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Objective This study was designed to observe the effect of electroacupuncture at Hegǔ (合谷LI4), or Houxī (后溪SI3) or Waiguān (外关TE5) acupoints on the function of the brain regions of a healthy human, and to explore the neural information mechanism of a specific connection between LI4 and the facial-oral area from the point of view of the brain function connection network. A further objective was to enrich knowledge of the specific connection between the body surface and the meridian route, and the specificity of acupoint effects. Methods A total of 30 healthy volunteers were randomly assigned to LI4, SI3, and TE5 groups. The members of each group were stimulated with electroacupuncture, and their heads were scanned using fMRI. DPARSFA 2.4 and REST 1.8 software were used for data preprocessing and statistical analysis. The paired t-test was used within group and the double sample t-test was used for two-group comparisons. Results In healthy people, left LI4 with electroacupuncture mainly caused a decrease of the functional connection of the right orofacial motor area of the brain, which remained decreased after removing the needle. When LI4 was compared with SI3 and TE5, LI4 caused a more significant decline in the functional connection of the right side of the brain during acupuncture. Conclusions Acupuncture at LI4 has a significant effect on the function of the face- and mouth-related areas in the brain, and there is a continuous effect. It is suggested that LI4 and the face and mouth have a specific relationship in the brain, which is most obvious during acupuncture.

The performance of ball screws degrades with two-stage features due to the deteriorating inner mechanism and environmental stress, which lowers the positioning accuracy of the ball screws. It thus affects the accuracy of computer numerical control machine tools. However, no research has been carried out on the degradation reliability for ball screws and current studies usually treat the performance degradation of ball screws as a deterministic, single-stage degradation process, ignoring the randomness and two-stage features in the degradation progress. To this end, we firstly formulated a framework of degradation reliability for ball screws, and then established a two-stage performance degradation model with eight unknown parameters. To estimate the unknown parameters, we proposed a two-phase, expectation-maximization estimation method. Finally, we established a degradation reliability model based on the degradation test data and validated the model through experimental data, which shows the model can capture the real-degradation behavior of ball screws.

Objective Postoperative delirium (POD) is a common postoperative complication that is relevant to poor outcomes. Therefore, it is critical to find effective methods to identify patients with high risk of POD rapidly. Creating a fully automated score based on an automated machine-learning algorithm may be a method to predict the incidence of POD quickly. Materials and methods This is the secondary analysis of an observational study, including 531 surgical patients who underwent general anesthesia. The least absolute shrinkage and selection operator (LASSO) was used to screen essential features associated with POD. Finally, eight features (age, intraoperative blood loss, anesthesia duration, extubation time, intensive care unit [ICU] admission, mini-mental state examination score [MMSE], Charlson comorbidity index [CCI], postoperative neutrophil-to-lymphocyte ratio [NLR]) were used to established models. Four models, logistic regression, random forest, extreme gradient boosted trees, and support vector machines, were built in a training set (70% of participants) and evaluated in the remaining testing sample (30% of participants). Multivariate logistic regression analysis was used to explore independent risk factors for POD further. Results Model 1 (logistic regression model) was found to outperform other classifier models in testing data (area under the curve [AUC] of 80.44%, 95% confidence interval [CI] 72.24%-88.64%) and achieve the lowest Brier Score as well. These variables including age (OR = 1.054, 95%CI: 1.017~1.093), extubation time (OR = 1.027, 95%CI: 1.012~1.044), ICU admission (OR = 2.238, 95%CI: 1.313~3.793), MMSE (OR = 0.929, 95%CI: 0.876~0.984), CCI (OR = 1.197, 95%CI: 1.038~1.384), and postoperative NLR (OR = 1.029, 95%CI: 1.002~1.057) were independent risk factors for POD in this study. Conclusions We have built and validated a high-performing algorithm to demonstrate the extent to which patient risk changes of POD during the perioperative period, thus leading to a rational therapeutic choice.

There is an emerging body of literature suggesting that unlike the chronic neuroinflammatory response, acute neuroinflammation is self-regulated and is beneficial for central nervous system homeostasis and cognitive integrity. However, the neurophysiological alterations upon acute neuroinflammation and their implications on cognitive function remain poorly understood. In the present study, we reliably established a mouse model of acute and self-limiting neuroinflammation by administering a single intraperitoneal injection of low-dose lipopolysaccharide, which induced reversible sickness behavior and increased pro-inflammatory cytokine expression in the medial prefrontal cortex (mPFC). During acute neuroinflammation, fast-spiking parvalbumin-expressing interneurons (PV interneurons) in the mPFC exhibited a hyperexcitable phenotype exemplified by increased input resistance, decreased rheobase current, and a higher frequency of action potentials. Furthermore, PV interneurons in the prelimbic subregion of the mPFC were excessively recruited into circuits supporting novel object recognition memory, which remained intact after acute neuroinflammation. Together, our findings suggest that alterations in PV neuronal excitability resulting from acute neuroinflammation may mediate neuronal recruitment and confer a beneficial outcome on functional integrity of NOR circuit in the mPFC.

A noninvasive test to discriminate indolent prostate cancers from lethal ones would focus treatment where necessary while reducing overtreatment. We exploited the known activity of heat shock protein 90 (Hsp90) as a chaperone critical for the function of numerous oncogenic drivers, including the androgen receptor and its variants, to detect aggressive prostate cancer. We linked a near-infrared fluorescing molecule to an HSP90 binding drug and demonstrated that this probe (designated HS196) was highly sensitive and specific for detecting implanted prostate cancer cell lines with greater uptake by more aggressive subtypes. In a phase I human study, systemically administered HS196 could be detected in malignant nodules within prostatectomy specimens. Single-cell RNA sequencing identified uptake of HS196 by malignant prostate epithelium from the peripheral zone (AMACR+ERG+EPCAM+ cells), including SYP+ neuroendocrine cells that are associated with therapeutic resistance and metastatic progression. A theranostic version of this molecule is under clinical testing.

In this study, an experiment was conducted to investigate the bearing behaviour of an external double-layered (EDL) flange connection under axial compression. The initial geometric imperfection of the flange plates was measured before the experiment to evaluate its effect on the compression capacity. Furthermore, finite element analysis was conducted and its results were compared with the experimental results. The initial imperfection was observed to be strongly related to the mechanical properties of the EDL flange connection. Moreover, stresses at symmetrical positions of the end plates and stiffened plates were asymmetrical, and most of the stiffened plates fully yielded in their sections adjacent to the end plates. On the basis of the initial imperfection measurements, three basic imperfection modes were proposed for the end plate. Finite element models considering these modes could predict the experimental results well. The load distribution coefficients of a stiffened plate and an end plate were obtained by considering the initial imperfection, and they are presented here along with practical design methods for the two components.

Background Tumor protein p53 (TP53) is the most frequently mutated gene in head and neck squamous cell carcinoma (HNSC), and TP53 mutations are associated with inhibited immune signatures and poor prognosis. We established a TP53 mutation associated risk score model to evaluate the prognosis and therapeutic responses of patients with HNSC. Methods Differentially expressed genes between patients with and without TP53 mutations were determined by using data from the HNSC cohort in The Cancer Genome Atlas database. Patients with HNSC were divided into high- and low-risk groups based on a prognostic risk score that was generated from ten TP53 mutation associated genes via the multivariate Cox regression model. Results TP53 was the most common mutant gene in HNSC, and TP53 mutations were associated with immunogenic signatures, including the infiltration of immune cells and expression of immune-associated genes. Patients in the high-risk group had significantly poorer overall survival than those in the low-risk group. The high-risk group showed less response to anti-programmed cell death protein 1 (PD-1) therapy but high sensitivity to some chemotherapies. Conclusion The risk score based on our TP53 mutation model was associated with poorer survival and could act as a specific predictor for assessing prognosis and therapeutic response in patients with HNSC.

Alzheimer's disease is a common cause of dementia, for which no disease-modifying therapy is yet available. Aβ3-10-KLH, a vaccine for active immunization, has been shown to prevent pathological changes in young transgenic models of AD, but the effects of treatment with it and its effects on mitochondrial dysfunction remain unclear. We immunized 6-month-old Tg-APPswe/PSEN1dE9 mice with Aβ3-10-KLH to analyze whether it is capable of eliminating amyloid-β after its appearance. The vaccine effectively decreased amyloid-β deposits, improved cognitive function and ameliorated mitochondrial dysfunction. These results indicate the potential of Aβ3-10-KLH as a vaccine to treat AD.

INTRODUCTION The blood-brain barrier (BBB) disruption contributes to postoperative delirium, but cost-effective and non-invasive assessment of its permeability is not practicable in the clinical settings. Urine albumin to creatinine ratio (UACR), reflecting systemic vascular endothelial dysfunction, may be a prognostic and predictive factor associated with postoperative delirium. The aim was to analyze the relationship between UACR and postoperative delirium in elderly patients undergoing elective non-cardiac surgery. MATERIALS AND METHODS Through stratified random sampling, a cohort of 408 individuals aged 60 years and older scheduled for elective non-cardiac surgery were included between February and August 2019 in the single-center, prospective, observational study. The presence of delirium was assessed using the Confusion Assessment Method (CAM) or Confusion Assessment Method for the ICU (CAM-ICU) on the day of surgery, at 2 h after the surgery ending time and on the first 3 consecutive days with repeated twice-daily, with at least 6-h intervals between assessments. Urine samples were collected on one day before surgery, and 1st day and 3rd day after surgery. The primary outcome was the presence of postoperative delirium, and association of the level of UACR with postoperative delirium was evaluated with unadjusted/adjusted analyses and multivariable logistic regression. RESULTS Postoperative delirium was observed in 26.75% (107 of 400) of patients within 3 days post-surgery. UACR-Pre (OR, 1.30; 95% CI, 1.14-1.49, p

Pancreatic cancer is considered as one of the most aggressive tumor types, representing over 45,750 mortality cases annually in the USA solely. The aggressive nature and late identification of pancreatic cancer, combined with the restrictions of existing chemotherapeutics, present the mandatory need for the advancement of novel treatment systems. Ongoing reports have shown an important role of microRNAs (miRNAs) in the initiation, migration, and metastasis of malignancies. Besides, abnormal transcriptional levels of miRNAs have regularly been related with etiopathogenesis of pancreatic malignancy, underlining the conceivable utilization of miRNAs in the management of pancreatic disease patients. In this review article, we give a concise outline of molecular pathways involved in etiopathogenesis of pancreatic cancer patients as well as miRNA implications in pancreatic cancer patients. Ensuing sections describe the involvement of miRNAs in the diagnosis, prognosis, and therapy of pancreatic cancer patients. The involvement of miRNAs in the chemoresistance of pancreatic cancers was also discussed. End area portrays the substance of survey with future headings.

High-index semiconductor nanoantennae represent a powerful platform for nonlinear photon generation. Devices with reduced footprints are pivotal for higher integration capacity and energy efficiency in photonic integrated circuitry (PIC). Here, we report on a deep subwavelength nonlinear antenna based on dilute nitride GaNP nanowires (NWs), whose second harmonic generation (SHG) shows a 5-fold increase by incorporating ∼0.45% of nitrogen (N), in comparison with GaP counterpart. Further integrating with a gold (Au) thin film-based hybrid cavity achieves a significantly boosted SHG output by a factor of ∼380, with a nonlinear conversion efficiency up to 9.4 × 10-6 W-1. In addition, high-density zinc blende (ZB) twin phases were found to tailor the nonlinear radiation profile via dipolar interference, resulting in a highly symmetric polarimetric pattern well-suited for coupling with polarization nano-optics. Our results manifest dilute nitride nanoantenna as promising building blocks for future chip-based nonlinear photonic technology.

Purpose Significant displacement of the mandibular canal (MC), which occurs frequently in extensive mandibular cystic lesion cases, may raise the risk of inferior alveolar neurovascular bundle injury in surgery. The aim of the present study was to measure the association between positional changes of the MC and the direction (in the coronal plane) of bone expansion of cystic lesions in the mandible. Patients and Methods We performed a retrospective study of patients who had undergone decompression and enucleation surgery from January 2014 to December 2018. Based on coronal planes of cone-beam computerized tomography, the centroids of the expanded mandibles were calculated and considered markers for evaluation of the directions of bone expansion. In addition, the changes in the position of the MC before decompression and enucleation were measured and compared. A Cartesian coordinate system was introduced in this study to illustrate the relationship of positional changes between the displacement of the MC and expansion of the mandible in a straightforward manner. Statistical analysis was performed using the paired t test, unpaired t test, one-way analysis of variance or linear regression as appropriate. Results Thirty-six patients with an average age of 29.8 years (14 men, 22 women) who received treatment of decompression and enucleation for mandibular cystic lesions were included in this study. The MCs were displaced in the direction toward the lower edge of the mandible and opposite to the direction of mandibular expansion. In addition, the MCs were relocated close to their original location by 1.67 ± 1.45 mm (mean ± standard deviation) approximately 1 year after decompression, accounting for 22.66% of the total displacement. Conclusions In mandibular cystic lesion cases, the MCs tend to displace opposite to the direction of mandibular expansion and relocate less after decompression.

This article proposes a deep convolutional neural network with perceptible generalization ability for structural topology optimization. The architecture of the neural network is made up of encoding...

Purpose The purpose of this study was to explore the efficacy, safety, and tolerability of a novel cyclosporine formulation for dry eye disease (DED). Methods This is an exploratory, multicenter, single-blind, randomized, positive-controlled Phase II clinical trial between cyclosporine ophthalmic gel (CyclAGel) and an open-label comparator (Restasis, positive control). A total of 240 eligible patients with moderate to severe DED were randomized to 4 study groups: CyclAGel 0.05%/once daily (QD) (n = 59), CyclAGel 0.05%/BID (n = 60), CyclAGel 0.1%/QD (n = 60), and Restasis 0.05%/BID (n = 61). After receiving BID dosing of hypromellose eye drops during a 2-week run-in period, patients were randomized to the respective treatment group and dosed QD or BID for 12 weeks. Efficacy was assessed based on a number of sign and symptom end points, including eye dryness score (visual analog scale), 6 other parameters of symptoms for dryness (burning/stinging, itching, foreign body sensation, discomfort, sensitivity to light, and pain), and corneal fluorescein staining. The Schirmer test was used to assess dry eye symptoms (visual analog scale severity) at visit 3 (week 2), visit 4 (week 6), and visit 5 (week 12). Findings CyclAGel showed a consistent improvement in eye dryness score and the 6 other parameters of symptoms for dryness, corneal fluorescein staining, breakup time, and Schirmer test scores compared with Restasis over the 12-week treatment period. However, there were no statistically significant differences between CyclAGel and Restasis after baseline corrections were made, and the results of the full analysis set remained consistent with those of the per-protocol set (P > 0.05). Moreover, each CyclAGel-treated group (0.05%/QD, 0.05%/BID, and 0.1%/QD) exerted better effects than the Restasis group, and CyclAGel 0.05%/QD showed the most significant improvement. The number of ocular-related treatment-emergent adverse events was low in all treatment groups, with no serious drug-related treatment-emergent adverse events. Implications CyclAGel showed excellent safety, tolerability, and comfort profiles at 2 concentrations and frequency in moderate to severe DED.

Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of ossification of the posterior longitudinal ligament (OPLL). Its prognostic factors for decompression have not been well studied. Additionally, no detailed radiological standard has been set for hoisting the vertebrae-OPLL complex (VOC) in ACAF.To identify the possible prognostic factors for decompression outcomes after ACAF for cervical OPLL, to determine the critical value of radiological parameters for predicting good outcomes, and to establish a radiological standard for hoisting the VOC in ACAF.This was a retrospective multicenter study.A total of 121 consecutive patients with OPLL who underwent ACAF at a point between January 2017 and June 2018 at any one of seven facilities and were monitored for at least 1 year afterward were enrolled in a multicenter study.Japanese Orthopedic Association (JOA) scores, recovery rate (RR) of neurologic function, and surgical complications were used to determine the effectiveness of ACAF.Patients were divided into two groups according to their RR for neurologic function. Patients with an RR of ≥50% and an RR of50% were designated as having good and poor decompression outcomes, respectively. The relationship between various possible prognostic factors and decompression outcomes was assessed by univariate and multivariate analysis. The receiver operating characteristic curve was used to determine the optimal cutoff value of the radiological parameters for prediction of good decompression outcomes. Next, the patients were redivided into three groups according to the cutoff value of the selected radiological parameter (postoperative anteroposterior canal diameter [APD] ratio). Patients with postoperative APD ratios of ≤80.7%, 80.7%-100%, and ≥100% were defined as members of the incomplete, optimal, and excessive antedisplacement groups, respectively. Differences in decompression outcomes among the three groups were compared to verify the reliability of the postoperative APD ratio and assess the necessity of excessive antedisplacement.Multivariate logistic regression analysis showed that patients' age at surgery (odds ratio [OR]=1.18; 95% confidence interval [CI]=1.08-1.29; p.01) and postoperative APD ratio (OR=0.83; 95% CI=0.77-0.90; p.01) were independently associated with decompression outcomes. The optimal cutoff point of the postoperative APD ratio was calculated at 80.7%, with 86.2% sensitivity and 73.5% specificity. There were no significant differences in the postoperative JOA scores and RRs between the excessive antedisplacement group and optimal antedisplacement group (p.05). However, a lower incidence of cerebrospinal fluid leakage and screw slippage was observed in the optimal antedisplacement group (p.05).Patients' age at surgery and their postoperative APD ratio are the two prognostic factors of decompression outcomes after ACAF. The postoperative APD ratio is also the most accurate radiological parameter for predicting good outcomes. Our findings suggest that it is essential for neurologic recovery to restore the spinal canal to more than 80.7% of its original size (postoperative APD ratio80.7%), and restoration to less than its original size (postoperative APD ratio100%) will help reduce the incidence of surgical complications. This may serve as a valuable reference for establishment of a radiological standard for hoisting the VOC in ACAF.

He Liu,1,2,* Mingsheng Dai,1,3,* Huilian Guan,1 Xing Gao,1 Yang Zhou,1 Xun Sun,1 Jian Zhou,1 Xiaoyi Hu,1 Xiang Li,1 Yu Song,1 Yuan Han,4 Junli Cao1,2 1Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou City 221002, Jiangsu Province, People’s Republic of China; 2Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou City 221004, Jiangsu Province, People’s Republic of China; 3Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 4Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai 20031, People’s Republic of China*These authors contributed equally to this workCorrespondence: Junli CaoJiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, NO. 209 Tongshan Road, Yunlong District, Xuzhou City 221004, Jiangsu Province, People’s Republic of ChinaTel/Fax +86-0516-83262686Email caojl0310@aliyun.comYuan HanDepartment of Anesthesiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, People’s Republic of ChinaEmail hanyuan2002@163.comPurpose: Malnutrition has been considered as a risk factor for postoperative delirium (POD). The Prognostic Nutritional Index (PNI) is a validated tool for assessing nutritional status. This study aimed to investigate the association between preoperative PNI values and the occurrence of POD in elderly surgical patients.Methods: The retrospective cohort study included 361 elderly individuals who underwent noncardiac surgery between 2018 and 2019. Perioperative data were collected from the patients’ medical records. PNI was used to evaluate preoperative nutritional status. The primary outcome was the occurrence of POD. Univariate and multivariate logistic regression analyses were used to identify key factors associated with POD and assess the relationship between PNI values and the occurrence of POD. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of PNI for POD.Results: Seventy-two (19.9%) individuals developed postoperative delirium after surgery. Compared with patients of normal nutrition status (PNI ≥ 50), mild malnutrition (PNI 45– 50) did not increase the risk of POD, while patients with moderate to severe malnutrition (PNI 40– 45) (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.31– 6.50) and serious malnutrition (PNI < 40) (OR, 3.15; 95% CI, 1.12– 8.83) were more likely to develop POD. The cut-off value of PNI was 46.05 by ROC curve analysis, the area under the curve (AUC) was 0.69 (95% CI 0.62– 0.77).Conclusion: Preoperative PNI value is related to postoperative delirium in elderly patients after noncardiac surgery.Keywords: noncardiac surgery, elderly patients, nutritional status, prognostic nutritional index, postoperative delirium

Background: Several recent studies have attempted to document VBG and NVBG following mandibular reconstruction, mainly the advantages and disadvantages, but very few have specifically evaluated the differences in large parameters including both radiographic and functional aspects for long-term follow-up. However, the object of this study is to compare between two different methods of reconstruction in mandibular defects and to determine the outcomes of different reconstruction options using autogenous vascularized and nonvascularized bone grafts for mandibular reconstruction. Patients and Methods: a total of 39 patients, 22 (56.4%) females and 17 (43.6%) males, with a mean age of 36.41 years at the time of presentation (age ranged for 48 years). Study was performed in two stages at the Department of Head and Neck Surgery - Oral and Maxillofacial oncology. In the First stage (N=39), bone-density, bone resorption, and bone graft failure were examined radiographically on panorex and CBCT. The second stage included functional evaluation (physical examination and questionnaire) based on pain, infection, speech and recurrence. Both groups were followed-up for at least 1month, 6 months and 1 year. Results:the results show significant difference in Pain after one month (p=0.032), radiodensity (p=0.05), bone graft resorption (p=0.03) for 1 year follow-up in favor of the VBG group compared to the NVBG group, there was no statistical difference in bone graft failure, infection, speech and recurrence between the two groups. Conclusion: Vascularized bone graft is the method of choice, especially in extensive malignant defects. On the other hand, novascularized bone graft (81.2% success rate) is a suitable complementary flap for mandible reconstruction mainly in benign and healthy patients. For future studies, large sample size with long-term follow-up more than 1 year will be required to validate our study.

Ball bearings are one of the most common components used in rotating machines. They reduce the rotational friction between the shaft and fixed components and maintain the center line of rotation of the shaft. A damaged bearing will cause abnormal vibration and noise, and often results in machine failure and loss of production. In this study the public database on ball bearings, provided by the Vibration Institute of Machinery Failure Prevention Technology (MFPT), was used for data retrieval and analysis, and a diagnosis model was created according to the data sets of the bearing in the database. Three different approaches were used for the extraction of features and a classifier was used to implement a diagnostic system. The aim of this study was a comparison of three approaches. The first was the Short-time Fourier Transform (STFT) where the time-frequency domain image is extracted as the feature used for status identification. The second and third approaches were based on the Chen-Lee Chaotic and the Lorenz Chaotic Systems and chaotic dynamic error maps were used in analysis and feature status identification. Chaotic systems are particularly sensitive to the slightest changes in input signals, and the time domain signals from bearings in different conditions were mapped onto individual images. The feature images extracted by the three different approaches were then used for training and verification in a Convolutional Neural Network (CNN). From the results of the experiments, it can be seen that all three approaches gave high identification rates. The interactive verification identification rate of the Chen-Lee chaotic system with CNN under three statuses reached 98.33%, and it also had the best computational efficiency in the condition without losing any classification accuracy. This will make a substantial contribution to real-time ball bearing fault diagnosis.

Organic-inorganic hybrid lead halide perovskites are potential candidates for next-generation light-emitting diodes (LEDs) in terms of tunable emission wavelengths, high electroluminescence efficiency, and excellent color purity. However, the device performance is still limited by severe non-radiative recombination losses and operational instability due to a high degree of defect states on the perovskite surface. Here, an effective surface engineering method is developed via the assistance of guanidinium iodide (GAI), which allows the formation of surface-2D heterophased perovskite nanograins and surface defect passivation due to the bonding with undercoordinated halide ions. Efficient and stable red-emission LEDs are realized with the improved optoelectronic properties of GAI-modified perovskite nanograins by suppressing the trap-mediated non-radiative recombination loss. The champion device with a high color purity at 692 nm achieves an external quantum efficiency of 17.1%, which is 2.3 times that of the control device. Furthermore, the operational stability is highly improved, showing a half-lifetime of 563 min at an initial luminance of 1000 cd m-2. The proposed GAI-assisted surface engineering is a promising approach for defect passivation and phase engineering in perovskite films to achieve high-performance perovskite LEDs.

BACKGROUND Novel coronavirus disease 2019 (COVID-19) was first found in Wuhan, China, and it has rapidly spread worldwide since the end of 2019. There is an urgent need to treat the physical and psychological aspects of COVID-19. Interpersonal psychotherapy (IPT)-based psychological intervention is an evidence-based therapy for depression and post-traumatic stress disorder. CASE SUMMARY This report describes a case of COVID-19 in a patient who transmitted the disease to his entire family. The patient received four sessions of IPT-based psychological intervention. We used the Hamilton Rating Scale for Depression and Patient Health Questionnaire to measure depression level, and the Hamilton Anxiety Scale and Generalized Anxiety Disorder to measure anxiety among the patients. CONCLUSION This case shows that IPT-based therapy can reduce COVID-19 patient depression and anxiety and the advantage of IPT-based therapy.

A novel approach for phenotype prediction is developed for data-independent acquisition (DIA) mass spectrometric (MS) data without the need for peptide precursor identification using existing DIA software tools. The first step converts the DIA-MS data file into a new file format called DIA tensor (DIAT), which can be used for the convenient visualization of all the ions from peptide precursors and fragments. DIAT files can be fed directly into a deep neural network to predict phenotypes such as appearances of cats, dogs, and microscopic images. As a proof of principle, we applied this approach to 102 hepatocellular carcinoma samples and achieved an accuracy of 96.8% in distinguishing malignant from benign samples. We further applied a refined model to classify thyroid nodules. Deep learning based on 492 training samples achieved an accuracy of 91.7% in an independent cohort of 216 test samples. This approach surpassed the deep-learning model based on peptide and protein matrices generated by OpenSWATH. In summary, we present a new strategy for DIA data analysis based on a novel data format called DIAT, which enables facile two-dimensional visualization of DIA proteomics data. DIAT files can be directly used for deep learning for biological and clinical phenotype classification. Future research will interpret the deep-learning models emerged from DIAT analysis.

Background Tumor spread through air spaces (STAS) is an important pattern of invasion and impacts the frequency and location of recurrence. The objective was to assess the correlation between metabolic tumor burden of positron emission tomography/computed tomography (PET/CT) and 2015 World Health Organization (WHO) classification of lung adenocarcinoma, and to establish a risk prediction model of STAS. Methods We reviewed 127 consecutive patients. The SUVmax, SUVmean, SUVpeak, MTV, TLG, diameter, and CTV were measured. All risk factors were analyzed by multivariate logistic regression analysis; regression coefficients and odds ratios were calculated for independent risk factors. A STAS risk prediction model was created using the regression coefficients to determine the predictive probability (PP). Results The nodule types and SUV were significantly correlated with 2015 WHO pathological categories (P

Circulating factors associated with aging have been shown to be involved in the development of age-related chronic and acute brain diseases. Here, we aimed to investigate the roles and mechanisms of CCL12, a circulating factor that is highly expressed in the plasma of aged rodents after intracerebral hemorrhage (ICH) using parabiosis and ICH models. Neurological deficit score (NDS), mortality rate, brain water content (BWC), and levels of inflammatory factors were determined to assess the degree of ICH-induced brain injury. Peripheral inflammatory cell infiltration was examined using immunofluorescence and flow cytometry. After confirming that acute brain injury after ICH was aggravated with age, we found that brain and plasma CCL12 levels were markedly higher in old mice than in young mice after ICH, and that plasma CCL12 was able to enter the brain. Using CCL12-/- mice, we showed that the degree of damage in the brain-as determined by NDS, mortality rate, BWC, levels of inflammatory factors, and numbers of degenerative and apoptotic neural cells and surviving neurons was significantly attenuated compared to that observed in old wild-type (WT) mice. These effects were reversed in CCL12-treated old mice. The detrimental effects caused by CCL12 may involve its ability to recruit macrophages and T cells. Finally, the administration of an anti-CCL12 antibody markedly improved the outcomes of ICH mice. Our results are the first to indicate that elevated peripheral CCL12 levels in old mice aggravates ICH-induced brain injury by recruiting macrophages and T cells. Thus, CCL12 may be a new target for ICH treatment.

IL26 is a unique amphipathic member of the IL10 family of cytokines that participates in inflammatory signaling through a canonical receptor pathway. It also directly binds DNA to facilitate cellular transduction and intracellular inflammatory signaling. Although IL26 has almost no described role in cancer, our in vivo screen of inflammatory and cytokine pathway genes revealed IL26 to be one of the most significant inflammatory mediators of mammary engraftment and lung metastatic growth in triple-negative breast cancer (TNBC). Examination of human breast cancers demonstrated elevated IL26 transcripts in TNBC specimens, specifically in tumor cells as well as in Th17 CD4+ T cells within clinical TNBC specimens. IL26 did not have an autocrine effect on human TNBC cells, but rather its effect on engraftment and growth in vivo required neutrophils. IL26 enhanced mouse-derived DNA induction of inflammatory cytokines, which were collectively important for mammary and metastatic lung engraftment. To neutralize this effect, we developed a novel IL26 vaccine to stimulate antibody production and suppress IL26-enhanced engraftment in vivo, suggesting that targeting this inflammatory amplifier could be a unique means to control cancer-promoting inflammation in TNBC and other autoimmune diseases. Thus, we identified IL26 as a novel key modulator of TNBC metastasis and a potential therapeutic target in TNBC as well as other diseases reliant upon IL26-mediated inflammatory stimulation. Significance: These findings identify IL26 as a unique, clinically relevant, inflammatory amplifier that enhances TNBC engraftment and dissemination in association with neutrophils, which has potential as a therapeutic target.

Thermal behaviors significantly affect the contact stiffness and position accuracy of the rolling linear guide, which worsen the performance of the precision machinery. In this paper, based on the modified lumped capacitance method (MLCM) and finite element method (FEM), a thermal model of rolling linear guides has been formulated in terms of the geometric parameters, friction, gyroscopic moment, and loading conditions. Experimental results show that the thermal model can well predict the real-time temperature variation under different working conditions. Further analysis shows that, the applied vertical load, carriage velocity, and toque load significantly influence the temperature variation of linear guides, while the influence of the torque load on temperature variation decreases with increasing vertical load levels. Besides, the reasons of the steady-state temperature variation considering the load distribution model are also discussed.

Image classification is an important application of deep learning. In a typical classification task, the classification accuracy is strongly related to the features that are extracted via deep learning methods. An autoencoder is a special type of neural network, often used for dimensionality reduction and feature extraction. The proposed method is based on the traditional autoencoder, incorporating the “distance” information between samples from different categories. The model is called a semi-supervised distance autoencoder. Each layer is first pre-trained in an unsupervised manner. In the subsequent supervised training, the optimized parameters are set as the initial values. To obtain more suitable features, we use a stacked model to replace the basic autoencoder structure with a single hidden layer. A series of experiments are carried out to test the performance of different models on several datasets, including the MNIST dataset, street view house numbers (SVHN) dataset, German traffic sign recognition benchmark (GTSRB), and CIFAR-10 dataset. The proposed semi-supervised distance autoencoder method is compared with the traditional autoencoder, sparse autoencoder, and supervised autoencoder. Experimental results verify the effectiveness of the proposed model.

One of the key issues on orthotropic steel deck (OSD) is the reduction of serviceability due to fatigue cracks even though the bridge still keeps a certain level of robustness itself, and accuratel...

An 85-year-old man presented with a 6-month history of worsening left proptosis and painless ophthalmoplegia. Imaging revealed an extensive intraconal and extraconal tumor extending to the level of the optic foramen, as well as the scalp, cheek, and the nasal bridge. Incisional biopsy was consistent with lacrimal gland adenocarcinoma. The patient underwent a left orbital exenteration followed by immunotherapy with pembrolizumab. The treatment was stopped prematurely after 5 cycles due to development of autoimmune colitis. Four months later, the patient developed new contralateral disease in the right orbit and an incisional biopsy again showed lacrimal gland adenocarcinoma. Following the incisional biopsy, no further treatment was administered, but over the ensuing 6 months, there was dramatic spontaneous regression of the tumor both clinically and radiographically. At 28 months, the patient is still alive with relatively stable disease.

Oil is an important industrial raw material used as both a fuel and energy source and is the pillar of national economies. With the development of the petroleum industry, oil pollution is becoming ...

Nanoscale laser sources with downscaled device footprint, high energy efficiency, and high operation speed are pivotal for a wide array of optoelectronic and nanophotonic applications ranging from on-chip interconnects, nanospectroscopy, and sensing to optical communication. The capability of on-demand lasing output with reversible and continuous wavelength tunability over a broad spectral range enables key functionalities in wavelength-division multiplexing and finely controlled light-matter interaction, which remains an important subject under intense research. In this study, we demonstrate an electrically controlled wavelength-tunable laser based on a CdS nanoribbon (NR) structure. Typical "S"-shaped characteristics of pump power dependence were observed for dominant lasing lines, with concomitant line width narrowing. By applying an increased bias voltage across the NR device, the lasing resonance exhibits a continuous tuning from 510 to 520 nm for a bias field in the range 0-15.4 kV/cm. Systematic bias-dependent absorption and time-resolved photoluminescence (PL) measurements were performed, revealing a red-shifted band edge of gain medium and prolonged PL lifetime with increased electric field over the device. Both current-induced thermal reduction of the band gap and the Franz-Keldysh effect were identified to account for the modification of the lasing profile, with the former factor playing the leading role. Furthermore, dynamical switching of NR lasing was successfully demonstrated, yielding a modulation ratio up to ∼21 dB. The electrically tuned wavelength-reversible CdS NR laser in this work, therefore, presents an important step toward color-selective coherent emitters for future chip-based nanophotonic and optoelectronic circuitry.

Study design A retrospective study of 257 normal children at a single center from July 2016 to November 2018 was performed. Objective To evaluate the spinopelvic parameters in a population of normal children and adolescents in mainland China. Summary of background data Values for sagittal parameters of the spine vary significantly by ages and different population. No study has yet quantified the normal measures for children and adolescents in China, or how these measures compare with other populations. Methods Pelvic incidence (PI), sacral slope, pelvic tilt, thoracic kyphosis (TK, T5-T12), lumbar lordosis (LL, L1-S1), and sagittal vertical axis were measured and evaluated by whole spine AP&lateral X-ray images. Results A total of 257 subjects, including 116 boys (45%) and 141 girls (55%) aged 3 to 12 years, were enrolled. Correlation matrix analysis demonstrated that sagittal balance is strongly correlated with age and Risser sign, including PI, a reported fixed parameter. Further investigation showed that PI could be expressed by the equation PI = 26.243+1.153×age. Conclusion PI was not a fixed but a dynamic parameter in the population under 12-year old. Indeed, PI increases with age and bone maturity in childhood. We also found lower PI, pelvic tilt, and sacral slope compared with published studies of adolescents in other countries. These results may aid in the treatment of patients with spinal deformity, to help them achieve a certain degree of sagittal spinopelvic balance. Level of evidence 2.

With the trend of Industry 4.0, the global machine tool industry is developing towards smart manufacturing. The ball bearing is a key component of the rotary axis of machine tool, and its functionality is to bear the external load on the axis as well as maintain the center position of the axis. A damaged bearing will result in abnormal vibration and noise, and thus will lead to the damage of the machine and produced workpieces. Therefore, inspection and identification of ball bearing failures is particularly important. This paper discusses the fault signals of ball bearings published by the Society for Machinery Failure Prevention Technology (MFPT) and creates a recognition model for the ball bearing state based on different fault states, and then we adopt two different approaches for feature extraction. The first approach implements Finite Impulse Response Filter (FIR) and Approximate Entropy (ApEn) to extract the signal features. The second approach utilizes the Chen-Lee chaotic system for analysis and takes its chaotic attractor as the feature of the state recognition. The comparison of model recognition accuracy for Back Propagation Neural Network (BPNN), Support Vector Machine (SVM), and K Nearest Neighbor (KNN) was conducted after acquiring the features through the two approaches in this paper. The results of the experiments in this paper show that both of the feature extraction approaches enable the state to be recognized easily. The Chen-Lee chaotic system with BPNN not only reaches 100% identification rate and it has the highest overall efficiency; it takes only 0.054 second to complete the feature extraction for 63 sets of data; this study is able to provide timely and precise solution for the failure of key mechanical components.

The abrasion of milling cutters is an important factor that affects the accuracy of a workpiece. The intervals between cutter changes is based on the burr condition of the edges on the finished products as well as their dimensional precision. Delayed replacement of cutters will result in a degradation of workpiece quality and it is important that the wear of cutters be monitored in a timely manner. In this study the actual vibration signals generated in a milling process were measured using an Automatic Intelligent Diagnosis Mechanism (AIDM) to determine cutter wear. The AIDM included two feature extraction approaches and three classification methods. The first approach used the Finite Impulse Response Filter (FIR) with Approximate Entropy (ApEn) for feature extraction. The second approach was nonlinear feature mapping using a fractional order Chen-Lee chaotic system. This used chaotic dynamic error centroids and chaotic dynamic error mapping for status identification. After feature extraction the results were substituted into a Back Propagation Neural Network (BPNN), Support Vector Machine (SVM), and a Convolutional Neural Network (CNN) for identification. The results of the experiments showed that a Chaotic Dynamic Error Map of the fractional order Chen-Lee chaotic system in the AIDM had an identification rate of 96.33% using a convolutional neural network. In addition, it was shown that the AIDM model could automatically select the most suitable feature extraction and classification model from the input signal and could determine the wear level milling cutters.

Background Homeodomain-interacting protein kinase 2 (HIPK2) has increasingly drawn attention as recent researches demonstrated its unique role in the regulation of multiple fundamental processes such as apoptosis, proliferation and DNA damage repair. Most importantly, HIPK2 was shown to play regulatory role in inflammation and influence the phenotype and activity of fibroblasts. In this study, we aimed to evaluate the impact of HIPK2 gene variant on risk of radiation pneumonitis for patients with pulmonary malignancies. Methods 169 lung cancer patients with radiotherapy were included in our prospective study and genotyped by Sanger Sequence method. Multivariable Cox hazard analysis and multiple testing were applied to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of all factors possibly related to the risk of radiation pneumonitis (RP). Results Patients with Mean Lung Dose (MLD) ≥ 15Gy, Lung V20 ≥ 24% had higher risk of RP ≥ grade 2 compared with those counterparts (HR = 1.888, 95% CI: 1.186–3.004, P = 0.007; HR = 2.126, 95% CI: 1.338–3.378, P = 0.001, respectively). Importantly, CC genotype of HIPK2: rs2030712 were strongly related to an increased occurrence of RP ≥ grade 2 (HR = 2.146, 95% CI: 1.215–3.791, P = 0.009). Conclusion HIPK2: rs2030712 was found to be significantly related to RP of grade ≥ 2 in our cohort, and may thus be one of the important predictors of severe RP before radiotherapy, if further validated in larger population. Trial registration Our study was prospective and observational. The research was registered in ClinicalTrials.gov database as NCT02490319.

Allogeneic blood or marrow transplantation (BMT) is a potentially curative therapy for patients with primary immunodeficiency (PID). Safe and effective reduced-intensity conditioning (RIC) approaches that are associated with low toxicity, use alternative donors, and afford good immune reconstitution are needed to advance the field. Twenty PID patients, ranging in age from 4 to 58 years, were treated on a prospective clinical trial of a novel, radiation-free and serotherapy-free RIC, T-cell-replete BMT approach using pentostatin, low-dose cyclophosphamide, and busulfan for conditioning with post-transplantation cyclophosphamide-based graft-versus-host-disease (GVHD) prophylaxis. This was a high-risk cohort with a median hematopoietic cell transplantation comorbidity index of 3. With median follow-up of survivors of 1.9 years, 1-year overall survival was 90% and grade III to IV acute GVHD-free, graft-failure-free survival was 80% at day +180. Graft failure incidence was 10%. Split chimerism was frequently observed at early post-BMT timepoints, with a lower percentage of donor T cells, which gradually increased by day +60. The cumulative incidences of grade II to IV and grade III to IV acute GVHD (aGVHD) were 15% and 5%, respectively. All aGVHD was steroid responsive. No patients developed chronic GVHD. Few significant organ toxicities were observed. Evidence of phenotype reversal was observed for all engrafted patients, even those with significantly mixed chimerism (n = 2) or with unknown underlying genetic defect (n = 3). All 6 patients with pre-BMT malignancies or lymphoproliferative disorders remain in remission. Most patients have discontinued immunoglobulin replacement. All survivors are off immunosuppression for GVHD prophylaxis or treatment. This novel RIC BMT approach for patients with PID has yielded promising results, even for high-risk patients.

Objective Despite the expectation of normal life expectancy for thyroid cancer, there are concerns about the decreased quality of life (QoL). The present study investigated the potential risk factors of deterioration in QoL scores in thyroid cancer patients after thyroidectomy. Materials and methods A total of 286 patients who were diagnosed with thyroid cancer after thyroidectomy were involved in this prospective, single-center, observational study from November 2018 to June 2019. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was used to assess the QoL 3 months after thyroidectomy. We investigated the effects of demographics (age, gender, education, marital status, area of residence, and annual mean income), tumor characteristics (histology, clinical stage, presence of metastasis, surgery type, and radiotherapy), and neurological deficits induced by recurrent nerve or superior laryngeal injury on QoL. Results The mean overall QoL in thyroid cancer survivors was 65.93 ±9.00 (on a scale of 0-100, where 100 was the best). Multivariate regression analysis confirmed that clinical stage (P < 0.010), surgery type (P < 0.001), histology (P < 0.001), neurological deficits (P < 0.001), and marital status (P < 0.001) were independent risk factors for decreased QoL 3 months after thyroidectomy. Conclusion Our study indicated that clinical stage, surgery type, histology, neurological deficits, and marital status were independent risk factors for decreased QoL at 3 months after thyroidectomy. Further exploration and validation of these findings in larger prospective studies are warranted.

Aim Drug resistance is an intractable issue urgently needed to be overcome for improving efficiency of antiepileptic drugs in treating refractory epilepsy. microRNAs (miRNAs) have been proved as key regulators and therapeutic targets in epilepsy. Accordingly, the aim of the present study was to identify a novel differentially expressed miRNA which could improve the efficiency of antiepileptic drugs during the treatment of refractory epilepsy. Methods and Results Serum samples were collected from children with refractory epilepsy. An in vivo refractory epilepsy model was developed in SD rats by electrical amygdala kindling. We identified that miR‐139‐5p was decreased and multidrug resistance‐associated protein 1 (MRP1) was remarkably upregulated in the serum samples from children with refractory epilepsy and the brain tissues from rat models of refractory epilepsy. After phenobarbitone injection in rat models of refractory epilepsy, the after discharging threshold in kindled amygdala was detected to screen out drug‐resistant rats. Dual‐luciferase reporter gene assay demonstrated that MRP1 was a target of miR‐139‐5p. In order to evaluate the effect of miR‐139‐5p/MRP1 axis on drug resistance of refractory epilepsy, we transfected plasmids into the hippocampus of drug‐resistant rats to alter the expression of miR‐139‐5p and MRP1. TUNEL staining and Nissl staining showed that miR‐139‐5p overexpression or MRP1 downregulation could reduce the apoptosis and promote survival of neurons, accompanied by alleviated neuronal damage. Conclusion Collectively, these results suggest an important role of miR‐139‐5p/MRP1 axis in reducing the resistance of refractory epilepsy to antiepileptic drugs.

Patients are often supplemented with a sufficient dose of thyroxine after thyroidectomy for thyroid cancer. However, the influence of thyroxine supplementation on fetal growth in pregnant women after thyroidectomy for thyroid cancer remains unclear. The aim of this study was to investigate the effect of thyroxine supplementation on neonatal birth weight. This cohort study included 49,896 pregnant women (278 patients with a history of thyroidectomy for thyroid cancer and 39,363 control cases after exclusion). Thyroid parameters were examined in pregnant women and their newborns. The associations between maternal thyroid function and neonatal birth weight and small for gestational age were studied using regression analyses. In the levothyroxine supplementation group, free thyroxine (FT4) levels were significantly higher in both early pregnancy (P < 0.001) and late pregnancy (P < 0.001) groups than in the control group. Furthermore, levels of neonatal thyroid stimulating hormone (P = 0.032) and birth weight (P = 0.043) were significantly lower than those in the control group. We also observed a significant inverse association between maternal FT4 levels in early pregnancy and neonatal birth weight (P=0.028), especially in male newborns (P=0.036). In summary, after thyroidectomy for thyroid cancer, a sufficient dose of thyroxine supplementation in early pregnancy is significantly associated with reduced birth weight and may need to be monitored.

Chronic wound repair is a common complication in patients with diabetes mellitus, which causes a heavy burden on social medical resources and the economy. Hypaphorine (HYP) has good anti-inflammatory effect, and chitosan (CS) is used in the treatment of wounds because of its good antibacterial effect. The purpose of this research was to investigate the role and mechanism of HYP-nano-microspheres in the treatment of wounds for diabetic rats. The morphology of HYP-NPS was observed by transmission electron microscopy (TEM). RAW 264.7 macrophages were used to assess the bio-compatibility of HYP-NPS. A full-thickness dermal wound in a diabetic rat model was performed to evaluate the wound healing function of HYP-NPS. The results revealed that HYP-NPS nanoparticles were spherical with an average diameter of approximately 50 nm. The cell experiments hinted that HYP-NPS had the potential as a trauma material. The wound test in diabetic rats indicated that HYP-NPS fostered the healing of chronic wounds. The mechanism was through down-regulating the expression of pro-inflammatory cytokines IL-1β and TNF-α in the skin of the wound, and accelerating the transition of chronic wound from inflammation to tissue regeneration. These results indicate that HYP-NPS has a good application prospect in the treatment of chronic wounds.

While tremendous progress has recently been made in perovskite light‐emitting diodes (PeLEDs), large‐area blue devices feature inferior performance due to uneven morphologies and vast defects in the solution‐processed perovskite films. To alleviate these issues, a facile and reliable interface engineering scheme is reported for manipulating the crystallization of perovskite films enabled by a multifunctional molecule 2‐amino‐1,3‐propanediol (APDO)‐triggered “anchoring effect” at the grain‐growth interface. Sky‐blue perovskite films with large‐area uniformity and low trap states are obtained, showing the distinctly improved radiative recombination and hole‐transport capability. Based on the APDO‐induced interface engineering, synergistical boost in device performance is achieved for large‐area sky‐blue PeLED (measuring at 100 mm2) with a peak external quantum efficiency (EQE) of 9.2% and a highly prolonged operational lifetime. A decent EQE up to 6.1% is demonstrated for the largest sky‐blue device emitting at 400 mm2., A facile and effective grain‐growth manipulation scheme enabled by interface “anchoring effect” is proposed for high‐quality sky‐blue perovskite emitter. Remarkable boost in device performance is achieved for large‐scale sky‐blue perovskite LEDs with peak external quantum efficiencies of 9.2% and 6.1% measured at scales of 100 and 400 mm2, respectively.

Background The objective of this study was to explore the stigma and related influencing factors in patients with chronic insomnia disorder (CID). Methods A total of 70 CID patients and 70 healthy controls (CON) were enrolled in the study. The Pittsburgh Sleep Quality Index (PSQI) and the 17-Item Hamilton Depression Rating Scale (HAMD-17) were used to assess sleep quality and depressive symptoms, respectively. The Chinese-Beijing version of the Montreal Cognitive Assessment scale (MoCA-C) was used to assess cognitive function. Stigma and life quality were measured using the Chronic Stigma Scale and the 36-Item Short-Form Health Survey (SF-36). Results The ratio of individuals with stigma was significantly different between CID and CON groups (C2 = 35.6, p p p p p p p p p p p p = 0.001), emotional role (U = 1451.5, p p p

Finding effective and objective biomarkers to inform the diagnosis of schizophrenia is of great importance yet remains challenging. Relatively little work has been conducted on multi-biological data for the diagnosis of schizophrenia. In this cross-sectional study, we extracted multiple features from three types of biological data, including gut microbiota data, blood data, and electroencephalogram data. Then, an integrated framework of machine learning consisting of five classifiers, three feature selection algorithms, and four cross validation methods was used to discriminate patients with schizophrenia from healthy controls. Our results show that the support vector machine classifier without feature selection using the input features of multi-biological data achieved the best performance, with an accuracy of 91.7% and an AUC of 96.5% (p Lactobacillus, Haemophilus, and Prevotella), the blood features (superoxide dismutase level, monocyte-lymphocyte ratio, and neutrophil count), and the electroencephalogram features (nodal local efficiency, nodal efficiency, and nodal shortest path length in the temporal and frontal-parietal brain areas). The proposed integrated framework may be helpful for understanding the pathophysiology of schizophrenia and developing biomarkers for schizophrenia using multi-biological data.