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Neoadjuvant PD-(L)1 inhibitors may be promising for locally advanced non-small cell lung cancer (NSCLC) with potential pathological and survival benefits. But severe immune-related adverse events (irAEs) may cause fatal consequences which require early identification and timely intervention. The basis for most of these adverse events is a reactive hyperactivated T-cell response to normal tissues that results in the production of high levels of CD4 T-helper cell cytokines or increased migration of cytolytic CD8 T cells in normal tissues. It is recommended that all patients receiving PD-(L)1 inhibitors routinely have thyroid function studies, complete blood counts, and liver function and metabolic panels at each treatment and at intervals of 6 to 12 weeks for the first 6 months after finishing treatment. Herein, we report a rare case who had two grade 3–4 irAEs consecutively occurring after PD-1 induction therapy and surgery. A 59-year-old man with stage IIIA squamous cell lung cancer receiving 3 cycles of neoadjuvant nab-paclitaxel, carboplatin, and nivolumab was reevaluated for resectability. The patient experienced acute serum transaminase elevation right after induction therapy. Seven days after surgery he had severe pneumonia. These two serious complications were both eventually relieved by a month long treatment of corticosteroids but not regular medicine which verified the diagnosis of irAEs. Although results of clinical trials of neoadjuvant immunotherapy are worth expecting, our case calls attention to careful surveillance and timely management of irAEs during the perioperative use of PD-(L)1 inhibitors. We also further discuss the standard use of corticosteroids for irAEs based on a review of literature.

Efforts to improve coaching effectiveness require an understanding of the common sources of coaches’ knowledge acquisition. Sports coaches utilise multiple learning sources, yet limited direct evidence elucidates the manner in which Chinese coaches learn to coach and the evolution of their learning sources throughout their careers’ development. This research examines the actual and preferred sources of coaching knowledge for Chinese coaches and analyses changes in learning sources from Junior to Senior level coaches. One hundred coaches from China, including 60 Junior coaches, 23 Intermediate coaches and 17 Senior coaches, completed an online questionnaire. The survey results indicated that coaches acquire knowledge from formal, informal and non-formal learning situations. However, formal coach education (coach education programmes) is the most important source of knowledge acquisition for all coaches. Furthermore, as coaches develop, the sources to acquire knowledge will gradually change from athletic experience to interaction with other coaches. Based on these findings, we suggest that national sport governing bodies build more comprehensive coach education systems by establishing a scientific mentoring system and organising regular coach-themed clinics, seminars, meetings and so on. Future research is needed to examine how coaches in China’s dominant programmes learn to coach and how this learning is practically applied.

Chaotic Brillouin optical correlation domain analysis (BOCDA) has been proposed and experimentally demonstrated with the advantage of high spatial resolution. However, it faces the same issue of the temperature and strain cross-sensitivity. In this paper, the simultaneous measurement of temperature and strain can be preliminarily achieved by analyzing the two Brillouin frequencies of the chaotic laser in a large-effective-area fiber (LEAF). A temperature resolution of 1 °C and a strain resolution of 20 µε can be obtained with a spatial resolution of 3.9 cm. The actual temperature and strain measurement errors are 0.37 °C and 10 µε, respectively, which are within the maximum measurement errors.

Background The incidence of dry eye is high after a cataract surgery. However, the clinical efficacy of sodium hyaluronate combined with conventional eye drops for dry eye after cataract surgery remains unclear. The currently available studies were based on small sample sizes, and no systematic review on this topic has been conducted. Thus, a meta-analysis was performed to systematically and accurately evaluate the clinical value of sodium hyaluronate in the treatment of dry eye after cataract surgery. Methods English-language databases including PubMed, Cochrane, and Web of Science, and Chineselanguage databases including (CNKI), Wanfang Database, and CQVIP were systematically searched for relevant articles published up to December 31, 2019. The pooled effect size of qualitative data was evaluated with relative risk (RR) and 95% confidence interval (CI), and the overall effect of the quantitative data was estimated by using weighted mean difference (WMD) or standard mean difference (SMD) and 95% CI. Randomized controlled clinical trials concerning the use of sodium hyaluronate combined with conventional treatment for dry eye after cataract surgery were included. The quality of the included literature was evaluated by RevMan5.3 software, and the rest of the statistical data were analyzed using the "meta" package of the R3.5.1 software. Results A total of 24 articles including 2,177 eyes (1,088 eyes in the combination group and 1089 eyes in the control group) were included. Twelve articles reported the total effective rate after 1 month of treatment (I2 =71%), and the random effects model was used to estimate RR. The total effective rate in the combination group was 1.33 times that of the control group (95% CI: 1.21, 1.47). Ten articles reported the dry eye symptom score after 1 month of treatment (I2 =92%). The SMD was estimated using the random effects model. The dry eye symptom score in the combination group was significantly lower than that in the control group, with an SMD of -2.98 (95% CI: -3.69, -2.27). Seventeen articles reported the tear film break-up time (BUT) after 1 month of treatment. As shown in the random effects model, BUT was significantly longer in the combination group than in the control group, with an MD of 2.06 (95% CI: 1.63, 2.49). Sixteen articles described the scores of a fluorescein (FL) eye stain test after 1 month of treatment. As shown in the random effects model, FL score was significantly lower in the combination group than in the control group, with an SMD of -2.52 (95% CI: -3.23, -1.81). Eight articles reported the results of Schirmer I test (SIt) after 1 month of treatment. As estimated by the random effects model, the wetting length in SIt was significantly higher in the combination group than in the control group, with an MD of 1.50 (95% CI: 0.53, 2.48). In the elderly population, BUT was significantly higher in the combined group than in the control group, with an MD of 2.97 (95%CI: 2.47, 3.47); however, the FL score and SIt showed no such significant difference. Conclusions For the patients with dry eye after cataract surgery, sodium hyaluronate on the basis of conventional anti-inflammatory treatment is highly effective as it can improve the dry eye symptom score and the results of 3 tests for dry eye. However, high-quality studies are warranted to further investigate the safety of sodium hyaluronate.

We propose a long-range, high-precision optical time domain reflectometry (OTDR) technology based on the hybrid integrated short-external-cavity chaotic semiconductor laser (SCSL) which has the advantages of small volume, simple process, low cost, mass production, stable performance, and high yield. The chaotic signal generated by the hybrid integrated SCSL exhibits a certain extent of oscillations and fluctuates randomly in time series. It can be seen from the auto-correlation curve that the generated chaotic signal has no time-delay signature and the theoretical spatial resolution is 1 cm according to the full width of half maximum. In this letter, not only the measurement of multiple single reflection events but also the measurement of double-reflection events was realized, and the spatial resolutions at different distances were verified. Finally, the spatial resolution and range-independent breakpoints measurement has been realized, and the detection range of 76.54 km and the spatial resolution of 1 cm (7.7 million resolved points) have been experimentally demonstrated.

Background Recent studies indicate that ultrasound can detect changes in tracheal diameter during endotracheal tube (ETT) cuff inflation. We sought to assess the accuracy of ultrasound measurement of tracheal diameter, and to determine the relationship between tracheal wall pressure (TWP), cuff inflation volume (CIV), and the degree of tracheal deformation. Methods Our study comprised two parts: the first included 45 porcine tracheas, the second 41 porcine tracheas. Each trachea was intubated with a cuffed ETT, which was connected to an injector and the manometer via a three-way tap. The cuff was inflated and the cuff pressure recorded before and after intubation. The tracheal diameter was measured using ultrasound. This included three separate measurements: outer transverse diameter (OTD), internal transverse diameter (ITD), and anterior tracheal wall thicknesses (ATWT). A precision electronic Vernier caliper was also used to measure tracheal diameter. We calculated TWP and the percentage change of tracheal diameter. The Bland–Altman method, linear regression, and locally weighted regression (LOESS) were used to analyze the data. Results There were strong correlation and agreement for OTD (r = 0.97, P r = 0.90, P r = 0.58, P r = 0.75, P r = 0.77, P r = 0.75, P r = 0.84, P r = 0.84, P Conclusions Use of ultrasound to measure OTD and ITD is accurate, but is less accurate for ATWT. There is a close correlation between OTD%, ITD%, CIV and TWP.

To investigate the effect of ablation behavior on the matrix effect, nanosecond laser ablation inductively coupled plasma mass spectrometry is used to analyze variations in element signal intensities of NIST 610 and GSE-1G standard samples with different laser fluence. Scanning electron microscopy and super depth-of-field microscopy are used to capture the morphology of the ablation crater and obtain depth information, respectively. A pump–probe shadowgraph is used to record the dynamic process of plasma plume evolution during sample ablation. Experimental results show that the proportion of refractory elements to volatile elements in the ablation materials with two different matrices increases with an increase in laser fluence. For the GSE-1G matrix, this range of increase is relatively small, and the signal loss of refractory elements occurs at a higher laser fluence. Combined with the morphology of the ablation crater and evolution of the plasma plume, this potential cause is related to the plasma shielding, which is beneficial to form and deposit large particles, resulting in the loss of refractory elements at high energy fluence.

Part 1: Regular Papers; International audience; To achieve the fast recovery of optical transport networks following a disaster, we investigate a novel scheme to enable cooperation between carriers. Carriers can take advantage of their surviving or recovered optical resources to aid one another with emergency lightpath support to reduce efficiently the burden of recovery, which is heavy immediately after disasters. These lightpaths can be employed exclusively by the counterpart carriers to satisfy their highest priority traffic demands, such as safety confirmation and victim relief. In addition, we introduce an incentive to carriers to prompt cooperation. The carrier cooperation-planning problem is decomposed into eight tasks, and distributed to individual carriers and a third-party organization. During cooperation, the carriers’ confidential information can be strictly protected by employing a carrier optical network abstraction mechanism. The evaluation results reveal that our proposal can significantly reduce the burden on recovery and the corresponding cost for carriers, resulting in fast and efficient disaster recovery.

Instrumented indentation testing (IIT) is extensively and successfullyused as an alternative technique for investigations of the mechanical properties of steels, where traditional specimens, such as round bar specimens for tensile tests, are not acquirable. The IIT is based on an assumption that the true stress-strain curve of the analyzed sample follows one of the known constitutive equations, such as the Hollomon, Ludwik, Swift, or other predefined equations. However, steel samples exposed to extreme conditions, such as media with high-temperature or neutron irradiation may exhibit a novel stress-strain relation that follows an unknown constitutive equation. In this situation, the accuracy of the IIT may be doubtful. This article proposes a constitutive model independent technique, called macro-pillar compression testing (MPCT), where constitutive equations are not necessary. The MPCT was conducted on a specimen with pillars and established on the theory of the compression testing. In this study, a modified imaginary radius function was proposed for the pillar to consider its sinking and barreling effect during the compression. Finally, three different types of steel (austenitic stainless, low-alloy and low-carbon steel) were used to verify the accuracy of the MPCT. Both MPCT and round bar tensile tests were performed on each type. The test results show that the true strain-stress curves obtained by MPCT have a good agreement with the corresponding curves by tensile tests.

Acute brain injury (ABI) usually causes long-term disability and a high mortality. During ABI, cerebral autoregulation is affected, and the harmony of cerebral circulation is interrupted. As venous system contains nearly 70–80% of the circulatory volume inside the inflexible cranial cavity and is more susceptible to the elevation of intracranial pressure than the arterial system, almost all kinds of ABI can present with changes in cerebral venous system. With the development of venous imaging and increased use of high resolution imaging protocols, understanding of venous structure, morphology and metabolism has become feasible and important, which may provide critical information for clinical diagnosing and prognosis prediction in ABI. In this chapter, we summarized the features found on venous imaging related to ABI, and discussed their clinical significance.

Concentric rings are observed on the front surface when a laser pulse focuses on the rear surface of fused silica. The spatial distribution of concentric rings presents a certain regularity, and the width and depth of the ring gradually increase from inside to outside. These features of the concentric rings are affected by the laser wavelength and energy. Their formation mechanism is explored by means of combining a time-resolved pump-probe shadowgraph and surface damage morphology. Concentric rings are formed during the irradiation process of one nanosecond pulses, whose radius and depth characteristics may record the relationship between the early stage of laser-induced damage structure and the evolution of early plasma.

The ablation dynamics of a standard geological sample induced using a nanosecond laser was recorded using a high time-resolved pump-probe shadowgraph. During the early shock wave formation, multiple asymmetric spikes within one laser pulse result in multiple shock waves which swell and fuse. Observations of the multilayer structure inside the ablation plume showed that the intensity of the plasma luminescence gradually decreased with an increase in the delay time. The ablation plume perturbs the air at supersonic speed, forming shock waves with compressible discontinuity sweeping through the gas, changing its pressure, density, and fluid velocity. Based on the classic Riemannian problem, a theoretical model was used to simulate the dynamics of the pressure, velocity, and density inside the ablation plume. The Taylor–Sedov theory was used to deduce the transient velocity, pressure, and temperature of the shock wave. The radius, velocity, pressure, and temperature of the shock wave reach 587.4 μm, 2852.9 m/s, 265.8 MPa, and 27 874.6 K, respectively, when the National Institute of Standards and Technology standard reference material 614 is ablated at 80 ns using a 17 mJ laser pulse at atmospheric pressure. The structure of the multilayer ablation plume may alter the volatilization and agglomeration of different elements, resulting in elemental fractionation during the laser sampling for laser ablation inductively coupled plasma mass spectrometry.

This paper briefs the characteristics of variable air volume (VAV) air-conditioning system. Because it consumes the most energy in all energy consumption system. And the VAV air-conditioning system has many features such as many variables, big lag and nonlinear. The system uses the conventional control algorithm to cause many problems, for example slow response and low precision. So starting from the major direction of the intelligent control theory, we discuss the control methods optimization of the VAV air-conditioning system, for example the distributed control and the neural network control. Control system based on fuzzy predictive PID algorithm is simulated through the MATLAB software. The result shows that the designed controller has obvious advantages, and compared with the traditional PID control, its control effect is much better.

The aim of this study was to evaluate the impact of pretreatment quality of collaterals, involving velocity and extent of collateral filling, on recanalization after intravenous thrombolysis (IVT). A retrospective analysis was performed of 66 patients with acute middle cerebral artery (MCA) M1 segment occlusion who underwent MR perfusion (MRP) imaging before IVT. The velocity of collateral filling was defined as arrival time delay (ATD) of contrast bolus to Sylvian fissure between the normal and the affected hemisphere. The extent of collateral filling was assessed according to the Alberta Stroke Program Early CT (ASPECT) score on temporally fused maximum intensity projections (tMIP). Arterial occlusive lesion (AOL) score was used to assess the degree of arterial recanalization. ATD (OR = 0.775, 95% CI = 0.626–0.960, p = 0.020), but not tMIP-ASPECT score (OR = 1.073, 95% CI = 0.820–1.405, p = 0.607), was independently associated with recanalization (AOL score of 2 and 3) at 24 hours after IVT. When recanalization was achieved, hemorrhagic transformation (HT) occurred more frequently in patients with slow collaterals (ATD ≥ 2.3 seconds) than those with rapid collaterals (ATD p = 0.011). In conclusion, the velocity of collaterals related to recanalization, which may guide the decision-making of revascularization therapy in acute ischemic stroke.

Objective Leptomeningeal collaterals, which affects tissue fate, are still challenging to assess. Four-dimensional CT angiography (4D CTA) originated from CT perfusion (CTP) provides the possibility of non-invasive and time-resolved assessment of leptomeningeal collateral flow. We sought to develop a comprehensive rating system to integrate the speed and extent of collateral flow on 4D CTA, and investigate its prognostic value for reperfusion therapy in acute ischemic stroke (AIS) patients. Methods We retrospectively studied 80 patients with M1 ± internal carotid artery (ICA) occlusion who had baseline CTP before intravenous thrombolysis. The velocity and extent of collaterals were evaluated by regional leptomeningeal collateral score on peak phase (rLMC-P) and temporally fused intensity projections (tMIP) (rLMC-M) on 4D CTA, respectively. The cutoffs of rLMC-P and rLMC-M score for predicting good outcome (mRS score ≤ 2) were integrated to develop the collateral grading scale (CGS) (rating from 0–2). Results The CGS score was correlated with 3-months mRS score (non-recanalizers: ρ = -0.495, p = 0.01; recanalizers: ρ = -0.671, p < 0.001). Patients with intermediate or good collaterals (CGS score of 1 and 2) who recanalized were more likely to have good outcome than those without recanalization (p = 0.038, p = 0.018), while there was no significant difference in outcome in patients with poor collaterals (CGS score of 0) stratified by recanalization (p = 0.227). Conclusions Identification of collaterals based on CGS may help to select good responders to reperfusion therapy in patients with large artery occlusion.

Background and Purpose— We aim to investigate whether lower admission serum calcium levels are associated with hemorrhagic transformation (HT) after intravenous thrombolysis (IVT). Methods— A total of 362 patients treated with IVT was divided into 4 quartiles based on admission serum calcium levels (Q1[2.31] mmol/L). HT was classified as hemorrhagic infarction and parenchymal hemorrhage. Logistic regression was applied to assess the association between serum calcium levels and the incidence of HT. Results— Compared with Q4, HT was more common in Q1 (odds ratio, 2.580; 95% CI, [1.258–5.292]; P =0.010), Q2 (odds ratio, 2.382; 95% CI, [1.163–4.877]; P =0.018), and Q3 (odds ratio, 2.293; 95% CI, [1.133–4.637]; P =0.021). Hemorrhagic infarction was more common in Q1 ( P =0.037), and Q2 ( P =0.018), compared with Q4, and parenchymal hemorrhage was more common in Q1 ( P =0.029) than Q4. Conclusions— Lower admission serum calcium level is independently associated with HT after IVT, and this hypothesis needs larger confirmatory trials.

The mechanical properties of metals which were subjected to high temperatures or neutron irradiation decrease drastically during a long period of service. The small punch test (SPT) was introduced, by which various material properties could be obtained from a fairly small disk specimen, with an almost non-destructive method, from an in-service pressure vessel. However, due to the relatively thin samples, the microdefects which may have a severe effect on the small punch samples may present little effect on the conventional large sample. In this paper, Q345R and Q235A steels were used to carry out SPT in order to study the effect of microdefects on the mechanical properties. The effects of microdefect on the load–displacement curve of SPT were investigated. The result shows that Q235A steel has obvious microdefects and shows scattering in load–displacement curves and rough fracture morphology. The microdefects have an obvious effect on the ultimate strength and have no effect on the yielding strength. The finite element analysis result shows good accordance with the test result.

The aim of this paper was to propose a creep-fatigue life prediction model based on multiple regression analysis of the existing experimental data. Three different factors including temperature, hold time, and total strain range, were taken into consideration in this model. The prediction capacity of the present model was verified through comparison between predicted results and existing experimental data of different materials with different testing conditions. A good agreement was found between the predicted results and the experimental data.

Three-dimensional TCAD simulation is used to explore a new charge-collection mechanism in highly-scaled MOSEFT. The results show the charge collection with the parasitic bipolar conduction can cause an increased SEU sensitivity. Then the problem of multiple-node upset in a 0.18µm 12-T SEU hardened SRAM cell is also studied. Unlike traditional multiple node charge collection in which diffusions near a single event strike collect the deposited carriers, a novel mechanism involves direct drift-diffusion collection at a NFET transistor in conjunction with parasitic bipolar conduction in nearby PFET transistor. The charge collection with the parasitic bipolar conduction compromise the SEU hardened design, thus causing upsets.

This paper concerns the fields of self-levelling crane systems. We firstly design a practical but simplified 3D crane model. And then, focusing on the self-levelling adjusting mechanism, we derive its static equilibrium equations as the model equations, based on engineering requirements. Thirdly, we propose a try-and-get (TAG) method to realize self-levelling adjustment. Finally, we analyze the defects of the TAG method and put forward an On-Line TAG algorithm, which performs well in the simulation.