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Information topology graph has been extensively used in modeling network management, where it is necessary to continually optimize the management of the dynamic network. However, frequent reconfiguration may lead to an increased overhead and a degraded latency. Since the mobility in a vehicular network is restricted by the road, there is an internal relatively stable part embedded in the entire dynamic network. Thus, in this study, this characteristic is first used to reduce reconfiguration, where the maximum stable subgraph is extracted and configuration only needs to be reconsidered for the rest of the network. However, there are three main challenges in the modeling and solving procedure, namely the evaluation of stability of part of the network, the assurance of the coherence in the set of extracted vehicles and the huge computation complexity of the subgraph enumeration. Therefore, in this study, first, the vehicular network is modeled by constructing the time-evolving information topology graph, in which a subgraph similarity is constructed to quantify the stability of part of network. Second, a maximum stable subgraph extraction optimization problem is presented, where the coherence constraint of vehicles is proposed. Finally, a gradual contraction extraction algorithm is proposed to solve the optimization problem with a low complexity. The simulation results reveal that the proposed algorithm can extract a stable subgraph with an approximate maximum size, and has a higher adaptability than the compared ones. Furthermore, it was found that the application of the proposed algorithm in resource allocation can effectively reduce the reconfiguration.

BACKGROUND AND PURPOSE Psoriasis is a chronic inflammatory skin disease associated with both innate and adaptive immune responses. The stimulator of interferon genes (STING) protein engages in sensing of cytosolic DNA to initiate dsDNA-driven immune responses. In vitro and in vivo anti-psoriasis effects of STING antagonist H-151 were explored. EXPERIMENTAL APPROACH We analysed the gene expression profile of STING and related downstream targets in the skin samples of healthy people and psoriasis patients from the GEO database. Cellular inhibitory activity of H-151 on STING pathway was confirmed via qPCR and western blotting. The preventive effect of topical application of H-151 on imiquimod-induced psoriatic mice was examined through histological, immunohistochemical, immunofluorescent, flow cytometric analysis, ELISA Kits and other approaches. Preliminary mechanistic studies were also performed. KEY RESULTS Gene expressions of STING and its downstream target were up-regulated in lesional skin samples from psoriasis patients. Topical administration of H-151 attenuated the skin lesions in imiquimod-induced psoriatic mouse model, while the secretion of pro-inflammatory cytokines (IL-17, IL-23 and IL-6), infiltration of M1 macrophages and differentiation of Th17 cells were significantly suppressed by H-151 treatment. Mechanistically, H-151 inhibited STING/NF-κB signalling in both keratinocytes and immune cells. CONCLUSION AND IMPLICATIONS H-151 displayed anti-inflammatory activity in both keratinocytes and immune cells, and decreased the severity of psoriatic response in vivo. Inhibition of STING signalling pathway may represent a novel therapeutic approach to psoriasis and related complications.

BACKGROUND Although climate change and agricultural practices have non-negligible impacts on crop yields, their quantitative contributions to soybean yields remain unclear. First-order difference multiple regression was used to determine the respective contributions of climate change and agricultural practice to changes in soybean yields at station level from 1981 to 2010 in northeast China. RESULTS From 1981 to 2010, the soybean yields at 87% of the stations were increasing with an average 41.18 kg ha year-1 change trend in northeast China. The individual impacts of climate change and agricultural practice on soybean yield were -0.33% to 0.58% year-1 and -3.3% to 7.89% year-1 , respectively. The sensitivity of the soybean yield to climatic factors was related to latitude, and yields at high-latitude stations were positively correlated with temperature but negatively correlated with accumulated sunshine hours. Climate change contributed -24% to 38% to the trend in soybean yield, and the temperature had the greatest effect of all the climatic factors. CONCLUSION The contribution of agricultural practices was greater than that of climate change, counteracting the adverse effects of climate change and even affecting the direction of soybean yield changes. In adaptive decision making, priority should be given to management measures that have less impact on the environment, such as breeding new varieties adapted to specific latitudes, thus promoting the sustainable production of soybeans. © 2021 Society of Chemical Industry.

Background: Buyang Huanwu Tang (BYHWT) and relevant Traditional Chinese medicine (TCM) has its unique advantages in the treatment of cerebral ischemia. However, its pharmacological mechanism has not been fully explained. Objective: Base on the multi-component, also the entire disease network targets, the present study sets out to identify major bioactive ingredients, key disease targets, and pathways of BYHWT against cerebral ischemia disease by systematic pharmacological methodology. Methods: Both the bioactive compounds from the BYHWT and the positive drugs against cerebral ischemia were fully investigated. The binding targets of the positive drugs were then obtained. A virtual screening protocol was then used to highlight the compound-target interaction and network was constructed to visualize the compound-target binding effect after docking analysis. Moreover, the targets enrichment analysis for biological processes and pathways were performed to further explore the function of bio-targets protein gene and its role in the signal pathway. Results: A total of 382 active ingredients of the BYHWT and 23 candidate disease targets were identified. Virtual screening results indicated that multiple bioactive compounds targeted multiple proteins. Each compound acts on one or more targets. The mechanisms were linked to 20 signaling pathways, and the key mechanism was related to serotonergic synapse, calcium signaling pathway and camp signaling pathways. Conclusion: The present study explored the bioactive ingredients and mechanisms of BYHWT against cerebral ischemia by systematic pharmacological methodology. The novel methodology would provide a reference for the lead discovery of precursors, disease mechanism and material base for TCM.

Background Surgery is an important component in the treatment of esophageal cancer. For patients not eligible for R0 resection, defined as locally advanced unresectable esophageal cancer, a new approach is to transform the cancer into a resectable state by preoperative treatment. However, preoperative chemo/radiation is unsatisfactory. Therefore, the aim of this study was to assess the safety and efficacy of chemo/radiotherapy combined with a programmed cell death protein 1 (PD‐1) inhibitor in the preoperative transformation of unresectable esophageal cancer. Methods Patients were evaluated as having unresectable, locally advanced esophageal cancer at baseline and were re‐evaluated as possible R0 resection candidates after PD‐1 inhibitor treatment. Patient data were derived from the prospective database of Peking University Cancer Hospital Thoracic Surgery I. Preoperative chemotherapy plus PD‐1 inhibitor treatment was defined as “transformation treatment.” The objective response rate, operation rate (proportion of patients who underwent surgery), R0 rate, and treatment safety were analyzed retrospectively. Results A total of 36 patients were enrolled into the study, and 94.4% (34/36) completed the planned transformation treatment. The objective response rate was 71.4% (25/35), and 75% (27/36) of the patients who completed transformation treatment underwent surgery. For these surgical patients, 81.5% (22/27) obtained R0 resection, and 22.2% (6/22) had pathological complete response (pCR). During transformation treatment, 22.2% (8/36) patients had ≥ grade 3 complications. There were no reoperations or perioperative deaths. After surgery, 29.6% (8/27) had ≥ grade 3 complications. Conclusions Esophagectomy after immunotherapy is safe with acceptable complications. Compared with chemotherapy alone, chemotherapy combined with immunotherapy had a more favorable transformation effect for patients with unresectable esophageal cancer., Thirty‐six patients were enrolled. All patients received preoperative immunotherapy and 94.4% (34/36) completed the planned transformation treatment. The objective response rate was 71.4% (25/35), and 75% (27/36) of the patients who completed transformation treatment underwent surgery. For these surgical patients, 81.5% (22/27) obtained R0 resection, and 22.2% (6/22) had pathological complete response (pCR) as confirmed by postoperative pathological report.

In the cooperative vehicle infrastructure system (CVIS), due to the limitation of deployment conditions, some roadside units (RSUs) need to use renewable energy to supply power and transmit the fused sensor network’s data to the backbone network through the passing vehicles. Aiming at the problem of energy consumption and time delay guarantee of multiple self-powered RSUs in the CVIS, a distributed packet scheduling optimization strategy for energy-delay trade-off in self-powered RSUs is proposed. The strategy can minimize the system energy consumption by constraining the packet queue length of the self-powered RSUs. A dynamic optimization model of distributed packet adaptive scheduling for multiple self-powered RSUs is established based on the Lyapunov optimization theory. Based on the knapsack algorithm, the analytical algorithm of the optimization model is proposed. The simulation results show that the packet scheduling strategy can reduce the energy consumption and delay of the system by satisfying the upper limit of the packet queue length.

Metastatic prostate cancer (mPCa) is responsible for most prostate cancer (PCa) deaths worldwide. The present study aims to explore the molecular differences between mPCa and PCa. The authors downloaded GSE6752, GSE6919, and GSE32269 from the Gene Expression Omnibus and employed integrated analysis to identify differentially expressed genes (DEGs) between mPCa and PCa. Functional and pathway-enrichment analyses were performed, and a protein–protein interaction (PPI) network and modules were constructed. Clinical mPCa specimens were collected to verify the results by performing RT-qPCR. The Cancer Genome Atlas database was used to conduct a survival analysis, and an immunohistochemical assay was performed. The invasion ability of PCa cells was verified by Transwell assay. One-hundred six consistently DEGs were found in mPCa compared with PCa. DEGs significantly enriched the positive regulation of cell proliferation, cell division, and cell adhesion in small cell lung cancer and PCa. Cell division, nucleoplasm, and cell cycle were selected from the PPI network, and the top 10 hub genes were selected. CDC20 and PTTG1 with genetic alterations were significantly associated with poorer disease-free survival. Immunohistochemical assay results showed that the expression levels of CDC20 and PTTG1 in mPCa were higher than those in PCa. The results of the migration assay indicated that CDC20 and PTTG1 could enhance the migration ability of PCa cells. The present study revealed that CDC20 and PTTG1 contribute more to migration, progression, and poorer prognoses in mPCa compared with PCa. CDC20 and PTTG1 could represent therapeutic targets in mPCa medical research and clinical studies.

The prestressed concrete girder with corrugated steel webs is one of the most promising steel–concrete hybrid structures applied to highway and railway bridges, owing to its excellent mechanical properties and efficient material utilisation. Composite bridges with corrugated steel webs (CBCSWs) have undergone rapid development in China since 2005, resulting in remarkable technical progress in many aspects. A state-of-the-art review of CBCSWs in China is presented. Based on data collected for over 90 CBCSWs built in China during the years 2005–2018, characteristics relating to bridge span, structural type and construction methods are comprehensively analysed. Some mechanical issues regarding the design and construction of typical CBCSWs are elaborated to understand fully their structural performance and promote their development. Furthermore, a few representative CBCSWs are expounded in relation to their innovative structural design and construction techniques; their respective characteristics are highlighted. Finally, several conclusions are drawn and future research directions are predicted: the CBCSW is a competitive bridge solution when 80–200 m main spans are required; advanced materials, innovative structure types and advanced construction methods making good use of corrugated steel web are the source of its development. The experiences in this study can serve as a useful base for constructing more excellent and impressive CBCSWs.

BACKGROUND The ideal depth of general anesthesia should achieve the required levels of hypnosis, analgesia, and muscle relaxation while minimizing physiologic responses to awareness. The choice of anesthetic strategy in patients with coronary heart disease (CHD) undergoing major noncardiac surgery is becoming an increasingly important issue as the population ages. This is because general anesthesia is associated with a risk of perioperative cardiac complications and death, and this risk is much higher in people with CHD. AIM To compare hemodynamic function and cardiovascular event rate between etomidate- and propofol-based anesthesia in patients with CHD. METHODS This prospective study enrolled consecutive patients (American Society of Anesthesiologists grade II/III) with stable CHD (New York Heart Association class I/II) undergoing major noncardiac surgery. The patients were randomly allocated to receive either etomidate/remifentanil-based or propofol/remifentanil-based general anesthesia. Randomization was performed using a computer-generated random number table and sequentially numbered, opaque, sealed envelopes. Concealment was maintained until the patient had arrived in the operating theater, at which point the consulting anesthetist opened the envelope. All patients, data collectors, and data analyzers were blinded to the type of anesthesia used. The primary endpoints were the occurrence of cardiovascular events (bradycardia, tachycardia, hypotension, ST-T segment changes, and ventricular premature beats) during anesthesia and cardiac troponin I level at 24 h. The secondary endpoints were hemodynamic parameters, bispectral index, and use of vasopressors during anesthesia. RESULTS The final analysis included 40 patients in each of the propofol and etomidate groups. The incidences of bradycardia, hypotension, ST-T segment changes, and ventricular premature beats during anesthesia were significantly higher in the propofol group than in the etomidate group (P < 0.05 for all). The incidence of tachycardia was similar between the two groups. Cardiac troponin I levels were comparable between the two groups both before the induction of anesthesia and at 24 h after surgery. When compared with the etomidate group, the propofol group had significantly lower heart rates at 3 min after the anesthetic was injected (T1) and immediately after tracheal intubation (T2), lower systolic blood pressure at T1, and lower diastolic blood pressure and mean arterial pressure at T1, T2, 3 min after tracheal intubation, and 5 min after tracheal intubation (P < 0.05 for all). Vasopressor use was significantly more in the propofol group than in the etomidate group during the induction and maintenance periods (P < 0.001). CONCLUSION In patients with CHD undergoing noncardiac major surgery, etomidate-based anesthesia is associated with fewer cardiovascular events and smaller hemodynamic changes than propofol-based anesthesia.

BACKGROUND Nonalcoholic fatty liver disease (NAFLD) affects more than one-quarter of the global population. Due to the lack of approved chemical agents, many patients seek treatment from traditional Chinese medicine (TCM) formulas. A variety of systematic reviews have been published regarding the effectiveness and safety of TCM formulas for NAFLD. AIM To critically appraise available systematic reviews and sort out the high-quality evidence on TCM formulas for the management of NAFLD. METHODS Seven databases were systematically searched from their inception to 28 February 2020. The search terms included “non-alcoholic fatty liver disease,” “Chinese medicines,” “systematic review,” and their synonyms. Systematic reviews involving TCM formulas alone or in combination with conventional medications were included. The methodological quality and risk of bias of eligible systematic reviews were evaluated by using A Measure Tool to Assess Systematic Reviews 2 (AMSTAR 2) and Risk of Bias in Systematic Review (ROBIS). The quality of outcomes was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS Seven systematic reviews were ultimately included. All systematic reviews were conducted based on randomized controlled trials and published in the last decade. According to the AMSTAR 2 tool, one systematic review was judged as having a moderate confidence level, whereas the other studies were rated as having a low or extremely low level of confidence. The ROBIS tool showed that the included systematic reviews all had a high risk of bias due to insufficient consideration of identified concerns. According to the GRADE system, only two outcomes were determined as high quality; namely, TCM formulas with the HuoXueHuaYu principle were better than conventional medications in ultrasound improvement, and TCM formulas were superior to antioxidants in alanine aminotransferase normalization. Other outcomes were downgraded to lower levels, mainly because of heterogeneity among studies, not meeting optimal information sample size, and inclusion of excessive numbers of small sample studies. Nevertheless, the evidence quality of extracted outcomes should be further downgraded when applying to clinical practice due to indirectness. CONCLUSION The quality of available systematic reviews was not satisfactory. Researchers should avoid repeatedly conducting systematic reviews in this area and focus on designing rigorous randomized controlled trials to support TCM formula applications.

Few large-sample research data sets exist on long-term survival and prognostic factors among patients with primary malignant melanoma of the esophagus (PMME), a rare malignancy associated with poor outcomes. We sought to investigate postoperative survival and prognostic factors in patients with PMME.We retrospectively analyzed long-term follow-up results for patients with PMME who underwent surgery at 10 Chinese centers between January 1998 and January 2018. We performed uni- and multivariate analyses to investigate clinicopathologic factors associated with survival.Median overall survival for the entire group (N = 70 patients) was 13.5 months. Female sex (hazard ratio [HR], 0.352; 95% confidence interval [CI], 0.138-0.900; P = .029), ≥12 lymph nodes dissected (HR, 0.274; 95% CI, 0.133-0.563; P .001), absence of lymph node metastasis (HR, 0.195; 95% CI, 0.084-0.451; P .001), and postoperative adjuvant therapy (HR, 0.474; 95% CI, 0.249-0.901; P = .023) were factors of favorable prognosis. Preoperative pathologic diagnosis of PMME was as low as 47.1%. A high proportion of patients had lymph node metastasis, including those with early-stage tumors. Rates of lymph node metastasis were 54.2% (13/24) for pT1, 44.4% (12/27) for pT2, 57.1% (8/14) for pT3, and 100% (5/5) for pT4. Regional lymph node recurrence (N = 43 [61.4%]) was the predominant postoperative pattern of recurrence or metastasis.Female sex, pN0, increased number of lymph nodes dissected, and postoperative adjuvant therapy were associated with better outcomes among patients with PMME. Preoperative pathologic diagnosis of PMME was low, patients had lymph node metastasis (even those with early-stage tumors), and regional lymph node recurrence was common.

Zhibai Dihuang pill (ZBDH), a Chinese herbal formula, has been widely used as an adjunctive therapy to help reduce the patient's steroid dose and maintain low disease activity in systemic lupus erythematosus (SLE).This systematic review evaluates the therapeutic effect of modified ZBDH in reducing steroid use in patients with SLE.A systematic literature search was carried out using seven databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chinese VIP Information and Wanfang Database, from their inception to June 1st, 2019. The search terms included "systemic lupus erythematosus," "Chinese medicine" and "clinical trial," and their synonyms. Subject headings matching the above terms were also used.This meta-analysis included randomized controlled trials that evaluated the reduction of steroid dose in patients with SLE. Traditional Chinese medicine (TCM) formulas in experimental group should be prescribed based on ZBDH and used as adjunctive therapy and the comparator should contain steroids.Two authors independently conducted database search, study selection, data extraction and quality assessment. The extracted information contained study design, sample size, recruitment mode, diagnostic criteria, inclusion and exclusion criteria, participant characteristics, TCM patterns, TCM formulas and treatment outcomes. The primary outcome was the change of steroid dose. Secondary outcomes included SLE Disease Activity Index (SLEDAI), biomarkers of disease activity and clinical response rate. STATA 15.0 was used to analyze the pooled effects reported as weighted mean difference (WMD) or odds ratio, with a 95% confidence interval (CI).In total, 20 trials involving 1470 SLE patients were included. The pooled result showed that modified ZBDH taken in combination with standard care led to a larger reduction in steroid dose, compared to standard care alone (WMD: 3.79; 95% CI: 2.58-5.01; P 0.001). Favorable outcomes were also seen in secondary outcome criteria, such as SLEDAI and complement 3. The modified ZBDH treatments were well tolerated without increasing adverse effects.The systematic review provided preliminary evidence supporting the use of ZBDH as a co-therapy to aid steroid dose reduction in patients with SLE. However, more rigorous studies should be conducted to validate these findings, and explore the mechanisms of ZBDH's relevant bioactive constituents.

We investigate, for the first time, the effect of line-edge roughness (LER)-induced variability for dual-metal gate (DMG) Fin field-effect transistors (FinFETs) using a computer-aided-design simulation. The Gaussian autocorrelation function is utilized for generating the LER sequence. From the standard deviations of subthreshold swing (SS), threshold voltage (VTH), and transconductance (gm), the simulation results indicate that the LER-induced electrostatic integrity variability is related to the ratio of control gate to total gate lengths. The variability caused by LER degrades with respect to the length of control gate near the source. Our work fills a gap in the study of LER-induced variability for DMG FinFETs, and suggests that the length of the control gate near the source should be greater than or equal to the screen gate near the drain in the entire gate.

Background Hysterosalpingography (HSG) is an accepted radiologic diagnostic modality for initial infertility workup, and is generally considered uncomfortable and painful. However, the management of pain related to HSG remains inefficient. As an emerging nonpharmacologic and noninvasive pain control strategy, virtual reality (VR) distraction has been successfully used in areas such as burns, blunt force trauma, hospital-based needle procedures, dental/periodontal procedures, and urological endoscopy patients. This study aims to evaluate the analgesic effect of VR during HSG. Methods/design A single-center, parallel-group, randomized controlled trial will be carried out in the Radiology Department of Yinchuan Women and Children Healthcare Hospital, Yinchuan. A total of 200 participants who are scheduled for HSG will be enrolled in this study. The participants will be randomized (1:1) into two groups: a VR group and a blank control group. The VR group will receive routine care plus immersive VR intervention and the blank control group will receive routine care. Outcomes will be monitored at baseline, immediately after HSG and 15 min after HSG for each group. The primary outcome is the worst pain score during HSG by a visual analog scale (VAS). The secondary outcomes include: affective pain, cognitive pain, and anxiety during the HSG procedure; worst pain within 15 min after HSG; patient satisfaction and acceptance with pain management; physiological parameters; adverse effects; HSG results; and immersion perception score of the VR system (for the VR condition only). Discussion This study will focus on exploring a simply operated, noninvasive and low-cost analgesia during the HSG procedure. The results of this trial will provide data on the feasibility and safety of VR distraction therapy during HSG. Trial registration Chinese Clinical Trial Register, ChiCTR1900021342. Registered on 16 February 2019.

Objective Whether cervical disc arthroplasty (CDA) is superior to anterior cervical discectomy and fusion (ACDF) remains controversial, especially in relation to long‐term results. The present study aimed to evaluate the long‐term safety and efficiency of CDA and ACDF for cervical disc disease. Methods We performed this study according to the Cochrane methodology. An extensive search was undertaken in PubMed, Embase, and Cochrane databases up to 1 June 2019 using the following key words: “anterior cervical fusion,” “arthroplasty,” “replacement” and “artificial disc”. RevMan 5.3 (Cochrane, London, UK) was used to analyze data. Safety and efficiency outcome measures included the success rate, functional outcome measures, adverse events (AE), adjacent segment degeneration (ASD), secondary surgery, and patients’ satisfaction and recommendation rates. The OR and MD with 95% confidence interval (CI) were used to evaluate discontinuous and continuous variables, respectively. The statistically significant level was set at P

BACKGROUND Irritable bowel syndrome (IBS) and functional constipation (FC) are two commonly encountered functional gastrointestinal disorders in clinical practice and are usually managed with Western medicines in cooperation with traditional Chinese medicine (TCM) interventions. Although clinical practice guidelines (CPGs) have been developed to assist clinicians with their decisions, there are still gaps in management with regard to integrative medicine (IM) recommendations. AIM To comprehensively review the currently available CPGs and to provide a reference for addressing the gaps in IBS and FC management. METHODS We searched mainstream English and Chinese databases and collected data from January 1990 to January 2019. The search was additionally enriched by manual searches and the use of publicly available resources. Based on the development method, the guidelines were classified into evidence-based (EB) guidelines, consensus-based (CB) guidelines, and consensus-based guidelines with no comprehensive consideration of the EB (CB-EB) guidelines. With regard to the recommendations, the strength of the interventions was uniformly converted to a 4-point grading scale. RESULTS Thirty CPGs met the inclusion criteria and were captured as data extraction sources. Most Western medicine (WM) CPGs were developed as EB guidelines. All TCM CPGs and most IM CPGs were identified as CB guidelines. Only the 2011 IBS and IM CPG was a CB-EB set of guidelines. Antispasmodics and peppermint oil for pain, loperamide for diarrhea, and linaclotide for constipation were relatively common in the treatment of IBS. Psyllium bulking agents, polyethylene glycol and lactulose as osmotic laxatives, bisacodyl and sodium picosulfate as stimulant laxatives, lubiprostone and linaclotide as prosecretory agents, and prucalopride were strongly recommended or recommended in FC. TCM interventions were suggested based on pattern differentiation, while the recommendation level was considered to be weak or insufficient. CONCLUSION WM CPGs generally provide a comprehensive management algorithm, although there are still some gaps that could be addressed with TCM. Specific high-quality trials are needed to enrich the evidence.

Acute pain is the most common complaint in Emergency Department (ED) admissions, and options for analgesia are limited. Nitrous oxide/oxygen possesses many properties showing it may be an ideal analgesic in the ED.The aim of this study is to evaluate the safety and analgesic effect of the fixed nitrous oxide/oxygen mixture for trauma patients in the ED.We enrolled 60 patients in this double-blind, randomized study. The treatment group received conventional pain treatment plus a mixture of 65% nitrous oxide/oxygen. The control group received the conventional pain treatment plus oxygen. Primary outcome was the reduction in pain intensity at 5 and 15 min after the start of intervention. Secondary outcomes include adverse events, physiological parameters, and satisfaction from both patients and health care professionals.Initial pain scores for the nitrous oxide/oxygen group (6.0 [5.0-8.0]) and the oxygen group (6.75 [5.0-9.0]) were comparable (p = 0.57). The mean numerical rating scale scores at 5 min were 3.4 ± 1.8 and 7.0 ± 1.8 for nitrous oxide/oxygen and oxygen, respectively (p 0.01). The mean pain intensity at 15 min in the treatment group was 3.0 ± 1.9, compared with 6.3 ± 2.2 in the control group (p 0.01). Both patients' (8.0 [7.0-9.0] vs. 4.0 [2.0-6.0], p 0.01) and physicians' (8.5 [8.0-9.0] vs. 4.0 [3.0-6.0], p 0.01) satisfaction scores in the treatment group were significantly higher than the oxygen group. No serious adverse events were observed.This study gives supporting evidence for the safety and effectiveness of using self-administered nitrous oxide/oxygen mixture in the ED for moderate-to-severe traumatic pain.

Background DNA damage repair is an important mechanism of platinum resistance. HOXB7 is one member of HOX family genes, which are essential developmental regulators and frequently dysregulated in cancer. Recently, its relevance in chemotherapy resistance and DNA damage repair has also been addressed. However, little is known regarding the association between HOXB7 and chemotherapy resistance in esophageal squamous cell carcinoma (ESCC). Methods The association between HOXB7 expression detected by immunohistochemisty and tumor regression grade (TRG) and long-term survival was analyzed in 143 ESCC patients who underwent neoadjuvant chemotherapy. CCK8 assay was used to examine the effect of cisplatin in a panel of four ESCC cell lines. A stable cell strain with HOXB7 knockdown of KYSE150 and KYSE450 was established to explore the effect on cisplatin sensitivity. The interaction of HOXB7 with Ku70, Ku80 and DNA-PKcs was determined by GST-pull down, coimmunoprecipitation and immunofluorescent colocalization. Finally, we investigated whether disrupting HOXB7 function by a synthetic peptide HXR9 blocking the formation of HOXB7/PBX could enhance cisplatin sensitivity in vitro and in vivo. Results High expression of HOXB7 was associated with cisplatin resistance and worse chemotherapy efficacy. HOXB7 knockdown reinforced cisplatin sensitivity. It was identified that HOXB7 interacts with Ku70, Ku80 and DNA-PKcs. HOXB7 knockdown was related to the downregulation of Ku70, Ku80 and DNA-PKcs as well as arrested cell cycle in S phase. HOXB7 inhibition by HXR9 had a synergistic effect to improve cisplatin sensitivity. Conclusion HOXB7 may be a biomarker for the prediction of chemoresistance of ESCC and serves as a promising therapeutic target.

The variations of the aortic arch and its branches are rare. The surgical treatment of esophageal cancer would be challenged for combination with this anomaly. This study intends to review significant group cases to analyze the influence of this variation on esophagectomy. Methods From 2013 to 2019, 19 patients with aortic arch and brachiocephalic vessels variations underwent esophagectomy, accounting for 0.3% during the same period. The abnormalities were distributed as follows: left-sided aortic arch combined with aberrant right subclavian artery (LAA + ARSA) occurred 13 cases, right-sided aortic arch anomalies with mirror image arch branches (RAA + MIAB) in 1 case, and right-sided aortic arch combined with aberrant left subclavian artery (RAA + ALSA) in 5 case. Of the patients with LAA + ARSA, 11 patients underwent the McKeown esophagectomy, and 2 patients via transhiatal. All patients with RAA underwent left thoracotomy approach.Perioperative outcomes and long-term survival were analyzed. Results The tumors were mostly located in the upper and middle thorax (47.4% and 42.1%). The R0 resection rate was 89.5% (17/19). Recurrent laryngeal nerve injury occurred in 2 patients, anastomotic fistula in 1 patient. Two patients died within 30 days postoperatively. The yield of lymph nodes was 21.8 ± 9.4. The sampling rate of lymph nodes along the recurrent laryngeal nerve was 61.5% in LAA + ARSA group, while 16.7% in RAA group. Recurrence happened in 5 cases (29.4%), including 2 regional relapse. Four patients died after recurrence, with a median time to death of 20 months (range: 10–48 months). Conclusion For aortic arch and brachiocephalic artery variations in esophageal cancer, aberrant right subclavian artery and right-sided aortic arch are the most common types. The surgical strategy is closely related to the aortic arch position. Due to the combined variation of the recurrent laryngeal nerve, the upper mediastinal lymph nodes dissection would be conservative, but with acceptable oncologic results.

A three-axis micro magnetic sensor (MS) is developed based on the standard 180 nm complementary metal oxide semiconductor (CMOS) technology. The MS designs two magnetic sensing elements (MSEs), which consists of an x/y-MSE and an z-MSE, to reduce cross-sensitivity. The x/y-MSE is constructed by an x-MSE and an y-MSE that are respectively employed to detect in the x- and y-direction magnetic field (MF). The z-MSE is used to sense in the z-direction MF. The x/y-MSE, which is constructed by two magnetotransistors, designs four additional collectors that are employed to increase the sensing current and to enhance the sensitivity of the MS. The Sentaurus TCAD software simulates the characteristic of the MS. The measured results reveal that the MS sensitivity is 534 mV/T in the x-direction MF, 525 mV/T in the y-direction MF and 119 mV/T in the z-axis MF.

Background Colorectal carcinoma (CRC) is the third most common cancer and the second most common cause of cancer-related death worldwide. RNA N6-methyladnosine (m6A) and methyltransferase-like 3 (METTL3) play an important role in cancer. However, the roles of m6A and METTL3 in CRC progression are still elusive. Methods Adenoma and CRC samples were applied to detect m6A and METTL3 levels, and tissue microarrays were performed to evaluate their associations with survival of CRC patients. The biological functions of METTL3 were investigated by CCK8, wound healing and transwell assays. M6A epitranscriptomic microarray, RNA stability and luciferase reporter assays were performed to explore the mechanism of METTL3 in CRC. Results m6A and METTL3 levels were significantly upregulated in both adenoma and CRC tissues, and the CRC patients with high m6A or METTL3 level had both shorter overall survival. METTL3 knockdown markedly inhibited the proliferation, migration and invasion of CRC cells. M6A epitranscriptomic microarray revealed that the cell polarity regulator Crumbs3 (CRB3) was the downstream target of METTL3. METTL3 knockdown markedly inhibited the degradation of CRB3 mRNA to increase the CRB3 expression. In addition, CRB3 level was also markedly reduced in both adenoma and CRC tissues, and the CRC patients with high CRB3 level had higher overall survival and disease free survival. CRB3 knockdown significantly promoted the proliferation, migration and invasion of CRC cells. Finally, CRB3 knockdown inhibited Hippo pathway, and increased nuclear localization of YAP. Conclusions The m6A and METTL3 levels were significantly increased in both adenoma and CRC tissues. The CRC patients with high m6A or METTL3 levels had shorter overall survival. Mechanistically, METTL3 regulated the initiation and progression of CRC via regulating m6A-CRB3-Hippo pathway.

Content Delivery Networks (CDNs) are critical for providing good user experience of cloud services. CDN providers typically collect various multivariate Key Performance Indicators (KPIs) time series to monitor and diagnose system performance. State-of-the-art anomaly detection methods mostly use deep learning to extract the normal patterns of data, due to its superior performance. However, KPI data usually exhibit non-additive Gaussian noise, which makes it difficult for deep learning models to learn the normal patterns, resulting in degraded performance in anomaly detection. In this paper, we propose a robust and noise-resilient anomaly detection mechanism using multivariate KPIs. Our key insight is that different KPIs are constrained by certain time-invariant characteristics of the underlying system, and that explicitly modelling such invariance may help resist noise in the data. We thus propose a novel anomaly detection method called SDFVAE, short for Static and Dynamic Factorized VAE, that learns the representations of KPIs by explicitly factorizing the latent variables into dynamic and static parts. Extensive experiments using real-world data show that SDFVAE achieves a F1-score ranging from 0.92 to 0.99 on both regular and noisy dataset, outperforming state-of-the-art methods by a large margin.

Background: Acupuncture is a classical complementary therapy, but benefits in palliative cancer pain are still unclear due to lack of consistent evidence. Objectives: To comprehensively evaluate th...

Background The morbidity of knee arthritis is increasing among aged people and total knee arthroplasty has been its mainstream treatment to date. Postoperative rehabilitation is an important part of the procedure. However, the intense pain during the functional exercise involved has always been a challenge for both patients and health care professionals. The aim of this study is to test the analgesic effect of a mixture of nitrous oxide/oxygeb (1:1) inhalation for patients who are doing functional exercise 1 month after total knee arthroplasty. Methods/design This double-blind, randomized, placebo-controlled study will be implemented in the Rehabilitation Department in the General Hospital of Ningxia Medical University. Patients aged between 50 and 75 years who underwent a primary unilateral total knee arthroplasty are eligible for inclusion. The key exclusion criteria include: epilepsy, pulmonary embolism, intestinal obstruction, aerothorax. The treatment group (A) will receive a pre-prepared nitrous oxide/oxygen mixture plus conventional treatment (no analgesics), and the control group (B) will receive oxygen plus conventional treatment (no analgesics). Patients, physicians, therapists, and data collectors are all blind to the experiment. Assessments will be taken immediately after functional exercise begins (T0), 5 min (T1) after functional exercise begins, and 5 min after functional exercise has finished (T2). Patients will be randomly allocated between a treatment group (A) and a control group (B) in a ratio of 1:1. Primary outcome, including pain severity in the procedure, will be taken for each group. Secondary outcomes include blood pressure, heart rate, oxygen saturation, side effects, knee joint range of motion, Knee Society Score (KSS), rescue analgesia need, and satisfaction from both therapists and patients. Discussion This study will focus on exploring a fast and efficient analgesic for patients who are doing functional exercise after total knee arthroplasty. Our previous studies suggested that the prefixed nitrous oxide/oxygen mixture was an efficacious analgesic for the management of burn-dressing pain and breakthrough cancer pain. The results of this study should provide a more in-depth insight into the effects of this analgesic method. If this treatment proves successful, it could be implemented widely for patients doing functional exercise in the rehabilitation department. Trial registration ChiCTR-INR-17012891. Registered on 6 October 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3472-7) contains supplementary material, which is available to authorized users.

Purpose To investigate the relationship of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism in male population having spouses with early spontaneous abortion. Methods A total of 345 males whose spouses had at least one early spontaneous abortion were included in the study group, and 145 males who planned to have a second child were included in the control group. Semen was collected in a sterile cup by masturbation. After liquefaction, the sperm concentration and forward motility sperm rate (PR) were obtained. The genomic DNA was extracted from peripheral vein, followed by MTHFR C677T polymorphism detection through PCR-gold magnetic nanoparticle chromatography. Results The numbers of alleles and genotypes of MTHFR in the case group were 303 (C), 387 (T), 64 (CC), 175 (CT), and 106 (TT) cases, respectively. The numbers of allele and genotype of MTHFR in the control group were 167 (C), 123 (T), 145 (CC), 65 (CT), and 29 (TT) cases. There were significant differences in the distribution frequency of genotypes (χ2 = 17.005, P = 0.000) and alleles (χ2 = 15.295, P = 0.000) between the two groups. For cases with more spontaneous abortion, more cases had CT and TT phenotypes. Participants with genotype CT had the highest sperm concentration and PR in both groups (P

In this study, the impact of orientation of metal-gate granularity on analog figures-of-merit (FOMs) in high-k/metal-gate junctionless (JL) fin-field-effect transistor (FinFET) and gate-all-around (GAA) nanowire metal-oxide-semiconductor-field-effect-transistor (NWFET), with a similar ratio of average grain size to gate area is investigated. Further, their FOMs when operating in the linear and saturated regions have been compared using three-dimensional technology computer-aided design simulation. According to the standard deviation and relative deviation of the FOMs, it is observed that their FOMs are significantly affected by the work-function variation (WFV). In addition, as expected, the influence of WFV on the JL FinFET is greater than that on the GAA NWFET. Our study provides insights for circuit design using high-k/metal-gate technology.

Multi-label learning has been extensively studied in many areas such as information retrieval, bioinformatics, and multimedia annotation. However, multi-label datasets often have noisy, irrelevant and redundant features with high dimensionality. Accompanying with these issues, a critical challenge is known as the curse of dimensionality. As an effective data preprocessing method, feature selection has received much attention for that it can provide a way in reducing computation time, improving prediction performance and enhancing understanding of the data. Based on this, a large number of information-theoretical-based feature selection methods are developed to solve the learning problem, i.e. multi-label classification. Unfortunately, most of existing information-theoretical-based feature selection methods are either directly transformed from single-label feature selection methods or insufficient in light of using heuristic algorithms as the search component. Motivated by this, in this paper, we propose a novel mutual-information-based feature selection method, which obtains the optimal solution via constrained convex optimization with less time. Specifically, by incorporating the label information into the feature selection process, label-correlation is taken into consideration to generate the generalized model. Finally, the experimental results on various multi-label datasets demonstrate the effectiveness and efficiency of the proposed framework.

Magnetic seeding agglomeration (MSA), i.e., adding magnetic seeds and a low intensity pre-magnetization for fine agglomeration, was applied to the flotation of coal, pyrite and hematite ore slimes. Size analysis and flotation tests highlight that the MSA improved flotation recovery and kinetics of pyrite ore while causing some loss in selectivity, and in the presences of the polyacrylamide for coal and starch for hematite the agglomeration flotation was further strengthened due to the synergetic effect between the flocculants and magnetic seeds. Magnetism analyses and calculation confirmed the adsorption of magnetic seeds onto minerals, resulting in a decreased threshold magnetic field intensity for the MSA to happen. Then atomic force microscope (AFM) study found that there exists a long range force between magnetic seeds and minerals, which facilitates the adsorption of magnetic seeds on minerals. FTIR shows both the polyacrylamide and starch adsorbed onto minerals and magnetic seeds, thus acting as the bridging media between minerals and magnetic seeds, intensifying the agglomeration in flotation. Surface characterization of the MSA was understood by SEM imaging, and models of the MSA were proposed.

In multi-label learning, different labels may have their own inherent characteristics for distinguishing each other, in the meanwhile, exploiting the correlations among labels is another practical yet challenging task to improve the performance. In this work, we present a new method for the joint learning of label-specific features and label correlations. The key is the design of an optimization framework to learn the weight assignment scheme of features, and the correlations among labels are taken into account by constructing additional features at the same time. Through iteratively optimizing the two sets of unknown variables, which are referred to feature weights and label correlations-based features, label-specific features of each label are available to achieve multi-label classification. Comprehensive experiments on various multi-label data sets including two collected traditional Chinese medicine data sets reveal the advantages of our proposed algorithm.

A radio frequency microelectromechanical system switch (MSS) manufactured by the complementary metal oxide semiconductor (CMOS) process is presented. The MSS is a capacitive shunt type. Structure for the MSS consists of coplanar waveguide (CPW) lines, a membrane, and springs. The membrane locates over the CPW lines. The surface of signal line for the CPW has a silicon dioxide dielectric layer. The fabrication of the MSS contains a CMOS process and a post-process. The MSS has a sacrificial oxide layer after the CMOS process. In the post-processing, a wet etching of buffer oxide etch (BOE) etchant is employed to etch the sacrificial oxide layer, so that the membrane is released. Actuation voltage for the MSS is simulated using the CoventorWare software. The springs have a low stiffness, so that the actuation voltage reduces. The measured results reveal that actuation voltage for the MSS is 10 V. Insertion loss for the MSS is 0.9 dB at 41 GHz and isolation for the MSS is 30 dB at 41 GHz.

Computer vision (CV) is a field of artificial intelligence that trains computers to interpret and understand the visual world for a variety of exciting downstream tasks such as self-driving cars, checkout-less shopping, smart cities, cancer detection, and more. The field of CV has been revolutionized by deep learning over the last decade. This tutorial looks under the hood of modern day CV systems, and builds out some of these tech pipelines in a Jupyter Notebook using Python, OpenCV, Keras and Tensorflow. While the primary focus is on digital images from cameras and videos, this tutorial will also introduce 3D point clouds, and classification and segmentation algorithms for processing them.

The fabrication and characterization of a magnetic micro sensor (MMS) with two magnetic field effect transistors (MAGFETs) based on the commercial complementary metal oxide semiconductor (CMOS) process are investigated. The magnetic micro sensor is a three-axis sensing type. The structure of the magnetic microsensor is composed of an x/y-MAGFET and a z-MAGFET. The x/y-MAGFET is employed to sense the magnetic field (MF) in the x- and y-axis, and the z-MAGFET is used to detect the MF in the z-axis. To increase the sensitivity of the magnetic microsensor, gates are introduced into the two MAGFETs. The sensing current of the MAGFET enhances when a bias voltage is applied to the gates. The finite element method software Sentaurus TCAD was used to analyze the MMS&rsquo, s performance. Experiments show that the MMS has a sensitivity of 182 mV/T in the x-axis MF and a sensitivity of 180 mV/T in the y-axis MF. The sensitivity of the MMS is 27.8 mV/T in the z-axis MF.

CDN (Content Delivery Network) has become an important infrastructure of the Internet. However, building an anomaly detection system to monitor and guarantee CDN service quality is non-trivial. Current anomaly detection system usually suffers from undesirable performance in terms of high rate of false positive and false negative, which consequently impacts on its practical deployment. Identifying the root cause of a false detection is critical for diagnosing and improving the performance of anomaly detection. In this paper, we propose a novel feedback mechanism for prediction-based anomaly detection in CDN . Specifically, we introduce a carefully-designed metric named Fittingscore to diagnose whether the prediction model can fit the data well. Further, a threshold adjustment mechanism is proposed to dynamically adjust the thresholds of residual errors. Extensive experiments employing a three-month real CDN dataset collected from a top ISP-operated CDN in China show our proposed method can significantly improve the performance of anomaly detection.

We investigate the use of artificial neural networks (NNs) as an alternative tool to current analytical methods for recognizing knots in a given polymer conformation. The motivation is twofold. First, it is of interest to examine whether NNs are effective at learning the global and sequential properties that uniquely define a knot. Second, knot classification is an important and unsolved problem in mathematical and physical sciences, and NNs may provide insights into this problem. Motivated by these points, we generate millions of polymer conformations for five knot types: 0, 3_{1}, 4_{1}, 5_{1}, and 5_{2}, and we design various NN models for classification. Our best model achieves a five-class classification accuracy of above 99% on a polymer of 100 monomers. We find that the sequential modeling ability of recurrent NNs is crucial for this result, as it outperforms feed-forward NNs and successfully generalizes to differently sized conformations as well. We present our methods and suggest that deep learning may be used in specific applications of knot detection where some error is permissible. Hopefully, with further development, NNs can offer an alternative computational method for knot identification and facilitate knot research in mathematical and physical sciences.

Supplemental Digital Content is available in the text, Background: Non-alcoholic fatty liver disease (NAFLD) with abnormal transaminase were main targeted disorder in clinical intervention. Acupuncture embedding has been used as a modified acupuncture therapy in current management, while no comprehensive summarization has been established. Hence, we conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of acupoint embedding alone or in combination for NAFLD with abnormal transaminase, and to provide potential regimen for further verification. Methods: Seven English and Chinese databases were systematically researched from inception to February 28, 2019, including PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese biomedical literature database (SinoMed), Chinese National Knowledge Infrastructure (CNKI), Chinese VIP information (VIP), and WanFang database. Academic dissertations were also searched as supplement. The searching terms included “nonalcoholic fatty liver disease,” “acupoint embedding,” “clinical trial,” with their corresponding synonyms. Randomized controlled trials (RCTs) and quasi-RCTs involving acupoint embedding alone or in combination for adult patients with NAFLD with abnormal transaminase were included. The diagnosis of NAFLD should be confirmed by radiologic evidence. Two researchers independently completed predefined data sets extraction and quality assessment. STATA 15.0 was applied to estimate the combined effect presented as odds ratio or mean difference (MD) with a 95% confidence interval (CI). The primary outcome was the change of serum alanine aminotransferase (ALT). Results: A total of fifteen studies with 1349 patients were included. Meta-analysis reported that acupoint embedding alone or in combination was superior to conventional medications on ALT change (MD: 16.58, 95%CI: [10.42, 22.74], P < .001). The benefits were also demonstrated in other outcomes, including aspartate aminotransferase, triglyceride, and total cholesterol, total efficacy rate and radiological efficacy rate. The safety profile of acupoint embedding was satisfactory. BL18 (Ganshu) was the most frequently utilized acupoint. Conclusion: To some extent, the systematic review supported the application of acupoint embedding in management of NAFLD, while further high-quality studies should be designed to evaluate the practical effect of acupoint embedding.

This study aims to evaluate the safety and analgesic efficacy of pre-mixed nitrous oxide/oxygen mixture treatment of pain induced by dressing change for perianal abscess.This protocol is a randomized, double-blind, placebo-controlled trial.This study will be implemented in the Hospital of Traditional Chinese Medicine. Subjects enrolled in this study are hospitalized patients who suffered from moderate to severe pain due to dressing change after incision and drainage. Two hundred patients will be selected and randomly assigned to either an intervention or a control group. The intervention group will get routine pain treatment plus pre-mixed nitrous oxide/oxygen mixture treatment and the control group will be treated with routine pain management plus medical air treatment. All these patients, medical staff and investigators are blind to the nature of the gas in each cylinder, which is randomized. Data will be collected at baseline (T0), 5 min (T1) after the starting of intervention and 5 min post intervention (T2) for each group. The primary outcome is the level of pain relief at T1 and T2. The secondary outcomes cover physiological parameters, adverse events, satisfaction of patients and health professionals and the acceptance from patients.Results of this study will be discussed and the safety and effect of nitrous oxide/oxygen treatment of pain induced by dressing change will be proven.When the finding of this study has an active effect on the treatment of pain caused by dressing change, it may provide more options for nursing staff to choose nurse-led analgesia techniques and then improving the level and quality of pain care as well as patients' overall satisfaction with the Anorectal Department in China.目的: 本研究旨在评估肛周脓肿术后换药引起疼痛时的预混合一氧化二氮/氧气混合物治疗的安全性和镇痛效果。 设计: 该方案是一项随机、双盲、安慰剂对照试验。 方法: 本研究将在中医医院实施。本研究的受试者是因切开引流后换药而引起中度至重度疼痛的住院患者。共计200名患者,这些患者将被随机分配到干预组或对照组。干预组接受常规疼痛治疗加上预混合一氧化二氮/氧气混合物治疗,而对照组主要接受常规疼痛治疗和医用气体治疗。所有患者、医务人员和调查人员都不清楚气瓶中气体的性质,并且,这些气瓶都是随机分配。应分别在基线(T0)、干预开始后5分钟(T1)和干预结束后5分钟(T2)收集数据。主要疼痛缓解结果见T1和T2。次要结果包括生理参数、不良事件、患者和卫生专业人员的满意度以及患者的接受程度等。 讨论: 将讨论这项研究的结果,并对一氧化二氮/氧气治疗换药引起的疼痛的安全性和效果进行证明。 影响: 如果本研究的调查结果显示,治疗过程中,换药引起的疼痛可带来积极影响,则可为护理人员选择镇痛技术,并且所选择的阵痛技术将由护士主导,从而提高我国肛肠科疼痛护理的水平和质量,提高患者的整体满意度,并可为患者提供更多选择。.

This study proposed a designing method for lampshade with free-from surface and fabricated the optimum lampshade structure with 3D printer. Theoretical and measurement results showed high similarity and preserved lower power consumption.

This study describes the fabrication of an ammonia gas sensor (AGS) using a complementary metal oxide semiconductor (CMOS)&ndash, microelectromechanical system (MEMS) technique. The structure of the AGS features interdigitated electrodes (IDEs) and a sensing material on a silicon substrate. The IDEs are the stacked aluminum layers that are made using the CMOS process. The sensing material, polypyrrole/reduced graphene oxide (PPy/RGO), is synthesized using the oxidation&ndash, reduction method, and the material is characterized using an electron spectroscope for chemical analysis (ESCA), a scanning electron microscope (SEM), and high-resolution X-ray diffraction (XRD). After the CMOS process, the AGS needs post-processing to etch an oxide layer and to deposit the sensing material. The resistance of the AGS changes when it is exposed to ammonia. A non-inverting amplifier circuit converts the resistance of the AGS into a voltage signal. The AGS operates at room temperature. Experiments show that the AGS response is 4.5% at a concentration of 1 ppm NH3, and it exhibits good repeatability. The lowest concentration that the AGS can detect is 0.1 ppm NH3

Ever wonder how the Tesla Autopilot system works (or why it fails)? In this tutorial we will look under the hood of self-driving cars and of other applications of computer vision and review state-of-the-art tech pipelines for object detection such as two-stage approaches (e.g., Faster R-CNN) or single-stage approaches (e.g., YOLO/SSD). This is accomplished via a series of Jupyter Notebooks that use Python, OpenCV, Keras, and Tensorflow. No prior knowledge of computer vision is assumed (although it will be help!). To this end we begin this tutorial with a review of computer vision and traditional approaches to object detection such as Histogram of oriented gradients (HOG).

DNS tunnel is a technology used to bypass firewalls for data exfiltration. It takes advantage of the characteristic of firewalls that always allow DNS traffic pass. Most of the studies have realized the detection of DNS tunnels from the perspective of traffic and payload. In recent years, due to the popularity of machine learning and data mining methods, researchers began trying to use them to detect DNS tunnels. However, these detection methods require a lot of professional knowledge to extract and construct feature set, and the detection results are often unsatisfactory. In order to solve the problem of manual feature extraction limitation and improve the detection accuracy of DNS tunnels, we propose a deep learning method, called Byte-level CNN, to detect the DNS tunnels in this paper. Furthermore, we propose to represent DNS packets with bytes for the first time, as the converted computable data to the CNN model. Compared with traditional machine learning methods, our byte-level CNN method can learn full information in the whole DNS packets, especially the sequential and structural information, besides common statistical information, and therefore achieves good performance results. The simulation showed that the detection accuracy and recall rate are significantly improved, and the complex manual feature extraction process is avoided as well.

Background The current study aimed to determine the oncological efficacy and surgical safety of multiple pulmonary resections (MPRs) after prior curative surgery for local regional recurrent or second primary lung cancers. Methods All cases of lung cancer included in our prospective database between January 2000 and July 2015 were retrospectively reviewed. The oncological efficacy endpoints for synchronous and metachronous MPR were five-year overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) rates after the second surgery. The surgical safety endpoints were postoperative mortality and complications (Clavien-Dindo classification) within 30 days. Results In total, 67 MPR cases were identified. There were no significant differences in the five-year OS and DFS between the synchronous MPR group (n = 50) and the propensity score-matched solitary major pulmonary resection group (n = 250) (5-year OS 84.5% vs. 69.0%, log rank P = 0.112; DFS 64.4% vs. 58.0%, log rank P = 0.278). The five-year OS and PFS of the metachronous MPR group (n = 17) were significantly better than those in the non-surgical control group (n = 19) (5-year OS 94.1% vs. 50.7%, log rank P = 0.005; 5-year PFS 53.9% vs. 10.5%, log rank P = 0.020). No postoperative mortality or severe complications occurred in the MPR group. Conclusion The oncological efficacy of MPR is superior to the non-surgical approach for the management of local regional recurrent or second primary lung cancer, with comparable postoperative mortality and complications.

A design method and corresponding fabrication procedures are proposed for a dual frusto-conical reflector of a downlight luminaire. The profile of the dual frusto-conical reflector consists of two flat-slant reflective surfaces with slightly different slopes. The optimum dual frusto-conical reflector can be obtained with the proposed design method. The finished product of the dual frusto-conical reflector is fabricated by a 3D printer and followed by surface polishing and reflection paint spraying. The measurement results show that luminaires exhibited 70% optimum illuminance confined within an illumination area of 1.8 m 2 , and the optimum illumination intensity is at 252 lux. The optimum efficiency of the proposed luminaire can reach 158 lm/W for normal-white light-emitting diode (LED) and 119 lm/W for warm-white LED, respectively.

Globally, breast cancer is the most common malignancy affecting women. The incidence of breast cancer has been growing among Asian American women. Mammography is a screening procedure that provides early diagnosis for the timely treatment to reduce premature mortality due to breast cancer. However, there are no national data available that summarize the rates of mammography screening among Asian American women. Some small-scale studies have reported low rates of mammography uptake among Asian American women. This cross-sectional study utilized the fourth-generation, multi-theory model (MTM) of health behavior change to explain the correlates of mammography screening among Asian American women between the ages of 45–54 years. A 44-item instrument was evaluated for face, content, and construct validity (using structural equation modeling) and reliability (Cronbach’s alpha) and administered electronically to a nationally representative sample of Asian American women (n = 374). The study found that Asian American women who have had received mammograms in the past 12 months as per recommendations, all three constructs of MTM, namely, participatory dialogue (β = 0.156, p &lt, 0.05), behavioral confidence (β = 0.236, p &lt, 0.001), and changes in the physical environment (β = 0.426, p &lt, 0.001) were statistically significant and crucial in their decision to initiate getting a mammogram, accounting for a substantial 49.9% of the variance in the decision to seek mammography. The study also found that the MTM constructs of emotional transformation (β = 0.437, p &lt, 0.001) and practice for change (β = 0.303, p &lt, 0.001) were significant for maintaining the repeated behavior of getting annual mammograms and were responsible for 53.9% of the variance. This evidence-based study validates the use of MTM in designing and evaluating mammography screening promotion programs among Asian American women aged 45–54 years.

Importance Safety and efficacy of neoadjuvant chemoradiotherapy (nCRT) vs neoadjuvant chemotherapy (nCT) for treatment of locally advanced esophageal squamous cell carcinoma (ESCC) remain uncertain given lack of high-level clinical evidence. Objective To compare safety and long-term survival of nCRT followed by minimally invasive esophagectomy (MIE) with that of nCT followed by MIE for patients with locally advanced ESCC. Design, Setting, and Participants A prospective, multicenter, open-label, randomized clinical trial that compared safety and efficacy of nCRT vs nCT followed by MIE for patients with locally advanced ESCC. From January 1, 2017, to December 31, 2018, 264 patients with ESCC of clinical stages from cT3 to T4aN0 to 1M0 were enrolled. Analysis was performed on an intention-to-treat basis from January 1, 2017, to August 30, 2020. Interventions Eligible patients were randomized to the nCRT group (n = 132) or the nCT group (n = 132) by a computer-generated random system. The chemotherapy, based on paclitaxel and cisplatin, was administered to both groups, while 40 Gy of concurrent radiotherapy was added for the nCRT group. At about 6 weeks after neoadjuvant therapy, MIE via thoracoscopy and laparoscopy was performed for the patients in both groups. Main Outcomes and Measures The primary outcome was 3-year overall survival. Secondary outcomes included postoperative complications, mortality, postoperative pathologic outcome, recurrence-free survival time, and quality of life. Results Among 264 patients (226 men [85.6%]; mean [SD] age, 61.4 [6.8] years), postoperative morbidity was 47.4% in the nCRT group (54 of 114) and 42.6% in the nCT group (46 of 108), with no significant difference between groups (difference, 4.8%; 95% CI, −8.2% to 17.5%;P = .48). Distribution of the severity of complications was similar between the 2 groups based on Clavien-Dindo classification. The 90-day perioperative mortality rate was 3.5% for the nCRT group (4 of 114) and 2.8% for the nCT group (3 of 108) (P = .94). The R0 resection rates were similar between groups (109 of 112 [97.3%] vs 100 of 104 [96.2%];P = .92). However, patients in the nCRT group had a higher pathologic complete response (residual tumor, 0%) rate (40 of 112 [35.7%] vs 4 of 104 [3.8%];P Conclusions and Relevance Initial results of the trial showed that nCRT followed by MIE has similar safety to and better histopathologic outcome than nCT followed by MIE for treatment of locally advanced ESCC. Trial Registration ClinicalTrials.gov Identifier:NCT03001596

Background Xuesaitong dispersible tablet (XST) product has been clinically proven to be effective for treating cardio-cerebrovascular disease. Furthermore, herb–drug interactions between the XST product and drugs that are commonly co-administered, such as aspirin (ASA), must be explored to ensure safe clinical use. Study design and methods The current study aims to investigate whether the XST product interacts with ASA when they are administered concomitantly to ensure safety and efficacy. A ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC–MS/MS) method was developed for the simultaneous determination of ginsenoside Rg1 (Rg1), ginsenoside Rd (Rd), notoginsenoside R1 (R1) and salicylic acid (SA) in rat plasma to investigate the pharmacokinetic interaction of XST and ASA in blood stasis model rats. Results and conclusion The ASA and XST combination noticeably altered R1 and Rg1 absorption, distribution and disposition. This study indicates that co-administration of XST and ASA can cause an apparent herb–drug pharmacokinetic interaction in blood stasis model rats.