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New transmission techniques for short-reach optical transmission applications especially datacenter interconnections are highly expected to break current bandwidth bottleneck, among which mode division multiplexing (MDM) based on few-mode fiber (FMF) is promising by exploring different linearly-polarized (LP) modes or mode groups as spatial transmission channels. However, it has been a great challenge to deal with degenerate modes in FMFs. In this paper, a FMF design utilizing multiple ring perturbations in fiber core to suppress modal crosstalk during fiber transmission is firstly proposed and a 6-LP-mode double-ring-core (DRC) FMF is fabricated with a high minimum refractive index difference (min|neff|) of 1.4910-3 among all the modes. Secondly, a novel degenerate-mode-selective coupler (DMSC) converting each degenerate LPmn mode into the LP11 mode in a two-mode fiber is proposed. Then intensity-modulation/direct-detection (IM/DD) MDM transmission scheme without any digital signal processing (DSP) can be realized utilizing mode multiplexer/demultiplexer (MUX/DEMUX) consisting of cascaded mode-selective couplers (MSC) and DMSCs, in which each degenerate or non-degenerate LP mode is considered as an independent transmission channel. Then based on the proposed DRC-FMF and mode MUX/DEMUX, we demonstrate a 4-LP-mode prototype system using commercial single-mode 10 Gbps SFP + modules and 4K video transceivers without any hardware or software modifications. Finally, the intra-LP-mode dispersion (ILMD) effect in a weakly-coupled FMF is analyzed and a modified fixed-analyzer method is proposed for its measurement. Experimental results show that it may be one of the major impairments for IM/DD MDM transmission.

Background Acylcarnitine is an intermediate product of fatty acid oxidation. It is reported to be closely associated with the occurrence of diabetic cardiomyopathy (DCM). However, the mechanism of acylcarnitine affecting myocardial disorders is yet to be explored. This current research explores the different chain lengths of acylcarnitines as biomarkers for the early diagnosis of DCM and the mechanism of acylcarnitines for the development of DCM in-vitro. Methods In a retrospective non-interventional study, 50 simple type 2 diabetes mellitus patients and 50 DCM patients were recruited. Plasma samples from both groups were analyzed by high throughput metabolomics and cluster heat map using mass spectrometry. Principal component analysis was used to compare the changes occurring in the studied 25 acylcarnitines. Multivariable binary logistic regression was used to analyze the odds ratio of each group for factors and the 95% confidence interval in DCM. Myristoylcarnitine (C14) exogenous intervention was given to H9c2 cells to verify the expression of lipid metabolism-related protein, inflammation-related protein expression, apoptosis-related protein expression, and cardiomyocyte hypertrophy and fibrosis-related protein expression. Results Factor 1 (C14, lauroylcarnitine, tetradecanoyldiacylcarnitine, 3-hydroxyl-tetradecanoylcarnitine, arachidic carnitine, octadecanoylcarnitine, 3-hydroxypalmitoleylcarnitine) and factor 4 (octanoylcarnitine, hexanoylcarnitine, decanoylcarnitine) were positively correlated with the risk of DCM. Exogenous C14 supplementation to cardiomyocytes led to increased lipid deposition in cardiomyocytes along with the obstacles in adenosine 5′-monophosphate (AMP)-activated protein kinase (AMPK) signaling pathways and affecting fatty acid oxidation. This further caused myocardial lipotoxicity, ultimately leading to cardiomyocyte hypertrophy, fibrotic remodeling, and increased apoptosis. However, this effect was mitigated by the AMPK agonist acadesine. Conclusions The increased plasma levels in medium and long-chain acylcarnitine extracted from factors 1 and 4 are closely related to the risk of DCM, indicating that these factors can be an important tool for DCM risk assessment. C14 supplementation associated lipid accumulation by inhibiting the AMPK/ACC/CPT1 signaling pathway, aggravated myocardial lipotoxicity, increased apoptosis apart from cardiomyocyte hypertrophy and fibrosis were alleviated by the acadesine.

Background Based on interim analyses and modeling data, lower doses of bamlanivimab and etesevimab together (700/1400 mg) were investigated to determine optimal dose and expand availability of treatment. Methods This Phase 3 portion of the BLAZE-1 trial characterized the effect of bamlanivimab with etesevimab on overall patient clinical status and virologic outcomes in ambulatory patients ≥12 years old, with mild-to-moderate coronavirus disease 2019 (COVID-19), and ≥1 risk factor for progressing to severe COVID-19 and/or hospitalization. Bamlanivimab and etesevimab together (700/1400 mg) or placebo were infused intravenously within 3 days of patients’ first positive COVID-19 test. Results In total, 769 patients were infused (median age [range]; 56.0 years [12, 93], 30.3% of patients ≥65 years of age and median duration of symptoms; 4 days). By day 29, 4/511 patients (0.8%) in the antibody treatment group had a COVID-19-related hospitalization or any-cause death, as compared with 15/258 patients (5.8%) in the placebo group (Δ[95% confidence interval {CI}] = −5.0 [−8.0, −2.1], P Conclusions These data support the use of bamlanivimab and etesevimab (700/1400 mg) for ambulatory patients at high risk for severe COVID-19. Evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants will require continued monitoring to determine the applicability of this treatment. Clinical Trials Registration NCT04427501.

OBJECTIVE To investigate the efficacy and safety of additional S-1 chemotherapy to S-1 plus oxaliplatin (SOX) regimen chemotherapy for Stage III gastric carcinoma (GC) after radical resection. PATIENTS AND METHODS A total of 161 patients who were pathologically diagnosed as Stage III GC after D2 gastrectomy and received SOX regimen adjuvant chemotherapy between January 2012 and April 2016 were included in this retrospective study. SOX regimen postoperative chemotherapy was composed of Oxaliplatin and S-1, administrated every 3 weeks for 8 scheduled courses. After SOX chemotherapy, 76 patients preferred additional chemotherapy with S-1 (the ACT group), while additional S-1 chemotherapy was not given to the other 85 patients (control group). The ACT with S-1 was administrated every 3 weeks for 8 scheduled courses. Treatment was terminated in case of life-threatening adverse events or tumor progression, or patients' demand for termination. Progression-free survival (PFS), overall survival (OS), and adverse events were analyzed. RESULTS ACT group obtained markedly improved 3-year PFS [p = 0.04; hazard ratio (HR) for disease progression, 0.58; 95% confidence interval (CI), 0.34-0.98] and OS than the control group (p = 0.0469; HR for death, 0.56; 95% CI, 0.32-0.99). No chemotherapy-related mortality occurred. Patients of the ACT group suffered more common and severer hand-foot syndrome (HFS) (p = 0.02). CONCLUSIONS Additional S-1 chemotherapy may be helpful for improving the disease progression and survival for patients with Stage III GC after radical resection with an acceptable safety profile.

Background Patients with underlying medical conditions are at increased risk for severe coronavirus disease 2019 (Covid-19). Whereas vaccine-derived immunity develops over time, neutralizing monoclonal-antibody treatment provides immediate, passive immunity and may limit disease progression and complications. Methods In this phase 3 trial, we randomly assigned, in a 1:1 ratio, a cohort of ambulatory patients with mild or moderate Covid-19 who were at high risk for progression to severe disease to receive a single intravenous infusion of either a neutralizing monoclonal-antibody combination agent (2800 mg of bamlanivimab and 2800 mg of etesevimab, administered together) or placebo within 3 days after a laboratory diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The primary outcome was the overall clinical status of the patients, defined as Covid-19–related hospitalization or death from any cause by day 29. Results A total of 1035 patients underwent randomization and received an infusion of bamlanivimab–etesevimab or placebo. The mean (±SD) age of the patients was 53.8±16.8 years, and 52.0% were adolescent girls or women. By day 29, a total of 11 of 518 patients (2.1%) in the bamlanivimab–etesevimab group had a Covid-19–related hospitalization or death from any cause, as compared with 36 of 517 patients (7.0%) in the placebo group (absolute risk difference, −4.8 percentage points; 95% confidence interval [CI], −7.4 to −2.3; relative risk difference, 70%; P

The efficient community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in the current pandemic of coronavirus disease-2019 (COVID-19), which in severe and critical cases results in progressive pulmonary infection, complicated by respiratory failure, with a high prevalence of acute respiratory distress syndrome. Of all age groups, older adults have the greatest risk of severe COVID-19 and the associated complications. Globally, there are many reports of the rapid spread of COVID-19 among residents of skilled nursing facilities, with high associated rates of morbidity and mortality. With over 1.3 million residents in nursing home care in the USA, there is an urgent need for therapeutic strategies to prevent COVID-19 in these populations. Lilly, in collaboration with the National Institute of Allergy and Infectious Diseases, conducted the BLAZE-2 trial to evaluate the efficacy and safety of the monoclonal antibody bamlanivimab (LY3819253) in preventing SARS-CoV-2 infection and COVID-19, defined as symptomatic infection, in skilled nursing and assisted living facilities. It is a phase 3 randomized, double-blind, placebo-controlled trial, where participants were randomized to bamlanivimab (4200 mg) or placebo and then followed up for 24 weeks. Conducting a trial in the midst of a pandemic in these facilities poses several challenges, including a vulnerable elderly population, travel restrictions, supply chain interruptions, and defining the target population. The operational challenges were addressed by the innovative use of mobile research units which are customized, equipped, and staffed to support BLAZE-2 randomization and participant dosing within the skilled nursing and assisted living facilities. Herein, we describe the design of the study, the analytics behind facility selection, and an innovative operational model. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05699-3.

Deep learning methods such as convolutional neural networks (CNN) have been shown to be highly effective in complex nonlinear modeling or classification in multimode fiber transmission systems with intensity-only detection. However, such powers are often realized along with time-consuming training processes requiring large number of data samples, which may not be achievable in some practical implementations where only limited numbers of samples are available. In this paper, aiming at high-accuracy perturbation location in a multimode fiber specklegram sensing (FSS) system with small size training data set, we compare and analyze the performance of the CNN based FSS system using fibers under different conditions of mode coupling. We demonstrate that, by utilizing a ring core fiber (RCF) supporting a few weakly-coupled mode groups(MGs), high accuracy of around 100% in the classification of perturbation locations can be more easily achieved with faster convergence speed and fewer training samples, compared with FSS systems using conventional OM3 multimode fibers (MMFs) with hundreds of modes. Furthermore, owing to similar low-level characteristics extracted from the speckle-pattern images, the CNN exhibits good performance of transfer learning in a more practical RCF based FSS system with foot-stepping perturbations, confirming their good potential of extension into practical systems.

Aim This study investigated the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on renal outcomes in Asian patients with type 2 diabetes mellitus (T2DM). Materials and methods We searched Medline, EMBASE, and the Cochrane Library to identify randomized controlled trials published up to April 2020 that compared SGLT2 inhibitors with placebo or active comparator and reported any renal outcomes in Asian patients with T2DM. Random effects models and inverse variance weighting were used to calculate relative risks with 95% confidence intervals (CIs). Results We included 14 studies, totaling 3792 patients, in the analysis. In the short term, SGLT2 inhibitors significantly slowed estimated glomerular filtration rate (eGFR) decline (MD: 0.80; 95% CI: 0.66 to 0.94; p p p p = 0.11). However, dapagliflozin does appear to reduce albuminuria (p = 0.005). Lastly, SGLT2 inhibitors increased the incidence of adverse events (AEs) related to renal function (OR: 1.90; 95% CI: 1.24 to 2.91; p = 0.003), but did not increase the incidence of renal impairment (OR: 0.85; 95% CI: 0.40 to 1.81; p = 0.68). Conclusion The use of SGLT2 inhibitors in Asian patients with T2DM can help delay the decline of eGFR and reduce Scr and UA. Although SGLT2 inhibitors have no overall advantage in reducing albuminuria, dapagliflozin does appear to reduce albuminuria, and while they may increase the occurrence of AEs related to renal function, they do not increase the incidence of renal impairment.

We reported femtosecond laser-induced self-organized micro/nanostructures on Zr64.13Cu15.75Ni10.12Al10 amorphous surfaces. A set of process methods that induced sub-wavelength LIPSS (laser-induced periodic surface structures) structures and SWPSS (super-wavelength periodic structure) nearly twice the wavelength using 1030 nm wavelengths were observed. Using linear scanning can completely cover a layer of micro/nanostructures on the surface. Clear surface structures can be observed throughout the laser ablation area, and their cycles and structural fluctuations can be controlled by process parameters. The causes and structures of the two micro/nanostructures were discussed.

Summary Background & aims Adipose tissue loss is one of the features in patients with cancer cachexia. However, whether subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) contribute differently to the progress of cancer cachexia in gastric cancer patients with cachexia remains unclear. This study aim to investigate the effect of SAT and VAT in gastric cancer patients with cachexia. Methods Gastric cancer patients who underwent surgery were divided into cancer cachexia group and non-cachexia group. A new deep learning system was developed to segment SAT and VAT from the computed tomography images at the third lumbar vertebra. Indexes of SAT (SATI) and VAT (VATI) were compared between cachexia and non-cachexia groups. The prognostic values of SATI and VATI for patients with gastric cancer cachexia were analyzed by Kaplan–Meier method and Cox regression. Results A total of 1627 gastric cancer patients (411 cachexia and 1216 non-cachexia) were included in this study. A new V-Net-Based segmentation deep learning system was developed to quickly (0.02 s/image) and accurately segment SAT (dice scores = 0.96) and VAT (dice scores = 0.98). The SATI of gastric cancer patients with cachexia were significantly lower than non-cachexia patients (44.91 ± 0.90 vs. 50.92 ± 0.71 cm2/m2, P Conclusion SAT and VAT showed different effects on gastric cancer patients with cachexia. More attention should be paid to the loss of SAT during the progress of cancer cachexia.

PurposeAs inter-company cooperation and competition grow, orchestration capability plays an increasingly important role. This paper aims to present an overview of orchestration capability in the business and management field, identify the current state and explore future research trends.Design/methodology/approachThis literature review is based on 132 papers collected from the Web of Science (WoS) Core Collection data (1997–March 2021). HistCite was used to analyze the year of publication, leading scholars, influential articles, key journals, top countries and institutions. Research streams were identified from analysis of co-citation, bibliographic coupling and keyword co-occurrence by HistCite and VOSviewer.FindingsThis paper finds that Hitt MA is the most prolific scholar, and the Strategic Management Journal is the most dominating publication among the orchestration capability publications. The USA and Texas A&M University are the most influential countries and institutions, respectively. Three major clusters are identified based on citation mapping, bibliographic coupling analysis of documents and keywords co-occurrence analysis: dynamic capability and resource-based view, resource orchestration and network orchestration. Based on the three clusters, the authors analyze how resource orchestration and network orchestration research develops over time and summarize the evolutionary path of orchestration capability literature.Research limitations/implicationsThis article builds on data from WoS Core Collection, and some new but important articles may not be analyzed, since bibliometrics consider high citation as an indicator to select influential articles.Practical implicationsWith the rapid development of the digital economy, the frequent interactions between companies pose many challenges for businesses. Enterprises can take orchestration actions effectively and efficiently from various perspectives and continuously improve their orchestration capabilities in collaboration with partners to achieve and sustain competitive advantages.Originality/valueThis paper provides a systematic review of orchestration capability using bibliometric analysis, which has not been employed in previous studies. Besides, this article presents a broad understanding of how scholars have researched the subject over the years.

Background A novel and improved methodology is still required for the diagnosis of diabetic kidney disease (DKD). The aim of the present study was to identify novel biomarkers using extracellular vesicle (EV)-derived mRNA based on kidney tissue microarray data. Methods Candidate genes were identified by intersecting the differentially expressed genes (DEGs) and eGFR-correlated genes using the GEO datasets GSE30528 and GSE96804, followed by clinical parameter correlation and diagnostic efficacy assessment. Results Fifteen intersecting genes, including 8 positively correlated genes, B3GALT2, CDH10, MIR3916, NELL1, OCLM, PRKAR2B, TREM1 and USP46, and 7 negatively correlated genes, AEBP1, CDH6, HSD17B2, LUM, MS4A4A, PTN and RASSF9, were confirmed. The expression level assessment results revealed significantly increased levels of AEBP1 in DKD-derived EVs compared to those in T2DM and control EVs. Correlation analysis revealed that AEBP1 levels were positively correlated with Cr, 24-h urine protein and serum CYC and negatively correlated with eGFR and LDL, and good diagnostic efficacy for DKD was also found using AEBP1 levels to differentiate DKD patients from T2DM patients or controls. Conclusions Our results confirmed that the AEBP1 level from plasma EVs could differentiate DKD patients from T2DM patients and control subjects and was a good indication of the function of multiple critical clinical parameters. The AEBP1 level of EVs may serve as a novel and efficacious biomarker for DKD diagnosis.

Long-term peritoneal dialysis (PD) is accompanied by low-grade intraperitoneal inflammation and may eventually lead to peritoneal membrane injury with a high solute transport rate and ultrafiltration failure. Osteopontin (OPN) is highly expressed through the stimulation of pro-inflammatory cytokines in many cell types. This study aimed to investigate the potential of OPN as a new indicator of peritoneal deterioration. One hundred nine continuous ambulatory PD patients were analyzed. The levels of OPN and IL-6 in peritoneal effluents or serum were analyzed by ELISA kits. The mean effluent OPN concentration was 2.39 ± 1.87 ng/mL. The OPN levels in drained dialysate were correlated with D/P Cr (p < 0.0001, R = 0.54) and D/D0 glucose (p < 0.0001, R = 0.39). Logistic regression analysis showed that the OPN levels in peritoneal effluents were an independent predictive factor for the increased peritoneal solute transport rate (PSTR) obtained by the peritoneal equilibration test (p < 0.001). The area under the receiver operating characteristic curve of OPN was 0.84 (95% CI: 0.75–0.92) in predicting the increased PSTR with a sensitivity of 86% and a specificity of 67%. The joint utilization of effluent OPN with age, effluent IL-6, and serum albumin further increased the specificity (81%). Thus, OPN may be a useful indicator of peritoneal deterioration in patients with PD.

Recently weakly-coupled mode-division multiplexing (MDM) transmission systems and networks based on ultralow-modal-crosstalk few-mode fiber (FMF) have attracted much interest, for which optical amplification technologies with low modal crosstalk and two-dimension mode-wavelength gain flattening are highly desired. In this paper, we propose for the first time a design method for few-mode Erbium-doped fiber (FM-EDF) with multi-ring-core (MRC) structures of both index and Erbium doping, which has high compatibility with the transmission MRC-FMF and low differential modal gain (DMG) with simple pump injection requirement. By sharing the boundaries of ring areas for both index and Erbium doping, the design method also helps to reduce the complexity of preform fabrication. We show by simulation that at 1550-nm signal wavelength, a 6-mode MRC-EDF can achieve a minimum DMG of 0.35-dB with only LP11 pump light injection and a 10-mode MRC-EDF can achieve a minimum DMG of 0.60-dB with LP01 and LP03 pump lights injection. Besides, the tolerance of DMG to the variation of fiber parameters induced by fabrication is analyzed. The proposed FM-EDF is beneficial for the practical applications of weakly-coupled MDM transmission systems and networks.

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (Covid-19), which is most frequently mild yet can be severe and life-threatening. Virus-neutralizing monoclonal antibodies are predicted to reduce viral load, ameliorate symptoms, and prevent hospitalization. Methods In this ongoing phase 2 trial involving outpatients with recently diagnosed mild or moderate Covid-19, we randomly assigned 452 patients to receive a single intravenous infusion of neutralizing antibody LY-CoV555 in one of three doses (700 mg, 2800 mg, or 7000 mg) or placebo and evaluated the quantitative virologic end points and clinical outcomes. The primary outcome was the change from baseline in the viral load at day 11. The results of a preplanned interim analysis as of September 5, 2020, are reported here. Results At the time of the interim analysis, the observed mean decrease from baseline in the log viral load for the entire population was −3.81, for an elimination of more than 99.97% of viral RNA. For patients who received the 2800-mg dose of LY-CoV555, the difference from placebo in the decrease from baseline was −0.53 (95% confidence interval [CI], −0.98 to −0.08; P=0.02), for a viral load that was lower by a factor of 3.4. Smaller differences from placebo in the change from baseline were observed among the patients who received the 700-mg dose (−0.20; 95% CI, −0.66 to 0.25; P=0.38) or the 7000-mg dose (0.09; 95% CI, −0.37 to 0.55; P=0.70). On days 2 to 6, the patients who received LY-CoV555 had a slightly lower severity of symptoms than those who received placebo. The percentage of patients who had a Covid-19–related hospitalization or visit to an emergency department was 1.6% in the LY-CoV555 group and 6.3% in the placebo group. Conclusions In this interim analysis of a phase 2 trial, one of three doses of neutralizing antibody LY-CoV555 appeared to accelerate the natural decline in viral load over time, whereas the other doses had not by day 11. (Funded by Eli Lilly; BLAZE-1 ClinicalTrials.gov number, NCT04427501.)

We have demonstrated direct generation of high-order orbital angular momentum (OAM) modes by chiral long-period gratings (CLPGs) written in a few mode fiber (FMF) via a CO2 laser. The high-order core modes (LP11, LP21, and LP31 modes) were realized by the CLPGs through high order diffraction modes with efficiencies of more than 99.69%. The -1st, −2nd, and −3rd order OAM modes can be generated directly by the CLPGs with various grating periods. The proposed method opens a new path to implement all fiber high-order OAM mode generation. The OAM mode converters can be adopted as wavelength tunable mode converters by adjusting twist rate of the CLPGs, which could be widely used in optical communication and fiber sensing system based on FMFs.

Pulmonary arterial hypertension (PAH) is associated with increased inflammation and abnormal vascular remodeling. Astragaloside IV (ASIV), a purified small molecular saponin contained in the well‑know herb, Astragalus membranaceus, is known to exert anti‑inflammatory and anti‑proliferation effects. Thus, the present study investigated the possible therapeutic effects of ASIV on monocrotaline (MCT)‑induced PAH. Rats were administered a single intraperitoneal injection of MCT (60 mg/kg), followed by treatment with ASIV at doses of 10 and 30 mg/kg once daily for 21 days. Subsequently, right ventricle systolic pressure, right ventricular hypertrophy and serum inflammatory cytokines, as well as pathological changes of the pulmonary arteries, were examined. The effects of ASIV on the hypoxia‑induced proliferation and apoptotic resistance of human pulmonary artery smooth muscle cells (HPASMCs) and the dysfunction of human pulmonary artery endothelial cells (HPAECs) were evaluated. MCT elevated pulmonary artery pressure and promoted pulmonary artery structural remodeling and right ventricular hypertrophy in the rats, which were all attenuated by both doses of ASIV used. Additionally, ASIV prevented the increase in the TNF‑α and IL‑1β concentrations in serum, as well as their gene expression in lung tissues induced by MCT. In in vitro experiments, ASIV attenuated the hypoxia‑induced proliferation and apoptotic resistance of HPASMCs. In addition, ASIV upregulated the protein expression of p27, p21, Bax, caspase‑9 and caspase‑3, whereas it downregulated HIF‑1α, phospho‑ERK and Bcl‑2 protein expression in HPASMCs. Furthermore, in HPAECs, ASIV normalized the increased release of inflammatory cytokines and the increased protein levels of HIF‑1α and VEGF induced by hypoxia. On the whole, these results indicate that ASIV attenuates MCT‑induced PAH by improving inflammation, pulmonary artery endothelial cell dysfunction, pulmonary artery smooth muscle cell proliferation and resistance to apoptosis.

BACKGROUND/AIM Traditional Chinese medicine (TCM) Brucea javanica (BJO) has shown anti-proliferation efficacy on human carcinoma cells in vitro. The aim of the present study was to evaluate for the first time the efficacy of BJO combined with the first-line chemotherapeutic drug gemcitabine (GEM) on tumor growth-inhibition and survival in a pancreatic cancer patient-derived orthotopic xenograft (PDOX) mouse model. MATERIALS AND METHODS The pancreatic cancer tumor fragment originated from a patient at the Hefei First People's Hospital (Anhui, PR China). The surgical specimen was transplanted orthotopically in nude mice using surgical orthotopic implantation (SOI). All mice were randomized and assigned to 5 groups: G1: saline vehicle (0.1ml per mouse, oral, once per day); G2: GEM [100 mg/kg, intraperitoneal (i.p), twice per week]; G3: GEM+BJO [100 mg/kg GEM, i.p, twice per week+1g/kg BJO, oral, once per day (qd)]; G4: BJO (1g/kg, oral, qd). Group 5 and Group 6 were used to observe survival [G5: saline vehicle (0.1ml per mouse, oral, qd), G6: BJO (1g/kg, oral, qd)]. Body weight and tumor volume were measured twice per week. TUNEL staining was used to determine apoptosis. RESULTS The combination of GEM + BJO resulted in a reduced tumor growth rate (p

Background The study aimed to construct an intelligent difficulty scoring and assistance system (DSAS) for endoscopic retrograde cholangiopancreatography (ERCP) treatment of common bile duct (CBD) stones. Methods 1954 cholangiograms were collected from three hospitals for training and testing the DSAS. The D-LinkNet34 and U-Net were adopted to segment the CBD, stones, and duodenoscope. Based on the segmentation results, the stone size, distal CBD diameter, distal CBD arm, and distal CBD angulation were estimated. The performance of segmentation and estimation was assessed by mean intersection over union (mIoU) and average relative error. A technical difficulty scoring scale, which was used for assessing the technical difficulty of CBD stone removal, was developed and validated. We also analyzed the relationship between scores evaluated by the DSAS and clinical indicators including stone clearance rate and need for endoscopic papillary large-balloon dilation (EPLBD) and lithotripsy. Results The mIoU values of the stone, CBD, and duodenoscope segmentation were 68.35 %, 86.42 %, and 95.85 %, respectively. The estimation performance of the DSAS was superior to nonexpert endoscopists. In addition, the technical difficulty scoring performance of the DSAS was more consistent with expert endoscopists than two nonexpert endoscopists. A DSAS assessment score ≥ 2 was correlated with lower stone clearance rates and more frequent EPLBD. Conclusions An intelligent DSAS based on deep learning was developed. The DSAS could assist endoscopists by automatically scoring the technical difficulty of CBD stone extraction, and guiding the choice of therapeutic approach and appropriate accessories during ERCP.

Background. The purpose of this study was to evaluate the efficacy and safety of Panax ginseng extract (GS-KG9) in the treatment of hepatic dysfunction. Methods. A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2017 to January 2019. The trial included 60 subjects between the ages of 19 and 70 who had higher alanine transaminase (ALT) levels than the normal upper limit. The subjects were randomly divided into two groups: GS-KG9 (n = 30) and placebo (n = 30). The former was administered three GS-KG9 capsules (3 g/day) and the latter three placebo capsules (3 g/day) twice each day orally after meals in the morning and evening for 12 weeks. The primary goal was to observe the changes in ALT and gamma-glutamyl transferase (GGT) levels. The safety of the treatment was assessed and adverse events (AEs) were recorded. Results. Out of 60 subjects, nine were excluded from the efficacy analysis because they met the exclusion criteria. Therefore, a total of 51 subjects were evaluated for the effectiveness of the treatment (26 in the GS-KG9 group and 25 in the placebo group). After 12 weeks of treatment, the ALT levels were significantly reduced in the GS-KG9 group compared to the placebo group (p=0.009). The GGT level of the GS-KG9 group was significantly lower than that of the placebo group (p=0.036). Mild AEs, such as diarrhea, occurred during the study. There were no significant differences between the two groups. Conclusion. The results of this trial suggest that GS-KG9 might be an effective and safe option for mild hepatic dysfunction. This trial is registered with KCT0004080.

A comprehensive understanding of excited-state dynamics of semiconductor quantum dots or nanomaterials at the atomic or molecular level is of scientific importance. Pure inorganic (or non-covalently protected) seimiconductor molecular nanoclusters with atomically precise structure are contributive to establish accurate correlation of excited-state dynamics with their composition/structure, however, the related studies are almost blank because of unresolved solvent dispersion issue. Herein, we designedly created the largest discrete chalcogenide seimiconductor molecular nanoclusters (denoted P2-CuMSnS, M = In or/and Ga) with great dispersibility, and revealed an interesting intracluster “core-shell” charge transfer relaxation dynamics. A systematic red shift in absorption spectra with the gradual substitution of In by Ga was experimentally and computationally investigated, and femtosecond transient absorption measurements further manifested there were three ultrafast processes in excited-state dynamics of P2 nanoclusters with the corresponding amplitudes directed by composition variation. Current results hold the great promise of the solution-processible applications of semiconductor-NC-based quantum dots and facilitate the development of atomically precise nano-chemistry.

Background: Recently, a resurgence of pertussis has been observed worldwide despite broad vaccination coverage. The purpose of this study was to identify the clinical characteristics and the aetiol...

Rectifying semiconductor junctions are crucial to electronic devices. They convert alternating current into a direct one by allowing unidirectional charge flows. Analogous to the current-flow rectification for itinerary electrons, here, a polar rectification that is based on the localized oxygen vacancies (OVs) in a Ti/fatigued-SrTiO3 (fSTO) Schottky junction is first demonstrated. The fSTO with OVs is produced by an electrodegradation process. The different movabilities of localized OVs and itinerary electrons in the fSTO yield a unidirectional electric polarization at the interface of the junction under the coaction of external and built-in electric fields. Moreover, the fSTO displays a pre-ferroelectric state located between paraelectric and ferroelectric phases. The pre-ferroelectric state has three sub-states and can be easily driven into a ferroelectric state by an external electric field. These observations open up opportunities for potential polar devices and may underpin many useful polar-triggered electronic phenomena.

Knowledge sharing is commonly recognised as a key prerequisite of team innovativeness. What are the quality dimensions of knowledge sharing process that make it beneficial in terms of team innovati...

Objectives Evaluating potential relationships between progression‐free survival (PFS) and tumor gene expression patterns and mutational status was an exploratory objective of the phase 3 TOURMALINE‐MM1 study (NCT01564537) of ixazomib‐lenalidomide‐dexamethasone (IRd) vs placebo‐Rd in 722 patients with relapsed/refractory multiple myeloma (MM). Methods We utilized gene expression and mutation data from screening bone marrow aspirates to identify tumors with non‐canonical nuclear factor‐κB (NF‐κB) signaling pathway activation. Results DNA/RNA sequencing data were available for 339 (47.0%)/399 (55.2%) patients; 49/339 (14.5%) patients had non‐canonical NF‐κB pathway gene mutations (tumor‐necrosis‐factor receptor‐associated factor 2, 3 [TRAF2, TRAF3], baculoviral‐inhibitor‐of‐apoptosis repeat‐containing 2/3 [BIRC2/3]), and PFS was significantly longer with IRd vs placebo‐Rd in these patients (hazard ratio [HR] 0.23). In patients with lower TRAF3 expression (median not reached vs 11 months, HR 0.47) and higher NF‐κB‐inducing kinase (NIK) expression (median not reached vs 14 months, HR 0.45), both associated with non‐canonical NF‐κB pathway activation, PFS was significantly longer with IRd vs placebo‐Rd. TRAF3 expression was decreased in patients harboring t(4;14) and 1q21 amplification, suggesting increased non‐canonical NF‐κB pathway activation. Conclusions Adding ixazomib to Rd provides clinical benefit in MM tumors with increased non‐canonical NF‐κB pathway activity. This is a potential mechanism for activity in 1q21 amplified high‐risk tumors.

Summary Background Colonoscopy performance varies among endoscopists, impairing the discovery of colorectal cancers and precursor lesions. We aimed to construct a real-time quality improvement system (ENDOANGEL) to monitor real-time withdrawal speed and colonoscopy withdrawal time and to remind endoscopists of blind spots caused by endoscope slipping. We also aimed to evaluate the effectiveness of this system for improving adenoma yield of everyday colonoscopy. Methods The ENDOANGEL system was developed using deep neural networks and perceptual hash algorithms. We recruited consecutive patients aged 18–75 years from Renmin Hospital of Wuhan University in China who provided written informed consent. We randomly assigned patients (1:1) using computer-generated random numbers and block randomisation (block size of four) to either colonoscopy with the ENDOANGEL system or unassisted colonoscopy (control). Endoscopists were not masked to the random assignment but analysts and patients were unaware of random assignments. The primary endpoint was the adenoma detection rate (ADR), which is the proportion of patients having one or more adenomas detected at colonoscopy. The primary analysis was done per protocol (ie, in all patients having colonoscopy done in accordance with the assigned intervention) and by intention to treat (ie, in all randomised patients). This trial is registered with http://www.chictr.org.cn , ChiCTR1900021984. Findings Between June 18, 2019, and Sept 6, 2019, 704 patients were randomly allocated colonoscopy with the ENDOANGEL system (n=355) or unassisted (control) colonoscopy (n=349). In the intention-to-treat population, ADR was significantly greater in the ENDOANGEL group than in the control group, with 58 (16%) of 355 patients allocated ENDOANGEL-assisted colonoscopy having one or more adenomas detected, compared with 27 (8%) of 349 allocated control colonoscopy (odds ratio [OR] 2·30, 95% CI 1·40–3·77; p=0·0010). In the per-protocol analysis, findings were similar, with 54 (17%) of 324 patients assigned ENDOANGEL-assisted colonoscopy and 26 (8%) of 318 patients assigned control colonoscopy having one or more adenomas detected (OR 2·18, 95% CI 1·31–3·62; p=0·0026). No adverse events were reported. Interpretation The ENDOANGEL system significantly improved the adenoma yield during colonoscopy and seems to be effective and safe for use during routine colonoscopy. Funding Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Hubei Province Major Science and Technology Innovation Project, and the National Natural Science Foundation of China.

To observe the effect of moxa-stick moxibustion plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) in preventing chemotherapy infection in gastric cancer and its effect on immune function. A total of 70 patients with gastric cancer treated by chemotherapy were randomly divided into an observation group and a control group, with 35 cases in each group. The control group was given rhG-CSF, and the observation group was given additional moxa-stick moxibustion on the basis of rhG-CSF. Both groups were treated for 2 chemotherapy cycles, totally 6 weeks. The number of patients with infection, the duration of infection and the duration of continuous use of antibiotics were observed. The leukocytes and granulocytes counts, the levels of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were measured before and after treatment, and the levels of CD4, CD8 and natural killer (NK) cells were analyzed. The infection rate of the observation group was significantly lower than that of the control group (P 0.05). Moxa-stick moxibustion plus rhG-CSF can significantly reduce the incidence and severity of chemotherapy infection in gastric cancer, increase the leukocytes and granulocytes counts, and regulate the levels of inflammatory factors, which may be related to the improvement of the immune function of the patients.

Background/Aims: Esophageal squamous cell carcinoma is a common malignant tumor in recent years, and the key for improving the survival rate is early diagnosis and treatment. Computed virtual chromoendoscopy with the Fujinon intelligent color enhancement (FICE) system was reported to improve visualization of neoplastic and nonneoplastic lesions in gastroscopy and colonoscopy. The purpose of this study was to evaluate the value of FICE in the diagnosis of early esophageal squamous cell carcinoma and precancerous lesions. Materials and Methods: Two hundred fifty-seven patients with suspicious lesions of the esophagus were examined successively by FICE, magnifying FICE, Lugol chromoendoscopy, and magnifying Lugol chromoendoscopy in the hospital. The lesions and the intrapapillary capillary loop (IPCL, microvessels at the surface of esophageal carcinoma) were observed and compared with the pathologic diagnosis that was regarded as the golden standard. Results: The positive rates of early esophageal squamous cell carcinoma were 92.6% and 88.9% as examined by FICE and Lugol chromoendoscopy (p>0.05), and 96.3% and 92.6% as examined by magnifying FICE and magnifying Lugol chromoendoscopy (p>0.05), respectively. The magnifying FICE could observe the IPCL of the esophagus clearly. Early esophageal squamous cell carcinoma and high-grade intraepithelial neoplasia were mainly type IV and type V. Low-grade intraepithelial neoplasia and esophagitis were type II and type III, and normal esophagus was type I; however, the observation of the IPCL by magnifying Lugol chromoendoscopy was not clear. Conclusion: Fujinon intelligent color enhancement and magnifying FICE are complements to Lugol chromoendoscopy and magnifying Lugol chromoendoscopy in the diagnosis of early esophageal lesions.

The purpose of this article is to explore brand value networks and transmission mechanism in sharing economy based on prosumption logic. This study used Charmaz’s constructivist grounded theory to analyze the lectures and interviews, which come from founders and executives of Airbnb, Uber, Xiaozhu.com, and Didi. After coding analysis, we finally proposed a research model to explain the frame of brand value and showed the brand value transmission mechanism based on prosumption logic. In this article, we constructed that the frame of brand value based on prosumption logic consists of brand value, brand value net, and water wave effect. The water wave effect reveals the transmission mechanism of brand value under the logic of prosumption, which is not a chain transmission model, but a water wave mechanism. Overall, our results enrich the literature in the field of brand value in sharing economy.

This paper presents the concept of magnetic functional integrated DC motor drive. It uses the field winding of a wound-field DC motor as the inductor of its drive circuit. The field winding in a wound-field DC motor not only builds the required magnetic field for the electric-mechanic energy conversion, but also acts as the inductor to buffer the energy for the drive circuit. One magnetic component is shared to realize different functions for motor and its drive circuit, simultaneously. The weight, loss and cost of the drive system can be reduced due to the saving of extra bulky inductors for the drive circuit. This concept can be applied to all DC-DC drive circuits using inductor as its energy buffer. An example of magnetic functional integrated DC motor drive using the buck-boost converter is used to explain the concept in detail. The feasibility and the new features are verified experimentally by comparing with the conventional motor drive.

The texture edge continuity of a finger vein image is very important for the accuracy of feature extraction. However, the traditional inpainting methods which, without accurate texture constraints, are easy to cause the vein texture of the inpainted image to be blurred and break. A finger vein image inpainting method with Gabor texture constraints is proposed. The proposed method effectively protects the texture edge continuity of the inpainted image. Firstly, using the proposed vertical phase difference coding method, the Gabor texture feature matrix of the finger vein image, which can accurately describe the texture information, can be extracted from the Gabor filtering responses. Then, according to the local texture continuity of the finger vein image, the known pixels, which have different texture orientations with the center pixel in the patch, are filtered out using the Gabor texture constraining mechanism during the inpainting process. The proposed method eliminates irrelevant information interference in the inpainting process and has a more precise texture propagation. Simulation experiments of artificially synthetic images and acquired images show that the finger vein images inpainted by the proposed method have better texture continuity and higher image quality than the traditional methods which do not have accurate texture constraints. The proposed method improves the recognition performance of the finger vein identification system with the acquired damaged images.

Purpose: The purpose of this paper is to investigate the adoption model of user-generated content in Web 2.0 Internet environment. The author hopes to verify the quality of user-user interaction, and test the influence of such interaction on users’ perceived usefulness and adoption willingness. Design/Methodology/Approach: The influence of user generated content on e-commerce websites has been addressed in both practical and theoretical fields. This study focuses on the connotation of prosumption behavior and the quality of user-user interaction through qualitative research. It clarifies the mechanism of user interaction and counterproductive behavior in the Web 2.0 Internet platform for those from the double process theory perspective of Elaboration Likelihood Model (ELM). This study has investigated quantitatively. The authors used structural equations modeling on 58 users (21 offline and 37 online users of book.douban). Findings: Firstly, the results emphasized the effect of user-user interaction quality on user information usefulness and information willingness. In addition, the research results also proved that users’ perceived usefulness of UGC information and the willingness of UGC adoption have played a positive role in users’ subsequent prosumption behavior. Finally, we applied our theoretical findings to derive managerial implications. Originality/Value: This paper not only revealed quantitatively the nature of prosumption behavior and quality of user-user interaction, but also figured out the antecedents and consequences of information adoption.

Recent studies have indicated that the presence of ground-glass opacity (GGO) components is associated with favorable survival. The purpose of this study was to reveal the prognostic value of GGO components and differences in prognostic factors for part-solid and solid lesions in invasive stage I NSCLC.The cases of 2010 patients with completely resected invasive pathological stage I NSCLC were reviewed according to the eighth edition of the TNM classification. Patients were categorized into the pure-GGO, part-solid, and solid groups based on consolidation-to-tumor ratio. Cox multivariate proportional hazard analyses were conducted to identify independent prognostic factors in each group.Of the 2010 patients, 146 (7.3%) were in the pure-GGO group, 732 (36.4%) were in the part-solid group, and 1132 (56.3%) were in the solid group. Cox multivariate analyses revealed that GGO absence was a strong independent risk factor for worse recurrence-free survival (p0.001). For the pure-GGO group, there was no recurrence in spite of the invasive stage. For the part-solid group, visceral pleural invasion could not predict recurrence-free survival in general (p = 0.514) or in each tumor size group (for tumors size ≤1 cm, p = 0.664; for tumors size1 to 2 cm, p = 0.456; for tumors size2 to 3 cm, p = 0.900; and for tumors size3 to 4 cm, p = 0.397). For the solid group, adenocarcinoma subtype was not a prognostic factor for recurrence-free survival in general (p = 0.162) or in each tumor size group (for tumors size ≤ 2 cm, p = 0.092; for tumors size2 to 3 cm, p = 0.330; and for tumors size3 to 4 cm, p = 0.885).The presence of GGO components was a strong predictor in patients with invasive pathological stage I NSCLC. Risk factors were distinct in the part-solid and solid groups. There was no prognostic value of visceral pleural invasion in the part-solid group. Adenocarcinoma subtype did not have prognostic value in the solid group.

Weakly-coupled mode division multiplexing (MDM) technique based on few mode fiber (FMF) with low linear-polarized (LP) modal crosstalk is promising for capacity enhancement of short-reach transmission. In this paper, we propose a double-ring-core FMF for simultaneous 6-LP-mode weakly-coupled MDM transmission. FMF with ring-core structure is theoretically analyzed by deriving from a step-index circular-core FMF with perturbed ring areas. Then simplified method is proposed to define boundaries of ring areas in FMF and increase the minimum effective refractive index difference ( min | Δ n e f f | ) among all the modes. Fabricated by commercial fabrication technique, the FMF achieves a min | Δ n e f f | up to 1.49 × 10−3 while its maximum Δ n between core and cladding is only 0.828%, which greatly reduces the difficulty of fiber fabrication. Thanks to the ultralow modal crosstalk of the FMF, we successfully demonstrate simultaneous 6-LP-mode (LP01, LP11, LP21, LP02, LP31 and LP12) 4-wavelength 71-km weakly-coupled MDM transmission using 10 Gb/s optical on-off-keying (OOK) intensity modulation and direct detection (IM/DD) without any digital signal processing (DSP). The design method can be extended to weakly-coupled FMFs with more ring areas.

An acquired cholesteatoma generally occurs as a consequence of otitis media and eustachian tube dysfunction. Patients with acquired cholesteatoma generally present with chronic otorrhea and progressive conductive hearing loss. There are many microbes reportedly associated with acquired cholesteatoma. However, conventional culture-based techniques show a typically low detection rate for various pathogenetic bacteria and fungi. Metagenomic next-generation sequencing (mNGS), an emerging powerful platform offering higher sensitivity and higher throughput for evaluating many samples at once, remains to be studied in acquired cholesteatoma. In this study, 16 consecutive patients from January 2020 to January 2021 at the Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU) were reviewed. We detected a total of 31 microbial species in patients, mNGS provided a higher detection rate compared to culture (100% vs. 31.25%, p = 0.000034). As the severity of the patient’s pathological condition worsens, the more complex types of microbes were identified. The most commonly detected microbial genus was Aspergillus (9/16, 56.25%), especially in patients suffering from severe bone erosion. In summary, mNGS improves the sensibility to identify pathogens of cholesteatoma patients, and Aspergillus infections increase bone destruction in acquired cholesteatoma.

Background: Acute acalculous cholecystitis (AAC) is characterized by the development of cholecystitis in the gallbladder without gallstones or with small gallstones unrelated to inflammatory diseases. This disease is not rare in the elderly bedridden patients with co-morbidities and prone to develop life-threatening gangrene or perforation of gallbladder. Early imaging is essential for detecting and effectively treating AAC. This study aimed to evaluate the use of ultrasound diagnostic criteria for the diagnosis and prognosis of elderly long-term bedridden patients with suspected AAC.Methods: We retrospectively studied 374 elderly bedridden patients with clinical manifestations of AC at the acute stage of the disease. Gallbladder anomalies were found in 92 patients by ultrasound examination, which correlated with the duration time of clinical manifestations, complications, as well as therapeutic prognosis. The major and minor ultrasound criteria of AAC were made according to the Tokyo Guidelines 2018. Ultrasound results were thought to be AAC positive when they met two major criteria or one major and two minor criteria.Results: Forty-three (46.7%) of the 92 patients presented with AAC (+) test results based on the ultrasound criteria, with a higher incidence of complications (27.9%) than AAC (–) patients (0%; P < 0.001). The median length of symptoms (8 vs. 4 days, P < 0.001) and duration of antibiotic therapy (13 vs. 5 days, P < 0.001) were longer in the AAC (+) group.Conclusions: The ultrasound-based AAC (+) group often had a worse prognosis than the AAC (–) group. Therefore, patients from the AAC (+) group should receive a follow-up ultrasound examination to detect disease progression early.

An all-fiber mode power splitter (MPS) for mode-division multiplexing (MDM) transmission is proposed and numerically investigated. The MPS is based on the configuration of the symmetric few-mode fiber (FMF) coupler, with the operation of four modes ( L P 01 , L P 11 , L P 21 , and L P 02 ). By comprehensively optimizing the FMF coupling parameters, including both the coupling area distance D and the coupling length L , MPSs with various power splitting ratios from 90%:10% to 50%:50% under the condition of different single guided mode injection are obtained. Then, the MPS with a 90%:10% power splitting ratio under the simultaneous injection of L P 01 , L P 11 , L P 21 , and L P 02 modes is reported, which can be used as the mode tap for the optical performance monitoring. Moreover, based on the proposed MPS structure, selective mode power strippers with more than 25 dB mode extinction ratio for L P 01 , L P 11 , L P 21 , and L P 02 modes are numerically verified. The arbitrary single guided mode arising in the FMF can be selectively coupled into another FMF, together with an insertion loss of less than 1 dB. Owing to the flexible setting of the mode power splitting ratio, the proposed MPS may become a potential solution to realizing system performance monitoring and mode power routing in MDM systems.

This study uses 31 provinces and municipalities from China’s textile industry as a research sample and divides the region into four geographical areas: eastern, central, western, and northeastern. It quantified smart servitization in the textile industry using input–output data and applied the fuzzy set qualitative comparison analysis to identify potential pathways for promoting smart servitization in the textile industry. The study’s findings indicate that there are significant geographical differences in the level of smart servitization in the textile industry across China. Moreover, the transformation and development of the textile industry require the co-operation of numerous factors, and the Chinese textile industry’s transformation paths can be summarized as “high-input” path, “technology—aggregation” path, “open” path, and “economic-agglomeration” path.

Vein contraction and venous compression typically caused by low temperature and excessive placement pressure can blur the captured finger vein images and severely impair the quality of extracted features. To improve the quality of captured finger vein image, this paper proposes a 26-layer generator network constrained by Neighbors-based Binary Patterns (NBP) texture loss to recover the clear image (guessing the original clear image). Firstly, by analyzing various types and degrees of blurred finger vein images captured in real application scenarios, a method to mathematically model the local and global blurriness using a pair of defocused and mean blur kernels is proposed. By iteratively and alternatively convoluting clear images with both kernels in a multi-scale window, a polymorphic blur training set is constructed for network training. Then, NBP texture loss is used for training the generator to enhance the deblurring ability of the network on images. Lastly, a novel network structure is proposed to retain more vein texture feature information, and two residual connections are added on both sides of the residual module of the 26-layer generator network to prevent degradation and overfitting. Theoretical analysis and simulation results show that the proposed neighbors-based binary-GAN (NB-GAN) can achieve better deblurring performance than the the-state-of-the-art approaches.

Open-domain dialogue generation in natural language processing (NLP) is by default a pure-language task, which aims to satisfy human need for daily communication on open-ended topics by producing related and informative responses. In this paper, we point out that hidden images, named as visual impressions (VIs), can be explored from the text-only data to enhance dialogue understanding and help generate better responses. Besides, the semantic dependency between an dialogue post and its response is complicated, e.g., few word alignments and some topic transitions. Therefore, the visual impressions of them are not shared, and it is more reasonable to integrate the response visual impressions (RVIs) into the decoder, rather than the post visual impressions (PVIs). However, both the response and its RVIs are not given directly in the test process. To handle the above issues, we propose a framework to explicitly construct VIs based on pure-language dialogue datasets and utilize them for better dialogue understanding and generation. Specifically, we obtain a group of images (PVIs) for each post based on a pre-trained word-image mapping model. These PVIs are used in a co-attention encoder to get a post representation with both visual and textual information. Since the RVIs are not provided directly during testing, we design a cascade decoder that consists of two sub-decoders. The first sub-decoder predicts the content words in response, and applies the word-image mapping model to get those RVIs. Then, the second sub-decoder generates the response based on the post and RVIs. Experimental results on two open-domain dialogue datasets show that our proposed approach achieves superior performance over competitive baselines., Accepted by ACM MultiMedia 2021

In this paper we report the design, fabrication and measurement of a novel 8-core FiFo device using fused tapering method and trench-assisted bridge fiber. The device is constitutive of 8-core fiber, tapered bridge fiber bundle and single-mode fibers. The minimum and maximum insertion loss of the Fi/Fo device are 0.25 dB and 0.98 dB, respectively.

Background H type hypertension is defined as homocysteine (Hcy) ≥ 10 μmol/L in combination with primary hypertension. Studies demonstrated that the existence of hyperhomocysteine (HHcy) in hypertensive exacerbates the poor outcome of cardiocerebral incidents. This study was to investigate the current epidemic situation of H type hypertension and determine the risk factors in order to find intervention targets for H type hypertensives. Methods We conducted a cross-sectional study using cluster sampling design in Shanghai, China from July 2019 and April 2020. 23,652 patients with primary hypertension were enrolled in this study. Their medical information was recorded, and the level of Hcy concentrations and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms were detected. Results In total, 22,731 of 23,652 patients were recorded. The mean age was 68.9 ± 8.6 y and 43% were men. 80.0% of the enrolled patients had H type hypertension. The frequency of allele T was 40.9%, and the proportions of the CC, CT, and TT genotypes were 36.1%, 46.0%, and 17.9%, respectively. Compared with the TT genotype, the plasma Hcy concentration levels were lower in patients with the CC/CT genotype (18.96 ± 13.48 μmol/L vs. 13.62 ± 5.20/14.28 ± 5.36, F = 75.04, p Conclusions The prevalence of H type hypertension in patients with primary hypertension was 80.0%, which was higher than the 75% found in prior report in China. Age, gender, and MTHFR C677T polymorphisms rather than smoking and diabetes were independently associated with H type hypertension.

Innate lymphoid cells (ILCs) are emerging as important players in inflammatory diseases. The oral mucosal barrier harbors all ILC subsets, but how these cells regulate the immune responses in periodontal ligament tissue during periodontitis remains undefined. Here, we show that total ILCs are markedly increased in periodontal ligament of periodontitis patients compared with healthy controls. Among them, ILC1s and ILC3s, particularly NKp44+ILC3 subset, are the predominant subsets accumulated in the periodontal ligament. Remarkably, ILC1s and ILC3s from periodontitis patients produce more IL-17A and IFN-γ than that from healthy controls. Collectively, our results highlight the role of ILCs in regulating oral immunity and periodontal ligament inflammation and provide insights into targeting ILCs for the treatment of periodontitis.

Inflammatory bowel disease (IBD) affects 0.3% of the global population, yet the etiology remains poorly understood. Anti-inflammation therapy has shown great success, but only 60% of patients with IBD benefit from it, indicating that new targets are needed. Here, we report the discovery of an intrinsic counter regulatory mechanism in colitis pathogenesis that may be targeted for IBD treatment. In response to microbial invasion, resident Vimentin+ stromal cells, connective tissue cells genetically marked by Twist2, are activated during the propagation phase of the disease, but not during initiation and resolution phases, and become a primary source of prostaglandin E2 (PGE2). PGE2 induction requires a nuclear factor κB-independent, TLR4-p38MAPK-Cox2 pathway activation. Ablation of each of the pathway genes, but not Rela or Tgfb1, in Twist2 cells enhanced M1 macrophage polarization and granulocyte/T helper 1 (TH1)/TH17 infiltration and aggravated colitis development. PGE2 administration ameliorated colitis in mouse models with defective PGE2 production but not in animals with normal PGE2 induction. Analysis of clinical samples and public domain data revealed increased expression of Cox2, the rate-limiting enzyme of PGE2 biosynthesis, in inflamed tissues, and especially in colon Vimentin+Twist2+ stromal cells, in about 60% of patients with active Crohn's disease or ulcerative colitis. Moreover, Cox2 protein expression was negatively correlated with disease severity, suggesting an involvement of stromal cells in IBD pathogenesis. Thus, the study uncovers an active immune pathway in colitic inflammation that may be targeted to treat patients with IBD with defects in PGE2 production.

The involvement of cardiomyopathy during sepsis means higher mortality and prolonged length of hospital stay. Many efforts have been made to alleviate the apoptosis of cardiomyocytes in sepsis. The huge potential of IL-13 in tissue repair has attracted increasing attention. In the present study, we used LPS-treated mice or primary cardiomyocytes as a sepsis model to explore the anti-apoptotic ability of IL-13. It was found that an increased level of exogenous IL-13 was beneficial to the recovery of heart function in sepsis, and this anti-apoptotic effect of IL-13 was probably through enhancing the phosphorylation of STAT3 Ser727. In addition, we identified that the heart protective effect of IL-13 was associated with type 2 innate lymphocytes (ILC2). All these findings may provide a potential promising treatment for sepsis-induced cardiomyopathy.

Porokeratosis (PK) is considered a skin-specific autoinflammatory keratinization disease. Intriguingly, four causative genes of PK are in turn arranged in mevalonate pathway, with MVD variants being the commonest followed by MVK variants in a cohort of Chinese patients. Based on our previous findings, PK patients with MVK or MVD variants show different phenotypes. Using targeted exome sequencing and exonic CNV screening, we identified 14 mutations in the 26 PK patients, including six novel mutations (MVK: c.118_226 + 1337dup, c.388_392delGATATinsC, c.613A > T, c.768G > C, and MVD: c.250C > T, c.988T > G). Peripheral T-cell subsets were analyzed by flow cytometry in PBMCs from 22 PK patients with MVK or MVD variants and 27 normal controls (NCs). In contrast to NCs, significantly decreased frequencies of CD8+ and Vγ9Vδ2 T cells were observed in the PK patients with MVD variants. Moreover, it was found that dysregulated secretion of pro-inflammatory cytokines by T-cell in both PK patients with MVK and MVD variants. Collectively, our findings enriched the Human Gene Mutation Databases and provided the cues to further studies on autoreactive CD8 + T and γδT cells in the pathogenesis of PK.

Introduction: Minimally invasive endoscopic resection is often effective in the management of early gastrointestinal tumors. However, advanced and more effective methods of endoscopic examination are required to improve the rate of diagnosing early gastrointestinal tumors. Discussion: The development of dye-based image-enhanced endoscopy (d-IEE) and equipment-based image-enhanced endoscopy (e-IEE) has helped improve the diagnostic rate of early gastrointestinal tumor using endoscopy. In some special cases, these methods are still not accurate in diagnosing lesions. On the basis of these e-IEEs, a new endoscopic technique, linked color imaging (LCI), that combines a specific short wavelength narrow band of light with white light, has been developed. Conclusion: In this article, we summarized the characteristics of LCI and the development of research regarding digestive tract examination. Plain language summary Application of linked color imaging in early gastrointestinal neoplasms At present, the complete diagnosis of early gastrointestinal tumors and precancerous lesions can be made by gastrointestinal endoscopy. With the improvement of therapeutic instruments and operators’ experience, endoscopic therapy can often achieve significant effect in the treatment of early gastrointestinal tumors. The development and spread of equipment-based image-enhanced endoscopy (e-IEE) mode has helped improve the diagnosis rate of early gastrointestinal tumors under endoscopy. However, in some special cases, these methods are still not accurate for the diagnosis of lesions. On the basis of these E-IEEs, a new endoscopic technique, linked color imaging (LCI), has been developed, which combines a specific short wavelength narrow band of light with white light. LCI can significantly improve the diagnostic rate of all types of gastrointestinal mucosal lesions. Tumor lesions and inflammatory lesions can be distinguished by observing the mucosal microvascular structure and color difference. LCI helps detect early gastrointestinal mucosal lesions by taking advantage of the differences in light absorption of different wavelengths and contrast of enhanced colors in the later stage.