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The incidence of opioid use disorder (OUD) is increasing worldwide, and the opioid-related overdose crisis is currently a major global challenge. This study investigated the effects of adjuvant laser meridian massage (LMM) in men with OUD undergoing methadone maintenance treatment (MMT).A case-controlled study was conducted from February 2019 to April 2020. Fourteen men with OUD on MMT were enrolled from an addiction treatment center as an experimental group. An age-matched control group comprising 13 men was also enrolled. The experimental group received LMM on the back, including over the Bladder meridian and Governor Vessel, three times weekly for 4 weeks. The control group received only MMT. Urinary morphine levels, patients' self-reports of the number of episodes or days of heroin use, and visual analog scale scores for heroin craving/refusal to use heroin during the previous week were evaluated. Quality of life was reported using the Short Form (SF)-12v2.The experimental group showed a significant decrease in heroin use (p 0.05), whereas the control group showed a significant increase in heroin craving (p 0.05). The SF-12v2 Health Survey revealed a significant improvement in physical health in the experimental group (P 0.05).The results of this study suggest that laser meridian massage can be considered a safe, well-tolerated, and potentially useful adjuvant intervention for opioid use disorder.

While acupuncture has been used for thousands of years, modern technology to develop new needle materials has rarely been discussed. We aim to explore a new acupuncture needle material and compare the differences in the needling sensations between the acupuncture needle surface treated with nitrogen applied supercritical fluid (SCF-N) and conventional stainless steel needles.This was a double-blind cohort study. The acupuncture needles were randomly used in this experiment, including the SCF-N-treated needles and the control stainless steel needles. LI 4 (Hegu) and LI 11 (Quchi) acupuncture points in the Yangming Large Intestine Meridian of Hand were treated. Physical electrical resistance, scanning electron microscopy, energy dispersive spectrometry, and visual analog scale (VAS) score including the sensations of soreness, numbness, distention, and heaviness were assessed.The proportion of nitrogen (N) was significantly higher in the SCF-N-treated needles than in the stainless steel needles group (2.3 ± 0.2% vs 0.0 ± 0.0%, P 0.01). The cumulative de-qi sensation score at the LI 4 Hegu acupoint (1.87 ± 1.88 vs 1.54 ± 1.62, P = 0.014), especially the sensation of soreness score (2.76 ± 2.06 vs 2.13 ± 1.85, P = 0.045), revealed statistically significant differences between both groups. SCF-N surface treatment of acupuncture needles may lower the electrical resistance more than the control stainless steel needles (24.67 ± 0.88 kW vs 26.45 ± 0.75 kW, p 0.01).Acupuncture needles modified with SCF-N surface treatment can enhance de-qi sensations to improve electrical conductivity of the meridian and therapeutic effects on the Yangming Large Intestine Meridian of Hand. SCF-N surface treated needles can be as a new acupuncture needle material in the future.

Pallet pooling is regarded as a sustainable and cost-effective measure for the industry, but challenging to advocate due to weak data and pallet authentication.In order to establish trust between end-users and pallet pooling services, we propose an end-to-end, bidirectional authentication system for transmitted data and pallets based on blockchain and Internet-of-things (IoT) technologies. In addition, secure data authentication fosters the pallet authenticity in the whole supply chain network, which is achieved by considering the tag, location, and object-specific features. To evaluate the object-specific features, the scale invariant feature transform (SIFT) approach is adopted to match key-points and descriptors between two pallet images. According to the case study, it is found that the proposed system provides a low bandwidth blocking rate and a high probability of restoring complete data payloads. Consequently, positive influences on end-user satisfaction, quality of service, operational errors, and pallet traceability are achieved through the deployment of the proposed system.

Background Cognitive impairment has been identified as a core feature of depression. Serum triglycerides (TG), gonadal hormone and sex difference were shown to influence cognitive performance. The purpose of this study was to investigate the associations among serum TG, gonadal hormone, sex difference and cognitive performance in patients with major depressive disorders (MDD). Methods The enrolled 183 patients (male/female = 80/103) meeting DSM-IV criteria for MDD were divided into high TG group (patients-HTG) and normal TG group (patients-NTG) according to TG level. Serum TG, estradiol (E2) and testosterone (T) levels were measured by the glycerokinase peroxidase-peroxidase and chemiluminescence methods. Cognition was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The study was conducted between August 2016 and January 2020. Results In female, patients-HTG had lower immediate memory, language, attention, delayed memory and RBANS total scores than patients-NTG after adjusting for covariates. There were significant differences in serum E2 and T levels between patients-HTG and patients-NTG in female after controlling for covariates. In female patients-HTG, serum E2 level was positively associated with immediate memory, delayed memory and RBANS total scores, and serum T level was positively related to immediate memory, language and RBANS total scores. These findings were not seen in male patients. Conclusions Our data suggested that patients-HTG exhibited poorer cognitive function compared with patients-NTG in female. Moreover, the decline in serum gonadal hormone level might contribute to the high TG development of female MDD, and was further implicated in their cognitive decline.

Circular section tubular members with smaller wind load shape coefficient and higher stability are widely used in ultra-high-voltage (UHV) transmission towers. However, the tubular members, especially those with a large slenderness ratio, are prone to vortex-induced vibration (VIV) within a specific wind speed range. The sustained vibration of members can easily cause fatigue failure of joints and threaten the operational safety of transmission lines. Consequently, a novel countermeasure for the VIV of tubular towers using a new type of radial spoiler is proposed, whose mechanism is to change the vortex shedding frequency by destroying the large-scale vortexes into small-scale vortexes. Then, the parametric analysis of different variables is carried out based on the orthogonal experiment and numerical simulation, including the height H and length B of the spoiler and the distance S between adjacent spoilers. The results show that the above three parameters all have significant influences on vortex shedding frequency. Additionally, a practical design method of the new radial spoiler is proposed, and the recommended values of H, B, and S are 1D∼2D, 1.5H∼3H, and 5D∼12.5D, respectively, where D is the diameter of the tubular member. Finally, a numerical verification of the suppression effects is carried out, demonstrating that the proposed quick design method is simple and reliable, which can be widely used in the VIV design of tubular towers.

Notch and size effects show vital influence on fatigue performance of engineering components, which deserve particular attention for ensuring their structural integrity and reliability. In this study, the influences of size effect and stress gradient on effective stress as well as fatigue life were studied. Specifically, the effective stress methods were integrated with stress gradient, by which the relationship between stress gradient and size effect was discussed. In addition, a new stress gradient-based method for notch fatigue analysis was proposed by coupling the Weibull model with critical distance theory. Fatigue tests on Ni-based superalloy GH4169 notch specimens with different sizes were conducted at 650 °C, and experimental data of Al 2024-T351 alloy and low carbon steel En3B notch specimens were utilized for model validation and comparison. Results indicate that the proposed method provides more accurate fatigue life predictions than other effective stress methods.

BackgroundOropharyngeal administration of colostrum (OAC) may provide immunoprotective and anti-inflammatory effects that potentially reduce the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis and improve short-term outcomes. Our objective was to evaluate the role of OAC in the early prevention of NEC and late-onset sepsis in preterm infants with gestational age (GA) ≤ 32 weeks.MethodsA pilot, single-center, 1:1 parallel randomized controlled trial was conducted in a 40-bed tertiary neonatal intensive care unit (NICU) in China from 1 January 2019 to 30 September 2020. Preterm infants were randomly divided into two groups with GA ≤ 32 weeks. The OAC group included preterm infants who received 0.4 ml of maternal colostrum via the oropharyngeal route every 3 h for 10 days beginning within the first 48 h after birth, and the control group included preterm infants who received normal saline instead. Data from the two groups were collected and compared.ResultsA total of 127 infants in the OAC group and 125 infants in the control group were enrolled. The incidence of NEC (Bell stage 2 or 3) and late-onset sepsis were lower in the OAC group [2.36% vs. 10.40%, relative risk (RR) 0.23 (95% confidence interval (CI) 0.07, 0.78), adjusted RR 0.23 (95% CI 0.06, 0.84); 4.72% vs. 13.60%, RR 0.35 (95% CI 0.14, 0.85), adjusted RR 0.36 (95% CI 0.14, 0.95)]. In addition, the incidence of proven sepsis and intraventricular hemorrhage (IVH) (stage 3 or 4) were lower in the OAC group [2.36% vs. 8.80%, RR 0.27 (95% CI 0.08, 0.94); 1.57% vs. 7.20%, RR 0.22 (95% CI 0.05, 0.99)], and the time to achieve full enteral feeding was shorter (23.13 ± 9.45 days vs. 28.50 ± 14.80 days). No adverse reactions were observed in either group.ConclusionsOropharyngeal administration of colostrum is a safe and simple NICU procedure that may yield a potential effect in decreasing the incidences of NEC, late-onset sepsis, and severe IVH and shorten the time to achieve full enteral feeding in preterm infants with GA ≤ 32 weeks.Trial registrationChinese Clinical Trial Registry,ChiCTR1900023697, Registered 8 June 2019, retrospectively registered.

To evaluate the effect of Danhong Injection (丹红注射液, DH) on the index of microcirculatory resistance (IMR) and myocardial injury in patients with unstable angina undergoing elective percutaneous coronary intervention (PCI). Seventy-eight patients with unstable angina were randomly divided into DH group (39 cases) and the control group (39 cases) during elective PCI. Randomization was performed using a random-number table. The DH group received DH at a dosage of 40 mL (mixed with 250 mL saline, covered by a light-proof bag, intravenous drip) during PCI and daily for 7 consecutive days, while the control group only received the same dosage of saline. Both groups received standardized treatment. The IMR and fractional flow reserve (FFR) were measured at maximal hyperemia before and after PCI. Myocardial markers, including myoglobin, creatine kinase (CK), creatine kinase MB (CK-MB), and coronary troponin T (cTnT) values were measured at baseline and 24 h after PCI. Among the 78 patients enrolled, the baseline and procedural characteristics were similar between the two groups. There was no significant difference in pre-PCI myocardial markers and coronary physiological indexes between the two groups. However, post-PCI CK and CK-MB levels in the DH group were significantly lower than those in the control group (111.97 ± 80.97 vs. 165.47 ± 102.99, P=0.013; 13.08 ± 6.90 vs. 19.75 ± 15.49, P=0.016). Post-PCI myoglobin and cTNT-positive tend to be lower in the DH group than in the control group but did not reach statistical significance (88.07 ± 52.36 vs. 108.13 ± 90.94, P=0.52; 2.56% vs.7.69%, P=0.065). Compared with the control group, the post-IMR levels of the DH group tended to decrease, but there was no statistical difference (20.73 ± 13.15 vs. 26.37 ± 12.31, P=0.05). There were no statistical differences in post-FFR in both groups. The peri-procedural myocardial injury of the DH group was significantly lower than that of the control group (2.56% vs. 15.38%, P=0.025). During the 30-d follow-up period, no major adverse cardiovascular events occurred in either group. This study demonstrated benefit of DH in reducing myocardial injury and potential preserving microvascular function in patients with unstable angina undergoing elective PCI.

This article presents an active cylindrical metasurface with spatial reconfigurability to achieve dynamic control of the radar cross section (RCS) reduction. The proposed metasurface is designed based on the combination of microwave transmission network and Mie scattering. In particular, by modulating the spatial coding sequence of p-i-n diodes in meta-atoms, the surface impedance of the metasurface can be dynamically changed, which enables an active metasurface to operate in an expanded frequency band via time-division multiplexing technique. Both simulated and measured results demonstrate that the proposed cylindrical metasurface with an ultrathin thickness of $0.018\lambda $ can be continuously tuned across a wide fractional bandwidth over 32% for reducing backward scattering by 10 dB. The proposed metasurface with ultrathin thickness, tunability, conformal profile, and high performance may be applied to wideband RCS reduction, as well as advanced noninvasive detection, communication, etc.

Yu-Chiang Hung,1,* Pao-Yen Lin,2,* Hsienhsueh Elley Chiu,1 Po-Yu Huang,1 Wen-Long Hu1,3,4 1Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 2Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 3Fooyin University College of Nursing, Kaohsiung, Taiwan; 4Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan*These authors contributed equally to this workCorrespondence: Wen-Long HuDepartment of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosong District, Kaohsiung City, 833, TaiwanEmail oolonghu@gmail.comObjective: To evaluate the treatment effectiveness of laser acupuncture (LA) in patients with musculoskeletal pain.Methods: Major electronic databases, including Medline, PubMed, Embase, Cochrane Library, CINAHL, and Scopus were searched to identify double-blind, randomized controlled trials of LA in musculoskeletal disorders. The primary outcome was the treatment efficacy for pain. The secondary outcomes included the comparison of disability, functional impairment, and dropout rate between LA and sham treatment, as well as the effect of sham treatment for pain. The results from included studies were synthesized with the random effects model.Results: In total, 20 articles comprising 568 patients receiving LA and 534 patients receiving sham treatment were included in the current study. Our analysis showed LA significantly reduced pain (g=0.88, 95% confidence interval [CI]=0.35 to 1.42, p=0.001), disability (g=0.68, 95% CI=0.29 to 1.08, p< 0.001), and functional impairment (g=0.67, 95% CI=0.32 to 1.03, p< 0.001). Through meta-regression analysis, we found these effects were not moderated by mean age, the percentage of females, or treatment duration. Additionally, there was no significant difference between the two groups in dropout rate (risk ratio=0.73, p=0.08), and the sham treatment significantly reduced only pain intensity (g=0.54, 95% CI=0.32 to 0.77, p< 0.001).Conclusion: Our findings supported that LA significantly reduced pain, disability, and functional impairment in patients with musculoskeletal disorders. Further researches are required to determine the optimal therapeutic parameters and the suitable patients for receiving LA.Protocol Registration: CRD42020190919.Keywords: laser acupuncture, meta-analysis, pain, randomized controlled trial, traditional Chinese medicine

Purpose We aimed to explore whether complete eradication of tumor burden with stereotactic body radiotherapy (SBRT) would affect the outcomes of oligometastatic renal cell carcinoma (RCC). Materials and methods Patients diagnosed with extracranial oligometastatic RCC (no more than five metastases) between 2007 and 2019 were reviewed. Those without nephrectomy were excluded. SBRT to all, some and no lesions were defined as complete, incomplete, and no SBRT. Progression-free survival (PFS) and cancer-specific survival (CSS) were analyzed using Kaplan–Meier method, Cox regression model and the Fine and Gray method. Result A total of 101 patients were included, 51.5% of whom had p = 0.043) and CSS (not reached vs. 55.3 months; p = 0.012) compared with the no or incomplete SBRT group. In multivariate analysis, ECOG 0–1 (HR 0.389, 95% CI 0.167–0.906, p = 0.029) and complete SBRT were prognostic factors for CSS (HR 0.307, 95% CI 0.108–0.876, p = 0.027). Complete SBRT was associated with improved CSS in the subgroups of patients with age Conclusion Complete eradication of tumor burden with SBRT was associated with better survival in patients with oligometastatic RCC. The recommendation of SBRT to all lesions should be individualized.

Applied a non-radical non-oriented Slack Based Measure (SBM) model of Data Envelopment Analysis (DEA) to measure the linkage efficiency between the two sectors from 2009 to 2016. The paper analyzes the current situation of manufacturing and logistics efficiency, presents a way to improve the linkage efficiency of manufacturing and logistics industry, and using Tobit regression to analyze the environmental factors that affect the linkage efficiency. The results show that: Totality, the two industries in the three northeast provinces show a steady development trend in the period from 2009 to 2016, but the development of the two industries in northeast China is still insufficient. Unexpected pollutant output is the main reason for the decline of manufacturing efficiency in the regions. The redundancy of input factors is the main reason that affects the efficiency decline of the logistics industry. The results of Tobit regression analysis show that the investment of science and technology and opening to the outside world have a positive influence on the efficiency of the two industries, and government consumption has a negative effect on the efficiency of the two industries. This is to correctly understand and grasp the status of two industry linkage development in three northeast provinces. And it provides a certain basis for the development policy of the two-industry linkage development.

Scanner-based robotic grinding has shown great potential for replacing the manual method to achieve efficient and automatic manufacturing. However, its application has been limited by the grinding quality, which is affected by the pose errors between the robot and other workcells (a scanner, a workpiece, and a tool). To improve the pose accuracy, this article proposes a novel estimation method for above three pose errors, where a cylinder is used as the calibration object. Using differential kinematics, the relationship between the hand-eye pose error and the reconstructed error is built. The hand-eye pose error is estimated by scanning and reconstructing a cylinder. An iterative method is presented to find the optimized orientation error vector, avoiding the uncertain error of multiple solutions using the Schmidt method. Based on the speed adjoint transformation, a mathematical model between the workpiece/tool pose errors and grinding error is built. Then, an experimental estimation approach for the workpiece/tool pose errors is presented by shape matching the measured points of the grinded cylinder with the design model. Unlike the traditional static construction method, this method uses large-scale measured points with high measurement accuracy to improve the estimation accuracy and stability and can estimate the pose error caused during the dynamic grinding process, such as vibration and force deformation. Finally, pose error estimation and compensation experiments are performed to verify the feasibility of the proposed method.

Check-dams are the most important measure to control the soil and water loss in highly erodible catchments on the Chinese Loess Plateau. Based on the data of check-dams from 1950 to 2014, our study roundly analyzed the regional distribution, function and the problems of check-dams on the Loess Plateau. A total of 17,094 check-dams with a storage capacity of over 100,000 m3 and an average density of 0.027 counts km−2 were installed on the Loess Plateau. Check-dams’ densities varied greatly in the Qinghai Province, Gansu Province, Ningxia Hui Autonomous Region, Inner Mongolia Autonomous Region, Shaanxi Province, Shanxi Province and Henan Province. The highest density of check-dams reached 0.088 counts km−2 in Shaanxi Province, whereas the lowest density of check-dams was only 0.005 counts km−2 in Qinghai Province. However, after decades of operation, 3025 large check-dams and 2257 medium check dams are dangerous and have security risks, which are seriously threatening downstream safety. The dangerous rate of check-dams is high. Specifically, the check-dams in Shanxi and Qinghai Province have the highest dangerous rates, with both exceeding 53%. Therefore, there is an urgent need for carrying out reinforcement of the dangerous check-dams. The results are helpful to policymakers to extend and develop check-dams.

To explore the effectiveness of Danhong Injection (丹红注射液) on improving microcirculatory injury after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). A randomized controlled trial was conducted and 90 patients were enrolled. A random sequence was generated using statistical analysis software. Patients with microcirculatory injuries after PCI were randomly divided into 3 groups for treatment (30 subjects in each group): Danhong Injection group: after PCI, Danghong Injections were given with intravenous administration with 40 mL twice a day for a week; statins intensive group: after PCI, atorvastatin calcium tablets were given oral medication with 80 mg once, and then atorvastatin 40 mg daily for 1 week; the control group: after PCI, atorvastatin calcium tablets were given oral medication with 10–20 mg daily for 1 week. The index of microcirculation resistance (IMR) was used to assess microcirculatory injury during PCI. The IMR of the target vessel was reexamined after 1 week of drug treatment. After one week’s drug treatment, IMR was significantly decreased in both statins intensive group and Danhong Injection group compared with the control group (P

In this paper, we explore the problem of removing atmospheric turbulence to obtain better images of remote sidereal star systems. The imaging process is remodeled as a transmit–receive wireless communication paradigm in a novel approach for correcting space- and time-varying blur in stellar images. In particular, the effect of starlight passing through atmospheric turbulence is modeled as multipath fading communication channels. The problem is then transformed into channel equalization in space and time domains to produce a sharp stellar image. This approach involves first estimating the center of a blurred stellar image. Next, linear regression obtains an equivalent two-dimensional channel response through decomposition of the blurred image into the weighted sum of the diffraction-limited patterns in the spatial domain. Finally, an alignment algorithm is implemented for synthesis, and a final output is generated. Experiments were performed with real field-captured images; the results revealed that this approach could be used to effectively correct image blur and obtain diffraction-limited stellar images.

Obtaining fresh nonlinear optical (NLO) materials is an attractive and challenging topic for the development of laser techniques. Using benchmark AgGaQ2 (Q = S, Se) as the template, new KAg3Ga8Se14 is obtained by a solid-state reaction. Its structure can be built by the intergrowth of 2 : 1 AgGaSe2 and Ga2Se3-like slabs if the K site is occupied by Ag. Powdery KAg3Ga8Se14 demonstrates moderate phase-matchable NLO responses, and a LDT of ca. 2 × AgGaS2. DFT calculations reveal that both AgSe4 and GaSe4 tetrahedral motifs contribute a lot to the NLO performance. This work reveals a new class of promising infrared NLO materials, and the design strategy may apply to other systems.

Detection of surface defects on wet-blue leather is much more challenging than raw-hide leather. Since wet-blue leather turns blue and contains moisture after pre-treatment, it is a semi-product of the cowhide processing. At present, the defect detection of wet-blue leather is mostly carried out manually and is time-consuming and labor-intensive for professional inspectors. This paper is the first to use hyperspectral imaging (HSI) to implement the surface inspection of five wet-blue leather defects including brand masks, rotten grain, rupture, insect bites, and scratches in the pixel level detection. Hyperspectral Leather Defect Detection Algorithm (HLDDA) including Hyperspectral Target Detection (HTD) and Deep Learning (DL) techniques was proposed in this paper. In HTD, Weighted Background Suppression Constrained Energy Minimization (WBS-CEM) and WBS-Hierarchical CEM (WBS-hCEM) were developed in this paper by using weighting to suppress the background and enhance the contrast between the target and background. Experimental results showed that the overall performance of WBS was better than the original CEM. In the DL part, 1D-Convolutional Neural Network (CNN), 2D-Unet and 3D-UNet architectures were designed to segment defect areas. For various characteristics of defects, 1D-CNN emphasizes on defects with spectral features, 2D-Unet emphasizes on defects with spatial features, and 3D-Unet can simultaneously process spatial and spectral information in HSI. The experimental results verified that the proposed HLDDA could effectively quantify and estimate the size of the defect, thereby accelerating the leather inspection process by professional inspectors and develop an automated leather grading system towards Industry 4.0.

The thermally activated delayed fluorescence (TADF) materials with aggregation-induced emission (AIE) properties have attracted increasing interest for their applications as the emitters in non-doped organic light-emitting diodes (OLEDs). In this work, three quinoline-based TADF molecules 9,9-dimethyl-10-(quinolin-2-yl)-9,10-dihydroacridine (DMAC-QL), 10-(quinolin-2-yl)-10H-phenoxazine (PXZ-QL) and 10-(quinolin-2-yl)-10H-phenothiazine (PTZ-QL) were conveniently synthesized by a one-step reaction starting from commercially available materials. The twisted conformation was confirmed by single crystal analysis, and all the compounds exhibited high thermal stability. Moreover, the ΔEST values of DMAC-QL, PXZ-QL and PTZ-QL were 0.06, 0.10 and 0.04 eV, and their delay lifetimes were 2.15, 1.86 and 15.76 μs, respectively, indicating their excellent TADF properties. They also exhibited typical AIE and aggregation-induced delayed fluorescence (AIDF) properties in THF/H2O solution. The non-doped OLEDs based on the emitters DMAC-QL, PXZ-QL and PTZ-QL were fabricated, and the maximal EQEs of the devices were 7.7, 17.3 and 14.8%, respectively, along with turn-on voltages of 3.2, 2.6 and 2.8 eV. It was further found that the efficiency roll-off of the non-doped device based on PXZ-QL was very small due to its short delay lifetime and excellent AIE and AIDF properties.

LBS has become an integral part of people's life nowadays. However, the GPS restricted by the shielding effect is unavailable for indoor environments. Therefore, accurately locating an electronic device indoors has become a challenging issue in recent years. This work employs the CSi combined with neural networks to achieve an accurate indoor positioning. The CSi refers to known channel properties of a communication link in wireless communications. This information describes how a signal propagates from the transmitter to the receiver and represents the combined effects of, for example, scattering, fading, and power decay with distance. This work will evaluate several neural networks for the positioning, including the FCNN, CNN, and GCNN. in multi-carrier communication systems, the CSi of adjacent subcarriers has a high correlation, and hence, the CNN is promising to learn and extract the features of this input information corresponding to the location of radio devices. Beyond that, we also investigate an improved CNN, that is, the GCNN, which has more talent to locate in indoor environments than traditional CNNs. Experimental results show that the proposed GCNN can achieve a root-mean-square error (RMSE) of less than 0.08m and 0.3m for 16 and two antennas, respectively. in addition, the computational complexities and required numbers of parameters of compared deep neural networks have been analyzed as well.

Achieving independent control of the amplitude and phase of the electromagnetic (EM) wave by a thin flat device is very important in wireless and photonic communications. However, most of the reported metasurfaces, so far, have realized only the simultaneous control of the amplitude and phase of the linearly polarized EM wave. This communication presents a strategy to realize the independent and arbitrary control of the amplitude and phase responses for the circularly polarized EM wave by using a dual-phase hybrid metasurface that integrates both geometric and propagation phases. A beam deflector with a tailorable amplitude is then designed to verify the proposed strategy. As a proof of concept of its practical application, a circularly polarized reflector antenna with a high gain and an extremely low sidelobe is implemented by the proposed metasurface. Experimental results are in good accordance with the simulation ones, demonstrating that the sidelobe of the designed antenna can be reduced by 8 dB compared with a reflector antenna actualized by the phase-only metasurface. The proposed methodology and the metasurface can provide a new degree of freedom in controlling the circularly polarized waves by simultaneous phase and amplitude modulations, which may trigger many interests in EM/optical integration and complex EM-wave manipulations, as well as advanced metadevices for real-world applications.

Purpose Improved antitumor responses have been observed in patients after combination radiation therapy (RT) and immune checkpoint blockade (ICB). Whether these clinical responses are linked to the host systemic immune system has not been elucidated. Methods and Materials In this single-institution prospective observational study, peripheral blood was longitudinally collected from 10 patients with metastatic disease who had responded to anti-PD-1/anti-PD-L1 ICB and received RT (8-50 Gy in 1-5 fractions) upon disease progression at the following timepoints: baseline (pre-RT), 1 to 2 weeks post-RT, and post-ICB (cycle 1) on reintroduction post-RT. To thoroughly characterize the interaction between combined RT-ICB and the host immune system, we performed high-dimensional, mass cytometry–based immunophenotyping of circulating lymphocytes using a 40-marker panel addressing lineage, differentiation, activation, trafficking, cytotoxicity, and costimulatory and inhibitory functions. Phenotypic expression of circulating lymphocytes was compared across patients and time points and correlated with post-RT tumor responses. Results Foremost, we demonstrated excellent posttreatment clinical responses, including 4 local responses with >50% reduction in radiated tumor size, 1 out-of-field response, and 4 patients who resumed ICB for >1 year. Baseline and post-RT immune states were highly heterogeneous among patients. Despite this interindividual heterogeneity in baseline immune states, we observed a systemic immune reaction to RT-ICB common across patients, histology, and radiation sites; a subset of pre-existing Ki-67+ CD8+ T cells were increased post-RT and further expanded upon reintroduction of ICB post-RT (2.3-fold increase, P = .02). Importantly, RT did not alter the phenotypic profile of these Ki-67+ CD8+ T cells, which was characterized by a distinct activated and differentiated effector phenotype. Conclusions Collectively, these findings point toward a sustained reinvigoration of host antitumor immunity after RT-ICB and suggest an expansion in activated Ki-67+ CD8+ T cells as a possible demonstration of this synergy, thereby providing new insights that may support the development of optimal sequencing strategies.

This study proposed a new type of diffuser which can not only accelerate the wind approaching the turbine before wind velocity reaches the rated velocity, but also reduces the wind drag on the diffuser when wind velocity is overrated one. A passive adaptive flexible flange constructed of two flexible cantilevered plates is developed for the diffuser. The flow distribution around the diffuser equipped with a flexible flange, as well as the wind drag on the diffuser, varies with the deformation of the flexible flange under the wind drag. Wind tunnel experiments and numerical analysis are conducted to study the flow distribution around the diffuser and the corresponding wind drag on it at different wind velocities. Experimental results reveal that the drag reduction rate of the diffuser with the passive adaptive flexible flange is 17.9% at the velocity of 20 m/s. Numerical results overall match well with the experimental measurement, such as velocity and pressure distributions, although the simulated values are slightly lower than the experimental ones.

Background The application of factor analysis in the study of the clinical symptoms of coronavirus disease 2019 (COVID-19) was investigated, to provide a reference for basic research on COVID-19 and its prevention and control. Methods The data of 60 patients with COVID-19 in Jingzhou Hospital of Traditional Chinese Medicine and the Second People's Hospital of Longgang District in Shenzhen were extracted using principal component analysis. Factor analysis was used to investigate the factors related to symptoms of COVID-19. Based on the combination of factors, the clinical types of the factors were defined according to our professional knowledge. Factor loadings were calculated, and pairwise correlation analysis of symptoms was performed. Results Factor analysis showed that the clinical symptoms of COVID-19 cases could be divided into respiratory-digestive, neurological, cough-wheezing, upper respiratory, and digestive symptoms. Pairwise correlation analysis showed that there were a total of eight pairs of symptoms: fever-palpitation, coughexpectoration, expectoration-wheezing, dry mouth-bitter taste in the mouth, poor appetite-fatigue, fatiguedizziness, diarrhea-palpitation, and dizziness-headache. Conclusions The symptoms and syndromes of COVID-19 are complex. Respiratory symptoms dominate, and digestive symptoms are also present. Factor analysis is suitable for studying the characteristics of the clinical symptoms of COVID-19, providing a new idea for the comprehensive analysis of clinical symptoms.

Purpose The blockchain technology provides a way to record transactions that is designed to be highly secure, transparent, trustable, traceable, auditable and tamper-proof. And, the internet of things (IoT) technology provides the ability to transfer data over a network without requiring human-to-human or human-to-computer interaction, which is able to link computing devices and digitized machines, things, objects, animals and people that are provided with digital unique identifiers (UIDs). This paper aims to explore the combined application of blockchain and IoT-based technologies, especially on the intellectual property protection area. Design/methodology/approach In this paper, the authors propose a high-level architecture design of blockchain and IoT-based intellectual property protection system, which can help to process three types of intellectual property: (1) patents, copyrights, trademarks etc.; (2) industrial design, trade dress, craft works, trade secrets etc.; and (3) plant variety rights, geographical indications, etc. Findings Using blockchain peer-to-peer network and IoT devices, the proposed method can help people to establish a trusted, self-organized, open and ecological intellectual property protection system. Originality/value To the best of the authors’ knowledge, this is the first work that applied blockchain and IoT technologies on traditional intellectual property protection and trade ecosystem.

Introduction Data on the associations between esophageal histological lesions and risk of esophageal squamous cell carcinoma (ESCC) in general populations are limited. We aimed to investigate these associations in a large Chinese general population to inform future Chinese ESCC screening guidelines. Methods We performed endoscopic screening of 21,111 participants aged 40-69 years from 3 high-risk areas of China in 2005-2009, and followed the cohort through 2016. Cumulative incidence and mortality rates of ESCC were calculated by baseline histological diagnosis, and hazard ratios of ESCC, overall and by age and sex, were assessed using the Cox proportional hazards models. Results We identified 143 new ESCC cases (0.68%) and 62 ESCC deaths (0.29%) during a median follow-up of 8.5 years. Increasing grades of squamous dysplasia were associated with the increasing risk of ESCC incidence and mortality. The cumulative ESCC incidence rates for severe dysplasia/carcinoma in situ, moderate dysplasia (MD), and mild dysplasia were 15.5%, 4.5%, and 1.4%, respectively. Older individuals (50-69 years) had 3.1 times higher ESCC incidence than younger individuals (40-49 years), and men had 2.4 times higher ESCC incidence than women. Conclusions This study confirmed that increasing grades of squamous dysplasia are associated with increasing risk of ESCC and that severe dysplasia and carcinoma in situ require clinical treatment. This study suggests that in high-risk areas of China, patients with endoscopically worrisome MD should also receive therapy, the first screening can be postponed to 50 years, and endoscopic surveillance intervals for unremarkable MD and mild dysplasia can be lengthened to 3 and 5 years, respectively.

In this article, we theoretically and experimentally demonstrate a single-layered spin-decoupled metasurface and its application to a dual-circularly polarized reflector antenna. A developed method is first analyzed to guide the design of broadband spin-decoupled metasurface. Then, a quasi-I-shaped meta-atom, which exhibits a phase coverage of $2\pi $ and high cross-polarization conversion efficiency within 12–21 GHz, is accordingly designed to actualize spin-decoupled phase change by simultaneously tuning the structural parameters and self-rotation of the element. To illustrate the independent phase control of orthogonal spins, a dual-circularly polarized multiplexing reflector antenna is designed with offset configuration. The experimentally measured results of the assembled reflector antenna are in good agreement with the simulated ones, showing a peak gain of 29.5 and 29.6 dBic, peak aperture efficiency (AE) of 53% and 54%, 3 dB gain bandwidth (BW) of 13.2–20.2 GHz (41.9%) and 13.4–20.2 GHz (40.5%), and 3 dB axial ratio (AR) BW of 11.8–21 GHz (56.1%) and 11.5–22 GHz (62.7%) for left-hand circular polarization (LHCP) and right-hand circular polarization (RHCP) radiations, respectively. The design strategy and the well-performed multiplexing reflector antenna may have promising perspective in many practical applications, for example, satellite communication system and long-distance wireless communication system.

In this article, a novel transmission–reflection-selective metasurface (MS) is introduced to realize symmetric transmission for horizontal-polarized ( $x$ -polarized) waves but asymmetric reflections for vertical-polarized ( $y$ -polarized) waves propagating along opposite directions. Based on the theoretical analysis, the proposed MS is finally engineered to transmit $x$ -polarized wave but anomalously reflect $y$ -polarized wave for forward direction. As for backward direction, the designed MS acts as a polarizer grating capable of transmitting $x$ - but specularly reflecting $y$ -polarized wave. As an example of its practical application, the designed MS is applied to form a folded reflector antenna with a reduced backward radar cross section (RCS). Both the MS and the folded reflector antenna are numerically simulated, physically implemented, and experimentally measured. The measured results of the folded reflector antenna coincide well with the simulated ones, showing a peak gain of 23.1 dB and a 3 dB gain bandwidth of 29.3% (12.8–17.2 GHz), as well as a −20 dB cross-polarized level bandwidth of 41.6% (11.4–17.4 GHz). Furthermore, the backward RCS of the antenna can be reduced from 11.2 to 18.4 GHz (48.6%) for $y$ -polarization and 14.1 to 16.2 GHz (13.9%) for $x$ -polarization, with the bandwidth defined by RCS reduction higher than 10 dB. The proposed MS and its application to backward RCS reduction of high-gain antenna may promote the uses of metamaterials to many real-world applications.

This is a meta-analysis of randomized double-blind controlled-placebo trials (RCTs) examining the effectiveness, tolerability, and safety of intranasal esketamine in treating major depressive disorder (MDD).Standardized mean difference (SMD), risk ratio (RR) and their 95% confidence intervals (CIs) were calculated using RevMan version 5.3.Four RCTs with 7 active arms covering 708 patients with MDD on intranasal esketamine (n = 419) and placebo (n = 289) were included. Compared with placebo, adjunctive intranasal esketamine was associated with significantly greater study-defined response (RR=1.39, 95%CI: 1.18 to 1.64, P0.0001) and remission (RR=1.42, 95%CI: 1.17 to 1.72, P = 0.0004) at endpoint assessment. Intranasal esketamine had greater study-defined response starting at 2 h (RR= 2.77, 95%CI: 1.62 to 4.76, P = 0.0002), peaking at 24 h (RR=5.42, 95%CI: 1.38 to 21.20, P = 0.02), and at least lasting for 28 days (RR=1.36, 95%CI: 1.16 to 1.58, P = 0.0001). Similarly, intranasal esketamine had significantly greater study-defined remission starting at 2 h (RR=7.71, 95%CI: 2.16 to 27.55, P = 0.002), peaking at 24 h (RR=6.87, 95%CI: 1.55 to 30.35, P = 0.01), and lasting for 28 days (RR=1.38, 95%CI: 1.11 to 1.72, P = 0.004). Intranasal esketamine had a significantly higher rate of discontinuation due to intolerability (RR=3.50, 95%CI: 1.38 to 8.86, P = 0.008). Discontinuation due to any reasons and inefficacy were similar between the two groups.Intranasal esketamine appears to have an ultra-rapid antidepressant effect for MDD, at least lasting for 28 days. The long-term therapeutic effect and safety of intranasal esketamine need to be further examined in large-scale RCTs.

To assess the trends in characteristics, treatments, and outcomes of acute myocardial infarction (AMI) patients in tertiary Chinese medicine (CM) hospitals in China between 2006 and 2013. This retrospective study was based on two nationwide epidemiological surveys of AMI in tertiary CM hospitals during 2 years (2006 and 2013). Patients admitted to the hospital for AMI were enrolled. Hospital records were used as the data source. Case data were derived regarding baseline characteristics, treatments, and outcomes of patients to assess changes from 2006 to 2013. Logistic regression was used to analyze the relationship between prognosis, general influencing factors of disease, and various treatment measures. Totally 26 tertiary CM hospitals in 2006 and 29 tertiary CM hospitals in 2013 (18 were repetitive) were surveyed. A total of 2,311 patients with AMI were enrolled (1,094 cases in 2006 and 1,217 cases in 2013). From 2006 to 2013, the mean age did not significantly change, but the proportion of patients younger than 65 years increased. The prevalence of risk factors such as hypertension, diabetes, and hyperlipidemia also increased. Significant increases were observed in primary percutaneous coronary intervention [20.48% (2006) vs. 24.90% (2013)] and revascularization [36.11% (2006) vs. 52.42% (2013)]. In-hospital mortality decreased from 11.15% in 2006 to 10.60% in 2013. A mortality logistic regression analysis identified reperfusion therapy [odds ratio (OR), 0.222; 95% confidence interval (CI), 0.106–0.464], Chinese patent medicines (OR, 0.394; 95% CI, 0.213–0.727), and CM decoctions (OR, 0.196; 95% CI, 0.109–0.353) as protective factors. Reperfusion and revascularization capabilities of tertiary CM hospitals have improved significantly, but in-hospital mortality has not significantly decreased. Efforts are needed to improve medical awareness of AMI and expand the use of CM to reduce in-hospital mortality in China.

Nowadays, public transportation junctions (PTJs) such as metro stations and railway stations can involve up to half of urban traffic and account for a large portion of energy usage in urban areas. The tremendous traffic and energy flows in PTJs have induced severe problems in safety and efficiency. Thus, in this paper, we present a comprehensive edge computing enabled navigation framework to aid the emergent evacuation processes within PTJs with respect to energy and safety restrictions. From the energy-saving aspect, due to the resource restraints of the on-site Internet of Things (IoT) based environmental monitoring system, a queueing network model is utilised to balance the energy utilisation and reduce the congestion of the sensing and navigation process during emergency. From the safety aspect, three edge computing aided cooperative strategies are proposed to dynamically assign evacuees into several groups to adapt their course of action with regard to their physical conditions and immediate environments. Simulation results show that the use of the queueing network model can reduce and balance the energy utilisation of the on-site IoT network. Experiments also show that the use of cooperative strategies to adjust the evacuees' category and the associated routing algorithm can achieve higher survival rates.

Background: Pre-marketing clinical research of drugs can not completely solve the safety problems in the process of wide application of drugs post-marketing, so it is necessary to re-evaluate the safety and effectiveness of drugs after marketing. Objective: To detect and analyze the adverse drug reaction (ADR) signals of Selective Serotonin Reuptake Inhibitor (SSRIs) post-marketing and provide references for clinical rational drug use. Methods: Reporting Ratio (ROR) method was used to mine the adverse reaction signals of SSRIs in the Adverse Reaction Reporting System (ARES) of the Food and Drug Administration of the United States (FDA), and the results were analyzed and evaluated. Results: Adverse Drug Events (ADEs) of fluoxetine, fluvoxamine, paroxetine, sertraline and citalopram were 40,217, 2907, 52,439, 63,849 and 42,588 cases respectively. After ROR test, there were 187 ADR signals of the five drugs, among which ADR was most prominent in psychiatric and nervous system. It mainly includes adverse reactions such as anxiety, depression, suicidal ideation, 5-HT syndrome, withdrawal syndrome and so on. Conclusion: The study based on ADR signals in the real world is helpful to evaluate the post-marking safety drugs and provide references for safety in clinical medication.

Wireless devices, including smartphones/PDAs and the network equipment that connects them, consume a significant amount of power. The global greenhouse gas emissions produced by the operation of information and communication technology (ICT) infrastructure is comparable to that produced by the aviation industry. This situation is getting worse since billions of wireless devices, such as the Internet of Things devices, are expected to be newly added to the Internet in the coming decade. Consequently, there are multiple research and development projects that aim at addressing this issue, including some IEEE standards intended to reduce the environmental impact of the ICT industry. These standards include energy-efficient communications and networking. Although these emerging techniques have attracted considerable attention and have been studied recently, there are still many open research challenges to be addressed.

With the increasing lifespan of human, cardiovascular diseases (CVDs) and cancer are the main diseases leading to the death in the world. Aging is related to a progressive decline in cardiovascular function and structure. While human body suffer from oxidative stress, reactive oxygen species (ROS) are generated as metabolic by-products, which lead to inactivate proteins, damage nucleic acids, and alter the fatty acids of lipids. The accumulation of this oxidative damage contributes to the development of heart disease, diabetes, chronic inflammatory diseases, and cancer. Polyphenols have been widely studied as an anti-oxidant agent in the world. Danshen, the dried root or rhizome of Salvia miltiorrhiza Bunge. is a common Traditional Chinese medicine used in cardiovascular disease and cancer. The main polyphenols in Danshen are phenolic acids (including Salvianolic acids A and B, rosmarinic acid, and their derivatives) and flavonoids. Salvianolic acids have potent anti-oxidative capabilities due to their polyphenolic structure and exhibit cardiovascular protection through mechanisms of ROS scavengers, reduction of leukocyte-endothelial adherence, inhibition of inflammation and indirect regulation of immune function. Salvianolic acids A and B have been reported to owe anti-cancer, anti-inflammatory activities not only through inducing apoptosis, halting cell cycle and adjourning metastasis by targeting multiple deregulated signaling networks of cancer but also sensitizing cancer cells to chemotherapeutic agents.

Large-scale replication of the hierarchical microstructure of bio-template is a long-standing challenge due to the large shrinkage when the bio-templates are burned off. In this work, TiO2 based biomimetic metamaterials have been successfully synthesized by sputtering technique, followed by tape assisted transferring and thermal oxidation process. Tile-like arrays of the scale replicas with ridge-lamellae hierarchical microstructures have been obtained and exhibit bright blue-purple structure color. More interestingly, they exhibit significantly enhanced photocatalytic activity to decompose methylene blue under solar light illumination, with the degradation rate of methylene blue almost five times that of TiO2 thin films with the same sample area. The enhancement on the visible light photocatalytic activity in TiO2 replicas can be attributed to a synergy effect of the presence of Ti3+ doping, the air-TO2 interaction, and hierarchical microstructure. The controlling factors that affect the microstructure, structural color and photocatalytic activity of the TiO2 replicas have been discussed in detail. This work offers a scalable and precise approach to replicate various bio-templates based on transition metal oxides, such as ZnO, Fe3O4, CoO, and VO2, thereby providing the new opportunity for infrared sensing, photocatalytic and photonic applications.

Objectives The objective of the study was to assess the clinical efficacy of computed tomography (CT)-guided cryoablation as a means to treat adrenal metastasis (AM) secondary to lung cancer. Materials and methods This study was a single-center retrospective study that analyzed 39 consecutive patients with AM secondary to lung cancer who underwent CT-guided cryoablation in our center. The rates of complete ablation, local recurrence, local recurrence-free survival (RFS), and overall survival (OS) were analyzed. Results The rates of primary and secondary complete ablation were 94.9% and 100%, respectively, and none of the patients suffered from a hypertensive crisis associated with the treatment. Over the follow-up period, 20.5% of the patients experienced local recurrence, and the median RFS duration was 26 months. The cumulative 1-, 3-, and 5-year local RFS rates in this study were 84.6%, 51.3%, and 5.9%, respectively. Extra-adrenal gland metastases were detected in five patients. Over the course of follow-up, 26 patients died. The mean OS duration was 34 months with cumulative 1-, 3-, and 5-year OS rates of 89.7%, 53.4%, and 8.3%, respectively. Advanced age (P = 0.001), primary adenocarcinoma (P = 0.006), other primary lung cancers (P = 0.038), and primary Stage III lung cancers (P = 0.007) were all found to be independent predictive factors of poor OS in these patients. Conclusion CT-guided cryoablation can be safely and effectively used to control AM secondary to lung cancer, and patients with AM secondary to lung squamous cell carcinoma may be best suited for this form of treatment.

Background The purpose of this study was to retrospectively analyze clinical characteristics and prognostic risk factors of urosepsis patients admitted to two intensive care units in Shanghai, China. Methods Clinical data from patients diagnosed with urosepsis were retrospectively retrieved and analyzed from ICU in two regional medical centers from January 2015 to December 2019. Results Two hundred two patients were included in the subsequent analysis eventually, with an average age of 72.02 ± 9.66 years, 79.21% of the patients were female and the mortality rate of 15.84%.The proportion of patients with chronic underlying diseases such as diabetes and hypertension was relatively high (56.44, 49.50%, respectively), and the incidence of shock was also high (41.58%) correspondingly. The most common pathogen isolated was Escherichia coli (79.20%), of which the extended-spectrumβ-lactamases (ESBLs)(+) accounted for 42.57%. In multivariate analysis, the strongest predictors for death were mechanical ventilation (OR 7.260, 95% CI 2.200–23.963; P = 0.001),chronic kidney disease (CKD) (OR 5.140, 95% CI 1.596–16.550; P = 0.006), APACHE II score (OR 1.321, 95% CI 1.184–1.473; P P = 0.020). Both APACHE II score and lactate had the ideal predictive value, with the area under the ROC curve (AUC) of 0.858 and 0.805 respectively. Conclusion The patients with urosepsis were characterized by a higher proportion of female, older age, more percentage of comorbidities in this region, and patients with ESBLs (+) Escherichia coli infection were more prone to shock. Mechanical ventilation, comorbidity with CKD, APACHE II score and lactate were independent risk factors for death in urosepsis patient, but lactate level and APACHE II score had better predictive value for prognosis.

In order to improve the accuracy and speed of cat-eye target recognition, a cat-eye target recognition method combining fully convolutional residual network and visual saliency is proposed. This method is based on semantic segmentation. Firstly, the collected active and passive images were preprocessed, and saliency detection is used to enhance the cat-eye target in the different image. Second, the active image is segmented by the full convolutional residual network to achieve background suppression and target enhancement, and the fusion result graph containing the cat-eye target region is obtained by the and operation of the two results. Finally, the candidate target area of the cat-eye target Recognition, to extract real cat-eye target. The experimental results show that the proposed method has high accuracy and fast running time, and can be used for real-time detection.

Objective: To compare the efficacy and safety of conventional treatments (CTs) to those that included traditional Chinese medicine injections (TCMIs) in patients with combined coronary heart disease and heart failure (CHD-HF).Methods: Eight electronic literature databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure Database, Chinese Scientific Journal Database, Wanfang Database, Chinese Biomedical Database) were searched from their inceptions to May 18, 2021, to identify relevant randomised controlled trials (RCTs). The primary outcomes analyzed included the total effectiveness rate and adverse events (ADRs). The secondary outcomes analyzed included the left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP), brain natriuretic peptide (BNP), and 6-min walk test (6MWT). Cochrane risk-of-bias tool was used to assess quality of the analyzed RCTs. Stata and OpenBUGS software were used to prior to the systematic review and network meta-analysis.Results: Sixty-one eligible trials involved 5,567 patients and one of the following 15 TCMIs: Shuxuetong, Shenmai, Shenfu, Shengmai, Danshenduofenyansuan, Danhong, Dazhuhongjingtian, Xinmailong, Dengzhanxixin, Gualoupi, Shuxuening, Xuesaitong, Yiqi Fumai, Shenqi Fuzheng, Huangqi. Network meta-analysis revealed that Shuxuetong injection + CT group was superior to CT only in improving the total effectiveness rate [odds ratio (OR): 7.8, 95% confidence interval (CI): 1.17–27.41]. Shenmai injection + CT was superior to CT only for LVEF (OR: 8.97, CI: 4.67–13.18), Xinmailong injection + CT was superior to CT only for NT-proBNP (OR: −317.70, CI: −331.10–303.10), Shenqi Fuzheng injection + CT was superior to CT only for BNP (OR: −257.30, CI: −308.40–242.80); and Danhong injection + CT was superior to CT only for 6MWT (OR: 84.40, CI: 62.62−106.20). Different TCMIs had different toxicity spectrums.Conclusion: TCMIs combined with CT are better than CT alone in treating CHD-HF. Different TCMIs improve different outcomes. Additional properly designed RCTs are needed to conduce a more refined comparison of various TCMIs.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021258263].

BackgroundThe clinical role of deficient DNA mismatch repair (dMMR)/microsatellite instability-high (MSI-H) in gastric cancer (GC) is still controversial. We aimed to analyze the relationship between dMMR/MSI-H and clinicopathological features along with survival.MethodsPatients who were diagnosed with GC at the three big cancer centers in China from 2015 to 2020 were evaluated retrospectively. MMR/MSI status was assessed using immunohistochemistry/PCR. Clinical and pathological data were collected from the medical record system.ResultsA total of 196 patients with dMMR/MSI-H status were enrolled for analysis. The prevalence of MSI-H/dMMR in GC was 6.6%. Another 694 proficient MMR (pMMR) GC patients were enrolled for comparison. Compared with pMMR patients, dMMR/MSI-H patients were associated with older age, female predominance, distal location in the stomach, earlier TNM stage, intestinal subtype, better differentiation, and more negative HER2 status. The median overall survival (OS) of the dMMR/MSI-H group was better than that of the pMMR/microsatellite stability (MSS) group (not reached vs. 53.9 months, p = 0.014). Adjuvant chemotherapy had no impact in both disease-free survival (DFS) and OS of dMMR/MSI-H patients (p = 0.135 and 0.818, respectively). dMMR/MSI-H patients had poorer response and progression-free survival (PFS) of first-line chemotherapy, though they were statistically significant (p = 0.361 and 0.124, respectively).ConclusionsdMMR/MSI-H GC patients have specific clinicopathological characteristics and better prognosis than pMMR patients.

Background Fatal pericardial tamponade caused by aortic or atrial perforation due to erosion of atrial septal occluders has been reported previously, but the timing of erosion is uncertain, and the process is also unclear. Case presentation We present a case of a 5-year-old boy with erosion of the aorta and atrium by the occluder not leading to perforation or pericardial tamponade because of early detection and timely surgery. A small amount of pericardial effusion may be the only manifestation of early erosion. This case firstly revealed the early process of device erosion in children. Conclusions An absent aortic rim may be a higher risk factor for erosion than oversized device for a child, and it is wise to choose a relatively small occluder or change to surgery. This may be helpful for preventing and treating serious complications caused by erosion of the occluder.

Background:Neoadjuvant chemotherapy (NAC) plays an important role in the management of locally advanced breast cancer. It allows for downstaging of tumours, potentially allowing for breast conservation. NAC also allows for in-vivo testing of the tumours’ response to chemotherapy and provides important prognostic information. There are currently no clearly defined clinical models that incorporate imaging with clinical data to predict response to NAC. Thus, the aim of this work is to develop a predictive AI model based on routine CT imaging and clinical parameters to predict response to NAC. Methods:The CT scans of 324 patients with NAC from multiple centers in Singapore were used in this study. Four different radiomics models were built for predicting pathological complete response (pCR): first two were based on textural features extracted from peri-tumoral and tumoral regions, the third model based on novel space-resolved radiomics which extract feature maps using voxel-based radiomics and the fourth model based on Deep Learning (DL). Clinical parameters were included to build a final prognostic model. Results:The best performing models were based on space-resolved and deep learning approaches. Space-resolved radiomics improves the clinical AUCs of pCR prediction from 0.743 (0.650 to 0.831) to 0.775 (0.685 to 0.860) and our DL model improved it from 0.743 (0.650 to 0.831) to 0.772 (0.685 to 0.853). The tumoral radiomics model performs the worst with no improvement of the AUC from the clinical model. The peri-tumoral combined model gives moderate performance with an AUC of 0.765 (0.671 to 0.855). Conclusions:Radiomics features extracted from diagnostic CT augments the predictive ability of pathological complete response when combined with clinical features. The novel space-resolved radiomics and deep learning radiomics approaches outperformed conventional radiomics techniques.

Simple Summary Nasopharyngeal cancer (NPC) is a malignant epithelial tumor endemic to parts of Asia and associated with infection by the Epstein–Barr virus (EBV) in these regions. The cancer is often detected at a late stage which is associated with poor outcomes (63% 5-year survival). Advances for the management of this disease have remained largely stagnant and treatment relies primarily on radiotherapy and chemotherapy, as well as surgery when indicated. Nevertheless, our understanding of its underlying biology has grown rapidly in the past two decades, laying the foundation for the development of improved therapeutics which have the potential to improve outcomes. This review offers a comprehensive, up-to-date summary of this disease, with a focus on the role of somatostatin receptor 2 (SSTR2) in NPC and how this increased knowledge may lead to improved diagnosis and management of this disease. Abstract Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor, most commonly located in the pharyngeal recess and endemic to parts of Asia. It is often detected at a late stage which is associated with poor prognosis (5-year survival rate of 63%). Treatment for this malignancy relies predominantly on radiotherapy and/or systemic chemotherapy, which can be associated with significant morbidity and impaired quality of life. In endemic regions NPC is associated with infection by Epstein–Barr virus (EBV) which was shown to upregulate the somatostatin receptor 2 (SSTR2) cell surface receptor. With recent advances in molecular techniques allowing for an improved understanding of the molecular aetiology of this disease and its relation to SSTR2 expression, we provide a comprehensive and up-to-date overview of this disease and highlight the emergence of SSTR2 as a key tumor biomarker and promising target for imaging and therapy.

BACKGROUND Evidence shows that simplified SOFA scoring system has better clinical practice. OBJECTIVE This study aimed to validate and compare the scores acquired with simplified organ dysfunction criteria optimized for electronic health records (eSOFA), and simplified and accurate sequential organ failure assessment (sa-SOFA) for their accuracies in predicting the prognosis of septic patients. METHODS This retrospective observational study was conducted at three major academic hospitals. Clinical data from 574 patients diagnosed with sepsis following the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)were retrospectively retrieved and analysed. Scores from the quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA) were used as reference scores. The area under the receiver operating characteristic curve (AUROC) was used to assess the performance of eSOFA and sa-SOFA scores in predicting in-hospital mortality. RESULTS AUROC analysis demonstrated the predictability of the four scoring systems for sepsis surveillance, listed in descending order as: sa-SOFA, 0.790 (95% confidence interval [CI]: 0.754-0.822); SOFA, 0.774 (95% CI: 0.738-0.808); eSOFA, 0.729 (95% CI: 0.691-0.765); and qSOFA, 0.618 (95% CI: 0.577-0.658). Moreover, sa-SOFA and SOFA scores (Z = 1.950, P = .051) did not significantly differ from each other in discriminatory power, but the sa-SOFA score had a higher power than eSOFA score (P values

OBJECTIVE To report the long-term clinical outcomes of low-risk (LR) and intermediate-risk (IR) prostate cancer patients treated with low-dose-rate brachytherapy (LDR-BT) and external beam radiation therapy (EBRT). PATIENTS AND METHODS Men with biopsy-proven low- and intermediate-risk prostate cancer received EBRT and LDR-BT in an Asian academic center from 2000 to 2019 were reviewed. Kaplan-Meier survival analysis was performed to compare biochemical failure-free survival (bFFS) and overall survival (OS) between LDR and EBRT in the low- and intermediate-risk cohorts. RESULTS 642 patients (521 EBRT and 121 LDR-BT) with low- and intermediate-risk prostate cancer were included for analysis. In the intermediate-risk group, 5- and 10-year bFFS was 96%, 89% and 86%, 61% for LDR-BT and EBRT, respectively. LDR-BT was associated with a statistically significant improvement of bFFS in the intermediate-risk cohort (HR 2.7, p = 0.02). In the low-risk cohort, no difference of bFFS was found between LDR-BT and EBRT (HR 1.9, p = 0.08). Hormone therapy was more common in EBRT than LDR-BT for intermediate-risk group (71% versus 44%, p