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In order to achieve thermal treatment of coal slime and depth control of NOx, a 75 t/h circulating fluidized bed (CFB) boiler arranging post-combustion air is constructed. In the experiment, the combustion atmosphere and the ratio of primary air and secondary air are adjusted to decrease the NOx emissions below 50 mg/m3 (dry basis at 6% O2). Compared with conventional CFB combustion, the post-combustion technology decreases the NOx emissions from 92.9 to 65.4 mg/m3 by adjusting the combustion atmosphere. Then, the primary air volume is adjusted to decrease the NOx emissions further. On the one hand, decreasing primary air volume contributes to inhibiting the NOx generation in the dense phase. On the other hand, it is proved that the combination of the cyclone and a post-combustion chamber plays a crucial role in the de-NOx process of post-combustion technology. More char particles are brought to the cyclone as the primary air volume decreases. The NOx reduction in the cyclone and the post-combustion chamber is promoted. Finally, the NOx emissions are decreased to 42.6 mg/m3 when the ratio of primary air and secondary air is 50.0%. In addition, the SO2 emissions and the combustion efficiency during the ultra-low NOx condition are 23.2 mg/m3 and 98.3%, respectively.

Coal slime has been discharged or piled up on the spot as solid waste for a long time, causing a lot of waste of resources and environmental pollution. A 75 t/h circulating fluidized bed (CFB) boiler with post-combustion technology was built for combustion of coal slime. To explore the post-combustion technology and the influences of post-combustion air speed and number of post-combustion air nozzles on combustion and original NOx emission characteristics of Yankuang Coal Slime, the experiments were carried out on a 75 t/h circulating fluidized bed industrial boiler. The experimental results showed that post-combustion technology makes the NOx original emission lower and can meet ultra-low emission requirement. Both the post-combustion air speed and the number of post-combustion air nozzles affected the post-combustion air flow. As the post-combustion air speed and the number of post-combustion air nozzles increase, NOx original emissions decreased and CO emissions increased slightly.

Ya Bin Zhou,* Yuan Yuan Xiao,* Jin Jing Chao, Lin Ma Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuan Yuan XiaoDepartment of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of ChinaTel +86 10 59616884Fax +86 10 59718700Email xyy81924@126.comAbstract: Tinea capitis is a common dermatophytosis predominantly occurring in children, which needs oral antifungal drug therapy. Itraconazole pulse therapy has been widely applicated in the treatment of adult onychomycosis. However, only a few studies are available for the treatment of pediatric tinea capitis with itraconazole pulse therapy. The therapy schedules vary with respect to dose and intermission. Here, we report four cases of tinea capitis that were treated with a novel high-dose itraconazole pulse therapy (6– 10 mg/kg/d with 3 weeks off between consecutive pulses). After 2– 3 pulses therapy, all the patients were cured and no adverse reactions were observed. We demonstrate the efficacy and safety of this novel itraconazole pulse therapy schedule. It may be a promising therapy in the treatment of tinea capitis in children.Keywords: tinea capitis, itraconazole pulse therapy, children, Microsporum canis, Nannizzia gypsea

It has previously been shown that cerebello-thalamo-cortical (CTC) hyperconnectivity is likely a state-independent neural signature for psychosis. However, the potential clinical utility of this change has not yet been evaluated. Here, using fMRI and clinical data acquired from 214 untreated first-episode patients with schizophrenia (62 of whom were clinically followed-up at least once at the 12th and 24th months after treatment initiation) and 179 healthy controls, we investigated whether CTC hyperconnectivity would serve as an individualized biomarker for diagnostic classification and prediction of long-term treatment outcome. Cross-validated LASSO regression was conducted to estimate the accuracy of baseline CTC connectivity for patient-control classification, with the generalizability of classification performance tested in an independent sample including 42 untreated first-episode patients and 65 controls. Associations between baseline CTC connectivity and clinical outcomes were evaluated using linear mixed model and leave-one-out cross validation. We found significantly increased baseline CTC connectivity in patients (P = .01), which remained stable after treatment. Measures of CTC connectivity discriminated patients from controls with moderate classification accuracy (AUC = 0.68, P < .001), and the classification model had good generalizability in the independent sample (AUC = 0.70, P < .001). Higher CTC connectivity at baseline significantly predicted poorer long-term symptom reduction in negative symptoms (R = 0.31, P = .01) but not positive or general symptoms. These findings provide initial evidence for the putative “CTC hyperconnectivity” anomaly as an individualized diagnostic and prognostic biomarker for schizophrenia, and highlight the potential of this measure in precision psychiatry.

Schizophrenia is a complex and heterogeneous syndrome. Whether quantitative imaging biomarkers can identify discrete subgroups of patients as might be used to foster personalized medicine approaches for patient care remains unclear. Cross-sectional structural MR images of 163 never-treated first-episode schizophrenia patients (FES) and 133 chronically ill patients with midcourse schizophrenia from the Bipolar and Schizophrenia Network for Intermediate Phenotypes (B-SNIP) consortium and a total of 403 healthy controls were recruited. Morphometric measures (cortical thickness, surface area, and subcortical structures) were extracted for each subject and then the optimized subtyping results were obtained with nonsupervised cluster analysis. Three subgroups of patients defined by distinct patterns of regional cortical and subcortical morphometric features were identified in FES. A similar three subgroup pattern was identified in the independent dataset of patients from the multi-site B-SNIP consortium. Similarities of classification patterns across these two patient cohorts suggest that the 3-group typology is relatively stable over the course of illness. Cognitive functions were worse in subgroup 1 with midcourse schizophrenia than those in subgroup 3. These findings provide novel insight into distinct subgroups of patients with schizophrenia based on structural brain features. Findings of different cognitive functions among the subgroups support clinical differences in the MRI-defined illness subtypes. Regardless of clinical presentation and stage of illness, anatomic MR subgrouping biomarkers can separate neurobiologically distinct subgroups of schizophrenia patients, which represent an important and meaningful step forward in differentiating subtypes of patients for studies of illness neurobiology and potentially for clinical trials.

Carcinoma arising from a mucinous cystic neoplasm (MCN) of the pancreas is termed MCN with associated invasive carcinoma (MCN‐AIC) in the fifth WHO classification of digestive tumors (2019). The prognosis of this malignancy varies depending on the relationship of the invasive carcinoma to the cyst capsule, but limited data are available. This study identified 165 surgically resected MCNs including 15 MCN‐AICs from a single center between 2008 and 2018 and analyzed their clinicopathologic features. The results confirmed that non‐invasive MCNs were completely cured by surgery. All MCN‐AICs showing an encapsulated invasion pattern (defined as invasive carcinoma limited to the ovarian‐type stroma, cystic septa, and capsule) had an excellent prognosis with a 5‐year survival rate of 100%, even when the size of the invasive component was up to stage T2. By contrast, MCN‐AICs with extracapsular involvement had unfavorable clinical outcomes. Our study demonstrates that the pattern of invasion of MCN‐AIC can predict patient prognosis. Pathologic stage T1 and T2 encapsulated MCN‐AICs may be completely cured with surgical resection alone or when combined with postoperative chemotherapy.

BACKGROUND Alström syndrome (AS, OMIM ID 203800) is a rare disease involving multiple organs in children and is mostly reported in non-Chinese patients. In the Chinese population, there are few reports on the clinical manifestations and pathogenesis of AS. This is the first report on the association between AS and Graves’ hyperthyroidism. CASE SUMMARY An 8-year-old Chinese girl was diagnosed with AS. Two years later, Graves’ hyperthyroidism developed with progressive liver dysfunction. The patient’s clinical data were collected; DNA from peripheral blood of the proband, parents and sibling was collected for gene mutation detection using the second-generation sequencing method and gene panel for diabetes. The association between the patient’s genotype and clinical phenotype was analyzed. She carried the pathogenic compound heterozygous mutation of ALMS1 (c.2296_2299del4 and c.11460C>A). These stop-gain mutations likely caused truncation of the ALMS1 protein. CONCLUSION The manifestation of hyperthyroidism may suggest rapid progression of AS.

Background Hepatocellular carcinoma (HCC) is a common malignant tumor with a poor prognosis. We aimed to identify a new prognostic model of HCC based on differentially expressed (DE) immune genes. Methods The DE immune genes were identified based on an analysis of 374 cases of HCC and 50 adjacent non-tumor specimens from the Cancer Genome Atlas (TCGA) database. Univariate Cox analysis, Lasso regression, and multivariate Cox analysis were used to construct the model based on the training group. Survival analysis and the receiver operating characteristic (ROC) curves were used to evaluate model performance. The testing group and the entire group were subsequently used for validation of the model. Results A five-immune gene model consisted of HSPA4, ISG20L2, NDRG1, EGF, and IL17D was identified. Based on the model, the overall survival was significantly different between the high-risk and low-risk groups (P = 7.953e-06). The AUCs for the model at 1- and 3-year were 0.849 and 0.74, respectively. The reliability of the model was confirmed using the validation groups. The risk score was identified as an independent prognostic parameter and closely related to the content of immune cells from human HCC specimens. Conclusion We identified a five-immune gene model that can be used as an independent prognostic marker for HCC.

The NOx emission of conventional circulating fluidized bed (CFB) boilers could hardly meet the increasing strict standards in China, so the initial NOx emission and control of Shenmu coal and char were investigated in a 0.5 MWth high temperature CFB test platform with a main combustion zone (MCZ) and a post-combustion zone (PCZ), the reducing atmosphere in MCZ suppressed the formation of NOx, high temperature in PCZ made the residual carbon and CO burnout, the technology of high temperature CFB with post-combustion had the advantage of decreasing the initial NOx emission while maintaining the combustion efficiency of fuel. The experimental results showed that as the injection position of post-combustion air (PCA) moving backward, the reducing zone in PCZ was enlarged so more NOx could be converted to N2. When PCA was injected from PCA1 and PCA3, NOx and CO emission were both relatively lower than other injection positions, the temperature in PCZ of Shenmu char was more uniform and its NOx emission was lower compared to Shenmu coal, the peak temperatures of MCZ and PCC were 968 °C and 936 °C respectively, the initial NOx emission of Shenmu coal was 46 mg/m3 (at 6% O2), meanwhile, the CO emission was 139 ppm. The initial NOx emission of Shenmu char could reach 41 mg/m3 when the temperatures of MCZ and PCZ were 931 °C and 913 °C respectively, the new ultra-low emission requirement (≤50 mg/m3) was successfully achieved without additional denitration equipment, so the technology of high temperature CFB with post-combustion is an effective ultra-low nitrogen combustion technology.

Background and Aims ORISE Gel is a recently introduced, FDA-approved submucosal lifting agent used in endoscopic resection of GI lesions. Histologically evident gel deposits in resected specimens may pose a potential diagnostic pitfall. In order to aid in recognition of this procedure-related artifact, we report the largest histologic series of ORISE Gel in endoscopic and surgical resection specimens to date. Methods Included were 58 endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) specimens with ORISE Gel injection, and 5 interval surgical resection specimens with previous ORISE Gel injection. Patient demographics and endoscopy reports were obtained. Histologic slides from all cases were reviewed. Histochemical stains were performed on select cases. Results Fifty-one EMR and 7 ESD specimens were identified. In 51 out of 58 (88%) endoscopic resection specimens, amorphous, pale blue-gray, finely granular material was evident in the submucosa, as well as focally within the mucosa in 4 cases. Most cases showed homogenous near-complete filling of the submucosa with this material, whereas a few demonstrated areas of condensation and retraction. Mucicarmine and PAS stains were negative for mucin. Interval surgical resection specimens revealed extensive deposition of dense, eosinophilic material with associated multinucleated giant cells in the submucosa in all cases, with transmural extension in 3 cases. Conclusion ORISE Gel injection during endoscopic resection of gastrointestinal lesions results in deposition of amorphous, blue-gray material seen in histologic sections, whereas interval surgical resection specimens demonstrate dense, eosinophilic material with an associated giant cell reaction. Awareness of these artifacts will help avoid misinterpretation of their presence as pathologic findings.

Endoscopic submucosal dissection (ESD) is commonly used in Asia for resection of large non-pedunculated colorectal polyps (LNPCPs) and early (T1) colorectal cancers. It allows for en bloc removal and is often curative. We describe outcomes of colorectal ESD from a United States (US) academic medical center and compare this to international experiences. Retrospective review was performed of colonic lesions referred to the University of Chicago Medical Center for ESD from 2012 to 2020. Clinical and procedural data were collected. The study included 78 lesions with mean size of 29.7 mm (range 10–100 mm). The overall en bloc resection rate was 73.1% (n = 57). Between the first and second half of the study, it improved from 61.5 to 84.6% (p = 0.02). Histology showed adenocarcinoma in fifteen lesions (19.2%). Of all neoplastic lesions (n = 68), resection with negative margins (R0) was achieved in 54 cases (79.4%). Adverse events occurred in 9 cases (11.5%), but most (n = 6, 66.7%) were successfully treated endoscopically. Follow-up endoscopy was performed in 46 patients (59.0%) at a mean interval of 6.8 months (SD ± 5.0 months) with two case of recurrent lesion (4.3%). This study shows successful colorectal ESD outcomes at a US tertiary center. The en bloc resection rate was lower than other cohorts, but a learning curve was demonstrated. The R0 resection, lesion recurrence, and adverse event rates were similar to other non-Asian experiences, but not as favorable as in Asia [Fuccio et al. in Gastrointest Endosc 86:74–86.e17, 2017]. Increased ESD training in the US can help optimize utilization and outcomes.

The one-year and median overall survival (mOS) rates of advanced gastroesophageal adenocarcinomas (GEA) are ∼50% and Significance:This study highlights excellent outcomes achieved by individually optimizing chemotherapy, biomarker profiling, and matching of targeted therapies at baseline and over time for GEA. Testing a predefined treatment strategy resulted in improved outcomes versus historical controls. Therapeutic resistance observed in correlative analyses suggests that dual targeted inhibition may be beneficial.This article is highlighted in the In This Issue feature, p. 211

BACKGROUND Infantile-onset inflammatory bowel disease (IO-IBD) occurs in very young children and causes severe clinical manifestations, which has poor responses to traditional inflammatory bowel disease (IBD) treatments. At present, there are no simple and reliable laboratory indicators for early screening IO-IBD patients, especially those in whom the disease is caused by monogenic diseases. AIM To search for valuable indicators for early identifying IO-IBD patients, especially those in whom the disease is caused by monogenic diseases. METHODS A retrospective analysis was performed in 73 patients with IO-IBD admitted to our hospital in the past 5 years. Based on the next-generation sequencing results, they were divided into a monogenic IBD group (M-IBD) and a non-monogenic IBD group (NM-IBD). Forty age-matched patients with allergic proctocolitis (AP) were included in a control group. The clinical manifestations and the inflammatory factors in peripheral blood were evaluated. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to identify the screening factors and cut-off values of IO-IBD as well as monogenic IO-IBD, respectively. RESULTS Among the 44 M-IBD patients, 35 carried IL-10RA mutations, and the most common mutations were c.301C>T (p.R101W, 30/70) and the c.537G>A (p.T179T, 17/70). Patients with higher serum tumor necrosis factor (TNF)-α value were more likely to have IBD [odds ratio (OR) = 1.25, 95% confidence interval (CI): 1.05-1.50, P = 0.013], while higher serum albumin level was associated with lower risk of IBD (OR = 0.86, 95%CI: 0.74-1.00, P = 0.048). The cut-off values of TNF-α and albumin were 17.40 pg/mL (sensitivity: 0.78; specificity: 0.88) and 36.50 g/L (sensitivity: 0.80; specificity: 0.90), respectively. The increased ferritin level was indicative of a genetic mutation in IO-IBD patients. Its cut-off value was 28.20 ng/mL (sensitivity: 0.93; specificity: 0.92). When interleukin (IL)-10 level was higher than 33.05 pg/mL (sensitivity: 1.00; specificity: 0.84), or the onset age was earlier than 0.21 mo (sensitivity: 0.82; specificity: 0.94), the presence of disease-causing mutations in IL-10RA in IO-IBD patients was strongly suggested. CONCLUSION Serum TNF-α and albumin level could differentiate IO-IBD patients from allergic proctocolitis patients, and serum ferritin and IL-10 levels are useful indicators for early diagnosing monogenic IO-IBD.

Chang'e-3(CE-3) has been the first spacecraft to soft-land on the Moon since the Soviet Union's Luna 24 in 1976. The spacecraft arrived at Mare Imbrium on December 14, 2013 and the same day, Yutu lunar rover separated from lander to start its exploration of the surface and the subsurface around the landing site. The rover was equipped, among other instruments, with two Lunar Penetrating Radar systems (LPR) having a working frequency of 60 and 500 MHz. The radars acquired data for about two weeks while the rover was slowly moving along a path of about 114 m. At Navigation point N0209 the rover got stacked into the lunar soil and after that only data at fixed position could be collected. The low frequency radar data have been analyzed by different authors and published in two different papers, which reported totally controversial interpretations of the radar cross sections. The present study is devoted to resolve such controversy carefully analyzing and comparing the data collected on the Moon by Yutu rover and on Earth by a prototype of LRP mounted onboard a model of the CE-3 lunar rover. Such analysis demonstrates that the deep radar features previously ascribed to the lunar shallow stratigraphy are not real reflectors, rather they are signal artefacts probably generated by the system and its electromagnetic interaction with the metallic rover.

The diagnosis of invasive adenocarcinoma of the gallbladder can sometimes be challenging. The presence of true desmoplastic reaction facilitates the diagnosis of invasion. However, desmoplasia-like changes can be observed in benign gallbladder conditions, and recognition of desmoplasia may be challenging based on morphology. In this study, we tested the expression pattern of microfibril-associated protein 5 (MFAP5), a promising immunohistochemical marker for desmoplasia, in benign gallbladders with desmoplasia-like reaction and gallbladders with invasive adenocarcinoma. We also evaluated the diagnostic utility of MFAP5 in challenging cases with an interobserver agreement study. The results showed that all benign cases retained intact/positive MFAP5 staining pattern in periglandular connective tissue, whereas 79.3% (23 out of 29) of cases of adenocarcinomas demonstrated diffuse and complete loss of MFAP5 staining in the tumor stroma. Interobserver agreement was improved by 2.66 times when images of MFAP5 immunohistochemistry were provided. In conclusion, MFAP5 expression is downregulated in the desmoplastic stroma of gallbladder adenocarcinoma and may provide a useful diagnostic marker in difficult cases.

Background Despite its benefits, a major concern regarding antipsychotic treatment is its possible impact on the brain’s structure and function. This study sought to explore the characteristics of white matter structural networks in chronic never-treated schizophrenia and those treated with clozapine or risperidone, and its potential association with cognitive function. Methods Diffusion tensor imaging was performed on a unique sample of 34 schizophrenia patients treated with antipsychotic monotherapy for over 5 years (17 treated with clozapine and 17 treated with risperidone), 17 never-treated schizophrenia patients with illness duration over 5 years, and 27 healthy control participants. Graph theory and network-based statistic approaches were employed. Results We observed a disrupted organization of white matter structural networks as well as decreased nodal and connectivity characteristics across the schizophrenia groups, mainly involving thalamus, prefrontal, and occipital regions. Alterations in nodal and connectivity characteristics were relatively milder in risperidone-treated patients than clozapine-treated patients and never-treated patients. Altered global network measures were significantly associated with cognitive performance levels. Structural connectivity as reflected by network-based statistic mediated the difference in cognitive performance levels between clozapine-treated and risperidone-treated patients. Limitations These results are constrained by the lack of random assignment to different types of antipsychotic treatment. Conclusion These findings provide insight into the white matter structural network deficits in patients with chronic schizophrenia, either being treated or untreated, and suggest white matter structural networks supporting cognitive function may benefit from antipsychotic treatment, especially in those treated with risperidone.

For realizing the coupling pyrolysis of coal and combustion of semi-coke, this paper explored the effect of pyrolysis temperature on the combustion characteristics and NO emission of Pingshuo semi-coke. The main physical and chemical properties, which might affect the NO emission, were also investigated systematically. As the pyrolysis temperature increased, the nitrogen content of semi-coke gradually decreased and the proportion of quaternary nitrogen (N-Q) gradually increased. CaO produced by the decomposition of CaCO3 would promote the transformation from HCN to NO. Pore structure was most developed at 750 °C, which was beneficial to the conversion of HCN and reduction of NO. Combustion experiments were carried out on a thermogravimetric–mass spectrometry. It was found that increasing the pyrolysis temperature would cause the combustion reaction to occur at a higher temperature. Evolved gases during the combustion were quantitatively analyzed by equivalent characteristic spectrum analysis. The yield of HCN during combustion first decreased and then increased and the yield of NO decreased while the pyrolysis temperature increased. There was an optimum pyrolysis temperature for the minimum conversion rate of fuel-N to NO and HCN. For Pingshuo bituminous, this optimum pyrolysis temperature was 750 °C.

Regarding the financial support provided to micro and small enterprises (MSEs), deciding whether to prioritize economic benefit or social responsibility is a crucial policy choice, especially in developing countries. This paper establishes a new research framework for density of enterprise output value and wages conditional on loans to balance economic benefit (sales revenue) and social responsibility (employee payroll). Using data on 9125 Chinese enterprises from January 2015 to December 2017, this paper shows that loans have a range effect on sales revenue and employee payroll, which ascends gradually to a plateau and eventually descends. Based on this finding, this paper proposes a reallocation scheme. With total loans unchanged, fixed sales revenue can increase employee payroll by 3.8%. Similarly, fixed employee payroll can increase sales revenue by 5.2%. This study not only provides empirical evidence for financially supporting MSEs, but also provides alternative decision support for policy design.

Coronavirus disease 2019 (COVID-19) is a novel and lethal infectious disease, posing a threat to global health security. The number of cases has increased rapidly, but no data concerning kidney transplant (KTx) recipients infected with COVID-19 are available. To present the epidemiological, clinical, and therapeutic characteristics of KTx recipients infected with COVID-19, we report on a case series of five patients who were confirmed as having COVID-19 through nucleic acid testing (NAT) from January 1, 2020 to February 28, 2020. The most common symptoms on admission to hospital were fever (five patients, 100%), cough (five patients, 100%), myalgia or fatigue (three patients, 60%), and sputum production (three patients, 60%); serum creatinine or urea nitrogen levels were slightly higher than those before symptom onset. Four patients received a reduced dose of maintenance immunosuppressive therapy during hospitalization. As of March 4, 2020 NAT was negative for COVID-19 in three patients twice in succession, and their computed tomography scans showed improved images. Although greater patient numbers and long-term follow-up data are needed, our series demonstrates that mild COVID-19 infection in KTx recipients can be managed using symptomatic support therapy combined with adjusted maintenance immunosuppressive therapy.

Though gray matter deficits have been consistently revealed in chronic treated schizophrenia, it is still not clear whether there are different brain alterations between chronic never treated and treated patients. To explore the different patterns of gray matter alterations among chronic never treated patients and those treated with monotherapy, we recruited 35 never-treated chronic schizophrenia patients with illness durations ranging from 5 to 48 years, 20 illness duration-matched risperidone monotherapy and 20 clozapine monotherapy patients, and 55 healthy controls. GM (surface area, cortical thickness, and cortical volume) measures were extracted and compared using ANCOVA across the four groups followed by post hoc tests. Relative to controls, both treated and never-treated chronic schizophrenia patients showed reduced GM mainly involving the bilateral medial and rostral middle frontal, left banks superior temporal sulcus, left fusiform, and left pericalcarine cortex and increased in the left cuneus. Compared with the untreated patient group, the two treated groups showed reductions mainly in the bilateral prefrontal, temporal, and left inferior parietal lobules. The clozapine monotherapy patients demonstrated more severe decreases in the bilateral prefrontal cortex and left cuneus and less severe decreases in the left ventral temporal lobe than risperidone monotherapy patients. These findings provide new insights into the long-term effects of antipsychotic treatment on gray matter alterations in schizophrenia patients. Furthermore, the characteristic findings of reductions in the inferior parietal lobule might be specific for long-term antipsychotic treatment, which could be a possible target for medication development in the future.

The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of desmoplastic small round cell tumor, breast, and gastrointestinal stromal tumor specifically related to peritoneal surface malignancy. These guidelines are developed with input from leading experts including surgical oncologists, medical oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence.

The Chicago Consensus Working Group provides multidisciplinary recommendations for palliative care specifically related to peritoneal surface malignancies. These guidelines are developed with input from leading experts including surgical oncologists, medical oncologists, gynecologic oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence.

The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of neuroendocrine tumors specifically related to the management of peritoneal surface malignancy. These guidelines are developed with input from leading experts, including surgical oncologists, medical oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence.

Given the global epidemic of obesity, numerous strategies have been employed in the management of metabolic syndrome (MS) in this population. A meta-analysis was designed in the present investigation to evaluate the benefits of tea extract (TE) supplementation in MS in obesity.We conducted searches of published literature in MEDLINE, PsycINFO, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception in 1985 to May 2017. Randomized controlled trials (RCTs) which studied TE consumption in obesity with MS were analyzed. Results were summarized using weighted mean differences (WMDs), standardized mean differences (SMDs) or odds ratio (OR) by suitable effect model.Sixteen eligible randomized controlled trials, including 1090 subjects were identified. Benefits were demonstrated on reduction of Body Mass Index (BMI) (SMD, -0.27; 95% CI, -0.40 to -0.15, P 0.0001) and blood glucose (SMD, -0.22; 95% CI, -0.34 to -0.10, P = 0.0003), and increasing high-density lipoprotein (HDL) (SMD, 0.18; 95% CI, 0.01 to 0.35, P = 0.03). Limited benefits without significance were observed on blood pressure and other anthropometric, cholesterol, and biochemistry outcomes. All-cause adverse events were minimal (0.99; 95% CI: 0.55, 1.77, P = 0.97).This meta-analysis suggests that consumption of TE supplementation in the obese with MS has beneficial effects on improvement of lipid and glucose metabolism, as well as in the facilitation of weight loss.

Irritable bowel syndrome (IBS) is a functional bowel disorder that may involve disturbance of the gastrointestinal microbiota. We performed a systematic review and meta-analysis of the efficacy and safety of probiotics in patients with IBS.We searched the Cochrane Library, PubMed, EMBASE and Web of Science databases up to 1 April, 2019. Randomized controlled trials (RCTs) involving adults with IBS that compared probiotics to placebo or no therapy were eligible for the analysis. Dichotomous symptom data were pooled to calculate the relative risk (RR) with a 95% confidence interval (CI) of remaining symptoms after therapy. Continuous data were pooled using a standardized mean difference (SMD) with the 95% CI. Two reviewers assessed trial quality and extracted data independently.Thirty-five RCTs involving 3,452 patients were included in the analysis. Compared with placebo, patients using probiotics had a lower incidence of persistence of symptoms (RR 0.79, 95% CI 0.70 to 0.89, P 0.0001). Also, probiotics exerted a beneficial effect on global symptoms and the abdominal pain score (SMD -0.25, 95% CI -0.36 to -0.14, P 0.00001), bloating score (SMD -0.15, 95% CI -0.27 to -0.03, P = 0.01), and flatulence score (SMD -0.20, 95% CI -0.35 to -0.05, P = 0.01). However, patients treated with probiotics had a higher incidence of any adverse event (RR 1.21; 95% CI 1.02 to 1.44).Supplementation with multi-strain probiotics can improve IBS symptoms. Further research is required if probiotics are to be adopted as a treatment for IBS.

Mild thyroid peroxidase (TPO) deficiency is rare and can be extremely occult. This study aimed to replenish the phenotypic and genetic spectrum of mild TPO deficiency. Four unrelated patients with progressive goiter were described in this study. Genes associated with congenital hypothyroidism were analyzed and in vitro functional experiments were conducted to evaluate the residual TPO enzyme activities of each mutant. The four patients (age: 5–27 years old) were characterized by progressive goiter, discordant alteration in thyroid hormones with free triiodothyronine (FT3) to free thyroxine (FT4) ratio ranging from 0.557 to 1.012, two with slightly elevated TSH level and two with normal TSH level. Six different mutations of TPO gene were identified including three novel mutations (p.Glu337Lys, p.Ala544Val, and p.Glu641Lysfs∗21). Two mutants (p.Asp224del and p.Ala544Val) with residual TPO activity of 41 and 65% may explain the mild TPO-deficient picture in our study. After levothyroxine (L-T4) therapy, three patients showed gradual decline of FT3 to FT4 ratio and two patients showed reduced thyroid size. Patients with mild TPO deficiency can present with progressive goiter, normal TSH level, and largely reserved TPO activities.

A droplet-impacted fabric surface deposition process was established based on the two-phase volume of fluid (VOF) computing model. This study was important because implementation of drop-on-demand 3D printing used for forming flexible conductive lines on fabric depends on understanding the droplet deposition mechanism. The interaction of droplets and the fabric substrate, as well as the penetration process, were simulated. The distribution of pressure and velocity, and the influence of surface tension and viscosity, in the droplet deposition process were also studied. The simulation and confirmatory experimental results show that the internal pressure gradient in the liquid was the main reason for the droplet spreading, penetration, and bubble formation. These research results lay a theoretical foundation for droplet spray printing of conductive lines on fabric surfaces.

Objective Mutations in optineurin (OPTN) have been identified in familial and sporadic amyotrophic lateral sclerosis (ALS). We screened a cohort of Chinese patients for mutations in optineurin. We also performed an extensive literatures review of all mutations in optineurin identified previously to detect genotype–phenotype associations. Methods All 16 exons of the OPTN gene in a cohort of 15 familial ALS indexes and 275 sporadic ALS patients of Chinese origin were sequenced by targeted next generation sequencing. Results Two known heterozygous missense mutations in the OPTN, c.1481T> G (p.L494W), and c.1546G> C (p.E516Q), as well as one novel heterozygous missense mutation c.1690G> C (p.D564H) were each detected in one sporadic ALS patient. The patient carrying the p.E516Q mutation developed clinical features of ALS‐frontotemporal dementia (FTD) and the patient carrying the p.D564H mutation showed a phenotype of ALS. They both had an aggressive course, with a survival of 18 and 14 months respectively. Literature review showed that the clinical phenotypes in OPTN mutated ALS were not homogeneous, although some individuals showed a relatively slow progression and a long duration, some mutations carriers developed an aggressive progression and a short survival. Interpretation OPTN mutations contribute to ALS in Chinese population and account for 0.8% of sporadic ALS patients and 1.5% of familial ALS in the pooled Chinese ALS cohorts. Mutations in optineurin can cause aggressive ALS+/−FTD.

The use of deep learning models as priors for compressive sensing tasks presents new potential for inexpensive seismic data acquisition. Conventional recovery usually suffers from undesired artifacts, such as oversmoothing, and high computational cost. Generative adversarial networks (GANs) offer promising alternative approaches that can improve quality and reveal finer details. An appropriately designed Wasserstein GAN trained on several historical surveys and capable of learning the statistical properties of the seismic wavelet's architecture is proposed. The efficiency and precision of this model at compressive sensing are validated in three steps. First, the existence of a sparse representation with different compression rates for seismic surveys is studied. Then, nonuniform samplings are studied using the proposed methodology. Finally, a recommendation is proposed for a nonuniform seismic survey grid based on the evaluation of reconstructed seismic images and metrics. The primary goal of the proposed deep learning model is to provide the foundations of an optimal design for seismic acquisition without a loss in imaging quality. Along these lines, a compressive sensing design of a nonuniform grid over an asset in the Gulf of Mexico, versus a traditional seismic survey grid that collects data uniformly every few feet, is suggested, leveraging the proposed method.

Amorphous InGaZnO (a-IGZO) thin-film transistors (TFTs) with HfLaO as high-k gate dielectric have been fabricated, and p-type silicon wafers with resistivities of 0.001 ~ 0.002, 0.005, 0.02 ~ 0.021 and $5\sim 10\Omega \cdot $ cm are used as their gate electrodes. The carrier mobility of the samples show an increase with increasing gate acceptor concentration, indicating that the TFT performances are affected by the hole concentration in the gate electrode. The HfLaO gate dielectric is highly polarizable and so produces surface-optical phonons, which can scatter the electrons in the IGZO channel to reduce their mobility. Therefore, this work directly demonstrates that the holes in the gate electrode can have a screening effect to suppress this remote phonon scattering of the gate dielectric on the channel carriers, just like the electrons in the metal gate, ITO gate and n-silicon gate of field-effect transistors.

Although regional brain deficits have been demonstrated in schizophrenia patients by structural MRI studies, one important question that remains largely unanswered is whether the complex and subtle deficits revealed by MRI could be used as objective biomarkers to discriminate patients from healthy controls individually. To address this question, a total of 326 right-handed participants were recruited, including 163 drug-naive first-episode schizophrenia (FES) patients and 163 demographically matched healthy controls. High-resolution anatomic data were acquired from all subjects and processed via Freesurfer software to obtain cortical thickness and surface area measurements. Subsequently, the Support Vector Machine (SVM) was used to explore the potential utility for cortical thickness and surface area measurements in the differentiation of individual patients and healthy controls. The accuracy of correct classification of patients and controls was 85.0% (specificity 87.0%, sensitivity 83.0%) for surface area and 81.8% (specificity 85.0%, sensitivity 76.9%) for cortical thickness (p

As the spatial resolution of remote sensing images is improving gradually, it is feasible to realize “scene-object” collaborative image interpretation. Unfortunately, this idea is not fully utilized in vehicle detection from high-resolution aerial images, and most of the existing methods may be promoted by considering the variability of vehicle spatial distribution in different image scenes and treating vehicle detection tasks scene-specific. With this motivation, a scene context-driven vehicle detection method is proposed in this paper. At first, we perform scene classification using the deep learning method and, then, detect vehicles in roads and parking lots separately through different vehicle detectors. Afterward, we further optimize the detection results using different postprocessing rules according to different scene types. Experimental results show that the proposed approach outperforms the state-of-the-art algorithms in terms of higher detection accuracy rate and lower false alarm rate.

The checkerboard broth method based on the Clinical and Laboratory Standards Institute M38-A3 document was used in this study to evaluate the in vitro activity of allicin alone and in combination with the antifungal drugs (griseofulvin, fluconazole, itraconazole and terbinafine) against Microsporum canis isolated from patients with tinea capitis. When allicin was used alone, only weak anti-M. canis effects were found. The MIC50, MIC90 and geometric mean (GM) of terbinafine were the lowest among the compounds tested. Synergism was observed for the combinations of allicin with itraconazole and terbinafine. Only indifference was observed for the combinations of allicin with griseofulvin and fluconazole. Our study illustrated the synergism of allicin in combination with itraconazole and terbinafine, which could be a reference for the treatment of tinea capitis due to M. canis.

It has been reported that osteoporosis is a possible risk factor of benign paroxysmal positional vertigo (BPPV). We analyzed the correlation between osteoporosis and BPPV and the possible mechanism by performing evidence-based medicine meta-analysis and bioinformatics analysis. Initially, English articles related to osteoporosis and BPPV were obtained through PubMed and EMBASE databases. Stata12.0 software was used for meta-analysis to calculate the odd ratio (OR) and 95% confidence interval (CI) of outcome indicators, and the heterogeneity was evaluated by subgroup analysis, publication bias evaluation, and sensitivity analysis. In addition, microarray datasets related to BPPV and osteoporosis were obtained from gene expression omnibus (GEO) database to screen differentially expressed genes. At last, a mouse model of osteoporosis was established by bilateral oophorectomy for validation. RT-qPCR and Western blot analysis were performed to determine expression of related factors in mouse tissues. Osteoporosis was suggested as an important risk factor for BPPV through meta-analysis of these 12 articles. It was found that PPP2CA was upregulated in BPPV and low bone mineral density (BMD) samples. Moreover, PPP2CA induced dephosphorylation of BCL2, which may be involved in BPPV through regulation of BMD. Through this mechanism, silencing of PPP2CA could elevate the incidence of BPPV by promoting bone remodeling and reducing the density of otoconia around the macula. PPP2CA reduces BMD expression by inducing dephosphorylation of BCL2, which may be one of the mechanisms responsible for the onset of BPPV in osteoporosis.

Background The corpus callosum (CC) deficits have been well documented in chronic schizophrenia. However, the long-term impacts of antipsychotic monotherapies on callosal anatomy remain unclear. This cross-sectional study sought to explore micro- and macro-structural characteristics of the CC in never-treated patients and those with long-term mono-antipsychotic treatment. Methods The study included 23 clozapine-treated schizophrenia patients (CT-SCZ), 19 risperidone-treated schizophrenia patients (RT-SCZ), 23 never-treated schizophrenia patients (NT-SCZ), and 35 healthy controls (HCs). High resolution structural images and diffusion tensor imaging (DTI) data for each participant were obtained via a 3.0 T MR scanner. FreeSurfer was used to examine the volumes and fractional anisotropy (FA) values of the CC for each participant. Results There were significant deficits in the total and sub-regional CC volume and white matter integrity in NT-SCZ in comparison with healthy subjects. Compared with NT-SCZ, both CT-SCZ and RT-SCZ showed significantly increased FA values in the anterior CC region, while only RT-SCZ showed significantly increased volume in the mid-anterior CC region. Moreover, the volume of the mid-anterior CC region was significantly smaller in CT-SCZ compared to HCs. No correlations of clinical symptoms with callosal metrics were observed in schizophrenia patients. Conclusions Our findings provide insight into micro- and macro-structural characteristics of the CC in chronic schizophrenia patients with or without antipsychotics. These results suggest that the pathology itself is responsible for cerebral abnormalities in schizophrenia and that chronic exposure to antipsychotics may have an impact on white matter structure of schizophrenia patients, especially in those with risperidone treatment.

Network Public Opinion is significant in maintaining social harmony and stability and promoting transparency in government affairs. However, with the development of economy and transformation of society, our country has entered a high-risk period, which is full of unexpected public events. Unexpected mass accidents also cause hot discussions among the Internet users once they are exposed on the network. Different ideas, opinions, emotions, and attitudes about unexpected public events will be collected and collide on the Internet. It makes Network Public Opinion play an increasingly important role in the evolution of unexpected public events. It could promote the spread and upgrade of unexpected public events and bring more and more profound influence on to our social life. We use the case study method to analyze and solve the problems by applying the dynamic principles of the SIR epidemic model, comprehensively considering the social environment and various influencing factors, and constructing a mathematical model for the spread of network group events. The study uses Matlab to simulate the change trajectory of the number of participants in the network group events. By adjusting the number of contacts φ in the model, the development of network group emergencies can be effectively controlled and managed. As long as the government takes timely intervention measures, the dissemination of network group events can be basically controlled. Combined with public opinion big data to discover the important factors affecting the spread of public opinion, the control effect is obvious.

Esophageal cancer is the eighth most common cancer and the sixth leading cause of cancer death worldwide. Hence, for a better understanding of tumor microenvironment and to seek for novel molecular targets for esophageal cancer, we performed related studies on two histopathological subtypes of esophageal cancer: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). Bioinformatic analyses were conducted based on the RNA-seq, genomic mutation, and clinical data from TCGA and GEO cohorts. We clustered patients into high-immunity and low-immunity groups through the ssGSEA results. The ESTIMATE algorithm was used to evaluate the tumor microenvironment. Patients with high immunity in both ESCC and EAC had lower tumor purity and poor survival. Subsequently, CIBERSORT was performed to learn about the detailed difference of tumor-infiltrating lymphocytes (TILs) between high- and low-immunity patients. Specific increase of M2 macrophages and decrease of activated dendric cells can be observed in ESCC and EAC, respectively. The most enriched functions and pathways of high-immunity patients were immunoglobulin complex, MHC class II protein complex, and allograft rejection according to the GO terms and KEGG. Two prognostic immune-related multi-lncRNA risk models were constructed and validated by ROC curve and PCA in ESCC and EAC. High-risk patients in both subtypes had poor survival, advanced clinical characteristics, and higher drug susceptibility except cisplatin and sorafenib. In addition, the tumor mutation burden (TMB) was positively correlated with the risk level in the ESCC and EAC and showed distinct differences between the two subtypes. In summary, we comprehensively analyzed the tumor microenvironment for two subtypes of esophageal cancer, identified two multi-lncRNA signatures predictive for the prognosis, and explored the possibility of the signatures to forecast drug susceptibility as well as TMB for the first time. The findings may serve as a conceptual basis for innovative strategy of individualized immunotherapy for esophageal cancer.

Mucinous cystic neoplasm (MCN) of the pancreas is an exocrine cystic tumor with a potential of harboring malignancy. The latest World Health Organization classification of tumors of digestive system designates malignant MCN as MCN with associated invasive carcinoma (MCN-AIC). Since its separation from other pancreatic cystic tumors in 1978, much progress has been made in our understanding of MCN in epidemiology, clinical and pathological features, biological behavior, as well as prognostic characteristics. This review aims to summarize the current knowledge of MCN and MCN-AIC.

Radially symmetric Airy-like beams have the ability to autofocus abruptly, which leads to a wild application, for instance, particle manipulation and light bullets. On the basic of the theory of 1D self-accelerating Airy beam, this thesis starts the research on propagation property of Airy-like self-focusing pin-like beams. Based on the theory of stationary phase calculation, we obtain the trajectory function of Airy-like beams and dynamics of the optical beam before the focus and beyond. With the method of beam split-step Fourier method, we theoretically analyze the transverse and longitude amplitude trending of this optical beam. It turns out that Airy-like beam propose an abruptly autofocusing property like circularly symmetric Airy beam, its propagation follows a parabolic trajectory and tends to focus on the axial; after focusing, the optical beam morphs into a Bessel-like beam, its main lobe size decreases during the propagation and finally becomes pin-like.

A 4 year old boy presented with annular erythema on his nose. The lesion had begun as a small itchy macule seven days earlier. Initially, discoid eczema was diagnosed and he was treated with hydrocortisone butyrate ointment for three days. Although the pruritus improved, the skin rash became more extensive. The patient had no history of preceding injury or insect bite. The household had a cat. On physical examination, an annular erythematous lesion (1 cm ×1 cm) without scaling was observed on the boy’s nose (fig 1). Fig 1 1 cm × 1 cm infiltrated annular erythema without scaling on …

Background: Antipsychotic medications provide limited long-term benefit to ~30% of schizophrenia patients. Multimodal magnetic resonance imaging (MRI) data have been used to investigate brain features between responders and nonresponders to antipsychotic treatment; however, these analytical techniques are unable to weigh the interrelationships between modalities. Here, we used multiset canonical correlation and joint independent component analysis (mCCA + jICA) to fuse MRI data to examine the shared and specific multimodal features between the patients and healthy controls (HCs) and between the responders and non-responders.Method: Resting-state functional and structural MRI data were collected from 55 patients with drug-naïve first-episode schizophrenia (FES) and demographically matched HCs. Based on the decrease in Positive and Negative Syndrome Scale scores from baseline to the 1-year follow-up, FES patients were divided into a responder group (RG) and a non-responder group (NRG). Gray matter volume (GMV), fractional amplitude of low-frequency fluctuation (fALFF), and regional homogeneity (ReHo) maps were used as features in mCCA + jICA.Results: Between FES patients and HCs, there were three modality-specific discriminative independent components (ICs) showing the difference in mixing coefficients (GMV-IC7, GMV-IC8, and fALFF-IC5). The fusion analysis indicated one modality-shared IC (GMV-IC2 and ReHo-IC2) and three modality-specific ICs (GMV-IC1, GMV-IC3, and GMV-IC6) between the RG and NRG. The right postcentral gyrus showed a significant difference in GMV features between FES patients and HCs and modality-shared features (GMV and ReHo) between responders and nonresponders. The modality-shared component findings were highlighted by GMV, mainly in the bilateral temporal gyrus and the right cerebellum associated with ReHo in the right postcentral gyrus.Conclusions: This study suggests that joint anatomical and functional features of the cortices may reflect an early pathophysiological mechanism that is related to a 1-year treatment response.

Although tinea capitis is common in children, but it is rare in newborns. It should be differentiated with neonatal lupus erythematosus, nummular eczema, psoriasis, seborrheic dermatitis, erythema annular centrifugum, annular urticaria, and annular erythema of infancy. Tinea capitis usually needs oral antifungal therapy, but the data of use in newborn is limited. Here, we report a case of tinea capitis caused by Microsporum canis in a 23-day-old female newborn. The patient was given itraconazole oral solution pulse therapy with an excellent outcome. Itraconazole oral solution pulse therapy may be a promising therapy for tinea capitis in infants, especially in newborns.

OBJECTIVES: Little is known about the effect of antibiotic treatment on the gut microbiota in children with chronic pancreatitis (CCP). Our objective was to identify the main gut microbiota genera and characterize these patients’ functional mutations after using antibiotics.METHODS: The 16S rRNA sequencing method was used to compare the gut microbiota of healthy controls (HCs) with CCP using and not using antibiotics.RESULTS: All CCP demonstrated a significantly reduced alpha diversity of the gut microbiota (P＜0.01). The gut microbiota's alpha diversity and the abundance of genera’s beta diversity did not show statistical differences between the non-antibiotics and antibiotics groups. There were 15 altered genera with common abundance in the non-antibiotics and antibiotics groups compared to the HC group. The area under the curve (AUC) of the top three probiotics, i.e., Faecalibacterium, Eubacterium, and Subdoligranulum, was 0.91. Among the 13 genera altered in the non-antibiotics group, the top three genera were not appropriate as biomarkers for cases receiving antibiotics. Compared to these 13 genera, the differences between the genera and the proportion of gram-positive bacteria in the 17 genera altered only in the antibiotics group were not statistically significant. The Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis indicated that the antibiotics caused alterations in the abundance of certain genera. The enriched functions and the altered gut microbiota in the two groups had their enriched functions.CONCLUSIONS: The use of antibiotics affects the gut microbiota of CCP, but the effect of disease on gut microbiota is still obvious.

Crohn's disease (CD) is a chronic granulomatous disease that affects the gastrointestinal system. Additionally, CD has multiple extraintestinal manifestations, and bronchopulmonary manifestations are extremely rare. Pulmonary lesions can occur before the diagnosis of CD; thus, pulmonary manifestations are often overlooked, which leads to misdiagnoses. Herein, we present a case with pulmonary nodules being exhibited before the patient was diagnosed with CD. To the best of our knowledge, only a few cases concerning this phenomenon have been reported. We describe an 11-year-old boy with a two-year history of anemia and without any gastrointestinal symptoms. He did not receive any thorough inspection until arthralgia occurred. Multiple nodules were found in his bilateral lungs via computed tomography scan. Combined with the child's medical history, physical examinations, and all of the investigations, the final diagnosis was CD with pulmonary nodules and arthritis. After 2 months of treatment, the patient's symptoms had significantly improved. To summarize the clinical manifestations, auxiliary examination features, and treatments of CD in children with pulmonary involvement, we also review the relevant characteristics of pulmonary involvement in CD patients. This case indicates the importance of recognizing the pulmonary manifestations of CD. Clinicians should be aware of the possibility of CD when their patients have lung nodules, even in children with no typical manifestations of CD.

Having shown great performance in human parsing, convolutional neural networks(CNNs) come with much computation budget. In this paper, a novel class-level aware network(CANet), which employs an asymmetric encoder-decoder architecture, is presented to achieve reliable human parsing results in a memory friendly way. To achieve the trade-off between speed and accuracy in human parsing, we design group-split-bottleneck(GS-bt) block, where group convolution and channel split are utilized in the residual block. In decoder network, the attention pyramid pooling module(APPM) is proposed to recovering the details of human parsing. Moreover, a multi-class classification branch is developed to extract class-level information and revise human parsing results. Compared to current models, our model has less parameters and experiments demonstrate that the proposed CANet can reach state-of-the-art results on PASCAL-Person-Part dataset.