies and stricter central regulation. Market advocates argue instead that local demand and parental-choice remedies will spark quality gains while ensuring competitive prices. Federal and state governments have responded with an array of policy interventions: targeting subsidies on preschools serving low-income families; enacting statewide quality standards; creating tax credits and vouchers for the “working poor” and middle-class families. This article assesses the influence of these alternative policies on preschool quality, based on a national survey of 1,805 centers in 36 states. Discrete policy effects are assessed after taking into account the influence of contextual sources of family demand: statewide levels of wealth, maternal employment, and poverty rates. Contrary to K–12 patterns, we find that center quality is higher in centers receiving greater subsidies. However, the subsidy effect depends on the particular indicator of quality being observed; effects are also conditioned by state-level contexts. Statewide sources of family demand, antecedent to policy interventions, help to raise certain facets of preschool quality. Tax credits hold no discernible influence on quality. Implications for building policy strategies in “managed choice” school settings are discussed.

Nephrogenesis requires a fine balance of many factors that can be disturbed by intrauterine growth restriction (IUGR), leading to a low nephron endowment. The aim of this study was to test the hypothesis that IUGR affects expression of key proteins that regulate nephrogenesis, by a comparative proteomic approach. IUGR was induced in Sprague-Dawley (SD) rats by isocaloric protein restriction in pregnant dams. A series of methods, including two-dimensional gel electrophoresis (2-DE), silver staining, mass spectrometry and database searching was used. After silver staining, 2-DE image analysis detected an average 730 + or - 58 spots in the IUGR group and 711 + or - 73 spots in the control group. The average matched rate was 86% and 81%, respectively. The differential proteomic expression analysis found that 11 protein spots were expressed only in the IUGR group and one in the control group. Seven protein spots were up-regulated more than fivefold and two were down-regulated more than fivefold in the IUGR group compared with those in control group. These 21 protein spots were preliminarily identified and were structural molecules, including vimentin, perlecan, gamma-actin and cytokeratin 10, transcription regulators, transporter proteins, enzymes, and so on. These proteins were involved primarily in energy metabolism, oxidation and reduction, signal transduction, cell proliferation and apoptosis. Data from this study may provide, at least partly, evidence that abnormality of metabolism, imbalance of redox and apoptosis, and disorder of cellular signal and cell proliferation may be the major mechanisms responsible for abnormal nephrogenesis in IUGR.

Objective Intrauterine growth restriction (IUGR) is associated with hypertension and chronic kidney disease in adulthood. Postnatal overnutrition after IUGR may be of pathogenic importance for the development of diabetes and cardiovascular disease. This study was to identify the effects of IUGR and a postnatal high-protein diet on the kidneys in adult rats. Methods Intrauterine growth restriction was induced in Sprague-Dawley rats by isocaloric protein restriction in pregnant dams. IUGR pups were divided into two groups that were a standard-protein diet (IUGR group) or a high-protein diet (HP group). A comparative proteomic method was used to study the differences of protein expression profiles between normal adult rats and adult rats with IUGR and the effects of a postnatal high-protein diet on the protein expression profiles of the kidneys. Results The IUGR adults had higher urinary excretion of protein and blood pressure than controls and the HP diet caused more severe hypertension and proteinuria than IUGR itself. The differential proteomic expression analysis found 12 proteins that had significantly differential expression between the IUGR and control groups, which were transcription regulators and structural molecules. The differential proteomic expression analysis between the HP and control groups found 13 proteins that had significantly differential expression and were involved primarily in body metabolism, oxidation reduction, and apoptosis regulation. Conclusion An HP diet intervention after IUGR worsens the severity of hypertension and proteinuria, and this study may provide valuable experimental evidence of proteins involved in the pathogenesis of kidney disease in IUGR and the effect of postnatal overnutrition.