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This note considers the design and analysis of a distributed sensor fault accommodation scheme for a class of nonlinear dynamical systems, modelled as interconnected subsystems. Each subsystem is subject to possible local sensor faults or may be impacted by a sensor fault in a neighboring subsystem due to the exchange of information between neighboring controllers. The proposed adaptive approximation-based distributed fault accommodation scheme is triggered in the event that a sensor fault is detected. The stability of the closed-loop system in the presence of sensor faults is rigorously analyzed both for the period prior to the detection of the fault, as well as after the detection of the fault when the fault accommodation scheme is activated. The effectiveness of the proposed scheme is illustrated by a simulation example.

The event-triggered fault accommodation problem for a class of nonlinear uncertain systems is considered in this paper. The control signal transmission from the controller to the system is determined by an event-triggering scheme with relative and constant triggering thresholds. Considering the event-induced control input error and system fault threat, a novel event-triggered active fault accommodation scheme is designed, which consists of an event-triggered nominal controller for the time period before detecting the occurrence of faults and an adaptive approximation based event-triggered fault accommodation scheme for handling the unknown faults after detecting the occurrence of faults. The closed-loop stability and inter-event time of the proposed fault accommodation scheme are rigorously analyzed. Special cases for the fault accommodation design under constant triggering threshold are also derived. An example is employed to illustrate the effectiveness of the proposed fault accommodation scheme.

Renewable energy generation, as part of the global effort to mitigate climate change, will play a central role in reducing greenhouse gas emissions and achieving China’s goal of carbon emissions peak before 2030 and carbon neutral before 2060. However, the impact of carbon quota auctions on renewable energy generation has not been sufficiently discussed. The main purpose of this study is to investigate whether China can rely on quota auctions to increase renewable energy generation in the short term, and to demonstrate which is more effective in promoting renewable energy development, policy enforcement or auction constraints? The improved neo-trans-log production model, the multi-objective linear programming model and the dispatch heuristic were used to predict additional emission reduction cost, optimized power mix with different auctioning rates, with economic development, technological progress and the unique characteristics of China's power generation industry being taken into consideration. The results show that the auctioning rate will have little influence on the optimized energy production structure, especially on the share of renewable energy resources; when the total on-grid electricity generation ranges from 7625‒7926 billion kW h and the auctioning rate ranges from 0%‒5%, policy enforcement will influence the generation of renewable energy to a greater extent than auctioning in the near future.

Bus services play a crucial role in urban transit. It is significant to achieve the fine-grained service-level passenger flow prediction (SPFP), namely to predict the total number of passengers for each service of each bus line passing through each station during the next short-term interval. However, it faces great challenges due to complex factors including inter-station and inter-line spatial dependencies, intra-station and inter-service temporal dependencies, and internal/external influences. To address these challenges, we propose a multitask deep-learning (MDL) approach, called MDL-SPFP , to jointly predict the arriving bus service flow, line-level on-board passenger flow and line-level boarding/alighting passenger flow by leveraging well-designed deep neural networks called ARM . The MDL framework can mutually reinforce the prediction of each type of flow, and finally integrate the outputs to achieve the fine-grained service-level prediction. The ARM network combines three modules, Attention mechanism, Residual block and Multi-scale convolution, to well capture various complex non-linear spatio-temporal dependencies and influence factors. Extensive experiments based on a large-scale realistic bus operation dataset are conducted to confirm that our MDL-SPFP approach outperforms 10 state-of-the-art baselines, and improves 22.39% accuracy than the best baseline.

The purpose of the study was to investigate whether premenopausal body mass index (BMI) and waist circumference (WC) influence age at menopause. A total of 2116 women aged 35-64 years from two communities of the CMCS Beijing cohort were recruited in 1992 and followed up to 2018. Of 1439 premenopausal women at baseline, 6 women data were missing. Finally, 1433 women were included for analysis. Overweight was defined as BMI 24-27.99 kg/m

Background: The association between preoperative overt hypothyroidism and early outcomes after coronary artery bypass grafting (CABG) is unclear. This study aimed to evaluate the influence of overt hypothyroidism on the outcomes of CABG. Methods: The series included 189 overt hypothyroid patients, who underwent CABG at Fuwai Hospital. These patients were 1:4 matched with 737 euthyroid patients using propensity score matching. The early postoperative outcomes were compared. Results: After propensity score matching, the incidences of impaired wound healing, reintubation, and the total complications were higher in hypothyroid patients than euthyroid patients (11.8% vs. 0.9%, P < 0.001; 2.1% vs. 0.4%, P = 0.03; 39.6% vs. 30.3%, P = 0.015, respectively). Multivariate analysis showed overt hypothyroidism was significantly associated with the occurrence of impaired wound healing (odds ratio [OR]=12.29, P < 0.001), reintubation (OR=5.71, P = 0.047), and the total complications (OR=1.31, P = 0.049). The OR of the total complications was 1.43 (P = 0.03) in hypothyroid patients with abnormal thyroid-stimulating hormone compared with euthyroid patients. The proportions of the use of dopamine, adrenaline, milrinone, and dobutamine in hypothyroid patients were higher than euthyroid patients (75.4% vs. 67.6%, P = 0.038; 10.7% vs. 6.1%, P = 0.028; 3.2% vs. 0.3%, P = 0.001; 4.8% vs. 1.2%, P = 0.004, respectively). The total duration of inotropic support and mechanical ventilation time in hypothyroid patients were longer than euthyroid patients (median duration: 4 days vs. 3 days, P = 0.003; 17 hours vs. 15 hours, P < 0.001, respectively). Conclusions: CABG in overt hypothyroid patients is associated with a higher incidence of postoperative complications, stronger postoperative inotropic support, and longer mechanical ventilation time.

Previous reports demonstrated a bleeding avoidance potential of angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) and β-blocker. It remains unclear whether early guideline-directed medical therapy [GDMT, i.e., the combined use of β-blocker, angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) and statin] confers protection against bleeding in the setting of high-intensity antithrombotic therapy. We assessed associations between the use of early (within the first 24 h) GDMT and in-hospital major bleeds, ischemic events and mortality among ST-elevation myocardial infarction (STEMI) patients treated with percutaneous coronary intervention (PCI) in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project. Among 34,538 STEMI patients without contra-indications to GDMT and eligible for analysis, 35.5% received early GDMT. In a 1-to-2 propensity-score matched cohort, compared with non-early GDMT, early GDMT was associated with a 25% reduction in major bleeds [odds ratio (OR) 0.75, 95% confidence interval (CI) 0.60–0.94], with parallel reductions in ischemic events (OR 0.60, 95%CI 0.45–0.78) and in-hospital mortality (OR 0.43, 95%CI 0.31–0.61). Early GDMT-associated reduction in major bleeds was generally consistently observed across different major bleeding definitions and in sensitivity analyses. Additionally, no significant interaction was observed in subgroup analyses. In a large nationwide registry, early initiation of GDMT was associated with reduced risk for in-hospital major bleeds in STEMI patients treated with PCI. To improve the outcome of STEMI, further effort should be made to reinforce the early use of GDMT in this patient population.

N6-methyladenosine (m6A) has recently emerged as an important regulatory mechanism for gene expression and aberrant m6A modification plays an important role in tumor progression. Emerging evidence has shown that aberrant m6A modification induced by cigarette smoking is involved in carcinogenesis, but whether cigarette smoking affects m6A modification and thus deteriorates to non-small cell lung cancer (NSCLC) is still unclear. Here, we identified a tumor suppressor gene-DAPK2 which was significantly associated with poor prognosis of NSCLC patients, especially in patients with a smoking history. Low levels of DAPK2 were detected in smokers and in NSCLC tissues. Cigarette smoking induced aberrant N6-methyladenosine modification of DAPK2, which resulted in decreased DAPK2 mRNA stability and expression of its mRNA and protein. This modification was mediated by the m6A “writer” METTL3 and the m6A “reader” YTHDF2. Mechanistically, we further demonstrated that DAPK2 functions as a tumor suppressor and downregulation of DAPK2 substantially enhances the proliferation and migration abilities in vitro and in vivo by activating NF-κB signaling pathway. Notably, the BAY 11–7085, a NF-κB signaling selective inhibitor, was shown to efficiently suppressed downregulation of DAPK2-induced oncogenic phenotypes of NSCLC cells. Our study reveals that cigarette smoking induces aberrant N6-methyladenosine of DAPK2 to promote NSCLC progression, which provides new insight into the mechanisms of NSCLC progression and a specific therapeutic target for NSCLC patients with a smoking history.

Background Obesity is known as a common risk factor for osteoporosis and type 2 diabetes mellitus (T2DM). Perirenal fat, surrounding the kidneys, has been reported to be unique in anatomy and biological functions. This study aimed to explore the relationship between perirenal fat and bone metabolism in patients with T2DM. Methods A total of 234 patients with T2DM were recruited from September 2019 to December 2019 in the cross-sectional study. The biochemical parameters and bone turnover markers (BTMs) were determined in all participants. Perirenal fat thickness (PrFT) was performed by ultrasounds via a duplex Doppler apparatus. Associations between PrFT and bone metabolism index were determined via correlation analysis and regression models. Results The PrFT was significantly correlated with β-C-terminal telopeptides of type I collagen (β-CTX) (r = −0.14, P < 0.036), parathyroid hormone (iPTH) (r = −0.18, P ≤ 0.006), and 25 hydroxyvitamin D (25-OH-D) (r = −0.14, P = 0.001). Multivariate analysis confirmed that the association of PrFT and β-CTX (β = −0.136, P = 0.042) was independent of other variables. Conclusion This study showed a negative and independent association between PrFT and β-CTX in subjects with T2DM, suggesting a possible role of PrFT in bone metabolism. Follow-up studies and further research are necessary to validate the associations and to elucidate the underlying mechanisms.

Dopamine depletion and microstructural degradation underlie the neurodegenerative processes in Parkinson’s disease (PD). To explore early alterations and underlying associations of dopamine and microstructure in PD patients utilizing the hybrid positron emission tomography (PET)-magnetic resonance imaging (MRI). Twenty-five PD patients in early stages and twenty-four matched healthy controls underwent hybrid 18F-fluorodopa (DOPA) PET-diffusion tensor imaging (DTI) scanning. The striatal standardized uptake value ratio (SUVR), DTI maps (fractional anisotropy, FA; mean diffusivity, MD) in subcortical grey matter, and deterministic tractography of the nigrostriatal pathway were processed. Values in more affected (MA) side, less affected (LA) side and mean were analysed. Correlations and mediations among PET, DTI and clinical characteristics were further analysed. PD groups exhibited asymmetric pattern of dopaminergic dysfunction in putamen, impaired integrity in the microstructures (nigral FA, putaminal MD, and FA of nigrostriatal projection). On MA side, significant associations between DTI metrics (nigral FA, putaminal MD, and FA of nigrostriatal projection) and motor performance were significantly mediated by putaminal SUVR, respectively. Early asymmetric disruptions in putaminal dopamine concentrations and nigrostriatal pathway microstructure were detected using hybrid PET-MRI. The findings further implied that molecular degeneration mediates the modulation of microstructural disorganization on motor dysfunction in the early stages of PD., To explore early alterations and underlying associations of dopamine levels and microstructure in Parkinson’s Disease (PD), Shang et al use a hybrid positron emission tomography (PET)-magnetic resonance imaging (MRI) approach in early stage patients and age-matched controls. Their data implies that molecular degeneration mediates the effects of microstructural disorganization on motor dysfunction in the early stages of PD.

Dyskalemia involves critical electrolyte abnormalities and increases mortality risk in patients with acute clinical conditions. However, the association between dyskalemia and adverse outcomes in the general population is less well established. To investigate the association of serum potassium levels with mortality and cardiovascular events in the general population and to explore the characteristics of individuals at high risk. A prospective cohort study. A total of 5220 participants aged 50–79 years in the Chinese Multi-provincial Cohort Study. Serum potassium levels were measured by the ion-selective electrode method. The outcomes were incident cardiovascular disease (CVD), CVD death, non-CVD death, and total death. Of the 5220 participants, 48.2% were men, and the mean age was 62.3 (SD 7.6) years. Hyperkalemia was found in 8.7% of the participants and was significantly associated with total death (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.18–2.23) and CVD death (HR, 2.12; 95% CI, 1.25–3.61) after adjustment. Furthermore, the HRs (95% CIs) of hyperkalemia combined with 2 and ≥ 3 risk factors were 2.37 (1.50–3.74) and 4.06 (2.37–6.95) for total death and 3.26 (1.56–6.80) and 8.42 (4.06–17.50) for CVD death, respectively. The 10-year cumulative incidence of total death was 17.4% for participants with 2 or more risk factors. Hyperkalemia is associated with an increased risk of all-cause and CVD death, and this risk is more pronounced in patients with multiple risk factors. Our findings suggest that early identification and management of hyperkalemia in the general population are warranted.

Background and objectives This study aimed to compare outcomes between neoadjuvant imatinib and upfront surgery in patients with localized rectal gastrointestinal stromal tumors (GIST) patients. Methods Eighty-five patients with localized rectal GIST were divided into two groups: upfront surgery ± adjuvant imatinib (Group A, n = 33) and the neoadjuvant imatinib + surgery + adjuvant imatinib (Group B, n = 52). Baseline characteristics between groups were controlled for with inverse probability of treatment weighting (IPTW) adjusted analysis. Results The response rate to neoadjuvant imatinib was 65.9%. After the IPTW-adjusted analysis, patients who underwent neoadjuvant therapy had better distant recurrence-free survival (DRFS) and disease-specific survival (DSS) compared with those who underwent upfront surgery (5-year DRFS 97.8 vs. 71.9%, hazard ratio [HR], 0.15; 95% CI, 0.03-0.87; p = 0.03; 5-year DSS 100 vs. 77.1%; HR, 0.11; 95% CI, 0.01-0.92; p = 0.04). While no significant association was found between overall survival (OS) and treatment groups (p = 0.07), 5-year OS was higher for the neoadjuvant group than upfront surgery group (97.8% vs. 71.9%; HR, 0.2; 95% CI, 0.03-1.15). Conclusions In patients with localized rectal GIST, neoadjuvant imatinib not only shrunk the tumor size but also decreased the risk of metastasis and tumor-related deaths when compared to upfront surgery and adjuvant imatinib alone.

Cerebral ischaemia is accompanied by infectious complications due to immunosuppression, known as stroke-induced immunodepression (SIID). Orexin-A (OXA), a neuropeptide produced in the hypothalamus, has been reported to have neuroprotective properties after stroke and is known to modulate inflammatory processes in peripheral tissues. The aim of this study was to determine the effects of orexin-A (OXA) on cerebral ischaemic inflammatory injury and SIID following experimental stroke. Cerebral ischaemia was induced in C57/BL6 mice by middle cerebral artery occlusion (MCAO). A mouse model of pneumonia and poststroke pneumococcal pneumonia was established by intratracheal inoculation with S. pneumoniae in a normal mouse or MCAO mouse model on the third day. We found that OXA postconditioning inhibited cerebral ischaemic inflammatory injury. The mechanism involved downregulation of the NF-κB signalling pathway. In addition, OXA may serve as a potential treatment target for attenuating stroke-induced immunodepression in mice.

As a common chronic metabolic disease, the development of diabetes mellitus (DM) may also be accompanied by liver damage and inflammatory disorders. Sitagliptin is an inhibitor of dipeptidyl peptidase-4 (DPP4, also known as CD26), which is clinically used for DM treatment. However, the mechanism of sitagliptin’s efficiency in liver diseases is largely unknown. In this study, mice suffering from streptozotocin (STZ) exhibit elevated liver DPP4 expression and activity, as well as inflammatory and chronic liver injury phenotype, whereas specifically inhibiting the activity of DPP4 in mouse liver tissues and hepatocytes by sitagliptin contributes to decreased cytokines, oxidative stress, cell apoptosis, and inflammation in STZ-induced diabetic mice. Moreover, sitagliptin reduced TNFα or LPS-induced cellular reactive oxygen species (ROS) level, cell apoptosis, and protein expression in the NFκB signaling pathway in HepG2 cells or primary mouse hepatocytes. Altogether, our study confirms that sitagliptin may protect liver tissue by alleviating ROS production and NFκB signaling activation, providing a putative mechanism for preventing the development of diabetic liver disease.

Mobile crowdsensing (MCS) and unmanned vehicle sensing (UVS) provide two complementary paradigms for large-scale urban sensing. Generally, MCS has a lower cost but often confronts sensing imbalance and even blind areas due to the limitation of human mobility, whereas UVS is often capable of completing more demanding tasks at the expense of limited energy supply and hardware cost. Thus, it is significant to investigate whether we could integrate the two paradigms for high-quality urban sensing in a cost-effective collaborative way. However, it is nontrivial due to complex and long-term optimization objectives, uncontrolled dynamics, and a large number of heterogeneous agents. To address the collaborative sensing problem, we propose an actor–critic-based heterogeneous collaborative reinforcement learning (HCRL) algorithm, which leverages several key ideas: local observation to handle expanded state space and extract the states of neighbor nodes, generalized model to avoid environment nonstationarity and ensure the scalability and stability of network, and proximal policy optimization to prevent the destructively large policy updates. Extensive simulations based on a mobility model and a realistic trace data set are conducted to confirm that HCRL outperforms the state-of-the-art baselines.

Objective. Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes, leading to disability and decreased quality of life. In past research and clinical studies, the lower limb function of DPN patients was often the principal subject of research, with little attention given to the upper limb and hand. Our goal was to assess and compare hand function between elderly diabetic patients with DPN and without DPN. Methods. A total of 52 diabetic patients were registered and underwent hand function assessments and electrodiagnostic tests. Dynamometer, pinch meter, Semmes Weinstein monofilaments, and the Purdue Pegboard Test (PPT) were used to assess the patients’ grip strength, pinch strength, tactile sensory threshold, and hand dexterity. Results. Compared with the non-DPN group, the elderly DPN group showed worse thumb-middle fingertip pinch strength and thumb-little fingertip pinch strength in the dominant hand (3.50 (2.50, 4.25) vs. 4.50 (3.00, 5.00), p = 0.019 ; 1.50 (1.00, 2.00) vs. 2.50 (2.00, 3.00), p < 0.001 ); the elderly DPN group displayed worse thumb-middle fingertip pinch strength, thumb-ring fingertip pinch strength, and thumb-little fingertip pinch strength in the nondominant hand (3.50 (2.00, 4.50) vs. 4.00 (3.00, 5.00), p = 0.013 ; 2.50 (1.25, 3.00) vs. 3.00 (2.50, 3.50), p = 0.033 ; 1.00 (0.75, 2.25) vs. 2.50 (2.00, 2.50), p < 0.001 ). The elderly DPN group scored lower than the non-DPN group on the PPT test of assembly ( 13.96 ± 5.18 vs. 16.96 ± 4.61 , t = 2.212 , p = 0.032 ). Conclusion. Motor function limitation is the principal hand dysfunction in elderly patients with DPN, which is mainly manifested as a decline in fingertip pinch strength and a decrease in hand dexterity. This trial is registered with Clinical Trial Registry no. ChiCTR1900025358.

Marine structures are inevitably influenced by parametric perturbations as well as multiple external loadings. Among these loadings, earthquake is generally more destructive and unpredictable than others. It is significant to develop effective active control schemes to guarantee the safety, stability, and integrity of marine structures subject to earthquakes and parametric perturbations. In this paper, the problem of networked [Formula: see text] robust damping control is addressed to stabilize a marine structure subject to earthquakes. First, in consideration of perturbations of the structure parameters, an uncertain model of the networked marine structure under earthquakes is presented. Second, a robust networked [Formula: see text] control scheme is presented to suppress seismic responses of the structure. By using stability theory of time-delay systems, several sufficient conditions on robust stability of the networked marine structure system are obtained, and the linear matrix inequality methods are utilized to solve the gain matrix of the controller. Finally, simulation indicates that compared with the traditional robust [Formula: see text] control and the proposed networked [Formula: see text] control, the seismic responses amplitudes of the marine structure under the two controllers are almost the same, while the latter is more economic than the former.

This article examines the importance of managing the costs of modern corporate structures at a strategic level, in the context of the specific crisis caused by the COVID-19 coronavirus pandemic. The strategic cost management system is considered as a complex tool for improving the efficiency of the corporate structure. We made the analysis of this system from three positions: the concept of the value chain, the concept of strategic positioning, the concept of factor analysis. We introduced a new notion of “business quality” which is applicable to modern corporate structures at the strategic level. The notion is characterized by two main approaches: from the point of view of internal mechanisms of corporate governance (an objective approach based on obtaining comprehensive information) and from the point of view of external mechanisms (a subjective approach based on the attitude of external stakeholders to the value of corporate securities).

Incentive mechanism design has aroused extensive attention for crowdsourcing applications in recent years. Most research assumes that participants are already in the system and aware of the existence of crowdsourcing tasks. Whereas in real-life scenarios without this assumption, it is more effective to leverage incentive tree mechanisms that incentivize both users’ direct contributions and solicitations to other users. Although such mechanisms have been investigated, we are the first to propose budget-balanced incentive tree mechanisms, called generalized lottrees , which require the total payout to be equal to the announced budget, while guaranteeing several desirable properties including continuing contribution incentive , continuing solicitation incentive , value proportional to contribution , unprofitable solicitor bypassing , and unprofitable Sybil attack . Moreover, three types of generalized lottree mechanisms, 1-Pachira , $K$ K -Pachira and Sharing-Pachira , are presented for supporting diversified requirements. A solid theoretical guideline on the mechanism selection is provided based on the Cumulative Prospect Theory. Both extensive simulations and realistic experiments with 82 users are conducted to confirm our theoretical analysis.

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in patients with chronic kidney disease (CKD) and acute coronary syndrome (ACS). This study aimed to explore the frequency and impact of AF on clinical outcomes in CKD patients with ACS. Methods CKD inpatients with ACS between November 2014 and December 2018 were included based on the improving care for cardiovascular disease in China-ACS (CCC-ACS) project. Included patients were divided into an AF group and a non-AF group according to the discharge diagnosis. Multivariable logistic regression was used to adjust for potential confounders. Results A total of 16,533 CKD patients with ACS were included. A total of 1418 (8.6%) patients had clinically recognized AF during hospitalization, 654 of whom had an eGFR of 45 to 2, and 764 had an estimated glomerular filtration rate (eGFR) 2. Compared with the non-AF group, the AF group had a higher risk of in-hospital mortality [OR 1.250; 95% CI (1.001–1.560), P = 0.049] and major adverse cardiovascular events (MACEs) [OR 1.361; 95% CI (1.197–1.547), P 2, patients with eGFR 2 had a 1.512-fold increased risk of mortality and a 1.435-fold increased risk of MACEs. Conclusions AF was a risk factor affecting the short-term prognosis of ACS patients in the CKD population. Furthermore, the lower the eGFR, the higher the risk of in-hospital mortality and MACEs in CKD patients with ACS. Trial registry: Clinicaltrial.gov, NCT02306616. Registered 29 November 2014, https://clinicaltrials.gov/ct2/show/NCT02306616?term=NCT02306616&draw=2&rank=1

As a simple binary compound, p-type SnS shows great competitiveness in thermoelectrics due to the certain appealing carrier and phonon transport behaviors, coupled with its cost-effectiveness, earth-abundance and environmental compatibility. To promote the application of low-cost thermoelectric devices, we synthesized n-type SnS crystals through bromine doping. Herein, we report a high in-plane power factor of ∼28 µW cm−1 K−2, and attribute it to an outstanding in-plane carrier mobility in the crystal form and the large Seebeck coefficient benefitting from the low carrier concentration. The calculations of elastic properties show that the low lattice thermal conductivity in SnS is closely related to its strong anharmonicity. Combining the excellent electrical transport properties with low thermal conductivity, a final ZT of ∼0.4 is attained at 300 K, projecting a conversion efficiency of ∼5% at 873 K along the in-plane direction.

Mortise-and-tenon joints have been widely used for thousands of years in wooden architectures in virtue of their artistic and functional performance. However, imitation of similar structural and mechanical design philosophy to construct mechanically adaptive materials at the molecular level is a challenge. Herein, we report a mortise-and-tenon joint inspired mechanically interlocked network (MIN), in which the [2]rotaxane crosslink not only mimics the joint in structure, but also reproduces its function in modifying mechanical properties of the MIN. Benefiting from the hierarchical energy dissipative ability along with the controllable intramolecular movement of the mechanically interlocked crosslink, the resultant MIN simultaneously exhibits notable mechanical adaptivity and structural stability in a single system, as manifested by decent stiffness, strength, toughness, and deformation recovery capacity.

Due to significant differences in imaging mechanisms between multimodal images, registration methods have difficulty in achieving the ideal effect in terms of time consumption and matching precision. Therefore, this paper puts forward a rapid and robust method for multimodal image registration by exploiting local edge information. The method is based on the framework of SURF and can simultaneously achieve real time and accuracy. Due to the unpredictability of multimodal images’ textures, the local edge descriptor is built based on the edge histogram of neighborhood around keypoints. Moreover, in order to increase the robustness of the whole algorithm and maintain the SURF’s fast characteristic, saliency assessment of keypoints and the concept of self-similar factor are presented and introduced. Experimental results show that the proposed method achieves higher precision and consumes less time than other multimodality registration methods. In addition, the robustness and stability of the method are also demonstrated in the presence of image blurring, rotation, noise, and luminance variations.

Cardiovascular disease (CVD) is the leading cause of death in Asia. To combat the harmful impacts of CVD on public health in Asian countries with more effective strategies and actions, it is crucial to understand the current epidemiologic features of CVD in Asia. Through a systematic study and analysis of various timely data on CVD epidemiology in Asian countries from multiple sources, this state-of-the-art review provides an overview of the important epidemiologic features of CVD in Asia. Current and future challenges in CVD prevention implied by the epidemiologic features in Asian countries are highlighted and discussed in this review.

Facial nerve schwannomas located at internal auditory canal and cerebellopontine angle (IAC/CPA FNS) were diagnosed intraoperatively, it poses a therapeutic dilemma to the surgeon.To report our experience in managing IAC/CPA FNS and to propose a treatment strategy.A total of 14 patients with IAC/CPA FNS who were diagnosed intraoperatively and treated by operation between 2015 and 2019 were retrospectively studied.Unilateral hearing loss was the most common symptom and all these patients had normal facial nerve function preoperatively. Surgical approaches used in these patients including translabyrinthine (2 cases), retrosigmoid (RS) (11 cases), and middle cranial fossa (MCF) approach (1 case). Eight patients underwent partial resection, three patients underwent subtotal resection and three patients had complete tumor removal with facial nerve reconstruction. All partial resection patients and two patients underwent subtotal resection achieved a long-term HB grade I facial nerve function. The long-term facial nerve function of patients underwent complete resection and nerve grafting was no better than HB grade III.1 of the eight patients underwent partial resection experienced tumor regrowth during the follow-up.Partial or subtotal resection for IAC/CPA FNS may provide an opportunity of retaining excellent facial nerve function. Regular postoperative imaging is helpful to monitor the recurrence.

Background Omega-3 polyunsaturated fatty acids (PUFAs) produce lipid mediators with both anti-inflammatory and pro-resolution properties, including resolvins. The purpose of this study was to detect serum resolvin E1 (RVE1) levels in Hashimoto’s thyroiditis (HT) patients and healthy controls (HCs) and to evaluate the relationship of RVE1 with thyroid autoimmunity. Methods A total of 57 participants were recruited, including 30 untreated HT patients and 27 age- and sex‐matched HCs. The levels of RVE1 in serum were measured via enzyme-linked immunosorbent assay (ELISA). An electrochemiluminescence immunoassay was used for the measurement of thyroid-stimulating hormone (TSH), total T4 (TT4), TT3, free T4 (FT4), FT3, anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb) levels. Hemogram tests and routine biochemical analyses were performed on each sample. Results The serum level of RVE1 of HT patients (24.09, 15.76–34.38 pg/mL) was significantly lower than that of healthy controls (28.51, 20.76–51.23 pg/mL) (P = 0.027). RVE1 levels showed a downward trend with increasing TgAb levels (P for trend = 0.001). Multivariable ordinal logistic regression analysis showed that RVE1 levels were negatively correlated with increasing TgAb levels in both the unadjusted (OR = 0.9446, 95 % CI = 0.9111–0.9782, P = 0.002) and adjusted models (OR = 0.9380, 95 % CI = 0.8967–0.9811, P = 0.005). Conclusions Decreased RVE1 levels might be a sign that HT is associated with inflammatory resolution dysfunction. RVE1 may serve as a protective factor against increased TgAb levels.

Possessing inherently low thermal conductivity, BiSbSe3 is a promising thermoelectric material for medium temperature. Therefore, to substantially optimize the thermoelectric performance of BiSbSe3, researchers mainly focus on the strategies to improve its electrical transport properties. Among these strongly coupled thermoelectric parameters, carrier concentration and effective mass are two intrinsic variables to decisively affect the electrical transport properties. In this work, Cl as a donor dopant is effective to provide extra electrons in n-type BiSbSe3, and the carrier concentration and effective mass can be well optimized simultaneously with increasing Cl content owing to the multiple conduction bands in BiSbSe3. What’s more, maximum weighted mobility ∼53 cm2 V−1 s−1 is obtained in Cl-doped BiSbSe3, which contributes to a largely enhanced power factor ∼4.8 μW cm−1 K-2 at room temperature and outperforms other halogen-doped BiSbSe3 samples. Finally, combining the significantly enhanced power factor and maintained low thermal conductivity, a maximum ZT ∼1.0 is achieved in Cl-doped BiSbSe3 at 800 K.

Background The aim of this study was to examine the possible association between serum micronutrients (vitamin D, retinol, zinc), C-reactive protein (CRP), and obesity among children and adolescents. Methods Weight and height were measured and serum 25-hydroxy vitamin D, serum retinol, serum zinc, and CRP were measured in 2818 children and adolescents (6–17 years of age), and the data of 10 investigation sites in Zhejiang Province were used. The difference of micronutrients (vitamin D, retinol, zinc) and CRP among different nutritional status were explored by ANOVA and Chi-square test. The associated factors of micronutrients and CRP of overweight and obesity were explored by multifactor analysis. Results There were significant differences between male students and female students on BMI, 25(OH)D3, and CRP, and there were significant differences between children and adolescents and between students living in urban area and rural area on BMI, 25(OH)D3, retinol, and zinc(t > 1.96, p F = 2.612, 15.022, p Conclusion Gender, living area, age, CRP concentration, and vitamin A status were associated with children and adolescents with overweight and obesity compared to low/normal BMI. More attention in the intervention of overweight and obesity should be paid to boys living in urban areas, and high serum concentration of CRP should also be concerned.

Uniformly aligned silicon nanowire (SiNW) arrays are promising building blocks for a range of photoelectrical and sensing devices attributable to their unique optical, electrical, structural, mecha...

Objective This study investigated changes of plasma cytokines and aimed to build a dynamic nomogram for diabetic macular edema (DME) in type 2 diabetes mellitus (T2DM). Methods In a pilot cohort, plasma samples were selected from 9 T2DM patients and 9 DME patients to screen for cytokine differences. The screening cytokines were then validated by enzyme-linked immunoassay in a cohort, which contained 100 DME (DME group) and 100 T2DM patients without DME (T2DM group). A dynamic nomogram for predicting DME was developed, based on the plasma cytokines. Results In the pilot cohort, 11 plasma cytokines were significantly increased in the DME group. In the validation cohort, platelet-derived growth factor (PDGF)-BB, tissue inhibitors of metalloproteinase (TIMP)-1, angiopoietin (ANG-1), and vascular endothelial cell growth factor receptor (VEGFR)-2 were confirmed to be significantly elevated in the DME group. The dynamic nomogram demonstrated good calibration and discrimination, with an area under the receiver operating characteristic curve (AUC) of 0.88. In the test set, sensitivity, specificity, and AUC were 73.3%, 80.0%, and 0.84, respectively. Conclusion Plasma cytokines were closely associated with DME. A novel dynamic monogram including ANG-1, PDGF-BB, TIMP-1, and VEGFR2 was a novel tool for predicting DME.

Background:. Cumulative blood pressure (BP), a measure incorporating the level and duration of BP exposure, is associated with the risk of cardiovascular disease (CVD). However, the level at which cumulative BP could significantly increase the risk remains unclear. This study aimed to investigate the association of 15-year cumulative BP levels with the long-term risk of CVD, and to examine whether the association is independent of BP levels at one examination. Methods:. Data from a 26-year follow-up of the Chinese Multi-provincial Cohort Study-Beijing Project were analyzed. Cumulative BP levels between 1992 and 2007 were calculated among 2429 participants free of CVD in 2007. Cardiovascular events (including coronary heart disease and stroke) occurring from 2007 to 2018 were registered. Adjusted hazard ratios (HRs) for CVD incidence associated with quartiles of cumulative systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated. Results:. Of the 2429 participants, 42.9% (1042) were men, and the mean age in 2007 was 62.1 ± 7.9 years. Totally, 207 CVD events occurred during the follow-up from 2007 to 2018. Participants with higher levels of cumulative SBP or DBP exhibited a higher incidence rate of CVD (P

Background Subclinical hypothyroidism (SCH) is characterized by an elevated thyroid-stimulating hormone and normal free thyroxine. This study aimed to evaluate the influence of SCH on the recovery of patients after coronary artery bypass grafting (CABG). Methods From January 2015 to December 2018, 548 SCH patients and 6718 euthyroid patients who underwent CABG were identified. Propensity score matching was used to create two cohorts with similar baseline characteristics (n = 545 in each group). The early postoperative outcomes were compared. Results After CABG, there was no difference in the incidence of postoperative atrial fibrillation between the two groups (20.4% in the SCH group and 20.6% in the euthyroidism group; odds ratio: 0.99; 95% confidence interval: 0.74-1.33; p = 0.94). Subgroup analyses did not indicate an effect in any category of patients. The proportions of the use of dopamine and noradrenaline in the SCH group were higher than those in the euthyroid patients (76.7% vs. 68.6%, p = 0.003; 56.5% vs. 49.0%, p = 0.01, respectively). The total duration of inotropic support in the SCH group was longer than that in the euthyroid patients (median duration: 4 vs. 3 days, p = 0.002). The incidence of impaired wound healing was higher in the SCH group than in the euthyroid group (3.7% vs. 1.1%, p = 0.005). Conclusions Compared with euthyroidism, SCH is not associated with an increased risk of atrial fibrillation in patients undergoing CABG. It is associated with an increased risk of several minor perioperative problems, which should be anticipated and preemptively managed.

This paper addresses a fault accommodation issue for flexible hypersonic vehicles by the static output feedback. Firstly, a longitudinal dynamics for hypersonic vehicles is established in the ODE-b...

The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable morbidity and mortality. Tocilizumab, an inhibitor of IL-6, has been widely repurposed as a treatment of severely ill patients without robust evidence supporting its use. In this study, we aimed to systematically describe the effectiveness of treatment and prevention of the cytokine storms in COVID-19 patients with tocilizumab. In this multicentered retrospective and observational cohort study, 65 patients with COVID-19 receiving tocilizumab and 130 not receiving tocilizumab were propensity score matched at a ratio of 2:1 based on age, sex, and comorbidities from January 20, 2020 to March 18, 2020 in Wuhan, China. After adjusting for confounding, the detected risk for in-hospital death was lower in the tocilizumab group versus nontocilizumab group (hazard ratio = 0.47; 95% confidence interval = 0.25–0.90; p = 0.023). Moreover, use of tocilizumab was associated with a lower risk of acute respiratory distress syndrome (odds ratio = 0.23; 95% confidence interval = 0.11–0.45; p < 0.0001). Furthermore, patients had heightened inflammation and more dysregulated immune cells before treatment, which might aggravate disease progression. After tocilizumab administration, abnormally elevated IL-6, C-reactive protein, fibrinogen, and activated partial thromboplastin time decreased. Tocilizumab may be of value in prolonging survival in patients with severe COVID-19, which provided a novel strategy for COVID-19–induced cytokine release syndrome. Our findings could inform bedside decisions until data from randomized, controlled clinical trials become available.

Background The incidence and the risk factors of in-hospitalized acute kidney injury (AKI) in patients hospitalized for atrial fibrillation (AF) were unclear. Methods The Improving Care for Cardiovascular Disease in China-AF (CCC-AF) project is an ongoing registry and quality improvement project, with 240 hospitals recruited across China. We selected 4527 patients hospitalized for AF registered in the CCC-AF from January 2015 to January 2019. Patients were divided into the AKI and non-AKI groups according to the changes in serum creatinine levels during hospitalization. Results Among the 4527 patients, the incidence of AKI was 8.0% (361/4527). Multivariate logistic analysis results indicated that the incidence of in-hospital AKI in patients with AF on admission was 2.6 times higher than that in patients with sinus rhythm (OR 2.60, 95% CI 1.77–3.81). Age (per 10-year increase, OR 1.22, 95% CI 1.07–1.38), atrial flutter/atrial tachycardia on admission (OR 2.16, 95% CI 1.12–4.15), diuretics therapy before admission (OR 1.48, 95% CI 1.07–2.04) and baseline hemoglobin (per 20 g/L decrease, OR 1.21, 95% CI 1.10–1.32) were independent risk factors for in-hospital AKI. β blockers therapy given before admission (OR 0.67, 95% CI 0.51–0.87) and non-warfarin therapy during hospitalization (OR 0.71, 95% CI 0.53–0.96) were associated with a decreased risk of in-hospital AKI. After adjustment for confounders, in-hospital AKI was associated with a 34% increase in risk of major adverse cardiovascular (OR 1.34, 95% CI 1.02–1.90, p = 0.023). Conclusions Clinicians should pay attention to the monitoring and prevention of in-hospital AKI to improve the prognosis of patients with AF.

Among the intricately coupled thermoelectric parameters, carrier effective mass (m*) and carrier density (n) are two key parameters to determine the electrical transport properties. To enhance the broad-temperature thermoelectric performance in n-type PbSe, this work elaborately optimizes its power factor with the intrinsically proportional relationship between carrier effective mass and carrier density, n ∼ (m*)3/2. Herein, the carrier effective mass in n-type PbSe is first optimized with Sn alloying and undergoes a decrease from ∼0.34me in PbSe to ∼0.25me in Pb0.77Sn0.23Se because of band sharpening. This reduced carrier effective mass contributes to an obvious enhancement of carrier mobility, thereby boosting the maximum power factor from ∼16.8 μW cm−1 K−2 in PbSe to ∼20.5 μW cm−1 K−2 in Pb0.85Sn0.15Se. Moreover, to match the reduced carrier effective mass in n-type Pb0.85Sn0.15Se, its carrier density is well tuned with Ag counter doping, which further facilitates a high average power factor in the whole working temperature range. The average power factor in Pb0.85Sn0.15Se systems increases from ∼15.6 μW cm−1 K−2 with a carrier density of ∼6.21 × 1019 cm−3 to ∼17.6 μW cm−1 K−2 with a carrier density of ∼2.12 × 1019 cm−3 at 300–873 K. Finally, an average ZT (ZTave) of ∼0.95 is achieved in the n-type Pb0.85Sn0.15Se sample at 300–873 K, and the sample outperforms most other n-type PbSe-based thermoelectric materials.

Cold injury refers to local or systemic injury caused by a rapid, massive loss of body heat in a cold environment. The incidence of cold injury is high. However, the current situation regarding the diagnosis and treatment of cold injury in our country is not ideal. To standardize and improve the level of clinical diagnosis and treatment of cold injury in China, it is necessary to make a consensus that is practical and adapted to the conditions in China. We used the latest population-level epidemiological and clinical research data, combined with relevant literature from China and foreign countries. The consensus was developed by a joint committee of multidisciplinary experts. This expert consensus addresses the epidemiology, diagnosis, on-site emergency procedures, in-hospital treatment, and prevention of cold injury.

Background: Previous studies from high altitudes have reported significantly higher prevalence of congenital heart disease (CHD), consisting almost solely of simple CHD. Little is known about the occurrence of complex CHD. Neonates with complex CHD are likely admitted to NICU. We examined the prevalence and spectrum of complex CHD in NICU in order to depict a truer picture of CHD at high altitude.Methods: We reviewed charts of 4,214 neonates admitted to NICU in Qinghai province (average altitude 3,000m). Echocardiography was performed in 1,943 babies when CHD was suspected based on clinical examinations.Results: CHD was diagnosed in 1,093(56.3% of echoed babies). Mild CHD in 96.8%(1058 babies). Moderate CHD in 0.8%(9) included 1(0.1%) large secundum atrial septal defect, 3(0.3%) moderate pulmonary stenosis, 2(0.2%) aortic stenosis and 3(0.3%) partial anomalous pulmonary venous connection. Severe CHD in 2.4%(26) included 6(0.5%) complete atrioventricular septal defect, 5(0.5%) complete transposition of the great arteries, 5(0.5%) hypoplastic right heart, 3(0.3%) hypoplastic left heart, 3(0.3%) double outlet right ventricle, 3(0.3%) tetralogy of Fallot, 2(0.2%) truncus arteriosus, 2(0.2%) total anomalous pulmonary venous connection, 2(0.2%) severe aortic stenosis, 2(0.2%) Interrupted aortic arch and 2(0.2%) severe pulmonary stenosis and 1(0.1%) single-ventricle abnormality. At two-years follow-up in 737(67.4%) patients, 18(90%) with severe CHD and 38(5.3%) with mild and moderate CHD died, and 15 underwent cardiac surgery with 1 early death.Conclusions: At high altitude, a wide spectrum of CHD exists, with many heretofore unreported complex CHD. There is urgent need for routine echocardiography and early interventions in newborns particularly in NICU.

Few large-sample research data sets exist on long-term survival and prognostic factors among patients with primary malignant melanoma of the esophagus (PMME), a rare malignancy associated with poor outcomes. We sought to investigate postoperative survival and prognostic factors in patients with PMME.We retrospectively analyzed long-term follow-up results for patients with PMME who underwent surgery at 10 Chinese centers between January 1998 and January 2018. We performed uni- and multivariate analyses to investigate clinicopathologic factors associated with survival.Median overall survival for the entire group (N = 70 patients) was 13.5 months. Female sex (hazard ratio [HR], 0.352; 95% confidence interval [CI], 0.138-0.900; P = .029), ≥12 lymph nodes dissected (HR, 0.274; 95% CI, 0.133-0.563; P .001), absence of lymph node metastasis (HR, 0.195; 95% CI, 0.084-0.451; P .001), and postoperative adjuvant therapy (HR, 0.474; 95% CI, 0.249-0.901; P = .023) were factors of favorable prognosis. Preoperative pathologic diagnosis of PMME was as low as 47.1%. A high proportion of patients had lymph node metastasis, including those with early-stage tumors. Rates of lymph node metastasis were 54.2% (13/24) for pT1, 44.4% (12/27) for pT2, 57.1% (8/14) for pT3, and 100% (5/5) for pT4. Regional lymph node recurrence (N = 43 [61.4%]) was the predominant postoperative pattern of recurrence or metastasis.Female sex, pN0, increased number of lymph nodes dissected, and postoperative adjuvant therapy were associated with better outcomes among patients with PMME. Preoperative pathologic diagnosis of PMME was low, patients had lymph node metastasis (even those with early-stage tumors), and regional lymph node recurrence was common.

Aims The potential difference in the impacts of lifestyle factors (LFs) on progression from healthy to first cardiometabolic disease (FCMD), subsequently to cardiometabolic multimorbidity (CMM), and further to death is unclear. Methods and results We used data from the China Kadoorie Biobank of 461 047 adults aged 30–79 free of heart disease, stroke, and diabetes at baseline. Cardiometabolic multimorbidity was defined as the coexistence of two or three CMDs, including ischaemic heart disease (IHD), stroke, and type 2 diabetes (T2D). We used multi-state model to analyse the impacts of high-risk LFs (current smoking or quitting because of illness, current excessive alcohol drinking or quitting, poor diet, physical inactivity, and unhealthy body shape) on the progression of CMD. During a median follow-up of 11.2 years, 87 687 participants developed at least one CMD, 14 164 developed CMM, and 17 541 died afterwards. Five high-risk LFs played crucial but different roles in all transitions from healthy to FCMD, to CMM, and then to death. The hazard ratios (95% confidence intervals) per one-factor increase were 1.20 (1.19, 1.21) and 1.14 (1.11, 1.16) for transitions from healthy to FCMD, and from FCMD to CMM, and 1.21 (1.19, 1.23), 1.12 (1.10, 1.15), and 1.10 (1.06, 1.15) for mortality risk from healthy, FCMD, and CMM, respectively. When we further divided FCMDs into IHD, ischaemic stroke, haemorrhagic stroke, and T2D, we found that LFs played different roles in disease-specific transitions even within the same transition stage. Conclusion Assuming causality exists, our findings emphasize the significance of integrating comprehensive lifestyle interventions into both health management and CMD management., Graphical Abstract High-risk lifestyle factors are associated with all disease transition stages from healthy to first cardiometabolic disease, to cardiometabolic multimorbidity, and then to death, but to different extents.

Aims This study aimed to investigate changes of plasma cytokines and to develop machine learning classifiers for predicting non-proliferative diabetic retinopathy among type 2 diabetes mellitus patients. Results There were 12 plasma cytokines significantly higher in the non-proliferative diabetic retinopathy group in the pilot cohort. The validation cohort showed that angiopoietin 1, platelet-derived growth factor-BB, tissue inhibitors of metalloproteinase 2 and vascular endothelial growth factor receptor 2 were significantly higher in the NPDR group. Machine learning algorithms using the random forest yielded the best performance, with sensitivity of 92.3%, specificity of 75%, PPV of 82.8%, NPV of 88.2% and area under the curve of 0.84. Conclusions Plasma angiopoietin 1, platelet-derived growth factor-BB, and vascular endothelial growth factor receptor 2 were associated with presence of non-proliferative diabetic retinopathy and may be good biomarkers that play important roles in pathophysiology of diabetic retinopathy. Materials and methods In pilot cohort, 60 plasma cytokines were simultaneously measured. In validation cohort, angiopoietin 1, CXC-chemokine ligand 16, platelet-derived growth factor-BB, tissue inhibitors of metalloproteinase 1, tissue inhibitors of metalloproteinase 2, and vascular endothelial growth factor receptor 2 were validated using ELISA kits. Machine learning algorithms were developed to build a prediction model for non-proliferative diabetic retinopathy.

All-dielectric nanostructures have attracted attention for highly efficient light manipulation. Higher Q-factor Fano resonance can be excited due to the rich phenomenology of optical modes supported by high-index dielectric materials with low intrinsic material loss, including both electric and magnetic multipolar Mie resonances. So far, there have been few studies done on the sensing with Fano-resonant all-dielectric resonator nanostructures. Here, an all-dielectric self-referenced optical sensor is numerically demonstrated based on Si quadrumers and mirror-symmetric 1-D photonic crystals (1DPCs) hybridstructure, operating at the infrared wavelength range with higher sensing performance and much more stable reference signal. Magnetic Fano resonance and Fabry-Perot resonance were combined into such a hybridstructure for the first time. The influences of the gap distance, including Δx and Δy , on the coupling effects between the Si nanodimers along the polarization direction and the 1DPCs are systematically discussed. The sensing performance has been numerically investigated in different analytes with the sensitivity and figure of merit (FOM) of 760 nm/RIU and 1515 RIU−1 respectively, which paves the way to be a much more sensitive detection of small refractive index changes in an unstable environment and suggests potential applications in biological and chemical sensing.

Profile-cast provides a novel data dissemination paradigm in mobile opportunistic networks, allowing messages to be disseminated to nodes based on their profiles rather than network identities. Profile-cast has attracted increasing attention, but most of existing algorithms cannot account for some scenarios where multiple attributes need to be considered simultaneously in a profile. We focus on the multi-attribute profile-cast (MapCast) paradigm, where the node’s profile is represented by a multi-dimensional vector, which may contain multiple attributes of the node such as its behavior, interest, social information, etc. First, we consider a scenario with a fixed source node. We construct a message dissemination tree using the node encounter history. Then we propose a dissemination tree based MapCast algorithm, which adapts a heuristic search algorithm to select relay nodes so that the destination node can receive the message as soon as possible and the network has a low overhead. Second, we consider a more complex scenario with unfixed source nodes. In this scenario, the concept of group profile is defined, and a new high-efficient algorithm, group-profile based MapCast (G-MapCast), is proposed to limit the scope of message forwarding to the nodes whose profile or group profile satisfies certain delivery conditions. To further reduce the network overhead, we propose a network coding based MapCast algorithm on the basis of G-MapCast. Finally, we provide simulation results based on two real human contact datasets and verify the effectiveness and superiority of our algorithms.

Blood glucose levels are associated with the prognosis of patients with acute coronary syndrome (ACS). Glycated hemoglobin (HbA1c) reflects the average blood glucose level. The purpose of the study was to evaluate HbA1c as a prognostic indicator for ACS. In total, 27,337 ACS patients from the CCC-ACS (Improving Care for Cardiovascular Disease in China - Acute Coronary Syndrome) project were enrolled in this study and divided into three groups according to HbA1c level: Group I, HbA1c level

As an excellent tool, neutron generators have been used widely in prompt gamma-ray neutron activation analysis (PGNAA) technology. In this work, a new PGNAA laboratory was proposed to equip a D–T neutron generator. For safety reasons, radiation shielding of the laboratory was designed, and its protection efficiency was validated by using MCNP simulations and experiments. The results show that the proposed shielding can meet the radiation protection set by the International Commission on Radiological Protection and the Chinese government.

Objective:This study aimed to investigate the association between long-term survival and different management of major aortopulmonary collateral arteries in patients with pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries.Methods:From November, 2009 to October, 2018, a total of 98 consecutive patients with pulmonary atresia, ventricular septal defect, major aortopulmonary collateral arteries, and hypoplastic pulmonary arteries treated with modified Blalock–Taussig shunt or right ventricle–pulmonary artery connection were included. Fifty-five patients who received occlusion or ligation of major aortopulmonary collateral arteries during or after palliative procedure were occlusion group, and the other 43 patients were no occlusion group. The early and late outcomes were compared.Results:The mean duration of follow-up was 30.9 months in no occlusion group and 49.8 months in the occlusion group (p < 0.001). Multivariate analysis showed that only no occlusion of major aortopulmonary collateral arteries was predictive of total mortality (Hazard Ratio: 4.42, 95% CI: 1.27 to 15.42, p = 0.02). The Kaplan–Meier survival curves confirmed that patients without occlusion of major aortopulmonary collateral arteries demonstrated worse survival as compared with the occlusion group (p = 0.013). The Kaplan–Meier survival curves of patients who underwent different palliative procedures showed no differences.Conclusions:For patients with pulmonary atresia, ventricular septal defect and major aortopulmonary collateral arteries when a primary repair is not feasible, those without occlusion of major aortopulmonary collateral arteries have a higher risk of death following an initial palliative procedure compared with patients who underwent occlusion of major aortopulmonary collateral arteries. The occlusion of major aortopulmonary collateral arteries is not associated with a higher rate of complete repair or better improvement of pulmonary artery growth.

We investigate the topological edge modes in a rhombic waveguide array with imaginary coupling, which is realized by incorporating auxiliary waveguide between the coupled waveguides. By suitably tuning both real and imaginary couplings to generate an effective π flux, a non-Hermitian analog of Aharonov-Bohm (AB) cage is formed as the band structures become flat and coalesce into third-order exceptional points (EPs). We show the array can support gapped topological edge modes, which can be explained by mapping the system Hamiltonian into the square root of an anti-parity-time (PT) -symmetric waveguide array. In contrast to the linear power increase of bulk modes, the propagation of edge modes can be conserved or exponentially amplified depending on which termination is initially excited. Our study provides a promising way to realizing robust light propagation.

Background Circulating angiopoietin-like 2 (ANGPTL2) protein levels are known to be significantly increased in numerous chronic inflammatory diseases and are associated with the diagnosis and/or prognosis of cardiovascular diseases, diabetes, chronic kidney disease, and various types of cancers. However, no data regarding the relationship between ANGPTL2 and diabetic foot ulcers (DFUs) are available. Here, we explored the potential link between ANGPTL2 and DFUs. Methods A total of 68 participants with type 2 diabetes mellitus (T2DM) were recruited, including 28 patients with DFU and 40 diabetic patients without DFUs. The clinical characteristics of T2DM patients with and without DFUs were compared. Serum concentrations of ANGPTL2 and VEGF were measured using enzyme-linked immunosorbent assay (ELISA) kits. The correlations between ANGPTL2 and clinical variables were analyzed. Multiple linear regression and logistic regression models were constructed to test the associations between ANGPTL2 and the severity and presence of DFUs. Results Serum levels of ANGPTL2 were higher in patients with DFUs than those in diabetic controls. Serum ANGPTL2 levels were higher in the advanced stages of DFUs. Spearman correlation analysis revealed strong positive associations of ANGPTL2 with CRP, VEGF and ESR in all subjects. In addition, serum ANGPTL2 was still positively correlated with DFUs stage after adjusting the risk factors. After adjusting for age, sex, HbA1C and duration of diabetes, ANGPTL2 was found to be independently associated with the presence of DFUs. Conclusions Circulating ANGPTL2 levels are an independent risk factor for DFUs. This suggests that ANGPTL2 may play important roles in the development of DFUs, a possibility that needs to investigated in prospective studies.

Current biomarkers did not overcome the limitations of clinical application due to the heterogeneity of ovarian tumors. The role of nuclear factor of activated T cells (NFAT) in the prognosis of different histological subtypes of ovarian cancer remains unclear. NFAT expression was analyzed in 302 ovarian tumors from The Cancer Genome Atlas (TCGA) dataset and was further confirmed by 88 ovarian tumor specimens, including 30 clear-cell carcinoma, 34 serous carcinoma, and 24 papillary serous cystadenocarcinoma. The correlations between NFAT expression, cancer biomarkers, and clinical characteristics in different subtypes of ovarian tumors were analyzed. ALGGEN PROMO, reporter assay, and NFAT overexpression and knockdown were used to identify chondroadherin (CHAD) as the downstream target of NFAT. NFAT was significantly upregulated only in late-stage clear-cell carcinoma, but not in other two subtypes. NFAT levels were correlated with CA72-4 levels and poor overall survival and disease-free survival (P