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Abstract In this article, the multidisciplinary team of the Taiwan Academy of Tumor Ablation, who have expertise in treating lung cancer, present their perspectives on percutaneous image‐guided thermal ablation (IGTA) of lung tumors. The modified Delphi technique was applied to reach a consensus on clinical practice guidelines concerning ablation procedures, including a comprehensive literature review, selection of panelists, creation of a rating form and survey, and arrangement of an in‐person meeting where panelists agreed or disagreed on various points. The conclusion was a final rating and written summary of the agreement. The multidisciplinary expert team agreed on 10 recommendations for the use of IGTA in the lungs. These recommendations include terms and definitions, line of treatment planning, modality, facility rooms, patient anesthesia settings, indications, margin determination, post‐ablation image surveillance, qualified centers, and complication ranges. In summary, IGTA is a safe and feasible approach for treating primary and metastatic lung tumors, with a relatively low complication rate. However, decisions regarding the ablation technique should consider each patient's specific tumor characteristics.

Abstract The development of semiconducting polymers with good processability in green solvents and competitive electrical performance is essential for realizing sustainable large‐scale manufacturing and commercialization of organic electronics. A major obstacle is the processability‐performance dichotomy that is dictated by the lack of ideal building blocks with balanced polarity, solubility, electronic structures, and molecular conformation. Herein, through the integration of donor, quinoid and acceptor units, an unprecedented building block, namely TQBT, is introduced for constructing a serial of conjugated polymers. The TQBT, distinct in non‐symmetric structure and high dipole moment, imparts enhanced solubility in anisole—a green solvent—to the polymer TQBT‐T. Furthermore, PTQBT‐T possess a highly rigid and planar backbone owing to the nearly coplanar geometry and quinoidal nature of TQBT, resulting in strong aggregation in solution and localized aggregates in film. Remarkably, PTQBT‐T films spuncast from anisole exhibit a hole mobility of 2.30 cm2 V‐1 s‐1, which is record high for green solvent‐processable semiconducting polymers via spin‐coating, together with commendable operational and storage stability. The hybrid building block emerges as a pioneering electroactive unit, shedding light on future design strategies in high‐performance semiconducting polymers compatible with green processing and marking a significant stride towards ecofriendly organic electronics.

Abstract Background Thyroid‐associated ophthalmopathy (TAO) is the most common orbital disease in adults, potentially leading to disfigurement and visual impairment. However, the causes of TAO are not fully understood. IL‐35+B cells are a newly identified regulatory B cells (Bregs) in maintaining immune balance in various autoimmune diseases. Yet, the influence of IL‐35+Bregs in TAO remains unexplored. Methods This study enrolled 36 healthy individuals and 14 TAO patients. We isolated peripheral blood mononuclear cells and stimulated them with IL‐35 and CpG for 48 h. Flow cytometry was used to measure the percentages of IL‐35+Bregs. Results The percentage of circulating IL‐35+Bregs was higher in TAO patients, and this increase correlated positively with disease activity. IL‐35 significantly increased the generation of IL‐35+Bregs in healthy individuals. However, B cells from TAO patients exhibited potential impairment in transitioning into IL‐35+Breg phenotype under IL‐35 stimulation. Conclusions Our results suggest a potential role of IL‐35+Bregs in the development of TAO, opening new avenues for understanding disease mechanisms and developing therapeutic approaches.

Abstract To explore the genetic causal association between pulmonary artery hypertension (PAH) and iron status through Mendelian randomization (MR), we conducted MR analysis using publicly available genome‐wide association study (GWAS) summary data. Five indicators related to iron status (serum iron, ferritin, total iron binding capacity (TIBC), soluble transferrin receptor (sTfR), and transferrin saturation) served as exposures, while PAH was the outcome. The genetic causal association between these iron status indicators and PAH was assessed using the inverse variance weighted (IVW) method. Cochran's Q statistic was employed to evaluate heterogeneity. We assessed pleiotropy using MR‐Egger regression and MR‐Presso test. Additionally, we validated our results using the Weighted median, Simple mode, and Weighted mode methods. Based on the IVW method, we found no causal association between iron status (serum iron, ferritin, TIBC, sTfR, and transferrin saturation) and PAH (pβ > 0.05). The Weighted median, Simple mode, and Weighted mode methods showed no potential genetic causal association (pβ > 0.05 in the three analyses). Additionally, no heterogeneity or horizontal pleiotropy was detected in any of the analyses. Our results show that there are no genetic causal association between iron status and PAH.

Abstract Objective The primary aim of this study was to create a nomogram for predicting survival outcomes in penile cancer patients, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) and a Chinese organization. Methods Our study involved a cohort of 5744 patients diagnosed with penile cancer from the SEER database, spanning from 2004 to 2019. In addition, 103 patients with penile cancer from Sun Yat‐sen Memorial Hospital of Sun Yat‐sen University were included during the same period. Based on the results of regression analysis, a nomogram is constructed and validated internally and externally. The predictive performance of the model was evaluated by concordance index (c‐index), area under the curve, decision curve analysis, and calibration curve, in internal and external datasets. Finally, the prediction efficiency is compared with the TNM staging model. Results A total of 3154 penile patients were randomly divided into the training group and the internal validation group at a ratio of 2:1. Nine independent risk factors were identified, including age, race, marital status, tumor grade, histology, TNM stage, and the surgical approach. Based on these factors, a nomogram was constructed to predict OS. The nomogram demonstrated relatively better consistency, predictive accuracy, and clinical relevance, with a c‐index over 0.73 (in the training cohort, the validation cohort, and externally validation cohort.) These evaluation indexes are far better than the TNM staging system. Conclusion Penile cancer, often overlooked in research, has lacked detailed investigative focus and guidelines. This study stands as the first to validate penile cancer prognosis using extensive data from the SEER database, supplemented by data from our own institution. Our findings equip surgeons with an essential tool to predict the prognosis of penile cancer better suited than TNM, thereby enhancing clinical decision‐making processes.

Abstract Background Skeletal muscle mass and quality assessed by computed tomography (CT) images of the third lumbar vertebra (L3) level have been established as risk factors for poor clinical outcomes in several illnesses, but the relevance for dialysis patients is unclear. A few studies have suggested a correlation between CT‐determined skeletal muscle mass and quality at the first lumbar vertebra (L1) level and adverse outcomes. Generally, chest CT does not reach beyond L1. We aimed to determine whether opportunistic CT scan (chest CT)‐determined skeletal muscle mass and quality at L1 are associated with mortality in initial‐dialysis patients. Methods This 3‐year multicentric retrospective study included initial‐dialysis patients from four centres between 2014 and 2017 in China. Unenhanced CT images of the L1 and L3 levels were obtained to assess skeletal muscle mass [by skeletal muscle index, (SMI), cm2/m2] and quality [by skeletal muscle density (SMD), HU]. Skeletal muscle measures at L1 were compared with those at L3. The sex‐specific optimal cutoff values of L1 SMI and L1 SMD were determined in relation to all‐cause mortality. The outcomes were all‐cause death and cardiac death. Cox regression models were applied to investigate the risk factors for death. Results A total of 485 patients were enrolled, of whom 257 had both L1 and L3 images. Pearson's correlation coefficient between L1 and L3 SMI was 0.84 (P 0.05). Low L1 SMD (n = 280, 57.73%) was diagnosed based on the optimal cutoff value (

Abstract Background Gastrointestinal nematodes (GINs) have seriously affected the production and earnings of animal husbandry in various countries, while some species of GINs infect humans. At present, little is known about the species and prevalence of GINs in Qinghai‐Tibetan Plateau (QTP). Methods In this study, 528 fresh faecal samples were collected from typical areas in different altitudes with seven species of livestock in Qinghai, Tibet, Gansu and Yunnan Provinces. ITS‐2 rRNA gene of nematodes was employed to detect by PCR and sequencing analysis. Phylogenetic analysis of related sequences was performed using MEGA 6.0 software. Results The overall prevalence of GINs was 80.3% with 20 species of GINs detected, while Teladorsagia circumcincta was the dominant one, and four of which were zoonotic species such as Trichostrongylus colubriformis, Trichostrongylus axei, Trichostrongylus vitrinus and Oesophagostomum stephanostomum. Conclusion The study provided panoptic information on the prevalence and species diversity of GINs in QTP area, which is useful and valuable for reference of measure formulation in livestock husbandry and public health concerns. The parasites of T. circumcincta, Cylicocyclus nassatus, Strongylus edentatus, Cylicostephanus longibursatus, Telephlebia brevicauda, Cyathostomum catinatum, Mecistocirrus digitatus, Cooperia punctata, Cylicodontophorus bicoronatus, Nematodirus oiratianus and Oesophagostomum asperum were firstly reported the presence in QTP area. The study also showed that horse could be infected by T. circumcincta, goat could be infected by C. nassatus, cattle could be infected by S. edentatus and C. bicoronatus,and O. stephanostomum could infect yak, cattle and Mongolian sheep in worldwide. Nevertheless, more investigations are needed, such as microscopic examination, to accurately determine the species in the region.

Abstract The disorder‐to‐order (crystallization) process in phase‐change materials determines the speed and storage polymorphism of phase‐change memory devices. Only by clarifying the fine‐structure variation can the devices be insightfully designed, and encode and store information. As essential phase‐change parent materials, the crystallized Sb–Te binary system is generally considered to have the cationic/anionic site occupied by Sb/Te atoms. Here, direct atomic identification and simulation demonstrate that the ultrafast crystallization speed of Sb–Te materials is due to the random nature of lattice site occupation by different classes of atoms with the resulting octahedral motifs having high similarity to the amorphous state. It is further proved that after atomic ordering with disordered chemical occupation, chemical ordering takes place, which results in different storage states with different resistance values. These new insights into the complicated route from disorder to order will play an essential role in designing neuromorphic devices with varying polymorphisms.

Abstract How convective boundary‐layer (CBL) processes modify fluxes of sensible (SH) and latent (LH) heat and CO2 (Fc) in the atmospheric surface layer (ASL) remains a recalcitrant problem. Here, large eddy simulations for the CBL show that while SH in the ASL decreases linearly with height regardless of soil moisture conditions, LH and Fc decrease linearly with height over wet soils but increase with height over dry soils. This varying flux divergence/convergence is regulated by changes in asymmetric flux transport between top‐down and bottom‐up processes. Such flux divergence and convergence indicate that turbulent fluxes measured in the ASL underestimate and overestimate the “true” surface interfacial fluxes, respectively. While the non‐closure of the surface energy balance persists across all soil moisture states, it improves over drier soils due to overestimated LH. The non‐closure does not imply that Fc is always underestimated; Fc can be overestimated over dry soils despite the non‐closure issue.

Abstract Background Colorectal cancer (CRC) is one of the most common cancers worldwide. Comprehensive data on the economic burden of CRC at a population‐level is critical in informing policymaking, but such data are currently limited in China. Methods From a societal perspective, the economic burden of CRC in 2019 was estimated, including direct medical and nonmedical expenditure, disability, and premature‐death‐related indirect expenditure. Data on disease burden was taken from the GBD 2019 and analyzed using a prevalence‐based approach. The per‐person direct expenditure and work loss days were from a multicenter study; the premature‐death‐related expenditure was estimated using a human capital approach. Projections were conducted in different simulated scenarios. All expenditure data were in Chinese Yuan (CNY) and discounted to 2019. Results In 2019, the estimated overall economic burden of CRC in China was CNY170.5 billion (0.189% of the local GDP). The direct expenditure was CNY106.4 billion (62.4% of the total economic burden), 91.4% of which was a direct medical expenditure. The indirect expenditure was CNY64.1 billion, of which 63.7% was related to premature death. The predicted burden would reach CNY560.0 billion in 2030 given constant trends for disease burden; however, it would be alternatively reduced to

Abstract Background and aim Huntington's disease (HD) is an autosomal dominant inherited neurodegenerative disorder caused by CAG repeats expansion. Cognitive decline contributes to the loss of daily activity in manifest HD. We aimed to examine the cognition status in a Chinese HD cohort and explore factors influencing the diverse cognitive domains. Methods A total of 205 participants were recruited in the study with the assessment by neuropsychological batteries, including the mini–mental state examination (MMSE), Stroop test, symbol digit modalities test (SDMT), trail making test (TMT), verbal fluency test (VFT), and Hopkins verbal learning test–revised, as well as motor and psychiatric assessment. Pearson correlation and multiple linear regression models were applied to investigate the correlation. Results Only 41.46% of patients had normal global function first come to our center. There was a significantly difference in MMSE, Stroop test, SDMT, TMT, and VFT across each stage of HD patients (p

Background The presence of intraventricular hemorrhage (IVH) was extensively investigated and was associated with poor outcome in patients with intracerebral hemorrhage (ICH). However, the effect of the speed of ventricular bleeding on outcomes is unknown. Methods and Results We prospectively included patients with ICH who had baseline computed tomography scans within 6 hours after ictus between January 2016 and October 2021. The clinical characteristics were compared between patients with and without early neurologic deterioration (END). Ultraearly IVH growth (uIVHG) was defined as baseline IVH volume by onset‐to‐imaging time. The association between uIVHG and outcomes was assessed by using multivariable logistic regression analysis. We established the ultraearly IVH growth (uIVH) score and compared the areas under the receiver operating characteristic curves of the existing scores for predicting END. A total of 299 patients were finally enrolled. Of those, 38 patients (12.7%) experienced END at 24 hours and 89 patients (29.8%) had poor outcomes at 90 days. After adjustment for confounding factors, uIVHG (odds ratio, 1.061 [95% CI, 1.011–1.113]; P=0.016) was independently associated with END in multivariable analysis. A prediction score was developed on the basis of the logistic model. The uIVH score was developed as a sum of individual points (0–6) based on age, hematoma volume, National Institutes of Health Stroke Scale, hematoma expansion, and uIVHG ≥2.5 mL/h. In comparison with the ICH score and modified Emergency Department ICH Scale, the uIVH score exhibited best performance in the prediction of END. Conclusions uIVHG is associated with early neurologic deterioration and poor functional outcome in patients with ICH.

Objective For reconstructing the posterior cervical muscular–ligament complex, attachment points and various modified techniques were designed and applied in clinical practice. This study investigated the clinical and radiographic outcomes of open door laminoplasty with modified centerpiece mini‐plate fixation and extensor attachment point reconstruction in the treatment of cervical spondylotic myelopathy (CSM). Methods Sixty‐nine patients with CSM who underwent C3–C7 open door laminoplasty at our hospital from January 2016 to May 2018 were divided into two groups: 37 and 32 patients underwent laminoplasty with modified and conventional centerpiece titanium plate fixation (MPF and CPF groups), respectively. Changes in cervical spinal angle (CSA), cervical range of motion (ROM), posterior cervical muscle atrophy, neurological function (Japanese Orthopaedic Association [JOA] score), Neck Disability Index (NDI), and axial symptom severity were compared between the two groups. Results There were no significant differences in operative duration (136.7 ± 23.9 vs 128.3 ± 21.5 min, t = 1.525, p > 0.05), volume of intraoperative blood loss (275.9 ± 33.1 vs 268.2 ± 31.6 ml, t = 0.984, p > 0.05), lamina open angle (41.2° ± 4.5° vs 39.4° ± 4.1°, t = 1.726, p > 0.05), and spinal cord drift distance (2.4 ± 0.3 vs 2.3 ± 0.4 mm, t = 1.184, p > 0.05) between the two groups. After surgery, JOA score significantly increased (p 0.05). The NDI score was significantly decreased in both the groups (p 0.05). CSA decreased from 21.7° ± 2.8° to 18.3° ± 2.1°, and posterior cervical muscle cross‐sectional area decreased from 35.2 ± 4.9 cm2 to 31.0 ± 4.1 cm2 in the CPF group (p 0.05). Postoperative axial symptom severity was significantly worse in the CPF group than in the MPF group (Z = −2.357, p

Abstract The Pinatubo eruption in 1991 injected 10–20 Tg SO2 into the stratosphere, which formed sulfate aerosols through oxidation. Our modeling results show that volcanic heating significantly perturbs the heterogeneous and homogeneous chemistry including NOx and HOx catalytic cycles in the tropical stratosphere. The simulated tropical chemical ozone tendency is positive at 20 mb while negative at 10 mb in the tropics. The simulated ozone chemical tendency is of the same magnitude as the dynamical ozone tendency caused by the accelerated tropical upwelling, but with the opposite sign. Our study finds that the tropical ozone chemical tendency due to homogeneous chemistry becomes more important than heterogeneous chemistry 3 months after eruption. Sensitivity simulations further suggest that the tropical ozone tendency through heterogeneous chemistry is saturated when the injected amount exceeds 2 Tg.

Abstract Volcanic and wildfire events between 2014 and 2022 injected ∼3.2 Tg of sulfur dioxide and 0.8 Tg of smoke aerosols into the stratosphere. With injections at higher altitudes and lower latitudes, the simulated stratospheric lifetime of the 2014–2022 injections is about 50% longer than the volcanic 2005–2013 injections. The simulated global mean effective radiative forcing (ERF) of 2014–2022 is −0.18 W m−2, ∼40% of the ERF of the period of 1991–1999 with a large‐magnitude volcanic eruption (Pinatubo). Our climate model suggests that the stratospheric smoke aerosols generate ∼60% more negative ERF than volcanic sulfate per unit aerosol optical depth. Studies that fail to account for the different radiative properties of wildfire smoke relative to volcanic sulfate will likely underestimate the negative stratospheric forcings. Our analysis suggests that stratospheric injections offset 20% of the increase in global mean surface temperature between 2014–2022 and 1999–2002.

Abstract Most of the current bioadhesives cannot perform well on bleeding tissues while postoperative adhesion is a general but serious clinical issue. Here, a three‐layer biodegradable Janus tissue patch (J‐TP) that is able to simultaneously enable efficient closure of bleeding wounds with significantly promoted clotting ability and suppressed postoperative adhesion of tissues is reported. A dry adhesive hydrogel bottom layer of the J‐TP can form rapid (within 15 s) and strong (tensile strength up to 98 kPa) adhesion to bleeding/wet tissues with high bursting pressure (about 312.5 mmHg on a sealed porcine skin) through hydrogen binding and covalent conjugation between the carboxyl & N‐hydroxy succinimide (NHS) groups of hydrogel and the primary amine groups of tissues, while the phosphonic motifs can significantly reduce blood loss (by 81% on a rat bleeding liver model) of bleeding wounds. A thin polylactic acid (PLA) middle layer can improve the tensile strength (by 132%) of the J‐TP in wet conditions while the grafted zwitterionic polymers can effectively prevent postoperative tissue adhesion and inflammatory reaction. This J‐TP may be a promising tissue patch to assist the clinical treatment of injured bleeding tissues with inhibited postoperative adhesion.

Abstract Background Unilateral vocal fold paralysis (UVFP) affects the glottal gap, voice, and aerodynamics, whereas injection laryngoplasty (IL) using hyaluronate is an effective treatment for UVFP by decreasing the glottal gap to improve voice. Previous studies have shown that the involvement of cricothyroid (CT) muscle in UVFP patients further affects patients' aerodynamics, but it remains unclear whether the difference remains after IL. This study investigates whether the aerodynamic features observed in UVFP with CT involvement could still be observed after IL. Methods This study recruited UVFP patients with dysphonia, and IL was performed within 6 months of initial symptoms. All subjects received assessments including videolaryngoscopy, voice analysis, and aerodynamics at three time points: before IL, 1 month after IL, and 6 months after IL. The glottal gap, voice, and aerodynamics between patients with and without CT involvement (the CT+ and CT− groups) were compared, and the change (Δ) before and after IL and repeated‐measures analysis of variance (ANOVA) were also compared between the two groups. Result A total of 71 patients with UVFP (22 in the CT+ group and 49 in the CT− group) were analyzed. After IL, the CT+ group showed a lower sound pressure level (SPL), higher Δair pressure, and smaller Δaerodynamic power than the CT− group. Conclusion The CT+ group had a lower SPL, even after elevating air pressure to attempt to achieve a higher vocal intensity. The results suggest that although closure of the glottal gap was achieved by IL, the CT+ group still had a lower loudness and needed to sustain a higher peak air pressure when producing voice. Level of evidence Level 4.

Abstract The integration of high proportion renewable energy not only brings many benefits, but also increases the difficulty of power system stability analysis. One of the reasons for this problem is the unclear internal characteristics of new energy equipment. Therefore, there is an urgent need for a more detailed analysis of the characteristics of new energy equipment. Taking a double‐fed induction generator (DFIG), which has complex operation characteristics and is widely used, as an example, a detailed energy function (DEF) of DFIG for small signal stability analysis is proposed in this paper. This method performs DFIG's internal energy analysis, making the traditional energy structure more comprehensive. On this basis, the internal parameters of DFIG with high sensitivity to stability are obtained, and the damping evaluation index is constructed to evaluate the damping of DFIG. Finally, the proposed model's correctness and method are verified in the 4‐generator 2‐area system.

Abstract As traditional fossil energy sources such as coal cause serious environmental pollution, it is a major trend to promote the construction of a ‘clean’ power system with new energy sources as the mainstay. However, the uncertainty of intermittent energy output and its high proportion of grid connection bring challenges to the scheduling operation of the power system. In this paper, the authors propose a two‐stage robust dispatching strategy for the combined wind‐photovoltaic‐fired‐pumped storage system to improve the capacity of renewable energy (RER). The outer layer of the model is based on minimizing the start‐stop cost of thermal power units to obtain the start‐stop scheme of thermal power units, and the inner layer of the model integrates the system operation cost, pollutant emission cost, deviation penalty, and other constraints of wind power and PV output to obtain the dispatching scheme with the lowest overall operation cost under the worst scenario of wind power and PV fluctuation. The model is solved alternatively by column constraint generation algorithm (C&CG) and strong pairwise theory. The feasibility and effectiveness of the proposed method was verified based on the improved 30‐machine test system as an example.

Abstract Sparse recovery algorithms have been applied to the Space‐time adaptive processing for reducing the requirement of samples over the past 15 years. However, many Sparse recovery algorithms are not robust and need accurate user parameters. Conventional sparse Bayesian learning (SBL) algorithms are insensitivity to user parameters but converge slowly. To remedy the limitation, two iterative reweighted algorithms are proposed based on SBL. In order to minimise the SBL penalty function, we construct its upper‐bounding surrogate function via the concave conjugate function and apply iterative reweighted algorithms to minimise the surrogate function. Theoretical analysis and numerical experiments all exhibit great performance of the proposed algorithms.

Abstract As a widespread direct effect of global warming, drought is currently wreaking havoc on terrestrial ecosystems' structure and function, however, the synthesized analysis is lacked to explore the general rules between drought changes and main functional factors of grassland ecosystems. In this work, meta‐analysis was used to examine the impacts of drought on grassland ecosystems in recent decades. According to the results, drought greatly reduced aboveground biomass (AGB), aboveground net primary production (ANPP), height, belowground biomass (BGB), belowground net primary production (BNPP), microbial biomass nitrogen (MBN), microbial biomass carbon (MBC) and soil respiration (SR), and increased dissolved organic carbon (DOC), total nitrogen (TN), total phosphorus (TP), nitrate nitrogen (NO3−‐N), and the ratio of microbial biomass carbon and nitrogen (MBC/MBN). The drought‐related environmental factor mean annual temperature (MAT) was negatively correlated with AGB, height, ANPP, BNPP, MBC, and MBN, however, mean annual precipitation (MAP) had positive effect on these variables. These findings indicate that drought is threatening the biotic environment of grassland ecosystem, and the positive steps should be taken to address the negative effects of drought on grassland ecosystems due to climate change.

Abstract Background Recently, immunotherapy has been used to treat metastatic triple‐negative breast cancer (mTNBC). Basic research has indicated a relation between tumor heterogeneity and the immune response. Tumor heterogeneity derived from 18F‐FDG PET/CT is a potential predictor of chemotherapy results; however, few studies have focused on immunotherapy. This study aims to develop a convenient and efficient measurement of tumor heterogeneity for the prediction of immunotherapy in mTNBC patients. Methods We enrolled mTNBC patients who received immunotherapy (PD‐1/PD‐L1 antibody) plus chemotherapy as first‐line treatment and underwent 18F‐FDG PET/CT scans before treatment. We defined a novel index representing tumor heterogeneity calculated from the standard uptake value (SUV) as IATH and IETH. Optimal cutoffs were determined using time‐dependent receiver operator characteristics (ROC) analysis. Results A total of 32 patients were enrolled and analyzed in this trial. A significantly longer median PFS was observed in the low SUVmax group than in the high SUVmax group (9.4 vs. 5.8 months, HR = 0.3, 95% CI 0.1–0.9, p = 0.025). The median PFS of low‐IATH patients was significantly longer than that of high‐IATH patients (HR = 0.3, 95% CI 0.1–0.8, p = 0.022). Similarly, patients with low IETH had significantly longer PFS than patients with high IETH (9.4 vs. 4.9 months, HR = 0.3, 95% CI 0.1–0.7, p = 0.01). Multivariate analysis demonstrated IETH as an independent predictor of PFS. Conclusions This study proposed a novel method to assess intratumor and intertumor heterogeneity among metastatic breast cancer patients and determined that baseline IETH derived from 18F‐FDG PET/CT could represent a simple and promising predictor for first‐line immunotherapy among mTNBC patients.

This paper presents an improved whale optimization algorithm (IWOA) for optimizing the model predictive torque control (MPTC) of brushless DC motor (BLDCM) to further reduce the problems of strong torque pulsation and high ripple caused by the special structure of BLDCM. IWOA adds a randomized convergence factor strategy to the original algorithm, enabling the parameter weights to be adjusted in time. The relative error between the training set and the predicted values is reduced, and a suitable interval is selected for the target. The proposed method takes into account the switching frequency loss factor in the MPTC system of BLDCM, discarding the traditional trial-and-error method and choosing to control the parameter adjustment by the degree of deviation. The IWOA is compared with the popular whale optimization algorithm (WOA), dragonfly algorithm (DA), ant colony optimization (ACO) algorithm, and grey wolf optimization (GWO) algorithm on the MATLAB SIMULINK platform to verify the effectiveness of the method in dealing with improved chain tracking, reduced torque pulsation, and reduced speed error. The simulation results show that IWOA performs well, with an efficiency of 94.32%.

In order to solve the problem of small capacity and high energy consumption in China’s 5G communication technology system, the research proposes that based on the segmented weakly orthogonal matching pursuit (SWOMP) algorithm, it is combined with the compressed sensing matching pursuit algorithm to form a segmented backtracking weak selection positive algorithm and Cross Match Tracking (SCWOMP) algorithm. First, the sparseness of MIMO system technology and its transmission structure is analyzed. Then, the new model is built after comparing with other algorithms, and the problem of overestimating the low recovery probability in the calculation process is improved by the backtracking of the algorithm and the improvement of the angle of the atomic column selection, so as to reduce the number of iterations and improve the performance of the algorithm. The results show that, in the performance comparison of different sampling points under different compressed sensing recovery algorithms, the recovery probability of the SCWOMP algorithm is the best, and when the number of sampling points is 80, although the fixed step size of the SCWOMP algorithm is different, there is recovery. The probability has a maximum value, close to 1. Then, the improved compressed sensing recovery algorithm is simulated and analyzed. When the pruning coefficient is 0.5 and the number of sampling points is 80, the reconstruction rate has a maximum value, and when other algorithms reach the maximum reconstruction rate, the number of sampling points (M) is significantly greater than that of the SCWOMP algorithm. An increase in the rate of reduction of the reconstruction probability of the SCWOMP algorithm is significantly lower than that of other algorithms; when sparsity is equal to 70, the reconstruction probability becomes 0, indicating that SCWOMP has a wider reconfigurable range and has a significant performance effect. This shows that the proposed SCWOMP algorithm has the best detection performance for 5G communication symbol detection, which can effectively increase the capacity of the system and better promote technology.

Theoretical analysis and numerical simulation were conducted to study the disaster-causing mechanism of structural instability of the overlying strata induced by water–rock coupling and effectively prevent and control the powered support jammed accident during mining below the unconsolidated confined aquifer. The influencing factors on the stability of the overlying strata structure were analyzed, and the numerical simulation method of unconsolidated confined aquifer was designed. The disaster-causing mechanism and the evolution process of the stress–displacement–crack field of the overlying strata induced by water–rock coupling were discovered. Meanwhile, the prevention measures for the structural instability of the overlying strata were proposed and verified in some engineering practice. Results show that the stability of the overlying strata structure reduces with the increase in hydraulic pressure, the breaking interval of the main roof, and the decrease in the overlying strata strength and waterproof coal pillar height. The overlying strata structure keeps a stable equilibrium state before the fracture planes through a whole waterproof coal–rock pillar. When the hydraulic pressure is small or the bedrock surface is a thick topsoil layer, the sliding block is in a state of limit equilibrium for the decrease of pressure on the sliding block while the fracture planes through a whole waterproof coal–rock pillar because of the action of unloading during an overlying strata movement. When the hydraulic pressure is high, the pressure on the sliding block remains constant at about hydraulic pressure, and the intact shear fall of the sliding block occurs as a result of the hydraulic pressure of the confined aquifer and the weight of the sliding block, which may result in a powered support jammed accident. However, this type of accident can be prevented by drainage for decreasing hydraulic pressure, presplitting blasting of the hard main roof, overlying strata grouting reinforcement, and increasing the height of the waterproof coal–rock pillar.

Abstract Growing evidences have confirmed the effect of Sacubitril/Valsartan (SV) on antihypertension and cardiac protection in general population. However, there was no prospective study about the effect and safety of SV on resistant hypertension and myocardial work in hemodialysis patients. In this single‐center, prospective, before‐after study, enrolled patients were endured with resistant hypertension for more than 6 months. Participants were initially instructed to take SV 50 mg twice daily, and the dosage was gradually increased up to 100 mg twice daily. The primary outcomes were blood pressure (BP) control, N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), myocardial work (MW), fatigue and life quality. In addition, the adverse events were also recorded in this cohort. A total of 18 patients (34–64 years old) was finally enrolled and completed in this study. The SV‐based regimen provided significantly mean sitting systolic BP (msSBP) and mean sitting diastolic BP (msDBP) reductions from baseline (‐20.7/‐8.3 mm Hg), respectively. The cardiac remodeling parameters were partially improved. Compared to the baseline, NT‐proBNP was significantly reduced at week 4 (8119.50 [3710.75, 29300] pg/ml to 7216.50 [4124.75, 17455.00] pg/ml, p = .046), which was much lower at week 12 (3130.50 [2244.50, 9565.70] pg/ml, p = .037). Global MW index was higher at week 12 compared to the baseline (p = .026). MW efficiency was also improved accordingly compared to the baseline, even though the statistical difference was not significant (p = .226). Life quality and fatigue were improved at week 12 compared to the baseline (all p = .000). There was no serious adverse events were observed. SV safely and effectively controlled resistant hypertension and improved MW as well as life quality in hemodialysis patients.

Abstract In this paper, double PWM converter AC excitation system of the variable speed constant frequency doubly fed induction generator (DFIG) for wind power generation is taken as the research object. At present, most vector control systems of rotor‐side PWM converter adopt feedforward compensation to realize the purpose of power decoupling control. The decoupling effect is greatly affected by the power changes. A power decoupling control strategy based on auto‐disturbance rejection control (ADRC) is proposed. The decoupling control between active power and reactive power is realized by observing the coupling term and the total disturbance of the d‐axis and q‐axis components of the stator current and the stator voltage with the extended state observer and compensating. Simulation analysis and experimental test show that, on the basis of vector transformation, the rotor‐side PWM converter power decoupling control based on ADRC has a small overshoot and fast dynamic response when tracking the change of wind turbine input power, which can achieve the decoupling control between active power and reactive power well. The system has strong robustness and adaptability.

Abstract In this study, a network mode energy (NME) method is used to analyse the low‐frequency oscillation (LFO) of a power system with a high penetration of a permanent magnet synchronous generator (PMSG). This method is also utilized to determine the dominant inter‐area oscillation path. NME comes from a network potential energy based on a small signal mode, which includes a generator internal node mode potential energy and a line mode potential energy (LMPE). The exchange process and distribution of NME in the power system containing the PMSG are studied by analysing the composition of LMPE. A sensitivity index is constructed to determine the state variables of the generator and the PMSG, which remarkably influences energy distribution. Then, the path characteristics of LFO are analysed. The dominant inter‐area oscillation paths and energy interaction of the system connecting to the PMSG are determined. The proposed NME can be calculated on the basis of measurement information, and network energy decomposition is carried out using the measured line mode oscillation index. The mechanism of PMSG participating in oscillation is revealed from the network perspective to provide a basis for network‐based regulation. The correctness analysis and simulation of a four‐machine two‐area system with the PMSG and the New England 10‐machine 39‐bus system with the PMSG are carried out.

Abstract Aims Rheumatic heart disease (RHD) remains a major global health problem. Renin–angiotensin–aldosterone system inhibitors (RAASi) are commonly administered in the treatment of cardiovascular disease, but its role in RHD patients is still limited. We performed a retrospective study to determine the effect of RAASi on long‐term outcomes for RHD patients. Methods and results A 1:1 propensity score matching was implemented to balance baseline characteristics between groups RAASi and non‐RAASi. Cox proportional hazards regression model was used to investigate the associations of RAASi with the risks of all‐cause mortality, cardiovascular death (CVD), and cerebrovascular death. Binary logistic regression analysis was used to evaluate the associations of RAASi with the risks of 1, 3, and 5 year heart failure (HF) rehospitalization, new‐onset atrial fibrillation (AF), and new‐onset stroke. A total of 734 RHD patients were enrolled as study participants; nearly half of these participants had combined valve damage (54.4%), worse New York Heart Association functional class status (III and IV, 55.2%), surgical treatment (54.2%), and AF (65.0%). After propensity score matching, 514 RHD patients were finally analysed. RAASi treatment was associated with decreased risks of all‐cause mortality [adjusted hazard ratio (HR) = 0.52, 95% confidence interval (CI): 0.37–0.73, P

Abstract Background Bladder cancer is the second most common malignant tumor in the urogenital system. The research investigated the prognostic role of immune‐related long non‐coding RNA (lncRNA) in bladder cancer. Methods We extracted 411 bladder cancer samples from The Cancer Genome Atlas database. Single‐sample gene set enrichment analysis was employed to assess the immune cell infiltration of these samples. We recognized differentially expressed lncRNAs between tumors and paracancerous tissues, and differentially expressed lncRNAs between the high and low immune cell infiltration groups. Venn diagram analysis detected differentially expressed lncRNAs that intersected the above groups. LncRNAs with prognostic significance were identified by regression analysis. Multivariate Cox analysis was used to establish the risk score model. Then we established and evaluated the nomogram. Additionally, we performed gene set enrichment analysis to explore the potential functions of the screened lncRNAs in tumor pathogenesis. Results Three hundred and twenty differentially expressed lncRNAs were recognized. We randomly divided patients into the training data set and the testing data set at a 2: 1 ratio. In the training data set, 9 immune‐related lncRNAs with prognostic significance were identified. The risk score model was constructed to classify patients as high‐ and low‐risk cohorts. Patients in the low‐risk cohort had better survival outcomes than those in the high‐risk cohort. The nomogram was established based on the indicators including age, gender, tumor‐node‐metastases stage, and risk score. The model's predictive performance was confirmed by the receiver operating characteristic curve analysis, concordance index method, calibration curve, and decision curve analysis. The testing data set also achieved similar results. Bioinformatics analysis suggested that the 9‐lncRNA signature was involved in the modulation of various immune responses, antigen processing and presentation, and T cell receptor signaling pathway. Conclusions Our study uncovered the prognostic value of immune‐related lncRNAs for bladder cancer and showed that they may regulate tumor pathogenesis in various ways.

Abstract Mulberry has significant hypoglycemic effect and can be used as an auxiliary food for people with type 2 diabetes. However, it is rich in carbohydrate and cannot be consumed directly by diabetic patients. In the study, we fermented the mulberry to reduce the content of glucose and fructose, and added the soybean to reduce the loss of probiotics during fermentation and then determined its hypoglycemic effect. We induced type 2 diabetes mellitus (T2DM) mice by streptozotocin and measured its blood glucose, serum biochemistry, hepatic and pancreatic histopathology, and the diversity of the gut microbiota. After 5 weeks of oral DFMS administration, the glucose tolerance was improved significantly in T2DM mice. Furthermore, there were also significant increases in superoxide dismutase activity and glutathione concentration, and marked reductions in the concentrations of malondialdehyde and free fatty acids. Moreover, DFMS also prevented histopathological changes and the increases in the activities of alanine transaminase and aspartate transaminase. DFMS treatment also markedly increased the richness of the gut microbial community. The abundance of Bacteroidetes was increased, and those of Proteobacteria, Escherichia‐Shigella, and Lactobacillus were reduced. In summary, DFMS has a clear hypoglycemic effect in mice with T2DM.

Abstract The radiative forcing (RF) of volcanic sulfate is well quantified. However, the RF of pyrocumulonimbus (pyroCb) smoke with absorbing carbonaceous aerosols has not been considered in climate assessment reports. With the Community Earth System Model, we studied two record‐breaking wildfire events, the 2017 Pacific Northwest Event (PNE) and the 2019–2020 Australian New Year event (ANY), that perturbed stratospheric chemistry and the earth's radiation budget. We calculated a global annual‐mean effective RF (ERF) of −0.04 ± 0.02 and −0.17 ± 0.02 W/m2 at the top of the atmosphere (TOA) for PNE and ANY, respectively. The complexity of longwave RF led to an uncertainty of about 50% in the ERF at the TOA among climate models. We found that modeled ERF from wildfire smoke was 70%–270% more negative than the ERF of mass‐equivalent sulfate aerosol, highlighting its important role in the climate radiative budget.

Abstract Low‐cost and high‐performance photoelectrochemical (PEC) hydrogen production based on eco‐friendly colloidal core/shell quantum dots (QDs) represents a newly developing solar technology toward carbon neutrality. Herein, we present the synthesis of a novel type of environment‐friendly CuGaS2 (CGS)/ZnSe core/shell QDs with shell thicknesses‐tunable optoelectronic properties. As compared to CGS bare QDs, the prepared CGS/ZnSe core/shell QDs show enhanced visible light absorbance, emerging photoluminescence emission, tunable exciton lifetime, and improved photo‐stability. As a proof‐of‐concept, these eco‐friendly CGS/ZnSe core/shell QDs were applied as light sensitizers in a solar‐driven PEC hydrogen production system, delivering a nearly six times higher photocurrent density and improved device durability with respect to that of CGS core QDs under standard one sun AM 1.5G illumination. Our findings imply that such eco‐friendly core/shell QDs with tailored optoelectronic properties hold great potential for future “green” QDs‐based solar energy technologies.

Objective Previous studies have questioned the safety and efficacy of minor salivary gland biopsy in the diagnosis of Sjögren’s syndrome, citing complications and difficulty of pathologic evaluation. This study aims to determine the rate of biopsy specimen adequacy and the risk of complications after minor salivary gland biopsy. Study Design Case series. Setting Single tertiary care center. Methods We reviewed the records of all patients who underwent minor salivary gland biopsy at our institution from October 1, 2016, to September 1, 2021. Demographics, comorbidities, symptoms, and serologic results were recorded. The primary outcome was adequacy of the tissue sample. Complications of the procedure were recorded. Biopsies with at least one focus of ≥50 lymphocytes per 4-mm 2 sample were considered positive. Results We identified 110 patients who underwent minor salivary gland biopsy. Ninety-three (85%) were female, and the median age was 49.1 years (range, 18.7-80.5). Seventy-seven procedures (70%) were performed in the office setting, and 33 (30%) were performed in the operating room. Nearly all biopsy samples (n = 108, 98%) were adequate, and 33 (31%) were interpreted as positive. Four patients (4%) experienced temporary lip numbness, which resolved with conservative management. No permanent complications were reported after lip biopsy. Nineteen (58%) patients with positive biopsy results had no Sjögren’s-specific antibodies. Most patients with positive biopsy results (n = 20, 61%) subsequently started immunomodulatory therapy. Conclusion Minor salivary gland biopsy can be performed safely and effectively in both the office and the operating room. This procedure provides clinically meaningful information and can be reasonably recommended in patients suspected to have Sjögren’s syndrome.

Abstract LiNi0.8Co0.15Al0.05O2 (NCA) secondary particles with high tap density have a great potential for high volumetric energy density lithium (Li)‐ion power battery. However, the ionic conductivity mechanism of NCA with compact structure is still a suspense, especially the function of grain boundaries. Herein, we systematically investigate the Li‐ion transport behavior in both the primitive NCA (PNCA) secondary sphere densely grown by single‐crystal primary grains and ball‐milled NCA (MNCA) nanosized particle to reveal the role of grain boundaries for Li‐ion transport. The PNCA and MNCA have comparable Li‐ion diffusion coefficients and rate performance. Moreover, the graphene nanosheet conductive additive only mildly affects the Li‐ion diffusion in PNCA cathode, while which severely blocks the Li‐ion transport in MNCA cathode. Through high‐resolution transmission electron microscopy and electron energy loss spectroscopy, we clearly observe Li‐ion depletion at lower state of charge (SOC) and Li‐ion aggregation at high SOC along the grain boundaries of PNCA secondary particles during high‐rate lithiation process. The grain boundaries can construct an interconnected Li‐ion transport network for highly efficient Li‐ion transport, which contributes to excellent high‐rate performance of compact PNCA secondary particles. These findings present new strategy and deep insight in designing compact materials with excellent high‐rate performance.

Abstract The use of GNSS reflected signals to carry out passive detection of space targets is an emerging technical field. Unlike the traditional GNSS‐R in large‐scale environments such as oceans, vegetation, ice and snow, it is required to identify different targets within the detection range, which is one of the biggest challenges. To solve this problem, a hyperboloid observation equation based on the TDOA location model is constructed, which can eliminate the GNSS satellite orbit error, the satellite atomic clock error and the detection receiver clock error via differential technique. The consistency checking theory based on hypothesis and test is used to detect and distinguish different targets while locating. The simulation results show that the target detection and location accuracy can reach tens of metres, and when the different space targets are separated by 50 m, 100 m, 150 m, 200 m, and 250 m in sequence, the detection success rate of the method is 67.25%, 87.50%, 95.75%, 99.25%, and 99.75%, respectively, which indicates the feasibility and effectiveness of the method. The study provides a feasible technical approach for solving the multi‐target problem in GNSS‐R space target passive detection.

Abstract Aims The purpose of this retrospective propensity score‐matched study was to evaluate the superiority of different application approaches [continuous diuretics use (CDU) vs. intermittent diuretics use (IDU)] and types [loop diuretics (LDs) vs. thiazide diuretics (TDs)] of diuretics on long‐term outcomes for rheumatic heart disease (RHD) patients with compensated chronic heart failure (CHF). Methods and results A total of 494 RHD patients with compensated CHF were analysed after propensity score matching. Cox proportional hazards regression model was used to investigate the associations of different diuretic application approaches and types with all‐cause mortality, cardiovascular death (CVD), and cerebrovascular death. Binary logistic regression analyses were used to evaluate the associations of different diuretic application approaches and types with 1‐, 3‐, and 5‐year heart failure (HF) re‐hospitalization as well as new‐onset atrial fibrillation (AF). In the comparison between IDU and CDU strategies for RHD patients with compensated CHF, CDU was associated with increased risks of all‐cause mortality [adjusted hazard ratio (HR) = 2.47, 95% confidence interval (CI): 1.54–3.97, P 0.05). In the comparison between TDs and LDs among study participants receiving CDU strategy, LDs were not associated with cerebrovascular death and 1‐year HF re‐hospitalization (both adjusted P > 0.05) but with increased risks of all‐cause mortality (adjusted HR = 1.80, 95% CI: 1.09–2.99, P = 0.023), CVD (adjusted HR = 1.89, 95% CI: 1.04–3.44, P = 0.037), 3‐year (adjusted OR = 1.91, 95% CI: 1.06–3.43, P = 0.031) and 5‐year (adjusted OR = 2.16, 95% CI: 1.12–4.19, P = 0.022) HF re‐hospitalization, and new‐onset AF (adjusted OR = 2.66, 95% CI: 1.25–5.68, P = 0.012). Conclusions Continuous diuretics use (especially LDs) was associated with increased risks of all‐cause mortality, CVD, medium‐term/long‐term HF re‐hospitalization, and new‐onset AF in RHD patients with compensated CHF.

A carbon nanowire-modified surface with interdigitated electrode (IDE) sensing system was introduced to identify abdominal aortic aneurysm biomarker “papain,” also known as cysteine protease, used as the capture probe to identify Cystatin C. Papain was immobilized through the covalent integration of amine group on papain and the carboxyl group with carbon nanowire. This papain-modified electrode surface was utilized to detect the different concentrations of Cystatin C (100 pg/mL to 3.2 ng/mL). The interaction between papain and Cystatin C was monitored using a picoammeter, and the response curves were compared. With increasing Cystatin C concentrations, the total current levels were gradually increased with a linear range from 200 pg/mL to 3.2 ng/mL, and the current differences were plotted and the detection limit of Cystatin C was calculated as 200 pg/mL. The averaging of three independent experiments (n = 3) was made with 3δ estimation, and the determination coefficient was y = 1.8477 × 0.7303 and R2 = 0.9878. Furthermore, control experiments with creatinine and gliadin failed to bind the immobilized papain, indicating the specific detection of Cystatin C.

In order to research the force state of the piers subjected to a ship collision under the protection of floating anti-collision facilities, this study uses nonlinear spring connections to simulate the impact of ship damping and incidental water quality in the collision area. BIM technology is used to realize a safety evaluation method for the anti-collision floating box protection when the ship is colliding with piers. Established a BIM-based parametric preprocessing model for ships, piers, and anti-collision facilities, and opened the interface with ABAQUS longitudinally. After realizing the parameter adjustment of the BIM model, the visual parameter adjustment can be realized without destroying the boundary conditions, load conditions, and meshing. Taking a rigid frame bridge as an example, the most disadvantage position of the bridge pier under ship collision is determined by the parameterization method. At the same time, multi-condition analysis was carried out on the ship impacting the pier anti-collision floating box at different angles, different tonnages, and different speeds. Finally, the analysis results are traced back to the BIM model, achieving the unified integration of BIM model information and finite element analysis results and the purpose of visual analysis of any working conditions. The results show that the use of BIM parameterization technology to achieve linkage with the finite element preprocessing model can improve the efficiency of multi-condition sensitivity analysis and achieve the purpose of visual dynamic adjustment. The safety assessment analysis of the pier under the protection of the anti-collision pontoon on the pier under various working conditions shows that the anti-collision pontoon effectively reduces the hazard of the ship colliding with the pier, and the impact force gradually increases with the change from the oblique collision to the frontal collision. The peak impact force increases with the weight of the ship and shows a nonlinear relationship, such that the peak value of impact force increases with the speed increase, and the speed and the peak values of impact force show basically a linear relationship.

Mastering the formation mechanism and dynamic evolution pattern of bed separation zone during repeated mining is the key to the success or failure of separation grouting injection technology. Taking a mine in Ningdong as the engineering background, using the research methods of theoretical analysis, numerical simulated, and field measurement, four overburden structure models of single or multiple key strata with repeated mining and single or multiple key strata without repeated mining were constructed. The evolution pattern of bed separation zone was studied from four aspects: bed separation zone development mechanism, formation position, development form, and change of clearance. The results showed that when a single key stratum of repeated mining exists between coal seams, it is difficult to form a large separation area because there is no key stratum during the upper coal mining, and a separation area will be formed below the key stratum when mining the lower coal. When the key stratum exists above all coal seams, a large separation zone will be formed under the key stratum when the upper coal is mined. When mining the lower coal, when the coal seam spacing is less than 4 times of the mining height of the lower coal, the crack will penetrate the upper coal floor. If the key stratum is not completely broken, secondary separation may occur. When multiple key strata are all located above all coal seams, there will be bed separation zone under the high-level key stratum. When multiple key strata and coal seams are distributed at intervals, the separation below the high-level key stratum during upper coal mining and the separation below the low-level key stratum during lower coal mining are formed. Because the high-level key stratum bends and sinks after being affected by the mining of coal 1, the clearance of bed separation during mining coal 2 is slightly less than that during mining coal 1, which is contrary to the pattern that the greater the bed separation clearance increases with the increase of mining height.

Shield double-layer lining structure is used to bear large internal water pressure in water conveyance tunnel engineering, but the mechanism of joint stress of structure and force transmission between linings is still unclear. In this paper, a stress calculation model of the double-layer lining structure of shield water conveyance tunnel considering the influence of transition layer between the inner lining and the outer lining is presented. By analyzing the inner lining and outer lining separately, the calculation formulas of radial displacement and circumferential stress are obtained. Then, according to the deformation coordination condition, the relationship between the inner and outer lining radial displacements is established. Thus, the magnitude of the unknown interaction force among the structures is calculated. Finally, through the stress analysis of the lining structure, the axial force, shear force, and bending moment acted on the structure are obtained. By comparing finite element calculation results with analytical calculation results, the rationality of analytical solutions is verified. Based on the proposed analytical method, the influence of inner lining thickness and material parameters of transition layer on the internal force and deformation of lining structure is analyzed. The results show that with the increase of the thickness of the inner lining, the axial force and bending moment increase, while the internal pressure shared by the outer lining decreases. The larger the elastic modulus of the transition material, the smaller the difference between the internal force and deformation of the inner and outer linings.

Objective. To study the mechanism by which miR-21 regulates the differentiation and function of Th17/Treg cells in sepsis. Methods. A rat model with sepsis was made by cecal ligation and puncture (CLP). Then, some of the septic rats were transfected with miR-21 mimic or inhibitor by liposome. At 48 hours, lymphocytes and plasma from septic rats were isolated for further experimental detection. The expression of miR-21 in lymphocytes was detected by Polymerase Chain Reaction (PCR); the differentiation of Th17/Treg cells was counted by flow cytometry; lymphocyte apoptosis was observed by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay. The caspase-3/9 proteins were tested by Western blot; IL-10 and IL-17 were detected by enzyme-linked immunosorbent assay (ELISA). Results. Compared with the sepsis group (SP group), the Th17 cells increased significantly, the Treg cells decreased significantly, the apoptosis rate of lymphocytes decreased significantly, the mRNA and proteins of caspase-3/9 decreased significantly, the IL-17 decreased, and the IL-10 increased in the sepsis group transfected with miR-21 (SP + miR-21 mimic group). After transfection of miR-21 inhibitor, the results were almost opposite to those of SP + miR-21 mimic group. Conclusions. The differentiation and function of Th17/Treg cells were regulated by miR-21 in sepsis through caspase pathway.

Abstract Objective To describe the clinical characteristics of renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and bland thrombus (BT), and to evaluate the influence of BT on surgical treatment and cancer‐specific survival (CSS) of RCC with VTT. Methods We retrospectively reviewed clinical data of 123 patients with RCC and VTT, who underwent surgical treatment in our center between February 2015 and May 2018. Patients were divided into the BT group (21 patients) and non‐BT group (102 patients). Chi‐square and Mann‐Whitney U test were used for categorical and continuous variables respectively. Univariable log‐rank tests and multivariable Cox regressions were conducted to evaluate the prognostic significance of each variable. Kaplan‐Meier plots were performed to evaluate the influence of BT. Results In the delayed phase of enhanced magnetic resonance imaging (MRI), BT and VTT had difference. Patients were divided according to the relative position of BT: proximal end BT (one patients), contralateral renal vein BT (two patients), distal end BT (12 patients), and multiple BT (six patients). The average length of BT was 8.4 ± 5.8 cm (range: 0.6‐20.0 cm). Patients with BT had longer operative time (P = .001), more surgical blood loss (P = .004), higher proportion of open surgery (P = .006), more postoperative complications (P = .011). BT (hazard ratio [HR] = 3.323, P = .007) were independent risk factors for poor prognosis. Conclusions In the delayed phase of enhanced MRI, BT showed no obvious enhancement, while VTT usually showed enhancement. This was an important basis for preoperative imaging diagnosis of BT. The presence of BT increases the difficulty of surgery, and is correlated with adverse survival outcomes in patients with RCC and VTT.

Summary Transforming petrochemical processes into bioprocesses has become an important goal of sustainable development. The chemical synthesis of 2,5‐furandicarboxylic acid (FDCA) from 5‐hydroxymethylfurfural (HMF) is expensive and environmentally unfavourable. The study aims to investigate a whole‐cell biocatalyst for efficient biotransformation of HMF to FDCA. For the first time, a genetically engineered Pseudomonas putida S12 strain expressing 5‐hydroxymethylfurfural oxidase (HMFO) was developed for the biocatalytic conversion of HMF to FDCA. This whole‐cell biocatalyst produced 35.7 mM FDCA from 50 mM HMF in 24 h without notable inhibition. However, when the initial HMF concentration was elevated to 100 mM, remarkable inhibition on FDCA production was observed, resulting in a reduction of FDCA yield to 42%. We solve this substrate inhibition difficulty by increasing the inoculum density. Subsequently, we used a fed‐batch strategy by maintaining low HMF concentration in the culture to maximize the final FDCA titre. Using this approach, 545 mM of FDCA was accumulatively produced after 72 hs, which is the highest production rate per unit mass of cells to the best of our knowledge.

Abstract Although human leucocyte antigen (HLA)‐B27 is strongly associated with ankylosing spondylitis (AS), the association of unfolded protein response (UPR) induced by HLA‐B27 misfolding in AS remains controversial. Since dendritic cells (DCs) are crucial in induction of AS in HLA‐B27‐transgenic rats, and plasmacytoid DCs (pDCs) belong to one type of DCs, we here aim to study the relevance of pDCs and UPR in AS. Peripheral pDCs were isolated from 27 HLA‐B27(+) AS patients and 37 controls. The bone marrow (BM) and synovium of inflamed hips from AS patients and controls were obtained. We found a significantly higher frequency of pDCs in the peripheral blood, BM, or inflamed synovium of hips, which is associated with the enhanced expression of pDC trafficking molecules, CCR6 and CCL20 in the synovium of AS patients. Functional analysis further revealed that several inflammatory cytokines, including TNFα, IL‐6, and IL‐23, secreted by pDCs were significantly increased in AS patients as compared with those in controls. Remarkably, protein kinase RNA‐like endoplasmic reticulum kinase (PERK) pathway in UPR was up‐regulated in pDCs of AS patients. Notably, PERK inhibitor treatment significantly inhibited the enhanced cytokine production by pDCs of AS patients. Further, the extent of PERK activation was significantly associated with the increased disease severity of AS patients. Our data uncover the aberrant distribution and function of pDCs in AS patients. The up‐regulated PERK pathway in UPR of pDCs not only contributes to enhanced cytokine production of pDCs, but also is associated with increased disease activity of AS patients.

Objective To report the radiological and clinical outcomes of the modified scarf osteotomy for the treatment of hallux valgus deformity in adolescents. Methods This retrospective study analyzed 21 patients (31 feet) who underwent a modified scarf osteotomy for correcting juvenile hallux valgus deformity between March 2015 and January 2017. There were 3 male (3 feet) and 18 female (28 feet) patients. The average age at the time of surgery was 28.6 years (range, 20–35). Patients were postoperatively followed up in the outpatient department for 12–18 months. Clinical and radiological assessments were performed preoperatively and postoperatively at 1 year. Moreover, postoperative complications were recorded. Statistical analyses for differences between preoperative and postoperative values were performed. Results All the 21 patients were postoperatively followed up for 12–18 months, with an average of 13.2 ± 2.5 months. Clinical assessment showed that the American Orthopaedic Foot and Ankle Society score was increased from preoperative 58.0 ± 5.8 to postoperative 94.2 ± 6.6 points, respectively, and the visual analog scale score was remarkably decreased from preoperative 6.0 ± 2.0 to postoperative 1.5 ± 2.0 points at 1 year follow‐up. Further radiological assessment showed that the hallux valgus angle was 37.5° ± 9.2°, 14.1° ± 6.5°, and 14.5° ± 6.5° before surgery, half a year after surgery, and 1 year after surgery, respectively; the intermetatarsal angle was 14.1° ± 4.4°, 4.8° ± 3.2°, and 5.5° ± 4.9°, respectively; and the distal metatarsal articular angle was 31.0° ± 3.5°, 7.2° ± 2.3°, and 7.5° ± 2.1°, respectively. They were significantly improved at half a year after surgery and 1 year after surgery compared to those before surgery. Complications occurred in two patients (9.5%) who had numbness on the skin of the edge of the medial incision, and the symptoms were relieved after 10 months. There was no clinical recurrence in all patients. One of the 31 feet had hallux varus, which was corrected in a second operation. Notably, a postoperative radiograph of a typical case whose both feet had hallux valgus deformity and underwent modified scarf osteotomy and additional Akin osteotomy showed adequate correction of the hallux valgus angle (HVA, 11°), intermetatarsal angle (IMA, 6°), and distal metatarsal articular angle (DMAA, 8°) on left foot compared to preoperative HVA (28°), IMA (13°), and DMAA (35°). Conclusion The modified scarf osteotomy can effectively correct the adolescent hallux valgus deformity, which is worth popularizing.