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Due to the emergence of mobile 3D devices, multi-view 3D videos are expected to play increasingly important roles in providing immersively interactive experiences to users. Compared with traditional single-view videos, it is envisaged that a multi-view 3D video requires larger storage space and bandwidth consumption. Nevertheless, efficient caching for multi-view 3D videos in a mobile proxy has not been explored in the literature. In this paper, therefore, we first observe that the storage space can be effectively reduced by leveraging Depth Image Based Rendering (DIBR) in multi-view 3D videos. We then formulate a new cache management problem, named Adaptive View Selection and Cache Operation (AVSCO), and find the optimal policy based on Markov Decision Process (MDP). Afterward, we propose an approximate MDP to effectively aggregate similar states to reduce the MDP state space and devise an efficient and effective algorithm to support human visual continuity in AVSCO. Simulation results manifest that the proposed algorithms can significantly improve the cache hit rate and reduce the bandwidth consumption for the remote access compared with the existing cache replacement algorithms.

Steel–concrete hybrid towers have been proposed for onshore tall wind turbine tower installations. Their bottom sections are built with concrete and top sections with steel. The primary advantages of such hybrid towers include construction using low-cost durable material and avoidance of transport barriers associated with all-steel towers. In this study, a set of design constraints governing the geometry of hybrid towers was proposed to determine the optimal combination of concrete and steel sections. The primary constraint in tower design involves avoiding resonance because a resonant response can significantly damage the tower and trigger turbine fault conditions. A sensitivity analysis was conducted to explore the correlation between the natural frequency and geometry of a tower. The results demonstrated that an increase in the proportion of concrete can lead to a pronounced effect on the first modal frequency of taller towers. Additionally, geometric optimisation was performed on a 160 m tall tower. This resulted in a 12.7% reduction in the total cost compared with that of the initial design.

Autonomous driving approaches today are mainly based on perception-planning-action modular pipelines and the End2End paradigm respectively. The End2End paradigm is a strategy that directly maps raw sensor data to vehicle control actions. This strategy is very promising and appealing because complex module design and cumbersome data labeling are avoided. Since this approach lacks a degree of interpretability, safety and practicability. we propose an autonomous driving approach based on trajectory learning using deep neural networks in this paper. In comparison to End2End algorithm, it is found that the trajectory learning algorithm performs better in autonomous driving. As for trajectory learning algorithm, the CNN_Raw-RNN network structure is established, which is verified to be more effective than the original CNN_LSTM network structure. Besides, we propose an autonomous driving architecture of a pilot and copilot combination. The pilot is responsible for trajectory prediction via imitation learning with labeled driving trajectories, while the copilot is a safety module that is employed to verify the effectiveness of the vehicle trajectory by the results of the semantic segmentation auxiliary task. The proposed autonomous driving architecture is verified with a real car on urban roads without manual intervention within 40 km.

BACKGROUND: We sought to determine whether pseudocapsule (PS) features have prognostic implications in patients with metastatic renal cell carcinoma (mRCC). METHODS: We retrospectively reviewed 231 patients diagnosed with mRCC and treated with tyrosine kinase inhibitors; 188 patients with data available regarding the tumor-parenchyma interfacial PS of the primary tumor were enrolled for analysis. PS status was evaluated as intact (grade 0), merely involved (grade 1), penetrated (grade 2), and absent (grade 3). We applied the Kaplan-Meier method and Cox regression model to assess the survival impact. RESULTS: Of the 188 patients, 19 (10.1%), 61 (32.4%), 96 (51.1%) and 12 (6.4%) had grade 0, 1, 2 and 3 PS, respectively. PS status was significantly associated with histology (P=0.0206), venous tumor embolus (P=0.0511), microvascular invasion (P=0.0108) and microsatellite formation (P=0.0097). Patients without a PS had the worst overall survival (OS), with a 3-year OS rate of 12.7%, whereas the OS rates for grades 0, 1 and 2 were 78.8%, 50.8% and 43.6%, respectively. Adjusted by other variables, grade 3 and grade 2 PS gave rise to a much higher risk of death across the cohort [hazard ratio (HR) =5.217, P=0.0182; HR =3.765, P=0.0281, respectively]. Sarcomatoid change was also an independent factor for OS (HR =2.932, P=0.0075). In contrast, microsatellite formation was not associated with survival in the cohort. CONCLUSIONS: PS status has prognostic implications for OS in metastatic renal cancer. The absence of the PS and sarcomatoid change are two pathological features related to an extremely poor prognosis.

OBJECTIVES The aim of this study is to systematically evaluate the diagnostic ability of the contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) in hepatocellular carcinoma (HCC). METHODS We searched relevant studies from PubMed, Medline, and Embase database. After literature search, duplicate removal, and data extraction, we calculated and analyzed the pooled sensitivity, pooled specificity, pooled odds ratios of diagnostic, pooled likelihood ratio (LR) of positive and negative, and area under the curve (AUC), accuracy, and F1 score to evaluate the diagnostic value of CEUS LI-RADS for HCC. RESULTS Thirteen studies and 6491 patients were included in this analysis. The pooled sensitivity and pooled specificity were 0.72 (95% confidence interval [CI], 0.70-0.73) and 0.92 (95% CI, 0.91-0.93), respectively. The positive LR was 8.02 (95% CI, 4.93-13.06) and the negative LR was 0.31 (95% CI, 0.27-0.37). The pooled diagnostic odds ratio was 27.91 (95% CI, 15.39-50.63). The overall AUC was 0.8406 and the accuracy was 0.77. CONCLUSIONS CEUS LI-RADS is an effective and promising method to diagnose HCC.

Background Much is known about individual sensory deficits among older adults, but there is a dearth of information about the prevalence of multiple concurrent sensory deficits in this population. Methods We evaluated the prevalence of individual and multiple sensory impairments at the most recent clinic visit among participants aged 24 years and older in the Baltimore Longitudinal Study of Aging (BLSA) (hearing, vision, olfaction, proprioception, and vestibular function) and Atherosclerosis Risk in Communities Study (ARIC) (hearing, vision, olfaction). We compared observed prevalence of multiple sensory impairments with expected prevalence based on compounded probabilities of multiple impairments using Fisher Exact Tests. Also, we evaluated the comparability of different measures used between these two studies. Results In both studies, the prevalence of each individual sensory impairment was common (>10%), and higher with older age, and the most common pattern of co-occurring sensory impairments was hearing and visual impairments (17.4% [BLSA]; 50.2% [ARIC]). In BLSA, the pattern that differed the most between observed and expected prevalence was combined hearing, vision, and olfactory impairments (observed 5.2% vs 1.4% expected, p = .01). In ARIC, this difference was much smaller (observed 8.1% vs 7.2% expected, p = .49). Conclusions Although concurrent hearing and vision impairments were the most common co-occurring deficits, combined hearing, vision, and olfactory impairments are most likely to co-occur above chance, especially at older ages.

Because a high signal-to-noise ratio (SNR) is beneficial to the subsequent processing procedures, the noise attenuation is important. We propose an adaptive random noise attenuation framework based on convolutional neural networks (CNNs). The framework transforms the target function from effective signal learning to noise learning through residual learning, so as to improve the training efficiency. After sufficient training, the network transfers the learned seismic data features using a large synthetic data set to the testing of complex field data with unknown noise levels and, thus, attenuates the noise in an unsupervised way. Unsupervised noise reduction requires certain representativeness of the training data and a sufficient amount of training data sets. In the network architecture, we introduce residual learning and batch normalization (BN) to reduce the training parameters of the network, thereby shortening the time for feature learning. The activation function with leakage correction function can effectively retain negative information, and its combination with the double convolutional residual block can enhance the generalization ability and feature extraction performance of the network. In the test of synthetic data and complex field data with unknown noise levels, by comparing the noise reduction results of some classic denoising algorithms, the adaptive CNN proposed in this article can more effectively attenuate the noise and reconstruct the seismic waveform.

Background Patients with sickle cell disease (SCD) have vaso-occlusive crises (VOCs). Infusion centers (ICs) are alternatives to emergency department (ED) care and may improve patient outcomes. Objective To assess whether care in ICs or EDs leads to better outcomes for the treatment of uncomplicated VOCs. Design Prospective cohort. (ClinicalTrials.gov: NCT02411396). Setting 4 U.S. sites, with recruitment between April 2015 and December 2016. Participants Adults with SCD living within 60 miles of a study site. Measurements Participants were followed for 18 months after enrollment. Outcomes of interest were time to first dose of parenteral pain medication, whether pain reassessment was completed within 30 minutes after the first dose, and patient disposition on discharge from the acute care visit. Treatment effects for ICs versus EDs were estimated using a time-varying propensity score adjustment. Results Researchers enrolled 483 participants; the 269 who had acute care visits on weekdays are included in this report. With inverse probability of treatment-weighted adjustment, the mean time to first dose was 62 minutes in ICs and 132 minutes in EDs; the difference was 70 minutes (95% CI, 54 to 98 minutes; E-value, 2.8). The probability of pain reassessment within 30 minutes of the first dose of parenteral pain medication was 3.8 times greater (CI, 2.63 to 5.64 times greater; E-value, 4.7) in the IC than the ED. The probability that a participant's visit would end in admission to the hospital was smaller by a factor of 4 (0.25 [CI, 0.18 to 0.33]) with treatment in an IC versus an ED. Limitation The study was restricted to participants with uncomplicated VOCs. Conclusion In adults with SCD having a VOC, treatment in an IC is associated with substantially better outcomes than treatment in an ED. Primary funding source Patient-Centered Outcomes Research Institute.

Background We conducted a cost-effectiveness analysis incorporating recent phase III clinical trial (MONALEESA-7) data to evaluate the cost-effectiveness of ribociclib (RIB) as a first-line treatment for premenopausal women with hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC) from the United States healthcare payer perspective. In addition, because RIB has not been marketed in China, we identified the range of drug costs for which RIB could be considered cost effective from a Chinese healthcare system perspective. Patients and Methods A Markov model was developed to evaluate the cost-effectiveness of adding RIB to endocrine therapy over a lifetime. The clinical outcomes and utility data were obtained from published literature. Costs data were obtained from United States and Chinese official websites, and we determined the potential price for RIB in China based on its price in the United States. The main outcomes of this study were the incremental cost-effectiveness ratio (ICER) and quality-adjusted life-years (QALYs). Results The model projected that mean outcome was better with RIB and endocrine combined (3.83366 QALYs) than with endocrine therapy alone (2.71203 QALYs). In the United States, RIB and endocrine therapy cost an additional $604,960.06, resulting in an ICER of $539,357.95/QALY compared with endocrine monotherapy. Subgroup analyses indicated that, in China, the projected mean outcomes were better for RIB and endocrine therapy (6.37 QALYs) than for endocrine monotherapy (2.71 QALYs). The corresponding incremental costs were $224,731.88943. Thus, the ICER comparing RIB and endocrine therapy with endocrine therapy alone represented a $61,454.96/QALY gain. Conclusion Additional use of RIB is estimated to not be cost effective as a first-line treatment for premenopausal women with HR-positive, HER2-negative ABC in the United States. A value-based price for the cost of RIB is less than $31.74/200 mg for China.

Background Intrahepatic cholangiocarcinoma is an aggressive liver carcinoma with increasing incidence and mortality. A good auxiliary prognostic prediction tool is desperately needed for the development of treatment strategies. The purpose of this study was to explore the prognostic value of the radiomics nomogram based on enhanced CT in intrahepatic cholangiocarcinoma. Methods In this retrospective study, 101 patients with pathological confirmation of intrahepatic cholangiocarcinoma were recruited. A radiomics nomogram was developed by radiomics score and independent clinical risk factors selecting from multivariate Cox regression. All patients were stratified as high risk and low risk by a nomogram. Model performance and clinical usefulness were assessed by calibration curve, ROC curve, and survival curve. Results A total of 101patients (mean age, 58.2 years old; range 36–79 years old) were included in the study. The 1-year, 3-year, and 5-year overall survival rates were 49.5%, 26.6%, and 14.4%, respectively, with a median survival time of 12.2 months in the whole set. The least absolute shrinkage and selection operator (LASSO) method selected 3 features. Multivariate Cox analysis found three independent prognostic factors. The radiomics nomogram showed a significant prognosis value with overall survival. There was a significant difference in the 1-year and 3-year survival rates of stratified high-risk and low-risk patients in the whole set (30.4% vs. 56.4% and 13.0% vs. 30.6%, respectively, p = 0.018). Conclusions This radiomics nomogram has potential application value in the preoperative prognostic prediction of intrahepatic cholangiocarcinoma and may facilitate in clinical decision-making.

Background The optimal first‐line approach for patients with symptomatic atrial fibrillation (AF) remains unclear. We compared the efficacy and safety of cryoballoon ablation (CBA) and antiarrhythmic drugs (AADs) in the initial management of symptomatic AF. Hypothesis CBA is superior to AAD as initial therapy for symptomatic AF. Methods We searched the EMBASE, PubMed, and Cochrane Library databases for randomized controlled trials (RCTs) that compared CBA with AAD as first‐line treatment for AF from the date of database establishment until March 18, 2021. The risk ratio (RR) with a 95% confidence interval (CI) was used as a measure of treatment effect. Results Three RCTs that enrolled 724 patients in total were included in this meta‐analysis. Majority of the patients were relatively young and had paroxysmal AF. CBA was associated with a significant reduction in the recurrence of atrial arrhythmia compared with AAD therapy, with low heterogeneity (RR, 0.59; 95% CI, 0.49–0.71; p

Deep learning‐based approaches have made considerable progress in image classification tasks, but most of the approaches lack interpretability, especially in revealing the decisive information causing the categorization of images. This paper seeks to answer the question of what clues encode the discriminative visual information between image categories and can help improve the classification performance. To this end, an attention‐based clue extraction network (ACENet) is introduced to mine the decisive local visual information for image classification. ACENet constructs a clue‐attention mechanism, that is global‐local attention, between the image and visual clue proposals extracted from it and then introduces a contrastive loss defined over the achieved discrete attention distribution to increase the discriminability of clue proposals. The loss encourages considerable attention to be devoted to discriminative clue proposals, that is those similar within the same category and dissimilar across categories. The experimental results for the Negative Web Image (NWI) dataset and the public ImageNet2012 dataset demonstrate that ACENet can extract true clues to improve the image classification performance and outperforms the baselines and the state‐of‐the‐art methods.

In perovskite solar cells, doped organic semiconductors are often used as charge-extraction interlayers situated between the photoactive layer and the electrodes. The π-conjugated small molecule 2,2',7,7'-tetrakis[N,N-di(4-methoxyphenyl)amino]-9,9-spirobifluorene (spiro-OMeTAD) is the most frequently used semiconductor in the hole-conducting layer1-6, and its electrical properties considerably affect the charge collection efficiencies of the solar cell7. To enhance the electrical conductivity of spiro-OMeTAD, lithium bis(trifluoromethane)sulfonimide (LiTFSI) is typically used in a doping process, which is conventionally initiated by exposing spiro-OMeTAD:LiTFSI blend films to air and light for several hours. This process, in which oxygen acts as the p-type dopant8-11, is time-intensive and largely depends on ambient conditions, and thus hinders the commercialization of perovskite solar cells. Here we report a fast and reproducible doping method that involves bubbling a spiro-OMeTAD:LiTFSI solution with CO2 under ultraviolet light. CO2 obtains electrons from photoexcited spiro-OMeTAD, rapidly promoting its p-type doping and resulting in the precipitation of carbonates. The CO2-treated interlayer exhibits approximately 100 times higher conductivity than a pristine film while realizing stable, high-efficiency perovskite solar cells without any post-treatments. We also show that this method can be used to dope π-conjugated polymers.

Carbon fiber reinforced polymer confined concrete-filled steel tube (CFRP-CFST) columns are having promising utilization in offshore structures, which are usually subjected to the combination of axial forces, bending moments, and torsional moments. This paper thus presents a finite element (FE) study on CFRP-CFST columns under combined compression-bending-torsion load. The comprehensive FE modelling was established and then validated by the experimental data. Analysis of typical failure modes, load-deformation relations and full-range behavior was performed based on the FE simulation. Meanwhile, parametric analysis was conducted to reveal the sensitive parameters as well as their influence on the structural behavior and ultimate capacity of CFRP-CFST columns. Finally, correlation relations which can reasonably characterize the coupled ultimate capacity of columns were obtained and validated. Correspondingly, simplified design formulae for predicting the ultimate capacity correlation of CFRP-CFST columns under compression-bending-torsion load were proposed.

The effects of local factors on activation of immune cells infiltrating the central nervous system (CNS) in a rat model of traumatic brain injury (TBI) remain elusive. The cytokine, interleukin (IL)-15, is crucial for development and activation of CD8 T lymphocytes, a prominent lymphocytic population present in TBI lesions. We investigated whether IL-15 originates from astrocytes and whether IL-15 can evoke the CD8 T-lymphocyte response in TBI. We observed that astrocytes were activated in a rat model of TBI and that IL-15 was overexpressed on the surface of astrocytes. Further, CD8 T lymphocytes infiltrating TBI lesions colocalized with IL-15-expressing astrocytes. Activated CD8 T lymphocytes released granzyme B (Gra-b), which, in turn, activated caspase-3-induced poly(ADP-ribose) polymerase cleavage and, ultimately, neuronal apoptosis. Conversely, inhibition of astrocyte activation by pre-treatment with the specific inhibitor, fluorocitrate (FC), that reduces carbon flux through the Krebs cycle in astrocytes resulted in improved neurological function and memory. FC pre-treatment was also associated with downregulated IL-15 expression and CD8 T-cell activation as well as decreased levels of neuronal apoptosis, suggesting that IL-15 initiated a domino effect toward apoptosis. In contrast, rats pre-treated with recombinant rat IL-15 showed upregulated CD8 T-cell numbers and Gra-b levels, in addition to induction of neuronal apoptosis. Together, our results indicated that IL-15 could induce neuronal apoptosis by enhancing CD8 T-cell function in a rat model of TBI.

In underwater acoustic target recognition, deep learning methods have been proved to be effective on recognizing original signal waveform. Previous methods often utilize large convolutional kernels to extract features at the beginning of neural networks. It leads to a lack of depth and structural imbalance of networks. The power of nonlinear transformation brought by deep network has not been fully utilized. Deep convolution stack is a kind of network frame with flexible and balanced structure and it has not been explored well in underwater acoustic target recognition, even though such frame has been proven to be effective in other deep learning fields. In this paper, a multiscale residual unit (MSRU) is proposed to construct deep convolution stack network. Based on MSRU, a multiscale residual deep neural network (MSRDN) is presented to classify underwater acoustic target. Dataset acquired in a real-world scenario is used to verify the proposed unit and model. By adding MSRU into Generative Adversarial Networks, the validity of MSRU is proved. Finally, MSRDN achieves the best recognition accuracy of 83.15%, improved by 6.99% from the structure related networks which take the original signal waveform as input and 4.48% from the networks which take the time-frequency representation as input.

PurposeThe paper proposes customer involvement can be considered an organization-level construct of knowledge creation in the new process development. Specifically, the paper evaluates three distinct organizational practices as knowledge antecedents – competitor orientation, social network and internal coordination – that can facilitate the adoption of customer involvement in the process innovation development.Design/methodology/approachThe paper empirically tests this theory for 2,000 firms that are stratification sampled from a population of 33,844 Taiwanese firms, and a data set of 170 valid questionnaires is collected. The questionnaire was mainly modified from a Kim and Kim (2010) measure which was designed based on the 3rd edition of the Oslo Manual OECD/Eurostat 2005. The concept of customer involvement in new service development proposed by Alam (2002) was also applied to the questionnaire.Findings(1) The antecedents of customer involvement, which include competitor orientation, external social networks and internal coordination, function as a determinant to nourish customer involvement. (2) Customer involvement significantly positively mediates the relationship between knowledge antecedents and new process performance. (3) Customer involvement is a crucial knowledge creation for improving the new process innovation performance in manufacturing firms.Originality/valueTwo basic tenets of theory building serve as the foundation of the model in this paper. First, research on customer involvement is augmented by showing that customer involvement can emerge as a shared perception among organizational members that is distinct from individual-level involvement. Moreover, customer involvement in process innovation can help firms manage their knowledge and further enhance firm performance. Second, the knowledge management model provides a key lens through which researchers can take a process-oriented view that focuses on customer involvement as a unique capability that firms can develop in process innovation.

Backdoor data poisoning attacks add mislabeled examples to the training set, with an embedded backdoor pattern, so that the classifier learns to classify to a target class whenever the backdoor pattern is present in a test sample. Here, we address posttraining detection of scene-plausible perceptible backdoors, a type of backdoor attack that can be relatively easily fashioned, particularly against DNN image classifiers. A post-training defender does not have access to the potentially poisoned training set, only to the trained classifier, as well as some unpoisoned examples that need not be training samples. Without the poisoned training set, the only information about a backdoor pattern is encoded in the DNN's trained weights. This detection scenario is of great import considering legacy and proprietary systems, cell phone apps, as well as training outsourcing, where the user of the classifier will not have access to the entire training set. We identify two important properties of scene-plausible perceptible backdoor patterns, spatial invariance and robustness, based on which we propose a novel detector using the maximum achievable misclassification fraction (MAMF) statistic. We detect whether the trained DNN has been backdoor-attacked and infer the source and target classes. Our detector outperforms existing detectors and, coupled with an imperceptible backdoor detector, helps achieve posttraining detection of most evasive backdoors of interest.

Background Vision loss is associated with increased risk of falls and restricted physical activity, yet the relationship between multiple vision measures and objectively measured physical activity, especially activity patterns, in mid-to-late life is not well understood. Method This study included 603 participants aged 50 years and older (mean age = 73.5) in the Baltimore Longitudinal Study of Aging who had the following assessments: presenting and best-corrected visual acuity, contrast sensitivity, visual fields, stereo acuity, and free-living physical activity using a wrist-worn ActiGraph accelerometer for 7 days. Linear regression models were used to examine the association between vision measures and daily activity counts, active minutes, and activity fragmentation (defined as an active-to-sedentary transition probability), adjusting for potential confounders. Mixed-effects models estimated differences in activity by time of day comparing those with and without each visual impairment. Results In the fully adjusted model, worse presenting visual acuity, contrast sensitivity, and visual fields were associated with fewer activity counts, less active time, and more fragmented activity patterns (p < .05 for all). Participants with presenting or best-corrected visual acuity impairment had 19.2 and 29.3 fewer active minutes (p = .05 and p = .03, respectively) per day. Visual field impairment was associated with 268 636 fewer activity counts (p = .02), 46.2 fewer active minutes (p = .02) per day, and 3% greater activity fragmentation (p = .009). Differences in activity levels tended to be greatest from 6 am to 6 pm (p < .05). Conclusions Older adults with visual impairment have restricted and more fragmented patterns of daily activity. Longitudinal studies to quantify the long-term impacts of visual impairments on activity decline are warranted.

Background Nanofat is an autologous product prepared mechanically from harvested fat. In nanofat grafting, converters are employed for mechanical emulsification to facilitate fat injection. To date, the study of different converters has received scant attention regarding whether they affect the characteristics of nanofat in terms of the practical applications and indications. Objectives The authors set out to investigate the influence of different internal diameters of converters on biological functionality of nanofat during shuffling. Methods The 3-dimensional finite element method was employed to simulate the process of mechanical emulsification of fat and to research the stress with 5 different converters (3.76 mm, 2.00 mm, 1.20 mm, 1.00 mm, 0.80 mm). An assessment of the morphology of emulsified fat was conducted. Isolated stromal vascular fraction (SVF) was analyzed for cellular components, number, and viability through flowcytometry and live/ dead staining. Adipocytic and angiogenic differentiation assay allowed assessment of differentiation capacity of the SVF. Results The smaller the aperture of the converter, the greater the mechanical force on adipose tissue during mechanical emulsification, showing the different macroscopic and microscopic structure of the emulsified fat. No difference in viability or ratio of endothelial progenitor cells and other cells was found. Angiogenic and adipogenic differentiation capacity of the SVF significantly changed in 5 different converters. Conclusions The mechanical emulsification from different apertures of converters exerts different effects of adipose tissue structure, cell content, and multipotency differentiation but not its viability. Converters with different apertures can be selected according to clinical needs.

BACKGROUND Dark circles are one of the most perplexing cosmetic problems for modern people. Nowadays, a new porcine collagen filler has been popular in China and many countries and has high safety. AIMS The purpose of this study is to explore and quantify the efficacy of this collagen filler in treating structured dark circles objectively and systematically. METHODS This is a prospective study. Twenty patients were included and took standard facial photographs at preoperative (Tp), immediately postoperative (T0), 1 week (T1), 2 weeks (T2), 4 weeks (T4), 8 weeks (T8), and 12 weeks (T12). The efficacy was quantified by measuring the depression of the tear trough and infraorbital melanin content. Three dermatologists blinded to the treatment were responsible for completing the subjective evaluations. RESULTS The depression volume, depression-affected area, and depression maximum depth of the tear trough decreased significantly immediately postoperation, and then all values increased slowly with time (P

Objectives: The current Chinese draft nodal clinical staging system for unresectable esophageal cancer is controversial. Our study aimed to propose a new diagnostic criterion for lymph node metastasis (LNM) detected by multislice spiral computed tomography (MSCT) in nonsurgically treated esophageal squamous cell carcinoma (ESCC) patients and then develop a novel lymph node (LN) clinical staging system for better individual prognostic prediction. Methods: The short-axis diameters of regional LNs were measured in 393 nonsurgical patients. Regional nodes were considered positive for malignancy if the nodal size exceeded the optimal size, which was determined by Kaplan-Meier survival analysis. The novel LN clinical staging system was then constructed using the LASSO model based on the relative prognostic importance of different LN stations. Validation cohort was included to confirm the prognostic performance. Results: Regional nodes were considered positive for malignancy if they were larger than 10 mm in the low cervical and upper thoracic segments, 7 mm in the middle thoracic segment, and 8 mm in the lower thoracic and celiac segments. Using the LASSO model, stations 2R, 3A, 7 and 16 were qualified in the model. Further analysis showed that our LN clinical staging system had better homogeneity, discriminatory ability and clinical value than the draft nodal staging system. Conclusions: Our results show that the new diagnostic criterion may improve the diagnostic value of MSCT in metastatic LNs. The novel LN clinical staging system can stratify nonsurgically treated ESCC patients into different risk groups, providing valuable information for decision making and outcome prediction.

Coherent seismic noise is usually difficult to attenuate due to the similar morphological patterns between noise and useful signals. To attenuate coherent noise, special preknowledge should be utilized in a state-of-the-art approach, which causes significant inconvenience. Here, we develop an automatic method to attenuate coherent noise based on the adaptive dictionary learning algorithm. The adaptive dictionary algorithm can learn the features of both signals and coherent noise and leave obvious morphological differences in the dictionary atoms. These differences in the dictionary atoms can be transformed into statistical differences, which can be measured and then used to distinguish between signal and noise atoms. We evaluate several statistical metrics in characterizing the dictionary atoms and their feasibilities in distinguishing between signal and noise atoms. We find that the kurtosis metric can best represent the differences between signal and noise atoms, and then we design a kurtosis-based filter to reject those high-kurtosis atoms and their corresponding coefficient vectors for suppressing the coherent noise. Synthetic and real data examples demonstrate the performance of the proposed algorithm.

Structured light (SL) based three-dimensional (3D) imaging technology has been widely employed in many fields of computer vision. However, currently available SL based depth sensors are sensitive to imaging noises, which severely limits the performance of subsequent advanced vision tasks. In this letter, we propose a robust and practical SL illumination pattern coding method based on epipolar geometry. The proposed pattern can effectively alleviate coding redundancy in traditional global random speckle SL patterns and make the stereo matching more robust to noise. Meanwhile, this coding strategy supplies sufficient non-local similar blocks, which inspires us to propose a uni-direction block-stacking 3D filtering algorithm to further improve the 3D imaging quality. To verify the proposed algorithms, we developed a prototype using the off-the-shelf projector and camera. Both simulation and real scene experimental results show that the proposed methods can achieve high-quality 3D imaging performance under different noisy conditions.

Artificial intelligence (AI) on chips has recently driven the expansion of the Social Internet of Things (SIoT), where a group of SIoT devices with social relations can collaboratively identify and handle local events without the help of remote servers. On the other hand, mobile-edge computing (MEC) is a favorable way to locally process SIoT data for reducing data transmission and computation among SIoT devices and backhaul networks. Nevertheless, the load sharing among SIoT devices, MEC, and remote servers brings about new challenges for the communication and computation tradeoff, cross-layer design in SIoT, and forwarding and aggregation tradeoff. To tackle these issues, we formulate a new optimization problem, namely, SIoT collaborative group and device selection problem (SCGDSP), and prove the NP-hardness. We first explore the intrinsic properties of a fundamental SCGDSP case by finding the optimal collaborative group for each user request. Then, we design an approximation algorithm for the general SCGDSP that first evaluates candidate collaborative groups under different social relations, and then selects the collaborative groups and SIoT devices properly. For scalability, the proposed algorithm also supports dynamic user requests and can be distributionally deployed in massive networks enabling collaborative MEC. Moreover, it also sustains local SIoT services, where the computation only involves SIoT devices and MEC servers. Simulation results demonstrate that effective SIoT and collaborative group selection (ESCGS) can reduce by more than 50% of the total communication and computation costs compared with baseline schemes in the real networks from topology zoo. Moreover, the distributed ESCGS reduces by 87% of the running time with total 16.5-MB message overhead, requiring no more than 0.05-ms transmission delay in a 100-Gb/s backbone network with eight MEC servers, 1000 SIoTs, and 800 monitored locations.

Background Larger brain volumes are often associated with more free-living physical activity (PA) in cognitively normal older adults. Yet, whether greater brain volumes are associated with more favorable (less fragmented) PA patterns, and whether this association is stronger than with total PA, remains unknown. Methods Brain magnetic resonance imaging and wrist-worn accelerometer data were collected in 301 participants (mean age = 77 [SD = 7] years, 59% women) enrolled in the Baltimore Longitudinal Study of Aging. Linear regression models were fit to examine whether brain volumes (cc) were cross-sectionally associated with: (a) total daily PA minutes and (b) activity fragmentation (mean number of PA bouts / total PA minutes × 100). Sensitivity analyses were conducted by adjusting for counterpart PA variables (eg, fragmentation covariate included in the PA minutes model). Results Greater white matter volumes in the parietal and temporal lobes were associated with higher daily PA minutes (2.6 [SE = 1.0] and 3.8 [0.9] min/day, respectively; p < .009 for both) after adjusting for demographics, behavioral factors, medical conditions, gait speed, apolipoprotein E e4 status, and intracranial volume. Greater temporal white matter volume was associated with lower fragmentation (−0.16% [0.05], p = .003). In sensitivity analyses, observed associations between brain volumes and daily PA minutes remained significant while associations with fragmentation no longer remained significant. Conclusions Our results suggest white matter brain structure in cognitively normal older adults is associated with the total amount of PA and, to a lesser extent, the PA accumulation patterns. More work is needed to elucidate the longitudinal relationship between brain structure and function and PA patterns with aging.

A reasonable division of the unbalanced contribution is the premise of responsibility division and mitigation. As a large amount of renewable energy integrates into the power system, the disturbance of the system increases and the system impedance is no longer much smaller than the load impedance. The traditional unbalanced responsibility division method is difficult to calculate accurately. This study proposes a new method for calculating unbalanced contribution, which can effectively avoid the limitations of traditional methods. The robust independent component analysis is used to estimate the equivalent source signal. The sparse component analysis method is used to construct the screening criterion to screen the equivalent source signals to obtain estimated signals that are more in line with the real source signals. Then the equivalent negative sequence impedance of upstream and downstream is calculated, and the unbalanced responsibility is divided. This method is still effective when the system impedance is not much different from the load impedance. At the same time, the calculation accuracy is high and the anti-interference ability is strong. Simulation and field test verify the correctness and effectiveness of the proposed method.

Controlled synthesis of GaAs nanowires (NWs) with specific phases and orientations is important and challenging, which determines their electronic performances. Herein, single-crystalline GaAs NWs are successfully synthesized by using complementary metal-oxide semiconductor compatible Cu2O catalysts via chemical vapor deposition at an optimized temperature of 560 °C. In contrast to typically Au catalyzed GaAs NWs, the Cu2O catalyzed ones are found to grow along nonpolar orientations of zincblende and and wurtzite and . The Cu2O catalysts are found to change into orthorhombic Cu5As2 after the NW growth, which is also significantly distinguished from the Au-Ga catalyst alloy in the literature. The Cu5As2 alloy plays the epitaxy role in the nonpolar GaAs NW growth due to the lattice matching with the nonpolar planes of GaAs, which is verified by the atomic stack model. These nonpolar oriented GaAs NWs have minimized stacking faults, promising for the other semiconductor synthesis as well as electronic applications.

This paper investigates the low cycle fatigue (LCF) induced damages of high-strength circular concrete-filled steel tubular (CFT) beam-columns subjected to nonstationary loading history. The test specimens are fabricated by ultra-thin walled steel tubes with 2 mm in thickness to clarify the vulnerability concerning fatigue failure, and to evaluate the fatigue life of slender and over-design circular CFT beam-column members. Experimental results indicated that the specimens with a large D/t ratio together with thin-walled steel tubes tend to trigger highly-concentrated local buckling at column bottom where sequentially experienced premature fractures due to low cycle fatigue and the fragmentation of concrete infill. This complex LCF-induced failure mode can be identified by developing a new damage detection technique using polymer optical fiber sensors with distributed placement. It is found that the sequence of variable amplitudes during LCF history plays significant influences on the accumulation of plastic deformation which is not necessarily correlated to the sequence of nonstationary loading history induced by earthquake ground motions. Moreover, the epistemic uncertainty of variable amplitude of displacement demonstrates considerable influences on fatigue life with variable displacement amplitudes.

To analyze missed rib fractures and proper time for evaluation on CT at different ages and to determine factors that favor missed fractures. One hundred patients with rib fractures who underwent CT were classified into three groups according to their age: young, middle-aged, and elderly. CT was performed within 1 to 6 weeks after trauma. The imaging features and temporal changes of rib fractures were analyzed. At the first CT during the initial week, 638 ribs were detected with one or several fractures, overall 838 fractures were confirmed, and 6 were suspected. In the next 2–6 weeks, 47 occult rib fractures were additionally detected. The number of additionally diagnosed fractures was the highest in respectively the 3rd week among younger, 4th week in the middle-aged, and 6th week in the elderly groups. The detection of occult rib fractures was significantly delayed in the middle-aged and elderly groups compared with the young group (p < 0.05). The time to form bony callus was also significantly (p < 0.05) delayed with age, with significantly (p < 0.05) more time needed to form bony callus in the middle-aged (23.8 ± 4.5 days) and elderly (28.48 ± 5.1 days) groups than in the young group (18.0 ± 2.2 days). Most rib fractures can be detected within the first week after trauma. Detection of occult rib fractures will be delayed with increase of age, and repeated CT scanning should be appropriately postponed in patients at different ages. Trabecula, inner and outer plates, costal angle, and cartilage are the primary locations for occult and subtle fractures which should be carefully evaluated. • More rib fractures can be detected on repeated CT scans, especially for subtle and occult rib fractures. • Detection of all rib fractures helps relieve the patient’s concerns and determine the degree of personal injury for appropriate evaluation.

The development of micro-fabrication and micro-assembly technology is indispensable for the future manufacturing of miniaturized, functional, and integrated devices. This paper proposes a planar micro-assembly technology to make the assembly of micro-objects easier. Firstly, delicate three-dimensional (3D) structures were fabricated on glass and silicon slice substrates using femtosecond laser two-photon polymerization (2PP). Secondly, transparent fluorescent scintillation ceramic powder, referred to as fluorescent powder, was assembled using a laboratory-made 3D moving heating micro-operator into a microstructure on a glass substrate, and this device is used to assemble the graphene powder into the microstructure on the silicon slice substrate. The fluorescence spectra and Raman spectra characterizations of the fluorescent powder and graphene powder in the microstructure were carried out by using excitation light at 405 nm and 532 nm, respectively. According to the above results, it can be concluded that the powder properties of the fluorescent powder and graphene powder assembled into the microstructure were not changed. The experimental device could not only assemble many micron-sized powder materials into hollow microstructures of arbitrary shape but also joined microstructures with different materials and characteristics to form a complex hybrid microstructure system.

The aim of this research was to evaluate the resorption and osseointegration of an autogenous bone ring, which was grafted in a local vertical alveolar defect with simultaneous implant placement. Six Beagle dogs were enrolled in the study; their 4 nonadjacent mandibular premolars were extracted, and the buccal plate was removed to create bone defects in 2 of the 4 sites. Three months after extraction, Straumann implants (Ø 3.3 mm, length of 8 mm) were placed in the bone defect sites with simultaneous autogenous bone ring grafting and in the conventional extraction sites. After a 3-month healing period and a 3-month loading period, the animals were euthanized. The harvested samples were analyzed using micro-computed tomography (CT) scanning and histological analysis. From the micro-CT measurements, the average vertical bone resorption of the bone ring was 0.23 ± 0.03 mm, which was not significantly different from that around the conventional implant, 0.24 ± 0.12 mm (P > .05). The ratio of the bone volume to the total volume of the bone ring group was 91.11 ± 0.02, which was higher than that of the control group, 88.38 ± 2.34 (P < .05). From the hard tissue section, the bone rings developed fine osseointegration with the implants and the base alveolar bone. The results suggest autogenous bone ring grafting with simultaneous implant placement can survive in a local vertical bone defect with little bone resorption and good osseointegration in dogs with strict management. A bone ring graft must be compared with guided bone regeneration, and a larger and longer observation must be confirmed in clinical patients.

Purpose The aim of this study was to explore the effect of preventing first-stage wound dehiscence with new types of incision and flap design and to evaluate the effect of wound dehiscence on the bone resorption of the autogenous bone ring graft. Materials and methods In six beagle dogs, the second and fourth premolars on the bilateral mandible were extracted. After 3 months, on the left extraction sites, conventional alveolar crest incisions were made and the full-thickness flaps were elevated. However, on the right sites, the incisions were made at the mucogingival junction, the split-thickness flaps were elevated toward the lingual side, and the periosteum was elevated toward the buccal side. Then, Straumann implants (. 3.3, length 8 mm) were placed with simultaneous autogenous bone ring grafting. Next, the wounds on the left side were closed with periosteal releasing on buccal flaps conventionally, but the semi-thickness flaps on the right side were sutured with the elevated periosteum. After 3 months, the animals were euthanized, and the harvested samples were analyzed using microcomputed tomography and histology. Results The incidence rate of wound dehiscence in the new incision group was 16.7%, which was significantly lower than that in the conventional incision group (75%). There was hardly any vertical bone loss of the bone ring in the samples without wound dehiscence, but in wound dehiscence samples, severe bone loss, 2.47 ± 0.17 mm, was found on the buccal side of the bone ring, which was significantly higher than that on the lingual, mesial, and distal sides, 1.37 ± 0.14 mm, 1.00 ± 0.15 mm, and 1.03 ± 0.05 mm, respectively. Conclusion The use of a mucogingival junction incision and split-thickness flap design can effectively prevent first-stage wound dehiscence in autogenous bone ring grafting, which plays a key role in bone resorption of the graft.

Research on natural hazards has become a focus due to the serious threat to human life and property. Based on the Science Citation Index Expanded and the Social Sciences Citation Index in the Web of Science spanning 2000–2017, we analyze the characteristics, cooperating countries and research trends of existing articles in the field of natural hazards using a bibliometric method. And the findings provide meaningful data and references for the allocation of science and technology inputs in the fields of natural hazards research. The results show the following: The USA has made the largest contribution to the natural hazards literature and has been in the leading position during the period of research; three of the ten most influential institutions are American institutions, and six out of ten of the most-cited articles are American articles; furthermore, the USA is the country that has the highest degree of cooperation with other countries; Chinese publications rank in second place, and China is the country with the highest average annual growth rate (22.63%), and the Chinese Academy of Sciences is one of the most productive research institutions (2098) but with a low international influence. We also analyze the changes in the research on natural hazards in two time periods as well as the similarities and differences between disaster occurrences and research hotspots. We found that “earthquakes,” “landslides,” and “climate change” are frequently used keywords in natural disaster science. The frequency of the keywords “climate change,” “vulnerability,” and “adaptability” has significantly increased. In addition, the frequency of the keywords used in various countries is significantly affected by the geographical location and there is a discrepancy between the research hotspots and the actual disaster occurrences. It is recommended that countries need to adjust their research directions in natural hazards research, strengthen international cooperation and exchange, and promote the establishment and improvement of a global disaster prevention and reduction system.

The ideal periprocedural anticoagulation strategy for patients being treated with a novel oral anticoagulant (NOAC) during catheter ablation (CA) for atrial fibrillation (AF) is unclear. We evaluated the safety and efficacy of using a minimally interrupted NOAC strategy versus an uninterrupted NOAC or vitamin K antagonist (VKA) strategy during AF ablation. The Cochrane Library, PubMed, and EMBASE databases were searched for randomized controlled or prospective observational studies that compared a minimally interrupted NOAC strategy with an uninterrupted NOAC or VKA strategy from the time of database establishment up to December 2019. The primary endpoints were major bleeding, minor bleeding, and symptomatic thromboembolism. The secondary endpoint was silent cerebral infarction (SCI) as detected by post-ablation brain magnetic resonance imaging (MRI). A measurement of treatment effect for the endpoint was reported as pooled odds ratio (OR) with 95% confidence interval (CI). A total of 18 studies (6 randomized, 11 observational, and 1 randomized registry) with 6203 patients were included in the final analysis (47% of the patients received minimally interrupted NOAC). There was no significant difference between treatment groups regarding the risk for major bleeding (OR 1.04, 95% CI 0.69–1.57, P = 0.86, I2 = 27%). Different stratification methods did not yield significant difference regarding the risk for major bleeding. There was no difference between groups regarding the risk for minor bleeding (P = 1.00) or symptomatic thromboembolism (P = 0.26). Brain MRI results showed that both uninterrupted NOAC (OR 0.44, 95% CI 0.23–0.83, P = 0.01, I2 = 72%) and uninterrupted VKA (OR 0.48, 95% CI 0.24–0.97, P = 0.04, I2 = 36%) produced a significant reduction in the rate of SCI when compared with minimally interrupted NOAC. A periprocedural anticoagulation strategy of minimally interrupted NOAC is not superior to uninterrupted NOAC or VKA when used during AF ablation. There is evidence favoring the use of uninterrupted NOAC or VKA in terms of the risk for SCI.

To evaluate the effectiveness and safety of Chinese herbal external umbilicus treatment with Modified Dinggui Powder (加味丁桂散, MDGP) in patients with chronic nonbacterial prostatitis (CNP). A randomized, double-blind, placebo-controlled clinical trial was conducted among 72 patients with CNP. Participants were randomly allocated to a treatment group and a placebo group using computer software in a 1:1 ratio, and received either MDGP external umbilicus treatment (MDGP group, 36 cases) or placebo control groupl (36 cases) at acupoints Shenque (CV 8), twice a week for 4 weeks. In addtion, patients all received herbal medicine treatment twice a day for 4 weeks. The primary outcomes was the US National Institutes of Health Chronic Prostatitis Symptom Scores Index (NIH-CPSI) with a questionnaire at weeks 2 and 4. The secondary outcomes including prostatic fluid examination (white blood cells and lecithin bodies), the clinical efficacy evaluation, and the adverse events were also assessed during the entire trial. The NIH-CPSI scores regarding pain or discomfort scores showed greater improvement in the MDGP group than placebo control group at weeks 2 (P0.001) and week 4 (P0.004), respectively. NIH-CPSI scores of symptom severity, total scores, the amount of leukocytes number in the prostatic fifluid in the MDGP group were significantly improved (P 0.05). The clinical effective rate was 73.53% (25/34) in the MDGP group, which was significally higher than the placebo control group with 48.39% (25/31, P

Objective: To measure the validity and reliability of a Chinese version of Child Oral Health Impact Profile (COHIP) and to assess oral health-related quality of life (OHRQoL) with regard to gender, age, and cleft types in Chinese children with orofacial cleft (OFC). Design: A total of 120 patients with OFC (8-15 years old) and their parents were investigated with COHIP in the West China Hospital of Stomatology. Items were divided into oral symptoms, functional well-being, emotional well-being, school, and peer interaction subscales, and scores on all subscales were compared between and within groups. Results: The internal consistency measured by Cronbach α was satisfactory in children’s sample (0.85) and parents’ sample (0.90). The correlation between children’s and parents’ questionnaires was moderate to weak (Pearson r = 0.34), which was also supported by moderate intraclass correlation coefficients. The OHRQoL of children differed significantly from parents on the overall COHIP, functional well-being, emotional well-being, and school subscales. Older children had poor OHRQoL, functional well-being, and emotional well-being. Girls had poor emotional well-being. Children with cleft lip and palate and cleft palate performed worse on the overall COHIP, functional well-being, and school subscales. Parents, boys, and younger children had better treatment expectations and global health perceptions. Conclusion: The Chinese version of COHIP is a reliable and valid tool to assess OHRQoL in Chinese children with OFC. Parents’ reports could not replace children’s answers but add complementary information. Children’s gender, age, and cleft types should be considered in OHRQoL assessment and individual treatment plan.

This paper investigates the behavioral additionality effects of a unique high- and new- technology enterprise (HNTE) program in China. The program provides a reduced corporate income tax to certificated HNTEs. By distinguishing research expenses from development costs, we examine if the tax incentive program affects firms' composition of R&D investment, based on a sample of Chinese listed firms. The results indicate that the tax incentive program encourages firms to focus more on development than on research. The effects are also found to be heterogeneous among the first-time, repeated, and one-time certification users. The results imply that tax incentives prompt firms to invest in short-term development opportunities with promising private returns. Conversely, they are less likely to stimulate risky research projects with potential high rates of social and long-term economic returns. Our study highlights the importance of understanding the behavioral additionality effects for innovation policy evaluations and better policy designs.

Modeling the relationship between multimodal media, including images, videos, and text, can reduce the gap between the modalities and promote cross-media retrieval, image annotation, etc. In this paper, we propose a new approach called kernel-based mixture mapping (KMM) to model the semantic correlations between web images and text. With this approach, we first construct latent high-dimensional feature spaces based on kernel theory to address the nonlinearity of both the data distributions in the input spaces and the cross-model correlation. Second, we present a probabilistic neighborhood model to describe the spatial locality of semantics by assuming that proximate examples in feature spaces generally have the same semantics and a conditional model to describe cross-modal conditional dependency. Finally, we build a probabilistic mixture model to jointly model the spatial locality of semantics and the conditional dependency between different modalities. By combining nonlinear transformation and probabilistic models, KMM can address the nonlinearity of cross-modal correlation, the complexity of semantic distributions at the global scale, and the continuity of semantic distributions at the local scale. We present a hybrid optimization algorithm to find the solution of KMM based on expectation-maximization and subgradient ascent; this algorithm avoids estimating the parameters of KMM in high-dimensional feature space and is proved to converge to an (local) optimal solution. We demonstrate the performance of KMM using four public datasets. The experimental results show that our approach outperforms the compared methods when modeling the relationships between images and text.

Background Recurrence is the major cause of mortality in patients with resected HCC. However, without a standard approach to evaluate prognosis, it is difficult to select candidates for additional therapy. Methods A total of 201 patients with HCC who were followed up for at least 5 years after curative hepatectomy were enrolled in this retrospective, multicentre study. A total of 3144 radiomics features were extracted from preoperative MRI. The random forest method was used for radiomics signature building, and five-fold cross-validation was applied. A radiomics model incorporating the radiomics signature and clinical risk factors was developed. Results Patients were divided into survivor (n = 97) and non-survivor (n = 104) groups based on the 5-year survival after surgery. The 30 most survival-related radiomics features were selected for the radiomics signature. Preoperative AFP and AST were integrated into the model as independent clinical risk factors. The model demonstrated good calibration and satisfactory discrimination, with a mean AUC of 0.9804 and 0.7578 in the training and validation sets, respectively. Conclusions This radiomics model is a valid method to predict 5-year survival in patients with HCC and may be used to identify patients for clinical trials of perioperative therapies and for additional surveillance.

Batteries coupled to photovoltaic (PV) modules have been identified as a viable power source for independent “internet of things” portable electronic devices and to reduce the grid load during peak times. However, the poor matching of these systems can adversely affect the power conversion efficiency, safety, and cost due to increased charge control strategies and supporting load management equipment. In this work, we significantly improve the rate performance of the battery electrodes by asphalt-derived carbon coating, and strategically couple high-efficiency n-i-p type perovskite solar cells with either aqueous lithium or sodium (Li/Na)-ion batteries, for the first time, to create a low-cost and high-performance photovoltaic battery system. Both photovoltaic battery systems demonstrate stable cycling performance for at least 30 cycles. We also demonstrate a high energy-conversion and storage efficiency of about 9.3% at a high discharge rate of 2 C and show that this is significantly superior than previously integrated photovoltaic battery systems. We suggest that the enhanced power and efficient energy transfer between the perovskite solar cells and aqueous Li/Na-ion batteries make this system attractive for a wide range of energy needs.

Background Radical prostatectomy (RP) is the primary treatment of localized prostate cancer. Immediate urinary incontinence post-RP was still common and depressing without specific reason. Methods A multicenter cohort of 154 consecutive patients from 2018 to 2020, who was diagnosed with localized prostate cancer underwent either modified mini-incision retropubic radical prostatectomy (Mmi-RRP) or laparoscopic radical prostatectomy (LRP) or robotic-assisted radical prostatectomy (RARP). Seventy-two patients with Denonvilliers’ fascia (DF) spared were included in DFS (Denonvilliers’ fascia sparing) group. Whereas eighty-two patients with DF completely or partially dissected were set as Group Control. The primary outcome was immediate continence (ImC). Continuous data and categorical data were analyzed with t-test and Chi-square test, respectively. Odds ratios (ORs) were calculated with logistic regression. Results Urinary continence of Group DFS was significantly better than that of Group Control at each time point within one year after operation. Incidence rate of continence in Group DFS and Group Control were 83.3% vs 13.4% (P P P P = 0.02) at 1 year after operation, respectively. Positive surgical margin (PSM) showed no significant difference (20.8% vs 20.7%, P = 1.0). In multivariate analysis, DFS showed importance for ImC post RP (OR = 26.4, P Conclusions Denonvilliers’ fascia acted as the fulcrum and hammock for continence post RP. Preservation of DF contributed to better continence after RP without increase of PSM. Trail registration Our research was conducted retrospectively and approved by the ethical committees of Minhang Hospital, but not registered.

Organizing nodes into clusters and forwarding data to the Base Station (BS) in clustering routing protocols have been widely utilized to improve the energy efficiency, scalability and stability of Wireless Sensor Networks (WSN). Making decisions on how many clusters are formed, which nodes are selected as Cluster Heads (CHs) and who become the relay nodes significantly impact the network performance. Therefore, a Distributed clustering routing protocol combined Affinity Propagation (AP) with Fuzzy Logic called DAPFL is proposed in this paper, which considers not only energy efficiency but also energy balance to extend the network lifetime. In DAPFL, AP is firstly used to determine the number of clusters and select the best CHs simultaneously based on residual energy, distance between nodes. Then the optimal next-hop CHs are chosen by using fuzzy logic system with residual energy, data length and distance to BS as descriptors. Simulations in different scenarios are carried out to verify the effectiveness of DAPFL, and the results show that DAPFL exhibits the promising performance in terms of network energy consumption, standard deviation of residual energy, network throughput and lifetime, compared with the up-to-date distributed clustering routing protocols EEFUC, EEFRP, LEACH-AP and APSA.

Background: The rapid spread of Coronavirus Disease-19 (COVID-19) infection has been the most important public health crisis across the globe since the end of 2019. Anxiety and depression are the most common mental health problems among people during the pandemic, and many studies have reported anxiety and depressive symptoms in college students. However, information on the mental health status of international medical students during this critical period of time has been scarce, which hinders the efforts in making proper policy or strategies to help these students. The present study aims to explore the prevalence of anxiety and depressive symptoms in international medical students in China and to find out the factors that have potential predictive value for anxiety and depressive symptoms.Method: A cross-sectional study was carried out for international medical students during November 2020 at China Medical University in Shenyang, China. Five hundred and nineteen international students were interviewed with questionnaires containing demographic variables, Stressors in school, Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Simplified Coping Style Questionnaire (SCSQ), Perceived Stress Scale (PSS-10), the Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R) and Resilience Scale-14 (RS-14). Univariate logistic regression and stepwise multiple logistic regression analyses were conducted where appropriate to explore the predictive factors of anxiety symptoms and depressive symptoms.Results: The prevalence of anxiety symptoms and depressive symptoms in the sample population was 28.5% (148/519) and 31.6% (164/519), respectively. Stressors in school (β = 0.176, OR = 1.192, CI: 1.102–1.289), negative coping style (β = 0.639, OR = 1.894, CI: 1.287–2.788) and perceived stress (β = 0.230, OR = 1.258, CI: 1.184–1.337) were found to be the predictors of anxiety symptoms among the international medical students; while gender (β = −0.594, OR = 0.552, CI: 0.315–0.968), stay up late (β = 0.828, OR = 2.288, CI: 1.182–4.431), current place of residence (β = 1.082, OR = 2.951, CI: 1.256–6.931), stressors in the school (β = 0.303, OR = 1.354, CI: 1.266–1.496), negative coping style (β = 0.866, OR = 2.377, CI: 1.516–3.725), perceived stress (β = 0.233, OR = 1.262, CI: 1.180–1.351) were found to be predictors of depressive symptoms.Conclusion: The prevalence of anxiety symptoms and depressive symptoms was moderate among international medical students in China. The communal predictors of anxiety and depressive symptoms were stressors in school, negative coping style and perceived stress; while demographic factors such as gender (male), stay up late at night and current place of residence were found associated with depressive symptoms. These results suggest that proper stress management and specific interventions are needed to help students maintain their mental health during the COVID-19 pandemic period.

Purpose Using machine learning methods (MLMs) to predict stone-free status after percutaneous nephrolithotomy (PCNL). We compared the performance of this system with Guy’s stone score and S.T.O.N.E score system. Materials and Methods Data from 222 patients (90 females, 41%) who underwent PCNL at our center were used. Twenty-six parameters, including individual variables, renal and stone factors, surgical factors were used as input data for MLMS. We evaluate the efficacy of four different techniques: Lasso-logistic (LL), random forest (RF), support vector machine (SVM) and Naive Bayes. Model performance was evaluated using area under curve (AUC) and compared with Guy’s stone score and S.T.O.N.E score system. Results Overall stone free rate was 50% (111/222). To predict the stone-free status, all receiver operating characteristic curves of the four MLMs were above the curve for the Guy’s stone score. The AUCs of LL, RF, SVM and Naive Bayes were 0.879, 0.803, 0.818, 0.803 respectively. Those values were higher than the AUC of the Guy’s score system, 0.800. The accuracies of the MLMs (0.803–0.818%) were also superior to S.T.O.N.E score system (0.788%). Among the MLMs, Lasso-logistic showed the most favorable AUC. Conclusion Machine learning methods can predict stone-free rate with AUCs no inferior to those of Guy’s stone score and S.T.O.N.E score system.

Purpose: To evaluate the aspects affecting transfusion following percutaneous nephrolithotomy (PCNL).Background: From 2016 to 2019, 665 patients underwent PCNL for removal of renal calculi in our center. Complications, including hemorrhages, have been reported. Twenty-three patients (3.5%) have received a blood transfusion and twelve (1.9%) were treated by hyper-selective embolization. We focus on the influencing factors related to postoperative blood transfusion. The factors analyzed were (age, sex, hypertension, diabetes, serum creatinine level, preoperative hemoglobin, and use of anticoagulants or antiplatelet medications); renal and stone factors (previous surgery, abnormal anatomy, stone side, stone burden, stone type); and surgical features: (access number, the calyx of puncture and stone-free rate). These data were analyzed for the presence of bleeding.Results: Among individual factors, preoperative hemoglobin level (P