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Several algorithms for nuclear power plant (NPP) break event detection, isolation, localization, and size estimation are proposed. A break event can be promptly detected and isolated after its occurrence by simultaneously monitoring changes in the sensing readings and by employing an interquartile range-based isolation scheme. By considering the multi-sensor data block of a break to be rank-one, it can be located as the position whose lead field vector is most orthogonal to the noise subspace of that data block using the Multiple Signal Classification (MUSIC) algorithm. Owing to the flexibility of deep neural networks in selecting the best regression model for the available data, we can estimate the break size using multiple-sensor recordings of the break regardless of the sensor types. The efficacy of the proposed algorithms was evaluated using the data generated by Maanshan NPP simulator. The experimental results demonstrated that the MUSIC method could distinguish two near breaks. However, if the two breaks were close and of small sizes, the MUSIC method might wrongly locate them. The break sizes estimated by the proposed deep learning model were close to their actual values, but relative errors of more than 8% were seen while estimating small breaks’ sizes.

Pancreatic cancer is one of the common malignant tumors of the digestive system, and its clinical treatment is still very challenging. Most of the pancreatic cancer chemotherapeutic drugs have poor plasma stability, low cell uptake efficiency, and are prone to developing drug resistance and toxic side effects. Besides, pancreatic cancer often has a dense extracellular matrix, which consists of collagens, hyaluronic acid, and other proteoglycans. Among them, hyaluronic acid is a key component of the dense matrix, which results in vascular compression and insufficient perfusion, and hinders the delivery of chemotherapeutic drugs. In this study, we explore using hyaluronidase in tumor-bearing mice to eliminate the hyaluronic acid barrier, to reduce blood vessel compression and reshape the tumor microenvironment. In addition, we evaluate using doxorubicin-loaded nanoprobes to improve the stability and local tumor-killing effect of the drug. The nanoprobes have the characteristics of near-infrared optical imaging, which are used to monitor the tumor size in real-time during the treatment process, and dynamically observe the tumor inhibitory effect. The results show that elimination of the hyaluronic acid barrier combined with the doxorubicin-loaded nanoprobes can greatly increase drug penetration into tumor tissue and improve the effectiveness of chemotherapy drugs. This study provides a novel strategy for the treatment of pancreatic cancer.

The purpose of this study attempted to explore intentions of frontline employees on language learning in Macau hospitality industry. Without exploring learners’ intention, the successful language learning cannot be achieved. Various factors promote or hinder language learners from the implementation of behaviour, that is learning a language. As Macau is one of famous tourist destinations, diversifying single economic development on gaming industry has been enforced. Acting the platform between China and Lusophony countries has also been initiated. Developing language competence in hospitality industry becomes essential in Macau. Hence, this study is crucial for language teaching and learning contexts in hospitality industry while it is anticipated that more and more international tourists will be received in Macau soon after recovering from COVID-19. In this study, the theory of planed behaviour suggested by Ajzen (1991) [1] was applied to explore language learners’ behavioural intentions in terms of learning either English or Portuguese. After a pilot study, the main study was conducted in November 2019. The research findings showed attitude, subjective norm and perceived behavioural control had positive and significant impacts on language learning intention. Specifically, subjective norm was the most influential factor affecting learners’ behavioural intention, followed by perceived behavioural control and then attitude. Significant others therefore played the key factor on influencing learners to take an action on learning languages in the society of Macau. This finding may result from job requirements in the labour-market. Finally, the study contributes to educational literature by demonstrating the importance of intentions on frontline employees’ language learning by applying the theory of planned behaviour. Practically, based on the aspect of social psychology to scrutinise learners’ behavioural intention, it would allow language educators adopting effective teaching and learning approach to satisfy learners’ needs.

H2O2 has been widely applied in the fields of chemical synthesis, medical sterilization, pollutant removal, et al., due to its strong oxidizing property and the avoidable secondary pollution. Despite of the enhanced performance for H2O2 generation over g-C3N4 semiconductors through promoting the separation of photo-generated charge carriers, the effect of migration orientation of charge carriers is still ambiguous. For this emotion, surface modification of g-C3N4 was employed to adjust the migration orientation of charge carriers, in order to investigate systematically its effect on the performance of H2O2 generation. It was found that ultrathin g-C3N4 (UCN) modified by boron nitride (BN), as an effective hole-attract agent, demonstrated a significantly enhanced performance. Particularly, for the optimum UCN/BN-40% catalyst, 4.0-fold higher yield of H2O2 was obtained in comparison with the pristine UCN. As comparison, UCN modified by carbon dust demonstrated a completely opposite tendency. The remarkably improved performance over UCN/BN was ascribed to the fact that more photo-generated electrons were remained inside of triazine structure of g-C3N4, leading to the formation of larger amount of 1,4-endoxide. It is anticipated that our work could provide new insights for the design of photocatalyst with significantly improved performance for H2O2 generation.

Yu-Ting Huang,1 Chia-I Yu,2 Pao-Yu Chen,3,4 Chi-Chuan Wang,1,2,5 Chien-Chih Wu1,2 1Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; 2School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; 3Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; 4Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; 5Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, TaiwanCorrespondence: Chien-Chih WuDepartment of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, 7 Chung Shan S. Road, Taipei, TaiwanTel/Fax +886-2-23123456 ext. 63702/ +886-2-23310930Email 101440@ntuh.gov.twBackground: Antibiotic combination is commonly used to treat multidrug-resistant pathogens. Reports have indicated that tigecycline use is associated with hypofibrinogenemia. However, whether the bleeding risk of tigecycline is higher than that of other antibiotics remains unknown. The aim of this study was to compare the bleeding risk between colistin–tigecycline and colistin–carbapenem treatment.Methods: This retrospective cohort study enrolled adult patients treated with colistin along with tigecycline or carbapenems (doripenem, imipenem–cilastatin, or meropenem) for ˃72 hours during hospitalization. The primary outcome was major bleeding events, which were determined by a hemoglobin drop of ≥ 2 g/d and receipt of blood transfusions with whole blood or packed red blood cells. Multivariate logistic regression was applied to determine risk factors for bleeding events.Results: In total, 106 and 268 patients in the colistin–tigecycline and colistin–carbapenem groups met the criteria for analysis, respectively. The two groups did not differ significantly in demographic data, except for alanine aminotransferase (ALT), serum creatinine (SCr) and ulcer disease. The colistin–tigecycline group had a higher ALT, SCr and a lower proportion of ulcer disease. Major bleeding events did not differ significantly between the colistin–tigecycline and colistin–carbapenem groups (12.26% vs 9.33%, P = 0.40). Antibiotic duration [OR = 1.06 (1.02– 1.11), P=0.007)] and anticoagulant use [OR = 2.16 (1.05– 4.42), P=0.04] were associated with major bleeding events.Conclusion: Colistin–tigecycline treatment was not associated with a higher bleeding risk. Antibiotic duration and concurrent use of anticoagulant were the risk factors of bleeding events.Keywords: tigecycline, carbapenems, bleeding events

Objective Adiponectin is an adipocyte-derived hormone with an important role in glucose metabolism. The present study explored the effect of adiponectin in diverse population groups on pre-diabetes and newly diagnosed diabetes. Methods A total of 3300 individuals were enrolled and their data were collected in the analyses dataset from December 2018 to October 2019. Cluster analysis was conducted based on age, BMI, waistline, body fat, systolic blood pressure, triglycerides, and glycosylated hemoglobin 1c. Cluster analysis divided the participants into four groups: a young-healthy group, an elderly-hypertension group, a high glucose–lipid group, and an obese group. Odds ratio (OR) and 95% CIs were calculated using multivariate logistic regression analysis. Results Compared with the first quartile of adiponectin, the risk of pre-diabetes of fourth quartile was decreased 61% (aOR = 0.39, 95% CI (0.20–0.73)) in the young-healthy group; and the risk of diabetes of fourth quartile was decreased 85% (aOR = 0.15, 95% CI (0.02–0.67)) in the obese group. There were no significant correlations between the adiponectin level and diabetes/pre-diabetes in the other two groups. Additionally, receiver operating characteristic curve analysis indicated that adiponectin could significantly improve the diagnosis based on models in the young-healthy group (from 0.640 to 0.675) and the obese group (from 0.714 to 0.761). Conclusions Increased adiponectin levels were associated with decreased risk of pre-diabetes in the young-healthy population, and with a decreased the risk of diabetes in the obese population. An increased adiponectin level is an independent protective factor for pre-diabetes and diabetes in a specific population in south China.

Background Collagen fibers play an important role in tumor initiation, progression, and invasion. Our previous research has already shown that large-scale tumor-associated collagen signatures (TACS) are powerful prognostic biomarkers independent of clinicopathological factors in invasive breast cancer. However, they are observed on a macroscale and are more suitable for identifying high-risk patients. It is necessary to investigate the effect of the corresponding microscopic features of TACS so as to more accurately and comprehensively predict the prognosis of breast cancer patients. Methods In this retrospective and multicenter study, we included 942 invasive breast cancer patients in both a training cohort (n = 355) and an internal validation cohort (n = 334) from one clinical center and in an external validation cohort (n = 253) from a different clinical center. TACS corresponding microscopic features (TCMFs) were firstly extracted from multiphoton images for each patient, and then least absolute shrinkage and selection operator (LASSO) regression was applied to select the most robust features to build a TCMF-score. Finally, the Cox proportional hazard regression analysis was used to evaluate the association of TCMF-score with disease-free survival (DFS). Results TCMF-score is significantly associated with DFS in univariate Cox proportional hazard regression analysis. After adjusting for clinical variables by multivariate Cox regression analysis, the TCMF-score remains an independent prognostic indicator. Remarkably, the TCMF model performs better than the clinical (CLI) model in the three cohorts and is particularly outstanding in the ER-positive and lower-risk subgroups. By contrast, the TACS model is more suitable for the ER-negative and higher-risk subgroups. When the TACS and TCMF are combined, they could complement each other and perform well in all patients. As expected, the full model (CLI+TCMF+TACS) achieves the best performance (AUC 0.905, [0.873–0.938]; 0.896, [0.860–0.931]; 0.882, [0.840–0.925] in the three cohorts). Conclusion These results demonstrate that the TCMF-score is an independent prognostic factor for breast cancer, and the increased prognostic performance (TCMF+TACS-score) may help us develop more appropriate treatment protocols.

Accurate and consistent annual runoff prediction in regions is a hot topic in the management, optimization, and monitoring of water resources. A novel prediction model (ESMD-SE-WPD-LSTM) is presented in this study. Firstly, the extreme-point symmetric mode decomposition (ESMD) is used to produce several intrinsic mode functions (IMF) and a residual (Res) by decomposing the original runoff series. Secondly, the sample entropy (SE) method is employed to measure the complexity of each IMF. Thirdly, we adopt wavelet packet decomposition (WPD) to further decompose the IMF with the maximum SE into several appropriate components and detailed components. Then the LSTM model, a deep learning algorithm based recurrent approach, is employed to predict all components obtained in the previous step. Finally, the forecasting results of all components are aggregated to generate the final prediction. The proposed model, which is applied to five annual series from different areas in China, is evaluated based on four quantitative indexes (R, NSEC, MAPE and RMSE). The results indicate that the ESMD-SE-WPD-LSTM outperforms other benchmark models in terms of four quantitative indexes. Hence the proposed model can provide higher accuracy and consistency for annual runoff prediction, making it an efficient instrument for scientific management and planning of water resources.

Breast cancer resistance protein (BCRP/ABCG2) is a critical drug efflux transporters by limiting drugs’ transplacental transfer rates. More investigations on the regulation of placental BCRP offer great promise for enabling pronounced progress in individualized and safe pharmacotherapy during pregnancy. Histone deacetylases (HDACs) play an important role in epigenetic regulation of placental genes. It was reported recently by us that HDAC1 was involved in placental BCRP regulation in vitro. The aim of this study was to further explore the effect of HDAC1 on placental BCRP expression and functionality in animals. Randomly assigned C57BL pregnant dams received intraperitoneal injections of a negative control siRNA or Hdac1 siRNA from embryonic day 7.5 (E7.5) to E15.5, respectively. At E16.5, glyburide (GLB), a probe for evaluating placental BCRP efflux functionality, was injected via the tail vein. Animals were sacrificed through cervical dislocation at various times (5–180 min) after drug administration. The maternal blood, placentas, and fetal-units were collected. GLB concentrations were determined by a validated high-performance liquid chromatography/mass spectrometry (HPLC-MS) assay. Real-time quantitative PCR (qRT-PCR), Western blot, and immunohistochemical (IHC) analysis were employed to identify mRNA/protein levels and localization of gene expressions, respectively. It was noted that Hdac1 inhibition significantly decreased placental Bcrp expression, with markedly increases of GLB concentrations and area under the concentration-time curve (AUC) in fetal-units. Particularly, the ratios of fetal-unit/maternal plasma GLB concentrations were also significantly elevated following Hdac1 repression. Taken together, these findings suggested that HDAC1 was involved in positive regulation of placental BCRP expression and functionality in vivo. Supplementary Information The online version contains supplementary material available at 10.1007/s43032-021-00773-2.

Tidal observations influence the transport efficiency of international commercial ports and can be affected by mechanical failures or typhoon-induced storms. These factors cause observational interruptions, which lead to tidal data loss or anomaly. Thus, the applicability of the data is reduced. Existing methods still have certain limitations in accurately predicting the tide level because of the omission of a large amount of data. Therefore, missing value imputation and tide level forecasting of tidal data are crucial topics in tidal observation study. In this study, we propose a deep learning algorithm for missing value imputation and tide level forecasting of tidal data. The test data are obtained from the tidal data of Keelung Port, Taipei Port, Tamsui Port, Taichung Port, Jiangjun Port, Anping Port, Kaohsiung Port, Hualian Port, Suao Port, and Penghu Port, constructed by the Harbor and Marine Technology Center, Taiwan. The average error value for conducting missing value imputation is 0.086 m ± 5%, and the average error value for tide level forecasting is 0.071 m. The experimental results reveal that the deep neural network has better performance than the traditional statistical methods and other artificial neural networks.

In order to remove phosphorus element from steelmaking slag and decrease iron loss, malic acid was selected as the leaching agent to dissolve steelmaking slag. Firstly, the influences of different factors, such as malic acid concentration, slag particle size, temperature, liquid/solid ratio and stirring speed, on the leaching ratios of phosphorus and iron were studied. Then, the kinetics for the leaching process of phosphorus was analyzed. The results showed that the leaching ratios of phosphorus and iron increase significantly with increasing the malic acid solution concentration and liquid/solid ratio. When the concentration of malic acid solution increases up to 0.01492 mol/L, about 80% phosphorus can be dissolved, and iron leaching ratio is less than 17%. In addition, decreasing slag particle size can obviously increase the leaching ratio of phosphorus. However, temperature and stirring speed have no significant effect on the dissolution of phosphorus and iron. The leaching kinetics of phosphorus follows the unreacted shrinking core model. Diffusion through product layer is the rate-limiting step of the leaching process, and the corresponding apparent activation energy is determined to be 3.32 kJ/mol. Finally, a semi-empirical kinetic equation was established.

BACKGROUND Identifying novel colorectal cancer (CRC) prognostic biomarkers is crucial to helping clinicians make appropriate therapy decisions. Melatonin plays a major role in managing the circadian rhythm and exerts oncostatic effects on different kinds of tumours. AIM To explore the relationship between MTNR1B single-nucleotide polymorphism (SNPs) combined with gene hypermethylation and CRC prognosis. METHODS A total of 94 CRC tumour tissues were investigated. Genotyping for the four MTNR1B SNPs (rs1387153, rs2166706, rs10830963, and rs1447352) was performed using multiplex polymerase chain reaction. The relationships between the MTNR1B SNPs and CRC 5-year overall survival (OS) was assessed by calculating hazard ratios with 95%CIs. RESULTS All SNPs (rs1387153, rs2166706, rs10830963, and rs1447352) were correlated with decreased 5-year OS. In stratified analysis, rs1387153, rs10830963, and rs1447352 risk genotype combined with CDKN2A and MGMT methylation status were associated with 5-year OS. A strong cumulative effect of the four polymorphisms on CRC prognosis was observed. Four haplotypes of MTNR1B SNPs were also associated with the 5-year OS. MTNR1B SNPs combined with CDKN2A and MGMT gene methylation status could be used to predict shorter CRC survival. CONCLUSION The novel genetic biomarkers combined with epigenetic biomarkers may be predictive tool for CRC prognosis and thus could be used to individualise treatment for patients with CRC.

This study analyzes the rapid development of mobile payment in the fast-food restaurant industry and the effect it has on consumer behavior. Moreover, this work examines the influence of mobile payment users' motivation on satisfaction and the effects of motivation and satisfaction on continuance intention. A total of 547 questionnaires were collected in Shenzhen China prior to the late 2019 COVID-19 pandemic outbreak. The findings indicate that motivation and satisfaction each has a significant positive, direct effect on the continuance intention of mobile payment usage. The results show that intrinsic motivation, notably the Perceived Enjoyment factor, has a greater impact than satisfaction on continuance intention. Respondents are less satisfied with Perceived Privacy and Perceived Security but show greater satisfaction with Perceived Service Quality. Perceived Enjoyment and Perceived Service Quality can evoke the intention to continue to use mobile payment. The results of this research provide useful information for mobile payment providers and fast-food restaurant owners to further improve their services. The proposed consumer behavior framework of the continuance intention of mobile payment service usage can be used as a basis for hospitality researchers to refine research on mobile payment technology and service management.

AIMS The aims of this study were to evaluate the associations of metabolic abnormalities with incident diabetic kidney disease (DKD) and to explore whether dyslipidaemia, particularly high fasting triglyceride (TG), was associated with the development of DKD. METHODS In total, 11 142 patients with new-onset type 2 diabetes with baseline estimated glomerular filtration rates (eGFR) ≥60 mL/min/1.73 m2 were followed up during 2011-2016. Incident DKD was defined as eGFR

To investigate the relationship between blood pressure (BP) achieved during pregnancy and pregnant outcomes in non-severe chronic hypertensive women.This retrospective cohort study included pregnant women who diagnosed as non-severe chronic hypertension and delivered in Shanghai Renji Hospital from January 2010 to March 2017. Based on their mean antenatal office diastolic BP (dBP), patients were divided into higher BP achieved (HBPA, dBP ≥ 90 mmHg) group or lower BP achieved (LBPA, dBP 90 mmHg) group. Primary outcome measurement was the composite of fetal or neonatal mortality and morbidities. Secondary outcomes were the adverse maternal outcomes.Eligible 305 patients were included, among whom 98 were in HBPA group and 207 were in LBPA group. The HBPA group had significantly higher antenatal dBP [95.0 ± 4.8 vs 81.7 ± 5.6 mmHg, P 0.001] than the LBPA group. After adjusting for six confounding factors (age, body-mass index (BMI), weeks of gestation at first antenatal visit, dBP measured at first antenatal visit, antihypertensive medication usage during pregnancy, complicating other medical condition), primary outcome [34.7% vs 15.9%, 2.30 (1.23-4.30)] was significantly higher in HBPA group. The incidences of SGA [21.4% vs 11.1%, 2.12 (1.03-4.38)], NICU admission [19.4% vs 6.3%, 3.54 (1.48-8.49)], preeclampsia with severe features [22.4% vs 10.6%, 2.23 (1.10-4.54)], severe hypertension [8.2% vs 0.5%, 15.68 (1.78-138.04)] were higher, and earlier gestational age at delivery [37.1 ± 2.6 vs 37.7 ± 2.1, P = 0.031], lower birthweight [2861.0 ± 780.0 vs 3059.0 ± 616.3, P = 0.029] in the HBPA group.Lower BP achieved during gestation in pregnant women with non-severe chronic hypertension (CH) might improve both fetal/neonatal and maternal outcomes.

BackgroundWe hypothesised that occupational exposures differently affect subtypes of adult-onset asthma.ObjectiveWe investigated potential relations between occupation and three subtypes of adult asthma, namely atopic asthma, non-atopic asthma and asthma–COPD overlap syndrome (ACOS).MethodsThis is a population-based case–control study of incident asthma among working-age adults living in Pirkanmaa Hospital District in Southern Finland. The determinant of interest was occupation at the time of diagnosis of asthma or the job that the subject had quit due to respiratory symptoms. Asthma was divided into three mutually exclusive subtypes on the basis of any positive IgE antibody (atopic and non-atopic asthma) and presence of persistent airways obstruction in spirometry (ACOS). We applied unconditional logistic regression analysis to estimate adjusted OR (aOR), taking into account gender, age and smoking.ResultsThe following occupational groups showed significantly increased risk of atopic asthma: chemical industry workers (aOR 15.76, 95% CI 2.64 to 94.12), bakers and food processors (aOR 4.69, 95% CI 1.18 to 18.69), waiters (aOR 4.67, 95% CI 1.40 to 15.56) and those unemployed (aOR 3.06, 95% CI 1.52 to 6.17). The following occupations showed clearly increased risk of non-atopic asthma: metal workers (aOR 8.37, 95% CI 3.77 to 18.59) and farmers and other agricultural workers (aOR 2.36, 95% CI 1.10 to 5.06). Some occupational groups showed statistically significantly increased OR of ACOS: electrical and electronic production workers (aOR 30.6, 95% CI 6.10 to 153.35), fur and leather workers (aOR 16.41, 95% CI 1.25 to 215.85) and those retired (aOR 5.55, 95% CI 1.63 to 18.97).ConclusionsOur results show that different occupations are associated with different subtypes of adult-onset asthma.

BACKGROUND Quinine oxidoreductase 1 (NQO1) plays a vital role in protecting normal cells against oxidative damage and electrophilic attack. It is highly expressed in many solid tumors, suggesting a role in cancer development and progression. However, the role of NQO1 in gastric cancer and its effect on cancer development and prognosis have not been fully investigated. AIM To investigate the clinical relevance of NQO1 protein expression in gastric cancer and to explore the potential of NQO1 to serve as a prognostic biomarker and therapeutic target. METHODS In this retrospective study, gastric cancer specimens of 175 patients who were treated between 1995 and 2011 were subjected to immunohistochemistry analyses for NQO1. The correlation of NQO1 expression with gastric cancer prognosis and clinical and pathological parameters was investigated. RESULTS NQO1 protein was overexpressed in 59.43% (104/175) of the analyzed samples. Overexpression of NQO1 was associated with a significantly inferior prognosis. In addition, multivariate analysis suggested that NQO1 overexpression, along with tumor stage and patient age, are prominent prognostic biomarkers for gastric cancer. Moreover, NQO1 overexpression was correlated to a better response to 5-fluorouracil (5-FU)-based adjuvant chemotherapy. CONCLUSION NQO1 overexpression is associated with a significantly poor prognosis and better response to 5-FU in patients with gastric cancer. These findings are relevant for improving therapeutic approaches for gastric cancer patients.

The Hanjiang-to-Weihe River Water Transfer Project is a systematic water supply project which involves the water supply system, the water storage system and the water conveyance system. The water storage system of the reservoir involves the water retaining system and the discharge system. The function of the discharge system is an important guarantee for the safety of the project. Regarding the Hanjiang-to-Weihe River Water Transfer Project’s discharge system risk control as the goal, on the basis of risk events, the fault tree analysis of the risk causes and Bayesian network theory, a system of Bayesian networks is established. A reliable risk rate calculation method is chosen based on the feature of the risk. The Hanjiang-to-Weihe River Water Transfer Project discharge system failure risk calculation theory system is built based on the Bayesian network inference ability. The engineering of the Sanhekou reservoir drain system is taken as the research object. Based on the Monte Carlo simulation and the method of the reliability derivation, the component failure risk is calculated and the Bayesian network is constructed to compute the risk of system failure rate. The scenario analysis is used to judge the main risk factors that affect the drain system security. If the risk rate of floating debris and leakage increases by 50%, the rate of failure risk of the discharge system would increase by 1.35 × 10–5. If the risk rate of the discharge system is reduced to 0, the risk rate of floating objects and leakage should have to be reduced by 1.35 × 10–5. If the discharge system fails, the failure risk rate of floating objects and leaks is 1.82 × 10–1. It shows that the theory of Bayesian network system can dynamically identify, evaluate, reduce and control the risk of discharge system, which is of guiding significance for risk management of inter-basin water transfer projects.

Kai Liang,1– 4 Xinghong Guo,1– 4 Chuan Wang,1– 4 Fei Yan,1– 4 Lingshu Wang,1– 4 Jinbo Liu,1– 4 Xinguo Hou,1– 4 Wenjuan Li,1– 4 Li Chen1– 4 1Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China; 2Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, 250012, People’s Republic of China; 3Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, 250012, People’s Republic of China; 4Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, 250012, People’s Republic of ChinaCorrespondence: Li Chen; Wenjuan LiDepartment Of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China, Tel +86 18560083989; +86 18560080331Fax +860531-82169323Email chenli3@email.sdu.edu.cn; liwenjuan@qiluhospital.comPurpose: To develop a nomogram for predicting the risk of progression from prediabetes to diabetes and provide a quantitative predictive tool for early clinical screening of high-risk populations of diabetes.Materials and Methods: This study was a retrospective cohort study and part of the investigation conducted for the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. A total of 1857 prediabetic participants at baseline underwent oral glucose tolerance test and hemoglobin A1c (HbA1c) testing after 3 years. The areas under the receiver operating characteristic curves (AUCs) were adopted to measure the predictive value of progression to diabetes, using baseline fasting plasma glucose (FPG), 2-hr postprandial plasma glucose (2hPG), HbA1c or combined models. Decision curve analysis determined the model with the best discriminative ability. A nomogram was formulated and internally validated, providing an individualized predictive tool by calculating total scores.Results: After 3 years, 145 participants developed diabetes, and the annual incidence was estimated to be 2.60%. Among the three single indicators and four combined models, model 4 combined of FPG, 2hPG, and HbA1c showed the best performance in risk predication, with an AUC of 0.742. The nomogram constructed via model 4 was validated and demonstrated good prediction for the risk of diabetes. The nomogram score/predicted probability was a numeric value representing the prediction model score of individual patients. Notably, all nomogram scores showed relatively high negative predictive values.Conclusion: The nomogram constructed in this study effectively predicts and quantifies the risk of progression from prediabetes to diabetes after a 3-year follow-up and could be adopted to identify Chinese patients at high risk for diabetes in order to provide timely interventions.Keywords: nomogram, diabetes, prediabetes, predictive value

BACKGROUND: Cerebral perfusion pressure (CPP) calculated by mean arterial pressure (MAP) minus intracranial pressure (ICP) is related to blood flow into the brain and reflects cerebral ischemia and oxygenation indirectly. Near-infrared spectroscopy (NIRS) can assess cerebral ischemia and hypoxia non-invasively and has been widely used in neuroscience. However, the correlation between CPP and NIRS, and its potential application in traumatic brain injury, has seldom been investigated. METHODS: We used a novel wireless NIRS system and commercial ICP and MAP devices to assess the trauma to rat brains using different impact intensity. The relationship between CPP and NIRS parameters with increasing impact strength were investigated. RESULTS: The results showed that changes in CPP (∆CPP), oxy-hemoglobin {∆[HbO(2)]}, total-hemoglobin {∆[HbT]}, and deoxy-hemoglobin were inversely proportional to the increase in impact intensity, and the correlations between ∆CPP, NIRS parameters {∆[HbO(2)], and ∆[HbT]} were significant. CONCLUSIONS: The NIRS system can assess cerebral ischemia and oxygenation non-invasively and changes of HbO(2) and HbT may be used as reference parameters to assess the level of CPP in an animal model of traumatic brain injury.

A novel framework is proposed to integrate communication, control and computing (3C) into the fifth-generation and beyond (5GB) wireless networks for satisfying the ultra-reliable low-latency connectivity requirements of remote-e-Health systems. Non-orthogonal multiple access (NOMA) enabled 5GB network architecture is envisioned, while the benefits of bringing to the remote-e-Health systems are demonstrated. Firstly, the application of NOMA into e-Health systems is presented. To elaborate further, a unified NOMA framework for e-Health is proposed. As a further advance, NOMA-enabled autonomous robotics (NOMA-ARs) systems and NOMA-enabled edge intelligence (NOMA-EI) towards remote-e-Health are discussed, respectively. Furthermore, a pair of case studies are provided to show the great performance enhancement with the use of NOMA technique in typical application scenarios of 5GB in remote-e-Health systems. Finally, potential research challenges and opportunities are discussed., Comment: 8 pages, 6 figures

Background The aim of this study was to investigate whether AMN082 exerts its neuroprotective effect by attenuating glutamate receptor-associated neuronal apoptosis and improving functional outcomes after traumatic brain injury (TBI). Methods Anesthetized male Sprague–Dawley rats were divided into the sham-operated, TBI + vehicle, and TBI + AMN082 groups. AMN082 (10 mg/kg) was intraperitoneally injected 0, 24, or 48 h after TBI. In the 120 min after TBI, heart rate, mean arterial pressure, intracranial pressure (ICP), and cerebral perfusion pressure (CPP) were continuously measured. Motor function, the infarct volume, neuronal nitrosative stress-associated apoptosis, and N-methyl-d-aspartate receptor 2A (NR2A) and NR2B expression in the pericontusional cortex were measured on the 3rd day after TBI. Results The results showed that the AMN082-treated group had a lower ICP and higher CPP after TBI. TBI-induced motor deficits, the increase in infarct volume, neuronal apoptosis, and 3-nitrotyrosine and inducible nitric oxide synthase expression in the pericontusional cortex were significantly improved by AMN082 therapy. Simultaneously, AMN082 increased NR2A and NR2B expression in neuronal cells. Conclusions We concluded that intraperitoneal injection of AMN082 for 3 days may ameliorate TBI by attenuating glutamate receptor-associated nitrosative stress and neuronal apoptosis in the pericontusional cortex. We suggest that AMN082 administration in the acute stage may be a promising strategy for TBI.

s Background This study aimed to clarify the interrelationship and additive effects of contact force (CF), power and application time in both conventional and high-power short-duration (HPSD) settings. Methods Among 38 patients with paroxysmal atrial fibrillation who underwent first-time pulmonary vein isolation, 787 ablation points were collected at the beginning of the procedure at separate sites. Energy was applied for 60 s under power outputs of 25, 30 or 35 W (conventional group), or 10 s when using 50 W (HPSD group). An impedance drop (ID) of 10 Ω was regarded as a marker of adequate lesion formation. Results ID ≥ 10 Ω could not be achieved with CF < 5 g under any power setting. With CF ≥ 5 g, ID could be enhanced by increasing power output or prolonging ablation time. ID for 30 and 35 W was greater than for 25 W (p < 0.05). Ablation with 35 W resulted in greater ID than with 30 W only when CF of 10–20 g was applied for 20–40 s (p < 0.05). Under the same power output, ID increased with CF level at different time points. The higher the CF, the shorter the time needed to reach ID of 10 Ω and maximal ID. ID correlated well with ablation index under each power, except for lower ID values at 25 W. ID with 50 W for 10 s was equivalent to that with 25 W for 40 s, but lower than that with 30 W for 40 s or 35 W for 30 s. Conclusions CF of at least 5 g is required for adequate ablation effect. With CF ≥ 5g, CF, power output, and ablation time can compensate for each other. Time to reach maximal ablation effect can be shortened by increasing CF or power. The effect of HPSD ablation with 50 W for 10 s is equivalent to conventional ablation with 25 W for 40 s and 30–35 W for 20–30 s in terms of ID.

Non-alcoholic fatty liver disease (NAFLD), an emerging risk factor for diabetes, is now recognized as the most common liver disease worldwide. Mesenchymal stem cells (MSCs), a promising tool in regenerative medicine, release abundant molecules into the conditioned medium (CM). Increasing evidence showed that MSC-CM is beneficial for diabetes-associated NAFLD. However, the mechanism of how MSC-CM improves NAFLD remains uncertain. In this study, to determine the effects of MSC-CM on NAFLD, streptozotocin (STZ) and high-fat diet (HFD) induced T2DM mice model and palmitic acid (PA)-stimulated L-O2 cells were used and treated with MSC-CM. Our results demonstrated that MSC-CM improved insulin resistance in diabetic mice, amended the pathological structure of the liver, enhanced the liver's total antioxidant capacity and mitochondrial function, reduced inflammation and cell apoptosis. We further verified that SIRT1 played a key role in mediating the protective effect of MSC-CM. These findings provide novel evidence that MSC-CM has the potential to treat T2DM patients with NAFLD clinically.

The power supply for numerous wireless sensor network nodes is a bottleneck that restricts the development of Internet of Things. As a new energy harvesting method, Triboelectric Nanogenerator (TENG) has significant advantages in environmental energy harvesting, which provides technical ideas for addressing the power supply problem of wireless sensor nodes. Based on the principle of Triboelectric Nanogenerator and wind-induced flutter, this study proposes and systematically investigates a film-flapping Triboelectric Nanogenerator (FF-TENG) to realize wind energy harvesting with high efficiency. Herein, the electric field distribution in the film-flapping process is analyzed through simulation software, and the flapping state of the film is displayed using flow visualization. Furthermore, the influence of film materials, wind speed, film length, and film series connection on the output of the FF-TENG is studied. Increase in wind speed increased the film-flapping frequency and the FF-TENG’s short-circuit current, whereas the open circuit voltage and transferred charges remained stable when the wind speed was higher than 4.7 m/s. Increase in the film length decreased the flapping frequency sharply, and the output performance per unit length first increased and then decreased. For the FF-TENG with double tandem films, under the excitation of the leader film, the trailer one obtained wider flapping amplitude, which increased the output voltage of the FF-TENG with two tandem short films by 45% comparing with the one with single long film. Experimentally, the FF-TENG with double tandem films powered a temperature sensor successfully, and at least 300 LED lights were lighted simultaneously, which showed that it is promising for application in the field of wireless sensor power supplements.

Background Intravenous immunoglobulin (IVIG) resistance prediction remains substantial in Kawasaki disease (KD), with limited data on the predictive value of coagulation profile for IVIG resistance, particularly for repeated IVIG resistance. Therefore, the aim of our study was to testify the predictive validity of coagulation profile for both initial IVIG resistance and repeated IVIG resistance in KD. Methods A total of 385 KD patients were prospectively recruited between April 2015 and May 2019. Coagulation and other profiles were evaluated between the IVIG‐responsive and IVIG‐resistant groups. Multivariate logistic regression analysis was applied to determine the association between coagulation profiles and IVIG resistance. ROC curves analysis was further performed to assess the validity of coagulation profiles in predicting both initial IVIG resistance and repeated IVIG resistance. Results Prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen degradation products (FDPs), and D‐dimer were significantly increased in the initial IVIG‐resistant group with antithrombin III (ATIII) and thrombin time (TT) significantly reduced. Meanwhile, ATIII was declined markedly in repeated IVIG‐resistant patients. Multivariate logistic regression analysis showed that PT, APTT, D‐dimer, and ATIII were independent risk factors for predicting initial IVIG resistance and ATIII for predicting repeated IVIG‐resistant patients with KD. PT, APTT, D‐dimer, and ATIII cutoff values of 13.95 s, 41.15 s, 1.48 mg/L, and 89.5% yielded sensitivities of 73%, 32%, 71%, and 81%, and specificities of 55%, 88%, 62%, and 51% for predicting initial IVIG resistance, respectively. The cutoff value of ATIII for predicting repeated IVIG resistance was 68.5%, with sensitivity of 71% and specificity of 55%. Conclusions KD patients who have hypercoagulation during the acute phase might be at higher risk of developing IVIG resistance.

Background Neuroblastoma is the most common malignant extracranial solid tumor in pediatrics patients. Intraoperative hyperthermia is extremely rare in patients with neuroblastoma and can cause a series of complications. Here, we represent a case of neuroblastoma accompanied by hyperthermia during anesthesia, and propose a rational explanation and management options. Case presentation The patient had gait disturbance and sitting-related pain without fever. Magnetic resonance imaging revealed a soft tissue mass located in the right posterior mediastinum, paravertebral space and canalis vertebralis. Serum tumor marker screening showed that the patient had increased epinephrine, norepinephrine and neuron specific enolase levels, with an increased 24 hour urine vanillylmandelic acid level. Intraspinal tumor resection was conducted. The temperature of the patient rapidly arose to 40.1 °C over 10 minutes when waiting for tracheal extubation. The arterial gas analysis results indicated malignant hyperthermia was less likely, and dantrolene was not administered. Physical cooling methods were used, and the temperature dropped to 38.6 ℃. The trachea was successfully extubated. Histological results confirmed the diagnosis of neuroblastoma. Conclusions Hyperthermia during anesthesia is a serious adverse event. Catecholamines secreted from neuroblatoma cells can lead to hypermetabolism and hyperthermia. Surgeons and anesthesiologists should be aware of the possibility of hyperthermia in patients with neuroblastoma.

Background Limited brain metastasis is treated definitively with stereotactic radiosurgery when surgical resection is not indicated. Although this has historically been performed in a single fraction, multi-fraction approaches such as fraction radiosurgery (FSRS) and staged radiosurgery (SSRS) have been recently examined as alternative approaches for larger lesions to permit better tumor control without increased toxicity. Case report We present the case of a patient who developed symptomatic radionecrosis in two brain metastasis, 2.3 cm and 2.1 cm in size, which were treated with 18 Gy in one fraction, but no radionecrosis in a 3.3 cm lesion treated in two fractions of 15 Gy nor in two punctate lesions that were treated in one fraction of 20 Gy. Although she did not respond to steroids, she responded to bevacizumab symptomatically and on neuroimaging. Conclusion Congruent with other recent studies, our report suggests that large brain metastasis should be considered for FSRS/SSRS.

We compared the effectiveness and safety outcomes of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in patients with AF and VHD, as these patients have been partially excluded from clinical trials.This retrospective cohort study was conducted using the National Health Insurance Research Database in Taiwan. Patients with AF and VHD and above 20 years of age, who were prescribed oral anticoagulants such as warfarin, dabigatran, rivaroxaban, and apixaban, were included. Propensity score matching was performed to balance intergroup differences. The Cox proportional hazards model was used to compare the effectiveness and safety of warfarin and NOACs.We included 5833 NOAC-warfarin pairs, 3001 dabigatran-warfarin pairs and 2595 rivaroxaban-warfarin pairs. Warfarin and NOACs had similar risk of ischemic stroke (hazard ratio [HR], 0.92; 95% confidence interval [CI], 0.79-1.06;NOACs had a comparable risk of ischemic stroke and bleeding in patients with AF and VHD, and reduced the risk of venous thromboembolism, intracranial hemorrhage, and mortality, compared to warfarin. Therefore, NOAC is an effective and safe alternative to warfarin in these patients.

A flat Luneburg lens antenna for Ku-band (12–18 GHz) applications is proposed and designed using ceramic 3-D printing. Metamaterial structures and transformation optics technology are used to realize the gradient dielectric constant, compress the height, and reduce the weight of the Luneburg lens. The proposed 3-D printed Luneburg lens, combined with a 10 dB standard gain horn antenna, obtained an antenna gain up to 19.1 dBi over the operating frequency and the thickness reduction of 78%. In addition, the ability of the flat Luneburg lens to perform passive beam scanning with a limited power loss is achieved. This exploration of ceramic 3-D printing can serve as a reference for the development of ceramic components with complex structures.

Type 1 diabetes is a chronic metabolic disease characterized by hyperglycemia due to progressive destruction of pancreatic beta cells via autoimmune attack. Meteorin-like protein (metrnl) is a secreted protein homologous to the neurotrophin metrn and it is induced after exercise in the skeletal muscle. In our paper published previously, we showed that the serum level of metrnl was significantly correlated with the lipid profile, glucose profile and insulin resistance. In this experiment, we asked whether intravenous administration of metrnl could delay the onset of diabetes in non-obese diabetic (NOD) mice. 4-week-old NOD mice were injected intravenously with metrnl. Blood glucose levels were measured weekly. Insulitis scoring, intraperitoneal glucose tolerance test, adoptive T cell transfer, flow cytometry analysis and real-time PCR were performed to investigate the underlying mechanism. The results showed that intravenous administration of metrnl delayed the onset of diabetes in NOD mice. Histology of pancreas showed a decreased infiltration of leukocytes, which was in association with augmentation of regulatory T cells, suppression of autoreactive T cells and altered cytokine secretion. To sum up, the present study showed that intravenous administration of metrnl ameliorated islet lymphocyte infiltration and modulated immune cell responses, raising the possibility that it might be beneficial in improving islet function clinically.

Background Traumatic obturator dislocation of the hip joint associated with greater trochanter fracture is a rare injury. We used the lateral approach through the rectus abdominis to remove the femoral head dislocated into the obturator, and the posterolateral approach was used for reduction and internal fixation of the femoral greater trochanteric fracture and total hip replacement (THR). Good follow‐up results were achieved. To the best of our knowledge, this is the first report on this particular type of injury and on this approach to treating this type of injury. Case Report The patient was hospitalized due to a traffic accident that resulted in the patient experiencing swelling and deformity accompanied by limited mobility of the left hip and left knee. X‐ray examination and CT confirmed that the patient suffered from left hip obturator dislocation, greater trochanter fracture, pelvic fracture (Tile B), left acetabular fracture, right open tibiofibular comminuted fracture (Gustilo III), and posterior urethral injury. The femoral head was removed from the pelvic cavity through a pararectus approach under general anesthesia. A posterolateral approach was used for open reduction, and cable internal fixation for the left intertrochanteric fracture and uncemented THR were performed. Results The ability to work was restored 6 months after the operation. The Harris hip score, reflecting joint function, was 86 points after 2 years of follow‐up observation. Conclusion A lateral approach of rectus abdominis to remove the dislocated femoral head in the pelvis from the obturator should be selected, along with the posterolateral approach for reduction and internal fixation of the intertrochanteric fracture and THR. This case also provides a new reference for the treatment of this type of hip fracture dislocation., The femoral head was removed from the pelvic cavity through a pararectus approach under general anesthesia. A posterolateral approach for open reduction and cable internal fixation for the left intertrochanteric fracture and uncemented THR were performed.

Background The relationship between sleeping disorders and chronic kidney disease (CKD) has already been reported. Snoring, a common clinical manifestation of obstructive sleep apnea–hypopnea syndrome, is of clinical value in assessing sleeping disorder severity. However, investigations of the connection between snoring and CKD are limited, especially in normal-weight populations. This study assessed the relationship between snoring frequency and CKD in obese and normal-weight people in China. Methods A community-based retrospective cross-sectional study of 3250 participants was performed. Study participants were divided into three groups – the regularly snoring group, occasionally snoring group, and never snoring group – based on their self-reported snoring frequency. CKD was defined as an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2. Multiple logistic regression analysis was used to explore the relevance between snoring frequency and CKD prevalence. Results The CKD prevalence in obese participants was higher than that in normal-weight participants. Frequent snorers had a higher prevalence of CKD than those who were not frequent snorers in the obese group. Snoring frequency was correlated with CKD prevalence in obese participants independent of age, sex, smoking and drinking status, systolic blood pressure, triglyceride level, high-density lipoprotein, and homeostasis model assessment of insulin resistance (odds ratio: 2.66; 95% CI: 1.36–5.19; p=.004), while the same relationships did not exist in normal-weight participants (odds ratio: 0.79; 95% CI: 0.32–1.98; p=.614). Conclusions Snoring appears to be independently associated with CKD in obese but not in normal-weight Chinese adults.

The notion of personalized medicine demands proper prognostic biomarkers to guide the optimal therapy for an invasive breast cancer patient. However, various risk prediction models based on conventional clinicopathological factors and emergent molecular assays have been frequently limited by either a low strength of prognosis or restricted applicability to specific types of patients. Therefore, there is a critical need to develop a strong and general prognosticator. Methods: We observed five large-scale tumor-associated collagen signatures (TACS4-8) obtained by multiphoton microscopy at the invasion front of the breast primary tumor, which contrasted with the three tumor-associated collagen signatures (TACS1-3) discovered by Keely and coworkers at a smaller scale. Highly concordant TACS1-8 classifications were obtained by three independent observers. Using the ridge regression analysis, we obtained a TACS-score for each patient based on the combined TACS1-8 and established a risk prediction model based on the TACS-score. In a blind fashion, consistent retrospective prognosis was obtained from 995 breast cancer patients in both a training cohort (n= 431) and an internal validation cohort (n = 300) collected from one clinical center, and in an external validation cohort (n = 264) collected from a different clinical center. Results: TACS1-8 model alone competed favorably with all reported models in predicting disease-free survival (AUC: 0.838, [0.800-0.872]; 0.827, [0.779-0.868]; 0.807, [0.754-0.853] in the three cohorts) and stratifying low- and high-risk patients (HR 7.032, [4.869-10.158]; 6.846, [4.370-10.726], 4.423, [2.917-6.708]). The combination of these factors with the TACS-score into a nomogram model further improved the prognosis (AUC: 0.865, [0.829-0.896]; 0.861, [0.816-0.898]; 0.854, [0.805-0.894]; HR 7.882, [5.487-11.323]; 9.176, [5.683-14.816], and 5.548, [3.705-8.307]). The nomogram identified 72 of 357 (~20%) patients with unsuccessful 5-year disease-free survival that might have been undertreated postoperatively. Conclusions: The risk prediction model based on TACS1-8 considerably outperforms the contextual clinical model and may thus convince pathologists to pursue a TACS-based breast cancer prognosis. Our methodology identifies a significant portion of patients susceptible to undertreatment (high-risk patients), in contrast to the multigene assays that often strive to mitigate overtreatment. The compatibility of our methodology with standard histology using traditional (non-tissue-microarray) formalin-fixed paraffin-embedded (FFPE) tissue sections could simplify subsequent clinical translation.

To recycle vanadium from V-bearing steelmaking slag and V-bearing black shale, both were jointly roasted to generate vanadium-rich phase, and then vanadium was separated by magnetic separation in this study. The compositions of samples were determined by X-ray fluorescence meter and the phases in the samples were characterized using X-ray diffractometer. The experimental results showed that with increasing the ratio of CaO content to SiO2 content in the samples the vanadium separation efficiency first decreased, increased, and then decreased again. With increasing roasting temperature from 1423 to 1623 K, the vanadium separation efficiency increased. With increasing roasting time from one hour to four hours, the vanadium separation efficiency increased. The optimum conditions for vanadium recycling are the basicity of 1.2, roasting temperature of 1623 K, and roasting time of 4 hours. Under this condition, the separation efficiency of vanadium reaches 71.6%, and the concentrate contains 3.67% V2O5 and 46.9% Fe2O3. A flow for joint processing of V-bearing steelmaking slag and V-bearing black shale was proposed, which involves vanadium separating, and tailings utilizing.

As non-governmental organizations (NGOs) assume incrementally important roles in global environmental governance, literature regarding their functions also multiplies. Studies are available about their features, structural advantages or impacts. However, very few have sufficiently explained what makes them tick in the international system as non-state actors. In this article, we argue that NGOs’ important position in global governance lies in its authority. We build our analysis on sociological institutionalism and the principal–agent models, arguing that NGOs are independent and autonomous with both inherent authority and granted authority by sovereign states or inter-governmental organizations (IGOs). It is through this authority that NGOs could function independently and autonomously in global governance instead of being the affiliated or appendant actors of parties. To shed some new light on understanding NGOs in the international system from a theoretical perspective, we employ cases from environmental governance domain as evidence for illustration.

Traditionally, the optical interference and energy conversion could be modulated by dissipation and dispersion in nonlinear optomechanical systems. Here, in this article, we study the enhancement of dissipative coupling on transparency under generalized optomechanical coupling and theoretically illustrate the generation of optomechanically induced transparency with gain and interference tuning. It enables the enhancement of the controlling of fast (slow) light by an order of magnitude. This unifies the dispersive and dissipative coupling into generalized coupling in the study of optomechanically induced transparency and extends its applications from optical switching to optically controlled amplification under the red-sideband optical pumping.

Aim: To screen clinical and genetic risk factors and examine their combined effect on docetaxel, epirubicin and cyclophosphamide (TEC) regimen-induced liver injury (TEC-ILI). Patients & methods: We enrolled 396 breast cancer patients, and TEC-ILI-associated factors were screened by logistic regression analyses. Results: SOD2 rs4880 and ABCG2 rs2231142 polymorphisms correlated with an increased risk of TEC-ILI. Multivariate analysis incorporating clinical and genetic factors revealed that ABCC1 rs246221 (CC) and SOD2 rs4880 (AG/GG) increased the risk of TEC-ILI. Patients with at least two risk factors among nonalcoholic fatty liver disease, high low-density lipoproteinemia levels and the rs246221 or rs4880 adverse genotypes exhibited a significantly increased risk of developing TEC-ILI. Conclusion: The combination of clinical and genetic risk factors had higher predictive value for TEC-ILI than the interclinical risk factors alone.

In this paper we present a new data-driven method for pixel-level scene text segmentation from a single natural image. Although scene text detection, i.e. producing a text region mask, has been well studied in the past decade, pixel-level text segmentation is still an open problem due to the lack of massive pixel-level labeled data for supervised training. To tackle this issue, we incorporate text region mask as an auxiliary data into this task, considering acquiring large-scale of labeled text region mask is commonly less expensive and time-consuming. To be specific, we propose a mutually guided network which produces a polygon-level mask in one branch and a pixel-level text mask in the other. The two branches' outputs serve as guidance for each other and the whole network is trained via a semi-supervised learning strategy. Extensive experiments are conducted to demonstrate the effectiveness of our mutually guided network, and experimental results show our network outperforms the state-of-the-art in pixel-level scene text segmentation. We also demonstrate the mask produced by our network could improve the text recognition performance besides the trivial image editing application.

Adenovirus‐mediated herpes simplex virus thymidine kinase gene therapy (ADV‐TK) in combination with interventional treatment could relieve the symptoms in patients with widespread splenic metastasis., Adenovirus‐mediated herpes simplex virus thymidine kinase gene therapy (ADV‐TK) in combination with interventional treatment could relieve the symptoms in patients with widespread splenic metastasis

Purpose. Damage to corneal nerve fibers has been demonstrated in people with type 2 diabetes mellitus (T2DM) that further progresses with increasing severity of diabetic peripheral neuropathy. However, the role of C-peptide in corneal nerve damage has not been reported in T2DM. The present study investigated the relationship of fasting C-peptide levels with corneal neuropathy evaluated by corneal confocal microscopy (CCM) in patients with T2DM. Methods. 160 T2DM patients (72 females) aged 34-78 with duration ranging from 0 to 40 years underwent CCM to measure corneal nerve fiber length (CNFL), corneal nerve fiber density (CNFD), and corneal nerve branch density (CNBD). Pearson correlation analysis and multiple linear regression analysis were used to explore the association of fasting C-peptide levels with corneal nerve parameters. Partial correlation analysis (adjusted for age and gender) was also conducted to analyze the correlation of metabolic indexes with these three corneal nerve parameters. The relationship between fasting C-peptide levels and duration of diabetes was also explored by Pearson correlation analysis. Results. With an increase in fasting C-peptide levels, the values of CNFL, CNFD, and CNBD also showed a corresponding trend for an increase. Partial correlation analysis revealed that fasting C-peptide levels were positively associated with CNFL ( r = 0.245 , P = 0.002 ), CNFD ( r = 0.180 , P = 0.024 ), and CNBD ( r = 0.214 , P = 0.008 ) after adjusting for age and gender. Using multiple linear regression analysis, fasting C-peptide levels were also closely associated with CNFL ( P = 0.047 ) and CNBD ( P = 0.038 ) after multiple adjustments. However, this association disappeared after further adjusting for duration of diabetes. Further analysis indicated that fasting C-peptide levels declined with duration of diabetes ( r = − 0.267 , P = 0.001 ). Conclusions. C-peptide was closely associated with corneal neuropathy and disease duration in T2DM. C-peptide levels might be both an indicator of beta-cell function and a marker of disease severity (such as diabetic corneal neuropathy) and duration.

A leaky-wave antenna (LWA) is proposed on the basis of an ultrathin spoof surface plasmonic (SSP) waveguide, which can convert SSP waves into spatial multi-polarized radiation waves. The SSP waveguide is composed of a metallic strip line with periodic unit cells, and each unit consists of two orthogonally beveled slots. The feature of the single-conductor SSP waveguide determines that the leaky-wave radiation pattern is omnidirectional in the azimuth direction around LWA. Due to the design of orthogonally beveled slots, different polarized radiations can be achieved along the azimuth direction. Simulation results show that left-handed circularly polarized (LHCP), right-handed circularly polarized (RHCP), and linearly polarized (LP) radiations are achieved in different azimuth directions simultaneously, which are further validated by the experimental measurement. We also demonstrate a purely single polarized radiation by placing a metal reflector close to LWA, and the polarization is reconfigurable among LHCP, RHCP, and LP by mechanically rotating LWA.