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The high-precision QoS (quality of service) prediction is based on the comprehensive perception of state information of users and services. However, the current QoS prediction approaches have limited accuracy, for most state information of users and services (i.e., network speed, latency, network type, and more) are hidden due to privacy protection. Therefore, this article proposes a hidden-state-aware network (HSA-Net) that includes three steps called hidden state initialization, hidden state perception, and QoS prediction. A hidden state initialization approach is developed first based on the latent dirichlet allocation (LDA). After that, a hidden-state perception approach is proposed to abstract the initialized hidden state by fusing the known information (e.g., service ID and user location). The perception approach consists of four hidden-state perception (HSP) modes (i.e., known mode, object mode, hybrid mode and overall mode) implemented to generate explainable and fused features through four adaptive convolutional kernels. Finally, the relationship between the fused features and the QoS is discovered through a fully connected network to complete the high-precision QoS prediction process. The proposed HSA-Net is evaluated on two real-world datasets. According to the results, the HSA-Net's mean absolute error (MAE) index reduced by 3.67% and 28.84%, whereas the root mean squared error (RMSE) index decreased by 3.07% and 7.14% compared with ten baselines on average in the two datasets.

This paper presents the characteristics of HgCdTe mid-wavelength infrared (MWIR) electron-initiated avalanche photodiodes (e-APDs) as a function of temperature under different biases. The devices show a low dark current density of the order of ${10^{ - 7}} \text{A/cm}^2$ at 80 K when the reverse bias voltage is below 4 V, with an exponential gain above 100 at − 8 V. Low excess noise factor of around 1.2 is also demonstrated for the devices at 80 K. The dark current and gain characteristics at different temperatures are analyzed, along with the device simulation results. A varied-temperature impact ionization model for MWIR e-APD devices is adopted based on the experimental results. In addition, a significant increase of the dark current in the APD device is observed at high temperature under large reverse bias, which can be associated with the local electric field redistribution due to the accumulation of holes in the depletion region at high temperatures. The analysis presented in this work paves the way to achieve a high operating temperature (HOT) of the HgCdTe APD with further optimization.

Contrast-enhanced ultrasound (CEUS) for the differentiation of benign and malignant peripheral pulmonary lesions has been considered experimental for many years. This study was aimed at evaluating the feasibility of CEUS as a diagnostic modality in this area of discussion. CEUS diagnostic accuracy was explored by comparison with contrast-enhanced computed tomography (CECT). The collective included 449 patients with 449 definitive diagnoses (benign, 178; malignant, 271). Logistic regression analysis of CEUS data revealed that delayed time to enhancement, chaotic pattern of distribution of vessels and mild extent of enhancement were independent risk factors for predicting malignancy. Time to wash-out and homogeneity of enhancement did not differ between the two groups (p > 0.05). Based on histopathology or clinical follow-up as a reference standard, CEUS and CECT had similar diagnostic accuracies of 80.16% and 81.75%, respectively. CEUS is a potentially useful imaging tool for diagnosing peripheral pulmonary lesions.

In this paper, the performance of a secure massive multiple-input multiple-output (MIMO) system adopting low-resolution digital-to-analog converters (DACs) is analyzed over spatially correlated wireless channels. A tight lower bound for the achievable secrecy rate is derived with artificial noise (AN) transmitted in the null space of the user channels. Using the analytical results, the impact of spatial correlation on the secrecy rate is explicitly evaluated in the presence of low-resolution DACs. The analytical observations reveal that using low-resolution DACs can be beneficial to the secrecy performance compared with ideal DACs, when the channels are strongly correlated and optimal power allocation is not employed., Comment: accepted by IEEE Wireless Communication Letters

Objective To better understand the risks of bisphosphonates in order to develop guidance for appropriate clinical usage, to compared femoral fracture healing at different time points and to explore the effects of Residronate on fracture healing. Methods Osteoporosis model was achieved by ovariectomy surgery, followed by surgical incision of left femoral shaft 4 weeks after ovariectomy surgery. Three days after fracture surgery, risedronateor saline was fed by intragastric administration. X ray examination was used to check the callus formation, Bone Mineral Density (BMD), Bone Mineral Content (BMC), biomechanical, imaging and micromorphological of bone tissue as well as the trabecular bone parameters were all examined. The femoral pathology tissue of each rat was used to analyze trabecular bone parameters, including trabecular bone volume/tissue volume (Tb. BV/TV), bone surface to tissue volume ratio (BS/TV), trabecular bone mineral density (Tb. BMD), trabecular bone number (Tb. N), trabecular bone thickness (Tb. Th) and small bone Trabecular bone space (Tb. Sp). Results Via X‐ray and pathologically, risedronate treatment promoted the callus forming at the fracture site during the following 6 weeks after osteoporotic fracture by X‐ray (P, Using a rat osteoporotic model and controls we compared femoral fracture healing at different time points to explore the effects of Residronate on fracture healing at different time points measured: (i) via x‐ray and pathologically; (ii) through evaluation of bone mineral density and bone mineral content; and (iii) through load testing. Our results demonstrate that Risedronate could promote fracture healing at the first 3 weeks but delayed healing at the following 3 weeks. During the first 3 weeks, risedronate could obviously increase the BMD, decrease the BMC and delay the decrease of BMC of the fracture site. During the healing process of osteoporotic fracture rats, risedronate can improve the structural strength and mechanical index of newborn callus. It strongly recommends that longer than 7 weeks usage of third generation bisphosphonate of risedronate does not contribute to osteoporotic fracture.

OBJECTIVE: This study was undertaken to investigate the COVID-19 vaccine uptake rate and possible postvaccination effects in adults with epilepsy. METHODS: We invited adults with epilepsy attending three centers in China from July 24 to August 31, 2021 to participate in this study. We also asked age- and sex-matched controls among people attending for other chronic neuropsychiatric conditions and healthy controls accompanying people with illness attending the hospitals to participate. We excluded people who, under the national guidelines, had evident contradictions to vaccination. Participants were interviewed face-to-face using questionnaires. Vaccine uptake and postvaccine adverse events among the people with epilepsy were compared with those with neuropsychiatric conditions and controls. We also compared the willingness and reasons for hesitancy among unvaccinated participants. RESULTS: We enrolled 981 people, of whom 491 had epilepsy, 217 had other neuropsychiatric conditions, and 273 were controls. Forty-two percent of those with epilepsy had had the first dose of a vaccine, compared with 93% of controls and 84% of the people with neuropsychiatric conditions (p

Innate immune response acts as the first line of host defense against damage and is initiated following the recognition of pathogen-associated molecular patterns (PAMPs). For double-stranded DNA (dsDNA) sensing, interferon gene stimulator (STING) was discovered to be an integral sensor and could mediate the immune and inflammatory response. Selective STING antagonist C-176 was administered and pain behaviors were assessed following spared nerve injury (SNI)-induced neuropathic pain. The level of serum dsDNA following neuropathic pain was assessed using Elisa analysis. STING signaling pathway, microglia activation, and proinflammatory cytokines were assessed by qPCR, western blots, Elisa, and immunofluorescence staining. STING agonist DMXAA was introduced into BV-2 cells to assess the inflammatory response in microglial cells. dsDNA was significantly increased following SNI and STING/TANK-binding kinase 1 (TBK1)/nuclear factor-kappa B (NF-κB) pathway was activated in vivo and vitro. Early but not the late intrathecal injection of C-176 attenuated SNI-induced pain hypersensitivity, microglia activation, proinflammatory factors, and phosphorylated JAK2/STAT3 in the spinal cord dorsal horn, and the analgesic effect of C-176 was greatly abolished by recombinant IL-6 following SNI. We provided evidence clarifying dsDNA mediated activation of microglia STING signaling pathway, after which promoting expression of proinflammatory cytokines that are required for hyperalgesia initiation in the spinal cord dorsal horn of SNI model. Further analysis showed that microglial STING/TBK1/NF-κB may contribute to pain initiation via IL-6 signaling. Pharmacological blockade of STING may be a promising target in the treatment of initiation of neuropathic pain.

Neuroinflammation is a major contributor to neuropathic pain. Receptor interacting serine/threonine kinase 3 (RIP3) senses cellular stress, promotes inflammatory responses and activates c-Jun N-terminal kinase (JNK) signaling. Here, we assessed the involvement of RIP3-induced JNK signaling in chronic constriction injury (CCI)-induced neuropathic pain. We found that RIP3 inhibitors (GSK’872) and JNK inhibitors (SP600125) not only alleviated the radiant heat response and mechanical allodynia in CCI rats, but also reduced inflammatory factor levels in the lumbar spinal cord. CCI surgery induced RIP3 mRNA and protein expression in the spinal cord. GSK’872 treatment after CCI surgery reduced RIP3 and phosphorylated (p)-JNK expression in the spinal cord, whereas SP600125 treatment after CCI surgery had almost no effect on RIP3. Sinomenine treatment reduced RIP3, p-JNK and c-Fos levels in the spinal cords of CCI rats. These data demonstrated that RIP3 inhibition (particularly via sinomenine treatment) alleviates neuropathic pain by suppressing JNK signaling. RIP3 could thus be a new treatment target in patients with neuropathic pain.

Cutaneous melanoma is one of the most common malignant skin cancer with high lethality. Chemotherapy and photothermal therapy are important and extensively studied treatment modalities for melanoma. However, these therapies still face some challenges, which severely restrict their further applications, such as unsatisfactory efficacy of monotherapy, nonspecific uptake and release during drug delivery, and unexpected adverse effects from system administration. Recently, the strategies of collaboration, functional modification, stimuli-responsive design, and topical administration all show great prospect for solving above problems. In this research, a multifunctional nanoparticle-integrated dissolving microneedle drug delivery system was constructed, in which the nanoparticles were prepared based on the framework with the incorporation of photothermal agent (CuS) into Zeolitic imidazolate framework-8 and functionalized by hyaluronic acid. This system can co-load multi-modal drugs, improve specific uptake and distribution of targeted tumor, deliver drug locally, and release drug intelligently and spatiotemporally, thereby promising a low-dose administration with high efficiency. The high inhibiting tumor performance and excellent systematic safety were verified both in vitro and in vivo. Together, this smart design overcame the drawbacks of monotherapy and conventional system administration. We believe the nanoparticle-integrated dissolving microneedles will be in prospect of clinical application for more superficial tumors with further delicate optimization. Statement of significance Melanoma is one of the most common skin cancers with high lethality. Extensively studied chemotherapy and photothermal therapy still face some challenges, such as the limited therapeutic efficacy and the severe system adverse effects. In order to overcome these drawbacks, the multifunctional nanoparticle-integrated dissolving microneedles (DMNs) were designed. Especially, the nanoparticles could co-load multi-modal drugs, improve specific uptake, and release drug intelligently and spatiotemporally. The microneedles could increase the drug accumulation in tumor, thus achieving excellent therapeutic efficacy and reducing side effects. This system paved the way to a less invasive, more focused and efficient therapeutic strategy for melanoma therapy.

INTRODUCTION To improve compliance with voiding diaries in children with primary monosymptomatic nocturnal enuresis (PMNE), a new modified 3-day weekend frequency-volume chart (FVC) was designed, and the compliance and validity of this modified FVC was evaluated by comparing with the International Children's Continence Society (ICCS) recommended voiding diary. METHODS A total of 1200 patients with PMNE were enrolled in the study from 13 centers in China and were randomly assigned to record this modified FVC or the ICCS-recommended voiding diary. The primary outcome measure was the compliance, assessed by comparing the completing index and the quality score of diaries between two groups. The secondary outcome measure was the validity, evaluated by comparing the constituent of subtypes, micturition parameters and response rate to desmopressin. RESULTS Among the 1200 participants enrolled in the study, 447 patients completed the ICCS-recommended voiding diary and 469 completed the modified diary. The diurnal completing index and the quality score of the modified FVC group were better than those of the ICCS group. In addition, there was no significant difference between these two groups in the subtype classification, or in the response rate to desmopressin. CONCLUSIONS The modified FVC could be applied to obtain the voiding characteristics of children with PMNE as the ICCS-recommended voiding diary does and offers a reasonable and better choice for children with PMNE from the unselected population in the future.

Objective to evaluate the role of Contrast-Enhanced Ultrasound (CEUS) of the Simple Rules (SR) from the International Ovarian Tumor Analysis group for the differential diagnosis of benign and malignant adnexal tumors. Methods A total of 180 patients with suspected malignant adnexal masses admitted to Lanzhou University Second Hospital were included, all of whom received conventional ultrasound (US) and CEUS examination before surgery. All masses were assessed using SR in US and SR in CEUS respectively. To compare the diagnostic performance , the sensitivity, specificity, negative and positive predictive values , Youden index and area under the curves values of SR in US and SR in CEUS were obtained. Results SR in CEUS was better than SR in US with its sensitivity, negative predictive values , Youden index and area under the curves . The specificity and negative predictive value of SR in CEUS were lower than that of SR in US. Compared with SR in US, SR in CEUS significantly reduced the number of uncertain masses(21, 36.7% vs 66, 11.7%). Conclusion We concluded that SR in CEUS performed well in the diagnosis of malignant adnexal masses. SR in CEUS is a supplement to SR in US.

Hanqing Liu,1,&ast; Ling Zhan,1,&ast; Liantao Guo,1 Xizi Yu,1 Lingrui Li,1 Hongfang Feng,2 Dan Yang,3 Zhiliang Xu,1 Yi Tu,1 Chuang Chen,1 Shengrong Sun1 1Department of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People’s Republic of China; 2Department of Thyroid and Breast Surgery, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, Huangshi, 435000, Hubei, People’s Republic of China; 3Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shengrong Sun; Chuang ChenDepartment of Thyroid and Breast Surgery, Renmin Hospital of Wuhan University, Wuhan University at Jiefang Road 238, Wuhan, 430060, People’s Republic of ChinaTel/Fax +86 27 88041911Email sun137@sina.com; chenc2469@163.comPurpose: Many thyroid cancer patients have suffered from treatment delays caused by the coronavirus disease 2019 pandemic. Although there have been many reviews, recommendations, or clinical experiences, clinical evidence that evaluates patient disease status is lacking. The aim of our research was to evaluate thyroid cancer behaviour in the post-COVID-19 era.Patients and Methods: A retrospective study was conducted and thyroid cancer patient data from February 1, 2017 to September 15, 2020 were pooled for analysis. The demographic, ultrasound and pathological data of the pre- and post-COVID-19 groups were compared. Lymph node metastases, tumour size, extrathyroidal extension, and multifocality were compared year-by-year to evaluate annual changes in patient characteristics. Regression analyses were adopted to reveal cancer behaviour along with the admission date interval and to reveal risk factors for lymph node metastasis. Patient ultrasound data were compared before and after the lockdown to assess tumour progression. The outcomes of delays in treatment ≤ 180 days were then studied.Results: The post-lockdown patients were more likely to have multiple lesions (31.2% vs 36.5%, p = 0.040), extrathyroidal extension (65.5% vs 72.2%, p = 0.011) and lymph node metastases (37.7% vs 45.0%, p = 0.007), while tumour size remained stable (1.01cm vs.1.02cm, p = 0.758). The lymph node metastasis rate increased by year (p < 0.001). The tumour size correlated negatively with the post-lockdown admission date (p = 0.002). No significant difference in tumour size, multifocality or lymph node metastasis on ultrasound was revealed between the pre- and post-lockdown group. No significant difference in tumour size, multifocality, extrathyroidal extension or lymph node metastasis was revealed among patients with a delayed treatment time ≤ 180 days.Conclusion: Patients with a COVID-19-induced treatment delay had more aggressive cancer behaviour. Rebound medical visits and annually increasing aggressiveness may be potential reasons for this observation, as individual patient tumour did not progress during the delay.Keywords: treatment delay, lockdown, rebound medical visit, tumor behavior

Background Obesity, diabetes, and hypertension, as three of the most prevalent chronic diseases, remain a daunting health challenge. However, to our knowledge, no study has made a thorough examination of the association between the three chronic diseases and daytime napping, a widely accepted behavior in many countries. This is especially necessary among Tibetan populations, whose lifestyles and health outcomes may be unique, yet patterns of chronic diseases and napping are under-examined. Thus, we sought to explore the aforementioned association in the Tibetan population of China. Methods A total of 2902 participants aged 45–79 in 2019 were included. Multivariate logistic regressions were conducted in 2020. The sex disparity was examined through interaction and stratified analyses. Results Hypertension (40.7%) was more prevalent than obesity (20.2%) and diabetes (21.6%). Comparing to non-nappers, those who napped were more likely to have any conditions (OR = 1.30, 95% CI = 1.04–1.62 for 1–59 min/day group and OR = 1.40, 95% CI = 1.10–1.80 for ≥60 min/day group). Participants who had 1–59 min/day of napping were more likely to develop obesity (OR = 1.37, 95% CI = 1.07–1.75), and ≥ 60 min/day of napping was associated with diabetes (OR = 1.33, 95% CI = 1.01–1.74). The interactions between napping and sex were not statistically significant in the models. Conclusions The study revealed napping was unfavorably associated with obesity, diabetes, and any conditions in Tibetan people living on the Tibetan Plateau. Future interventions regarding the three chronic diseases may pay more attention to napping. Trial registration Not applicable.

OBJECTIVE To precisely prevent stroke, we evaluated three platelet function tests and their associations with clinical outcomes in ischemic stroke patients. METHODS On-treatment platelet reactivity of acute minor stroke patients taking aspirin plus clopidogrel was tested by light transmittance aggregometry (LTA), thromboelastography (TEG) and platelet function analyzer (PFA). Mann-Whitney U tests and receiver operating characteristic (ROC) curve analysis were used to assess their associations with recurrent events and clinical outcome prediction. RESULTS 127 acute minor stroke patients were stringently selected and followed for 13 months. Eight patients (6.3%) self-reported the recurrence and 13 (10.2%) patients self-reported bleeding. Recurrent patients displayed significantly higher on-treatment platelet reactivity when measured with LTA (p = 0.030) and PFA (p

Background: Alzheimer’s disease (AD) is a degenerative disorder, accompanied by progressive cognitive decline, for which there is no cure. Recently, the close correlation between AD and type 2 diabetes mellitus (T2DM) has been noted, and a promising anti-AD strategy is the use of anti-T2DM drugs. Objective: To investigate if the novel glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic polypeptide (GIP) receptor agonist DA4-JC shows protective effects in the triple APP/PS1/tau mouse model of AD. Methods: A battery of behavioral tests were followed by in vivo recording of long-term potentiation (LTP) in the hippocampus, quantified synapses using the Golgi method, and biochemical analysis of biomarkers. Results: DA4-JC improved cognitive impairment in a range of tests and relieved pathological features of APP/PS1/tau mice, enhanced LTP in the hippocampus, increased numbers of synapses and dendritic spines, upregulating levels of post-synaptic density protein 95 (PSD95) and synaptophysin (SYP), normalized volume and numbers of mitochondria and improving the phosphatase and tensin homologue induced putative kinase 1 (PINK1) - Parkin mitophagy signaling pathway, while downregulating amyloid, p-tau, and autophagy marker P62 levels. Conclusion: DA4-JC is a promising drug for the treatment of AD.

Organic photovoltaics are typically composed of at least four different materials, including the donor and acceptor components of the bulk heterojunction, the interfacial layers at each electrode, the electrodes themselves, and solution additives that may persist in the final sandwich structure. The interplay of surface energies between these different layers is profoundly complex, as the deposition and annealing of one layer on top of another may be influenced by the surface energy of these interfaces. While the energy levels of one layer with respect to adjacent layers are important to facilitate charge separation and collection at the electrodes, the relative surface energies of the interfaces in contact with the multicomponent bulk heterojunction can be beneficial or disadvantageous, or be neutral, with respect to the performance of the OPV device. Because the bulk heterojunction is a mixture of donor and acceptor polymers and/or small molecules, the accumulation of one of the components on the underlying electrode interface can be driven by surface energy considerations. A donor- or acceptor-rich interface may affect charge carrier flow to the electrode, thus affecting the overall efficiency. Here, ITO/PEDOT:PSS electrodes in forward organic photovoltaic devices are treated with five different thin interfacial layers to change the relative surface energy of this electrode with respect to the adjacent bulk heterojunction. Contact angle measurements with four probe liquids enable calculation of the surface energies, and the results are compared with the performance of forward-biased organic photovoltaic devices. Time-of-flight secondary ion mass spectrometry results substantiate the predictions of gradients in the bulk heterojunction layers, and grazing-incidence wide-angle X-ray scattering measurements show the impact on the polymer crystallites. Thus, a simple algorithm based on surface energy considerations may inform which interfacial layer for a given bulk heterojunction in an organic photovoltaic device can be the most appropriate.

Deep Semi-NMF (DSN), which learns hierarchical representations by stacking multiple layers Semi-NMF, shows competitive performance in unsupervised data analysis. However, the features learned from DSN always lack of representativity and discriminativity. In this paper, we build a novel Deep Semi-NMF network (DSNnet) to address the issues of DSN. Specifically, DSNnet contains multiple fully-connected layers, in which the activation function of each layer adopts Smoothly Clipped Absolute Deviation (SCAD). The non-negative hidden features are computed forwardly, while the network parameters are updated by the stochastic gradient descent method. Moreover, to enhance the discriminativity of features, we suggest simultaneously minimizing the reconstruction error of input and output, and maximizing the similarity between input and learned features. The proposed similarity measurement, which consists of global geometric similarity and local pointwise similarity, encourages the compactness between similar points and separateness between dissimilar points in the feature space, and is beneficial to preserve intrinsic information of original data. Extensive experiments conducted on several datasets illustrate the superiority of the proposed approach in comparison with state-of-the-art methods.

BACKGROUND Septic shock leads to multiple organ failure, and bacterial endotoxins and endogenous cytokines play essential roles in the pathogenesis. The oXiris® hemofilter can efficiently adsorb endotoxins and cytokines. CASE SUMMARY We admitted a critically ill 59 year-old male patient with gastrointestinal septic shock due to infection by a Gram-negative bacterium and septic acute kidney injury (AKI). Prior to intensive care unit admission, the patient reported intermittent diarrhea and decreased urine output. His blood pressure was 70/40 mmHg, necessitating fluid resuscitation and large doses of noradrenaline. Based on the results of a blood culture and the presence of hypotension, oliguria, and hypoxemia, we diagnosed septic shock, AKI, and multiple organ dysfunction. We administered continuous renal replacement therapy (CRRT) with an oXiris® hemofilter for 72 h with intermittent continuous veno-venous hemodiafiltration (CVVHDF), and changed the filter every 12 h. After his hemodynamic parameters were stable, we used a traditional filter (AN69 hemofilter) with intermittent CVVHDF. The 72 h CRRT with the oXiris® hemofilter led to stabilization of his vital signs, marked reductions in disease severity scores, and decreased levels of procalcitonin, endotoxin, and inflammatory factors. After 8 d of CRRT, his kidney function had completely recovered. CONCLUSION We conclude that the oXiris® hemofilter combined with appropriate antibacterial therapy was an effective treatment for this patient with gastrointestinal septic shock.

The important cues for a realistic lung nodule synthesis include the diversity in shape and background, controllability of semantic feature levels, and overall CT image quality. To incorporate these cues as the multiple learning targets, we introduce the Multi-Target Co-Guided Adversarial Mechanism , which utilizes the foreground and background mask to guide nodule shape and lung tissues, takes advantage of the CT lung and mediastinal window as the guidance of spiculation and texture control, respectively. Further, we propose a Multi-Target Co-Guided Synthesizing Network with a joint loss function to realize the co-guidance of image generation and semantic feature learning. The proposed network contains a Mask-Guided Generative Adversarial Sub-Network (MGGAN) and a Window-Guided Semantic Learning Sub-Network (WGSLN). The MGGAN generates the initial synthesis using the mask combined with the foreground and background masks, guiding the generation of nodule shape and background tissues. Meanwhile, the WGSLN controls the semantic features and refines the synthesis quality by transforming the initial synthesis into the CT lung and mediastinal window, and performing the spiculation and texture learning simultaneously. We validated our method using the quantitative analysis of authenticity under the Frechet Inception Score, and the results show its state-of-the-art performance. We also evaluated our method as a data augmentation method to predict malignancy level on the LIDC-IDRI database, and the results show that the accuracy of VGG-16 is improved by 5.6%. The experimental results confirm the effectiveness of the proposed method.

Xiling Hu,1,&ast; Yao Zhang,2,&ast; Bin Yao,2 Beisi Lin,2 Dan Yang,3 Cong Ling,4,&ast; Lingling Gao3,&ast; 1Department of Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 3School of Nursing, Sun Yat-sen University, Guangzhou, People’s Republic of China; 4Department of Neurosurgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Cong LingDepartment of Neurosurgery, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong, 510630, People’s Republic of ChinaTel +86-13580465121Email doctor200@126.comLingling GaoSchool of Nursing, Sun Yat-sen University, No. 74, Zhongshan Er Road, Guangzhou, Guangdong, 510085, People’s Republic of ChinaTel +86 13539965693Email gaoll@mail.sysu.edu.cnPurpose: The purpose of this exploratory qualitative study was to identify the needs and barriers to diabetes dietary education issues in a Chinese context among people with type 2 diabetes and also their family members.Patients and Methods: Nineteen patients with type 2 diabetes and 15 family members were randomly selected from a larger study in Guangzhou. Descriptive phenomenological qualitative inquiry guided this study.Results: Both patients and their family members claimed a variety of needs regarding diabetes dietary information and that it should be patient-centered. In addition, both groups identified the effectiveness and helpfulness of diabetes diet-related health education, but family members reported a lack of professional education. Patients reported that the barriers to diabetes diet-related health education were: 1) patients’ different faculties of memory and acceptance, 2) educators’ methods of explaining the information, 3) lack of advertising and intensity of publicity both inside and outside of the hospital. Family members identified that diabetes diet-related health education assisted them with taking care of patients with diabetes and it was also beneficial for themselves to gain more dietary knowledge and develop healthy dietary habits.Conclusion: It is necessary to make some adjustment to traditional diabetes dietary education. It may be a good strategy to investigate the needs and faculties of memory and acceptance of people with diabetes before starting a diabetes education program. Hospitals should intensify their publicity of diabetes education and make it more attractive to patients with diabetes and their family members. Educators should add information specifically for family members while conducting diabetes education. Tertiary hospitals could provide standardized training regarding diabetes-related health education to community family physicians; in this way, diabetes education could gradually be transferred to them and both groups of clinicians could share in the education.Keywords: diabetes, family members, dietary education, needs, barriers, qualitative

Corrosion had aroused extensive concern and attention because it was an unavoidable problem for marine equipment and facilities in service. However, the current status and development trend of marine environment corrosion research had seldom been systematically studied. Therefore, it was encouraged to use bibliometrics and information visualization analysis methods to conduct bibliometric analysis of related publications in the field of marine environment corrosion based on HistCite, CiteSpace, and VOSviewer software programs. Compared with the traditional comments of researchers in this field, this research provided a direction for the development of quantitative analysis and visualization of marine environment corrosion on a large scale. The results showed that the overall focus of research in the field of marine environment corrosion continued to increase from 1900 to 2019. China had the highest publication productivity, the USA had the highest h-index value and the second highest average citations per item value, Materials Science was the most popular subject category, Corrosion Science was the main journal and Melchers RE was the author with the most output contributions. This research also exhibited four hot spots in this field. In addition, this work could help new researchers to find research directions and identify research trends and frontiers in the field of marine environment corrosion by tracing the research hotspots of topic categories, countries, institutions, journals, authors, and publications in recent years.

In the field of network security , it is of great significance to accurately detect various types of Internet of Things (IoT) network intrusion attacks which launched by the attacker-controlled zombie hosts. In this paper, we propose a novel IoT network intrusion detection approach based on Adaptive Particle Swarm Optimization Convolutional Neural Network (APSO-CNN). In particular, the PSO algorithm with change of inertia weight is used to adaptively optimize the structure parameters of one-dimensional CNN. The cross-entropy loss function value of the validation set, which is obtained from the first training of CNN, is taken as the fitness value of PSO. Especially, we define a new evaluation method that considers both the prediction probability assigned to each category and prediction label to compare the proposed APSO-CNN algorithm with CNN set parameters manually (R-CNN). Meanwhile, the comprehensive performance of proposed APSO-CNN and other three well known algorithms are compared in the five traditional evaluation indicators and the accuracy statistical characteristics of 10 times independent experiments. The simulation results show that the multi-type IoT network intrusion attack detection task based on APSO-CNN algorithm is effective and reliable.

In this study, we report a new type of InGaAs/InP photodetector (PD) with nickel oxide (NiO) transparent p-region and electrode. By applying the NiO film, the device does not require the highly doped p-contact layer and the opaque p-contact metal electrode such as the traditional p-i-n PD. The epitaxial layer of the PD is simplified. Meanwhile, the optical power loss caused by the additional absorption in the highly doped p-contact layer can be avoided. With the fully covered transparent p-contact electrode, the PD can be illuminated from the p-side at the same time. The numerical simulation results show that the new structure can improve the 3-dB bandwidth and the RF output power of the PD.

Cardiovascular disorders pose great threat to public health. As a common type of cardiovascular disease, atherosclerosis is characterized by high morbidity and mortality/recurrence rate. However, the pathogenesis of atherosclerosis is complex and not fully understood. The aim of this study was to investigate the influences of hsa_circRNA_102541 (circ_102541) on proliferation and apoptosis of HUVEC cells and to identify the underlying mechanisms. RT-PCR was used to determine the expression levels of circ_102541, miR-296-5p, and PLK1 in atherosclerosis and healthy blood samples. Following the transfection with sh-circ_102541, LV-circ_102541, miR-296-5p mimics, miR-296-5p inhibitors, and si-PLK1, cell proliferation was evaluated using CCK8 assay; cell apoptosis was determined by flow cytometry; dual luciferase assay was performed to examine the interaction between abovementioned molecules. The levels of associated markers including PCNA and caspase-3 were assessed by western blotting and RT-qPCR. The expression of circRNA_102541 and PLK1 were significantly elevated in atherosclerosis specimens, where the level of miR-296-5p was reduced. Furthermore, circRNA_102541 could bind miR-296-5p and subsequently target PLK1. Following treatment with sh-circRNA_102541 or miR-296-5p mimics, proliferative ability and levels of PCNA were remarkably reduced in HUVEC cells, while apoptosis was significantly enhanced. Co-transfection with miR-296-5p mimics abrogated the effects induced by the overexpressed circ_102541. Additionally, treatment with si-PLK1 attenuated the biological behavior changes caused by miR-296-5p inhibitors in HUVEC cells. Moreover, transfection with LV-PLK1 reversed the effects triggered by miR-296-5p mimics. Taken together, circRNA_102541 was upregulated in atherosclerosis, and knockdown of circRNA_102541 suppressed cell proliferation while promoted apoptosis of HUVEC cells via miR-296-5p/PLK1. This novel pathway may serve essential roles on the development of atherosclerosis, and circRNA_102541 could be a promising therapeutic candidate for the treatment of atherosclerosis.

In studies of ballistic impact, the materials used in body armor must have high hardness, light weight, fatigue resistance, corrosion resistance, and other high performance characteristics. Aramid fibers are widely used in anti-ballistic materials. To facilitate the further development of aramid materials, this study reviews aramid research in recent years and analyzes the main factors affecting, and new methods for optimizing, anti-ballistic performance, with the emphasis on bulletproof fabrics. This review provides suggestions for future research and use of aramid materials for anti-ballistic performance.

A woman in her 20s suffering from chest tightness was referred with suspected cardiomyopathy by echocardiogram. No skeletal muscle and mental abnormalities were found. Her mother died of advanced heart failure at the age of 48, but the exact cause of heart failure is unclear. Cardiac magnetic resonance demonstrated normal left ventricular (LV) wall thickness; LV cavity was mildly enlarged (figure 1A); LV ejection fraction (EF) was decreased (EF=44.5%). We found prominent hypertrabeculations at mid-apical portions of the left ventricle (the ratio of the non-compacted to compacted myocardial layers=3.3, figure 1B). Furthermore, patchy non-ischaemic …

This study examines the impact of farmers' cooperatives participation and technology adoption on their economic welfare in China. A double selectivity model (DSM) is applied to correct for sample selection bias stemming from both observed and unobserved factors, and a propensity score matching (PSM) method is applied to calculate the agricultural income difference with counter factual analysis using survey data from 396 farmers in 15 provinces in China. The findings indicate that farmers who join farmer cooperatives and adopt agricultural technology can increase agricultural income by 2.77 and 2.35%, respectively, compared with those non-participants and non-adopters. Interestingly, the effect on agricultural income is found to be more significant for the low-income farmers than the high-income ones, with income increasing 5.45 and 4.51% when participating in farmer cooperatives and adopting agricultural technology, respectively. Our findings highlight the positive role of farmer cooperatives and agricultural technology in promoting farmers’ economic welfare. Based on the findings, government policy implications are also discussed.

Resilient city has attracted global attentions as a new concept for cities to deal with risks and challenges in recent years. Numerous researchers have successively conducted in-depth studies on the resilient city from different perspectives. To acquire an overview of resilient city and grasp the current research hotspots, a bibliometric analysis and visualization of the past decade of research on the resilient city was made. The data were collected from 1249 articles published in the Web of Science database from 2010 to 2019. As the widely used bibliometric analysis tools, CiteSpace and VOSviewer were adopted in this study. The temporal distribution of resilient city research, including annual publication outputs and high-cited papers, was symmetrically analyzed. Then, the spatial distribution of resilient city research, including countries, categories, institutions, co-citation journals, author collaboration network, and author co-citation network, was investigated. Hot topics and evolution trends of resilient city were revealed. The results show that the research of resilient city experienced three periods, namely, germination, rapid diffusion, and reflection and innovation periods. Current research focuses on four aspects, including psychological resilience at the microcommunity and group levels, assessment of urban disaster resilience, multiple theoretical frameworks of urban resilience, and urban resilience promotion strategy. Therefore, this study helps scholars and practitioners to gain a comprehensive understanding of the current research progress and evolution trends of the resilient city field.

Impact flash occurs when objects collide at supersonic speeds and can be used for real-time damage assessment when weapons rely on kinetic energy to destroy targets. However, the mechanism of impact flash remains unclear. A series of impact flash experiments of flat-head long-rod projectiles impacting thin target plates were performed with a two-stage light gas gun. The impact flash spectra for 6061 aluminum at 1.3–3.2 km/s collision speeds were recorded with a high-speed camera, a photoelectric sensor, and a time-resolved spectrometer. The intensity of the impact flash exhibited a pulse characteristic with time. The intensity (I) increased with impact velocity (V0) according to I∝V0n , where n = 4.41 for V0 > 2 km/s. However, for V0 2 km/s, a continuous spectrum (thermal radiation background) was observed and increased in intensity with V0. However, for V0

A novel frequency continuously tunable patch-slot antenna with wide-angle discrete scanning performance and one optional backward radiation state is presented. This antenna originates from combining one patch antenna with two endfire radiation slot antennas. By loading varactors on the patch, the working frequency is continuously adjusted, and simultaneously the maximum beam direction could be reconfigured by controlling four PIN diodes located on two slots. The proposed antenna is capable of reconfiguring its maximum beam direction to six discrete angles at 0°, −36°, −78°, +36°, +78°, and 180°. A prototype is fabricated and measured to validate the design, and experimental results demonstrate that the antenna has the merits of both wide-angle beam discrete scanning performance of ±78° in the H -plane and switchable backward radiation feature within frequency tuning range of 2.24–2.58 GHz.

A wideband circularly polarized (CP) pyramidal horn antenna (PHA) is proposed. A +45° or −45° rotated spoof surface plasmon polariton (SSPP) waveguide, which serves as a circular polarizer, is inserted into the PHA. The vertically polarized wave in the PHA is decomposed into two orthogonal components with equal amplitude. One component perpendicular to the circular polarizer propagates along the PHA as a fast wave, and the other one propagates along the SSPP waveguide as a slow wave. When length of the SSPP waveguide is chosen appropriately, the phase difference between these two components is +90° or −90°, which makes the PHA radiate left-handed or right-handed (LH or RH) waves. Furthermore, the phase differences approximately equal to +90° or −90° over a wide frequency range. As a result, a wideband LH or RH CP PHA is implemented. Since the SSPP waveguide is completely inserted into a standard gain PHA, its volume does not increase at all, and its appearance does not change. Measured results show that the CP PHA achieves 26% 3 dB axial ratio (AR) bandwidth (from 8.7 to 11.3 GHz), its reflection coefficients are less than −10 dB, and its gains range from 14.9 to 16.6 dBic.

We report the phase shift of two types of photodetectors for a variation of bias voltage and optical power. One type is PIN-PD and the other is a modified uni-traveling carrier photodetector (MUTC-PD). In PIN-PD, the phase change shows a photocurrent-dependent variation of about 15 degrees at 3 GHz. It exhibits good stability over a wide bandwidth as the bias voltage changes. By comparison, the phase shift of the MUTC-PD is more sensitive to the bias voltage and the photocurrent. The continuous tunable range of phase shift in MUTC-PD reaches 50 degrees at 10 GHz. It is demonstrated that the adjustable phase shift mainly results from the transit time and the impedance dynamic effects in response to the optical power and bias voltage.

Background The prognostic value of left atrial (LA) size and function in hypertrophic cardiomyopathy (HCM) is well recognized, but LA function is difficult to routinely analyze. Fast LA long-axis strain (LA-LAS) analysis is a novel technique to assess LA function on cine cardiovascular magnetic resonance (CMR). We aimed to assess the association between fast LA-LAS and adverse clinical outcomes in patients with HCM. Methods 359 HCM patients and 100 healthy controls underwent routine CMR imaging. Fast LA-LAS was analyzed by automatically tracking the length between the midpoint of posterior LA wall and the left atrioventricular junction based on standard 2- and 4-chamber balanced steady-state free precession cine-CMR. Three strain parameters including reservoir strain (εs), conduit strain (εe), and active strain (εa) were assessed. The endpoint was set as composite adverse events including cardiovascular death, resuscitated cardiac arrest, sudden cardiac death aborted by appropriate implantable cardioverter-defibrillator discharge, and hospital admission related to heart failure. Results During an average follow-up of 40.9 months, 59 patients (19.7%) reached endpoints. LA strains were correlated with LA diameter, LA volume index (LAVI) and LA empty fraction (LAEF) (all p Conclusions Fast LA reservoir and conduit strains are independently associated with adverse outcomes in HCM.

Rheumatoid arthritis (RA) is considered a chronic autoimmune inflammatory disease that causes great morbidity and shortens life expectancy; however, the precise pathogenesis of RA remains unclear. This study aimed to select hub genes correlated with the development of RA.Two gene expression profiles, GSE55235 and GSE12021, obtained from the Gene Expression Omnibus (GEO) were used to identify differentially expressed genes (DEGs) in control and RA samples using GEO2R, followed by other bioinformatics methods, including functional enrichment analysis, protein-protein interaction (PPI) networks, miRNA-hub gene network, and drug-hub gene interactions. In addition, qRT-PCR was finally conducted to confirm the reliability and validity of the expression level of the novel DEGs via freshly collected heparinized blood samples of healthy controls and RA patients.A sum of 136 upregulated and 37 downregulated DEGs were selected. Functional enrichment analysis indicated that all the upregulated DEGs were correlated with immune response, B cell receptor signalling pathway, and adaptive immune response. KEGG pathway enrichment analysis revealed that the upregulated DEGs were mostly related to cytokine-cytokine receptor interaction, primary immunodeficiency, chemokine signalling pathways, and cell adhesion molecules (CAMs). In total, 12 hub genes (IL15, KLRK1, GZMA, CXCR6, IGHV4-38-2, IGLL5, CXCL13, CXCL11, MS4A1, SDC1, SLAMF1, and PDCD1LG2) were identified and all these hub genes were upregulated, of which IGLL5 and IGHV4-38-2 were first reported to be correlated with the pathogenic mechanism and prognosis of RA. Furthermore, we also used qRT-PCR to validate the overexpression of IGLL5 and IGHV4-38-2 in RA patients compared to the healthy controls. In the miRNA-hub gene network, hsa-miR-1185-5p and hsa-miR-3679-5p might inhibit the expression of IGLL5 during the progression of RA. The 15 most promising candidate drugs, which were all approved by the Food and Drug Administration, may assist with the treatment of RA.Overall, these findings may assist with developing diagnostic, prognostic, and therapeutic biomarkers for RA. Key Points • IGLL5 and IGHV4-38-2 were first reported to be correlated with the pathogenic mechanism and prognosis of RA. • Besides, hsa-miR-1185-5p and hsa-miR-3679-5p may inhibit the expression of IGLL5 during the progression of RA.

Background Elucidation of the molecular mechanisms involved in the pathogenesis of coronavirus disease 2019 (COVID-19) may help to discover therapeutic targets. Methods To determine the metabolomic profile of circulating plasma from COVID-19 survivors with pulmonary sequelae 3 months after discharge, a random, outcome-stratified case-control sample was analyzed. We enrolled 103 recovered COVID-19 patients as well as 27 healthy donors, and performed pulmonary function tests, computerized tomography (CT) scans, laboratory examinations, and liquid chromatography-mass spectrometry. Results Plasma metabolite profiles of COVID-19 survivors with abnormal pulmonary function were different from those of healthy donors or subjects with normal pulmonary function. These alterations were associated with disease severity and mainly involved amino acid and glycerophospholipid metabolic pathways. Furthermore, increased levels of triacylglycerols, phosphatidylcholines, prostaglandin E2, arginine, and decreased levels of betain and adenosine were associated with pulmonary CO diffusing capacity and total lung capacity. The global plasma metabolomic profile differed between subjects with abnormal and normal pulmonary function. Conclusions Further metabolite-based analysis may help to identify the mechanisms underlying pulmonary dysfunction in COVID-19 survivors, and provide potential therapeutic targets in the future.

Transdermal drug delivery is an attractive route for dermatological disease therapy because it can directly target the lesion site on the skin, reduce adverse reactions associated with systemic administration, and improve patient compliance. However, the stratum corneum, as the main skin barrier, severely limits transdermal drug penetration, with compromised bioavailability. Microneedles (MNs), which are leveraged to markedly improve the penetration of therapeutic agents by piercing the stratum corneum and creating hundreds of reversible microchannels in a minimally invasive manner, have been envisioned as a milestone for effective transdermal drug delivery, especially for superficial disease therapy. Here, the emergence of versatile MNs for the transdermal delivery of various drugs is reviewed, particularly focusing on the application of MNs for the treatment of diverse skin diseases, including superficial tumors, scars, psoriasis, herpes, acne, and alopecia. Additionally, the promises and challenges of the widespread translation of MN-mediated transdermal drug delivery in the dermatology field are summarized.

Background The relationship between cancer and COVID‐19 has been revealed during the pandemic. Some anticancer treatments have been reported to have negative influences on COVID‐19‐infected patients while other studies did not support this hypothesis. Methods A literature search was conducted in WOS, PubMed, Embase, Cochrane Library, CNKI and VIP between Dec 1, 2019 and Sept 23, 2020 for studies on anticancer treatments in patients with COVID‐19. Cohort studies involving over 20 patients with cancer were included. The characteristics of the patients and studies, treatment types, mortality, and other additional outcomes were extracted and pooled for synthesis. RRs and forest plots were adopted to present the results. The literature quality and publication bias were assessed using NOS and Egger's test, respectively. Results We analyzed the data from 29 studies, with 5121 cancer patients with COVID‐19 meeting the inclusion criteria. There were no significant differences in mortality between patients receiving anticancer treatment and those not (RR 1.17, 95%CI: 0.96–1.43, I2=66%, p = 0.12). Importantly, in patients with hematological malignancies, chemotherapy could markedly increase the mortality (RR 2.68, 95% CI: 1.90–3.78, I2=0%, p, No significant difference was seen in any anticancer treatments in solid tumor subgroup. Chemotherapy, however, will lead to a higher mortality in patients with hematological malignancies.

The new coronavirus, which has become a global pandemic, has confirmed more than 88 million cases worldwide since the first case was recorded in December 2019, causing over 1.9 million deaths. Since COIVD-19 lesions have clear imaging features on CT images, it is suitable for the auxiliary diagnosis and treatment of COVID-19. Deep learning can be used to segment the lesions areas of COVID-19 in CT images to help monitor the epidemic situation. In this paper, we propose a multi-point supervision network (MPS-Net) for segmentation of COVID-19 lung infection CT image lesions to solve the problem of a variety of lesion shapes and areas. A multi-scale feature extraction structure, a sieve connection structure (SC), a multi-scale input structure and a multi-point supervised training structure were implemented into MPS-Net. In order to increase the ability to segment various lesion areas of different sizes, the multi-scale feature extraction structure and the sieve connection structure will use different sizes of receptive fields to extract feature maps of various scales. The multi-scale input structure is used to minimize the edge loss caused by the convolution process. In order to improve the accuracy of segmentation, we propose a multi-point supervision training structure to extract supervision signals from different up-sampling points on the network. Experimental results showed that the dice similarity coefficient (DSC), sensitivity, specificity and IOU of the segmentation results of our model are 0.8325, 0.8406, 09988 and 0.742, respectively. The experimental results demonstrated that the network proposed in this paper can effectively segment COVID-19 infection on CT images. It can be used to assist the diagnosis and treatment of new coronary pneumonia.

Background: Tuberculosis is a significant public health challenge and tuberculous tenosynovitis is therefore a rare form of musculoskeletal tuberculosis which usually affects the flexor tendons of the hand and wrist. Case presentation: We present a case of a 63-year-old male. He presented multiple progressively enlarging mass over the volar side of the right hand and wrist. He did not have a previous history of tuberculosis. However, his erythrocyte sedimentation rate was high and tuberculosis antibody test was slightly positive. Radiograph of chest showing multiple nodular and patchy dense shadows in bilateral lungs, and localized soft tissue mass around the radiocarpal joint. Excision biopsy of the mass was done and samples sent for histopathology comment. The findings were an inflamed, thickened synovia: suggestive of tuberculous tenosynovitis. Anti-tuberculous chemotherapy was commenced on the second postoperative day. Conclusion: Tuberculous tenosynovitis of the wrist is rare. However, in developing area where tuberculosis is prevalent, it should be part of the differential diagnosis of compound palmar ganglion in order to prevent delayed diagnosis and treatment.

BACKGROUND: Echocardiography has poor accuracy in grading the severity of pulmonary hypertension (PH) compared to cardiac catheterization. However, the relationship between degree of PH and prognostic outcomes remains uncertain. Our primary objective was to determine whether echocardiogram-assessed PH severity is associated with mortality and hospital readmission in the first year of life. METHODS: A retrospective cohort study of infants born less than 32 weeks of gestational age with bronchopulmonary dysplasia (BPD) underwent echocardiography was performed. Echocardiograms were performed at 36–38 weeks postmenstrual age. Data during hospitalization and post-discharge collected at 1-year age were analyzed with cox regression models and logistic regression models to identify the association of PH severity with mortality and readmission. Area under curve (AUC) was calculated to examine the accuracy of these models to reflect the likelihood of outcomes. RESULTS: Fifty-six of 237 (23.6%) infants were diagnosed as PH. Moderate and severe PH was significantly associated with mortality during the first one year of life (moderate PH vs. none HR =26.58, 95% CI: 4.40–160.78, P

Background Atrial fibrillation (AF) is a common arrhythmia, which is closely related to cardiovascular morbidity and mortality. Although acupuncture is used in the treatment of AF, the evidence is insufficient. The objective of this pilot trial is to evaluate the feasibility, preliminary efficacy, and safety of acupuncture in reducing AF burden for persistent AF after catheter ablation (CA). Methods and design This will be a multi-center, 3-arm, pilot randomized controlled trial in China. Sixty patients in total will be randomly assigned to the specific acupoints group, the non-specific acupoints group, or the non-acupoints group in a 1:1:1 ratio. The whole study period is 6 months, including a 3-month treatment period and a 3-month follow-up period. All patients will receive 18 sessions of acupuncture over 12 weeks after CA and appropriate post-ablation routine treatment. The primary outcome is AF burden at 6 months after CA measured by electrocardiography patch that can carry out a 7-day continuous ambulatory electrocardiographic monitoring. The secondary outcomes include AF burden at 3 months after CA, recurrence of AF, quality of life, etc. The adverse events will also be recorded. Discussion This pilot study will contribute to evaluating the feasibility, preliminary efficacy, and safety of acupuncture in reducing AF burden for persistent AF after CA. The results will be used for the sample size calculation of a subsequent large-scale trial. Trial registration Chinese Clinical Trial Registry ChiCTR2000030576. Registered on 7 March 2020.

Objectives: As of 11 Feb 2020, a total of 1,716 medical staff infected with laboratory-confirmed the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) in China had been reported. The predominant cause of the infection among medical staff remains unclear. We sought to explore the epidemiological, clinical characteristics and prognosis of infected medical staff. Methods: Medical staff who infected with SARS-Cov-2 and admitted to Union Hospital, Wuhan between 16 Jan to 25 Feb, 2020 were included in this single-centered, retrospective study. Data were compared by occupation and analyzed with the Kaplan-Meier and Cox regression methods. Results: A total of 101 medical staff (32 males and 69 females; median age: 33) were included in this study and 74.3% were nurses. A small proportion of the cohort had contact with specimens (3%) as well as patients infected with SARS-Cov-2 in fever clinics (15%) and isolation wards (3%). 80% of medical staff showed abnormal IL-6 levels and 33% had lymphocytopenia. Chest CT mainly manifested as bilateral (62%), septal/subpleural (77%) and groundglass opacities (48%). The major differences between doctors and nurses manifested in laboratory indicators. As of the last observed date, no patient was transferred to intensive care unit or died. Fever (HR=0.57; 95% CI 0.36-0.90) and IL-6 levels greater than 2.9 pg/ml (HR=0.50; 95% CI 0.30-0.86) were unfavorable factors for discharge. Conclusions: Our findings suggested that the infection of medical staff mainly occurred at the early stages of SARS-CoV-2 epidemic in Wuhan, and only a small proportion of infection had an exact mode. Meanwhile, medical staff infected with COVID-19 have relatively milder symptoms and favorable clinical course than ordinary patients, which may be partly due to their medical expertise, younger age and less underlying diseases. The potential risk factors of fever and IL-6 levels greater than 2.9 pg/ml could help to identify medical staff with poor prognosis at an early stage.

Xiling Hu,1,* Yao Zhang,2,* Shuo Lin,2 Xiaodi Guo,2 Dan Yang,3 Mengyin Cai,2,* Lingling Gao3,* 1Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China; 3School of Nursing, Sun Yat-Sen University, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mengyin CaiDepartment of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, Guangdong 510630, People’s Republic of ChinaTel +86 13922131451Email my.sabrina.c@163.comLingling GaoSchool of Nursing, Sun Yat-Sen University, No. 74, Zhongshan Er Road, Guangzhou, Guangdong 510085, People’s Republic of ChinaTel +86 13539965693Email gaoll@mail.sysu.edu.cnPurpose: To investigate the dietary knowledge, attitude and practice (KAP) among the family members (FMs) of Chinese type 2 diabetes mellitus (T2DM) patients and its influence on the KAP of T2DM patients.Patients and Methods: Two hundred thirty-six pairs of hospitalized T2DM patients and their FMs (472 in total) in our hospital were enrolled. A pair of self-designed questionnaires on dietary KAP (Cronbach’s α ≥ 0.763, I-CVI ≥ 0.857, S-CVI = 0.964, 0.958) were used to collect data and assess the KAP towards diabetes diets.Results: The mean score for dietary KAP of T2DM patients was 2.33 ± 0.60, 3.03 ± 0.44 and 2.77 ± 0.38, whereas that of their FMs was 2.37 ± 0.55, 3.08 ± 0.48 and 2.82 ± 0.61, respectively. Pearson’s correlation analysis showed that the glycosylated hemoglobin (HbA1c) of T2DM patients was negatively correlated to their dietary practice (r = − 0.218, P < 0.01). There was a positive correlation between T2DM patients and their FMs for dietary KAP (r = 0.306, P < 0.05). The dietary practice of T2DM patients was positively correlated with the dietary KAP of their FMs (r = 0.305, 0.252 and 0.136, respectively, P < 0.01). Logistic regression analysis revealed that the score for dietary knowledge and attitude, occupation, residence, family history, complications of the T2DM patient, and the sex and dietary knowledge score of the FM were significantly associated with dietary practice for T2DM patients.Conclusion: The dietary attitude of FMs was moderate but dietary knowledge and practice were poor. Dietary KAP was positively correlated with T2DM patients and their FMs.Keywords: type 2 diabetes mellitus, self-management, family characteristics

Purpose: To analyze the chest CT imaging findings of patients with initial negative RT-PCR and to compare with the CT findings of the same sets of patients when the RT-PCR turned positive for SARS-CoV-2 a few days later. Materials and methods: A total of 32 patients (8 males and 24 females; 52.9±7years old) with COVID-19 from 27 January and 26 February 2020 were enrolled in this retrospective study. Clinical and radiological characteristics were analyzed. Results: The median period (25%, 75%) between initial symptoms and the first chest CT, the initial negative RT-PCR, the second CT and the positive RT-PCR were 7(4.25,11.75), 7(5,10.75), 15(11,23) and 14(10,22) days, respectively. Ground glass opacities was the most frequent CT findings at both the first and second CTs. Consolidation was more frequently observed on lower lobes, and more frequently detected during the second CT (64.0%) with positive RT-PCR than the first CT with initial negative RT-PCR (53.1%). The median of total lung severity score and the number of lobes affected had significant difference between twice chest CT (P=0.007 and P=0.011, respectively). Conclusion: In the first week of disease course, CT was sensitive to the COVID-19 with initial negative RT-PCR. Throat swab test turned positive while chest CT mostly demonstrated progression.

Dental pulp stem cells are a type of adult stem cells with strong proliferative ability and multi-differentiation potential. There are no studies on treatment of vascular dementia with dental pulp stem cells. In the present study, rat models of vascular dementia were established by two-vessel occlusion, and 30 days later, rats were injected with 2 × 107 dental pulp stem cells via the tail vein. At 70 days after vascular dementia induction, dental pulp stem cells had migrated to the brain tissue of rat vascular dementia models and differentiated into neuron-like cells. At the same time, doublecortin, neurofilament 200, and NeuN mRNA and protein expression levels in the brain tissue were increased, and glial fibrillary acidic protein mRNA and protein expression levels were decreased. Behavioral testing also revealed that dental pulp stem cell transplantation improved the cognitive function of rat vascular dementia models. These findings suggest that dental pulp stem cell transplantation is effective in treating vascular dementia possibly through a paracrine mechanism. The study was approved by the Animal Ethics Committee of Harbin Medical University (approval No. KY2017-132) in 2017.