Search

Abstract Tribovoltaic effect is a phenomenon of the generation of direct voltage and current by the mechanical friction on semiconductor interface, which exhibits a brand‐new energy conversion mechanism by the coupling of semiconductor and triboelectrification. Here, the origin, interfaces, characteristics, mechanism, coupling effect and application of the tribovoltaic effect is summarized and reviewed. The tribovoltaic effect is first proposed in 2019, which has developed in various forms tribovoltaic nanogenerator (TVNG) including metal‐semiconductor, metal‐insulator‐semiconductor, semiconductor‐semiconductor, liquid‐solid and flexible interfaces. Compared with triboelectric nanogenerator, the TVNG has the characteristics of direct‐current, high current density (mA‐A cm−2) and low impedance (Ω‐kΩ). The two mainstream views on the tribovoltaic generation mechanism, one dominated by built‐in electric fields and the other dominated by interface electric fields, have been elaborated and summarized in detail. The tribo‐photovoltaic effect and tribo‐thermoelectric effect are also discovered and introduced because they can easily interact with other multi‐physical field effects. The TVNGs are suitable for making energy harvesting and self‐powered sensing devices for micro‐nano energy applications. This paper not only revisit the development of the tribovoltaic effect, but also makes prospects for mechanism research, device fabrication and integrated application, which can accelerate the evolution of smart wearable electronics and intelligent industrial components.

Abstract Butyrate (BU), a gut microbiota‐derived metabolite, has been reported to play a neuroprotective role in Parkinson's disease (PD). However, the specific molecular mechanism of BU has not been fully interpreted. This work aimed to verify the protective effects of BU against MPTP/MPP+‐induced neurotoxicity and explore the mechanisms involved. The results showed that BU protected against MPTP‐induced motor dysfunction and decreased tyrosine hydroxylase (TH) and dopamine transporter (DAT) levels. Additionally, BU pretreatment improved PC12 cell viability and reduced MPP+‐induced PC12 cell apoptosis. BU treatment also attenuated MPP+‐stimulated oxidative stress and inflammatory response in PC12 cells. Furthermore, BU inhibited MPTP/MPP+‐induced hyperactivation of the JAK2/STAT3 signaling in mice and PC12 cells. Besides, a JAK2 agonist, Coumermycin A1 (C‐A1), substantially reversed BU‐mediated inhibition on JAK2/STAT3 phosphorylation in MPP+‐challenged PC12 cells and abated BU‐induced repression on MPP+‐triggered apoptosis, oxidative stress, and inflammatory response in PC12 cells. To sum up, BU might exert neuroprotective effects against MPP+/MPTP‐induced neurotoxicity by inactivating the JAK2/STAT3 signaling.

Abstract Background Intracranial plasmacytomas are rare tumors arising from plasma cells with approximately half of the cases progressing to multiple myeloma (MM). However, there is a lack of comprehensive clinical cohort analysis on the clinical and pathological features, progression, and outcomes of intracranial plasmacytomas. Methods A retrospective analysis of 190 cases was conducted, combining data from 38 cases in a single institution and 152 cases from the literature. Patient demographics, clinical presentations, tumor locations, imaging features, surgical treatments, and follow‐up outcomes were collected and analyzed. Survival analysis and Cox regression analysis were performed to identify prognostic factors. Results A total of 190 intracranial plasmacytoma patients with an average age of 55.4 years were included in the study. The preoperative misdiagnosis ratio was high at 55.3%, and 59.7% of the tumors affected the calvaria convexity, compared to 40.3% located at the skull base. Resection and biopsy were achieved in 72.4% and 27.6% patients, respectively. Among them, 34.2% (65/190) of patients were initially diagnosed with MM with intracranial plasmacytoma as their first presentation (MM‐IPFP), while 63.2% (120/190) of patients were diagnosed with solitary intracranial plasmacytoma (SIP), including 61 extramedullary plasmacytomas and 59 solitary bone plasmacytomas. In the SIP group, 22.4% (24/107) of patients experienced disease progression leading to the development of MM during a median follow‐up time of 42.6 months (range 1–230 months). Multivariate analysis unveiled that radiotherapy (HR, 0.05; 95% CI, 0.00–0.87; p = 0.04), not surgery, was a protective prognostic factor for overall survival in MM‐IPFP patients. Comparison between the SIP progression group and non‐progression group revealed a significant difference of Ki‐67 index (non‐progression vs. SIP progression, 8.82% ± 7.03 vs. 16.5% ± 10.5, p

Abstract Background Lymph node metastasis (LNM) significantly impacts the prognosis of individuals diagnosed with cervical cancer, as it is closely linked to disease recurrence and mortality, thereby impacting therapeutic schedule choices for patients. However, accurately predicting LNM prior to treatment remains challenging. Consequently, this study seeks to utilize digital pathological features extracted from histopathological slides of primary cervical cancer patients to preoperatively predict the presence of LNM. Methods A deep learning (DL) model was trained using the Vision transformer (ViT) and recurrent neural network (RNN) frameworks to predict LNM. This prediction was based on the analysis of 554 histopathological whole‐slide images (WSIs) obtained from Qilu Hospital of Shandong University. To validate the model's performance, an external test was conducted using 336 WSIs from four other hospitals. Additionally, the efficiency of the DL model was evaluated using 190 cervical biopsies WSIs in a prospective set. Results In the internal test set, our DL model achieved an area under the curve (AUC) of 0.919, with sensitivity and specificity values of 0.923 and 0.905, respectively, and an accuracy (ACC) of 0.909. The performance of the DL model remained strong in the external test set. In the prospective cohort, the AUC was 0.91, and the ACC was 0.895. Additionally, the DL model exhibited higher accuracy compared to imaging examination in the evaluation of LNM. By utilizing the transformer visualization method, we generated a heatmap that illustrates the local pathological features in primary lesions relevant to LNM. Conclusion DL‐based image analysis has demonstrated efficiency in predicting LNM in early operable cervical cancer through the utilization of biopsies WSI. This approach has the potential to enhance therapeutic decision‐making for patients diagnosed with cervical cancer.

Abstract At present, commercial geothermal power stations are mainly high‐temperature and medium‐temperature geothermal energy, while the large number of low‐temperature geothermal energy resources are rarely used for power generation applications. This paper proposes a new model for energy conversion in low‐temperature geothermal power systems. The basic structure and working principle of this new model are analysed, in detail, a low‐temperature geothermal model and a Stirling engine model for geothermal energy conversion are established, and the control strategies on the rotor and stator sides of the Stirling‐driven doubly‐fed generator are discussed. Finally, the simulation analysis is carried out, and its results show that the thermal conversion efficiency of Stirling’s engine can reach 38%, the output AC voltage of the power generation system reaches the set value 50Hz, 190V, and the DC bus voltage is constant at 300V, which verified the validity of the proposed power generation model and related control strategies. This system expands the range of available heat sources in geothermal power generation, makes geothermal power generation more flexible in terms of site selection, power generation capacity and control, and provides a new idea for geothermal power generation structure.

Abstract Body area network has attracted extensive attention for its applications in athletics, medical, diagnosis, and rehabilitation training in the next generation personalized health care solutions. Here, a contact‐separation direct current triboelectric nanogenerators (CSDC‐TENGs) based self‐powered wireless body area network (SWBAN) is reported that enables multi‐joint movements monitoring for human motion. The CSDC‐TENG is designed as a flexible active sensor with an internal contact switch, and the flexible substrate makes the TENG‐sensor stick onto skin easily. Due to the internal switch, the CSDC‐TENG could generate a DC current, a large instantaneous output voltage exceeds 700 V, and an instantaneous power can reach 1.076 W, which is more than 23 000 times higher than that of the traditional contact‐separation mode TENG in same size and materials without the switch. By coupling with flexible coil, the fixed high‐frequency radio signals can be modulated and emitted clearly ranging from 6 to 16 MHz, which can be wirelessly received and demodulated through a reader. Moreover, the SWBAN is demonstrated in a real time monitoring system for joints motion. This work has realized the wearable TENG for self‐powered wireless real‐time monitoring of body movements driven by low‐frequency human daily activities, which may promote a tremendous development of intelligent healthcare, wireless sensing system and body area network.

Abstract Objective Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune‐mediated disease that targets the myelin sheaths of the peripheral nerves. Fingolimod is a sphingosine 1 phosphate (S1P) receptor antagonist with a high affinity for S1P receptors through the Akt–mTOR pathway, and prior research has suggested that it might be helpful in autoimmune illnesses. Methods Chronic experimental autoimmune neuritis (c‐EAN) was induced by immunizing Lewis rats with the S‐palm P0(180–199) peptide, and then the treatment group was intraperitoneally injected with fingolimod (1 mg/kg) daily. Hematoxylin and eosin staining was used to assess the severity of nerve injury. Immunohistochemistry staining showed that fingolimod's anti‐inflammatory effects on c‐EAN rats might be realized through the NF‐κB signaling pathway. Tumor necrosis factor‐α (TNF‐α), interferon‐γ (INF‐γ), interleukin‐1beta (IL‐1β), interleukin 6 (IL‐6), inducible nitric oxide synthase (iNOS), and intercellular adhesion molecule‐1 (ICAM‐1) were measured to evaluate the inflammation levels, and pAkt, p‐S6, and p‐p65 were used to measure the abundance of downstream activation markers to determine whether the Akt/mTOR/NF‐κB signaling pathway was activated in the c‐EAN model. Results Fingolimod treatment reduced the inflammatory reaction and the expression of NF‐κB in sciatic nerves. It also decreased the mRNA levels of the proinflammatory cytokines TNF‐α, IFN‐γ, IL‐1β, IL‐6, iNOS, and ICAM‐1 and pAkt, p‐S6, and p‐p65, representing the Akt/mTOR/NF‐κB signaling pathway. Conclusion Our data showed that fingolimod could improve the disease course, alleviate the decrease in inflammation, and reduce proinflammatory cytokines through the Akt/mTOR/NF‐κB axis in c‐EAN rats, which could be beneficial for the development of CIDP‐related research.

Aim. We sought to profile gut microbiota’s role in combination of Bu Fei Hua Yu (BFHY) with cisplatin treatment. Methods. Non-small cell lung cancer (NSCLC) mice model were constructed followed by treatment with cisplatin alone or combined with BFHY. Mice weight and tumor volume were measured during the experiment. And mice cecum were detected by hematoxylin and eosin, cecum contents were collected for Enzyme Linked ImmuneSorbent Assay, and stool were profiled for metagenomic sequencing. Results. Combination of BFHY with cisplatin treatment decreased the tumor growth and relieved the damage of cecum. Expressions of interleukin-6 (IL-6), interleukin-1β (IL-1β), monocyte chemotactic protein 1 (MCP), and interferon-γ (IFN-γ) were decreased compared with cisplatin treatment alone. Linear discriminant analysis effect size analysis showed that g_Parabacteroides was downregulated and g_Escherichia and g_Blautia were upregulated after cisplatin treatment. After combination with BFHY, g_Bacteroides and g_Helicobacter were decreased. g_Klebsiella, g_Unclssified_Proteobacteria, and g_Unclssified_Clostridiates were increased. Moreover, heatmap results showed that Bacteroides abundance was increased significantly after cisplatin treatment; BFHY combination treatment reversed this state. Function analysis revealed that multiple functions were slightly decreased in cisplatin treatment alone and increased significantly after combination with BFHY. Conclusion. Our study provided evidence of an efficacy of combination of BFHY with cisplatin on treatment of NSCLC and revealed that gut microbiota plays a role in it. The above results provide new ideas on NSCLC treatment.

Abstract Background A single‐agent of anti programmed cell death 1/programmed cell death ligand 1 (anti‐PD‐1/PD‐L1) therapy has been explored for resectable lung cancer before surgery. However, the effectiveness and safety of neoadjuvant programmed cell death 1 (PD‐1) blockade combined with chemotherapy have not been published. Methods Twenty‐one consecutive patients with potentially resectable squamous cell carcinoma of the lung who received neoadjuvant therapy followed by surgery in Beijing Cancer Hospital were included in this study. Eight patients received two cycles of neoadjuvant platinum‐based doublet chemotherapy combined with anti‐programmed cell death 1 (anti‐PD‐1) therapy, while 13 patients received two cycles of neoadjuvant platinum‐based doublet chemotherapy only. Chest computed tomography was repeated before neoadjuvant treatment and surgery. Adverse events were monitored. The major pathological response (MPR) rate was determined after surgery. Selected specimens were sent for immunohistochemical and multiplex immunofluorescence analyses, and T‐cell receptor DNA sequencing. Results Compared with neoadjuvant chemotherapy alone, the combination of PD‐1 blockade and chemotherapy increased the pathological complete response rate (37.5% vs. 7.69%) and MPR rate (50% vs. 38.46%). The pathological and radiological evaluations are not consistent. No unknown adverse effects were reported for all the patients. More tumor infiltrating lymphocytes were observed in patients who received PD‐1 blockade. No unknown pathological features associated with PD‐1 blockade were found. Immune suppression in the peritumoral spaces around the residual tumor cells was observed. The amino acid sequences of the T‐cell receptors are not significantly shared among the patients. Conclusions The combination of neoadjuvant chemotherapy and PD‐1 blockade is safe and feasible, and might indicate an increased MPR and pathological complete response rate. More investigations are needed for the best combination of the neoadjuvant therapy.

Abstract Background Focal cortical dysplasia type 2 (FCD2) is a malformation of cortical development that constitutes a common cause of pediatric focal epilepsy. Germline or somatic variants in the mammalian target of rapamycin (mTOR) signaling pathway genes are the pathogenesis of FCD2. Objective In this study, whole‐exome deep sequencing was performed on dysplastic cortex from focal epilepsy in children to explore genetic characteristics in FCD2. Methods Resected core lesions of FCD2 were confirmed by pathology, and peripheral blood was collected from 11 patients. Deep whole‐exome sequencing (>500X) was performed on derived genomic DNA, germline, or somatic variants in brain‐specific genes were analyzed and identified. Results In 11 patients, a heterozygous likely pathogenic germline variant of DEPDC5 was identified in one case, while somatic variants were found in four brain samples. The frequencies of the somatic variant allele were 2.52%–5.12%. Somatic variants in AKT3, TSC2, and MTOR (mTOR signaling pathway genes) were found in three samples. Besides, one somatic variant was detected in MED12 which has not been reported to associate with FCD2. Conclusion Our study expanded the variant spectrum in the mTOR‐GATOR pathway, and also detected a somatic variant in MED12 which was potentially associated with FCD 2.

Abstract Objective Amyotrophic lateral sclerosis (ALS) is an adult‐onset fatal neurodegenerative disease which lacks identified biological markers. A label‐free plasma surface‐enhanced Raman spectroscopy (SERS) method was developed to explore a simple and noninvasive test for ALS. Methods ALS patients were enrolled serially and plasma samples were collected at the time of diagnosis prior to the start of ALS treatment. SERS spectra were recorded using a Renishaw micro‐Raman system. Results To exclude the interference by varying disease severity, we enrolled three groups of ALS patients, including ALS‐1 (n = 60; ALSFRS‐R ≥ 42 and time interval ≤ 12 months), ALS‐2 (n = 61; ALSFRS‐R 12 months). The SERS spectra were analyzed using principal component analysis (PCA), which showed that ALS‐1, ALS‐2, ALS‐3, and control groups were separated significantly. Then, decision tree (DT) models and receiver operating characteristic curves were employed and identified that bands at 722 and 739 cm−1, and ratios of 635–722 cm−1 and 635–739 cm−1 were able to distinguish ALS from controls significantly. Finally, we highlighted six metabolism pathways correlated with ALS, including phenylalanine‐tyrosine‐tryptophan biosynthesis, aminoacyl‐tRNA biosynthesis, phenylalanine metabolism, pantothenate and CoA biosynthesis, porphyrin and chlorophyll metabolism, and pyrimidine metabolism. Interpretation: Plasma SERS could be a promising tool for the detection of ALS. The bands at 722 and 739 cm−1, and the ratios of 635–722 cm−1 and 635–739 cm−1 could serve as potential indicator for ALS.

Abstract Background Inflammatory factors have been considered a significant factor contributing to the development and progression of glioma. However, the relationship between circulating inflammatory factors and glioma risk as well as their prognostic values in glioma patients is still inconclusive. Here, we performed a meta‐analysis to address this issue. Methods Relevant articles were identified through PubMed, EMBASE, the Cochrane Library, Web of Science, Wanfang database, and China National Knowledge Infrastructure (CNKI) from inception to February 2019. The weighted mean differences (WMDs) or standard mean differences (SMDs) with 95% confidence intervals (CIs) were used to describe the predictive ability of the levels of circulating inflammatory factors on glioma risk. To evaluate the prognostic values of the circulating inflammatory factors in glioma, hazard ratios (HRs) with 95% CIs were used. Results Thirty‐one studies comprising 2587 patients were included. The overall analysis showed that increased circulating interleukin‐6 (IL‐6) [SMD 0.81 (95% CI: 0.21‐1.40; P = .008)], interleukin‐8 (IL‐8) [SMD 1.01 (95% CI: 0.17‐1.84; P = .018)], interleukin‐17 (IL‐17) [SMD 1.12 (95% CI: 0.26‐1.98; P = .011)], tumor necrosis factor‐α (TNF‐α) [SMD 1.80 (95% CI: 1.03‐2.56; P = .000)], transforming growth factor‐β (TGF‐β) [SMD 10.55 (95% CI: 5.59‐15.51; P = .000)], and C‐reactive protein (CRP) [SMD 0.95 (95% CI: 0.75‐1.15; P = .000)] levels were significantly associated with glioma risk. On the other hand, our results showed that circulating IL‐6 [HR 1.10 (95% CI: 1.05‐1.16; P = .000)] and CRP [HR 2.02 (95% CI: 1.52‐2.68; P = .000)] levels were highly correlated with a poor overall survival (OS) rate in glioma patients. Conclusion Our results indicate that increased circulating IL‐6, IL‐8, IL‐17, TNF‐α, TGF‐β, and CRP levels are significantly associated with increased glioma risk. Moreover, our meta‐analysis suggests that circulating IL‐6 and CRP may serve as powerful biomarkers for a poor prognosis in glioma patients.

Abstract The authors reveal a thermal actuating bilayer that undergoes reversible deformation in response to low‐energy thermal stimuli, for example, a few degrees of temperature increase. It is made of an aligned carbon nanotube (CNT) sheet covalently connected to a polymer layer in which dibenzocycloocta‐1,5‐diene (DBCOD) actuating units are oriented parallel to CNTs. Upon exposure to low‐energy thermal stimulation, coordinated submolecular‐level conformational changes of DBCODs result in macroscopic thermal contraction. This unique thermal contraction offers distinct advantages. It's inherently fast, repeatable, low‐energy driven, and medium independent. The covalent interface and reversible nature of the conformational change bestow this bilayer with excellent repeatability, up to at least 70 000 cycles. Unlike conventional CNT bilayer systems, this system can achieve high precision actuation readily and can be scaled down to nanoscale. A new platform made of poly(vinylidene fluoride) (PVDF) in tandem with the bilayer can harvest low‐grade thermal energy and convert it into electricity. The platform produces 86 times greater energy than PVDF alone upon exposure to 6 °C thermal fluctuations above room temperature. This platform provides a pathway to low‐grade thermal energy harvesting. It also enables low‐energy driven thermal artificial robotics, ultrasensitive thermal sensors, and remote controlled near infrared (NIR) driven actuators.

In recent years, nanomaterials have been widely used in sports equipment, and their application in sportswear has also attracted wide attention. This research mainly discusses the application of nanomaterial antibacterial technology in the design of antibacterial fabrics for sports apparel. The method of adding nano-TiO2 to the antibacterial textiles varies with the type of fiber or fabric, and the finishing method also changes accordingly. For chemical fibers, the method of blending spinning is mainly used. By adding nano-antibacterial particles in the spinning solution, the polymer is ejected from the spinneret to make antibacterial fibers. This processing method is characterized by good antibacterial durability. The preparation of antimite finishing agent is mainly the dispersion of nanopowder. The selection of the best dispersant is mainly determined by measuring the change of the volume sedimentation rate of TiO2 after 5 days under different dosage and pH value of each dispersant. Then, the particle size of nano-TiO2 and Ag in different dispersing conditions was tested by TEM, and finally, the best dispersing agent and dispersing process were determined. The optimum of nano-antimite and antibacterial finishing agent is as follows: the dispersing agent is TW-80, the amount of anhydrous ethanol in dispersing medium is 5 times that of powder, the amount of dispersing agent is 1.5 times that of powder, the pH value is 7, and the stirring time is not less than 30 min. In the preparation of nano-antimite and antibacterial finishing agent, nanomaterials were used. The weight of nano-TiO2 powder was 20 grams and that of Ag was 20 grams. The dispersion medium (absolute ethanol) was 100 mL of dispersant. The amount of TW-80 was 30 g, the amount of citric acid was 60 g, the emulsion was very stable, and there was only a small amount of precipitation after being static for 5 days. Considering the characteristics of silk knitted fabric, this experiment uses the exhaustion method in the finishing process to finish the silk knitted fabric. After 50 times of washing, the antibacterial rate of Staphylococcus aureus and Escherichia coli reached 95.13% and 87.44%, respectively. This study provides guidance for the application of nanomaterials in the antibacterial field of sports clothing.

Background. Diabetes mellitus (DM) is a prognostic marker in elderly patients with cardiovascular diseases, but its predictive value in elderly valvular heart disease (VHD) patients is unclear. This study aimed to investigate the effect of DM on the long-term outcome of elderly VHD patients. Methods. This single-center, observational study enrolled patients aged 65 and older consecutively with confirmed VHD using echocardiography. Patients, divided into the DM group and non-DM group, were followed up for major adverse cardiac and cerebrovascular events (MACCEs), including all-cause death, ischemic stroke, and heart failure rehospitalization. Results. Our study consisted of 532 patients over a median follow-up of 52.9 months. Compared with the non-DM group (n = 377), the DM group (n = 155) had higher incidences of ischemic stroke (25.2% vs. 13.5%, P=0.001), heart failure rehospitalization (37.4% vs. 20.7%, P

Traditional general architecture chips have shown excessive power consumption and insufficient functional redundancy in some customized applications. Flexible electronics also call for customized chips in smart wearable devices. Common chips in intelligent systems process digital signals, and continuous operation of the system clock brings great power consumption. Herein, an intelligent gesture recognition system is developed by combining the flexible 2D materials and an analog computing chip. The pressure‐sensitive sponge with graphene fillings is proposed as a piezoresistive sensor. A nine‐sensor array is used to detect the pressure field distribution caused by hand movement. To get rid of the power consumption caused by the system clock, a novel analog‐computing customized chip which adopts a near‐sensor processing architecture is proposed. It implements the binary neural network algorithm with an analog circuit and completes the recognition of the transmission signal at the hardware level. The chip possesses a low power consumption which is less than 1.8 mW. Moreover, a glove assembled by highly pressure‐sensitive material recognizes mute gestures including Arabic numerals 0–9, with a recognition rate as high as 98.5%. Herein, the prospects for the application of customized smart chips in the field of smart wearable electronics are illuminated.

Background. Paravalvular leak (PVL) is common after transcatheter aortic valve implantation (TAVI) and has been linked with worse survival. This study aimed to investigate the determinants and outcome of PVL after TAVI and determine the role of aortic valve calcification (AVC) distribution in predicting PVL. Methods and Results. This was a retrospective cohort study of 270 consecutive patients who underwent TAVI. Determinants and outcomes of ≥mild PVL were assessed. Matching rates of PVL jet with AVC distribution were calculated. AVC volume, larger annulus dimensions, and transvalvular peak velocity were risk factors for ≥mild PVL after TAVI. AVC volume was an independent predictor of ≥mild PVL. On the other hand, annulus ellipticity, left ventricular outflow tract nontubularity, and diameter-derived prosthesis mismatch were not found to predict PVL after TAVI. PVL jet matched, in varying proportions, with calcification at all aortic root regions, and the highest matching rate was with calcifications at body of leaflets. Moreover, matching rates were less with commissure compared to cusp calcifications. Mild or greater PVL was not associated with all-cause and cardiovascular mortality up to 1-year follow-up. Conclusion. ≥mild PVL after TAVI is common and can be predicted by aortic root calcification volume, larger annulus dimensions, and pre-TAVI transvalvular peak velocity, with calcification volume being an independent predictor for PVL. However, annulus ellipticity, left ventricular outflow tract nontubularity, and diameter-derived prosthesis mismatch had no role in predicting PVL. Importantly, body of leaflet calcifications (versus annulus and tip of leaflet) and cusp calcifications (versus commissure calcification) are more important in predicting PVL. No association between ≥mild PVL and increased risk of all-cause and cardiovascular mortality at 1-year follow-up.

The presence of a concealed karst cave above a deep highway tunnel may cause the collapse of the rock mass between the karst cave and tunnel during excavation. Rock mass collapse threatens the safety of tunnel construction personnel. A prediction method of the collapse region induced by a concealed karst cave above a deep highway tunnel is proposed on the basis of the upper bound theorem of limit analysis. An analytical expression of the collapse surface is derived from the variational principle. Using the analytical expression of the collapse surface, the shapes of the collapse surfaces are plotted for different rock mass parameters. Moreover, the minimum safe distance between the karst cave and tunnel is defined, and the computational equation of the minimum safe distance is derived. The proposed method is applied in a highway tunnel excavated in a karst terrain as a case study. Based on geological survey report parameters, the shape of the collapse surface and the minimum safe distance between the karst cave and tunnel are obtained. Finally, the collapse surface of the rock mass provided by the proposed approach is compared with that provided by numerical simulation, and the favorable result comparison shows that the proposed method is valid.

Objectives. To investigate the metabolic profile in patients with aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR) and explore the potential biomarkers to predict prognosis after TAVR based on metabolomics. Methods and Results. Fifty-nine consecutive AS patients were prospectively recruited. Blood samples from the ascending aorta, coronary sinus, and peripheral vein at before and after TAVR were collected, respectively. Liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry were performed to analyze the metabolic profile before and after TAVR. Influential metabolites were identified by integrating the univariate test, multivariate analysis, and weighted gene coexpression network analysis (WGCNA) algorithm. PLS-DA analysis revealed a significant extremely early (within 30 minutes after TAVR) alterations of metabolites in the ascending aorta, coronary sinus, and peripheral vein. The early (within 7 days after TAVR) changed metabolites in the peripheral vein were involved in purine metabolism, primary bile acid biosynthesis, glycerolipid metabolism, amino sugar and nucleotide sugar metabolism, one carbon pool by folate and alanine, and the aspartate and glutamate metabolism pathway. We used volcano plots to find that the cardiac-specific changed metabolites were enriched to the sphingolipid metabolism pathway after TAVR. Besides, WGCNA algorithm was performed to reveal that arginine and proline metabolites could reflect left ventricle regression to some extent. Conclusion. This is the first study to reveal systemic and cardiac metabolites changed significantly in patients with AS after TAVR. Some altered metabolites involved in the arginine and proline metabolism pathway in the peripheral vein could predict left ventricle regression, which merited further study.

Objective. To determine the subcellular localization of epithelial cell adhesion molecule (EpCAM) in labial salivary gland (LSG) and evaluate the diagnostic use of the extracellular domain of EpCAM (EpEX) and intracellular domain (EpICD) for primary Sjögren’s syndrome (pSS). Methods. Immunohistochemical (IHC) analysis was conducted using EpEX and EpICD domain-specific antibodies on labial salivary gland biopsy (LSGB) from participants. Chi-square or Fisher’s exact analysis, Mann–Whitney U-test, and Kruskal-Wallis test compared differences among groups. Independent risk factors of pSS were determined by multiple logistic regression analysis. Receiver-operator characteristic curves (ROC) were carried out to estimate the diagnostic value. Results. Compared to non-SS controls, loss of membranous EpEX and EpICD expression was observed in LSGB of pSS patients, which occurred in parallel with increased accumulation of cytoplastic and nuclear EpICD. The subcellular EpEX/EpICD expressions were associated with various features of pSS patients, especially histopathological grade of LSGB. Furthermore, high IHC scores of membranous EpEX were independent risk factors for pSS, even for the pSS patients at early stage. The IHC scores of subcellular EpEX/EpICD were of great diagnostic value for pSS with high sensitivity (70-80%) and specificity (85-95%). Conclusion. This study first found the aberrant expression pattern of EpCAM in LSG of pSS patients. The IHC scores of subcellular EpEX/EpICD were demonstrated to have the potential to act as diagnostic biomarkers for pSS.

Objectives. We aimed to assess the procedural and clinical results of transcatheter aortic valve replacement (TAVR) for nonraphe bicuspid aortic stenosis (AS) with coronary vs mixed cusp fusion. Background. It remains unclear whether cusp fusion morphology affects TAVR outcomes in patients with nonraphe bicuspid AS. Methods. This retrospective study enrolled consecutive patients with severe symptomatic AS and type-0 bicuspid aortic valve, who underwent TAVR at our institution between 2012 and 2017. TAVR outcomes were defined based on the Valve Academic Research Consortium-2 recommendations. Results. Compared to patients with mixed cusp fusion (44/71), those with coronary cusp fusion (27/71) had a larger ellipticity index for the aortic annulus (21.9% ± 9.0% vs 15.6% ± 9.3%, p=0.007) and increased left ventricular outflow tract obstruction (31.1% ± 9.4% vs 26.9% ± 7.5%, p=0.04) but comparable rates of second valve implantation (15.9% vs 14.8%), mild paravalvular leakage (PVL, 38.5% vs 30.2%), permanent pacemaker implantation (PPM, 25.9% vs 15.9%), and 30-day mortality (7.4% vs 6.8%). Use of a first-generation transcatheter heart valve was associated with higher risk for mild PVL (odds ratio (OR) = 4.37; 95% confidence interval (95% CI) = 1.14–16.75; p=0.03) but not PPM (OR = 0.77; 95% CI = 0.22–2.62; p=0.67), whereas a larger oversizing ratio tended to be associated with a higher PPM rate (OR = 1.49; 95% CI = 0.46–4.86; p=0.51) but lower incidence of mild PVL (OR = 0.51; 95% CI = 0.19–1.35; p=0.17). Conclusions. In AS patients with type-0 bicuspid valves, cusp fusion morphology does not affect the procedural or clinical results of TAVR. Use of second-generation transcatheter heart valves may provide more favorable results in such patients. This trial is registered with NCT01683474.