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Phase change materials (PCMs) are promising thermal energy storage materials due to their high specific latent heat. Conventional PCMs typically exploit the solid–liquid (s–l) transition. However, leakage and leaching are common issues for solid–liquid PCMs, which have to be addressed before usage in practical applications. In contrast, solid–solid (s–s) PCMs would naturally overcome these issues due to their inherent form stability and homogeneity. In this study, we report a new type of s–s PCM based on chemically linked polyethylene glycol (PEG, the PCM portion) with polylactic acid (PLA, the support portion) in the form of a block co‐polymer. Solid‐solid latent heat of up to 56 J/g could be achieved, with melting points of between 44 °C and 55 °C. For comparison, PEG was physically mixed into a PLA matrix to form a PEG:PLA composite. However, the composite material saw leakage of up to 9% upon heating, with a corresponding loss in thermal storage capacity. In contrast, the mPEG/PLA block co‐polymers were found to be completely homogeneous and thermally stable even when heated above its phase transition temperature, with no observable leakage, demonstrating the superiority of chemical linking strategies in ensuring form stability. [ABSTRACT FROM AUTHOR]

Objectives: To develop and validate an artificial intelligence system, the Prenatal ultrasound diagnosis Artificial Intelligence Conduct System (PAICS), to detect different patterns of fetal intracranial abnormality in standard sonographic reference planes for screening for congenital central nervous system (CNS) malformations.Methods: Neurosonographic images from normal fetuses and fetuses with CNS malformations at 18-40 gestational weeks were retrieved from the databases of two tertiary hospitals in China and assigned randomly (ratio, 8:1:1) to training, fine-tuning and internal validation datasets to develop and evaluate the PAICS. The system was built based on a real-time convolutional neural network (CNN) algorithm, You Only Look Once, version 3 (YOLOv3). An image dataset from a third tertiary hospital was used to further validate, externally, the performance of the PAICS and to compare its performance with that of sonologists with different levels of expertise. Furthermore, a prospective video dataset was employed to evaluate the performance of the PAICS in a real-time scan scenario. The diagnostic accuracy, sensitivity, specificity and area under the receiver-operating-characteristics curve (AUC) were calculated to assess the performance of the PAICS and to compare this with the performance of sonologists with different levels of experience.Results: In total, 43 890 images from 16 297 pregnancies and 169 videos from 166 pregnancies were used to develop and validate the PAICS. The system achieved excellent performance in identifying 10 types of intracranial image pattern, with macro- and microaverage AUCs, respectively, of 0.933 (95% CI, 0.798-1.000) and 0.977 (95% CI, 0.970-0.985) for the internal validation image dataset, 0.902 (95% CI, 0.816-0.989) and 0.898 (95% CI, 0.885-0.911) for the external validation image dataset and 0.969 (95% CI, 0.886-1.000) and 0.981 (95% CI, 0.974-0.988) in the real-time scan setting. The performance of the PAICS was comparable to that of expert sonologists in terms of macro- and microaverage accuracy (P = 0.863 and P = 0.775, respectively), sensitivity (P = 0.883, P = 0.846) and AUC (P = 0.891, P = 0.788), but required significantly less time (0.025 s per image for PAICS vs 4.4 s for experts, P < 0.001).Conclusions: Both in the image dataset and in the real-time scan setting, the PAICS achieved excellent diagnostic performance for various fetal CNS abnormalities. Its performance was comparable to that of experts, but it required less time. A CNN algorithm can be trained to detect fetal CNS abnormalities. The PAICS has the potential to be an effective and efficient tool in screening for fetal CNS malformations in clinical practice. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the feasibility of using deep‐learning algorithms to classify as normal or abnormal sonographic images of the fetal brain obtained in standard axial planes. Methods: We included in the study images retrieved from a large hospital database from 10 251 normal and 2529 abnormal pregnancies. Abnormal cases were confirmed by neonatal ultrasound, follow‐up examination or autopsy. After a series of pretraining data processing steps, 15 372 normal and 14 047 abnormal fetal brain images in standard axial planes were obtained. These were divided into training and test datasets (at case level rather than image level), at a ratio of approximately 8:2. The training data were used to train the algorithms for three purposes: performance of image segmentation along the fetal skull, classification of the image as normal or abnormal and localization of the lesion. The accuracy was then tested on the test datasets, with performance of segmentation being assessed using precision, recall and Dice's coefficient (DICE), calculated to measure the extent of overlap between human‐labeled and machine‐segmented regions. We assessed classification accuracy by calculating the sensitivity and specificity for abnormal images. Additionally, for 2491 abnormal images, we determined how well each lesion had been localized by overlaying heat maps created by an algorithm on the segmented ultrasound images; an expert judged these in terms of how satisfactory was the lesion localization by the algorithm, classifying this as having been done precisely, closely or irrelevantly. Results: Segmentation precision, recall and DICE were 97.9%, 90.9% and 94.1%, respectively. For classification, the overall accuracy was 96.3%. The sensitivity and specificity for identification of abnormal images were 96.9% and 95.9%, respectively, and the area under the receiver‐operating‐characteristics curve was 0.989 (95% CI, 0.986–0.991). The algorithms located lesions precisely in 61.6% (1535/2491) of the abnormal images, closely in 24.6% (614/2491) and irrelevantly in 13.7% (342/2491). Conclusions: Deep‐learning algorithms can be trained for segmentation and classification of normal and abnormal fetal brain ultrasound images in standard axial planes and can provide heat maps for lesion localization. This study lays the foundation for further research on the differential diagnosis of fetal intracranial abnormalities. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID‐19) pandemic presented formidable challenges in our ability to impart in‐person extra‐mural clinical training, including the Geriatric and Special Needs Program, to a group of 20 fourth‐year dental students. A new course delivery format was developed wherein students used a validated Rapid Oral Health Deterioration (ROHD) risk assessment tool to critically appraise clinical case information relating to a young adult with special needs. In the alternative virtual educational approach that was created, students applied an interprofessional practice concept leading to patient treatment planning outcomes. Providing adequate information, additional reading resources, a response template, clear instructions and a process‐oriented assessment policy all ensured a good level of participation from students in the alternative learning format. An association was noted between students' staging of risk for ROHD and their subsequent recommendations for treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND The objective of the present study was to evaluate the effects of four chemicals on the fermentation quality and aerobic stability of alfalfa ( Medicago sativa L.) silage. Wilted alfalfa was ensiled without additive (control), or with formic acid (FA), potassium diformate (KDF), sodium diacetate (SDA) or calcium propionate (CAP). RESULTS After 60 days of ensiling, the pH values in FA, KDF and SDA silages were lower ( P < 0.05) compared to that of control and CAP silages, and chemicals ( P < 0.05) decreased butyric acid and ammonia N concentrations and populations of aerobic bacteria and yeasts compared to the control. The SDA and CAP silages had a higher ( P < 0.05) lactic acid bacteria content compared to the FA and KDF silages. The SDA and CAP silages had higher ( P < 0.05) acetic and propionic acid contents compared to the other silages, respectively. The ammonia N concentrations in the FA and KDF silages were lower compared to the other silages during the first 5 days of aerobic exposure, and then increased sharply to 105 and 100 g kg-1 total N, respectively, which was higher ( P < 0.05) than that of the SDA and CAP silages on day 9 of aerobic exposure. Yeasts and aerobic bacteria counts in SDA silage slowly increased and remained at lower levels compared to the other silages after 7 days of aerobic exposure. CONCLUSION Additives prolonged the aerobic stability duration compared to the control, and the SDA and CAP silages remained stable for more than 216 h, followed by the KDF and FA silages (202 and 196 h, respectively). © 2017 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Purpose: Early detection of ocular abnormalities in newborns is essential for timely diagnosis and treatment. This study aimed to assess the 1-year result of a multicentre prospective neonatal eye examination programme with wide-field digital imaging system in China., Methods: A multicentre collaborative prospective study group for neonatal eye screening was established in nine hospitals, including eight Maternal and Children's Hospitals, and one general hospital across China from July 2016 to June 2017. Ocular examinations were performed on newborns within 28 days after birth using a wide-field digital imaging system. Data were reviewed and analysed. The primary outcome was the prevalence of ocular abnormalities in neonates., Results: We detected 13 514 (20.91%) abnormal cases in 64 632 newborns. The most frequent abnormality was retinal haemorrhage (RH; 11.83%). Most of mild RH resolved spontaneously. Among those who were beyond retinopathy of prematurity (ROP) screening criteria of China (gestational age ≥32 w and birthweight ≥2000 g), the total number of neonates with ocular abnormality was 12 218/62 799(19.45%). 59.44% of neonatal ocular abnormalities detected (accounting for 11.56% of all the screened population) needed further interference or observation. Among them, 258 patients (0.41% of all the screened population) needed immediate or timely intervention, including congenital cataract, retinal detachment, retinoblastoma and other ocular abnormalities. One thousand and ninety-eight patients (1.75% of all the screened neonates) should be followed up closely and needed further diagnosis or intervention if necessary, such as ROP or ROP-like retinopathy, familial exudative vitreoretinopathy and persistent hyperplasia of primary vitreous. Five thousand nine hundred and six patients (9.4%) with minor clinical significance needed short-term follow-up., Conclusions: This prospective multicentre study of newborn ocular examination showed a relatively high prevalence of ocular abnormalities. There are a relatively high percentage of congenital eye pathology that required further referral and treatment in those neonates who were not screened routinely. According to the benefits and risks associated with neonatal eye examinations, neonatal ocular screening programme can detect ocular abnormalities at the very early stage and may play a positive role in promoting paediatric eye health., (© 2020 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

The coronavirus disease 2019 (COVID-19) pandemic presented formidable challenges in our ability to impart in-person extra-mural clinical training, including the Geriatric and Special Needs Program, to a group of 20 fourth-year dental students. A new course delivery format was developed wherein students used a validated Rapid Oral Health Deterioration (ROHD) risk assessment tool to critically appraise clinical case information relating to a young adult with special needs. In the alternative virtual educational approach that was created, students applied an interprofessional practice concept leading to patient treatment planning outcomes. Providing adequate information, additional reading resources, a response template, clear instructions and a process-oriented assessment policy all ensured a good level of participation from students in the alternative learning format. An association was noted between students' staging of risk for ROHD and their subsequent recommendations for treatment., (© 2020 American Dental Education Association.)

Sweet syndrome (SS), also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disorder characterized by sudden onset of variably tender brightly erythematous-to-violaceous papules, plaques, or nodules. To clarify the frequency, clinical course, therapeutic response, and outcome of Sweet syndrome with malignancy. We conducted a retrospective review of patients diagnosed with SS between 2009 and 2019 with a diagnosis of Sweet syndrome in West China hospital. Records were analyzed for variables, clinical features, etiological factors, laboratory results, and treatment outcomes. The 25 cases under study consisted of 14 (56%) females and 11 (44%) males. Mean age was 52.2 years (range: 4-76 years). Nodules were the commonest lesion presentation (48%), involving mostly the lower limbs (52%). Pain of lesion was identified as the most common symptom (88%), followed by fever (76%) and cough (44%). Among the patients, 52% exhibited the classic form, 48% showed the malignancy-associated form, and 4% exhibited the drug-induced form in the setting of malignancy. Acute myeloid leukemia was the most common malignancy, observed in 5 of 12 patients (41.6%). Anemia (P = .002) was associated with malignancy (Chi-square test)., (© 2020 Wiley Periodicals LLC.)

Numb is known as a cell fate determinant as it identifies the direction of cell differentiation via asymmetrical partitioning during mitosis. It is considered as a tumour suppressor, and a frequent loss of Numb expression in breast cancer is noted. Numb forms a tri-complex with p53 and E3 ubiquitin ligase HDM2 (also known as MDM2), thereby preventing the ubiquitination and degradation of p53. In this study, we examined Numb expression in 125 patients with triple-negative breast cancer (TNBC). The results showed that 61 (48.8%) patients presented with a deficient or decreased Numb expression. The percentage of Ki67 > 14% in the retained Numb group was significantly lower than that in the decreased and deficient Numb groups (86.00% vs. 98.40%, P = .0171). This study aimed to detect the expression and migration of Numb, HDM2 and p53 in the membrane, cytoplasmic and nuclear fractions of normal mammary epithelial cell line MCF-10A and basal-like TNBC cell line MDA-MB-231. We obtained the cell fractions to identify changes in these three protein levels after the re-expression of NUMB in the MDA-MB-231 cells and the knocking down of NUMB in the MCF-10A cells. Results showed that Numb regulates p53 levels in the nucleus where the protein levels of Numb are positively correlated with p53 levels, regardless if it is re-expressed in the MDA-MB-231 cells or knocked down in the MCF-10A cells. Moreover, HDM2 was remarkably decreased only in the membrane fraction of NUMB knock-down cells; however, its mRNA levels were increased significantly. Our results reveal a previously unknown molecular mechanism that Numb can migrate into the nucleus and interact with HDM2 and p53., (© 2020 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)

Purpose: To compare the orbital cerebral spinal fluid pressure (CSFP) and trans-lamina cribrosa pressure difference (TLCPD) determined noninvasively in ocular hypertensive (OH) subjects and controls., Methods: Cross-sectional observational study. Magnetic resonance imaging was used to measure orbital subarachnoid space width (OSASW). The CSFP (mm Hg) was estimated from a published formula as 17.54 × MRI derived OSASW at 15 mm behind the globe + 0.47 × body mass index + 0.13 × mean arterial blood pressure -21.52. Estimated TLCPD was calculated as IOP- CSFP., Results: The orbital subarachnoid space width was significantly wider (p = 0.01) in the OH group than in the control group at all three measurement locations. The MRI derived CSFP value in OH (14.9 ± 2.9 mm Hg) was significantly higher than in the normal group (12.0 ± 2.8 mm Hg; p < 0.01). The estimated TLCPD value in OH (9.0 ± 4.2 mm Hg) was significantly higher than in controls (3.6 ± 3.0 mm Hg; p < 0.01)., Conclusion: The wider OSASW and higher estimated CSFP in OH subjects suggest a higher orbital CSFP. Despite a higher orbital CSFP that could be protective, the higher TLCPD in OH may play a significant role in the risk of developing glaucoma., (© 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Objective: The aim of this study is to provide histopathological evidence for a better understanding of the excision of bone underlying tumor., Study Design: Retrospective study., Methods: Thirty patients with histopathological diagnosis of sinonasal inverted papilloma (SIP) were enrolled. All patients underwent preoperative radiography to define the tumor location. The primary tumor and underlying bone, removed during endoscopic surgery, were examined under microscope., Results: Twenty-five of 30 specimens exhibited bony hyperostosis on computed tomography (CT) images, and 12 of 30 specimens showed evidence of bony lamellar erosion. Both coexisted in 11 cases. Half of the relapse cases (8 of 16) presented bone discontinuity on CT, which indicates a higher propensity for bone involvement when compared with primary SIP. On histopathology, 26 cases presented hyperostosis and 11 cases showed bone invasion. In total, 90% of cases covered both. Sixteen cases showed a growing tendency of inflammatory cells infiltration., Conclusion: Histopathological evidence of bone involvement indicates the importance of removal of the underlying bone at the time of endoscopic tumor resection. We hypothesized that bone involvement including bone invasion and osteogenesis may be induced by the tumor, and any microscopic lesion in the bony crevices probably indicates recurrence of SIP. Furthermore, infiltration of inflammatory cells may facilitate bone involvement and cause recurrence., Level of Evidence: NA. Laryngoscope, 127:2703-2708, 2017., (© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives/hypothesis: To explore whether the variables resulting from anatomical and physiological examinations can be combined to predict the outcomes of velopharyngeal surgery for obstructive sleep apnea (OSA)., Study Design: Prospective design with a retrospective review., Methods: A total of 119 patients with OSA received velopharyngeal surgery, including revised uvulopalatopharyngoplasty with uvula preservation and transpalatal advancement pharyngoplasty. The preoperative examinations of these patients, including polysomnography (PSG), physical examination, and three-dimensional computer tomography (3-D CT), were obtained for analysis., Results: The overall success rate was 62.2%. Three factors were found to be predictive in treatment outcomes (P<0.05). These were tonsil size, the percentage of time with oxygen saturation below 90% (CT90), and the vertical distance between the lower edge of the mandible and the lower edge of the hyoid (MH). After changing CT90 and MH into level variables, another regression analysis was performed and the result suggested that all three level variables could be included. A scoring system was then created based on these three variables and their odds ratio values. The total scores of all patients were calculated by the following equation: Total score=2.7 tonsil size (score)+2.2 CT90 (score)+1.6 MH (score). The differences in success rates among patients with total scores of <14, 14 to 17, 17 to 22, and ≥22 were all significant (P<0.05)., Conclusion: The anatomy of the pharynx and the physiology of OSA are both important in deciding outcomes of velopharyngeal surgery. Variables that could represent these two aspects can be combined to better guide patient selections., Level of Evidence: 4., (© 2013 The American Laryngological, Rhinological and Otological Society, Inc.)