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Background Mapping disease rates is an important aspect of epidemiological research because it helps inform public health policy. Disease maps are often drawn according to local administrative areas (LAAs), such as counties, cities, or towns. In LAAs with small populations, disease rates are unstable and are prone to appear extremely high or low. The empirical Bayes methods consider variance differences among different LAAs, thereby stabilizing the disease rates. The methods of kriging break the constraints of geopolitical boundaries and produce a smooth curved surface in the form of contour lines, but the methods lack the stabilizing effect of the empirical Bayes methods. Methods An easy-to-implement stabilized kriging method is proposed to map disease rates, which allows different errors in different LAAs. Results Monte Carlo simulations revealed that the stabilized kriging method had smaller symmetric mean absolute percentage error than three other types of methods (original LAA-based method, empirical Bayes methods, and traditional kriging methods) in nearly all scenarios considered. Real-world data analysis of oral cancer incidence rates in men from Taiwan demonstrated that the age-standardized rates in the central mountainous sparsely-populated region of Taiwan were stabilized using our proposed method, with no more large differences in numerical values, whereas the rates in other populous regions were not over smoothed. Additionally, the stabilized kriging map had improved resolution and helped locate several hot and cold spots in the incidence rates of oral cancer. Conclusions We recommend the use of the stabilized kriging method for mapping disease rates.

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are potentially fatal mucocutaneous diseases characterized by extensive necrosis and exfoliation of the epidermis. TEN and SJS are most often caused by various kinds of drugs. Other risk factors for SJS/TEN include pneumonia infection, HIV infection, genetic factors, underlying immune diseases, and tumors. SJS and TEN were first identified in 1922, but at present, a widely recognized view is that SJS and TEN represent phases in the continuous progress of the same disease. SJS/TEN has a very high mortality, but is rare, and cases of SJS/TEN combined with systemic lupus erythematosus (SLE) are even less common. Occasionally, acute cutaneous manifestations of SLE and SJS/TEN can be phenotypically similar, both causing extensive epidermal necrosis. In this paper, we present a recent case of a 32-year-old female SLE patient with a druginduced (the health product, astaxanthin) TEN/SJS. To provide context to this case, we have reviewed relevant case studies published in English, accessed via PubMed databases. The search covers all published case studies from 1988 to 2019. We collected a total of 30 cases in the literature, and analyzed their characteristics from the aspects of gender, suspicious medication history, and treatment in order to expand clinicians' approach to diagnosis and treatment.

Guselkumab effectively treats moderate-to-severe psoriasis.To evaluate the cumulative safety experience of guselkumab using pooled data from the VOYAGE 1 and 2 studies through 5 years.Patients were randomized to guselkumab, placebo with crossover to guselkumab at week 16, or adalimumab. The studies were identical through week 24. VOYAGE 1 evaluated continuous guselkumab treatment (adalimumab-crossover-to-guselkumab at week 52), while VOYAGE 2 assessed randomized withdrawal/retreatment (weeks 28-76). Open-label guselkumab treatment was administered starting at week 52 in VOYAGE 1 and week 76 in VOYAGE 2 and continued through week 252. Pooled safety data were adjusted by exposure and analyzed in the guselkumab groups, including placebo-crossover-to-guselkumab (n = 1221) and adalimumab-crossover-to-guselkumab (n = 500), through week 264.Patients were followed for a total of 7166 patient-years (PY). Overall, 1349 of 1721 guselkumab-treated patients (78.4%) continued treatment through week 252. The rates of adverse and serious adverse events were 149/100 PY and 5.01/100 PY, respectively. Rates of adverse events of interest were low: serious infections (0.85/100 PY), nonmelanoma skin cancer (0.34/100 PY), malignancies other than nonmelanoma skin cancer (0.45/100 PY), and major adverse cardiovascular events (0.29/100 PY). Year-to-year variability was evident, but no increasing trend was observed.No direct treatment comparisons were possible after week 52.The safety profile remained consistent and favorable during 5 years of continuous guselkumab treatment of psoriasis.

The considerable uncertainty in mechanical properties of composite bolted joints not only prevents advanced composite materials from efficient applications, but also threatens the safety and reliability of the aircraft structures. In this paper, the uncertainty in bearing fatigue properties of a CFRP double-lap, single-bolt joint was evaluated by combing a Progressive Fatigue Damage Model (PFDM) with the interval analysis method. In the PFDM, a residual-strain-based gradual material degradation model and a strain-based fatigue failure criterion were combined with a micromechanics-based sudden material degradation model to predict fatigue properties of the joint. Based on the interval analysis, the key uncertain parameters, which were firstly picked out from eighteen structural parameters of the joint, were described by estimated intervals, and the envelope cases were determined to estimate the lower and upper bounds of fatigue properties of the joint. The predicted results have the same tendency with the experimental results in literatures, which indicates that the PFDM combined with the interval analysis shows potential in efficiently evaluating the fatigue reliability of the complex bolted joints with an adequate accuracy.

Defect engineering through induction of dislocations is an efficient strategy to design and develop an electrode material with enhanced electrochemical performance in energy storage technology. Yet, synthesis, comprehension, identification, and effect of dislocation in electrode materials for lithium-ion batteries (LIBs) are still elusive. Herein, we propose an ethanol-thermal method mediated with surfactant-template and subsequent annealing under air atmosphere to induce dislocation into titanium niobium oxide (Ti2Nb14O39), resultant nanoscale-dislocated-Ti2Nb14O39 (Nano- dl -TNO). High-resolution transmission electron microscope (HRTEM), fast Fourier transform (FFT), and Geometrical phase analysis (GPA) denote that the high dislocation density engraved with stacking faults forms into the Ti2Nb14O39 lattice. The presence of dislocation could offer an additional active site for lithium-ion storage and tune the electrical and ionic properties of the Ti2Nb14O39. The resultant Nano- dl -TNO delivers superior rate capability, high specific capacity, better cycling stability, and making Ti2Nb14O39 a suitable candidate among fast-charging anode materials for lithium-ion batteries. Moreover, In-situ High-resolution transmission electron microscope (HRTEM) and Geometrical phase analysis (GPA) evinces that the removal of the dislocated area in the Nano- dl -TNO leads to the contraction of the lattice, alleviation of the total volume expansion, causing the symmetrization and preserves structural stability. The present findings and designed approach reveal the rose-colored perspective of dislocation engineering into mixed transition metal oxides as next-generation anodes for advanced lithium-ion batteries and all-solid-state lithium-ion batteries.

To understand the epidemiology, current treatment, and disease burden of systemic lupus erythematosus (SLE) in the Asia Pacific (APAC) region.A targeted literature review of published evidence on SLE in the APAC region was conducted, using the Medline database (2008-2018), conference proceedings, and other supplementary sources.The current review identified 70 studies conducted in China (n = 15), Japan (n = 13), Taiwan (n = 12), Korea (n = 9), Australia (n = 7), Hong Kong (n = 6), Singapore (n = 4), and multiple places within the APAC region (n = 4). Incidence rates (per 100,000 persons per year) ranged from 0.9-8.4, while prevalence rates ranged from 3.7-127 (per 100,000 persons); however, recent data were limited. Asian patients with SLE were reported to have higher disease severity, disease activity (higher SLE disease activity index scores), and organ damage accrual, along with increased morbidity, mortality, and susceptibility to renal involvement compared with other ethnicities in the APAC region. The risk of developing SLE is higher in the Asian population. Routinely used SLE therapies included belimumab, hydroxychloroquine, cyclophosphamide, tacrolimus, azathioprine, mycophenolate mofetil, and glucocorticoids; however, prescribing patterns varied across the region. Increased disease activity was associated with high economic burden and poor quality of life for SLE patients in the APAC region.SLE remains a disease with a significant unmet medical need for an innovative therapy that is well-tolerated and effective for patients in the APAC region. Further evidence is required to better characterize the disease and fully capture the burden and impact of SLE in the APAC region. This review has highlighted where there is a paucity of data from patients across the APAC region.

Given two multitemporal aerial images, semantic change detection (SCD) aims to locate the land-cover variations and identify their change types with pixelwise boundaries. This problem is vital in many earth vision-related tasks, such as precise urban planning and natural resource management. Existing state-of-the-art algorithms mainly identify the changed pixels by applying homogeneous operations on each input image and comparing the extracted features. However, in changed regions, totally different land-cover distributions often require heterogeneous feature extraction procedures for images acquired at different times. In this article, we present an asymmetric Siamese network (ASN) to locate and identify semantic changes through feature pairs obtained from modules of widely different structures, which involves areas of various sizes and applies different quantities of parameters to factor in the discrepancy across land-cover distributions during different times. To better train and evaluate our model, we create a large-scale well-annotated SEmantic Change detectiON Dataset (SECOND), while an adaptive threshold learning (ATL) module and a separated kappa (SeK) coefficient are proposed to alleviate the influences of label imbalance in model training and evaluation. The experimental results demonstrate that the proposed model can stably outperform the state-of-the-art algorithms with different encoder backbones.

This paper reports investigation of failure mechanisms of GaN-on-Si power device under electrostatic discharge (ESD) stress using on-wafer transmission-line pulse (TLP) testing. Hot-hole injections under the gate and filament formation in the buffer layer are examined by monitoring the threshold voltage (Vth) and on-resistance (Ron) subjected to a floating gate or an off-state gate voltage. Distinct and continued degradation has been observed after the ESD stress is removed indicating a slow de-trapping process due to deep-level buffer traps. Finally, 2D device simulation is used to probe the physical insight into failure mechanisms.

The artificial neural network was applied to predict the calcium yield during calcium treatment process. Three types of neural network models were established, and the optimal model was selected. Effects of contents and temperature of the molten steel on the calcium yield were calculated using the optimal model. The currently developed model can be used to improve the calcium yield and the stability of calcium content during the calcium treatment process.

Background Uncaria tomentosa, which has similar chemical constituents with Uncaria rhynchophylla, has been reported to alleviate cognitive impairments in Alzheimer’s disease (AD) animal models. This study aimed to compare the chemical constituents and anti-AD effect of the ethanol extracts of U. tomentosa (UTE) and U. rhynchophylla (URE). Methods The high-performance liquid chromatography (HPLC) was used to compare the chemical constituents of UTE and URE. Streptozotocin (STZ) was intracerebroventricularly (ICV) injected into adult male Sprague–Dawley (SD) rats to establish AD model. UTE (400 mg/kg) or URE (400 mg/kg) was administrated intragastrically once daily to the rats for 6 consecutive weeks. Morris water maze (MWM) test was conducted to assess the neurological functions in the STZ-induced AD rats. The brain tissues of the rats were harvested for further biochemical assay. Results The MWM test results showed both UTE and URE could significantly improve the learning and memory impairments induced by STZ in rats. Both UTE and URE could significantly inhibit the hyperphosphorylation of tau protein, reduce the elevated levels of pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α), enhance activities of antioxidant enzymes (SOD, CAT and GPx) and increase the protein expression of HO-1. In addition, UTE could decrease the malondialdehyde (MDA) level. Furthermore, both UTE and URE significantly enhanced Akt activation, down regulated the activation of glycogen synthase kinase 3β (GSK-3β), and induced the nuclear translocation of Nrf2 in the STZ-induced AD rats. Conclusions UTE and URE contained similar chemical constituents. We found for the first time that both of them could ameliorate cognitive deficits in the STZ-induced AD rats. The underlying molecular mechanism involve suppression of tau hyperphosphorylation, anti-oxidant and anti-neuroinflammation via modulating Akt (Ser473)/GSK3β (Ser9)-mediated Nrf2 activation. These findings amply implicate that both of UTE and URE are worthy of being developed clinically into pharmaceutical treatment for AD.

Background Although there are several publications on the new transoral robotic thyroidectomy technique, few have thoroughly reviewed its associated complications. This study analyzed the causes and prevention of transoral robotic thyroidectomy–specific complications and presented preventive measures. Methods The medical records of patients who underwent transoral robotic thyroidectomy performed by a single surgeon between March 1, 2009 and April 30, 2019 were retrospectively analyzed. Patient demographic, clinical, and operative data were analyzed using descriptive statistics. We describe the transoral robotic thyroidectomy–related complications experienced at our institution and how to overcome them. Results This study included a total of 423 patients who underwent transoral robotic thyroidectomy. The general surgical complications included immediate postoperative bleeding (2 cases) and delayed hematoma (3 cases). Chyle leakage and localized wound infection were found in 1 case each. Transient vocal cord palsy occurred in 4 cases, and 1 case developed transient hypoparathyroidism. The transoral robotic thyroidectomy–specific complications included zygoma bruise (2 cases), flap bruise (3 cases), chin flap perforation (2 cases), and oral commissure tearing (2 cases). The complications occurring when creating the flap included flap burns (4 cases), skin dimpling in the midline of the lower chin (2 cases), and hematomas in the intraoral trocar insertion sites (3 cases). Conclusion Surgeons familiar with thyroid surgery and experienced in robotic surgery can perform transoral robotic thyroidectomy without causing more complications than those seen with traditional surgery.

We determined the influence of gastro-oesophageal reflux disease (GERD) on quality of life (QOL) before and after functional-endoscopic-sinus-surgery (FESS) for chronic rhinosinusitis (CRS).Medically-recalcitrant CRS patients were recruited prior to FESS. GERD was diagnosed endoscopically. QOL was compared between patients withOf 187 CRS patients receiving FESS, 40 had GERD. Pre-operative QOL was significantly worse in CRS patients withCompared to CRS patients without GERD, those with GERD experienced poorer pre-operative QOL and greater QOL improvement after FESS.Associazione della malattia da reflusso gastroesofageo e la qualità di vita dei pazienti affetti da rinosinusite cronica.Abbiamo determinato l’impatto della malattia da reflusso gastroesofageo (GERD) sulla qualità della vita (QOL) prima e dopo chirurgia endoscopica funzionale nasosinusale (FESS) nel trattamento della rinosinusite cronica (CRS).I pazienti con CRS refrattari alle terapie mediche sono stati reclutati prima della FESS. La diagnosi di GERD è stata raggiunta endoscopicamente. La qualità della vita è stata confrontata tra pazienti con e senza GERD al basale e a un anno dopo la FESS.Dei 187 pazienti con CRS sottoposti a FESS, 40 erano affetti da GERD. La qualità della vita prima dell’intervento era significativamente peggiore nei pazienti affetti da CRS e con GERD rispetto a quelli senza GERD. I punteggi preoperatori della qualità della vita in relazione alla GERD (GERD-HRQL) e dell’indice dei sintomi da reflusso (RSI) sono stati correlati ciascuno con i punteggi SNOT-22 preoperatori. Rispetto ai pazienti con CRS senza GERD, i pazienti con GERD hanno dimostrato miglioramenti della SNOT-22 più significativi dopo trattamento FESS, i valori SNOT-22 postoperatori non erano più significativamente differenti tra i gruppi con GERD e senza GERD. Tuttavia, dopo la FESS, nei pazienti con CRS senza poliposi nasale (a differenza di quelli con poliposi nasale), il gruppo GERD (contro non-GERD) ha avuto una maggiore disfunzione del sonno e sintomi otologici/facciali.Rispetto ai pazienti con CRS senza GERD, quelli con GERD hanno beneficiato di un miglioramento della QOL maggiore dopo trattamento FESS.

Background Current evidence suggests that acupuncture is an effective adjunctive therapy that can bring potential benefits to patients with cardiac arrhythmias. However, there are relevant gaps in the optimal therapeutic strategy, which may cause uncertainties on the best practice of acupuncture treatment for arrhythmia. We aim to develop consensus-based recommendations for clinical guidance on acupuncture treatment of cardiac arrhythmias. Methods A multidisciplinary panel of specialists was invited to participate in a two-round semi-open clinical issue investigation. Meanwhile, relevant literature reviews were searched in 3 databases to provide evidence. Subsequently, an initial consensus voting list on acupuncture as an adjunctive therapy for cardiac arrhythmias was derived from the clinical investigation and literature review. Finally, 30 authoritative experts reached a consensus on the key issues of the voting list by a three-round modified Delphi survey. Consensus was defined when >80% agreement was achieved. Results Following the three-round Delphi survey, there were 32 items (91.43%) finally reaching consensus, including the following 5 domains: (I) the benefits of acupuncture for the appropriate population; (II) the general therapeutic principle; (III) the acupuncture strategy; (IV) the relevant adverse events; (V) others. Conclusions Consensus was achieved on some key elements. Given the lack of guidelines and the substantial heterogeneity of previous studies, these recommendations are of value in providing guidance for clinical practice of acupuncturists and in assisting patients with arrhythmia to obtain standardized acupuncture treatment. It also pointed out some problems that need to be carefully explored in future studies.

The performance of a low-profile dielectric resonator (DR) antenna (DRA) is hardly maintained across a wide frequency range due to the multiple higher-order modes. In this letter, a low-profile and broadband DRA is proposed with stable broadside radiation over a wide range of frequencies. A detailed analysis of the excited modes is conducted to identify proper modes for broadband operation. Different air regions are then introduced in the top layer of the proposed DRA. This allows the excitation of the higher-order DR modes with broadside radiation while suppressing the unwanted off-boresight modes. To validate the design, the DRA is developed to cover the frequency range of 3.25–6.1 GHz for potential 5G applications. The fabricated prototype is measured showing a broad bandwidth of ∼64.2%, a peak antenna gain of ∼9 dBi, and a low profile of only ∼0.07λ0.

Background The nonspecific clinical, radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases. The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis. Case summary A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week, which was aggravated for two days. The patient had been sexually active with the same male partner for the past years, but her partner was promiscuous. Abdominal contrast-enhanced computed tomography (CT) and positron emission tomography/CT suggested gastric cancer. The gastroscopy revealed an antral gastric ulcer with gastric retention, and also suggested gastric cancer. But no cancer cells were found in the biopsies taken during the two gastroscopies. Treponema pallidum (T. pallidum) antibodies: ELISA positive, rapid plasma reagin titer 1:16. Hematoxylin and eosin (HE) stain showed macrophage infiltration in the lamina propria. Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T. pallidum. The patient was finally diagnosed with gastric syphilis. Conclusion Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer. Penicillin can relieve symptoms of gastric syphilis.

At present, most of the widely used system codes for nuclear safety analysis are one-dimensional, which cannot effectively simulate the flow field of the reactor core or other structures. This is true even for the system codes containing three-dimensional modules with limited three-dimensional simulation function such as RELAP-3D. In contrast, the computational fluid dynamics (CFD) codes excel at providing a detailed three-dimensional flow field of the reactor core or other components; however, the computational domain is relatively small and results in the very high computing resource consuming. Therefore, the development of coupling codes, which can make comprehensive use of the advantages of system and CFD codes, has become a research focus. In this paper, a review focus on the researches of coupled CFD and thermal-hydraulic system codes was carried out, which summarized the method of coupling, the data transfer processing between CFD and system codes, and the verification and validation (V&V) of coupled codes. Furthermore, a series of problems associated with the coupling procedure have been identified, which provide the general direction for the development and V&V efforts of coupled codes.

The capability to support large wave vector bulk plasmon polariton (BPP) waves enables the application of hyperbolic metamaterials (HMMs) in sensing. However, there is a challenge arising from the excitation of BPP, and the highly confined polarization waves are unable to meet the requirements of practical application. In this study, an HMM/bilayer silver nanoparticles (Ag NPs) platform is proposed that allows the excitation and utilization of BPP for use as a surface-enhanced Raman scattering (SERS) substrate. According to the research results, the bilayer Ag NPs provide stronger plasmonic property and act as a light-matter coupler, so as to generate a large wave vector of scattered light and excite the BPP within the HMM. Besides, Ag NPs provide the nano antenna structure, and decouple the BPP into localized surface plasmon (LSP) that can be used directly to excite the electric fields. In addition, HMM produces a modulating effect on the plasmon resonance peak, which makes it possible to overlap the spectrum of resonance peak with excitation wavelengths, thus leading to a strong absorption peak at the incident laser wavelength region. Experimentally, the platform was applied to achieve SERS detection for adenosine molecules with a concentration of 10−6 M. It is believed that this plasmonic platform has a potential of application in surface-enhanced spectroscopy.

The aim of this trial was to evaluate the feasibility and effect of home-based transcutaneous electrical acupoint stimulation (TEAS) in patients with hypertension. In this randomized pilot trial, patients with hypertension were randomly assigned to the TEAS group or the usual care group. Participants in the usual care group were instructed to continue taking their antihypertensive drugs and received education on lifestyle modifications. In addition, participants in the TEAS group received 4 weekly sessions of noninvasive acupoint stimulation for 12 weeks at home. The primary outcome was the change in office systolic blood pressure at week 12 from baseline. Withdrawal from the study and adverse events associated with TEAS were also recorded. Sixty patients were randomized, with 30 patients in the TEAS group, of whom 1 was lost at week 36, and 30 patients in the usual care group, of whom 3 were lost by week 12. The reduction in systolic blood pressure at week 12 was greater in the TEAS group (−8.53 mm Hg; 95% CI [−13.37, −3.70 mm Hg]) than in the usual care group (−1.70 mm Hg; 95% CI [−4.29, −0.89 mm Hg]), with a between-group difference of −6.83 mm Hg (95% CI, [−12.23, −1.43 mm Hg]; P = 0.014). No TEAS-related adverse events occurred. In conclusion, home-based TEAS added to usual care for patients with hypertension was acceptable and safe and may be a potential treatment option. A larger randomized controlled trial of this intervention is warranted., Home-based transcutaneous electrical acupoint stimulation added to usual care for patients with hypertension was acceptable, safe and may be a potential treatment option. TEAS, transcutaneous electrical acupoint stimulation; SBP, systolic blood pressure.

Ratiometric probes facilitate quantitative studies via self-calibration and are cherished for bioimaging. Often, a small probe-product spectral separation leads to crosstalk, but the rational devel...

Background/purpose The estimated prevalence of xerostomia (lack of saliva) ranges from 10% to 50% of the general population. The oral cavity provides a multivariant environmental habitat to over 700 species of bacteria and fungi. We hypothesized that xerostomia will alter the composition of oral microbiota. Material and methods Nineteen xerostomia patients and 10 healthy normal volunteers were studied for the oral microbiota. Gingival plaques were collected and microbiota were detected using bacterial 16S ribosomal RNA and analyzed based on the levels of phylum and class. Results In all cases, phyla of Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Proteobacteria make up to 100% of oral microbiota at phylum level. Analyzing individual phylum, presence of Bacteroidetes in xerostomia patients and normal subjects were 23.12 ± 2.56% and 23.23 ± 2.58%, respectively. Mean percentage presence of Firmicutes phylum in xerostomia patients and normal subjects were 18.94 ± 1.83% and 14.06 ± 0.98%, respectively. Statistically significant difference was not observed between xerostomia patients and normal subjects in this study. Conclusion These observations revealed obvious but not statistically significant changes in oral major microorganism phylum between xerostomia patients and normal subjects in this study. More samples are needed to verify the current results and to use oral microbiota as a tool in the diagnosis of xerostomia.

Image line segment detection is a fundamental problem in computer vision and remote sensing. Although numerous state-of-the-art methods have shown great performance for straight line segment detection, line segment detection for distorted images without undistortion is still a challenging problem. Besides, there is a lack of a unified line segment detection framework for both distorted and undistorted images. To address these two problems, we propose a novel learning-based Unified Line Segment Detection method (i.e., ULSD) for distorted and undistorted images in this paper. Specifically, we first propose a novel equipartition point-based Bezier curve representation to model arbitrary distorted line segments. Then the line segment detection is tackled by equipartition point regression with an end-to-end trainable neural network. Consequently, the proposed ULSD is independent of camera distortion parameters and does not need any undistortion preprocessing. In the experiments, the proposed method is firstly evaluated on the pinhole, fisheye, and spherical image datasets, respectively, as well as trained and tested on the mixed dataset with differently distorted images. The experimental results on each distortion model show that the proposed ULSD is more competitive than the state-of-the-art methods for both accuracy and efficiency, especially for the results of the unified model trained on the mixed datasets, thus demonstrating the effectiveness and generality of the proposed ULSD to real-world scenarios. The source code and datasets are available at https://github.com/lh9171338/ULSD-ISPRS.

Background The recent randomized trials demonstrated that culprit-only percutaneous coronary intervention (CO-PCI) was superior to multivessel PCI (MV-PCI) among ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) complicated by cardiogenic shock, yet the real-world scenario remains to be determined. Methods Studies that compared CO-PCI versus MV-PCI in STEMI patients with MVD complicated by cardiogenic shock were identified by a systematic search of published articles. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated by using random-effects models. Results Eventually, 18 observational studies involving 73,528 patients were included. The results showed that CO-PCI was associated with lower risks of short-term renal failure (OR: 0.75; 95% CI: 0.64 to 0.88; I2=14.7%) and short-term stroke (OR: 0.86; 95% CI: 0.77 to 0.96; I2=0.0%) compared with immediate MV-PCI. But the risk of short-term myocardial infarction (OR: 1.12; 95% CI: 1.03 to 1.22; I2=0.0%) was increased. There was no significant difference during long-term follow-up. The results remained consistent after adding the only randomized trial. Discussion Based on real-world analyses, our meta-analysis suggested that CO-PCI decreased the risks of renal failure and stroke but increased the risk of myocardial infarction relative to immediate MV-PCI during short-term follow-up in STEMI patients with MVD complicated by cardiogenic shock. If possible in clinical practice, staged MV-PCI can be given a try to decrease the risks of renal failure and stroke associated with immediate MV-PCI and myocardial infarction associated with CO-PCI. However, the conclusions need to be confirmed by further large-scale studies.

Aims Interleukin (IL)-5 mediates the development of eosinophils (EOS) that are essential for tissue post-injury repair. It remains unknown whether IL-5 plays a role in heart repair after myocardial infarction (MI). This study aims to test whether IL-5-induced EOS population promotes the healing and repair process post-MI and to reveal the underlying mechanisms. Method and results MI was induced by permanent ligation of the left anterior descending coronary artery in wild-type C57BL/6 mice. Western blot and real-time polymerase chain reaction revealed elevated expression of IL-5 in the heart at 5 days post-MI. Immunohistostaining indicated that IL-5 was secreted mainly from macrophages and type 2 innate lymphoid cells in the setting of experimental MI. External supply of recombinant mouse IL-5 (20 min, 1 day, and 2 days after MI surgery) reduced the infarct size and increased ejection fraction and angiogenesis in the border zone. A significant expansion of EOS was detected in both the peripheral blood and infarcted myocardium after IL-5 administration. Pharmacological depletion of EOS by TRFK5 pretreatment muted the beneficial effects of IL-5 in MI mice. Mechanistic studies demonstrated that IL-5 increased the accumulation of CD206+ macrophages in infarcted myocardium at 7 days post-MI. In vitro co-culture experiments showed that EOS shifted bone marrow-derived macrophage polarization towards the CD206+ phenotypes. This activity of EOS was abolished by IL-4 neutralizing antibody, but not IL-10 or IL-13 neutralization. Western blot analyses demonstrated that EOS promoted the macrophage downstream signal transducer and activator of transcription 6 (STAT6) phosphorylation. Conclusion IL-5 facilitates the recovery of cardiac dysfunction post-MI by promoting EOS accumulation and subsequent CD206+ macrophage polarization via the IL-4/STAT6 axis. Translational perspective Accumulating evidence suggests that modulation of innate and adaptive immune responses is a promising therapeutic strategy for myocardial infarction. In this study, we demonstrate that IL-5 exerts cardioprotective effects on infarcted myocardium by promoting eosinophil accumulation and subsequent CD206+ macrophage polarization via the IL-4/STAT6 axis. Hence, regulation of cardiac IL-5 level or eosinophil count may become a therapeutic approach for post-myocardial infarction cardiac repair in humans.

Background/Purpose This study aims at investigating the epidemiological profile of chronic hepatitis C (CHC) regarding hepatitis C virus (HCV) genotype in Taiwan. Methods A total of 29,087 CHC patients with advanced fibrosis who received direct-acting antivirals (DAAs) therapy under Taiwan's National Health Insurance (NHI) during 2017–2018 were recruited. The HCV genotype distribution and its association with patients' demographic factors including age, gender, and geographical areas were examined. Results The most common genotypes were 1b (59.5%) and 2 (30.1%) with characteristics of older age (mean ± standard deviation (SD): 66.5 ± 10.7 years and 67.3 ± 10.9 years) and female gender predominant (57.1% and 59.4%), which were associated with iatrogenic infection decades ago. Most of patients with genotype 1a (5.9%) and 6 (3.7%) infection were relatively younger (59.2 ± 12.0 years and 60.0 ± 13.8 years) and male gender predominant (59.1% and 61.1%), except Liujia and Liuying districts in southern Taiwan. The youngest group (53.2 ± 11.8 years) and most male gender predominant (74.3%) was genotype 3 (0.37%). These genotypes with characteristics of being younger and male gender predominant were highly related to injection drug use in recent years. The number of genotype 4 patients were extremely rare (n = 25) and efficacy of genotype-4-specific-DAA was significantly poorer than non-genotype-4-specific DAA (P value = 0.0411). Conclusions The significant differences in demographic characteristics among CHC patients with different HCV genotypes found in this study suggest HCV genotype was highly associated with transmission pattern and may be used as a reference for HCV control.

Severe ischemic stroke damages neuronal tissue, forming irregular-shaped stroke cavities devoid of supporting structure. Implanting biomaterials to provide structural and functional support is thought to favor ingrowth of regenerated neuronal networks. Injectable hydrogels capable of in situ gelation are often utilized for stroke repair, but challenged by incomplete gelation and imprecise control over end-macrostructure. Injectable shape-memory scaffolds might overcome these limitations, but are not explored for stroke repair. Here, we report an injectable, photoluminescent, carbon-nanotubes-doped sericin scaffold (CNTs-SS) with programmable shape-memory property. By adjusting CNTs' concentrations, CNTs-SS′ recovery dynamics can be mathematically calculated at the scale of seconds, and its shapes can be pre-designed to precisely match any irregular-shaped cavities. Using a preclinical stroke model, we show that CNTs-SS with the customized shape is successfully injected into the cavity and recovers its pre-designed shape to well fit the cavity. Notably, CNTs-SS’ near-infrared photoluminescence enables non-invasive, real-time tracking after in vivo implantation. Moreover, as a cell carrier, CNTs-SS not only deliver bone marrow mesenchymal stem cells (BMSCs) into brain tissues, but also functionally promote their neuronal differentiation. Together, we for the first time demonstrate the feasibility of applying injectable shape-memory scaffolds for stroke repair, paving the way for personalized stroke repair., Graphical abstract Image 1, Highlights • A customized stroke cavity repairing strategy using preformed sericin-based scaffold with programmable shape-memory properties. • Injectability facilitates its' in vivo delivery and minimizes implantation injury. • Embedded CNTs endowing this biomaterial neuro-differentiation-promoting activity.

As the application of network encryption technology expands, malicious attacks will also be protected by encryption mechanism, increasing the difficulty of detection. This paper focuses on the analysis of encrypted traffic in the network by hosting long-day encrypted traffic, coupled with a weighted algorithm commonly used in information retrieval and SSL/TLS fingerprint to detect malicious encrypted links. The experimental results show that the system proposed in this paper can identify potential malicious SSL/TLS fingerprints and malicious IP which cannot be recognized by other external threat information providers. The network packet decryption is not required to help clarify the full picture of the security incident and provide the basis of digital identification. Finally, the new threat intelligence obtained from the correlation analysis of this paper can be applied to regional joint defense or intelligence exchange between organizations. In addition, the framework adopts Google cloud platform and microservice technology to form an integrated serverless computing architecture.

This letter presents a wideband high performance 45° linearly polarization 8 × 8-slot array antenna. The gap waveguide technology is utilized to realize the proposed antenna, so that the electromagnetic (EM) leakage among the metallic blocks can be cancelled. 2 × 4-slot subarrays are used to construct the array antenna. An additional cavity power divider layer is inserted between the layers of original cavity power dividers and radiation slots to balance the amplitude and phase distributions in wideband frequency band. This suppresses the grating lobes. Triangular blocks are loaded in the new cavity power divider layer to confine the EM field distribution, thereby improving cross-polarization discrimination (XPD). For demonstration, a prototype antenna covering 5G millimeter-wave (mmW) NR bands of 257, 258, and 261 is design, fabricated, and measured. Measured results show that an impedance bandwidth of 23–30 GHz (| S 11

BACKGROUND: This study aimed to build a radiomics model with deep learning (DL) and human auditing and examine its diagnostic value in differentiating between coronavirus disease 2019 (COVID-19) and community-acquired pneumonia (CAP). METHODS: Forty-three COVID-19 patients, whose diagnoses had been confirmed with reverse-transcriptase polymerase-chain-reaction (RT-PCR) tests, and 60 CAP patients, whose diagnoses had been confirmed with sputum cultures, were enrolled in this retrospective study. The candidate regions of interest (ROIs) on the computed tomography (CT) images of the 103 patients were determined using a DL-based segmentation model powered by transfer learning. These ROIs were manually audited and corrected by 3 radiologists (with an average of 12 years of experience; range 6-17 years) to check the segmentation acceptance for the radiomics analysis. ROI-derived radiomics features were subsequently extracted to build the classification model and processed using 4 different algorithms (L1 regularization, Lasso, Ridge, and Z test) and 4 classifiers, including the logistic regression (LR), multi-layer perceptron (MLP), support vector machine (SVM), and extreme Gradient Boosting (XGboost). A receiver operating characteristic curve (ROC) analysis was conducted to evaluate the performance of the model. RESULTS: Quantitative CT measurements derived from human-audited segmentation results showed that COVID-19 patients had significantly decreased numbers of infected lobes compared to patients in the CAP group {median [interquartile range (IQR)]: 4 [3, 4] and 4 [4, 5]; P=0.031}. The infected percentage (%) of the whole lung was significantly more elevated in the CAP group [6.40 (2.77, 11.11)] than the COVID-19 group [1.83 (0.65, 4.42); P

Background: Patients with typical atrial flutter (AFL) undergoing successful cavotricuspid isthmus ablation remain at risk for future development of new-onset atrial fibrillation (AF). Conventional monitoring (CM) techniques have shown AF incidence rates of 18%–50% in these patients. Objectives: To evaluate whether continuous monitoring using implantable loop recorders (ILRs) would enhance AF detection in this patient population. Methods: Veteran patients undergoing AFL ablation between 2002 and 2019 who completed at least 6 months of follow-up after the ablation procedure were included. We compared new-onset AF detection between those who underwent CM and those who received ILRs immediately following AFL ablation. Results: A total of 217 patients (age: 66 ± 9 years; all male) participated. CM was used in 172 (79%) and ILR in 45 (21%) patients. Median follow-up duration after ablation was 4.1 years. Seventy-nine patients (36%) developed new-onset AF, which was detected by CM in 51 and ILR in 28 (30% vs 62%, respectively, P < .001). AF detection occurred at 7.7 months (IQR: 4.7–17.5) after AFL ablation in the ILR group vs 41 months (IQR: 23–72) in the CM group (P < .001). Eleven patients (5%) experienced cerebrovascular events (all in the CM group) and only 4 of these patients (36%) were on long-term anticoagulation. Conclusion: Patients undergoing AFL ablation remain at an increased risk of developing new-onset AF, which is detected sooner and more frequently by ILR than by CM. Improving AF detection may allow optimization of rhythm management strategies and anticoagulation in this patient population.

Monitoring survival in cancer is a common concern for patients, physicians, and public health researchers. The traditional cohort approach for monitoring cancer prognosis has a timeliness problem. In this paper, we propose a survivorship-period-cohort (SPC) model for examining the effects of survivorship, period, and year-of-diagnosis cohort on cancer prognosis and for predicting future trends in cancer survival. We used the developed SPC model to evaluate the relative survival (RS) of patients with liver cancer in Taiwan (diagnosed from 1997 to 2016) and to predict future trends in RS by imputing incomplete follow-up data for recently diagnosed patient cohorts. We used cross-validation to select the extrapolation method and bootstrapping to estimate the 95% confidence interval for RS. We found that 5-year cumulative RS increased for both men and women with liver cancer diagnosed after 2003. For patients diagnosed before 2010, the 5-year cumulative RS rate for men was lower than that for women; thereafter, the rates were better for men than for women. The SPC model can help elucidate the effects of survivorship, period, and year-of-diagnosis cohort effects on cancer prognosis. Moreover, the SPC model can be used to monitor cancer prognosis in real time and predict future trends; thus, we recommend its use.

Wen Yang,1,* Xia Xu,2,* Ming Xu,1 Jun Zhou,1 Zihan Xi,1 Hui Guo,1 Jie Ming,1 Tao Huang1 1Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Tao Huang; Jie MingDepartment of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road No. 1277, Wuhan, Hubei Province, People’s Republic of ChinaTel +8613807112766; +8613905519049Fax +86 27-85726833Email huangtaowh@163.com; mingjiewh@126.comPurpose: Papillary thyroid cancer (PTC) patients could obtain poor prognosis if they have lymph node metastasis, identification of informative and robust biomarkers for predicting cervical lymph node metastasis is critical for improving clinical decision-making and patient prognosis.Materials and Methods: In this study, we analyzed the expression of X box binding protein 1 spliced-form (XBP1s) in 41 PTC tissue samples and extended our findings using public databases, then we investigated how XBP1s’ contributed to PTC progression in vitro.Results: We found that XBP1s’ expression was lower in PTC patients with cervical lymph node metastasis than non-metastasis patients by immunohistochemical analysis. With publicly accessible dataset, we showed that the XBP1 transcription was significantly decreased in thyroid cancer (TC) tissues with lymph node metastasis as compared to that without lymph node metastasis. Moreover, we also found that XBP1 expression was significantly correlated with patients’ gender, T classification, lymph node metastasis and PTC stages, and low XBP1 expression was associated with poor diseases free survival (DFS). In vitro, XBP1s overexpression could inhibit the invasion, migration, and wound healing capacity of PTC cells. Mechanistically, overexpression of XBP1s could enhance the expression of classical epithelial–mesenchymal transition (EMT) markers such as ZO-1 and E-cadherins, and downregulated N-cadherin in BCPAP cells.Conclusion: These findings suggest that XBP1s is a prognostic maker for thyroid carcinoma patients, and sustaining XBP1s expression might be a new strategy to control PTC progression.Keywords: XBP1s, lymph node metastasis, papillary thyroid cancer, EMT

Background It has been reported that the dysregulation of microRNAs (miRNAs) is implicated in the biological processes of diverse diseases, including the tumorigenesis of human cancers. MicroRNA-628–5p (miR-628–5p) is differentially expressed and plays a critical role in several cancers, but the role of miR-628–5p in cervical cancer has not been well studied. Methods The TCGA database and RT-qPCR were used to evaluate the expression profile of miR-628–5p in cervical cancer tissues. Transfection efficiency of synthetic miRNAs was detected using RT-qPCR. The biological effects of miR-628–5p on cervical cancer cells were assessed by the CCK-8 assay, flow cytometry, western blot analysis, and the tube formation assay. The expression levels of key proteins involved in cell apoptosis, the cell cycle and the PI3K pathway were analyzed by western blot analysis. Bioinformatic analysis and the luciferase reporter assay were performed to investigate the targeted relationship between miR-628–5p and vascular endothelial growth factor (VEGF). Results MiR-628–5p was downregulated and negatively correlated with Ki-67 expression in cervical cancer tissues, and its low level predicted poor survival of patients. Functional assays indicated that miR-628–5p inhibited cell proliferation and promoted cell apoptosis. Mechanically, VEGF was verified to be a downstream target of miR-628–5p. Moreover, overexpression of VEGF could reverse the effects of miR-628–5p on VEGF/PI3K/AKT signaling, cell proliferation, apoptosis, the cell cycle and angiogenesis in cervical cancer. Conclusions MiR-628–5p inhibited cervical cancer cell proliferation and promoted apoptosis by targeting VEGF.

Blind image quality assessment (BIQA) aims to evaluate the perceptual quality of image with no pristine image for comparison, which attracts extensive attention and is of wide applications. Research on human visual system (HVS) indicates visual perception is classically modeled as a hierarchical process. Meanwhile, empirical evidence shows that different levels of distortion generate individual degradation on hierarchical features. Although previous BIQA methods exploited different levels of feature, the degradations and correlations on hierarchical features are not detailedly analyzed. In this paper, hierarchical degradation is systematically analyzed by quantitative and qualitative experiments using interpretable hierarchical features. Additionally, as there exist strong relationships, these features cannot be simply concatenated for quality prediction. Inspired by the Bayesian brain theory, correlations among hierarchical features are thoroughly deduced with joint probability. Guided by the mathematical derivation, a new feature aggregation network (FANet) is designed to eliminate correlations for hierarchical features fusion. Finally, a novel end-to-end BIQA framework based on hierarchical feature aggregation is proposed, which eminently analyzes the degradations and correlations on hierarchical features. Experimental results on five benchmark databases show that the proposed method achieves state-of-the-art performance. Furthermore, cross-database evaluations demonstrate the generalization capability and robustness of the proposed method.

Background/purpose Oral submucous fibrosis (OSF) is an irreversible fibrosis disease and a potentially malignant disorder in the oral cavity. Various studies have shown that miR-21 was implicated in the fibrogenesis and carcinogenesis, but its functional role in the development of OSF has not been investigated. Methods The expression levels of miR-21 in arecoline-stimulated normal buccal mucosal fibroblasts (BMFs) and OSF specimens were determined by qRT-PCR. Exogenous administration of TGF-β and its inhibitor (SB431542) were utilized to examine the involvement of TGF-β signaling in miR-21 alteration. Collagen gel contraction, transwell migration, and invasion assays were used to assess the myofibroblast activities. The relationship between α-SMA and miR-21 was calculated using the Pearson correlation coefficient. Results MiR-21 expression was induced in BMFs by arecoline treatment in a dose-dependent manner. Our results showed that this upregulation was mediated by TGF-β signaling. Subsequently, we demonstrated that the administration of the miR-21 inhibitor suppressed the arecoline-induced myofibroblast characteristics, including a higher collagen gel contractility and cell motility, in normal BMFs. Furthermore, inhibition of miR-21 was sufficient to attenuate the myofibroblast features in fibrotic BMFs. Besides, we showed that the expression of miR-21 was aberrantly upregulated in the OSF tissues and there was a positive correlation between miR-21 and myofibroblast marker, α-SMA. Conclusion MiR-21 overexpression in OSF may be due to the stimulation of areca nut, which was mediated by the TGF-β pathway. Our data suggested that the repression of miR-21 was a promising direction to palliate the development and progression of OSF.

Objective Probiotics participate in regulating oral microbiota and reducing the prevalence of oral diseases; however, clinical research on probiotics is insufficient. Therefore, in this study, we performed in vitro screening of potential oral protective probiotic strains, and then evaluated the clinical efficacy of the selected strains on maintaining oral health. Materials and methods Fifty healthy individuals were recruited and randomly assigned into the placebo group and probiotics group, which included three strains of probiotics, Lactobacillus salivarius subs. salicinius AP-32, Lactobacillus paracasei ET-66, and Lactobacillus plantarum LPL28. Each group was blindly administered placebo or probiotics for four weeks. Results Next-generation sequencing results showed that the oral microbiota of Lactobacillus salivarius in the oral cavity were significantly increased in subjects supplemented with mixed probiotic lozenges. The antibacterial activities of viable probiotics were observed within two weeks. Both IgA levels and Lactobacillus and Bifidobacterium abundances in the oral cavity were significantly increased in the experimental groups, along with a reduced formation of plaque. Most participants reported that their oral health conditions and intestinal symptoms had improved. Conclusions Overall, our clinical study suggests that oral probiotic lozenges may enhance oral immunity, modulate oral microbiota, and improve oral health.

BACKGROUND Gastroesophageal varices are a rare complication of essential thrombocythemia (ET). ET is a chronic myeloproliferative neoplasm (MPN) characterized by an increased number of blood platelets. CASE SUMMARY A 46-year-old woman, who denied a history of liver disease, was admitted to our hospital on presentation of hematemesis. Laboratory examination revealed a hemoglobin level of 83 g/L, and a platelet count of 397 × 109/L. The appearance of gastric and esophageal varices with red colored signs as displayed by an urgent endoscopy was followed by endoscopic variceal ligation and endoscopic tissue adhesive. Abdominal computed tomography revealed cirrhosis, marked splenomegaly, portal vein thrombosis and portal hypertension. In addition, bone marrow biopsy and evidence of mutated Janus kinase 2, substantiated the onset of ET. The patient was asymptomatic with regular routine blood testing during the 6-mo follow-up period. Therefore, in this case, gastroesophageal varices were induced by ET. CONCLUSION MPN should be given considerable attention when performing differential diagnoses in patients with gastroesophageal varices. An integrated approach such as laboratory tests, radiological examination, and pathological biopsy, should be included to allow optimal decisions and management.

The microbial communities associated with insects play critical roles in many physiological functions such as digestion, nutrition, and defense. Meanwhile, with the development of sequencing technology, more and more studies begin to focus on broader biodiversity of insects and the corresponding mechanisms of insect microbial symbiosis, which need longer time collecting in the field. However, few studies have evaluated the effect of insect microbiome sample preservation approaches especially in different time durations or have assessed whether these approaches are appropriate for both next-generation sequencing (NGS) and third-generation sequencing (TGS) technologies. Here, we used Tessaratoma papillosa (Hemiptera: Tessaratomidae), an important litchi pest, as the model insect and adopted two sequencing technologies to evaluate the effect of four different preservation approaches (cetyltrimethylammonium bromide (CTAB), ethanol, air dried, and RNAlater). We found the samples treated by air dried method, which entomologists adopted for morphological observation and classical taxonomy, would get worse soon. RNAlater as the most expensive approaches for insect microbiome sample preservation did not suit for field works longer than 1 month. We recommended CTAB and ethanol as better preservatives in longer time field work for their effectiveness and low cost. Comparing with the full-length 16S rRNA gene sequenced by TGS, the V4 region of 16S rRNA gene sequenced by NGS has a lower resolution trait and may misestimate the composition of microbial communities. Our results provided recommendations for suitable preservation approaches applied to insect microbiome studies based on two sequencing technologies, which can help researchers properly preserve samples in field works.

Tian Shen,1,* Jing Wang,1,* Wen Yang,1 Linke Li,1 Yixin Qiao,1 Xiaohong Yan,1 Min Chen,2 Xiangdong Tang,3 Jian Zou,1 Yu Zhao1 1Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Otorhinolaryngology Head and Neck Surgery, Chengdu Shangjin Nanfu Hospital, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yu Zhao; Jian ZouDepartment of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaTel +86-18980601410; +86-18980605883Email yutzhao@163.com; zoujian926@163.comObjective: To investigate the possible correlation between obesity and hematological parameters in children with obstructive sleep apnea (OSA).Methods: A total of 460 children was initially included in our study, which were divided into children with OSA and children without OSA. Multiple analysis was performed for obesity by adjusting confounding factors such as age and gender in 460 children. Further, to minimize the influence of confounding factors and selective bias, propensity score matching (PSM) was performed in children with OSA. Hematological parameters such as inflammatory and coagulable parameters were compared between the normal weight children with OSA and the obese children with OSA following PSM.Results: OSA (OR = 3.061; P< 0.001; 95% CI, 1.772– 5.288) represented an independent risk factor for obesity. Besides, the obese children with OSA had higher levels of white blood cell (WBC) (P< 0.001), neutrophil (NEUT) (P< 0.001), neutrophil-lymphocyte ratio (NLR) (P=0.006), fibrinogen (FIB) (P=0.033), while had a lower level of activated partial thromboplastin time (APTT) (P=0.048). No significant differences were observed in other hematological parameters. In linear regression, the results indicated that the levels of WBC (R2 = 0.123, Beta = 0.289, P< 0.001), NEUT (R2 = 0.124, Beta = 0.282, P< 0.001), NLR (R2 = 0.105, Beta = 0.184, P=0.026) and FIB (R2 = 0.086, Beta = 0.246, P=0.003) were positively correlated with BMI, while the level of APTT (R2 = 0.057, Beta = − 0.171, P=0.044) was significantly negatively correlated with BMI.Conclusion: OSA was an independent risk factor contributing to obesity. WBC, NEUT, NLR, FIB and APTT are correlated with obesity in children with OSA (aged from 2 to 14 years). These indicators could be used to estimate the status of inflammation and hypercoagulation in the obese children with OSA.Keywords: obstructive sleep apnea, obesity, propensity score matching, hematological parameter, inflammation, hypercoagulation

The application of compression sleeve (CS) has rapidly developed in the medicine and rehabilitation fields and is commonly used for improving sensorimotor function. Despite a considerable amount of sensorimotor-related evidence and clinical outcomes analysis being available, little is known about the effects of CS-induced sensory afferent input on corticomuscular functional connectivity (corticomuscular coherence, CMC) and reaction time (RT). Therefore, the purpose of this study was to investigate the effect of wearing CS on CMC and sensorimotor performance. Fourteen healthy volunteers were enrolled in this study and randomly performed visual tracking motor task, RT test and joint position sense (JPS) test with and without CS (CS and non-CS conditions). Electroencephalography and electromyography of the wrist extensor during the visual tracking motor task were used to calculate CMC. Joint angle steadiness, joint position error, pre-motor time (PMT), electromechanical delay (EMD) time and RT were calculated to compare sensorimotor performance with and without CS. When wearing CS decreased CMC, shortened both PMT and RT compared to the non-CS condition (p

OBJECTIVE To assess the efficacy of intensive acupuncture (3 times weekly for 8 weeks) versus sham acupuncture for knee osteoarthritis (OA). METHODS In this multicenter, randomized, sham-controlled trial, patients with knee OA were randomly assigned to receive electroacupuncture (EA), manual acupuncture (MA), or sham acupuncture (SA) 3 times weekly for 8 weeks. Participants, outcome assessors, and statisticians were blinded with regard to treatment group assignment. The primary outcome measure was response rate, which is the proportion of participants who simultaneously achieved minimal clinically important improvement in pain and function by week 8. The primary analysis was conducted using a Z test for proportions in the modified intent-to-treat population, which included all randomized participants who had ≥1 post-baseline measurement. RESULTS Of the 480 participants recruited in the trial, 442 were evaluated for efficacy. The response rates at week 8 were 60.3% (91 of 151), 58.6% (85 of 145), and 47.3% (69 of 146) in the EA, MA, and SA groups, respectively. The between-group differences were 13.0% (97.5% confidence interval [97.5% CI] 0.2%, 25.9%; P = 0.0234) for EA versus SA and 11.3% (97.5% CI -1.6%, 24.4%; P = 0.0507) for MA versus SA. The response rates in the EA and MA groups were both significantly higher than those in the SA group at weeks 16 and 26. CONCLUSION Among patients with knee OA, intensive EA resulted in less pain and better function at week 8, compared with SA, and these effects persisted though week 26. Intensive MA had no benefit for knee OA at week 8, although it showed benefits during follow-up.

Single image super-resolution (SISR) has witnessed substantial progress recently by deep learning-based methods, due to the data-driven end-to-end training. However, most existing DL-based models are built intuitively, with little thought on priors. And the lack of interpretability limits their further improvements. To avoid this, this paper presents an end-to-end trainable unfolding network which leverages both DL- and prior-based methods. Specifically, we introduce the reweighted algorithm into CSC model and solve it by learning weighted iterative soft thresholding algorithm in a convolutional manner. Based on this, we present a SISR model by learning weighted convolutional sparse coding, in which the channel attention is resorted to learn the weight. Extensive experiments demonstrate the superiority of our method to recent state-of-the-art SISR methods, in terms of both quantitative and qualitative results.

BackgroundThe volume of residual alveolar bone is critical to the survival of dental implants. When the volume of alveolar bone in the posterior maxillary region is less than 4 mm, maxillary sinus floor elevation (MSFE) with the lateral approach is an effective option. Traditionally, this standard approach is usually conducted at 4–6 months after tooth extraction (standard MSFE). However, defective dentition due to extraction can impair mastication during the period of bone remodeling, especially if the molars on both sides are severely compromised and must be extracted. MSFE before extraction (modified MSFE) can take full advantage of residual tooth strength. However, the effectiveness and practicability of the modified MSFE procedure remain unknown. Therefore, the aim of this study was to compare the clinical outcomes of modified vs. standard MSFE, in order to provide references to periodontists.Methods/designThe study cohort included 25 adult patients (50 surgery sites) recruited from Peking University Hospital and School of Stomatology who met the inclusion criteria. The two sides of each patient will be randomly divided into two groups: a test group-modified MSFE or a control group-standard MSFE. The surgical duration and patient-reported outcomes (visual analog scale for discomfort) will be documented. Clinical indicators, including implant survival rates, mucosal conditions, and complications, will be recorded every 6 months during the 5-year follow-up period. The volume of the alveolar bone and marginal bone level will be assessed radiographically (cone-beam CT and periapical films) every 6 months. Histological analysis of biopsy samples retrieved from both sides will be performed to evaluate the biological features of the bone.DiscussionThe current study will explore the implant survival rates, safety, reliability, effectiveness, and practicability of the modified MSFE procedure. Moreover, the extent of osteogenesis on the sinus floor will also be assessed. The results of this trial will provide strategies for the modified MSFE procedure to achieve ideal clinical outcomes.Trial registrationInternational Clinical Trials Registry PlatformChiCTR1900020648. Registered on 1 January 2019

BackgroundImmunoglobulin M (IgM) mesangial deposition in pediatric minimal change disease (MCD) has been reported to be associated with steroid dependence and poor renal outcomes. However, the evidence linking the impacts of IgM mesangial deposition to the treatment prognosis in adult-onset MCD is still elusive.MethodsIn this retrospective cohort study, 37 adult patients with MCD received kidney biopsies from January 2010 to May 2020. Immunofluorescence microscopy was performed and the patients dichotomized according to IgM mesangial deposition (12 patients with positive IgM deposition; 25 patients with negative IgM deposition). We analyzed the clinical features, the dosage of immunosuppressive agents, and the response to treatment for 2 years between the two groups.ResultsAnalysis of the clinical symptoms, the dosage of immunosuppressive treatment, and the time to remission revealed no statistical difference between the groups. However, compared to the negative IgM group, the frequency of relapses was significantly higher in the positive IgM group during the two-year follow-up period (the negative IgM group 0.25 episodes/year; the positive IgM group 0.75 episodes/year,p = 0.029). Furthermore, multivariate linear regression revealed that the positivity of IgM mesangial deposition is independently associated with the frequency of relapses (regression coefficient B 0.450, 95% CI 0.116–0.784,p = 0.010).ConclusionsOur findings indicated that adult-onset MCD patients with IgM mesangial deposition have a high risk of relapses. Therefore, intensive monitoring of disease activity should be considered in MCD adults with IgM mesangial deposition.

We consider the problem of network security under false data injection attacks over wireless sensor networks.To resist the attacks which can inject false data into communication channels according to a certain probability, we formulate the online attack detection problem as a partially observable Markov decision process problem and design a detector for each sensor based on the framework of model-free reinforcement learning. By numerical simulations, we illustrate the effectiveness of the proposed reinforcement learning algorithm and show the performance of the proposed detector compared with the typical detector in the existing works.