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Objectives: Thrombomodulin (TM) is closely related to the pathogenesis of autoimmune diseases, including systemic lupus erythematosus (SLE). However, current evidence on circulating TM levels in SLE patients is contradictory. We conducted this meta-analysis to more accurately assess circulating TM levels in patients with SLE and lupus nephritis (LN) and to analyze related influencing factors. Methods: Systematic search of relevant documents was conducted in PubMed, Embase, and The Cochrane Library databases (up to 28 February 2021). Studies on the comparison of circulating TM between SLE patients and controls were screened and evaluated for inclusion. Random-effects model analysis was applied to calculate the combined standardized mean difference (SMD) with a 95% confidence interval (CI). Heterogeneity was estimated by Q statistics and I2. Results: A total of 353 articles were identified, 14 provided adequate information for this study finally. The results illustrated that SLE patients had higher TM levels than healthy controls (SMD=0.38, 95% CI: 0.02 to 0.74, p=0.04). Circulating TM levels were increased in patients with active SLE compared to inactive SLE patients (SMD=1.12, 95% CI: 0.03 to 2.20, p=0.04). In addition, circulating TM levels of SLE patients with LN were higher than those without LN (SMD=4.55, 95% CI: 1.97 to 7.12, p=0.001). Conclusions: The circulating TM levels in SLE patients are enhanced. In addition, circulating TM levels may be practical in reflecting the disease activity and nephritis involvement of SLE patients.

Background & Aims Non-alcoholic fatty liver disease (NAFLD), the hepatic correlate of the metabolic syndrome, is a major risk factor for hepatobiliary cancer (HBC). Although chronic inflammation is thought to be the root cause of all these diseases, the mechanism whereby it promotes HBC in NAFLD remains poorly understood. Herein, we aim to evaluate the hypothesis that inflammation-related dysregulation of the ESRP2-NF2-YAP/TAZ axis promotes HB carcinogenesis. Methods We use murine NAFLD models, liver biopsies from patients with NAFLD, human liver cancer registry data, and studies in liver cancer cell lines. Results Our results confirm the hypothesis that inflammation-related dysregulation of the ESRP2-NF2-YAP/TAZ axis promotes HB carcinogenesis, supporting a model whereby chronic inflammation suppresses hepatocyte expression of ESRP2, an RNA splicing factor that directly targets and activates NF2, a tumor suppressor that is necessary to constrain YAP/TAZ activation. The resultant loss of NF2 function permits sustained YAP/TAZ activity that drives hepatocyte proliferation and de-differentiation. Conclusion Herein, we report on a novel mechanism by which chronic inflammation leads to sustained activation of YAP/TAZ activity; this imposes a selection pressure that favors liver cells with mutations enabling survival during chronic oncogenic stress. Lay summary Non-alcoholic fatty liver disease (NAFLD) increases the risk of hepatobiliary carcinogenesis. However, the underlying mechanism remains unknown. Our study demonstrates that chronic inflammation suppresses hepatocyte expression of ESRP2, an adult RNA splicing factor that activates NF2. Thus, inactive (fetal) NF2 loses the ability to activate Hippo kinases, leading to the increased activity of downstream YAP/TAZ and promoting hepatobiliary carcinogenesis in chronically injured livers.

Hand, foot and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) is a contagious viral disease, and toll-like receptors (TLRs) play essential roles in resisting the pathogen. The aim of this study was to assess the potential relationship between several TLRs polymorphisms and the HFMD severity in a Chinese children population. A total of 328 Chinese children with HFMD were included in the present study. The polymorphisms of TLR3 (rs3775290, rs3775291, rs3775296, rs1879026, rs5743312, rs5743313, rs5743303, rs13126816 and rs3775292), TLR4 (rs4986790, rs4986791, rs2149356, rs11536889 and rs41426344), TLR7 (rs179009, rs179010, rs179016, rs3853839, rs2302267, rs1634323 and rs5741880) and TLR8 (rs3764880, rs2159377, rs2407992, rs5744080, rs3747414, rs3764879 and rs5744069) genes were selected. The study indicated that individuals with the GG genotype of TLR3 single nucleotide polymorphism (SNP) rs1879026 had a higher risk of developing severe cases (GG vs GT: OR=1.875, 95% CI, 1.183-2.971, P=0.007). Meanwhile, TLR3 rs3775290 CC genotype and C allele were associated with lower disease severity in females (CC vs CT: OR=0.350, 95% CI, 0.163-0.751, P=0.006; C vs T: OR=0.566, 95% CI, 0.332-0.965, P=0.036). TLR3 rs3775291 CC genotype showed 2.537 folds higher risk of developing severe cases in females (CC vs CT: OR=2.537, 95% CI, 1.108-5.806, P=0.026). Moreover, TLR3 rs1879026 GG genotype was found to be related to increased risk of severe cases in males (GG vs GT: OR=2.076, 95% CI, 1.144-3.768, P=0.016). The current findings show that the genetic variants of TLR3 rs1879026, rs3775290 and rs3775291 are associated with the severity of EV-A71-associated HFMD in the Chinese children population. This article is protected by copyright. All rights reserved.

Cardiovascular diseases are a major cause of morbidity and mortality worldwide and there is an urgent need to develop new pharmacotherapies for managing cardiovascular diseases. In China, traditional Chinese medicine has been used in clinical settings for thousands of years. Although traditional Chinese medicine is very popular, Western medicine experts have not yet accepted it because some ingredients and mechanisms of action for its therapeutic effect are not fully clear. Emerging evidence has established that traditional Chinese medicine inhibits oxidative stress and inflammatory response, suppresses apoptosis, promotes angiogenesis, regulates autophagy and gut microbiota, and modulates metabolomics, among others. Therefore, it has a beneficial role against cardiovascular disease occurrence and progression, such as atherosclerosis, hypertension, myocardial ischemia/reperfusion injury, myocardial infarction, cardiomyopathy, arrhythmia, cardiac remodeling, pulmonary arterial hypertension, and heart failure. In this review, we have summarized the research progress on the relevant mechanisms by which traditional Chinese medicine regulates cardiovascular diseases in 2020 to reveal its application to cardiovascular disease prevention and/or therapy.

Background: Abnormal expression and function of long non-coding RNAs (lncRNAs) are closely related to the pathogenesis of systemic lupus erythematosus (SLE). In this study, we aimed to investigate the association of lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1) gene single-nucleotide polymorphisms (SNPs) with susceptibility and clinical characteristics of SLE patients. Methods: A case-control study including 489 SLE patients and 492 healthy controls was conducted. Four MALAT-1 SNPs (rs4102217, rs591291, rs11227209, and rs619586) were genotyped in all subjects, their correlation with SLE susceptibility and clinical characteristics were also analyzed. Results: Results showed that the rs4102217 locus was associated with the risk of SLE. In recessive models, the GG+CG genotype of rs4102217 was associated with the decreased risk of SLE compared to CC (p = 0.036, OR = 0.348, 95% CI: 0.124-0.975). In additive models, the GG genotype of rs4102217 was associated with the decreased risk of SLE compared to CC (p = 0.040, OR = 0.355, 95% CI: 0.127-0.996). However, no association was found between MALAT-1 gene polymorphism and clinical manifestations of SLE (all p > 0.05). Conclusion: In summary, MALAT-1 rs4102217 is associated with susceptibility to SLE, suggesting that MALAT-1 may play a role in SLE.

Objective: The study aims to establish a new method in the Tetralogy of Fallot (ToF) called the pulmonary valve bi-orifice method (pulmonary annular sparing with an individualized autologous pericardial patch; thus, two orifices are formed at the level of the pulmonary valve annulus) to reconstruct the right ventricular outflow tract (RVOT).Methods: A retrospective analysis of 128 TOF patients from October 2009 to June 2018 with severe pulmonary valve dysplasia who underwent transvalvular annular patch (TAP) procedure (control group) or an individualized pulmonary valve bi-orifice procedure (observation group) were studied. The RVOT for each patient in the observation group was individually reconstructed per the patient's weight and the size of the autologous pulmonary valve using the bi-orifice method; however, increasing the cross-sectional area of the pulmonary valve annulus without destroying its integrity. The result was then compared to the control group, where TAP procedures were applied to evaluate the short to mid-term outcome(s). An in vitro simulation test was used to verify the anti-regurgitation mechanism of the new method.Results: The in vitro simulation test indicated that the anti-regurgitation mechanism was completed by the pericardial patch and the autologous pulmonary valve movement toward each other. Thus, for clinical applications, patients in both groups were compared. The results showed no significant differences in cardiopulmonary bypass and aortic cross-clamp time, mechanical ventilation, and ICU and post-operative residence between the two groups.During the follow-up period (3- to 12-years), 14 patients in the observation group had mild regurgitation after surgery (22.2%), while 10 patients had moderate pulmonary regurgitation (15.8%) with no right ventricular (RV) dilation. On the other hand, 22 patients (39.6%) had moderate to severe regurgitation in the control group, while left pulmonary artery stenosis occurred in one patient. In the control group, six patients (9.2%) with severe RV dilation were reoperated.Conclusion: Individualized pulmonary valve bi-orifice procedure is a safe and excellent method for reconstructing RVOT in ToF.

Objective: We investigated the potency of cardiac repair based on echocardiography-guided multiple percutaneous left ventricular intramyocardial injection of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) after myocardial infarction (MI).Methods: Mice with surgically induced MI were randomly divided into three groups (n = 8 in each group) and subjected to echocardiography-guided percutaneous left ventricular infarcted border injection of hiPSC-CMs (single dose; 10 μl 3 × 105 cells) or repeated injections of hiPSC-CMs at post-MI weeks 1 and 2 (multiple doses). The sham group of animals underwent all surgical procedures necessary for MI induction except for ligation. Then 4 weeks after MI, heart function was measured with transthoracic echocardiography. Engraftment was evaluated through the detection of human-specific cardiac troponin T. Infarct size and collagen volume were calculated with Sirius Red/Fast Green staining. Angiogenesis was evaluated with isolectin B4 staining. Cardiac remodeling was evaluated from the cardiomyocyte minimal fiber diameter in the infarcted border zone. Apoptosis was detected via TdT-mediated dUTP Nick-End Labeling (TUNEL) staining in cardiomyocytes from the infarcted border zone.Results: No mice died after echocardiography-guided percutaneous left ventricular intramyocardial injection. hiPSC-CMs were about nine-fold higher in the multiple-dose group at week 4 compared to the single-dose group. Multiple-dose transplantation was associated with significant improvement in left ventricular function, infarct size, angiogenesis, cardiac remodeling, and cardiomyocyte apoptosis.Conclusion: Echocardiography-guided multiple percutaneous left ventricular intramyocardial injection is a feasible, satisfactory, repeatable, relatively less invasive, and effective method of delivering cell therapy. The delivery of hiPSC-CMs indicates a novel therapy for MI.

The observational association between gut microbiome and systemic lupus erythematosus (SLE) has been well documented. However, whether the association is causal remains unclear. The present study used publicly available genome-wide association study (GWAS) summary data to perform two-sample Mendelian randomization (MR), aiming to examine the causal links between gut microbiome and SLE. Two sets of MR analyses were conducted. A group of single nucleotide polymorphisms (SNPs) that less than the genome-wide statistical significance threshold (5 × 10-8) served as instrumental variables. To obtain a comprehensive conclusion, the other group where SNPs were smaller than the locus-wide significance level (1 × 10-5) were selected as instrumental variables. Based on the locus-wide significance level, the results indicated that there were causal effects of gut microbiome components on SLE risk. The inverse variance weighted (IVW) method suggested that Bacilli and Lactobacillales were positively correlated with the risk of SLE and Bacillales, Coprobacter and Lachnospira were negatively correlated with SLE risk. The results of weighted median method supported that Bacilli, Lactobacillales, and Eggerthella were risk factors for SLE and Bacillales and Coprobacter served as protective factors for SLE. The estimates of MR Egger suggested that genetically predicted Ruminiclostridium6 was negatively associated with SLE. Based on the genome-wide statistical significance threshold, the results showed that Actinobacteria might reduce the SLE risk. However, Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) detected significant horizontal pleiotropy between the instrumental variables of Ruminiclostridium6 and outcome. This study support that there are beneficial or detrimental causal effects of gut microbiome components on SLE risk.

Due to the emergence of rapid, mass-produced information in the Web2.0 era, a large amount of weakly labeled information (star ratings, etc.) has been widespread. The Weakly-Supervised Deep Embedding (WDE) model is a good choice for utilizing this kind of data. The ratings are treated as weakly-supervised signals for pre-training, fine tuning the whole model with a small amount of manually labeled data. In this research, we proposed to change the original unidirectional transmission into bidirectional in the LSTM layer to capture the semantics in both directions, and an attention mechanism is introduced, which is helpful to capture the important information in the context and improve the accuracy of sentiment classification. Finally, we use TF-IDF and LDA topic models to mine the review topics and extract the consumers’ opinions on different sentiment polarities.

A case of an 85-year-old male on apixaban and clopidogrel undergoing pacemaker implantation is described. After procedure he developed unilateral tension hemothorax and required emergent drainage and exploratory thoracotomy. No vascular, cardiac, or pulmonary source was identified. After multidisciplinary discussions, it was speculated that spontaneous intercostal vessel rupture due to forceful coughing and elevated blood pressure during the procedure was the most likely cause of bleeding.

Atrial fibrillation (AF), the most common cardiac arrhythmia, is a global epidemic. AF can cause heart failure and myocardial infarction and increase the risk of stroke, disability, and thromboembolic events. AF is becoming increasingly ubiquitous and is associated with increased morbidity and mortality at higher ages, resulting in an increasing threat to human health as well as substantial medical and social costs. Currently, treatment strategies for AF focus on controlling heart rate and rhythm with medications to restore and maintain sinus rhythm, but this approach has limitations. Catheter ablation is not entirely satisfactory and does not address the issues underlying AF. Research exploring the mechanisms causing AF is urgently needed for improved prevention, diagnosis, and treatment of AF. Exosomes are small vesicles (30–150 nm) released by cells that transmit information between cells. MicroRNAs in exosomes play an important role in the pathogenesis of AF and are established as a biomarker for AF. In this review, a summary of the role of exosomes in AF is presented. The role of exosomes and microRNAs in AF occurrence, their therapeutic potential, and their potential role as clinical biomarkers is considered. A better understanding of exosomes has the potential to improve the prognosis of AF patients worldwide, reducing the global medical burden of this disease.

Background: Recently, many studies have indicated the potential roles of vitamin D in rheumatoid arthritis (RA). In the present study, the published available GWAS summary data was used to perform two-sample Mendelian randomization (MR) to infer the causal effect between circulating vitamin D levels and RA risk.Methods: Single nucleotide polymorphisms (SNPs) which significantly associated with exposure were selected as instrumental variables from larger-scale genome-wide association study (GWAS). The robust analytical methods including MR Egger, inverse variance weighted (IVW), weighted median and weighted mode were conducted to infer the causal links. Results: The IVW method suggested that there was no causal relationship of genetically predicted circulating vitamin D on RA (Asian: odds ratio (OR)=0.911, 95% confidence interval (CI), 0.542-1.534, P=0.727; European: OR=0.897, 95% CI, 0.633-1.269, P=0.538). MR Egger (Asian: OR=0.937, 95% CI, 0.373-2.352, P=0.895; European: OR=0.853, 95% CI, 0.469-1.553, P=0.639), weighted median (Asian: OR=0.895, 95% CI, 0.499-1.606, P=0.711; European: OR=0.885, 95% CI, 0.620-1.264, P=0.503) and weighted mode (Asian: OR=0.904, 95% CI, 0.515-1.588, P=0.738; European: OR=0.898, 95% CI, 0.618-1.306, P=0.604) demonstrated that vitamin D was not directly related to RA as well. Conclusions: The MR analysis indicates that there is no evidence of causal effect of genetically predicted circulating vitamin D levels on RA risk.

Objective Cardiac-implantable electronic device (CIED) infections are associated with significant morbidity and mortality. In this review, we describe the risk factors and pathogenesis of CIED infections and review the rationale and the evidence for the use of antibiotic-eluting envelopes (ABEs) in patients at increased risk for CIED infections. Findings The majority of CIED infections are caused by staphylococci that involve generator pocket and occur due to contamination of the device or the pocket tissues at the time of implantation. Clinical trials have shown that extending the duration of post-operative systemic antibacterial therapy is not beneficial in reducing CIED infection rate. However, ABEs that reduce device migration after implantation and provide sustained local delivery of prophylactic antibiotics at the pocket site, may provide benefit in reducing infection. Currently, there are two types of commercially available CIED envelope devices in the United States. The first ABE device (TYRX™, Medtronic Inc., Monmouth Junction, NJ) is composed of a synthetic absorbable mesh envelope that elutes minocycline and rifampin and has been shown to reduce CIED pocket infections in a large multi-center randomized clinical trial. The second ABE device (CanGaroo-G™, Aziyo Biologics, Silver Spring, MD) is composed of decellularized extracellular matrix (ECM) and was originally designed to stabilize the device within the pocket, limiting risk for migration or erosion, and providing a substrate for tissue ingrowth in a preclinical study. This device has shown promising results in a preclinical study with local delivery of gentamicin. Compared with artificial materials, such as synthetic surgical mesh, biologic ECM has been shown to foster greater tissue integration and vascular ingrowth, a reduced inflammatory response, and more rapid clearance of bacteria. Conclusions and relevance ABE devices provide sustained local delivery of antibiotics at the generator pocket site and appear beneficial in reducing CIED pocket infections. Given the continued increase in the use of CIED therapy and resultant infectious complications, innovative approaches to infection prevention are critical.

There is a growing body of evidence suggesting an association between air pollution exposure and tuberculosis (TB) incidence, but no meta-analysis has assembled all evidence so far. This review and meta-analysis aimed to derive a more reliable estimation on the association between air pollution and TB incidence. PubMed, Embase and Web of Science electronic databases were systemically searched for eligible literature. The PECO framework was used to form the eligibility criteria. Effect estimates and 95% confidence intervals (CIs) published in the included studies were pooled quantitatively. Seventeen articles met the inclusion criteria. The pooled estimates showed that long-term exposure to particulate matter with an aerodynamic diameter ≤10 μm (PM10) was associated with increased incidence of TB (per 10 μg/m3 increase in concentrations of PM10: risk ratios (RR) = 1.058, 95% CI: 1.021–1.095). Besides, long-term exposure to sulfur dioxide (SO2) and nitrogen dioxide (NO2) were significantly associated with TB incidence (per 1 ppb increase, SO2: RR = 1.016, 95% CI: 1.001–1.031; NO2: 1.010, 95% CI: 1.002–1.017). We did not find a significant association of PM2.5, ozone (O3) or carbon monoxide (CO) with TB risk, regardless of long-term or short-term exposure. However, in view of the 2016 ASA Statement and the biological plausibility of PM2.5 damaging host immunity, the association between PM2.5 and TB risk remains to be further established. This meta-analysis shows that long-term exposure to PM10, SO2 or NO2 is associated with increased odds of TB, and the specific biological mechanisms warrant further research.

This protocol is split into 3 sections: collecting tumor cells, passaging, and cryopreserving organoids. Phase 1: Aim:Collect viable cells from biopsy samples Tumor organoid: Colorectal Cancer Source: Human primary tissue Phase 2: Aim: Passage and expand organoid samples Phase 3: Aim: Organoid cryopreservation Tumor organoid: Colorectal Cancer Source: Human primary tissue

The Ets transcription factor family exerts crucial role in cell proliferation, apoptosis, differentiation and migration. Friend leukemia integration 1 (Fli1), a member of the Ets family, is expressed in fibroblasts, endothelial cells and immune cells. Fli1 gene is participated in the development, proliferation, activation, migration and other processes of immune cells. Fli1 can also affect the function of immune cells by regulating cytokines and chemokines. Emerging evidence has shown that Fli1 is implicated in the etiology of several autoimmune diseases, including systemic sclerosis (SSc) and systemic lupus erythematosus (SLE). In this review, we mainly discuss the current evidence for the role of Fli1 in these diseases.

This study provides a comprehensive and updated review of the literature with respect to the relationship between physical activity and depression in older adults. The evidence from both observational studies and experimental studies are collected to present a discussion on the type and dose of physical activity, as well as the underlying mechanisms of physical activity and depression in older adults. Overall, the results from previous studies support a solid inverse relationship between physical activity and depression in older adults, while the dose-effect relationship between them, as well as different effects among different types of physical activities, remains largely unexplored. Depression in older adults is related to an array of negative health outcomes and is more chronic compared to that in younger adults. Physical activity has been regarded as a promising non-pharmaceutical method in treating and preventing depression in older adults. Further experimental work and research need to be done to develop theoretically grounded and evidence-based interventions to better advance our knowledge of this topic and effectively promote physical activity in older adults.

Rationale and Objectives To investigate the feasibility of oxygen-challenge blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) at 3T for evaluating the early change of blood oxygenation before and after transcatheter arterial embolization (TACE) in patients with hepatocellular carcinoma (HCC). Materials and Methods Thirty HCC patients with cirrhosis (HCC group, n = 30) and 30 healthy volunteers (control group, n = 30) were included in this study. Patients in the HCC group underwent BOLD before and 1 month after TACE. Oxygen was administered via a mask. Differences between pre- and post-O2 T2* values were evaluated using a pairwise t-test. Analysis of variance was performed to assess the statistical differences in the T2* values measured in HCC group pre-TACE and post-TACE and in healthy volunteers. Results In the HCC group, the pre- and post-O2 T2* values of the cancerous area before TACE were 26.03 ± 3.30 and 26.84 ± 3.42 msec, respectively, and both decreased significantly to 8.67 ± 1.76 and 8.82 ± 1.80 msec, respectively, at 1 month after TACE (p Conclusion Oxygen-challenge BOLD MRI is feasible to assess post-TACE changes in HCC patients.

Introduction The present study aimed to investigate the prevalence and influential factors of thrombocytopaenia in systemic lupus erythematosus (SLE) patients among the Chinese population in order to provide evidence for improving the treatment and nursing of SLE patients. Methods A retrospective analysis of 3140 SLE patients admitted to two large tertiary hospitals was conducted in Anhui, China, from 2011 to 2018. In addition, the influential factors related to SLE with thrombocytopaenia were analysed through univariate and multivariate analysis. Results A total of 804 SLE patients had thrombocytopaenia (25.6%). The top 5 clinical manifestations of SLE inpatients were proteinuria (51.0%), lupus nephritis (45.9%), new rash (38.4%), haematuria (36.7%) and pyuria (32.2%). The incidence of neurological manifestations, oral mucosal ulceration, pleurisy, pericarditis, hyperglycaemia, leucocytopaenia, urinary casts, haematuria, pyuria and high disease activity in the thrombocytopaenia group were higher than those in the non-thrombocytopaenia group ( p 15.30 seconds (OR = 1.479, p = 0.032), activated partial thromboplatin time >45 seconds (OR = 1.924, p 21 seconds (OR = 1.629, p = 0.015) were associated with thrombocytopaenia. Conclusion Thrombocytopaenia has a high prevalence in SLE patients and is related to some baseline, clinical and laboratory characteristics, affecting multiple organs and systems.

Background Using synthetic antibiotic‐eluting envelope (ABE) is an effective intervention for prevention of cardiovascular implantable electronic device (CIED) infection. The biologic extracellular‐matrix envelope (ECME), may offer potential advantages over the synthetic ABE. To further minimize the risk of infection, the ECME can be hydrated in gentamicin prior to CIED implantation. We aimed to evaluate the efficacy and pharmacokinetics (PK) of gentamicin containing ECME in an animal model. Methods For all experiments, the ECME was hydrated in gentamicin (40 mg/Ml) (treatment) for 2 min. In vitro antimicrobial efficacy against six different bacterial species was assessed. In vivo experiments were conducted using a rabbit model of CIED pocket infection. Serum and ECM gentamicin concentrations were measured. Five different organisms were inoculated into the device pocket of control (ECME hydrated in 0.9% saline) and treatment groups. Macroscopic appearance and colony forming units from CIED, ECME, and tissue were determined. Results No bacteria were recovered from any culture after 12 h of exposure to the gentamicin containing ECME. Serum gentamicin levels dropped below the limit of quantification at 15 h after implant. Gentamicin concentration in the ECME remained relatively stable for up to 7 days. Signs of clinical infection were observed in the control but not in the treatment group. In the presence of gentamicin, statistically significant reduction was demonstrated across all tested bacterial species. Conclusions In this preclinical animal infection model, gentamicin containing ECME was highly effective in reducing bacterial burden in the implant pocket, while systemic exposure after implantation remained low.

Ammonium (NH4+) is a well-known alkaline species for haze formation and possesses potential impacts on human health and biological diversity. To date, regional source apportionments of NH4+ have been poorly understood in Northern China Plain (NCP). In this study, daily PM2.5 samples were synchronously collected in eight cities over the NCP region. In addition to water-soluble ions, the nitrogen isotopic composition of NH4+ (δ15N–NH4+) was also analyzed. The average concentrations of NH4+, a targeted species, varied from 0.9 μg/m³ to 42.5 μg/m³. Note that the significant enhancements of NH4+ coincided with increasing PM2.5 masses, suggesting that NH4+ was one of the contributing species for haze formation. The δ15N–NH4+averaged 12.4 ± 6.9‰ and the average δ15N–NH3 were further calculated to be −9.0 ± 6.7‰ over the NCP region. Both δ15N–NH4+ and δ15N–NH3 showed negative correlations with PM2.5 mass and there were no obvious differences among those 8 cities. Combining air-mass backward trajectories and quantifying contributions of potential sources, we pointed out that non-agricultural sources (fossil fuel related and NH3 slip) were dominant sources (totally contributed 42%–85%) not only on extreme haze phase but also on haze accumulation/dissipation phase in all 8 cities of NCP region in winter, the heating season in North China. However, the contribution of fossil fuel related source reduced to only 20%–35% while livestock breeding source rose to about 15%–32% and NH3 slip source kept contributing about 30% on the extreme haze phase. Thus, we considered that volatilization-related agricultural sources (especially livestock breeding) could discharge considerable NH3 to form SIA-led haze event in urban cities of the NCP region, even though non-agricultural sources were the foremost sources.

The effective microwave absorption materials could contribute to alleviating the electromagnetic wave pollution. However, conventional microwave absorption materials usually suffer from insufficient absorption intensity and the narrow effective absorption bandwidth. Herein, BiFeO3/BaFe7(MnTi)2.5O19 composites are proposed to address these issues through offering synergetic electromagnetic properties and proper electromagnetic properties. BiFeO3 combined with BaFe7(MnTi)2.5O19 exhibits dielectric multiple relaxation behaviors, strong ferromagnetic resonance and electromagnetic matching, ensuring increased multi-band microwave absorption. Accordingly, the minimum reflection loss (RL) of the composite with volume ratio of 1.5:1 reaches − 48 dB, and the bandwidth less than − 10 dB covers multi-frequencies at C, X and Ku band. These results suggest that BiFeO3/BaFe7(MnTi)2.5O19 composite could be a promising microwave absorption material in imaging, healthcare, information safety and military fields.

Significant life-course changes can be ‘windows of opportunity’ to disrupt practices. Using qualitative focus group data, this article examines whether the life-course change experienced by Chinese students migrating to the UK has an effect on environmentally impactful practices. It does so by examining how such practices are understood and performed by Chinese and UK students living in their own countries, and contrasting them with those of Chinese students in the UK. Using a social practice framework, these findings suggest that practices do change, and this change can be conceptualised using a framework of competences, materials, and meanings. The findings show meanings – the cultural and social norms ascribed to pro-environmental behaviour – to be particularly susceptible to the influence of ‘communities of practice’ where immigrants and natives mix, with pro-environmental behaviour change resulting from assimilation and mimesis rather than normative engagement.

Background With essentially no drug available to control the infection caused by the extensively drug-resistant Acinetobacter baumannii (XDR-Ab) in infants and young children, this study explored the clinical outcomes of pediatric patients with drug-resistant XDR-Ab who were treated with rifampicin in combination with sulbactam sodium. Methods The data for clinical outcomes, microbiological responses, and side effects were collected and evaluated for 12 critically ill infants and young children diagnosed with ventilator-associated pneumonia caused by XDR-Ab following surgical treatment for congenital heart disease in a pediatric cardiac intensive care unit. This study was approved by local institutional review board (IRB). Results Two patients died from the complex underlining diseases. The other 10 patients were weaned off the mechanical ventilation successfully within 4-15 days after the start of treatment with rifampicin combined with sulbactam sodium and discharged home. Three cases experienced adverse side effects, including severe rash and elevated aminotransferase level. Conclusion The combination of rifampicin and sulbactam sodium appeared to be an effective and safe therapy for severe ventilator-associated pneumonia caused by XDR-Ab in infants and young children. Side effects such as skin rashes and elevated aminotransferase levels can be reversed once rifampicin is discontinued in time. (Funded by the Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Chang-sha, China; the Departments of Anesthesiology and Pain Medicine of University of California Davis Health; and the National Institutes of Health.).

In recent years, deep learning-based models have achieved significant advances in manifold computer vision problems, but tedious parameter tuning has complicated their application to computer-aided diagnostic (CAD) systems. As such, this study introduces a novel pruning strategy to improve the accuracy of five lightweight deep convolutional neural network (DCNN) architectures applied to the classification of skin disease. Unlike conventional pruning methods (such as optimal brain surgeon), the proposed technique does not change the model size yet improves performance after fine tuning. This training approach, intended to improve accuracy without increasing model complexity, is experimentally verified using 1167 pathological images. The clinical data included 11 different skin disease types collected over the past ten years, with varying image quantities in each category. A novel hierarchical pruning method, based on standard deviation, is then developed and used to prune parameters in each convolution layer according to the different weight distributions. This training strategy achieves an 83.5% Top-1 accuracy using a pruned MnasNet (12.5 MB), which is 1.8% higher than that of unpruned InceptionV3 (256 MB). Comparative experiments using other networks (MobileNetV2, SqueezeNet, ShuffleNetV2, Xception, ResNet50, DenseNet121) and dataset (HAM10000) also demonstrate consistent improvements when adopting the proposed model training technique. This distinctive robustness across various network types and simple deployment demonstrates the potential of this methodology for generalization to other computer vision tasks.

A 51-year-old man underwent an atrial fibrillation ablation. Ultrasound was used for vascular access, given his body mass index (37 kg/m2). Two sheaths (6-F to 8.5-F) were inserted into each of the common femoral veins (FVs). Following the procedure, vascular closure was performed with the VASCADE

Background Microfidelity Cateter Technology has proven efficacy in ablating atrial arrhythmias in multiple pilot studies. Closely spaced radial microelectrodes render a focused near-field electrogram. Case series suggest that this catheter design facilitates accurate ablations with fewer radiofrequency (RF) lesions. Atrioventricular junction (AVJ) ablation is regarded as a straightforward procedure, but case records show wide variance in procedure times and number of RF lesions required. Methods Twenty-four patients scheduled for AVJ ablation were randomized to treatment with either the Microfidelity technology or standard 8mm/8 French ablation catheter. Both groups located the AVJ by fluoroscopic landmarks and His electrograms, and the MiFi group used electroanatomical mapping to create the location of his electrograms. The primary endpoints were development of Junctional Rhythm (JR) or Complete Heart Block (CHB), and time from first RF lesion until rhythm change. Secondary endpoints included number of RF applications. Results Patients were randomized one-to-one to the MiFi arm or standard ablation arm. JR or CHB was achieved in all patients. Time from first RF lesion until JR/CHB was: (Median/IQR) 325 sec/250–1270 sec. vs 287 sec/101–406 sec. Number of RF applications was 5/3–15 applications vs 4.5/1–5 applications. Total procedure time in the lab was 134 min/73.5–172.5 min vs 58 min/52–146 min. Microfidelity Technology vs Standard Conclusion Analysis suggests that the MiFi catheter is efficacious in ablating the AVJ, but requires greater RF duration and number of lesions, with wider case-by-case variability to achieve JR or CHB. Microfidelity technology and electroanatomical mapping did not result in faster time to completion than using fluoroscopic landmarks and His electrograms alone. Preoperative choice of sheath for catheter stability and contact may also play a role in a more efficient timely successful ablation of the AV node. Acknowledgement/Funding Boston Scientific

Colon cancer is one of the most common malignant tumors worldwide. Understanding the underlying molecular mechanisms is crucial for the development of therapeutic strategies for the treatment of patients with colon cancer. In the present study, a novel tumor suppressive microRNA, miR‑192, was demonstrated to be markedly downregulated in colon cancer cells compared with normal colon cells. By overexpressing miR‑192 in colon cancer HCT‑116 cells, the results of the present study revealed that miR‑192 inhibits cell proliferation, migration and invasion. Bioinformatics were used to determine the target gene of miR‑192 and Ras‑related protein Rab‑2A (RAB2A) was identified as a downstream target of miR‑192. Following the determination of the role of the miR‑192‑RAB2A pathway in colon cancer, small molecules that may regulate miR‑192 were screened and the results demonstrated that simvastatin is an activator of miR‑192. Furthermore, simvastatin upregulated miR‑192 and inhibited the expression of downstream targets of miR‑192, which subsequently led to suppressed proliferation, migration and invasion of colon cancer cells. In conclusion, the present study identified a novel colon cancer cell suppressor, as well as a small‑molecule activator of the tumor suppressor miR‑192, which may represent a therapeutic strategy for the treatment of patients with colon cancer.

Air pollution is an important risk factor for autoimmune diseases, but its association with the recurrence of rheumatoid arthritis (RA) remains unclear so far. This study aimed to investigate the short-term association between traffic-related air pollutants and hospital readmissions for RA in Hefei, China. Data on daily hospital readmissions for RA and traffic-related air pollutants, including particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and carbon monoxide (CO), from 2014 to 2018 were retrieved. A time-series approach using generalized linear regression model was employed. The analysis was further stratified by sex, age and season. A total of 1153 readmissions for RA were reported during the study period. A significant association between high-concentration PM2.5 (90th percentile) and RA readmissions was observed on lag1 (relative risk (RR) = 1.09, 95% confidence interval (CI): 1.01–1.19) and lasted until lag3 (RR = 1.06, 95%CI: 1.01–1.12). From lag2 to lag5, high-concentration NO2 (90th percentile) was associated with increased risk of RA readmissions, with the highest RR observed at lag 4 (1.11, 95%CI: 1.05–1.17). Stratified analyses indicated that females and the elderly appeared to be more vulnerable to high-concentration PM2.5 and NO2 exposure. High-concentration PM2.5 and NO2 in cold seasons were consistently significantly associated with increased risk of RA readmissions. Exposure to high-concentration PM2.5 and NO2 was associated with increased risk of RA readmissions. Protective measures against the exposure to high-concentration PM2.5 and NO2 should be taken to reduce the recurrence risk in RA patients, especially in females, the elderly and during cold seasons.

In online health-care community (OHC), patients can choose which physician would provide the expert consultation service. However, the success of registered service depends on many factors including online contributions by physicians in the OHC. This study investigates the moderating effect of physicians' endorsement on their online workload. With data from a leading OHC in China, we designed an empirical study involving 140156 records. The results show that for the physician's contribution behavior, the standardized coefficient was 0.317, and the standardized coefficient of the physician's popularity was 1.588. All estimates were statistically significantly at a 0.1% level. Our study discovered that the popularity of physicians plays a main role in gaining registered service, and their online contributions also increase the volume of this service. Moreover, the physicians from tertiary hospitals, with more thank letters and from larger cities were more potential to gain OHC service, comparing with physicians with higher position, with longer profile words, awards and longer relationship time.

Video-based bus passenger collection is considered to have a greater potential for counting passengers, but the difficulty lies in how to solve the problem of accurately tracking and determining the direction of the moving target under the complex state of motion. The traditional target detection algorithm, like frame subtraction and edge detection, is very difficult to deal with the situation of immediate multi-objective. Based on image preprocessing, an algorithm about intelligent video multi-target tracking and traffic statistics is designed aiming at the above-mentioned situation. The core contents in this paper includes: the grid-density clustering and line segment clustering, extraction and segmentation target connected domain that is handled to be a circular, tracking the motion vector of target feature point, finally ,achieving accurate statistics on the number of people getting on and off. Experiments show that this algorithm can effectively track more people simultaneously and the bus traffic statistical accuracy achieves the goal.

This system based on single-chip microcomputer control, with buttons and LCD monitor as the man-machine interface of numerical control dc power supply. System is mainly composed of rectification filter circuit, the output current control module, LCD display module current and voltage controlled constant current module. Button to SCM number controls the size of the output current DAC0832, LCD display the current value. This system controlled by single chip microcomputer DA output, make the whole circuit system has a stable output current, step precision is high, easy to control, etc.

Recent outbreaks of listeria, salmonella, and other pathogens have reinforced the need for more rigorous testing of food products. Millions are spent each year testing food. Certifying the safety of the food is a challenging task using traditional testing methods. Current methods require long incubation times before the first results are observed and still only represent a small fraction of the food that is sold. Long analysis methods also lead to loss of consumables. 18.9 billion pounds of produce are lost a year to spoilage. A fast and effective method is needed to decrease the amount of time necessary to test the safety of food. The goal is to provide accurate sample classification as quickly as possible, thus allowing pathogen-free product to be shipped to market with the shortest delay possible. An autonomous electrochemical sensor was combined with a powerful multi-class Probabilistic Neural Network (PNN) system to classify four species of organisms (E. Coli #25922, E. Coli # 11775, S. Epidermis #12228, or C. Albicans #10231). We used an evolutionary based kernel optimization algorithm to optimize the kernel parameters, and trained the system on data sampled from four different organisms. The trained and optimized model was validated on a set containing several samples that were not used to train the network. We showed that the network was able to correctly classify unknown samples in a shorter period than the industry standard of 24hours, thus providing a potential benefit to the agriculture industry.

The objective of this research is to develop a complex adaptive piecewise linear regression/probabilistic neural network (PNN) intelligent system for the rapid detection and classification of Escherichia coli (E.coli). The rapid detection and classification of E.coli is important because current methods require a long period of analysis before a classification can be determined. The objective of this paper is to describe the design and preliminarily evaluate an Intelligent Decision Support System (IDSS) that will validate the following hypotheses: an intelligent decision support system (IDSS) to allow the rapid collection and classification of E.coli can be designed and preliminarily evaluated, which will significantly decrease detection and classification times for E.coli bacteria, thereby addressing the food spoilage problem. The research in this paper provides a preliminary answer to: What performance improvement percentage can be realized against the 16 to 48 hours required for the conventional multistep methods of detection of microorganisms (using E.coli data as a baseline)? For the 16 hour period we have a 6.7% reduction in the time-to-detect period ((16-15)/15 × 100% = 6.7%) and for the 48 hour period we have a 220% reduction in time ((48- 15)/15×100% = 220%).

We hereby report the design and implementation of an Autonomous Microbial Cell Culture and Classification (AMC(3)) system for rapid detection of food pathogens. Traditional food testing methods require multistep procedures and long incubation period, and are thus prone to human error. AMC(3) introduces a "one click approach" to the detection and classification of pathogenic bacteria. Once the cultured materials are prepared, all operations are automatic. AMC(3) is an integrated sensor array platform in a microbial fuel cell system composed of a multi-potentiostat, an automated data collection system (Python program, Yocto Maxi-coupler electromechanical relay module) and a powerful classification program. The classification scheme consists of Probabilistic Neural Network (PNN), Support Vector Machines (SVM) and General Regression Neural Network (GRNN) oracle-based system. Differential Pulse Voltammetry (DPV) is performed on standard samples or unknown samples. Then, using preset feature extractions and quality control, accepted data are analyzed by the intelligent classification system. In a typical use, thirty-two extracted features were analyzed to correctly classify the following pathogens: Escherichia coli ATCC#25922, Escherichia coli ATCC#11775, and Staphylococcus epidermidis ATCC#12228. 85.4% accuracy range was recorded for unknown samples, and within a shorter time period than the industry standard of 24 hours.

Taking steam-turbine generator foundation of 1251 MW as the example in this paper, 1:8 test model is designed. Pseudo-dynamic test is carried out under intensity 7 frequently and rarely earthquake. And earthquake response characteristics of the foundation are researched. The test result shows that the foundation has the better emergency capecity. Even if design reference period is changed into 60 years from 50 years, the foundation will satisfy the requirements of seismic design standard.

Referring to research findings of existing traffic survey instrument, this paper bases on electronic traffic survey counter to insert GPRS module, micro-program controller, vehicle type selection keyboard and direction selection keyboard, and utilizes computer technology to establish data processing platform, studies and designs the traffic survey system on the basis of GPS, GPRS and GIS. This system can realize real-time monitoring on surveyors, accurate and timely transmission and processing of survey data, and automatic analysis and management of survey data.

In this paper, a new polishing technique was proposed to polish concave spherical surface by diamond spherical shell deposited by DC-Plasma Jet CVD(chemical vapor deposition), and preparation was studied from both experiment and theory. The deposited films were investigated by some techniques including: scanning electron microscopy (SEM), atom force microscopy (AFM), Raman spectroscopy, and roughness-profile-meter, which were used to analyze surface phase, microstructure, internal quality and surface roughness. The results show that the deposited diamond spherical shell film has some remarkable properties, such as high surface density, high hardness. Compared to traditional polishing techniques, it will have some potential advantages as convenient, flexible, efficient and precious. To adjust some important parameters as methane concentration, depositing time, and it can deposit the different size grain diamond spherical shell films, which are used to polish different precision degree concave spherical surfaces. Meantime, to change curvature of diamond spherical shell, it can adapt to polish various curvature radius concave spherical surfaces.

Wireless data transmission in short distance is a kind of technology instead of cable, which is widely used in many current fields. And it solved the problem that it is difficult for cable wiring due to the limit of environment and condition. For the problem that the length of control command is different and the launch module cannot judge the emission data in the wireless communication of controlling the LED screen display, this paper designs a wireless communication system which can automatically identify the command length and send it to the receiving equipment by wireless communication. After consulting documents and summarizing predecessors' experience, this paper provides the overall design scheme of wireless communication system which can automatically identify the command length. And the wireless data transceiver module consists of CC1101 wireless RF chip produced by TI enterprise and STC12LE2052AD produced by STC enterprise. Through testing and performance debugging, the system can send the command whose length is arbitrary to the receiver by wireless communication.

The extensive use of digital and network technology has pushed mankind from the industrial era into the information and digital era. In the digital era, digits are becoming an extensive global phenomenon and force. The ethical culture of digital globalization has provided not only a new space for cultural exchange and?integration among nations, but also a new environment for the formation of new global ethical principles and concepts. This article investigates a theme of scholarly concern, the theme of global ethics in the environment of the digital era.