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Due to the unpredictable and fluctuating nature of solar photovoltaic (PV), energy storage systems (ESS), such as batteries, are always integrated with PV systems to smooth the power supply. In this paper, a multi-port dc-ac converter (MPC) with differential power processing dc-dc converter (DPPC) is proposed for battery ESS integrated PV systems. The MPC is capable of regulating most of active power among PV, battery and ac grid, and only the differential power (partial power) needs to be handled by the dc-dc converter. Hence, the major merits of higher integration, higher efficiency, and lower cost can be achieved by the proposed configuration. A new cooperative control scheme for the MPC and DPPC is investigated, aiming at realizing flexible active power flow. Besides, a modified space vector pulse-width modulation (SVPWM) is developed for the MPC, taking into the consideration of the voltage variation of both PV and battery. The active power controllability of the MPC and the power rating of the DPPC are quantitatively analyzed. The effectiveness of the proposed configuration, control and modulation schemes is validated by experimental results.

A dual-polarized endfire array is presented in this paper for millimeter application. The substrate integrated mode-composite transmission line is introduced to exciting the dual-polarized radiation. Specially, the horizontal polarization is excited by the TEM-mode, while the vertical polarization is based on the TE10-mode. Two metal blocks sandwich the substrates to form a sandwich structure, and open-ended slot is designed on the block edge to construed complementary sources radiation. Benefiting from the wdieband feature of complementary sources, the proposed dual-polarized endfire array achieved a considerable bandwidth performance of 26.9% (24.8 GHz -32.5 GHz) based on the standard that both the voltage standing wave ratios of the two ports are less than 2. In terms with the key factor of dual-polarized antenna, isolation, measured results shows a high port isolation of over 36 dB and a cross-polarization discrimination rate of over 30 dB. The excellent dual-polarized performance gives the proposed endfire array the potential of application in millimeter wave mobile communications.

The grade groups (GGs) of Gleason scores (Gs) is the most critical indicator in the clinical diagnosis and treatment system of prostate cancer. End-to-end method for stratifying the patient-level pathological appearance of prostate cancer (PCa) in magnetic resonance (MRI) are of high demand for clinical decision. Existing methods typically employ a statistical method for integrating slice-level results to a patient-level result, which ignores the asymmetric use of ground truth (GT) and overall optimization. Therefore, more domain knowledge (e.g., diagnostic logic of radiologists) needs to be incorporated into the design of the framework. The patient-level GT is necessary to be logically assigned to each slice of a MRI to achieve joint optimization between slice-level analysis and patient-level decision-making. In this paper, we propose a framework (PCa-GGNet-v2) that learns from radiologists to capture signs in a separate two-dimensional (2-D) space of MRI and further associate them for the overall decision, where all steps are optimized jointly in an end-to-end trainable way. In the training phase, patient-level prediction is transferred from weak supervision to supervision with GT. An association route records the attentional slice for reweighting loss of MRI slices and interpretability. We evaluate our method in an in-house multi-center dataset ( N = 570) and PROSTATEx ( N = 204), which yields five-classification accuracy over 80% and AUC of 0.804 at patient-level respectively. Our method reveals the state-of-the-art performance for patient-level multi-classification task to personalized medicine.

In this article, a hybrid connected unified power quality conditioner integrating distributed generation (HCUPQC-DG) is proposed. Two dc ports are created at the dc link of the HCUPQC-DG, in which one low-voltage (LV) dc port is directly connected to distributed generation (DG), and the other high-voltage (HV) dc port is indirectly connected to DG through the front-end dc–dc converter. With the hybrid connected configuration, the HV is designed to ensure the dc–ac voltage conversion capability, whereas the LV, i.e., the voltage of DG, can be relatively low and vary in a wide range. Besides, most active power can be directly transferred from DG to the ac load or grid through the direct power flow path. Hence, the conversion efficiency is enhanced, and the power capacity of the front-end dc–dc converter is significantly reduced. The operating principle and the control and modulation strategies of the proposed HCUPQC-DG are discussed. Moreover, the power flow through the HCUPQC-DG is analyzed in detail to understand the system operation. Experimental results with a 3-kVA prototype are provided to verify the feasibility and effectiveness of the proposed HCUPQC-DG.

Solar energy based power generation systems can reduce pollutants emissions by reducing fossil fuel consumption. A new option for this idea is the Organic Rankine cycle coupled with a concentrating solar collector. The present study provides the Organic Rankine cycle performance using energy, exergy and economic approaches, selecting the appropriate operating fluid for the cycle consisting of Organic Rankine cycle and Linear Fresnel solar reflector. The effect of different organic fluid as well as different nanofluids on the overall performance of the cycle is investigated. Sensitivity analysis is discussed to evaluate the effect of various factors such as solar radiation, inlet temperature of solar system, mass flow rate, and inlet temperature and pressure of turbine on energy system performance. It was found that, the results provided in the present study do not correspond to any of the findings of previous similar studies. In addition, about 170 collectors of Linear Fresnel reflectors are needed to supply the thermal power required by the Organic Rankine cycle system. Under design conditions, the Levelized Cost of Energy and Simple payback time for the proposed hybrid system are obtained 0.0446 Euro/kWh and 7.74 years, respectively. Furthermore, the investment cost of the Linear Fresnel reflector system plays a key role in the economic justification of the proposed hybrid energy system.

Purpose To develop and validate a pretreatment computed tomography (CT)-based deep-learning (DL) model for predicting the treatment response to concurrent chemoradiation therapy (CCRT) among patients with locally advanced thoracic esophageal squamous cell carcinoma (TESCC). Methods and Materials We conducted a prospective, multicenter study on the therapeutic efficacy of CCRT among TESCC patients across 9 hospitals in China (ChiCTR2000039279). A total of 306 patients with locally advanced TESCC diagnosed by histopathology from August 2015 to May 2020 were included in this study. A 3-dimensional DL radiomics model (3D-DLRM) was developed and validated based on pretreatment CT images to predict the response to CCRT. Furthermore, the prediction performance of the newly developed 3D-DLRM was analyzed according to 3 categories: radiation therapy plan, radiation field, and prescription dose used. Results The 3D-DLRM achieved good prediction performance, with areas under the receiver operating characteristic curve of 0.897 (95% confidence interval, 0.840-0.959) for the training cohort and 0.833 (95% confidence interval, 0.654-1.000) for the validation cohort. Specifically, the 3D-DLRM accurately predicted patients who would not respond to CCRT, with a positive predictive value (PPV) of 100% for the validation cohort. Moreover, the 3D-DLRM performed well in all 3 categories, each with areas under the receiver operating characteristic curve of >0.8 and positive predictive values of approximately 100%. Conclusion The proposed pretreatment CT-based 3D-DLRM provides a potential tool for predicting the response to CCRT among patients with locally advanced TESCC. With the help of precise pretreatment prediction, we may guide the individualized treatment of patients and improve survival.

Pannexin 1 (PANX1) channel is a critical ATP-releasing pathway that modulates tumor immunity, progression, and prognosis. However, the roles of PANX1 in different cancers remain unclear. We analyzed the expression of PANX1 in human pan-cancer in the Oncomine and GEPIA2.0 databases. The prognostic value of PANX1 expression was determined using Kaplan-Meier plotter and OncoLnc tools. The correlation between PANX1 and tumor-infiltrating immune cells was investigated using the TIMER 2.0. In addition, the relationship between PANX1 and immunomodulators was explored using TISIDB. Finally, gene set enrichment analysis (GSEA) was performed utilizing LinkedOmics. The results indicated that PANX1 was overexpressed in most cancers compared to normal tissues. The high expression of PANX1 was associated with poor prognosis in multiple tumors, especially in pancreatic adenocarcinoma (PAAD). In addition, PANX1 was correlated with a variety of immunomodulators, such as CD274, IL10, CD276, IL2RA, TAP1, and TAP2. PANX1 expression level was significantly related to infiltration of multiple immune cells in many cancers, including cancer associated fibroblast, macrophage, and neutrophil cells. Further analysis revealed that PANX1 was significantly associated with T cells CD8+ (rho = 0.524, P = 1.94e-13) and Myeloid dendritic cell (rho = 0.564, P = 9.45e-16). GSEA results showed that PANX1 was closely associated with leukocyte cell-cell adhesion, endoplasmic reticulum lumen, ECM-receptor interaction, and Focal adhesion pathways in PAAD. PANX1 expression was higher in pan-cancer samples than in normal tissues. The high expression of PANX1 was associated with poor outcome and immune infiltration in multiple cancers, especially in PAAD.

A dual-dc-port dc–ac converter with virtual space vector pulsewidth modulation (SVPWM) based flexible power control is proposed for photovoltaic (PV)-battery hybrid systems. Two dc ports, in which one dc port is interfaced with PV and the other dc port is interfaced with the battery, are provided simultaneously by the dual-dc-port dc–ac converter. Hence, all the active power is transferred within single power conversion stage, and the dc–dc converter between PV and battery is removed. To realize flexible power control between PV, battery, and ac grid, a new control scheme consisting of an outer power loop and an inner virtual SVPWM is proposed, with fully considering the voltage variation of both PV and battery. Operation principle and power control capability of the dual-dc-port dc–ac converter are analyzed in detail. The effectiveness of the proposed solution is validated by experimental results.

Cervical cancer if not detected and treated promptly can be lethal to females. In several advanced nations, the relevance of coordinated screening services has been implemented. Nevertheless, most developing nations have not implemented a nationwide screening and vaccination programme accessible to all women owing to inadequate screening and vaccination services coupled with vaccine scepticism, misconception concerning vaccination, and lack of awareness are causing an upsurge in Africa's cervical cancer cases. Cervical cancer could be greatly reduced if comprehensive screening services and HPV vaccination are implemented. In this review, we discussed the cervical cancer incidence in Africa, factors influencing the high rate of cervical cancer in Africa, screening and HPV vaccination programs and the potential intervention and recommendations to reduce the incident and mortality rates of cervical cancer in Africa. Also, we highlighted the disadvantages and advantages of widely accessible screening tests in Africa.

In this paper, silver nanowires/polyaniline (Ag/PANI) composites were prepared by an in situ synthesis method. Interestingly, the permittivity changed from positive to negative along with the formation of percolation network. The plasma oscillations of free electrons from the network made a dominant effect on the negative permittivity behavior. Further investigation revealed that the composites with negative permittivity presented inductive character. The polymer-based epsilon-negative composites can be applied to electromagnetic shielding, flexible electronic devices, and stretchable sensors.

Colorectal cancer (CRC) is a malignant tumor and morbidity rates are among the highest in the world. The variation in CRC patients' prognosis prompts an urgent need for new molecular biomarkers to improve the accuracy for predicting the CRC patients' prognosis or as a complement to the traditional TNM staging for clinical practice. CRC patients' gene expression data of HTSeq‐FPKM and matching clinical information were downloaded from The Cancer Genome Atlas (TCGA) datasets. Patients were randomly divided into a training dataset and a test dataset. By univariate and multivariate Cox regression survival analyses and Lasso regression analysis, a prediction model which divided each patient into high‐or low‐risk group was constructed. The differences in survival time between the two groups were compared by the Kaplan–Meier method and the log‐rank test. The weighted gene co‐expression network analysis (WGCNA) was used to explore the relationship between all the survival‐related genes. The survival outcomes of patients whose overall survival (OS) time were significantly lower in the high‐risk group than that in the low‐risk group both in the training and test datasets. Areas under the ROC curves which termed AUC values of our 9‐gene signature achieved 0.823 in the training dataset and 0.806 in the test dataset. A nomogram was constructed for clinical practice when we combined the 9‐gene signature with TNM stage and age to evaluate the survival time of patients with CRC, and the C‐index increased from 0.739 to 0.794. In conclusion, we identified nine novel biomarkers that not only are independent prognostic indexes for CRC patients but also can serve as a good supplement to traditional clinicopathological factors to more accurately evaluate the survival of CRC patients., We identified a 9‐gene signature screened out based on batch survival analysis that can be used not only as an independent prognostic index for CRC patients but also as a favorable supplement to traditional clinicopathological factors for clinicians to more accurately and effectively evaluate the survival of CRC patients.

A broadband metasurface antenna is proposed in this letter. The antenna is based on a nonperiodic metasurface. The modal behavior of the metasurface and the slot is analyzed using characteristic modes analysis (CMA). Three desired modes of the metasurface are found. Furthermore, the slot acts not only as a feeding structure but also as a metasurface-loaded antenna. By combining the three modes of the metasurface and the modes of the slot, the wide bandwidth is achieved under multimode resonance. To verify the design, the proposed metasurface antenna is simulated, fabricated, and tested. The results show that the proposed metasurface antenna achieves a wide impedance bandwidth above 79% and a wide 3 dB realized gain bandwidth of 77%.

A complementary source array with enhanced beamwidth is presented based on the substrate-integrated waveguide (SIW) in this communication. The orthogonal complementary source consists of a SIW slot and a vertical monopole, of which the radiation pattern is heart-shaped, pointing to the direction perpendicular to both slot and monopole. To achieve an enhanced beamwidth from the heart-shaped pattern, the complementary sources are cascaded to form an array. In particular, the slots are etched alternately on both sides of the central axis to achieve an in-phase excitation, while the monopoles are uniformly loaded with an alternate antiphase excitation. This arrangement makes the heart-shaped pattern of each complementary source element alternately point to either side of the array axis, so that the synthesized radiation beamwidth is enhanced in the E-plane. Based on the proposed idea, a nine-element line array is designed, fabricated, and tested. Compared with the same-sized referenced SIW slot array with an E-plane half-power beamwidth (HPBW) of only 80°, the proposed complementary source array extends the HPBW to 180°.

A new perspective based on complementary sources radiation is presented for analyzing a widebeam composite microstrip-monopole antenna. The typical cavity model theory shows that the radiation patterns of the microstrip antenna could be calculated by using two parallel equivalent magnetic currents, and the E-plane beamwidth of the traditional microstrip antenna is mainly determined by the array factor. Loading the monopoles through the metal patch of the original microstrip antenna can construct complementary sources. Two monopoles are symmetrically loaded and two pairs of complementary sources are excited. Interestingly, the two pairs of complementary sources are aligned with in-phase magnetic current radiation sources and antiphase electronic current radiation sources, which indicates two heart-shaped radiation patterns pointing in opposite directions. The total far-zone radiated fields synthesized by the two heart-shaped radiation patterns can present wide E-plane beamwidth performance. An example antenna working at 4.4 GHz is designed for verification. With the introduction of a differential feeding scheme for a symmetrical radiation pattern, the E-plane radiation pattern can cover the upper half plane, i.e., $180^{\circ }$ , with a fluctuation of less than 1 dB and an antenna gain of over 3 dBi.

Background: Although estimates of suboptimal adherence to oral corticosteroids in asthma range from 30% to 50%, no ideal method for measurement exists; the impact of poor adherence in severe asthma is likely to be particularly high. Research Questions: What is the prevalence of suboptimal adherence detected by self-reporting and direct measures? Is suboptimal adherence associated with disease activity? Study Design and Methods: Data were included from individuals with severe asthma taking part in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes) study and prescribed daily oral corticosteroids. Participants completed the Medication Adherence Report Scale, a five-item questionnaire used to grade adherence on a scale from 1 to 5, and provided a urine sample for analysis of prednisolone and metabolites by liquid chromatography-mass spectrometry. Results: Data from 166 participants were included in this study: mean (SD) age, 54.2 (± 11.9) years; FEV 1, 65.1% (± 20.5%) predicted; female, 58%; 37% completing the Medication Adherence Report Scale reported suboptimal adherence; and 43% with urinary corticosteroid data did not have detectable prednisolone or metabolites in their urine. Good adherence by both methods was detected in 49 of the 142 (35%) of participants in whom both methods were performed; adherence detection did not match between methods in 53%. Self-reported high adherers had better asthma control and quality of life, whereas directly measured high adherers had lower blood eosinophil levels. Interpretation: Low adherence is a common problem in severe asthma, whether measured directly or self-reported. We report poor agreement between the two methods, suggesting some disassociation between self-assessment of medication adherence and regular oral corticosteroid use, which suggests that each approach may provide complementary information in clinical practice.

In this meta-analysis we assessed whether the diameter of ureteral stents (4.7-5-Fr, 6-Fr) has an impact on the rate of occurrence of urinary tract symptoms and complications after successful URS and intracorporeal lithotripsy. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A rigorous search for relevant studies published in MEDLINE, Embase, and the Cochrane Controlled Trials Register was conducted to find informative randomized controlled trials. The reference lists of relevant articles were also manually searched and reviewed. The protocol was prospectively registered at PROSPERO (CRD42020202164). All statistical evaluations were performed using RevMan software version 5.3.0. Seven articles comprising 547 patients were included in the meta-analysis. After placement of ureteral stents with different diameters for approximately 1 week, we found that ureteral stents with smaller diameters (4.7-5-Fr) were associated with significant improvements in the main domain scores on the Ureteral Stent Symptom Questionnaire, such as urinary symptoms (mean difference -4.47, 95% confidence interval -5.87 to -3.08; P < 0.00001) and body pain (mean difference -2.48, 95% confidence interval -4.37 to -0.59; P = 0.01), but poor outcomes in stent migration compared to ureteral stents with a 6-Fr diameter (odds ratio 3.00, 95% confidence interval 1.06-8.51; P = 0.04). However, there were no significant differences in Ureteral Stent Symptom Questionnaire scores with regard to work performance (mean difference -0.56, 95% confidence interval -2.52 to 1.40; P = 0.58), general health (mean difference -2.29, 95% confidence interval -4.95 to 0.37; P = 0.09), additional problems (mean difference -0.43, 95% confidence interval -1.02 to 0.15; P = 0.15), and complications such as fever (odds ratio 0.75, 95% confidence interval 0.24-2.39; P = 0.63). Ureteral stents with a diameter of 4.7-5-Fr have better outcomes than those with a diameter of 6-Fr, based on the Ureteral Stent Symptom Questionnaire pain and urinary tract symptoms scores. However, they are more prone to migration compared to those with a larger diameter.

Nanofabrication schemes usually suffer challenges in direct growth on complex nanostructured substrates. We provide a new technology that allows for the convenient, selective growth of complex nanostructures directly on three-dimensional (3D) homogeneous semiconductor substrates. The nature of the selectivity is derived from surface states modulated electrochemical deposition. Metals, metal oxides, and compound semiconductor structures can be prepared with high fidelity over a wide scale range from tens of nanometers to hundreds of microns. The utility of the process for photoelectrochemical applications is demonstrated by selectively decorating the sidewalls and tips of silicon microwires with cuprous oxide and cobalt oxides catalysts, respectively. Our findings indicate a new selective fabrication concept applied for homogeneous 3D semiconductor substrates, which is of high promise in community of photoelectronics, photoelectrochemistry, photonics, microelectronics, etc.

Group convolution has been widely used in deep learning community to achieve computation efficiency. In this paper, we develop CondenseNet-elasso to eliminate feature correlation among different convolution groups and alleviate neural network's overfitting problem. It applies exclusive lasso regularization on CondenseNet. The exclusive lasso regularizer encourages different convolution groups to use different subsets of input channels therefore learn more diversified features. Our experiment results on CIFAR10, CIFAR100 and Tiny ImageNet show that CondenseNets-elasso are more efficient than CondenseNets and other DenseNet' variants.

Three-vessel disease (TVD) is a severe coronary heart disease (CHD) with poor prognosis. Niemann-Pick C1-like 1 (NPC1L1) is a transporter protein for exogenous cholesterol absorption, and 3-hydroxy...

Purpose. The prevalence of carcinoma of the cervix is increasing in younger women. This study aimed to evaluate the sociodemographic, pathological, and clinical features, prognosis, and treatment of women aged ≤35 years with carcinoma of the cervix (CC). Methods and Materials. We retrospectively analysed the clinical information of 352 younger women with carcinoma of the cervix aged ≤35 years at the Gynaecological Oncology Department of Zhengzhou University People’s Hospital from April 2000 to January 2018. The overall survival was evaluated with the Kaplan–Meier model, and the log-ranked analysis was compared with the univariate analysis to determine prognostic survival-related risk factors. Cox Proportional Hazards analysis was further used in analysing parameters correlated with survival after univariate analysis. A p value p value = 0.002), histological type (SCC vs. non-SCC) (95.7% vs. 56.2%: p value = 0.001), surgical margin (negative vs. positive) (90.9% vs. 41.2%: p value = 0.001), and pelvic lymph node metastasis (no vs. yes) (93.4% vs. 39.2%: p value = .001). The Cox proportional hazards test demonstrated that lymph node metastases ([HR] = 2.924, 95% CI: 1.432–7.426; p = 0.014 ), tumour stage IIIA-IVA ([HR] = 3.765, 95% CI: 1.398–9.765; p = 0.016 ), and surgical margin ([HR] = 2.167, 95% CI: 1.987–9.554; p = 0.019 ) were independent prognostic risk factors for overall survival in younger women with cervical carcinoma. Conclusion. In conclusion, the status of lymph node metastases, tumour stage, and surgical margin and the type of histopathology substantially influence the rate of survival.

Ultra-dense networks (UDNs) have been known as an efficient method to satisfy tremendous traffic demands in future mobile networks. With high density deployment of small base stations (SBSs), mobile user equipments (UEs) will suffer frequent and unnecessary handovers (HOs) which severely degrade the quality of service (QoS) and/or quality of experience (QoE). To solve this problem, we propose a novel multi-attribute mobility management strategy according to link reliability level and throughput requirement. In particularly, the reference signal received quality (RSRQ) and speed of UE are taken into account for the link reliability index. Besides, the minimum throughput is considered for guaranteeing QoS requirement of users. The UE reconnects the target small cell with the highest priority, which are calculated according to link index, QoS index, and corresponding weights. The goal of proposed mobility management scheme is to improve HO performance and QoS of UEs. Extensive simulation experiences with different traffic types are evaluated and the simulation results indicate the effectiveness of our mobility management strategy in terms of throughput and HO delay.

Health literacy is the degree to which individuals have the capacity to obtain, process, communicate, and understand basic health information and services needed to make health decisions effectively. Adequate health literacy is essential for the optimal management of rheumatic diseases due to their multi-organ involvement and complex medication regimens. We review a recent quality assurance study which utilized a universal precautions health literacy approach and demonstrated significant improvement in medication adherence among patients with rheumatic diseases.

This is the first comprehensive overview of laccase-triggered anabolism from fundamental theory to biotechnology applications. Laccase is a typical biological oxidordeuctase that induces the one-electronic transfer of diverse substrates for engendering four phenoxy radicals with concomitant reduction of O

Background Polymyxins is a class of cyclic polypeptide antibiotics with strong antibacterial activity against Gram-negative bacteria. However, bacteria become resistant to Polymyxins. Thus, Polymyxin B (PMB) in combination with other antimicrobials may be a better choice in clinic. This study aimed to evaluate the synergistic bacteriostatic effect of PMB combined with Propofol medium and long chain fat emulsion injection against Escherichia coli in vitro. Methods The Minimal Inhibitory Concentration of Polymyxin B combined with Propofol medium and long chain fat emulsion injection and two drugs used alone against Escherichia coli were detected with the Kirby-Bauer disk diffusion (K-B) method, and the diameter of the inhibition zone was calculated to evaluate bacteriostatic effects. Results Different concentrations of PMB all had obvious bacteriostatic effects on Escherichia coli, while different concentrations of Propofol medium and long chain fat emulsion injection had no bacteriostatic effects on Escherichia coli. The bacteriostatic effect of the combination of PMB with Propofol medium and long chain fat emulsion injection against Escherichia coli was synergistic, and no effects of uncorrelated and antagonism were observed in this combination. Conclusions PMB combined with Propofol medium and long chain fat emulsion injection can improve the bacteriostatic effect for Escherichia coli in vitro.

Background/purpose: Oral lichenoid reactions (OLRs) are commonly characterized by the infiltration and activation of inflammatory cells at the interface of the oral mucosa. This study aimed to compare the cytokine profiles between intralesional and peripheral plasma from patients with OLRs and elucidate the cytokine profile in the OLR microenvironment. Materials and methods: A total of 26 paired intralesional and peripheral plasma samples were collected from patients with OLRs. A panel of 15 cytokines was measured using a Luminex assay. The reticular, erythema, and ulcerative score was used to evaluate the degree of OLR severity. Results: IL-10 was detected in a fewer number of intralesional samples (19/26) compared to peripheral samples (26/26, p = 0.01). The intralesional plasma exhibited significantly elevated levels of granzyme B (median 108.94 vs. 16.00), TGF-β1 (mean 30448.92 vs. 10199.04), TGF-β2 (mean 1659.73 vs. 1308.49), and TGF-β3 (mean 914.33 vs. 573.13) compared to the peripheral plasma (p = 0.001, p

In order to study the vibration wearing regularity and the strength failure point of stator end windings before and after static rotor eccentricity, the three-dimensional electromagnetic forces and the subsequent mechanical responses are studied in this paper. The electromagnetic force, stress, and deformation on the end winding of the QFSN-600-2YHG turbo-generator are calculated by the finite element method (FEM) through an electromagnetic-structure coupling. The radial vibration characteristics of the winding are verified by experiments. It shows that the vibration wearing in the same layer is more serious than that between two neighboring layers. For different layers, the interphase coils endure a larger wearing risk than the innerphase coils. Inside the same phase, the last coil along the rotating direction has the highest risk of insulation wearing. The occurrence of static rotor eccentricity will significantly increase the electromagnetic forces and the vibration amplitudes on some coils. The end-phase coil which is close to the minimum air-gap point is the most dangerous one due to the lasting overstresses and the intensified deformations.

Sparse representation (SR)-based pansharpening methods which combine the dictionary and estimated sparse coefficients have achieved visually and quantitatively great results in pansharpening proble...

Objective The type 1 and type 2 systemic lupus erythematosus (SLE) categorization system was recently proposed to validate the patients' perspective of disease and to capture a more comprehensive spectrum of symptoms. The objective of this study was to characterize the clinical manifestations of SLE subtypes and to determine the correlation between the patient- and physician-reported measures used in the model. Methods This was a cross-sectional study of patients with SLE in a university clinic. Patients completed the Systemic Lupus Activity Questionnaire (SLAQ) and 2011 American College of Rheumatology fibromyalgia (FM) criteria. Active SLE was defined as Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score ≥6, clinical SLEDAI score ≥4, or active lupus nephritis. We identified 4 groups: type 1 SLE (active SLE without FM), type 2 SLE (inactive SLE with FM), mixed SLE (active SLE with FM), and minimal SLE (inactive SLE without FM). Results In this cohort of 212 patients (92% female, mean age 45 years), 30% had type 1 SLE, 8% had type 2 SLE, 13% had mixed SLE, and 49% had minimal SLE. Regardless of SLE disease activity, patients with FM (21%), reported higher SLAQ scores, patient global assessment scores, and self-reported lupus flare that resulted in discordance between patient- and physician-reported measures. Conclusion Fatigue, widespread pain, sleep dysfunction, and mood disorders are common symptoms in SLE. Identifying these symptoms as type 2 SLE may be a method to improve patient communication and understanding. The level of type 2 SLE impacts patients' perception of disease and self-reported symptoms. The SLAQ may need to be reinterpreted based on the FM severity scale.

BACKGROUND In recent years, phosphodiesterase type 5 (PDE5) inhibitors have been proposed for relieving the ureteral stent-related symptoms. We conducted a meta-analysis to assess the efficacy and safety of PDE5 inhibitors in the treatment of ureteral stent-related symptoms. METHODS Randomized controlled trials (RCTs) that reported on the effectiveness of PDE5 inhibitors on ureteral stent-related symptoms were identified and collected from Medline, Embase, and Cochrane Library databases. RESULTS Four RCTs involving 352 patients were included. Following treatment with PDE5 inhibitors for 1 week, significant improvement of urinary symptoms (P

The recent outbreak of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has led to a worldwide pandemic. One week after initial symptoms develop, a subset of patients progresses to severe disease, with high mortality and limited treatment options. To design novel interventions aimed at preventing spread of the virus and reducing progression to severe disease, detailed knowledge of the cell types and regulating factors driving cellular entry is urgently needed. Here we assess the expression patterns in genes required for COVID-19 entry into cells and replication, and their regulation by genetic, epigenetic and environmental factors, throughout the respiratory tract using samples collected from the upper (nasal) and lower airways (bronchi). Matched samples from the upper and lower airways show a clear increased expression of these genes in the nose compared to the bronchi and parenchyma. Cellular deconvolution indicates a clear association of these genes with the proportion of secretory epithelial cells. Smoking status was found to increase the majority of COVID-19 related genes including ACE2 and TMPRSS2 but only in the lower airways, which was associated with a significant increase in the predicted proportion of goblet cells in bronchial samples of current smokers. Both acute and second hand smoke were found to increase ACE2 expression in the bronchus. Inhaled corticosteroids decrease ACE2 expression in the lower airways. No significant effect of genetics on ACE2 expression was observed, but a strong association of DNA- methylation with ACE2 and TMPRSS2- mRNA expression was identified in the bronchus.

Background Patients with severe asthma may have a greater risk of dying from COVID-19 disease. Angiotensin converting enzyme-2 (ACE2) and the enzyme proteases, transmembrane protease serine 2 (TMPRSS2) and FURIN, are needed for viral attachment and invasion into host cells. Methods We examined microarray mRNA expression of ACE2, TMPRSS2 and FURIN in sputum, bronchial brushing and bronchial biopsies of the European U-BIOPRED cohort. Clinical parameters and molecular phenotypes, including asthma severity, sputum inflammatory cells, lung functions, oral corticosteroid (OCS) use, and transcriptomic-associated clusters, were examined in relation to gene expression levels. Results ACE2 levels were significantly increased in sputum of severe asthma compared to mild-moderate asthma. In multivariate analyses, sputum ACE2 levels were positively associated with OCS use and male gender. Sputum FURIN levels were significantly related to neutrophils (%) and the presence of severe asthma. In bronchial brushing samples, TMPRSS2 levels were positively associated with male gender and body mass index, whereas FURIN levels with male gender and blood neutrophils. In bronchial biopsies, TMPRSS2 levels were positively related to blood neutrophils. The neutrophilic molecular phenotype characterised by high inflammasome activation expressed significantly higher FURIN levels in sputum than the eosinophilic Type 2-high or the pauci-granulocytic oxidative phosphorylation phenotypes. Conclusion Levels of ACE2 and FURIN may differ by clinical or molecular phenotypes of asthma. Sputum FURIN expression levels were strongly associated with neutrophilic inflammation and with inflammasome activation. This might indicate the potential for a greater morbidity and mortality outcome from SARS-CoV-2 infection in neutrophilic severe asthma.

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. OBJECTIVES The study sought to assess COVID-19`s impact on global cardiovascular diagnostic procedural volumes and safety practices. METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. RESULTS Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoradc echocardiography decreased by 59%, transesophageat echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). hi multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and teteheatth. CONCLUSIONS COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

Machine learning (ML) algorithms have been widely used in the classification of white blood cells (WBCs). However, the performance of ML algorithms still needs to be addressed for being short of gold standard data sets, and even the implementation of the proposed algorithms.In this study, the method of two-module weighted optimized deformable convolutional neural networks (TWO-DCNN) was proposed for WBC classification. Our algorithm is characterized as two-module transfer learning and deformable convolutional (DC) layers for the betterment of robustness. To validate the performance, our method was compared with classical MLs of VGG16, VGG19, Inception-V3, ResNet-50, support vector machine (SVM), multilayer perceptron (MLP), decision tree (DT) and random forest (RF) on our undisclosed WBC data set and public BCCD data set.TWO-DCNN achieved the best performance with the precisions (PREs) of 95.7%, 94.5% and 91.6%, recalls (RECs) of 95.7%, 94.5% and 91.6%, F1-scores (F1s) of 95.7%, 94.5% and 91.6%, area under curves (AUCs) of 0.98, 0.97 and 0.95 for low-resolution and noisy undisclosed data sets, BCCD data set, respectively.With accurate feature extraction and optimized network weights, the proposed TWO-DCNN showed the best performance in WBC classification for low-resolution and noisy data sets. It could be used as an alternative method for clinical applications.

Prostate cancer is the second most frequently diagnosed cancer in the men population. Combination anticancer therapy using doxorubicin (DOX) and another extract of traditional Chinese medicine is one nano-sized drug delivery system promising to generate synergistic anticancer effects, maximize the treatment effect, and overcome multi-drug resistance. The purpose of this study is to construct a drug delivery system for the co-delivery of DOX and tanshinones (TAN). Lipid nanoparticles loaded with DOX and TAN (N-DOX/TAN) were prepared by emulsification and solvent-diffusion method. PSMA targeted nanoparticles loaded with DOX and TAN (P-N-DOX/TAN) were synthesized by conjugating a PSMA targeted ligand to N-DOX/TAN. We evaluate the performance of this system in vitro and in vivo. P-N-DOX/TAN has a size of 139.7 ± 4.1 nm and a zeta potential of 11.2 ± 1.6 mV. The drug release of DOX and TAN from P-N-DOX/TAN was much faster than that of N-DOX/TAN. N-DOX/TAN presented more inhibition effect on tumor growth than N-DOX and N-TAN, which is consistent with the synergistic results and successfully highlighting the advantages of combing the DOX and TAN in one system. P-N-DOX/TAN achieved higher uptake by LNCaP cells (58.9 ± 1.9%), highest tumor tissue distribution, and the most significant tumor inhibition efficiency. The novel nanomedicine offers great promise for the dual drug delivery to prostate cancer cells, showing the potential of synergistic combination therapy for prostate cancer.

With the proliferation of microgrids (MGs) into the utility grid (UG), MGs with multiple distributed generations (DGs) face challenge to flexibly support voltage during UG faults. In this paper, a multi-stage voltage support optimization method is proposed to stabilize voltage, current and power, for safeguarding the MG operation and providing flexible power delivery capacity. The proposed method consists of three stages: 1) voltage stage in which the phase voltage instead of the sequence voltage regulation is considered to support voltage more precise; 2) current stage in which a novel current generation strategy with maximum current limiting (MCL) is formulated by directly embedding network impedance features; 3) power stage in which multiple matching scenarios for max/min active/reactive powers are developed to improve the flexibility of power delivery capacity. Several test cases are presented and pertinent results are discussed to validate the effectiveness of the proposed method for voltage support of MG with multiple DGs.

Complementary sources concept and half-mode/quarter-mode substrate integrated waveguide (HMSIW/QMSIW) technology are introduced in this paper to improve the back-radiation suppression and bandwidth of microstrip patch antennas (MPAs). The HMSIW cavity as the feeding structure brings an additional resonant frequency to the inherent resonant mode of typical MPAs, which efficiently extends the bandwidth of the MPAs. In addition, while stimulating the MPA mode, the HMSIW cavity drives a monopole by slightly breaking the shorting wall of the HMSIW cavity and loading a printed monopole. The loaded monopole and the equivalent magnetic currents of the MPA construct an orthogonal complementary source model that indicates back radiation suppression. A differential feeding scheme is also employed to enhance the radiation performance. The dual-polarized model, achieved by replacing the HMSIW cavity with QMSIW cavities, is also addressed and even fabricated and tested. The measured results show a differential impedance bandwidth of 15.4% from 1.91 GHz to 2.23 GHz with a differential port-to-port isolation of 38 dB. In the operating band, the average gain is 7.5 dBi, and the front-to-back ratio (FBR) is over 18 dB with a maximum value of 34 dB.

3D object recognition is one of the most important tasks in 3D data processing, and has been extensively studied recently. Researchers have proposed various 3D recognition methods based on deep learning, among which a class of view-based approaches is a typical one. However, in the view-based methods, the commonly used view pooling layer to fuse multi-view features causes a loss of visual information. To alleviate this problem, in this paper, we construct a novel layer called Dynamic Routing Layer (DRL) by modifying the dynamic routing algorithm of capsule network, to more effectively fuse the features of each view. Concretely, in DRL, we use rearrangement and affine transformation to convert features, then leverage the modified dynamic routing algorithm to adaptively choose the converted features, instead of ignoring all but the most active feature in view pooling layer. We also illustrate that the view pooling layer is a special case of our DRL. In addition, based on DRL, we further present a Dynamic Routing Convolutional Neural Network (DRCNN) for multi-view 3D object recognition. Our experiments on three 3D benchmark datasets show that our proposed DRCNN outperforms many state-of-the-arts, which demonstrates the efficacy of our method.

Water, as a green reaction medium, is safe, non-toxic, and rich in reserves on Earth, while visible light represents a renewable, clean, and abundant energy source. Organic transformations carried out under the irradiation of visible light in water are undoubtedly more attractive, and are in line with the concept of “green chemistry” to effectively minimize the environmental impact of chemical synthesis. This review focuses on the recent progress in visible-light-mediated organic transformations in water, and the related mechanisms are also discussed. Although great achievements have been made, they are just the tip of the iceberg and there is still great room for improvement. This review will facilitate the understanding of visible-light-mediated organic transformations in water and further stimulate the advancement of more novel relevant strategies.

This article develops a practical framework of Area Angle Monitoring (AAM) to monitor in real time the stress of bulk power transfer across an area of a power transmission system. Area angle is calculated from synchrophasor measurements in real time to provide alert to system operators if the area angle exceeds pre-defined thresholds. This article proposes a general method to identify the warning threshold of area angle and a simplified method to quickly update area angle thresholds under significant topology change. A mitigation strategy to relieve the area stress is also proposed. In order to handle the limited coverage of synchrophasor measurements, this article proposes a method to estimate phase angles for boundary buses without synchrophasor measurements, which extends the application scenario of AAM. AAM is verified for a power transmission area in the Western Electricity Coordinating Council system with both simulated data and synchrophasor measurements recorded from real events. A utility deployment for real-time application of AAM with livestream and recorded synchrophasor data is described.

Machine reading comprehension tasks require a machine reader to answer questions relevant to the given document. In this paper, we present the first free-form multiple-Choice Chinese machine reading Comprehension dataset (C^3), containing 13,369 documents (dialogues or more formally written mixed-genre texts) and their associated 19,577 multiple-choice free-form questions collected from Chinese-as-a-second-language examinations. We present a comprehensive analysis of the prior knowledge (i.e., linguistic, domain-specific, and general world knowledge) needed for these real-world problems. We implement rule-based and popular neural methods and find that there is still a significant performance gap between the best performing model (68.5%) and human readers (96.0%), especially on problems that require prior knowledge. We further study the effects of distractor plausibility and data augmentation based on translated relevant datasets for English on model performance. We expect C^3 to present great challenges to existing systems as answering 86.8% of questions requires both knowledge within and beyond the accompanying document, and we hope that C^3 can serve as a platform to study how to leverage various kinds of prior knowledge to better understand a given written or orally oriented text. C^3 is available at https://dataset.org/c3/., To appear in TACL

STUDY DESIGN An ex vivo study of the rabbit's vertebral endplate. OBJECTIVE The aim of this study was to assess the effect of axial compression and distraction on vascular buds and vascular endothelial growth factor (VEGFA) expression of the vertebral endplate (VEP). SUMMARY OF BACKGROUND DATA The abnormal load can lead to intervertebral disc degeneration (IDD), whereas axial distraction can delay this process. The effects of different mechanical loads on the intervertebral disc (IVD) have been hypothesized to be related to changes in the vascular buds of the VEP; moreover, the process that might involve the vascular endothelial growth factor (VEGF) within the VEP. METHODS Rabbit spinal segments (n = 40) were harvested and randomly classified into four groups: Control group, no stress was applied; Group A, a constant compressive load applied; Group B, compression load removed for a fixed time daily on a continuous basis, and substituted with a distraction load for 30 minutes; and Group C, compression removed for 30 minutes for a fixed period daily on a continuous basis. Tissue specimens were collected before the culture (day 0) and on day 14 post-culture of each group for analysis of IVDs' morphology, and protein and mRNA expression of Aggrecan, COL2al, VEGFA, and vascular endothelial growth factor receptor 2 of the VEPs. RESULTS Application of axial distraction and dynamic load compression significantly delayed time- and constant compression-mediated VEP changes and IDD. Moreover, the degree of degeneration was associated with loss of vascular buds, as well as the downregulation of VEGFA and its receptor. CONCLUSION The regulation of vascular buds and VEGF expression in the VEP represents one of the mechanisms of axial distraction and dynamic loading.Level of Evidence: N/A.

Zero-voltage-switching (ZVS) of dual active bridge (DAB) converter and its range extension have been studied intensively. However, this article proves that the external inductance location, i.e., placing on which side of the transformer, does affect the ZVS operation due to transformers’ parasitic capacitances, in particular, at a high switching frequency of higher than 1 MHz. Thus, this article, for the first time, gives the mathematical model of the resonant transition during the dead time and thereby analyzes partial hard switching under different modulation schemes with consideration of transformer's parasitic capacitances. From the analysis of ZVS operation, the solution of splitting the interfacing inductance and placing them on both sides of the transformer is proposed and its associated methodology of selecting these inductances is introduced. It extends the ZVS for all the switching devices and, therefore, enhances the efficiency or moves losses away from the critical semiconductor devices. Finally, the theoretical analysis is verified by the experimental results from a 1-MHz gallium nitride based DAB converter prototype.

One of the modular multilevel converter (MMC) applications with scalability is renewable energy generation. Nowadays, renewable energy is especially the source of momentum, which stimulates the energy transition and reduction of greenhouse gas emissions. However, its existing control schemes may not precisely reveal the inherent mannerism of MMCs. The aim of this article is to optimize the cell voltage, arm current, and circulating current of converter arms in MMCs based on the Lagrange multiplier of an energy cost function and arm current tracking control law. Meanwhile, determination of the capacitors and switch ratings in each cell still has a big challenge, and it can result in cell-voltage fluctuations under unbalanced grid-connection conditions. This article presents unique approaches to derive cell-voltage expression in terms of arm currents, which reduces cell-voltage fluctuations by injecting zero-mean current, and the duty-ratio control laws. Moreover, tradeoff between cell voltage and circulating current can be also conducted. Experimental and simulated results from a 3-kW single-phase MMC have verified the functionality of the proposed control method, analysis, and comprehensive discussion.

Purpose Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an essential occurrence in COPD management and is the leading cause of morbidity and mortality. Chinese herbal medicine is widely used in the treatment of AECOPD, but high quality randomized controlled trials are limited. This study aimed to evaluate the efficacy and safety of Chinese herbal medicine as adjuvant therapy for patients with AECOPD. Methods This was a randomized, double-blind, placebo-controlled study of 378 participants from eight centers in China. Participants were randomly assigned to receive 10 g of Chinese herbal medicine (according to the type of Traditional Chinese medicine syndrome: Sanhanhuayin, Qingrehuatan, or Zaoshihuatan granules) or placebo, two times per day, for 14 days, in addition to conventional medicine. Participants were followed up for 84 days after the treatment. The primary end point was the COPD assessment test (CAT) score. Secondary end points included the Modified British Medical Research Council (mMRC) questionnaire and the COPD patient-reported outcome scale (COPD-PRO). We also assessed treatment failure and treatment success rate, length of hospitalization, number of patients with acute exacerbations, number of patients readmitted due to AECOPD, and number of deaths and intubation. Results The between-group difference in the change from baseline for CAT on day 14 (end of treatment) was -2.11 (95% confidence interval [CI], -3.198 to -1.050; P

The aim of this study is to systematically evaluate existing evidence of the Chinese herbal formula, Zuogui pill (ZGP), for the treatment of osteoporosis. A systematic literature search was performed in six electronic databases. The authors independently extracted data in pairs and evaluated the risk of bias. A total of 221 articles were identified initially, of which 12 relevant studies were enrolled. The primary outcome was fracture incidence and bone mineral density (BMD) at different sites. Bone metabolism markers, clinical symptoms, quality of life, and adverse events or adverse drug reactions (ADRs) were secondary outcomes. The results showed that ZGP, combined with anti-osteoporosis drugs, significantly increased BMD at the lumbar spine, Ward's area, and total hip. In terms of markers for improved bone metabolism, ZGP plus conventional drugs dramatically improved the levels of alkaline phosphatase, bone Gla protein, bone alkaline phosphatase, and tartrate-resistant acid phosphatase. Gastrointestinal discomfort, dizziness, and fatigue were found in the combined therapy group. Although the results indicate that ZGP is a potential candidate for osteoporosis, evidence remains insufficient. Further rigorously designed and high-quality trials with a larger sample size are warranted to verify the current conclusions.

Purpose Stereotactic radiation therapy (SRT) and immune checkpoint inhibitors (ICI) may act synergistically to improve treatment outcomes but may also increase the risk of symptomatic radiation necrosis (RN). The objective of this study was to compare outcomes for patients undergoing SRT with and without concurrent ICI. Methods and materials Patients treated for BMs with single or multi-fraction SRT were retrospectively reviewed. Concurrent ICI with SRT (SRT-ICI) was defined as administration within 3 months of SRT. Local control (LC), radiation necrosis (RN) risk and distant brain failure (DBF) were estimated by the Kaplan-Meier method and compared between groups using the log-rank test. Wilcoxon rank sum and Chi-square tests were used to compare covariates. Multivariate cox regression analysis (MVA) was performed. Results One hundred seventy-nine patients treated with SRT for 385 brain lesions were included; 36 patients with 99 lesions received SRT-ICI. Median follow up was 10.3 months (SRT alone) and 7.7 months (SRT- ICI) (p = 0.08). Lesions treated with SRT-ICI were more commonly squamous histology (17% vs 8%) melanoma (20% vs 2%) or renal cell carcinoma (8% vs 6%), (p n = 59). Lesions treated with SRT-ICI had significantly improved 1-year local control compared to SRT alone (98 and 89.5%, respectively (p = 0.0078). On subset analysis of NSCLC patients alone, ICI was also associated with improved 1 year local control (100% vs. 90.1%) (p = 0.018). On MVA, only tumor size ≤2 cm was significantly associated with LC (HR 0.38, p = 0.02), whereas the HR for concurrent ICI with SRS was 0.26 (p = 0.08). One year DBF (41% vs. 53%; p = 0.21), OS (58% vs. 56%; p = 0.79) and RN incidence (7% vs. 4%; p = 0.25) were similar for SRT alone versus SRT-ICI, for the population as a whole and those patients with NSCLC. Conclusion These results suggest SRT-ICI may improve local control of brain metastases and is not associated with an increased risk of symptomatic radiation necrosis in a cohort of predominantly NSCLC patients. Larger, prospective studies are necessary to validate these findings and better elucidate the impact of SRT-ICI on other disease outcomes.

Background: The relationship between hematological cancer susceptibility and methionine synthase MTR A2756G (rs1805087) polymorphism is inconclusive based on data from past studies. Hence, this updated meta-analysis was conducted to investigate the relationship between methionine synthase reductase (MTR) rs1805087 polymorphism and hematological cancers. Method: We searched EMBASE, Google Scholar, Ovid and PubMed databases for possible relevant articles up to December 31, 2019. Results: The overall pooled outcome of our analysis showed lack of association between the risk of hematological malignancies and MTR A2756G polymorphism under the allele model (G vs A: odds ratio = 1.001, 95% CI: 0.944–1.061; p = 0.983), recessive model (GG vs GA + AA: odds ratio = 1.050, 95% CI: 0.942–1.170; p = 0.382). Conclusion: The findings in this study demonstrate a lack of relationship between hematological cancers and MTR A2756G.