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We demonstrate hole-transport-layer-free light-emitting diodes (LEDs) based on solution-processed multiple-quantum-well (MQW) perovskite. The MQW perovskite can self-assemble to a unique structure of vertically graded distribution with two-dimensional layered perovskite covered by three-dimensional-like perovskite at top, which can naturally form a barrier of electron transporting to the anode interface, thereby enhancing the charge capture efficiency. This leads to hole-transport-layer-free MQW perovskite LEDs reaching an external quantum efficiency (EQE) of 9.0% with emission peak at 528 nm, which is over 6 times of LEDs based on three-dimensional perovskite with the same device structure, representing the record EQE of hole-transport-layer-free perovskite LED.

OBJECTIVE: To investigate three-dimensional soft tissue changes of lips and related jaw changes in patients with skeletal class III malocclusion and facial asymmetry using cone-beam computerized tomography (CBCT). METHOD: This study included 46 CBCT scans of patients with aforementioned character before (T1) and 6–12 months after orthognathic surgery (T2). Subjects were divided into 2 groups according to two types of orthognathic surgery namely, the one-jaw surgery group who underwent bilateral sagittal splint ramus osteotomy (BSSRO) and the two-jaw surgery group who underwent Le Fort I osteotomy and BSSRO. Mimics 19.0 software are used for model reconstruction, landmark location and three-dimensional cephalometric analysis. Descriptive statistics and correlation analyses are used to investigate jaw hard tissue and lip soft tissue changes. RESULTS: In one-jaw group, the mandible shows changes in contour and position (p

This paper studies a common planning problem encountered in steelmaking production. The problem is to group different customer orders into a set of batches to accommodate the mass production mode o...

In video super-resolution, exploiting spatial information of reference frame and temporal information from neighbouring frames is significant but challenging. Since existing image super-resolution (SR) methods have achieved remarkable reconstruction results, in this paper, we propose a generic frame-wise dynamic fusion module (DFM) to fully aggregate temporal information into reference frame. Specifically, we employ dynamic convolution to flexibly fuse element-wise temporal information frame by frame. Before that, to handle large motion across frames, we propose a self-calibrated deformable (SCD) alignment module, in which motion offsets are predicted via self-calibrated convolution that explicitly expand receptive field of each convolutional layer through internal communications in a multi-resolution manner. The aligned features of each neighbouring frame are then fed to the DFM to make a temporal information fusion. Finally, the reference features containing spatial and temporal information are sent into SR reconstruction module for the high-resolution frame. Experimental results on several datasets demonstrate superior performance to state-of-the-art published methods on video super-resolution.

Recent advances indicate that bone and energy metabolism are closely related. However, little direct evidence on causality has been provided in humans. We aimed to assess the association of three bone-related biomarkers-25 hydroxyvitamin D (25OHD), parathyroid hormone (PTH), and osteocalcin (OCN)-with several metabolic phenotypes and investigate any causal relevance to the associations using a Mendelian randomization (MR) study. Serum 25OHD, PTH, and total OCN were measured at baseline in 5169 eligible Chinese participants in Changfeng study. Partial correlation and bivariate GREML analysis were used to estimate phenotypic and genetic correlations, respectively. Multiple linear regression and logistic regression were used to assess linear associations. Genomewide association analysis (GWAS) was performed. Bidirectional two-sample MR analyses were conducted to examine causal relationships between OCN and body mass index (BMI), diastolic blood pressure (DBP), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), glycated hemoglobin A1c (HbA1c), and type 2 diabetes (T2DM), using our GWAS result of OCN and GWAS statistics from Biobank Japan project (BBJ) and the largest meta-analysis of T2DM GWAS in East Asian population. Circulating OCN was significantly associated with higher DBP and HDL-C and decreased TG, blood glucose level, insulin resistance, liver fat content, bone mineral density, BMI, and a favorable body fat distribution pattern. GWAS identified one novel serum PTH locus and two novel serum OCN loci, explaining 0.81% and 1.98% of variances of PTH and OCN levels, respectively. MR analysis suggested a causal effect of T2DM on lower circulating OCN concentration (causal effect: -0.03; -0.05 to -0.01; p = 0.006 for T2DM_BBJ and -0.03; -0.05 to -0.01; p = 0.001 for T2DM_EAS). These findings indicate that T2DM might impact bone remodeling and provide a resource for understanding complex relationships between osteocalcin and metabolic (and related) traits in humans. © 2021 American Society for Bone and Mineral Research (ASBMR).

Three-dimensional (3D) perovskites have been demonstrated as an effective strategy to achieve efficient light-emitting diodes (LEDs) at high brightness. However, most 3D perovskite LEDs still suffer from serious efficiency roll-off. Here, using FAPbI3 as a model system, we find that the main reason for efficiency droop and degradation in 3D perovskite LEDs is defects and the ion migration under electrical stress. By introducing bifunctional-molecule 3-chlorobenzylamine additive into the perovskite precursor solution, the detrimental effects can be significantly suppressed through the growth of high crystalline perovskites and defect passivation. This approach leads to bright near-infrared perovskite LEDs with a peak external quantum efficiency of 16.6%, which sustains 80% of its peak value at a high current density of 460 mA cm-2, corresponding to a high brightness of 300 W sr-1 m-2. Moreover, the device exhibits a record half-lifetime of 49 h under a constant current density of 100 mA cm-2.

Brain drug delivery remains a major difficulty for several challenges including the blood–brain barrier, lesion spot targeting, and stability during circulation. Blood cells including erythrocytes, platelets, and various subpopulations of leukocytes have distinct features such as long-circulation, natural targeting, and chemotaxis. The development of biomimetic drug delivery systems based on blood cells for brain drug delivery is growing fast by using living cells, membrane coating nanotechnology, or cell membrane-derived nanovesicles. Blood cell-based vehicles are superior delivery systems for their engineering feasibility and versatile delivery ability of chemicals, proteins, and all kinds of nanoparticles. Here, we focus on advances of blood cell-based biomimetic carriers for from blood to brain drug delivery and discuss their translational challenges in the future.

Video super-resolution (VSR) is to restore a photo-realistic high-resolution (HR) frame from both its corresponding low-resolution (LR) frame (reference frame) and multiple neighboring frames (supporting frames). An important step in VSR is to fuse the feature of the reference frame with the features of the supporting frames. The major issue with existing VSR methods is that the fusion is conducted in a one-stage manner, and the fused feature may deviate greatly from the visual information in the original LR reference frame. In this paper, we propose an end-to-end Multi-Stage Feature Fusion Network that fuses the temporally aligned features of the supporting frames and the spatial feature of the original reference frame at different stages of a feed-forward neural network architecture. In our network, the Temporal Alignment Branch is designed as an inter-frame temporal alignment module used to mitigate the misalignment between the supporting frames and the reference frame. Specifically, we apply the multi-scale dilated deformable convolution as the basic operation to generate temporally aligned features of the supporting frames. Afterwards, the Modulative Feature Fusion Branch, the other branch of our network accepts the temporally aligned feature map as a conditional input and modulates the feature of the reference frame at different stages of the branch backbone. This enables the feature of the reference frame to be referenced at each stage of the feature fusion process, leading to an enhanced feature from LR to HR. Experimental results on several benchmark datasets demonstrate that our proposed method can achieve state-of-the-art performance on VSR task.

Background Treatment of chronic hepatitis C virus infection with direct acting antiviral therapy results in viral elimination in over 90% of cases. The duration of treatment required to achieve cure differs between individuals and relapse can occur. We asked whether cellular and transcriptional profiling of peripheral blood collected during treatment could identify biomarkers predictive of treatment outcome. Methods We analyzed peripheral blood collected during treatment of genotype 1 HCV with 24 weeks of sofosbuvir and weight-based or low dose ribavirin in a trial in which 29% of patients relapsed. Changes in host immunity during treatment were assessed by flow cytometry and whole blood gene expression profiling. Differences in expression of immune-relevant transcripts based on treatment outcome were analyzed using the Nanostring Human Immunology V2 panel. Results Multiple cellular populations changed during treatment, but pre-treatment neutrophil counts were lower and natural post-treatment killer cell counts were higher in patients who relapsed. Pre-treatment expression of genes associated with interferon-signaling, T-cell dysfunction, and T-cell co-stimulation differed by treatment outcome. We identified a pre- and post-treatment gene expression signature with high predictive capacity for distinguishing treatment outcome, but neither signature was sufficiently robust to suggest viability for clinical use. Conclusions Patients who relapse after hepatitis C virus therapy differ immunologically from non-relapsers based on expression of transcripts related to interferon signaling and T-cell dysfunction, as well as by peripheral neutrophil and NK-cell concentrations. These data provide insight into the host immunologic basis of relapse after DAA therapy for HCV and suggests mechanisms which may be relevant for understanding outcomes with currently approved regimens.

Efficient and stable deep-blue emission from perovskite light-emitting diodes (LEDs) is required for their application in lighting and displays. However, this is difficult to achieve due to the phase segregation issue of mixed halide perovskites and the challenge of synthesizing high-quality single-halide deep-blue perovskite nanocrystals through a traditional method. Here, we show that an antisolvent treatment can facilitate the in situ formation of perovskite nanocrystals using a facile spin-coating method. We find that the dropping time of the antisolvent can significantly affect the constitution of nanocrystal perovskite films. With a delay in the start time of the antisolvent treatment, small single-halide perovskite nanocrystals can be achieved, exhibiting efficient deep-blue emission. The LED device shows a stable electroluminescence (EL) peak at 465 nm, with a peak external quantum efficiency and a peak current efficiency of 2.4% and 2.5 cd A-1, respectively. This work provides a facile approach to changing the size of perovskite nanocrystals, thus effectively tuning their EL emission spectra.

This study aims to estimate the overall prevalence of microvascular complications of type 2 diabetes in mainland China, and to identify any associated risk factors.

As a non-invasive, low-cost medical imaging technology, magnetic resonance imaging (MRI) has become an important tool for brain tumor diagnosis. Many scholars have carried out some related researches on MRI brain tumor segmentation based on deep convolutional neural networks, and have achieved good performance. However, due to the large spatial and structural variability of brain tumors and low image contrast, the segmentation of MRI brain tumors is challenging. Deep convolutional neural networks often lead to the loss of low-level details as the network structure deepens, and they cannot effectively utilize the multi-scale feature information. Therefore, a deep convolutional neural network with a multi-scale attention feature fusion module (MAFF-ResUNet) is proposed to address them. The MAFF-ResUNet consists of a U-Net with residual connections and a MAFF module. The combination of residual connections and skip connections fully retain low-level detailed information and improve the global feature extraction capability of the encoding block. Besides, the MAFF module selectively extracts useful information from the multi-scale hybrid feature map based on the attention mechanism to optimize the features of each layer and makes full use of the complementary feature information of different scales. The experimental results on the BraTs 2019 MRI dataset show that the MAFF-ResUNet can learn the edge structure of brain tumors better and achieve high accuracy.

With the recent development of machine learning theory, many deep learning based methods have been proposed to extract features from hyperspectral sensed images (HSIs) and superior performance has been achieved. Although the data of HSIs is characterized by its high volume as well as with rich spectral and spatial information, the number of the labeled samples is always very limited. But many deep learning methods, especially the supervised approaches, often require numerous labeled samples to extract the effective features, and a prolonged training procedure is inevitable. To expand the set of the labeling samples, a huge amount of manpower and material resources are required, which may make the application unaffordable. In order to alleviate the dependence on HSIs’ labeled samples, in this paper an unsupervised spatial-spectral feature extraction method is proposed. Combining the two-dimensional convolutional neural network (2DCNN) with generative adversarial networks (GANs), the requirement of the labeled samples is reduced for the training of a learning network, and the spatial-spectral characteristic of the HSIs is utilized at the same time. Moreover, the principal component analysis (PCA) is introduced as a preprocess for the high-dimensional hyperspectral data, which not only removes redundant information, but also fits the proposed feature extraction model to hyperspectral data with different dimensions. To improve the generalization capability of the proposed model, a gradient penalty term is further investigated in the objective function of the GAN’s discriminator, which can optimize the discriminator’s convergence and improve the model’s overall generalization capability. Finally, a support vector machine is applied to classify the extracted features. Experimental results on three real data sets show that the proposed method can extract features from the hyperspectral data effectively. Through the GANs-based feature extraction and the specialized regularization, the proposed method achieves a good level of generalization capability, in which a model validated on a single dataset can be extended to different datasets while a satisfactory performance still remained.

Background This study evaluated the safety, pharmacokinetic (PK), and pharmacodynamic (PD) profiles of single ascending doses (SAD) and multiple ascending doses (MAD) of S086 in healthy Chinese volunteers. Research design and methods This randomized, double-blind, placebo-controlled, Phase I clinical trial enrolled 113 subjects, including 65 subjects in the SAD (60-1080 mg) study and 48 subjects in the MAD study (180-720 mg). The safety, PK (sacubitril, LBQ657, and EXP3174) and PD (MAD study: blood pressure, pulse) of S086 were assessed. Results There were no deaths, serious adverse events, or discontinuations due to TEAEs, and there were no significant safety concerns associated with S086. PK parameters for sacubitril, LBQ657, and EXP3174 increased in a dose-dependent manner after single oral doses of S086. Plasma concentrations of sacubitril, LBQ657, and EXP3174 were maintained at steady state within 5 days of once-daily oral administration of S086. In the MAD study, S086 administration was associated with a dose-dependent decrease in mean diastolic and systolic blood pressure compared to baseline. Conclusions The safety and PK profile profiles of S086 support the use of S086 240mg once daily in a future Phase II study in patients with heart failure. Trial registration The trial is registered at chinadrugtrials.org.cn (CT.gov identifier: CTR20182350 and CTR20182351).

Based on our practices and experience for component-based ERP cloud developments, three issues, component identification, granularity and evolution, were focused and discussed together. First, according to separation of concerns and best practices, a component-based hierarchy model was proposed to improve the efficiency of ERP cloud development and evolution. And three semantic layers were constructed and in each layer the corresponding types of reusable objects were defined. And one experience/product-based method were given to help identify and extract reusable ERP units. After that, based on the hierarchy model, a directed graph was created to depict CBS. Finally, a graph-based analysis method was proposed to evaluate the ripple effect of component evolution and its propagation.

OBJECTIVE To report the global burden of maternal disorders and their main subcategories in 195 countries and territories between 2007 and 2017. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimated maternal disease burden at global, regional, and country levels. Maternal disorders were disaggregated into 10 categories, and estimated incidence and disability-adjusted life years (DALYs) of maternal disorders were reported separately. Indicators were estimated in different geographic settings and different sociodemographic index (SDI) regions. Based on GBD 2017 estimates, we systematically examined the incidence and DALYs of maternal disorders and their main subcategories at the global, regional, and national levels during the period from 2007 to 2017 by age and SDI. RESULTS Globally, a total of 7.98 million maternal disorders occurred in 2017, with a 4.33% (95% uncertainty interval [UI] 3.24%-5.60%) decrease in age-standardized incidence rate and a more significant decrease (30.26%) in the age-standardized rate of DALYs. Most incidences and DALYs were found in low-income and middle-income countries, especially in the sub-Saharan region. The greatest incidence of maternal disorders was found to be in maternal abortion and miscarriage (2.00 million), and the highest disease burden was in maternal hemorrhage (2.23 million). CONCLUSION A slight increase in the incidence of maternal disorders and substantial reductions in DALYs of overall maternal disorders and their main subcategories were found from 2007 to 2017, especially in low-income countries and the sub-Saharan region. Maternal hemorrhage, hypertensive disorders, and indirect maternal death were the top three causes of maternal disorders disease burden.

Arbitrary style transfer is a technique for transferring an ordinary photograph to an image with another artistic style, which not only provides rich materials for film and game production, but also can be used for image restoration. To solve the problems that stylized images cannot maintain spatial consistency and content structure distortion, this paper proposes an arbitrary style transfer via self-attention network method. This algorithm can match the closest semantic style feature to the content feature, and adjust the local style efficiently and flexibly according to the semantic spatial distribution of the content image. Moreover, it can retain more original information about the structure. The experimental results show that the method can transfer the image into different styles with higher quality and better visual effects.

Recent innovations of next-generation sequencing such as RNA-seq have generated an enormous amount of comparative transcriptome data, which have shed lights on our understanding of the complexity of transcriptional regulatory systems. Despite numerous RNA-seq analyses, statistical methods and computational tools designed for phylogenetic transcriptome analysis and evolution have not been well developed. In response to this need, we developed software TreeExp2 specifically for RNA-seq data. The R-package TreeExp2 has implemented a suite of advanced, recently developed methods for transcriptome evolutionary analysis. Its main functions include the ancestral transcriptome inference, estimation of the strength of expression conservation, new expression distance, and the relative expression rate test. TreeExp2 provides an integrated, statistically sound framework for phylogenetic transcriptome analysis. It will considerably enhance our analytical capability for exploring the evolution and selection at the transcriptome level. The current version of TreeExp2 is available under GPLv3 license at the Github developer site https://github.com/jingwyang/TreeExp; last accessed November 12, 2019, and its online tutorial which describes the biological theories in details and fully worked case studies with real data can be found at https://jingwyang.github.io/TreeExp-Tutorial; last accessed November 12, 2019.

Solution-processable perovskites show highly emissive and good charge transport, making them attractive for low-cost light-emitting diodes (LEDs) with high energy conversion efficiencies. Despite recent advances in device efficiency, the stability of perovskite LEDs is still a major obstacle. Here, we demonstrate stable and bright perovskite LEDs with high energy conversion efficiencies by optimizing formamidinium lead iodide films. Our LEDs show an energy conversion efficiency of 10.7%, and an external quantum efficiency of 14.2% without outcoupling enhancement through controlling the concentration of the precursor solutions. The device shows low efficiency droop, i.e. 8.3% energy conversion efficiency and 14.0% external quantum efficiency at a current density of 300 mA cm−2, making the device more efficient than state-of-the-art organic and quantum-dot LEDs at high current densities. Furthermore, the half-lifetime of device with benzylamine treatment is 23.7 hr under a current density of 100 mA cm−2, comparable to the lifetime of near-infrared organic LEDs., Light-emitting diodes based on halide perovskites have made remarkable progress but their stability is the bottleneck. Here Miao et al. show 14% quantum efficiency at a current density of 300 mA cm-2 and 23.7 hr lifetime under a current density of 100 mA cm-2, making it promising for actual application.

Background The low influenza vaccine effectiveness (VE) observed during the A(H3N2)-dominated 2017–2018 season may be due to vaccine virus adaptation to growth in eggs. We compared the effectiveness of cell-cultured and egg-based vaccines among Medicare beneficiaries. Methods Retrospective cohort study on Medicare beneficiaries aged ≥65 years who received an influenza vaccine (cell-cultured, egg-based quadrivalent; egg-based high-dose, adjuvanted, or standard-dose trivalent) during the 2017–2018 season. We used Poisson regression to evaluate relative VE (RVE) in preventing influenza-related hospital encounters. Results Of >13 million beneficiaries, RVE for cell-cultured vaccines relative to egg-based quadrivalent vaccines was 10% (95% confidence interval [CI], 7%–13%). In a midseason interim analysis, this estimate was 16.5% (95% CI, 10.3%–22.2%). In a 5-way comparison, cell-cultured (RVE, 11%; 95% CI, 8%–14%) and egg-based high-dose (RVE, 9%; 95% CI, 7%–11%) vaccines were more effective than egg-based quadrivalent vaccines. Conclusions The modest VE difference between cell-cultured and egg-based vaccines only partially explains the low overall VE reported by the Centers for Disease Control and Prevention, suggesting that egg adaptation was not the main contributor to the low VE found among individuals aged ≥65 years. The midseason interim analysis we performed demonstrates that our methods can be used to evaluate VE actively during the influenza season.

Objectives The aim of this study was to evaluate the angiographic efficacy and clinical outcomes of the Restore paclitaxel-coated balloon in a randomized trial designed to enable its approval with an indication for small-vessel disease (SVD). Background Higher rates of restenosis and stent thrombosis limit the effectiveness of drug-eluting stent (DES) treatment of SVD. Whether a drug-coated balloon (DCB)–only strategy is effective in de novo SVD is not yet established. Methods In the noninferiority RESTORE SVD China trial, eligible patients with reference vessel diameter ≥2.25 and ≤2.75 mm were randomized to the Restore DCB or the RESOLUTE Integrity DES in a 1:1 ratio stratified by diabetes and number of lesions treated. Patients with RVD ≥2.00 and Results Between August 2016 and June 2017, a total of 230 subjects at 12 sites were randomized to the DCB group (n = 116) or DES group (n = 114); 32 patients were treated with the DCB in the very small vessel cohort. Nine-month in-segment percentage diameter stenosis was 29.6 ± 2.0% with the DCB versus 24.1 ± 2.0% with the DES; the 1-sided 97.5% upper confidence limit of the difference was 10.9%, achieving noninferiority of the DCB compared with the DES (p for noninferiority Conclusions In this multicenter randomized trial, the Restore DCB was noninferior to the RESOLUTE DES for 9-month in-segment percentage diameter stenosis. (Assess the Efficacy and Safety of RESTORE Paclitaxel Eluting Balloon Versus RESOLUTE Zotarolimus Eluting Stent for the Treatment of Small Coronary Vessel Disease; NCT02946307)

In this paper, we leverage the power of artificial intelligence in the receiver design for joint baseband demodulation and channel decoding. We consider a point-to-point communication system and develop a deep neural network (DNN) based joint demodulator and decoder (DeModCoder) that accomplishes the tasks of demodulation and decoding in a single operational block. We incorporate a multi-label classification (MLC) scheme for the considered DNN framework, which is trained offline over a wide-range of signal-to-noise ratios (SNRs) in a supervised learning manner and deployed online in real-time applications. Simulation results demonstrate that our developed DeModCoder outperforms the conventional block-based sequential demodulation and decoding schemes. We also observe that the MLC DeModCoder shows better performance than conventional multiple output classifier in high SNR region while incurring lower computational complexity.

To successfully pursue sustainable development and address the pressing issues of how to meet the needs of the present without compromising the ability of future generations to meet their needs, it is key to promote efficient bio-manufacturing and make a change towards a biosustainable society. Microalgae are regarded as potential candidates and as feasible feedstock for bio-production because of their fast growth rates and capability to generate a variety of chemicals and fuels via photosynthesis. However, there are bottlenecks in the current technologies, including low solar-to-biomass conversion efficiency and high energy inputs as well as impacts on the environment, which hinder industrial applications of microalgae production. This chapter focuses on the environmental impacts from microalgae biotechnologies. It is clear that microalgae cultivation for a single purpose is not economically feasible. To achieve more sustainable production it is necessary to provide a comprehensive analysis of the limiting factors involved in microalgae biotechnologies. Different operation modes and technologies are analysed and evaluated. This chapter also discusses scenarios of microalgal biotechnologies to demonstrate the potentials of microalgae production in different countries. Finally, the challenges and perspectives towards the industrialization of microalgal biotechnologies are summarized and proposed.

Background and Objective. Chronic obstructive pulmonary disease (COPD) features high morbidity. Different nursing interventions can relieve patient’s burden. This investigation quantitatively assessed the impact of transitional care (TC) on self-management of patients with acute exacerbation of COPD based on a questionnaire survey. Methods. Clinical information of 78 COPD patients treated with TC (intervention group) or routine care (control group) in Shanghai Pulmonary Hospital during March 2019 and August 2020 was gathered. Patients were followed up for 3 months after discharge. The intervention group ( n = 39 ) was subjected to a TC plan for 3 months to help patients and their family caregivers for self-management of COPD. TC was provided by specially trained nurses, and patients were supported by standardized tools. Nursing measures in the control group ( n = 79 ) included transitional support for 30 d after hospital discharge. In this way, patients were guaranteed to follow discharge plans and transit to outpatient nursing. Patient’s anxiety and depression symptoms, sleep quality, survival quality, mobility, and life quality at admission and after 3 months of discharge were assessed by Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Quality of Life Scale Abbreviated Version, Activity of Daily Life Scale, St. George’s Respiratory Questionnaire, and COPD Assessment Test. Results. Except for anxiety and depression, patient’s sleep quality, survival quality, mobility, and life quality in two groups were significantly improved. Moreover, average change of total CAT score during 3 months of intervention was -5.44, while that in the control group was -1.74 ( p = 0.011 ). Improvement of survival quality of patients in the intervention group ( p = 0.001 ) was markedly greater than that in the control group ( p = 0.016 ). Conclusion. Altogether, TC based on quantification by questionnaire survey is beneficial to COPD patient’s life quality and self-management.

BackgroundHuman babesiosis is a mild-to-severe parasitic infection that poses health concerns especially in older and other at-risk populations. The study objective was to assess babesiosis occurrence among US Medicare beneficiaries, ages 65 and older, during 2006–2017.MethodsOur retrospective claims-based study used Medicare databases. Babesiosis cases were identified using recorded diagnosis codes. The study estimated rates (per 100 000 beneficiary-years) overall, by year, diagnosis month, demographics, and state and county of residence.ResultsNationwide, 19 469 beneficiaries had babesiosis recorded, at a rate of 6 per 100 000 person-years, ranging from 4 in 2006 to 9 in 2017 (P ConclusionsOur 12-year study shows substantially increasing babesiosis diagnosis trends, with highest rates in well established endemic states. It also suggests expansion of babesiosis infections in other states and highlights the utility of real-world evidence.

Target localization has a wide range of military and civilian applications in wireless mobile networks. Examples include battle-field surveillance, emergency 911 (E911), traffic alert, habitat monitoring, resource allocation, routing, and disaster mitigation. Basic localization techniques include time-of-arrival (TOA), direction-of-arrival (DOA) and received-signal strength (RSS) estimation. Techniques that are proposed based on TOA and DOA are very sensitive to the availability of Line-of-sight (LOS) which is the direct path between the transmitter and the receiver. If LOS is not available, TOA and DOA estimation errors create a large localization error. In order to reduce NLOS localization error, NLOS identification, mitigation, and localization techniques have been proposed. This research investigates NLOS identification for multiple antennas radio systems. The techniques proposed in the literature mainly use one antenna element to enable NLOS identification. When a single antenna is utilized, limited features of the wireless channel can be exploited to identify NLOS situations. However, in DOA-based wireless localization systems, multiple antenna elements are available. In addition, multiple antenna technology has been adopted in many widely used wireless systems such as wireless LAN 802.11n and WiMAX 802.16e which are good candidates for localization based services. In this work, the potential of spatial channel information for high performance NLOS identification is investigated. Considering narrowband multiple antenna wireless systems, two xv NLOS identification techniques are proposed. Here, the implementation of spatial correlation of channel coefficients across antenna elements as a metric for NLOS identification is proposed. In order to obtain the spatial correlation, a newmulti-input multi-output (MIMO) channel model based on rough surface theory is proposed. This model can be used to compute the spatial correlation between the antenna pair separated by any distance. In addition, a new NLOS identification technique that exploits the statistics of phase difference across two antenna elements is proposed. This technique assumes the phases received across two antenna elements are uncorrelated. This assumption is validated based on the well-known circular and elliptic scattering models. Next, it is proved that the channel Rician K-factor is a function of the phase difference variance. Exploiting Rician K-factor, techniques to identify NLOS scenarios are proposed. Considering wideband multiple antenna wireless systems which useMIMO-orthogonal frequency division multiplexing (OFDM) signaling, space-time-frequency channel correlation is exploited to attain NLOS identification in time-varying, frequency-selective and spaceselective radio channels. Novel NLOS identification measures based on space, time and frequency channel correlation are proposed and their performances are evaluated. These measures represent a better NLOS identification performance compared to those that only use space, time or frequency.

To evaluate skeletal and dental changes in patients with skeletal Class III malocclusion and facial asymmetry after surgical-orthodontic treatment using cone-beam computerized tomography (CBCT).This study included forty adult patients diagnosed with skeletal Class III malocclusion and asymmetry who underwent either isolated mandibular surgery or bimaxillary surgery. CBCT scans were taken before treatment (T0), at the completion of presurgical orthodontic treatment (T1) and after treatment (T2). Mimics 17.0 and 3-Matics 7.0 were used to measure skeletal and dental parameters. Skeletal and dental changes within each group from pretreatment to posttreatment were assessed, and Pearson correlation analysis was used to analyze the correlations among skeletal changes.The three-dimensional changes in condylar position were insignificant after surgical-orthodontic treatment in either group (P 0.05). However, in the one-jaw surgery group, there were significant backward rotations of the condyle and ramus on the nondeviated side (P 0.05), and the condyle on the deviated side rotated inward and forward significantly in the two-jaw surgery group (P 0.05) at T2. There were no significant differences in the changes in the total alveolar bone thickness of bilateral first molars during dental decompensation (P 0.05). The ratio between the buccal and the total bone thickness around the maxillary first molar on the deviated side decreased significantly at T1, as did those around the mandibular first molar on the nondeviated side (P 0.05).Condylar angulations were less stable after treatment (7 to 9 months after surgery) in both the one-jaw and the two-jaw surgery groups, while condylar displacements were insignificant. In addition, orthodontists should keep a watchful eye to the relative position of the root in the alveolar bone during tooth decompensation.

Searching for cost-effective photothermal material that can harvest the full solar spectrum is critically important for solar-driven water evaporation. Metal oxides are cheap materials but cannot cover the full solar spectrum. Here we prepared a hydrogenated metal oxide (H

In this paper, we combine inverse design concept and direct binary search algorithm to demonstrate three ultra-compact high efficiency and low crosstalk on-chip integrated optical interconnection basic devices in the entire wavelength range of 1,400–1600 nm based on silicon-on-insulator platform. A 90-degree waveguide bend with a footprint of only 2.4 × 2.4 μm2 is designed, whose transmission efficiency up to 0.18 dB. A waveguide crossing with a footprint of only 2.4 × 2.4 μm2 is designed, which can provide insertion loss of less than 0.5 dB and crosstalk (CL) of lower than − 19 dB. A same direction waveguide crossing with footprint of only 2.4 × 3.6 μm2 is designed, which can provide the insertion loss of less than 0.56 dB and the crosstalk of lower than − 21 dB. Then, we use them to form several ultra-compact optical interconnect basic structures and performed the simulation calculation. They overall achieve high performance. This will significantly improve the integration density.

Liraglutide, a glucagon-like peptide 1 (GLP-1) analogue, could reverse NAFLD-induced liver damage by improving metabolic profiles, but the exact molecular mechanism has not been elucidated. Sestrin2 is a novel antioxidant protein, essential for regulating metabolic homeostasis. However, whether sestrin2-mediated redox balance participated in the protective effects of liraglutide against NAFLD is still elusive. The aim of the study was to determine whether liraglutide could ameliorate NAFLD by increasing Sestrin2-mediated signaling in obese mice. Following a normal diet or high fat diet (HFD) for 8 weeks, male C57BL/6 mice were treated with or without liraglutide for 4 weeks. Function and histopathology of liver were conducted to evaluate liver injury. Sestrin2-related AMPK and Nrf2/HO-1 pathway were examined. Antioxidative and inflammatory genes and were determined. HFD mice displayed significantly increased body weight, fat mass, lipids levels and impaired glucose homeostasis with reduced glucose tolerance and insulin sensitivity. Metabolic profiles, hepatic injury, and hepatic lipid accumulation from HFD mice were improved by liraglutide treatment. Liraglutide enhanced Sestrin2, phosphorylated AMPK, Nrf2, and HO-1 protein levels. Additionally, Liraglutide treatment increased mRNA levels of Sestrin2, Nrf2, HO-1 and down-stream genes catalase, GCLM and NQO1, but reduced malondialdehyde and TNF-α levels. Our findings indicated that liraglutide ameliorated obesity-related NAFLD through upregulating Sestrin2-mediated Nrf2/HO-1 pathway.

BACKGROUND The biological role of exosomes has attracted widespread attention in various fields of biomedicine. Exosome-delivered microRNAs (miRNAs) play crucial roles in cancer diagnosis. The aim of our study was to examine whether serum exosomal miR-17-5p could be identified as a diagnostic biomarker for breast cancer (BC). METHODS Eighty-three patients diagnosed with BC and thirty-four healthy women (controls) were included in this study. The expression level of serum exosomal miR-17-5p was identified by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and calculated by 2-ΔΔCq method. RESULTS Reduced level of exosomal miR-17-5p in serum from BC patients was found compared with healthy controls. In addition, miR-17-5p also had low expression in 34 pairs of tissue and serum samples. MiR-17-5p was highly concentrated in serum exosomes and the expression level was stable. In addition, the exosomal miR-17-5p could distinguish BC from healthy controls with the area under the ROC curve (AUC) of 0.784 (p < 0.0001, sensi¬tivity = 66.67%, specificity = 83.95%). The sensitivity and specificity of miR-17-5p were superior to conventional se¬rum biomarkers CEA, CA125, and CA153. We predicted target genes of miR-17-5p were also mainly involved in cancer-related pathways. CONCLUSIONS In conclusion, our findings strongly suggested that serum exosomal miR-17-5p could serve as a novel diagnostic biomarker for BC.

This paper reviews the AIM 2020 challenge on efficient single image super-resolution with focus on the proposed solutions and results. The challenge task was to super-resolve an input image with a magnification factor \(\times \)4 based on a set of prior examples of low and corresponding high resolution images. The goal is to devise a network that reduces one or several aspects such as runtime, parameter count, FLOPs, activations, and memory consumption while at least maintaining PSNR of MSRResNet. The track had 150 registered participants, and 25 teams submitted the final results. They gauge the state-of-the-art in efficient single image super-resolution.

This paper investigates a practical steelmaking scheduling problem with batching decisions and energy constraints, in which batching is used to decide how to group and sequence a number of jobs to form job groups so as to meet batch production mode. Incorporating energy consideration into the scheduling is motivated by practical demand and the potential to reduce the energy bill through optimal scheduling. Based upon our proposed energy expressions, an MINLP model is formulated and solved using the spatial branch and bound (B&B) algorithm, which is enhanced by the proposed decomposition strategy working as a node heuristic. The benefits of the integrated scheduling and some sensitivity analysis experiments are reported on an illustrative example. Experiments on randomly generated instances show that the energy expressions are superior to the one of Hadera et al. (2015) , the B&B outperforms the state-of-the-art commercial solvers and the decomposition strategy performs well running as an independent heuristic.

BackgroundStudies among individuals ages ≥65 years have found a moderately higher relative vaccine effectiveness (RVE) for the high-dose (HD) influenza vaccine compared with standard-dose (SD) products for most seasons. Studies during the A(H3N2)-dominated 2017–2018 season showed slightly higher RVE for the cell-cultured vaccine compared with SD egg-based vaccines. We investigated the RVE of influenza vaccines among Medicare beneficiaries ages ≥65 years during the 2018–2019 season.MethodsThis is a retrospective cohort study using inverse probability of treatment weighting and Poisson regression to evaluate RVE in preventing influenza hospital encounters.ResultsAmong 12 777 214 beneficiaries, the egg-based adjuvanted (RVE, 7.7%; 95% confidence interval [CI], 3.9%–11.4%) and HD (RVE, 4.9%; 95% CI, 1.7%–8.1%) vaccines were marginally more effective than the egg-based quadrivalent vaccines. The cell-cultured quadrivalent vaccine was not significantly more effective than the egg-based quadrivalent vaccine (RVE, 2.5%; 95% CI, −2.4% to 7.3%).ConclusionsWe did not find major effectiveness differences between licensed vaccines used among the elderly during the 2018–2019 season. Consistent with prior research, we found that the egg-based adjuvanted and HD vaccines were slightly more effective than the egg-based quadrivalent vaccines.

OBJECTIVE To critically appraise the methodological quality of clinical practice guidelines for headache produced over the last two decades, including those covering specific interventions using Traditional Chinese Medicine. METHODS The guidelines on headache disorders were obtained by searching a number of databases, including PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, and Wanfang database, three guideline-related databases [Guideline-International Network, National Guideline Clearinghouse, and Medlive], and the records of organizations that develop guidelines. The publication date was limited to the period from January 1996 to June 2015. The search terms “headache”, “headache disorders”, “cephalalgia”, “migraine”, “tension-type headache”, “practice guideline”, “consensus “, “statement”, “regulation”, and “recommendation” were used in the “MeSH” and “Free-text” fields. The guidelines were independently appraised by four researchers using the Appraisal of Guidelines for Research and Evaluation II instrument. RESULTS A total of 23 guidelines published between 1998 and 2014 were reviewed. The overall consistency of the four appraisers was good [interclass correlation coefficient 0.84; 95% confidence interval (CI) 0.82–0.86]. The mean (standard deviation) scores for scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence were 52.1 (18.0), 39.5 (17.1), 33.4 (21.0), 49.8 (21.9), 23.8 (19.3), and 24.2 (23.7). Only two guidelines were recommended, 12 were recommended with modification, and nine were not recommended. CONCLUSION Physical Traditional Chinese Medicine therapies were recommended to treat headache. The overall quality of headache guidelines was low in China, but evidence-based guidelines are gradually becoming mainstream. Guideline developers should carefully consider, in particular, three domains: rigor of development, applicability, and editorial independence.

In recent years, the user experience has gradually become the main focus in the design of consumer products, rather than the products’ features and functions. Therefore, designers should consider the user experience to be of paramount importance in the development of a successful product. In addition, user experience is not static, but rather it changes over the different stages of usage due to the variations in consumers’ sensory modalities and emotional responses. Therefore, this study aims to use psychophysiological measures to explore how the interaction between the user and the product at each different stage influences sensory modalities and emotional responses to products. The experiment was conducted in five stages according to the different levels of interaction for two tea products. Subjective data about sensory modalities and emotions related to the products were collected. In addition, the research gathered objective data to examine the feasibility of relating physiological measures to subjective experiences. The results showed that the tea experience tends to be dynamic over the different stages of usage, demonstrating important variations in the different sensory modalities and emotional feedback. In addition, physiological signals such as galvanic skin response, have been shown to be of potential value for evaluation of the user’s emotional reaction. Our findings could be important not only for a theoretical understanding of sensory and emotional feedback in a product experience but also as a measure of user experience using psychophysiological methods.

The traditional anchoring method of bolts has insufficient control over the surrounding rock of the coal roadway. Based on this background, full-stress anchoring technology of bolts was proposed. Firstly, a mechanical relationship model of a bolt-drawing, anchoring interface was established to obtain the equations of the axial force and obtain shear stress distribution as well as the decreasing-load transfer law of the anchoring section of bolts. Through studying the prestress-loading experimental device of bolts, we found that increasing the initial preload could increase the axial force under the same conditions and the retarded anchoring section could control the axial-force loss of bolts in the middle of the anchoring section. Under the full-stress anchoring mode, the effect of applying a pre-tightening force was better than that of applying a pre-tightening force under traditional anchoring methods. Moreover, FLAC3D (Fast Lagrangian Analysis of Continua 3D; ITASCA (Ita sca International Inc), Minnesota, USA) numerical simulation calculation was performed. Under the full-stress anchoring mode of bolts, the increased anchoring length reduced the damage of the anchoring section, with a wider control range of the rock formation and higher strength of the compressive-stress anchoring zone. Based on the above research, four methods for applying the full-stress anchoring technology of bolts in engineering were proposed. The full-stress anchoring technology of bolts in the coal roadway has been applied in the support project of the return-air roadway at working face 3204 of the Taitou Coking Coal Mine of the Xiangning Coking Coal Group, Shanxi. The maximum moving distance of the roof and floor of the roadway was reduced from 200 to 42 mm, and the maximum moving distance on both coal sides was reduced from 330 to 86 mm. The full-stress anchoring technology of bolts was able to control the surrounding rock in the coal roadway.

Accurate forecast of landfill gas (LFG) transport has remained as an active research area, due to the safety and environmental concerns, as well as the green energy potential. The iterative ensemble Kalman filter (IEnKF) has been used to characterize the heterogeneous permeability field of landfills. As a Monte Carlo-based method, IEnKF requires a sufficiently large ensemble size to guarantee its accuracy, which may result in a huge computational cost, especially for large-scale problems. In this study, an efficient probabilistic collocation based iterative Kalman filter (PCIKF) is developed. The polynomial chaos expansion (PCE) is employed to represent and propagate the uncertainties, and an iterative form of Kalman filter is used to assimilate the measurements. To further reduce the computational cost, only the zeroth and first-order ANOVA (analysis of variance) components are kept in the PCE approximation. As demonstrated by two numerical case studies, PCIKF shows significant superiority over IEnKF in terms of accuracy and efficiency. The developed method has the potential to reliably predict and develop best management practices for landfill gas production.

The settlement of any position of the municipal solid waste (MSW) body during the landfilling process and after its closure has effects on the integrity of the internal structure and storage capacity of the landfill. This paper proposes a practical approach for calculating the settlement and storage capacity of landfills based on the space and time discretization of the landfilling process. The MSW body in the landfill was divided into independent column units, and the filling process of each column unit was determined by a simplified complete landfilling process. The settlement of a position in the landfill was calculated with the compression of each MSW layer in every column unit. Then, the simultaneous settlement of all the column units was integrated to obtain the settlement of the landfill and storage capacity of all the column units; this allowed to obtain the storage capacity of the landfill based on the layer-wise summation method. When the compression of each MSW layer was calculated, the effects of the fluctuation of the main leachate level and variation in the unit weight of the MSW on the overburdened effective stress were taken into consideration by introducing the main leachate level's proportion and the unit weight and buried depth curve. This approach is especially significant for MSW with a high kitchen waste content and landfills in developing countries. The stress-biodegradation compression model was used to calculate the compression of each MSW layer. A software program, Settlement and Storage Capacity Calculation System for Landfills, was developed by integrating the space and time discretization of the landfilling process and the settlement and storage capacity algorithms. The landfilling process of the phase IV of Shanghai Laogang Landfill was simulated using this software. The maximum geometric volume of the landfill error between the calculated and measured values is only 2.02%, and the accumulated filling weight error between the calculated value and measured value is less than 5%. These results show that this approach is practical for satisfactorily and reliably calculating the settlement and storage capacity. In addition, the development of the elevation lines in the landfill sections created with the software demonstrates that the optimization of the design of the structures should be based on the settlement of the landfill. Since this practical approach can reasonably calculate the storage capacity of landfills and efficiently provide the development of the settlement of each landfilling stage, it can be used for the optimizations of landfilling schemes and structural designs.

The heat generated by surface plasmon in metal nanoparticles is an interesting topic in recent research on nano-optics. In this work, Au/TiO2 plasmonic photothermal films are obtained on the Polytetrafluoroethylene (PTFE) surface by a simple fabrication method for defogging and anti-icing/deicing. The experimental data demonstrates that the temperature of these plasmonic photothermal films increased by more than 25 ° C under light illuminating at 3 suns ( 300 mW / cm 2 ). The evaporation and deicing process of a water droplet on these plasmonic photothermal films are observed and analyzed, which exhibits their excellent ability of defogging and anti-icing/deicing. Furthermore, the influence of the Au/TiO2 concentration on plasmonic photothermal effect is also studied. The results point out that the film with a much small amount of Au nanoparticles ( ~ 3 % ) has the best performance, which is discussed based on the surface plasmon resonance. The novel plasmonic photothermal films with a simple fabrication method, low production cost, good photothermal effect, less heavy metal ions pollution, and insulation property, have broad potential applications in defogging, anti-icing, and deicing, etc.

We investigated oxidative stress markers and metal ions in patients with Alzheimer’s disease (AD). The serum levels of ceruloplasmin (CER), C-reactive protein (CRP), uric acid (UA), homocysteine (Hcy), copper, iron, and zinc were determined in 125 patients with AD (mild, n = 2 8; moderate, n = 42; and severe, n = 55) and 40 healthy control (HC) participants. Compared to HC, CER and UA levels were significantly lower in moderate and severe AD groups, whereas CRP and Hcy levels were significantly higher in the severe AD group. Copper level was significantly higher in moderate and severe AD groups than the other groups. Compared to HC, iron level was significantly higher in patients with AD, whereas zinc level was significantly lower in patients with AD. In patients with AD, the severity of cognitive impairment was positively correlated with CER, UA, and zinc levels, whereas it was negatively correlated with copper level. Taken together, our findings provide a novel approach to assess AD progression.

Objective To investigate whether selected cytokines are detectable in the embryo culture medium (EM) of human preimplantation embryos (HPE) and what the relationship is of the cytokines with clinical outcomes. Design Cross-sectional study. Setting University-affiliated tertiary teaching hospital. Patient(s) Three-hundred and thirty infertile women who underwent fresh cycle in vitro fertilization (IVF) between January and December 2014. Intervention(s) Collection on the day of transfer of the EM of each embryo that was transferred in all patients for measurement of cytokine levels. Main Outcome Measure(s) Measurement of 13 selected cytokines in the EM of day-3 HPE to analyze the relationship of the cytokine with embryo quality and clinical outcome. Result(s) Of the cytokines measured, only interleukin-8 (IL-8) was statistically significantly associated with clinical outcome. The rate of detectable IL-8 in the EM was 32.42%, and the pregnancy rate, implantation rate, and number of live births per in vitro fertilization (IVF) or intracytoplasmic sperm injection patient (N LBPP) were higher, and 0 IR was lower in patients for whom the medium from transferred embryos was positive for IL-8 (IL-8 positive group) compared with the patients for whom the medium tested negative for IL-8 (IL-8 negative group). Compared with the IL-8 negative group, a higher pregnancy rate was observed in the IL-8 positive group when the patients received equal good–ordinary quality embryos. Conclusion(s) In the EM from HPE, IL-8 is associated with higher pregnancy rates, higher IRs, and higher N LBPP, so IL-8 may be an independent predictor for pretransfer assessment of the embryo development potential in IVF patients.

// Miguel H. Bronchud 1 , Francesc Tresserra 2 , Wenjie Xu 3 , Sarah Warren 3 , Maite Cusido 4 , Bernat Zantop 5 , Ana Claudia Zenclussen 6 and Alessandra Cesano 3 1 Institut Bellmunt Oncologia, Hospital Universitario Dexeus. Grupo Quiron Salud, Barcelona, Spain 2 Servei Anatomia Patologica, Hospital Universitario Dexeus. Grupo Quiron Salud, Barcelona, Spain 3 Nanostring Technologies, Immune Oncology, Seattle, WA, USA 4 Ginecologia Oncologica, Hospital Universitario Dexeus. Grupo Quiron Salud, Barcelona, Spain 5 Servei Obstetricia i Neonatologia, Hospital Universitario Dexeus. Grupo Quiron Salud, Barcelona, Spain 6 Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany Correspondence to: Miguel H. Bronchud, email: // Keywords : materno-fetal tolerance, cancer microenvironment, placental microenvironment, immune vigilance, carcinogenesis Received : July 11, 2016 Accepted : October 25, 2016 Published : November 11, 2016 Abstract The hypothesis of this work is that, in order to escape the natural immune surveillance mechanisms, cancer cells and the surrounding microenvironment might express ectopically genes that are physiologically present in the placenta to mediate fetal immune-tolerance. These natural “placental immune-editing switch” mechanisms (PIES) may represent the result of millions of years of mammalian evolution developed to allow materno-fetal tolerance. Here, we introduce genes of the immune regulatory pathways that are either similarly over- or under-expressed in tumor vs normal tissue. Our analysis was carried out in primary breast cancer with metastatic homolateral axillary lymph nodes as well as placenta tissue (both uterine decidual tissue and term placenta tissue) from a pregnant woman. Gene expression profiling of paired non-self and self tissues (i.e. placenta/uterus; breast cancer/normal breast tissue; metastatic lymphnode/normal lymphnode tissue) was performed using the PanCancer Immune gene panel, a 770 Nanostring gene expression panel. Our findings reveal overlapping in specific immune gene expression in placenta and cancer tissue, suggesting that these genes might play an important role in maintaining immune tolerance both physiologically (in the placenta) and pathologically (in the cancer setting).

BACKGROUND Studies have found that the high-dose influenza vaccine has a higher relative vaccine effectiveness (RVE) versus standard-dose vaccines in some seasons. We evaluated the effect of age on the RVE of high-dose versus standard-dose influenza vaccines among Medicare beneficiaries. METHODS A 6-season retrospective cohort study from 2012 to 2018 among Medicare beneficiaries aged ≥65 years was performed. Poisson regression was used to evaluate the effect of age on the RVE of high-dose versus standard-dose influenza vaccines in preventing influenza-related hospitalizations. RESULTS The study included >19 million vaccinated beneficiaries in a community pharmacy setting. The Poisson models indicated a slightly increasing trend in RVE with age in all seasons. The high-dose vaccine was more effective than standard-dose vaccines in preventing influenza-related hospital encounters (ie, influenza-related inpatient stays and emergency department visits) in the 2012-2013 (RVE, 23.1%; 95% confidence interval [CI], 17.6%-28.3%), 2013-2014 (RVE, 15.3%; 95% CI, 7.8%-22.3%), 2014-2015 (RVE, 8.9%; 95% CI, 5.6%-12.1%), and 2016-2017 (RVE, 12.6%; 95% CI, 6.3%-18.4%) seasons and was at least as effective in all other seasons. We also found that the high-dose vaccine was consistently more effective than standard-dose vaccines across all seasons for people aged ≥85 years. Similar trends were observed for influenza-related inpatient stays. CONCLUSIONS The RVE of high-dose versus standard-dose influenza vaccines increases with age.

ERP cloud software and the related issues were focused in this paper. A business-aware framework was proposed in order to improve the flexibility of ERP implementation and evolution, in which users can change or update business processes as required. Such business changes can be captured by the process engine. And then the engine can call the analyzer to determine the complexity of these changes, which can be measured according to the property of forward compatibility defined to evaluate the scale and status of the coming evolution. After that, activity instance scheduler together with change locators can be called to cooperatively complete the process of ERP cloud service evolution by operating the caching sequence of cloud service instances. And practices showed that this mechanism was efficient.

Background: The Arctic Front Cryoballoon System is a technology in which substrate alterations in patients with atrial fibrillation (AF) recurrence have not been well characterized. In this study, we evaluated sites of pulmonary vein (PV) reconnections and the accuracy of the Achieve™ circular mapping catheter in detecting these reconnections after cryoablation. Methods: This study included 15 patients undergoing redo AF ablation after a prior single cryoablation procedure. PV reconnection sites were determined by measuring PV signals and high output pacing from 4 vectors of the Achieve catheter. The results were compared with a roving mapping catheter guided by rotational intracardiac echocardiography (ICE) in the left atrium. Results: All patients had PV reconnections (2.1 ± 0.8 veins/patient). The left superior PV was most commonly reconnected (n = 11), whereas the right inferior PV was least likely (n = 3). Both carinas (left: n = 11; right: n = 7) and left atrial appendage ridge (n = 11) were also frequently reconnected. Mapping with the Achieve catheter showed a positive predictive value (PPV) 100% and negative predictive value (NPV) 96% when compared with ICE guided mapping. In 2 patients, right superior PV reconnection was not identified by the Achieve. Conclusion: During redo AF ablation after index cryoablation, multiple PVs are usually reconnected, with both carinas and left atrial appendage ridge being common sites of reconnection. The Achieve mapping catheter was able to identify reconnection with high positive and negative predictive values. Key words: Achieve™, Cryoballoon, Ablation, Atrial Fibrillation, Pulmonary veins reconnections

Objective Donepezil is an acetylcholinesterase inhibitor (AChI) that improves cognitive function in Alzheimer's disease (AD) patients. However, AChIs are usually associated with peripheral adverse reactions. Here, we investigated the cardiac outcomes in elderly AD patients treated with donepezil. Materials and methods A total of 82 AD patients (age, 75.47 ± 6.53 years) received 5 mg or 10 mg donepezil (n = 41/group) once daily for 12 weeks. Next, we examined the heart rate (HR), cardiac rhythm, and PR, QRS, and QTc intervals. Results Compared to the 5-mg donepezil-treated group, the HR was slower in the 10-mg donepezil-treated group at the 4th, 8th, and 12th weeks of treatment (p = 0.041, 0.026, 0.008, respectively). The PR interval was longer in the 10-mg donepezil-treated group at the 12th week of treatment (p = 0.022). Compared to the pretreatment values, the post-treatment HR and PR interval in the 10-mg donepezil-treated group were significantly slower and longer, respectively (p = 0.002, p = 0.005). Further, the HR was significantly correlated to the donepezil dosage (p = 0.014). Similarly, donepezil dosage and treatment interval were significantly correlated (p = 0.048). Conclusion Taken together, our findings suggest that 10 mg donepezil decreased the HR of elderly AD patients without inducing severe cardiac outcomes. Therefore, AD patients receiving donepezil should undergo regular cardiovascular monitoring. .