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This article presents a novel class of dual-mode substrate-integrated waveguide (SIW) bandpass filters exploiting perturbed SIW rectangular cavities. By introducing metallized via-holes along the central line of an SIW rectangular cavity, the resonant frequency of TE101 mode can be shifted close to that of TE201 mode, thus creating a dual-mode resonator. This structure implements a doublet, which provides two poles and one or two transmission zeros (TZs). The pass bandwidth, spurious-free bandwidth, and positions of the TZs can be fully controlled by modifying the length of the perturbation, the side ratio of the rectangular cavity, and the offset of the input/output ports, respectively. Eight two-pole SIW filters are designed and investigated to demonstrate the high design flexibility. Moreover, a four-pole SIW filter with the asymmetric response and a five-pole SIW filter with quasi-elliptic response are designed, fabricated, and measured to describe the extension of the proposed approach to higher order filters.

Purpose: The study was aimed to examine components and provider’s characteristics of non-pharmacological intervention that affect delirium prevention in elderly inpatients. Additional effects on delirium prevention based on identified characteristics were explored.Methods: Studies were searched by using seven electronic databases and examined through Preferred Reporting Items Systematic Review and Meta-Analysis (PRISMA) flow diagram. The Risk of Bias (ROB) and the Risk of Bias Assessment tool for Non-randomized Study (RoBANS) were used to evaluate the quality of each included study.Results: Seven studies were selected for the systematic review. Most of the selected studies had a low risk of bias. Interventions of each study and delirium outcome were heterogeneous. Each multi-component non-pharmacological intervention consisted on average of five interventions. Giving orientation and promoting early mobilization were included in every study. Interventions that included giving orientation, promoting early mobilization, and supporting nutrition significantly decreased delirium incidence. Moreover, when health care providers who have an intimate relationship with patients provided non-pharmacological interventions, delirium incidence has significantly decreased.Conclusion: Non-pharmacological intervention, such as giving orientation, promoting early mobilization, should be included to prevent delirium for elderly inpatients. It is important to include healthcare providers who have an intimate relationship or regular contact with patients in order to decrease delirium incidence.

Aims/Introduction Elevated concentrations of fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c) are well‐established independent risk factors for progression to diabetes, cardiovascular comorbidities and mortality. Most previous studies on the relationships of anthropometric measures with hyperglycemia were carried out among adults and adolescents, but few data are available for the performance predication of the predictors for diagnosing elevated FPG or HbA1c among young children. Materials and Methods Involving 5,556 students of aged 7–9 years, a school‐based cross‐sectional survey was carried out between March and June 2019 in Shenzhen, China. Receiver operating characteristic curve analysis was utilized. Results The median was 4.6 (interquartile range [IQR] 4.3–4.8) mmol/L for FPG and 5.3% (IQR 5.1–5.5%) for HbA1c levels for all participants. For detecting elevated FPG, weight (0.651, IQR 0.583–0.719) and waist circumference (0.650, IQR 0.584–0.717) showed the highest area under the curve and 95% confidence interval, followed by body mass index and the z‐score of body mass index (both 0.635, IQR 0.567–0.703); other anthropometric measures showed poorer diagnostic efficiencies or no ability. For detecting elevated HbA1c, lower efficiencies for the Conicity Index (0.651, IQR 0.583–0.719), waist‐to‐height ratio, waist‐to‐hip ratio and waist‐to‐chest ratio were shown. The correlations of FPG and HbA1c levels with anthropometric indices were weak (Spearman’s r ≤ 0.179). Conclusions None of the evaluated anthropometric indicators approached an adequate predictive accuracy for the detection of elevated FPG or HbA1c levels in Shenzhen children aged 7–9 years. The current study did not recommend anthropometry screening for prediabetes in young children., Few data are available for the performance predication for diagnosing elevated fasting plasma glucose or hemoglobin A1c among young children. A school‐based cross‐sectional survey involving 5,556 students aged 7–9 years was carried out in Shenzhen, China. None of the evaluated anthropometric indicators approached an adequate predictive accuracy for the detection of elevated fasting plasma glucose or hemoglobin A1c levels. The current study did not recommend anthropometry screening for prediabetes in young children.

High-throughput genome sequencing and computation have enabled rapid identification of targets for personalized medicine, including cancer vaccines. Synthetic peptides are an established mode of cancer vaccine delivery, but generating the peptides for each patient in a rapid and affordable fashion remains difficult. High-throughput peptide synthesis technology is therefore urgently needed for patient-specific cancer vaccines to succeed in the clinic. Previously, we developed automated flow peptide synthesis technology that greatly accelerates the production of synthetic peptides. Herein, we show that this technology permits the synthesis of high-quality peptides for personalized medicine. Automated flow synthesis produces 30-mer peptides in less than 35 minutes and 15- to 16-mer peptides in less than 20 minutes. The purity of these peptides is comparable with or higher than the purity of peptides produced by other methods. This work illustrates how automated flow synthesis technology can enable customized peptide therapies by accelerating synthesis and increasing purity. We envision that implementing this technology in clinical settings will greatly increase capacity to generate clinical-grade peptides on demand, which is a key step in reaching the full potential of personalized vaccines for the treatment of cancer and other diseases.

Here we demonstrate a magnetic resonance coupling based wireless triboelectric nanogenerator (TENG) and fully self-powered wireless sensors. By integrating a microswitch and an inductor with the TENG, the pulsed voltage output is converted into a sinusoidal voltage signal with a fixed frequency. This can be transmitted wirelessly from the transmit coil to the resonant-coupled receiver coil with an efficiency of 73% for a 5 cm distance between the two coils (10 cm diameter). Analytic models of the oscillating and coupled voltage signals for the wireless energy transfer are developed, showing excellent agreement with the experimental results. A TENG of 40 × 50 mm2 can wirelessly light up 70 LEDs or charge up a 15 μF capacitor to 12.5 V in ~90 s. The system is further utilized for two types of fully self-powered wireless chipless sensors with no microelectronic components. The technologies demonstrate an innovative strategy for a wireless ‘green’ power source and sensing., Renewable energy based wireless power transfer is challenging. Here the authors show a resonant-coupled triboelectric nanogenerator as a wireless power source and have further utilized this system to explore two fully self-powered wireless chipless sensors.

Background The updated Veterans Aging Cohort Study (VACS) Index 2.0 combines general and human immunodeficiency virus (HIV)–specific biomarkers to generate a continuous score that accurately discriminates risk of mortality in diverse cohorts of persons with HIV (PWH), but a score alone is difficult to interpret. Using data from the North American AIDS Cohort Collaboration (NA-ACCORD), we translate VACS Index 2.0 scores into validated probability estimates of mortality. Methods Because complete mortality ascertainment is essential for accurate calibration, we restricted analyses to cohorts with mortality from the National Death Index or equivalent sources. VACS Index 2.0 components were ascertained from October 1999 to April 2018. Mortality was observed up to March 2019. Calibration curves compared predicted (estimated by fitting a gamma model to the score) to observed mortality overall and within subgroups: cohort (VACS/NA-ACCORD subset), sex, age 500 copies/mL, CD4 count Results Among 37230 PWH in VACS and 8061 PWH in the NA-ACCORD subset, median age was 53 and 44 years; 3% and 19% were women; and 48% and 39% were black. Discrimination in NA-ACCORD (C-statistic = 0.842 [95% confidence interval {CI}, .830–.854]) was better than in VACS (C-statistic = 0.813 [95% CI, .809–.817]). Predicted and observed mortality largely overlapped in VACS and the NA-ACCORD subset, overall and within subgroups. Conclusions Based on this validation, VACS Index 2.0 can reliably estimate probability of all-cause mortality, at various follow-up times, among PWH in North America.

Background Numerous studies have consistently demonstrated that high body mass index (BMI) is related to elevated serum alanine aminotransferase (ALT) among adults, but little is known about the association regarding adolescents, especially in China. In this study, we aimed to investigate the association between BMI and ALT activity among Chinese adolescents. Methods A school-based cross-sectional study was performed among nine high schools in Shenzhen, China between February 2017 and June 2018. A generalized linear-regression model adjusting for age and gender was conducted, and bivariate correlation analysis between ALT and BMI was also performed. Results A total of 7,271 adolescents aged from 9 years to 17 years were enrolled. Height, weight, BMI, and ALT were higher among boys than among girls (all P Conclusions We found a significant BMI−ALT relationship. BMI at 20.5 kg/m2 may be a cut-off for evaluating serum ALT. BMIs ≥27.1 kg/m2 for boys and ≥24.9 kg/m2 for girls were linked to an elevated ALT activity for Shenzhen adolescents.

Plasmon-polaritons are among the most promising candidates for next generation optical sensors due to their ability to support extremely confined electromagnetic fields and empower strong coupling of light and matter. Here we propose quantum plasmonic immunoassay sensing as an innovative scheme, which embeds immunoassay sensing with recently demonstrated room temperature strong coupling in nanoplasmonic cavities. In our protocol, the antibody-antigen-antibody complex is chemically linked with a quantum emitter label. Placing the quantum-emitter enhanced antibody-antigen-antibody complexes inside or close to a nanoplasmonic (hemisphere dimer) cavity facilitates strong coupling between the plasmon-polaritons and the emitter label resulting in signature Rabi splitting. Through rigorous statistical analysis of multiple analytes randomly distributed on the substrate in extensive realistic computational experiments, we demonstrate a drastic enhancement of the sensitivity up to nearly 1500% compared to conventional shifting-type plasmonic sensors. Most importantly and in stark contrast to classical sensing, we achieve in the strong-coupling (quantum) sensing regime an enhanced sensitivity that is no longer dependent on the concentration of antibody-antigen-antibody complexes -- down to the single-analyte limit. The quantum plasmonic immunoassay scheme thus not only leads to the development of plasmonic bio-sensing for single molecules but also opens up new pathways towards room-temperature quantum sensing enabled by biomolecular inspired protocols linked with quantum nanoplasmonics., Just Accepted Manuscript, Nano Letters 2019

A multi-layer interleaved folded half-mode substrate integrated waveguide (HMSIW) dual-band filter is proposed. The TE 101 and TE 102 mode of the HMSIW resonators form dual-band response by vertical coupling, and the bandwidth of the two passbands can be independently designed by adjusting the coupling apertures. Moreover, three transmission zeros (TZs) are obtained to improve out-of-band rejection, and the TZs can be flexibly designed below or above the passband. By vertically superimposing the HMSIW cavity, the HMSIW filter can be extended to multi-pole dual-band filters. A dual-band filter with centre frequency of 3.05 and 4.7 GHz was fabricated and measured to verify the proposed method. The simulated and measured results are in good agreement.

BACKGROUND: Use of electronic health records (EHRs) in health research may lead to the false assumption of complete event ascertainment. We present a systematic approach to estimate “observation windows” (OWs), defined as time periods within which the assumption of complete ascertainment of events is more likely to hold, as a quality control approach to reducing the likelihood of this false assumption. We demonstrate the impact of observation windows on estimating the rates of type 2 diabetes mellitus (diabetes) using EHR diagnosis, medication, and laboratory data from HIV clinical cohorts. METHODS: Data contributed by 16 HIV clinical cohorts to the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) were used to identify and evaluate OWs for an operationalized definition of diabetes occurrence as a case study. Procedures included: 1) gathering cohort-level data; 2) visualizing and summarizing gaps in observations; 3) systematically establishing start and stop dates during which complete ascertainment of diabetes events was reasonable; and 4) visualizing the diabetes OWs relative to the cohort open and close dates to identify periods of time during which immortal person time was accumulated and events were not fully ascertained. We estimated diabetes occurrence event rates and 95% confidence intervals ([,]) in the most recent decade that data were available (Jan 1, 2007 to Dec 31, 2016). RESULTS: The number of diabetes events decreased by 17% with the use of the diabetes OWs; immortal person-time was removed decreasing total person-years by 23%. Consequently, the diabetes rate increased from 1.23 (95% confidence interval [1.20, 1.25]) per 100 person-years to 1.32 ([1.29, 1.35] per 100 person-years with the use of diabetes OWs. CONCLUSIONS: As the use of EHR-curated data for event-driven health research continues to expand, OWs have utility as a quality control approach to complete event ascertainment, helping to improve accuracy of estimates by removing immortal person-time when ascertainment is incomplete.

Esophageal cancer (EC) is a highly prevalent malignancy in China. According to the data released by National Cancer Registry Center of China in 2015, the prevalence of EC was 21.17/100,000 in China in 2012, ranking fifth among all malignancies; the mortality rate was 15.58/100,000, ranking fourth. It is expected that there will be 477,900 new EC cases nationwide in 2015, whereas 375,000 people will die from EC (1,2). Worldwide, EC is the 8 th most common malignancy, with 416,000 new cases in 2012 (3). At present, EC treatment is based on multidisciplinary treatment, but surgery remains the most effective therapy in optimizing long-term prognosis in patients without metastatic disease. The ideal surgical approach is a matter of debate.

A horizontally polarized (HP) wideband antenna is designed and analyzed for wireless communication in this communication. The HP antenna is a combination of four quarter-wavelength slot elements, and fed by a wideband power divider with equal amplitude and zero phase difference output signals. Equivalent to the current loop, four slot elements rotate around the center of proposed structure, which gives rise to a monopolar radiation pattern. A prototype is designed, fabricated and measured. The results show that a deep null more than 20 dB appears in the broadside of the elevation plane radiation pattern. And a small ripple less than 2 dB in azimuth plane radiation pattern is obtained. The antenna has a wide impedance band of 33.3% for S11

The concept of minimally invasive cardiac surgery has been put forward for more than decades and continued to develop. Recently, minimally invasive aortic valve surgery is established as a safe and effective treatment for various aortic valvular heart diseases and ascending aorta disorders. This study is aimed at analyzing the safety and effectiveness of aortic valve replacement (AVR) through right anterior minithoracotomy for the treatment of patients with low left ventricular ejection fraction (LVEF). Retrospective analyses of 43 cases with low LVEF undergoing AVR through median sternotomy and 43 cases with low LVEF undergoing AVR through right anterior minithoracotomy were performed. Extracorporeal circulation time and aortic cross-clamping time were longer in patients undergoing AVR through right anterior minithoracotomy than those in patients undergoing AVR through median sternotomy ( P < 0.05 ). Patients undergoing AVR through right anterior minithoracotomy exhibited declines in the cardiac surgery intensive care unit (CSICU) stay, duration of mechanical ventilation, and the length of hospital stay than those undergoing AVR through median sternotomy ( P < 0.05 ). The volumes of 24 h chest drainage were reduced in patients undergoing AVR through right anterior minithoracotomy compared with those undergoing AVR through median sternotomy ( P < 0.05 ). The incidence rates of blood transfusion within 24 h and postoperative atrial fibrillation were lower in patients undergoing AVR through right anterior minithoracotomy than those in patients undergoing AVR through median sternotomy ( P < 0.05 ). As for cardiac function, patients with right anterior minithoracotomy had decreased left ventricular end diastolic diameter (LVEDD) but increased LVEF and left ventricular fractional shortening (LVFS) when compared to median sternotomy ( P < 0.05 ). With regard to inflammatory response, the serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) in patients with right anterior minithoracotomy were much lower than those in median sternotomy ( P < 0.05 ). All these results indicate that right anterior minithoracotomy is an alternative, less invasive approach to median sternotomy during AVR for patients with low LVEF.

This paper presents a tunable bandpass-to-bandstop filter using memristor and varactors for 5G wireless communications. Memristor has hard switching characteristics and behaves great linearity at high frequencies, thus it can be potentially used as an RF switch to achieve the bandpass-to-bandstop transformation. The proposed filter employs stub-loaded stepped-impedance resonator with four varactors and a memristor. The center frequency of the proposed filter can be flexibly tuned by adjusting varactors. The tuning range almost covers 5G frequency band (3.4 to 3.6 GHz) in both the bandpass and bandstop mode. The simulated results show that return loss is better than 22.18 dB in the bandpass mode and rejection level of bandstop mode is higher than 21.34 dB.

This paper presents a novel tunable transmission-line negative group delay (NGD) filter using memristors. The proposed filter is based on short-circuited coupled lines. The memristors with a wide tuning range are loaded in the coupling ports of corresponding coupled lines. The NGD characteristics of the proposed filter could be tuned by memristors, which could be controlled by a high-frequency voltage. The results show that the NGD variation is from −2.214 ns to −9.029 ns at the center frequency of 1.920 GHz. To enhance the NGD bandwidth, two NGD circuits (NGDCs) operating at slightly different center frequencies are connected in parallel.

A chiral network scheme is modified by the addition of microcavities leading to the prediction of a boost in concurrence. The protocol is expected to be robust against experimental imperfections and can be implemented in state-of-the-art integrated photonic platforms.

A single photon in a strongly nonlinear cavity is able to block the transmission of the second photon, thereby converting incident coherent light into anti-bunched light, which is known as photon blockade effect. On the other hand, photon anti-pairing, where only the entry of two photons is blocked and the emission of bunches of three or more photons is allowed, is based on an unconventional photon blockade mechanism due to destructive interference of two distinct excitation pathways. We propose quantum plexcitonic systems with moderate nonlinearity to generate both anti-bunched and anti-paired photons. The proposed plexitonic systems benefit from subwavelength field localizations that make quantum emitters spatially distinguishable, thus enabling a reconfigurable photon source between anti-bunched and anti-paired states via tailoring the energy bands. For a realistic nanoprism plexitonic system, two schemes of reconfiguration are suggested: (i) the chemical means by partially changing the type of the emitters; or (ii) the optical approach by rotating the polarization angle of the incident light to tune the coupling rate of the emitters. These results pave the way to realize reconfigurable nonclassical photon sources in a simple quantum plexcitonic platform with readily accessible experimental conditions.

This publisher’s note contains corrections to Opt. Lett. 44, 2081 (2019)OPLEDP0146-959210.1364/OL.44.002081.

Background People living with human immunodeficiency virus (HIV; PLWH) have a markedly elevated anal cancer risk, largely due to loss of immunoregulatory control of oncogenic human papillomavirus infection. To better understand anal cancer development and prevention, we determined whether recent, past, cumulative, or nadir/peak CD4+ T-cell count (CD4) and/or HIV-1 RNA level (HIV RNA) best predict anal cancer risk. Methods We studied 102 777 PLWH during 1996–2014 from 21 cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. Using demographics-adjusted, cohort-stratified Cox models, we assessed associations between anal cancer risk and various time-updated CD4 and HIV RNA measures, including cumulative and nadir/peak measures during prespecified moving time windows. We compared models using the Akaike information criterion. Results Cumulative and nadir/peak CD4 or HIV RNA measures from approximately 8.5 to 4.5 years in the past were generally better predictors for anal cancer risk than their corresponding more recent measures. However, the best model included CD4 nadir (ie, the lowest CD4) from approximately 8.5 years to 6 months in the past (hazard ratio [HR] for Conclusions Our results are consistent with anal cancer promotion by severe, prolonged HIV-induced immunosuppression. Nadir and cumulative CD4 may represent useful markers for identifying PLWH at higher anal cancer risk.

OBJECTIVES Venous thromboembolism (VTE) is a common postoperative complication. Previous studies have shown that the incidence of VTE after major thoracic surgery ranges from 2.3% to 15%. However, there have been no such data from China so far. To evaluate the incidence of postoperative VTE, we conducted a single-centre, prospective cohort study. METHODS Patients who underwent lung resections between July 2016 and March 2017 were enrolled in this study. None of the patients received any prophylaxis perioperatively. All patients were screened for deep venous thrombosis (DVT) using non-invasive duplex lower-extremity ultrasonography 30 days before surgery and within 30 days after surgery and before discharge. Chest tomography, pulmonary embolism protocol was carried out if patients had one of the following conditions: (i) typical symptoms of pulmonary embolism, (ii) high Caprini score (≥9 points) and (iii) newly diagnosed postoperative DVT. RESULTS Two hundred and sixty-two patients undergoing lung surgery were enrolled, including 115 benign and 147 malignant disease cases. The procedures included 84 sublobar lung resections, 161 lobectomies, 5 pneumonectomies and 12 mixed procedures. The overall postoperative incidence of VTE was 11.5% (30 of 262). Twenty-four patients were diagnosed with DVT (80.0%) and 6 with DVT + pulmonary embolism (20.0%). None of the patients diagnosed with VTE had obvious symptoms of VTE. The median time for VTE detection was 5 days postoperatively. The incidence of VTE was 7.0% in patients with benign lung diseases and 15.0% in those with malignant lung diseases (P

We study the phenomenon of controllable localization-delocalization transition in a quantum many-body system composed of nitrogen-vacancy centers coupled to photonic crystal cavities, through tuning the different detunings and the relative amplitudes of two optical fields that drive two nondegenerate transitions of the $\Lambda $-type configuration. We not only characterize how dissipation affects the phase boundary using the mean-field quantum master equation, but also provide the possibility of observing this photonic quantum phase transition (QPT) by employing several experimentally observable quantities, such as mean intracavity photon number, density correlation function and emitted spectrum, exhibiting distinct optical signatures in different quantum phases. Such a spin-cavity system opens new perspectives in quantum simulation of condensed-matter and many-body physics in a well-controllable way.

Background: Lung volume reduction surgery (LVRS) has shown early promise as a palliative therapy in severe emphysema, but with a controversy over its indications. The aim of this study was to evaluate whether patients with hypercapnia should be excluded from LVRS. Methods: Total 15 cases of severe emphysema with the level of PaCO2 exceeding 50 mmHg were retrospectively studied. Their basic characteristics, pulmonary function, preoperative and postoperative PaCO2 level as well as postoperative complications were calculated statistically. Results: All of the 15 patients received video-assisted thoracoscopic LVRS and finally discharged uneventfully from hospital after the surgical procedures. Nine cases were supported by mechanical ventilation after surgery with the median duration of 44 hours. One of them was treated by extracorporeal membrane oxygenation (ECMO) both during surgery and the first 4 days after surgery. The result of blood gas analysis on 3 months after hospital discharge decreased than that before surgery (60.07 vs . 55.61 mmHg, P=0.076), but without statistical significance. Conclusions: The emphysematous patients with hypercapnia should not be excluded from the benefits of LVRS.

We aimed to explore whether there were cold and heat temperature adverse effects on years of life lost (YLL) for non-accidental mortality in Yuxi, a southwest plateau region of China. From data for 89,467 non-accidental deaths over an 8-year study period, we used a general linear regression model combined with a distributed lag non-linear model to assess the burden of disease non-accidental mortality due to ambient temperature with the YLL indicator. We estimated the mean YLL change per 1 °C decrease from the 25th to 1st percentile mean temperature as the cold effect and per 1 °C increase from the 75th to 99th percentile as the heat effect. The 95% empirical confidence intervals (eCIs) were calculated by using a bootstrap simulation method. The exposure–response curve between average temperature and YLL was U-shaped. The cold effect peaked at the first day after exposure and disappeared at 2 weeks, and the heat effect only lasted for the first 3 days. A per 1 °C decrease from the 25th to 1st mean temperature percentile was associated with an increase of 15.6 (95% eCI: 2.4, 22.9) in YLL for non-accidental diseases, and the cumulative effects due to cold were stronger in contrast to that attributed by heat. Cold temperature had a significant impact on YLL among the subgroups, with higher YLL in cardiovascular disease, stroke, males, Han nationality, married, and those engaged in agriculture than their corresponding categories. An increasing death burden of non-accidental in Yuxi of China due to cold temperature was demonstrated, and the association was also modified by specific disease causes and individual features.

The contribution of this paper is to present a reconfigurable double-layer half-mode substrate integrated waveguide (HMSIW) bandpass filter with continuous center frequency and 3 dB bandwidth (BW) ...

This letter presents a miniaturized eighth-mode substrate-integrated waveguide (EMSIW) filter with tunable center frequency and variable bandwidth. The filter uses a stub-capacitor-loaded EMSIW structure which not only achieves miniaturization but also tunes the center frequency. The edge electrical coupling strength between the two resonators can be adjusted by loading varactor to achieve the bandwidth tunability. In addition, two transmission zeros are introduced to improve the upper stopband rejection. Both the simulated and measured results show a center frequency tuning range of 2.17–2.72 GHz, as well as demonstrate a 3-dB BW tuning range of 140–208 MHz around 2.17 GHz, 231–355 MHz around 2.45 GHz, and 314–435 MHz around 2.72 GHz. The measured insertion loss is 1.7–4.8 dB, and the return loss is better than 10 dB for all tuning ranges.

Plasmonic nanostructures are widely applied to couple with quantum emitters (QEs), so as to improve the optical performances of QE and obtain advanced photonic devices, such as the quantum photon source, quantum circuit. However, the huge loss of plasmonic nanostructures greatly hinders the future development of plasmon–QE hybrid systems. Herein, we propose the hyperbolic nanorods (HNR) which are built by alternate Au and SiO2 thin layers. The size of HNR discussed in this paper is mainly around 40 × 50 × 60 nm3, which is a subwavelength size benefiting for device miniaturization and integration. The photonic resonant mode of HNR can be tuned by simply changing its length/width ratio. Due to the hybridization of the surface plasmon polariton resonances associated with each metal–dielectric interface, the HNR possesses the advantage of small mode volume (V) as the Au plasmonic nanorod (PNR) with similar size, and its mode quality factor (Q) can be larger due to the lower loss. Therefore, when coupled with a resonant QE, the Purcell factor in HNR/QE is ∼20 times larger than that in the PNR/QE system. Furthermore, the HNR/QE hybrid also demonstrates obvious superiority over the PNR/QE in generating strong coupling and quantum entanglement. With the features of small V and low loss, it is believed that the HNR can not only greatly improve the optical properties of QE, but also be a powerful nanostructure for studying light–matter interactions.

Background The bone morphologies of intact knees were measured and compared between Chinese and Caucasian populations. However, to assess if distinct designs of implants are necessary for the Chinese population owing to different morphologies and sizes, the knee measurements after osteotomy performed in total knee arthroplasty were evaluated. Methods Thirty-seven Caucasian and 50 Chinese patients' knees were examined using computed tomography scans. Mimics were applied to reconstruct 3-dimensional bone models. Dimensions of the 3-dimensional knee models and simulated bone resections during total knee arthroplasty were measured using Geomagic Studio and Pro/ENGINEER. The morphologic measurements of the native and resected femur and tibia included the anteroposterior (AP) depth, mediolateral (ML) width, notch width, knee physical valgus angle, tibial slope angle, and the ML-to-AP ratio of the femur, tibia, and resected femur. Statistical analysis was performed using the independent samples t test and the Pearson correlation coefficient in SPSS for Windows. Values of P < .05 were considered significant. Results No measurements were significantly different between the Chinese and Caucasian knees. However, the Chinese female showed significant differences compared with the Chinese male on distal femoral measurements both presimulated and postsimulated osteotomy such as a smaller mean ML-to-AP ratio in presimulated (1.3 ± 0.1) and postsimulated (1.3 ± 0.1) osteotomy. Conclusion The necessity of designing a full set of total knee components specifically for the Chinese population is still undetermined. However, we suggest designing femoral components specific for the Chinese females because of different postosteotomy distal femoral ML-to-AP ratio between the Chinese males and the Chinese females.

Background: The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for distinguishing non-metastatic from metastatic mediastinal lymph nodes in lung cancer. Methods: IVIM-diffusion weighted imaging (DWI) exams were performed preoperatively on 66 patients with lung cancer from October 2015 to June 2016 in Beijing Chao-Yang Hospital, Capital Medical University. Fifty patients underwent enhanced chest computed tomography (CT) in our hospital, while the other 16 patients already had enhanced chest CT images when they were admitted. The patients’ complete preoperative examination included chest magnetic resonance imaging (MRI), enhanced chest CT, head MRI, bone scanning and cardiopulmonary function testing. None of the patients were receiving any treatment for their cancer prior to their evaluation and surgery, including neoadjuvant chemotherapy, radiation therapy, immunotherapy or gene targeted therapy. The following IVIM parameters of the mediastinal lymph nodes were measured: the short axis diameter, apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f). All of the patients underwent lobectomy and lymph node dissection. We compared the CT and MRI results and analysed the IVIM parameters of the pathologically determined non-metastatic and metastatic mediastinal lymph nodes in our 50 patients to generate the ROC curves and determine the best cut-off value for diagnosis. The remaining 16 patients’ IVIM parameters were used to verify the diagnostic cut-off value. This study was approved by the institutional research ethics committee of Beijing Chao-Yang Hospital (2014-S-166), and all the patients signed the MRI informed consent. Results: In this study, MRI was used to measure 140 groups of mediastinal lymph nodes in 50 cases, and the results showed that 19 groups of mediastinal lymph nodes were metastatic, while 121 groups of mediastinal lymph nodes were non-metastatic. The pathological analysis showed that 20 groups of mediastinal lymph nodes were metastatic and 120 groups of mediastinal lymph nodes were non-metastatic. CT was used to measure 273 groups of mediastinal lymph nodes, and the result showed that 34 groups of mediastinal lymph nodes were metastatic, while 239 groups of mediastinal lymph nodes were non-metastatic. The pathological analysis showed that 20 groups of mediastinal lymph nodes were metastatic and 253 groups of mediastinal lymph nodes were non-metastatic. The ADC, D, D*, f values and the short axis diameters of the non-metastatic lymph nodes (n=121) were 2.9370±0.743×10 −3 , 0.533±0.175×10 −3 , 0.384±0.121×10 −3 mm 2 /s, 0.426±0.120, 6.903±1.831 mm, respectively, and 1.863±0.691×10 −3 , 0.454±0.204×10 −3 , 0.358±0.106×10 −3 mm 2 /s, 0.413±0.085, 7.705±2.213 mm, respectively, for the metastatic lymph nodes (n=19). The ADC and D values of the non-metastatic lymph nodes were significantly higher than the values for the metastatic lymph nodes (P −3 mm 2 /s (0.897, 93.3%, 80.0%), Youden index 0.733; and D =0.344×10 −3 mm 2 /s (0.651, 90.8%, 50.0%), Youden index 0.651. When these cut-off values were applied as the diagnostic criteria in the remaining cases and compared with the pathology results, the diagnostic performance was good. Conclusions: IVIM is useful to distinguish metastatic from non-metastatic lymph nodes in lung cancer. The ADC and the D values are significantly lower in metastatic lymph nodes, making these parameters more sensitive than the other parameters (D*, f, and short axis diameter). As a result, IVIM can be used in the N-stage diagnosis of lung cancer.

Artificial intelligence (AI) based on deep learning, convolutional neural networks and big data has been increasingly effective in the diagnosis and treatment of multiple primary pulmonary nodules. In comparison to previous imaging systems, AI measures more objective parameters such as three‐dimensional (3D) volume, probability of malignant nodules, and possible pathological patterns, making the access to the properties of nodules more objective. In our retrospective study, a total of 53 patients with synchronous and metachronous multiple pulmonary nodules were enrolled of which 33 patients were confirmed by pathological tests to have primary binodules, and nine to have primary trinodules. A total of 15 patients had only one focus removed. The statistical results showed that the agreement in the AI diagnosis and postoperative pathological tests was 88.8% in identifying benign or malignant lesions. In addition, the probability of malignancy of benign lesions, preinvasive lesions (AAH, AIS) and invasive lesions (MIA, IA) was totally different (49.40±38.41% vs 80.22±13.55% vs 88.17±17.31%). The purpose of our study was to provide references for the future application of AI in the diagnosis and follow‐up of multiple pulmonary nodules. AI may represent a relevant diagnostic aid that shows more accurate and objective results in the diagnosis of multiple pulmonary nodules, reducing the time required for interpretation of results by directly displaying visual information to doctors and patients and together with the clinical conditions of MPLC patients, offering plans for follow‐up and treatment that may be more beneficial and reasonable for patients. Despite the great application potential in pneumosurgery, further research is needed to verify the accuracy and range of the application of AI.

Background: To compare the outcome of transcatheter aortic valve replacement (TAVR) with surgical aortic valve replacement (SAVR) in low and intermediate risk patients with severe aortic stenosis (AS). Randomized controlled trials (RCT) and propensity score matching (PSM) studies compare TAVR with SAVR in patients at low and intermediate surgical risk. Methods: Two authors searched relevant literature independently, then extracted data from the included studies, and assessed risk of bias and quality of study separately according to different study designs, besides that, the extracted data was analyzed via utilization of GRADE system to evaluate the quality of evidence separately. Results: Overall 15 studies (5 RCTs, 10 PSM studies) with total 12,057 patients were selected. Mortality and disabling stroke during follow-up period were comparable between TAVR and SAVR (RR 1.09, 95% CI: 0.81 to 1.46; RR 0.7, 95% CI: 0.45 to 1.07, respectively), TAVR revealed to be superior to SAVR regarding acute kidney injury (AKI), and onset of new atrial fibrillation (AF) (RCT: high certainty; AKI in PSM: moderate certainty, AF in PSM: low certainty). These results of RCT and PSM studies are consistent. In RCT review, SAVR was better in the following aspects: aortic valve (AV) re-intervention (high certainty), vascular complications, pacemaker implantation (moderate certainty), but comparable in the following aspects: myocardial infarction (MI), aortic insufficient (AI) (moderate certainty), major bleeding (low certainty). In PSM review, SAVR revealed a better result in AI and vascular complications (high certainty), but in the aspects of AV re-intervention, pacemaker implantation, major bleeding and MI (low certainty), it was comparable. Conclusions: TAVR is comparable to SAVR in terms of mortality and disabling stroke in severe AS patients at low and intermediate risk, but higher proportion of AV re-intervention observed in TAVR. Those results should encourage caution when extending the indications of TAVR into low risk patients, especially for young low risk patients. Systematic review registration: PROSPERO CRD 42018112626.

BackgroundResearch is needed to better understand relations between immunosuppression and HIV viraemia and risk for non-Hodgkin lymphoma, a common cancer in people living with HIV. We aimed to identify key CD4 count and HIV RNA (viral load) predictors of risk for non-Hodgkin lymphoma, overall and by subtype.MethodsWe studied people living with HIV during 1996-2014 from 21 Canadian and US cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. To determine key independent predictors of risk for non-Hodgkin lymphoma, we assessed associations with time-updated recent, past, cumulative, and nadir or peak measures of CD4 count and viral load, using demographics-adjusted, cohort-stratified Cox models, and we compared models using Akaike's information criterion.FindingsOf 102 131 people living with HIV during the study period, 712 people developed non-Hodgkin lymphoma. The key independent predictors of risk for overall non-Hodgkin lymphoma were recent CD4 count (ie, lagged by 6 months

Most of the current graphene plasmonic researches are based on the substrates with isotropic dielectric constant such as silicon. In this work, we investigate optical properties of graphene nanoribbon arrays placed on a uniaxially anisotropic substrate, where the anisotropy provides an additional freedom to tune the behaviors of graphene plasmons, and its effect can be described by a simple effective formula. In practice, the substrates of semi-infinite and finite thickness are discussed by using both the formula and full wave simulations. Particularly, the dielectric constants ε ∥ and ε ⊥ approaching zero are intensively studied, which show different impacts on the transverse magnetic (TM) surface modes. In reality, the hexagonal boron nitride (hBN) can be chosen as the anisotropic substrate, which is also a hyperbolic material in nature.

Graphene and its relatives, such as bilayer and trilayer graphene, are promising plasmonic materials. Very recently, graphene has been demonstrated to be precisely folded (Chen et al 2019 Science 365 1036–40), thus folded graphene provides another appealing platform for plasmonics. In folded graphene nanodisks, we find fundamental dipole modes (DMs) will exhibit mode splitting, with one parallel and another perpendicular to the folding axis. The two DMs show differences in field patterns and folding angle dependence, but they both can be tuned by the size of structures and the Fermi level of graphene. Some interesting high order modes are introduced as well, which can be further engineered by folding. Our studies enrich the current research of graphene plasmonics, and pave the way for particular plasmonic device applications.

Background Breakfast is commonly described as the most important meal of the day; however, we have little information regarding its relevance for childhood overweight and obesity in southern mainland China. This study aimed to assess the association between breakfast preferences, consumption location and overweight and obesity for children in Shenzhen. Methods Among 6126 children (median age 7.2 years) at primary schools, 3504 were finally included after a questionnaire survey and physical examination. Ten commonly consumed foods/beverages for breakfast in southern China were exposure variables, and consumption location, total energy demographic and other dietary characteristics were covariates in logistic regression to determine the effect of breakfast preferences on overweight and obesity, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Results Probability of overweight/general obesity was inversely associated with children eating plain congee for breakfast (adjusted OR 0.689, 95% CI 0.566–0.838), restricted to boys after stratification. Probability of overweight/general obesity and central obesity was positively associated with usually eating steamed rice roll for breakfast (OR 1.309, 95% CI 1.090–1.571 and OR 1.351, 95% CI 1.064–1.717, respectively), but the effect on overweight/obesity remained statistically significant for only boys after stratification. Eating steamed rice roll for breakfast and eating out for breakfast had an additive interaction on overweight/obesity. Additionally, eating bread for breakfast had a mild favorable effect on overweight/obesity but only for girls. Conclusions Keeping a healthy weight might benefit children who eat plain congee or bread for breakfast in China. However, frequent consumption of steamed rice roll for breakfast and especially eating out could contribute to overweight and obesity. Thus, we need to promote a healthier breakfast pattern among children in southern China to reduce the odds of obesity.

A beacon antenna is proposed using in beacon device of digital flight data recorder for harsh environment. The antenna has a simple structure and works at the center frequency of 2.645 GHz. Its fabrication employs a low-cost and planar printed technique. The antenna contains a main patch and 3 derivative elements, act as radiators. The proposed antenna is designed by employing the genetic algorithm (GA). A prototype antenna is fabricated and measured. The measurement results agree with the simulation data and show that this antenna possesses encouraging features. For example, it has a well-formed radiation pattern with a high gain level of 6dBi, the antenna achieves an impedance bandwidth of 2.3% of the center frequency (2.613 GHz ∼2.675 GHz) for S11

We previously found that a low dose of sorafenib had a prometastatic effect on hepatocellular carcinoma (HCC), which was caused by downregulation of TIP30 expression. More recently, metformin has been shown to have potential as a preventive and therapeutic agent for different cancers, including HCC. This study evaluated whether the combination of sorafenib and metformin is sufficient to revert the expression of TIP30, thereby simultaneously reducing lung metastasis and improving survival. Our data show that the combination of sorafenib and metformin inhibits proliferation and invasion in vitro, prolongs median survival, and reduces lung metastasis of HCC in vivo. This effect is closely associated with the upregulation of TIP30, partly through activating AMP-activated protein kinase. Thioredoxin, a prometastasis factor, is negatively regulated by TIP30 and plays an essential role during the process of HCC metastasis. Overall, our results suggest that metformin might be a potent enhancer for the treatment of HCC by using sorafenib.

A novel miniaturized dual-band bandpass filter (DBBPF) is presented by using a hybrid structure of ridged quarter-mode substrate integrated waveguide (RQMSIW) and open-ended stripline with loading stubs in this letter. TE 101 and TE 102 modes of the RQSMIW cavity are exploited to dominate the first and second passbands, respectively. By using the multilayer PCB process, a prototype dual-band filter operating at 1.37GHz and 2.45GHz is fabricated. The measurement results show the good agreement with the simulation ones.

This paper presents a half-mode substrate-integrated waveguide (SIW) filter with both continuous center frequency tuning and continuous bandwidth (BW) tuning. The out-of-band rejection of the bandpass filter is greatly improved by loading the tunable lowpass filter on the input/output feed line. Both the theoretical analysis and experiments are described to validate the proposed filter structure.

Stationary quantum correlation among two-level systems (TLSs) in steady state is one of unique resources for applications in quantum information processing. Here we propose a scheme to generate such quantum correlation among the TLSs inside a lossy cavity. It is found that, by applying a broadband squeezed laser acting as a squeezed-vacuum reservoir to the cavity, a stable quantum correlation of the TLSs can be generated. By adiabatically eliminating the cavity field, we derive a reduced master equation of the TLSs in the bad-cavity limit. We show that the generated quantum correlation is essentially determined by the squeezing features transferred from the squeezed-vacuum reservoir via the cavity field as a quantum bus. We study the effect of the system parameters, such as the squeezing, the detuning, the coupling strength, and the decay rate of the TLSs, on the performance of the scheme. The feasibility of our proposal is supported by the application of currently available experimental techniques.

Background: The high incidence of venous thromboembolism (VTE) has been perceived in post thoracic surgery patients. However, the significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for VTE predicting is not clear. To investigate that, we conducted a prospective single center study. Methods: A total of 111 patients undergoing lung surgery were enrolled in this study, included 52 primary lung cancer patients and 59 benign lung disease patients from July 2016 to March 2017. Preoperative and postoperative days 1, 3, and 5 coagulation and fibrinolysis related parameters were tested, including antithrombin (AT), fibrinogen degradation product (FDP), prothrombin time (PT), prothrombin time activity (PA), prothrombin time ratio (PR), international normalized ratio (INR), activated partial thromboplastin time (APTT), plasma fibrinogen (FBG), thrombin time (TT) and D-Dimer. The Doppler ultrasonography was performed before and after surgery for deep venous thrombosis (DVT) confirmation. Patients with new postoperative DVT, unexplained dyspnea, hemoptysis, chest pain, or high Caprini score (≥9) were received further computer tomography pulmonary angiography (CTPA) for pulmonary embolism (PE). We used the area under receiver-operating-characteristic (ROC) curve to discriminate patients between those who developed VTE and those who did not. Single factor analysis was utilized to define risk factors associated with VTE. Results: The overall incidence of VTE was 16.2% (18/111). The incidence of VTE in primary lung cancer patients was 23.1% (12/52), much higher than that in benign lung diseases 10.2% (6/59), but did not reach statistical significance (P=0.066). Among 18 VTE patients, 83.3% was DVT, 16.7% was DVT + PE and 72.2% was muscular veins of the calf thrombosis. D-Dimer was much higher in VTE group than that in non-VTE group preoperatively and at postoperative days 1, 3 (0.64±0.24 vs . 0.33±0.06, P=0.007; 3.14±0.75 vs . 1.51±0.09, P=0.005, and 1.88±0.53 vs . 0.76±0.05, P=0.001, respectively). And the ROC curve areas of preoperative and postoperative days 1, 3 of D-Dimer were 0.70, 0.71 and 0.74, respectively. And FDP was much higher in VTE group than that in non-VTE group at postoperative day 3 (6.78±1.43 vs . 3.79±0.15, P=0.004). But AT, PT, PA, PR, INR, APTT, FBG and TT there were no significantly difference. Conclusions: The overall incidence of VTE after lung surgery was 16.2%. The patients with preoperative high D-Dimer should receive VTE prophylaxis.

Esophageal cancer is an aggressive malignancy and a major cause of cancer-related deaths globally. In 2012, about 460,000 new cases of esophageal cancer were diagnosed worldwide, with 400,000 deaths attributed to the disease (1).

Background: Primary spontaneous pneumothorax (PSP) is a common disease which is often caused by the rupture of bullae in the lungs. The underlying pathogenesis of PSP remains unclear. Some molecules may be involved in the development of PSP potentially. The aim of this study was to investigate the expression of TGF-beta receptor 1 (TβR1), Smad2, Smad3 and Smad4 in the resected bullae of patients with PSP. Methods: From May 2015 to May 2016, 34 patients with PSP underwent video-assisted thoracoscopic surgery (VATS) bullectomy. Immunohistochemistry was performed to identify the expression of TβR1, Smad2, Smad3 and Smad4 in the resected pulmonary bullae tissues. The levels of these cytokines were calculated by immunoreactivity scoring system (IRS). Ten patients without pneumothorax associated disease were selected as the control group. Results: The analysis showed that the expression levels of TβR1, Smad2 and Smad4 were significantly higher in bullae tissues of patients with PSP than that in normal lung tissues (P=0.012, 0.031, 0.000 respectively). There was no significant difference between the expression level of Smad3 in bullae tissue of PSP patients and that in normal lung tissues of the control group (P=0.140). However, the absolute quantity of Smad3 expression in PSP bullae tissues was (4.2529±1.7193), scored by the IRS, which is higher than that in the control lung tissues (3.2600±2.2132). Also, the expression of TβR1, Smad2, Smad3 and Smad4 were not showed correlation with the clinical characteristics of PSP patients, such as age, sex, body mass index (BMI), recurrence and side of pneumothorax. Conclusions: TβR1, Smad2 and Smad4 highly expressed in bullae tissues of PSP patients. Our findings suggested that TβR1, Smad2 and Smad4 may be related to the development of PSP bullae.

Background High frequency of recurrence is the major cause of the poor outcomes for patients with hepatocellular carcinoma (HCC). microRNA (miR)-182-5p emerged as a high-priority miRNA in HCC and was found to be related to HCC metastasis. Whether the expression of miR-182-5p in tumor tissue correlated with early recurrence in HCC patients underwent curative surgery was unknown. Methods Real-time PCR (RT-PCR) and in situ hybridization (ISH) were conducted to assess the expression of miR-182-5p in HCC cells and tissues. Cell Counting Kit-8 (CCK-8), transwell assays were performed to detected cells proliferation and migration ability. Flow cytometry assays were used to detect cell apoptosis rate, and xenograft model was employed to study miR-182-5p in HCC growth and lung metastasis. The target of miR-182-5p was validated with a dual-luciferase reporter assay and western blotting. Immunohistochemistry, immumoblotting, and immunoprecipitation were performed to test relative protein expression. Results We showed that high expression of miR-182-5p in tumor tissues correlated with poor prognosis as well as early recurrence in HCC patients underwent curative surgery. miR-182-5p enhanced motility and invasive ability of HCC cells both in vitro and in vivo. miR-182-5p directly targets 3′-UTR of FOXO3a and repressed FOXO3a expression, activating AKT/FOXO3a pathway to promote HCC proliferation. Notably, miR-182-5p activated Wnt/β-catenin signaling by inhibiting the degradation of β-catenin and enhancing the interaction between β-catenin and TCF4 which was mediated by repressed FOXO3a. Conclusions Consistently, miR-182-5p can be a potential predictor of early recurrence for HCC patients underwent curative surgery, and FOXO3a plays a key mediator in miR-182-5p induced HCC progression.

Overexpression of CUB domain-containing protein 1 (CDCP1), a transmembrane glycoprotein and major substrate of Src family kinases (SFKs), always indicates unfavorable outcomes in various cancers. The characteristics of CDCP1 in hepatocellular carcinoma (HCC) have not been assessed. Most recently, CDCP1 was identified as a specific target gene of HIF-2α in clear cell renal carcinoma (CC-RCC). However, considering the role of HIF-2α in the progression of HCC is highly controversial, it is necessary to figure out whether HIF-2α and CDCP1 play a significant part in the metastasis of HCC. Our results showed that HIF-2α and CDCP1 were both induced by hypoxia, and the activation of CDCP1 was HIF-2α dependent. CDCP1 was governed by HIF-2α at mRNA and protein levels in HCC cell lines. Moreover, knocking down of HIF-2α not only inhibited cell invasion but also impaired the expression of Tyr(311) phosphorylation of protein kinase Cδ (PKCδ) which is a downstream factor of CDCP1 and has been reported to induce malignant migration in various tumors. Analysis of human HCC samples showed a negative correlation of CDCP1 expression with disease-free survival, and CDCP1 was an independent prognostic factors of disease-free survival. Taken together, these data demonstrated that HIF-2α could promote HCC cell migration by regulating CDCP1, and targeting HIF-2α-CDCP1-PKCδ pathway might be effective to inhibit HCC metastasis.