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To enhance the photocatalytic activity, loading proper semiconductor with high efficiency and low cost is one of the most valid approaches. Herein, various amounts of CoWO4 as a novel metal-free material were loaded on Mn0.47Cd0.53S (MCS) nanorods for photocatalytic hydrogen production reaction. The CoWO4/Mn0.47Cd0.53S-25 (CW/MCS-25) exhibits the highest hydrogen production rate of 41.53 mmol·h−1·g−1 in the Na2S/Na2SO3 system, which is about 2.68 times higher than that of pristine MCS. The Mapping and HRTEM reveals the deposited of CoWO4 on the MCS. The detailed analyses of XPS, EIS, TRPL spectra and transient photocurrent responses indicate that CoWO4 and MCS interacted closely and the photogenerated electrons of CoWO4 can be transferred into MCS. In particular, the introduction of CoWO4 can further transfer the photogenerated holes of MCS, thereby inhibiting the photocorrosion of MCS and improving photocatalytic activity. This work provides a reference for the exploration of noble metal-free composite material and shows great potential in the photocatalytic application.

BACKGROUND: This study investigates the correlation between white matter structural damage and cognitive impairment in patients with Parkinson’s disease (PD) and mild cognitive impairment (MCI). METHODS: A total of 40 patients with PD were divided into two groups, i.e., a mild cognitive impairment (PD-MCI) and a normal cognitive (PDN) group, and 20 healthy patients were enrolled as the control group. Changes in the white matter structure of patients with PD were evaluated using diffusion tensor imaging (DTI), and cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) scale and Mini-Mental State Examination (MMSE). Finally, the correlations between the two groups were analyzed. RESULTS: The Unified Parkinson’s Disease Rating Scale score was significantly higher in the PD-MCI than in the PDN group (P=0.008). The total MoCA and MMSE scores in the PD-MCI group were significantly lower than in the PDN and control groups (P

In industrial engineering, hydrogen is usually transported and stored after being liquefied, which is an energy-intensive process. Aiming to liquefy hydrogen with high efficiency and low consumption, a novel hydrogen liquefaction process based on dual-path hydrogen refrigeration is proposed innovatively and simulated by Aspen HYSYS to determine the key parameters. Taking the specific energy consumption (SEC) as the objective function for the optimization by genetic algorithm (GA), optimum parameters could be obtained. Meanwhile, the single variable method is conducted to analyze the impact of key parameters on process characteristics. Under the premise of complete liquefaction, the SEC, coefficient of performance (COP) and exergy efficiencies (EXE) of the proposed system are 7.041 kWh/kg LH2, 0.1834, 0.5413, respectively. Compared with the other three hydrogen liquefaction systems simulated under the same conditions, they are decreased by 22.16% and increased by 33.58% and 42.37%, respectively. The results show that the proposed system shows better performance under lower consumption.

Epidemiologic studies have indicated that dyslipidemia may facilitate the progression of cognitive dysfunction. We previously showed that patients with metabolic syndrome (MetS) had significantly higher plasma levels of electronegative very-low-density lipoprotein (VLDL) than did healthy controls. However, the effects of electronegative-VLDL on the brain and cognitive function remain unclear. In this study, VLDL isolated from healthy volunteers (nVLDL) or patients with MetS (metVLDL) was administered to mice by means of tail vein injection. Cognitive function was assessed by using the Y maze test, and plasma and brain tissues were analyzed. We found that mice injected with metVLDL but not nVLDL exhibited significant hippocampus CA3 neuronal cell loss and cognitive dysfunction. In mice injected with nVLDL, we observed mild glial cell activation in the medial prefrontal cortex (mPFC) and hippocampus CA3. However, in mice injected with metVLDL, plasma and brain TNF-α and Aβ-42 levels and glial cell activation in the mPFC and whole hippocampus were higher than those in control mice. In conclusion, long-term exposure to metVLDL induced levels of TNF-α, Aβ-42, and glial cells in the brain, contributing to the progression of cognitive dysfunction. Our findings suggest that electronegative-VLDL levels may represent a new therapeutic target for cognitive dysfunction.

We have studied the laser pulse shape dependence of the conversion efficiency of λ = 1.03 μm laser pulse energy into 13.5 nm extreme ultraviolet (EUV) emission from a Sn laser-produced plasma. Laser pulses of arbitrary temporal shape ranging from hundreds of picoseconds to several nanoseconds were generated using a programmable pulse synthesizer based on a diode-pumped chirped pulse amplification Yb: YAG laser. Measurements show that the conversion efficiency favors the use of nearly square pulses of duration longer than 2 ns, in agreement with hydrodynamic/atomic physics simulations. A 35% increase in conversion efficiency was obtained when Q-switched pulses were substituted by square pulses of a similar duration. Experiments conducted irradiating a Sn target with a sequence of two time-delayed 250 ps pulses showed a 30 percent increase in the EUV yield respect to a single pulse of the same total energy when the pulse separation was optimum at 2.1 ns. This suggests that re-heating of the plasma with delayed laser pulses could be used to improve the EUV yield. The spectroscopic characterization of EUV emission and in-band EUV images that characterize the source size are also presented.

Higher energy densities in rechargeable batteries can be achieved using thicker cathode films, though this is a challenging endeavor since the electrochemical performance of thick electrodes is sub...

A smart diffraction grating immunosensor based on antigen-responsive hydrogel with enhanced analyte-induced volume changes is developed for highly selective and sensitive detection of human immunog...

Aims/Introduction Electronegative low‐density lipoprotein (L5) is the most atherogenic fraction of low‐density lipoprotein and is elevated in people with metabolic syndrome (MetS), whereas the retinol‐binding protein 4 receptor (stimulated by retinoic acid 6 [STRA6]) cascade is disrupted in various organs of patients with obesity‐related diseases. Our objective was to investigate whether L5 from MetS patients capably induces pathogenesis of aorta through disrupting the STRA6 cascade. Material and Methods We examined the in vivo and in vitro effects of L5 on the STRA6 cascade and aortic atherogenic markers. To investigate the role of this cascade on atherosclerotic formation, crbp1 transfection was carried out in vitro. Results This study shows that L5 activates atherogenic markers (p38 mitogen‐activated protein kinases, pSmad2 and matrix metallopeptidase 9) and simultaneously suppresses STRA6 signals (STRA6, cellular retinol‐binding protein 1, lecithin‐retinol acyltransferase, retinoic acid receptor‐α and retinoid X receptor‐α) in aortas of L5‐injected mice and L5‐treated human aortic endothelial cell lines and human aortic smooth muscle cell lines. These L5‐induced changes of the STRA6 cascade and atherogenic markers were reversed in aortas of LOX1−/− mice and in LOX1 ribonucleic acid‐silenced human aortic endothelial cell lines and human aortic smooth muscle cell lines. Furthermore, crbp1 gene transfection reversed the disruption of the STRA6 cascade, the phosphorylation of p38 mitogen‐activated protein kinases and Smad2, and the elevation of matrix metallopeptidase 9 in L5‐treated human aortic endothelial cell lines. Conclusions This study shows that L5 from MetS patients induces atherogenic markers by disrupting STRA6 signaling. Suppression of STRA6 might be one novel pathogenesis of aorta in patients with MetS., Dyslipoproteinemia can cause aortic injuries by utilizing electronegative low‐density lipoprotein caused disruption of stimulated by retinoic acid 6 signaling. The suppression of stimulated by retinoic acid 6 might be one novel pathogenesis of aorta in people with metabolic syndrome.

Operando studies that probe how electrochemical reactions propagate through a battery provide valuable feedback for optimizing the electrode architecture and for mitigating reaction heterogeneity. Transmission-geometry depth-profiling measurements carried out with the beam directed parallel to the battery layers – in a radial geometry – can provide quantitative structural insights that resolve depth-dependent reaction heterogeneity which are not accessible from conventional transmission measurements that traverse all battery layers. However, these spatially resolved measurements are susceptible to aberrations that do not affect conventional perpendicular-beam studies. Key practical considerations that can impact the interpretation of synchrotron depth-profiling studies, which are related to the signal-to-noise ratio, cell alignment and lateral heterogeneity, are described. Strategies to enable accurate quantification of state of charge during rapid depth-profiling studies are presented.

The preliminary designed hydrogen liquefaction plant process based on liquid nitrogen precooling and helium gas turbine expansion refrigeration is firstly modified, simulated and analyzed by Aspen HYSYS. In addition, the multi-parameter optimization of the system is carried out by genetic algorithm (GA) by considering the specific energy consumption (SEC) of the system as the objective function. After optimization, it can be found that the SEC of the system is 7.1329 kWh kgLH2−1, which is 19.65% lower than that of base case and the coefficient of performance (COP) and figure of merit (FOM) are 0.1704 and 0.4941, which are higher than that prior to the process optimization. In addition, sensitivity analysis is conducted to present the effects of different operation conditions of the designed process on the features of the hydrogen liquefaction process. Compared with the other two systems of hydrogen liquefaction, the process in this paper shows the best performance.

With the development of the wireless network techniques, the number of cyber-attack increases significantly, which has seriously threat the security of Wireless Local Area Network (WLAN). The traditional intrusion detection technology is a prevalent area of study for numerous years, but it may not have a good detection performance in a real-time way. Therefore, it is urgent to design a detection mechanism to detect the attacks timely. In this paper, we exploit a CDBN (Conditional Deep Belief Network)-based intrusion detection mechanism to recognize the attack features and perform the wireless network intrusion detection in real time. To avoid the impact of the imbalanced dataset and the data redundancy on the detection accuracy, a window-based instance selection algorithm “SamSelect” is adopted to undersample the majority class data samples, and a Stacked Contractive Auto-Encoder (SCAE) algorithm is proposed to reduce the dimension of the data samples. By doing so, our proposed mechanism can effectively detect the potential attack and achieve high accuracy. The experiment results show that CDBN can be effectively combined with “SamSelect” and SCAE, and the proposed mechanism has a high detection speed and accuracy, with the average detection time 1.14 ms and the detection accuracy 0.974.

OBJECTIVES: Extracellular vesicle microRNAs (EV-miRNAs) have been demonstrated to be reliable candidate biomarkers for clinical applications. However, the clinical application potential of serum EV-miR-215-5p for gastric cancer (GC) remains poorly understood. The goal of our study was to determine the efficacy of serum EV-miR-215-5p in predicting the prognosis of GC. METHODS: Blood samples were collected from 118 patients with GC, 60 patients with benign gastric disease and BGD and 70 healthy controls. The relative levels of serum EV-miR-215-5p were measured using quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: Compared to patients with BGD and normal controls, GC patients exhibited remarkably higher serum EV-miR-215-5p level, especially those with early tumor recurrence (ETR). Receiver operating characteristic (ROC) curve analysis showed that serum EV-miR-215-5p was able to distinguish GC patients from BGD patients or healthy controls and GC patients with ETR from those without ETR. In addition, increased serum EV-miR-215-5p levels were notably correlated with invasive depth, TNM stage, and lymph node metastasis. Moreover, serum EV-miR-215-5p levels were greatly decreased after surgical treatment, but increased at the time of ETR. Survival analysis showed that patients with higher serum EV-miR-215-5p had shorter survival. Furthermore, serum EV-miR-215-5p was an independent risk factor for GC. CONCLUSIONS: Serum EV-miR-215-5p might be a novel biomarker for predicting ETR and prognosis of GC.

While online advertising is one of the major sources of income for search engines, pumping up the incomes from business advertisements while ensuring the user experience becomes a challenging but emerging area. Designing high-quality advertisements with persuasive content has been proved as a way to increase revenues through improving the Click-Through Rate (CTR). However, it is difficult to scale up the design of high-quality ads, due to the lack of automation in creativity. In this paper, we present Commonsense-Enriched Advertisement on Search Engine (CHASE) --- a system for the automatic generation of persuasive ads. CHASE adopts a specially designed language model that fuses the keywords, commonsense-related texts, and marketing contents to generate persuasive advertisements. Specifically, the language model has been pre-trained using massive contents of explicit knowledge and fine-tuned with well-constructed quasi-parallel corpora with effective control of the proportion of commonsense in the generated ads and fitness to the ads' keywords. The effectiveness of the proposed method CHASE has been verified by real-world web traffics for search and manual evaluation. In A/B tests, the advertisements generated by CHASE would bring 11.13% CTR improvement. The proposed model has been deployed to cover three advertisement domains (which are kid education, psychological counseling, and beauty e-commerce) at Baidu, the world's largest Chinese search engine, with adding revenue of about 1 million RMB (Chinese Yuan) per day.

ObjectiveThe present study aimed to assess the clinical value of conventional ultrasound (C-US), ultrasound elastography (UE), percutaneous contrast-enhanced ultrasound (P-CUES), and the combination of these three ultrasonography modalities for evaluating the risk of axillary lymph node (ALN) metastasis in breast invasive ductal carcinoma (IDC).MethodsThis retrospective analysis included 120 patients with pathologically confirmed IDC who underwent sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Based on the gold standard of postoperative pathology, ALN pathology results were evaluated and compared with findings obtained using C-US, UE, P-CUES, and the three modalities combined.Results(1) There was a statistically significant difference between the histological grade of the tumor and the pathological condition of ALNs. (2) The difference between C-US parameters and UE score were statistically significant. The accuracy of P-CEUS localization of SLNs was 100% (96/96) when compared with localization guided by methylene blue. The difference in the distribution of the four SLN enhancement patterns was statistically significant. (3) The sensitivity, specificity, positive predictive value, and negative predictive value of C-US and UE were 75%, 71%, 58%, and 89%, and 71%, 72%, 50%, and 86%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of P-CUES were 91%, 82%, 78%, 92%, respectively. When all three modalities were combined, the sensitivity, specificity, positive predictive value, and negative predictive value were 94%, 89%, 86%, and 95%, respectively. In the detection of ALN metastasis, there was a good correlation between histopathological results and evaluations based on the three combined ultrasonography modalities (kappa: 0.82, pConclusionsWhen compared to C-US, UE, or P-CEUS alone, the combination of the three ultrasonography modalities was found to be superior in distinguishing metastatic and non-metastatic ALNs. This combined strategy may aid physicians in determining the most appropriate approach to ALN surgery as well as the prognosis of breast IDC.

Aim: This study aimed to investigate the effects of high-dose radioactive iodine (131I) treatment on the clinical metrics of renal function in patients with differentiated thyroid carcinoma (DTC).Patients and methods: The clinical metrics of renal function were analysed in 850 patients with DTC who received 131I therapy between January 2012 and December 2019. According to the baseline renal function metrics, the patients were divided into normal renal function group (group A) and abnormal renal function group (group B). Each group was further divided into three subgroups (subgroups 1, 2, and 3) based on the cumulative dose of 131I. The clinical metrics of renal function including serum creatinine (SCr) levels, blood urea nitrogen (BUN) levels and estimated glomerular filtration rate (eGFR) were measured within 1 month before the initiation of 131I therapy, 1 year after the last therapy, and 5 years after the initial therapy. The changes in renal function metrics before and after 131I therapy were compared in each group.Result: In group A (588 patients), no significant difference in the mean levels of SCr and BUN and eGFR was observed in the three subgroups (P >0.05), regardless of gender, before the initial 131I therapy and 1 year after the last therapy. A total of 8, 3, and 2 patients presented with abnormal renal function after 131I treatment in subgroups 1, 2, and 3, respectively. No statistically significant difference was observed in the incidence of renal dysfunction among the three subgroups (P = 0.287). The mean age of patients with renal dysfunction was significantly greater than that of patients without renal dysfunction after 131I treatment. In group B, of the 262 patients with abnormal renal function, SCr and BUN levels were elevated in 168 and 155 patients, respectively, and eGFR 2 was found in 87 patients before the initial 131I therapy. No significant difference was observed in the parameters among the three subgroups. However, SCr and BUN levels were found to be increased in all subgroups 5 years after the initial 131I therapy, and they were positively correlated with the cumulative dose of 131I. The difference was statistically significant (P 131I therapy, and it was negatively correlated with the cumulative dose of 131I. The difference was statistically significant (P Conclusion: Our findings suggest that the nephrotoxicity of high-dose 131I therapy, regardless of gender, is very low in patients with DTC with normal renal function; however, high-dose 131I therapy may exacerbate the loss of renal function in those with renal dysfunction.

Acute kidney injury (AKI) is a frequent clinical complication in critically ill patients, and it rapidly develops into renal failure with high morbidity and mortality. However, other than dialysis, no effective therapeutic interventions can offer reliable treatment to limit renal injury and improve survival. Here, we firstly reported that remdesivir (RDV, GS-5734), a broad-spectrum antiviral nucleotide prodrug, alleviated AKI by specifically inhibiting NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome activation in macrophages. Mechanically, RDV effectively suppressed the activities of nuclear transcription factor (NF)-κB, mitogen-activated protein kinase (MAPK), which further led to the reduction of the inflammasome genes of NLRP3 transcription, limiting the activation of NLRP3 inflammasome in vivo and in vitro. RDV also inhibited other pro-inflammatory genes including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-12, IL-1β, and interferon–β (IFN-β), leading to the reduction of inflammatory factors release. Thus, RDV can ameliorate AKI via modulating macrophage inflammasome activation and inflammatory immune responses and may have a therapeutic potential for patients with AKI in clinical application.

Background: Exosomes are small (30–150 nm) membrane vesicles released by cells that transmit intercellular information. As one of the contents of exosomes, microRNAs (miRNAs) may play an important role in the pathogenesis of atrial fibrillation (AF). Exosomal miRNAs potentially function as biomarkers in AF, as shown in many other diseases. Methods: To identify the different expression level of plasma exosomal miRNAs between persistent AF and sinus rhythm (SR) patients, we performed high-throughput sequencing of small RNAs in the exosomes of AF (n=4) and SR (n=4) patients. Target genes of the DE miRNAs were predicted and put into gene ontology analysis and pathway analysis. In the validation phase, we performed quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) of 6 of the DE miRNAs in AF (n=40) and SR (n=20) patients. Univariate and multivariate logistic analysis were used to analyze risk factors of AF. Results: With high-throughput sequencing, we revealed 39 differentially expressed (DE) miRNAs in circulating exosomes. We validated 4 of the DE plasma exosomal miRNAs (miR-483-5p, miR-142-5p, miR-223-3p, miR-223-5p) using qRT-PCR. Univariate logistic analysis shows miR-483-5p, miR-142-5p, miR-223-3p are related with AF, while multivariate logistic analysis suggests miR-483-5p is independently in correlation with AF. Conclusions: This discovery opens up a new perspective in the complicated mechanism underlying AF and the DE plasma exosomal miRNAs exert enormous potential of acting as biomarkers in assessing severity or prognostic of AF and help selecting therapeutic strategy.

In this paper, an “embedded chip” packaging platform using POL-kW packaging for use with High Power LED devices is presented. Prototype samples have been fabricated and tested. The authors will describe thermal modeling analysis as well as experimental results from the prototype samples. A thermal simulation model has been developed to look at the thermal properties and attributes of the POL-kW LED structure and will be compared to conventional AlN and IMS based LED packages. The process flow and fabrication details of a POL-kW LED package will be summarized to provide a better understanding of the technical and performance advantages. Initial results have shown that the presence of POL vias directly connected to the LED chip reduce the thermal path and, thereby, the thermal resistance of the package. Furthermore, the POL-kw LED package offers a thinner profile and smaller form factors which allows higher integration density.

A simple grating system based on poly(N-isopropylacrylamide-co-acrylamide) (poly(NIPAM-co-AAm)) hydrogel for sensitive and rapid detection of ethanol concentration is developed. The hydrogel gratin...

Epidemiological studies have reported that elderly patients with metabolic syndrome (MetS) are significantly more likely to develop neuronal degenerative diseases than those without MetS. Our previous study showed that patients with MetS had significantly higher levels of negatively charged very low density lipoproteins (VLDLs) in the plasma than healthy controls. Highly electronegative VLDL is a key risk factor for endothelial dysfunction and atrial fibrillation. However, the impact of negatively charged VLDL in brain immunity remains unclear. In this study, VLDLs were isolated from normal healthy (nVLDL) individuals or patients with MetS (metVLDL). Primary astroglia and microglia mixed cell cultures as well as microglial-enriched cultures were used to test the effects of VLDLs. Microglia/astroglia activation as evidenced by their morphological changes and production of pro-inflammatory factors, such as tumor necrosis factor-α (TNF-α) and prostaglandin E2 (PGE2), were assessed by immunofluorescence staining and ELISA, respectively. Our results showed that metVLDLs mainly act on the microglia, and not the astroglia, with low concentration (0.05–0.5 μg/mL) inducing cell morphological changes and decreased cellular processes in the microglia. However, nVLDL treatment at these concentrations had no effects on microglia and astroglia. Most importantly, TNF-α and PGE2 levels significantly increased in the microglia treated with metVLDL via a dose-dependent manner. Together, our data indicate that metVLDLs can contribute to MetS-associated brain disorders through microglia activation and neuroinflammation.

Exploration of low-cost and earth-abundant photocatalysts for efficient photocatalytic H2 evolution from water is an attractive solution to the global energy and environmental problems. Although MoS2 has been proved as an efficient co-catalyst for the H2 evolution reaction (HER), controllably and accurately constructing MoS2-hybridized photocatalysts at where the electrons extracted still remains a challenge. Here, a facile two-step approach of photoetching-photodeposition has been developed to prepare MoSx/etched-CdS (Mo-Cd(e)-S) with heterostructure accurately constructed on the CdS surface defects. This structure can significantly accelerate photo-induced charge separation and transportation owing to the place of heterostructure construction matching well with that of electrons extracted, numerous active sites introduced, and shorter charge transfer path from bulk to surface. Therefore the charge recombination is significantly retarded. As a result, the Mo-Cd(e)-S exhibits outstanding photocatalytic performance with a state-of-the-art H2 generation rate of 22.5 mmol g−1 h−1 under visible light irradiation (λ ≥ 420 nm) which is 70 times higher than that of pristine CdS. This work opens a new avenue for the low-cost but high efficient photocatalysts development.

Acute respiratory distress syndrome (ARDS) is a severe acute disease that threatens human health, and few drugs that can effectively treat this disease are available. Fraxin, one of the main active ingredients of Cortex Fraxini, a Chinese herbal medicine, has presented various pharmacological and biological activities. However, the effects of fraxin on ARDS have yet to be reported. In the present study, the protective effect of fraxin in lipopolysaccharide (LPS)-induced ARDS in a mouse model was analyzed. Results from the hematoxylin and eosin staining showed that fraxin might alleviate pathological changes in the lung tissues of mice with ARDS. ELISA and Western blot results revealed that fraxin might inhibit the production of inflammatory factors, namely, IL-6, TNF-α, and IL-1β, and the activation of NF-κB and MAPK signaling pathways in the lungs. Thus, the inflammatory responses were reduced. Fraxin might inhibit the increase in reactive oxygen species (ROS) and malondialdehyde (MDA), a product of lipid peroxidation in lung tissues. Fraxin might increase the superoxide dismutase (SOD) activity to avoid oxidative damage. Vascular permeability was also assessed through Evans blue dye tissue extravasation and fluorescein isothiocyanate-labeled albumin (FITC-albumin) leakage. Fraxin might inhibit the increase in pulmonary vascular permeability and relieve pulmonary edema. Fraxin was also related to the inhibition of the increase in matrix metalloproteinase-9, which is a glycocalyx-degrading enzyme, and the relief of damages to the endothelial glycocalyx. Thus, fraxin elicited protective effects on mice with LPS-induced ARDS and might be used as a drug to cure ARDS induced by Gram-negative bacterial infection.

High-energy ultrashort pulse optical lasers operating at high repetition rate are required to drive intense compact coherent soft X-ray sources, including soft X-ray lasers, for applications in nanoscience and nanotechnology, material studies, and high field science. This paper reviews two types of high-power solid-state laser systems developed at Colorado State University to pump compact, high repetition rate, and plasma-based soft X-ray lasers. One is a flashlamp-pumped, petawatt-class Ti:sapphire chirped-pulse amplification laser that generates 0.85 PW pulses of 30 fs duration at 3.3 Hz repetition rate. Using a fraction of the output energy from this laser, we have demonstrated gain-saturated, compact, repetitive lasers down to 6.85 nm in Ni-like Gd and have observed gain in shorter wavelength transitions, down to 5.85 nm in Ni-like Dy. The second type of pump laser is an all diode-pumped chirped-pulse amplification system based on cryogenically cooled Yb:YAG active mirror amplifiers that produces 1 J pulses of picosecond duration at 500 Hz repetition rate. These compact diode-pumped laser systems have enabled new advances in high-average-power tabletop soft X-ray lasers that include 100 Hz demonstrations at wavelengths ranging from 10.9 to 18.9 nm, as well long duration operation at these high repetition rates for periods up to one hour. These and other recent results that include the operation of an 18.9 nm laser Ni-like Mo laser at 400 Hz repetition rate open a path to compact kilohertz repetition rate soft X-ray lasers.

During the past two decades, research on membrane and membrane-based separation process has developed rapidly in water treatment, gas separation, biomedicine, biotechnology, chemical manufacturing and separation process integration. In China, remarkable progresses on membrane preparation, process development and industrial application have been made with the burgeoning of the domestic economy. This review highlights the recent development of advanced membranes in China, such as smart membranes for molecular-recognizable separation, ion exchange membrane for chemical productions, antifouling membrane for liquid separation, high-performance gas separation membranes and the high-efficiency hybrid membrane separation process design, etc. Additionally, the applications of advanced membranes, relevant devices and process design strategy in chemical engineering related fields are discussed in detail. Finally, perspectives on the future research directions, key challenges and issues in membrane separation are concluded.

To maintain the pressure of cargo tank and to minimize natural gas loss, two nitrogen expansion cycles for boil-off gas (BOG) re-liquefaction systems, specifically designed for small LNG ships are proposed and optimized: 1) Case 1, re-liquefaction process with the parallel nitrogen expansion, 2) Case 2, re-liquefaction process with the serial nitrogen expansion. The simulation and analysis of the two processes are carried out by using Aspen HYSYS and the genetic algorithms are selected as the optimization method. It can be found that the specific energy consumption (SEC) of 0.7333 kWh/kgLNG, the coefficient of performance (COP) of 0.2538 and the figure of merit (FOM) of 0.2827 are achieved in Case 1 and the SEC of 0.7539 kWh/kgLNG, the COP of 0.2464 and the FOM of 0.2757 are achieved in Case 2 by comparing the two optimized cases. Moreover, the total exergy losses for Case 1 and Case 2 are 153.34 kW and 160.69 kW, respectively.

Quantitative magnetic resonance image (MRI) in individual muscles may be useful for monitoring disease progression in Duchenne muscular dystrophy (DMD). The purpose of this study was to measure T2 relaxation time of thigh muscles in children with DMD and healthy boys, and to correlate the T2 relaxation time of muscles with the fat fraction (FF) at quantitative magnetic resonance and results of clinical assessment. Thirty-two boys with DMD and 18 healthy boys were evaluated with T2 mapping and three-point Dixon MRI. Age, body mass index (BMI), muscle strength assessment, timed functional tests (time to walk or run 10 metres, rise from the floor and ascend four stairs), and the North Star Ambulatory Assessment (NSAA) were evaluated. Spearman's correlation was used to assess the relationships between FF and clinical assessments and T2 relaxation time. The mean T2 relaxation time of thigh muscles in DMD was significantly longer than that in the control group (P

Spontaneous solar-driven water splitting to generate H2 with no pollution discharge is an ideal H2 generation approach. However, its efficiency remains far from real application owing to the poor light-harvesting and ultrafast charge recombination of photocatalysts. To address these issues, herein, we employed a novel but simple chemical bath deposition (CBD) method to construct CdS/SrTiO3 nanodots-on-nanocubes at room temperature (ca. 25 °C). The as-synthesized nanohybrids not only expand light absorption from ultraviolet (UV) to visible light but also significantly retard charge recombination owing to the well-defined heterostructure formation. As a result, the CdS/SrTiO3 exhibits high photocatalytic performance with H2 evolution rate of 1322 μmol g−1 h−1, which is 2.8 and 12.2 times higher than that of pristine CdS and SrTiO3, respectively. This work provides a universal approach for the heterostructure construction, and inspired by this, higher efficient photocatalysts for H2 evolution may be developed in the near future.

Millimeter wave, especially the high frequency millimeter wave near 100 GHz, is one of the key spectrum resources for the sixth generation (6G) mobile communication, which can be used for precise positioning, imaging and large capacity data transmission. Therefore, high frequency millimeter wave channel sounding is the first step to better understand 6G signal propagation. Because indoor wireless deployment is critical to 6G and different scenes classification can make future radio network optimization easy, we built a 6G indoor millimeter wave channel sounding system using just commercial instruments based on time-domain correlation method. Taking transmission and reception of a typical 93 GHz millimeter wave signal in the W-band as an example, four indoor millimeter wave communication scenes were modeled. Furthermore, we proposed a data-driven supervised machine learning method to extract fingerprint features from different scenes. Then we trained the scene classification model based on these features. Baseband data from receiver was transformed to channel Power Delay Profile (PDP), and then six fingerprint features were extracted for each scene. The decision tree, Support Vector Machine (SVM) and the optimal bagging channel scene classification algorithms were used to train machine learning model, with test accuracies of 94.3%, 86.4% and 96.5% respectively. The results show that the channel fingerprint classification model trained by machine learning method is effective. This method can be used in 6G channel sounding and scene classification to THz in the future.

National Natural Science Foundation of China (Grant Nos. 11872148, U1908217, 61801034). It is inevitable that high-intensity, wide-spectrum electromagnetic emissions are generated by the power electronic equipment of the Extra High Voltage (EHV) power converter station. The surveillance flight of Unmanned Aerial Vehicles (UAVs) is thus, situated in a complex electromagnetic environment. The ubiquitous electromagnetic interference demands higher electromagnetic protection requirements from the UAV construction and operation. This article is related to the UAVs patrol inspections of the power line in the vicinity of the EHV converter station. The article analyzes the electromagnetic interference characteristics of the converter station equipment in the surrounding space and the impact of the electromagnetic emission on the communication circuits of the UAV. The anti-electromagnetic interference countermeasures strive to eliminate or reduce the threats of electromagnetic emissions on the UAV’s hardware and its communication network. publishersversion published

To explore the clinical efficacy and safety of fumigation with Dibazol eye drops in the treatment of juvenile middle and low myopia. From January 2019 to January 2020, a total of 158 adolescent patients with moderate and low myopia were randomly divided into control group and observation group, with 79 cases in each group. The observation group was treated with ultrasonic atomization fumigation of 10 times diluted Dibazol eye drops, once a day. The patients in the control group were treated with Dibazol eye drops once a day for 30 d. The uncorrected visual acuity and best corrected visual acuity of the control group and the observation group were measured before and after treatment. The diopter and astigmatism of the two groups were detected by comprehensive refractometer. The therapeutic effect and adverse reactions of the two groups were compared after treatment. The total effective rate of the observation group was 75.95 %, which was significantly higher than 56.96 % of the control group (p 0.05). After treatment, there was no significant difference in astigmatism between the observation group and the control group (p>0.05). The incidence of eye irritation in the observation group was 2.53 %, which significantly alleviated the incidence of adverse reactions (p

Background: Bulleyaconitine A (BLA) is a diterpenoid alkaloid from the rhizomes of Aconitum bulleyanum Diels and has been clinically used for chronic pain treatment in China for many years. However, the newly reported adverse events of BLA indicated that BLA still has potential safety issues. Materials and Methods: To assess the safety of BLA, analgesic tests, acute toxicity studies, repeated-dose oral toxicity studies, and tissue distribution studies after single and repeated administration of BLA were carried out. Results: Administration of 0.14 mg/kg BLA showed potent analgesic effects in both analgesic tests. In acute toxicity study, the LD50 value of BLA was calculated to be 3.4434 mg/kg. In the subchronic toxicity study, the no observed adverse effect level was 0.25 mg/kg, and the lowest observed adverse effect level was 0.5 mg/kg. The spleen, liver, and kidneys are newly identified target organs of BLA toxicity after long-term administration. Moreover, unlike a single BLA administration, repeated administration showed BLA redistribution from organs with an abundant blood supply to immune and metabolic organs. Conclusions: These results suggested that BLA itself would be nontoxic at a dosage of 0.25 mg/kg in rats and should be carefully used when combining BLA with medications that can cause spleen, liver, or kidney injury.

Background: In the management of locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (CRT), the relationship between systemic inflammation-based predictors and tumor response remains unclear. This study aimed to determine whether these inflammatory factors can predict tumor response.Methods: Totally 205 LARC patients underwent neoadjuvant CRT and curative surgery between 2008 and 2017 were analyzed. After propensity score matching, 146 patients (73 matched pairs) were enrolled in this study. The hematological parameters were collected and their relationship with tumor response was investigated.Results: After propensity score matching, the neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) before CRT in good response group were significantly lower than those in poor response group, while there was no significant difference in all hematological characteristics between two groups after CRT. The cutoff values​​ of pre-CRT NLR and pre-CRT PLR were 3.10 and 198.7 after receiver operating characteristic analysis. Multivariate analysis model indicated that pre-CRT PLR was not related with tumor response, while pre-CRT NLR≥3.1 was the predictor of poor tumor response (OR=2.047, 95%CI =1.241-3.377, p=0.005). Besides, patients with NLR≥3.1 had a significantly poor tumor regression grade rates compared with patients with NLRConclusion: The increased NLR before CRT can be regarded as a hematological factor for poor tumor response in LARC, and higher NLR also represents worse tumor regression grade.

The aim of this study was to examine the effect of extract of pre-germinated brown rice (EP) on metabolic and cardiovascular dysfunction in a rat model of T2DM. Hypertensive rats were divided into: (1) normal diet (ND group), (2) induced T2DM (DM group), and T2DM rats that were treated with (3) EP30 mg/kg (EP30 group) or (4) EP300 mg/kg (EP300 group) per day for 4 weeks. T2DM symptoms included: weight loss, hyperglycaemia, hypoinsulinemia, hyperlipidaemia, higher HbA1c, glucose in urine, and lower GLP-1. EP treatment improved metabolic parameters, activated insulin signalling, and increased lipid metabolism, and also ameliorated T2DM-associated increases in levels of inflammation, free radicals, cardiac hypertrophy and fibrosis. EP reduced T2DM and related cardiovascular complications by increasing insulin signalling and lipid metabolism, and reducing levels of inflammation and free radicals. Thus, EP may be a potential candidate for the treatment of metabolic syndrome and related cardiovascular complications.

Background Henoch‐Schonlein purpura nephritis (HSPN) is a serious complication of Henoch‐Schonlein purpura (HSP), which is usually treated with immunosuppressant and glucocorticoid. This study was designed to explore the effect of dexamethasone and gamma globulin combined with prednisone in the treatment of pediatric HSPN. Methods According to the treatment plan, 60 children treated with dexamethasone and gamma globulin were included in the control group, and the rest 55 children treated with dexamethasone and gamma globulin combined with prednisone were selected as the research group. The clinical manifestations, therapeutic effect, immune function, serum inflammatory factors, blood coagulation function, urine routine, renal function, and adverse reactions were compared between the two groups. Results The clinical manifestations of children in the research group were significantly better than those in the control group after treatment (P, Comparison of immune function indexes between the two groups before and after treatment. A, After treatment, the CD3+ level of children in both groups increased, and its change in the research group was more obvious than that in the control group. B, After treatment, the CD4+ level of children in both groups elevated, and its change in the research group was more significant than that in the control group. C, After treatment, the CD8+ level of children in both groups increased, and its change in the research group was more significant than that in the control group. D, After treatment, the ratio of CD4+/CD8+ decreased in both groups, and the change in the research group was more significant than that in the control group. E, After treatment, the IgA level of the two groups of children declined, and the IgA level in the research group changed more significantly than that in the control group. Note: * represents the comparison between the two groups, P

Considering Chinese listed companies’ repurchases in manufacturing industry from 2005 to 2018 as a sample, this paper uses the mediation effect model to empirically study the relationship between share buybacks and sustainable financial growth. The conclusions of the study are as follows. (1) Regarding the Chinese capital market, share repurchase can in general promote corporate sustainable development. (2) Capital structures plays a partial mediating role between share repurchases and sustainable financial growth. This study expands the research scope of the economic consequences of share repurchases and has certain implications for the implementation of repurchase decisions by firms.

Background Renal cancer is a common malignant tumor with an increasing incidence rate. Methods In this study, based on the gene expression profiles, we analyzed the compositions of tumor-infiltrating immune cells (TIICs) in renal cancer and paracancerous samples using CIBERSORT. The proportions of 22 TIICs subsets in 122 paired renal carcinoma and paracancerous samples, and 224 Wilms tumor (WT) samples varied between intragroup and intergroup. Results After analyzed the difference of TIICs composition between renal cancer and paired paracancerous samples, we found that M0 macrophages and CD8 T cells were significantly elevated, while naive B cells were significantly decreased in renal cancer samples compared with paracancerous samples. Survival analysis showed that high overall TIICs proportion, the low proportion of resting mast cells and the high proportion of activated memory CD4 T cells were associated with poor prognosis of renal cancer patients. In addition, 3 clusters were identified by hierarchical clustering analysis, and they presented a distinct prognosis. Cluster 1 had superior survival outcomes, while cluster 2 had an inferior survival outcome. Conclusions Our study indicated that overall TIICs proportion, certain TIICs subset proportion, including resting mast cells and activated memory CD4 T cells, and distinct cluster patterns were associated with the prognosis of renal cancer, which was significant for the clinical surveillance and treatment of renal cancer.

Objective We aimed to investigate risk factors related to remnant gallbladder (RGB) stones. Methods This retrospective study included 73 patients with RGB, in groups with and without RGB calculi. Univariate analyses were used to identify nine variables associated with RGB calculi: sex, age, body mass index (BMI), time to detection, surgical method, length of RGB, angle of RGB and common hepatic duct (CHD), choledocholithiasis, and remnant cholecystitis. Multivariate logistic regression was performed to assess independent predictors of RGB stones. A receiver operating characteristic (ROC) curve was used to estimate model accuracy and determine cut-off values of independent predictors. Results We enrolled 73 patients, 33 with and 40 without RGB stones. Univariate analyses showed that age, BMI, time to detection, length of RGB, angle of RGB and CHD were predictors for RGB calculi. Multivariate analyses indicated that time to detection, length of RGB, and angle of RGB and CHD were independent predictors for RGB calculi. The area under the ROC curve of the model was 0.940. Cut-off values of the three indicators were 1.5 years, 2.25 cm, and 22.5°, respectively. Conclusion Time to detection, length of RGB, and angle of RGB and CHD were independent predictors of RGB calculi.

Background Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and remodeling of left atrium. Methods Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 h after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrium diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchical linear model was conducted to test the independencies of each variable’s correlation with LAD. Results The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P P Conclusions Postprandial VLDL-χ is associated with atrial remodeling particularly in the MetS group. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients. Trial registration ISRCTN 69295295. Retrospectively registered 9 June 2020.

Objective Dry eye syndrome in which tear fluid quality or abnormality, or kinetic abnormality is caused by various reasons, resulting in decreased tear film stability. In recent years, more and more results from the studies indicate that miRNA alterations are involved in dry eye syndrome. And miRNA‐146a‐5p is a key regulator to regulate the inflammatory response. In this paper, we demonstrated whether miRNA‐146a‐5p could cure dry eye syndrome by regulating target genes based on network analysis. Methods In current study, we collected the blood of patients with dry eye disease served as a model group; the blood of healthy people was served as control group. The expression of miRNA‐146a‐5p in the patients was detected by RT‐PCR, the genes controlled by miRNA‐146a‐5p were predicted by TargetScan, miRDB, miRWalk, and PicTar databases, and the genes regulated by miRNA‐146a‐5p which relative with dry eye disease were selected by drawing Venn diagram. Results The comparison of the general information between patients and healthy people was no significant difference, and it indicated that the two groups were comparable. The results of databases showed that IRAK1 was one of the target genes regulated by miRNA‐146a‐5p, and it is related to dry eye disease. The expression of miRNA‐146a‐5p was negatively related to IRAK1 mRNA and protein, while IRAK1 had a positive correlation with IL‐6, TNF‐α, and CBP proteins. Conclusion These results emphasized that miRNA‐146a‐5p could inhibit the expression of IRAK1, IL‐6, TNF‐α, and CBP to help reduce the inflammatory response in dry eye syndrome., IRAK1 is the target gene regulated by miRNA146a‐5p in dry eye syndrome.

This paper proposes a solution for sensing spatial angular velocity. A high-performance digital interface application specific integrated circuit (ASIC) for triple-axis micro-electromechanical systems (MEMS) vibratory gyroscopes is presented. The technique of time multiplexing is employed for synergetic stable drive control and precise angular velocity measurement in three separate degrees of freedom (DOF). Self-excited digital closed loop drives the proof mass in sensing elements at its inherent resonant frequency for Coriolis force generation during angular rotation. The analog front ends in both drive and sense loops are comprised of low-noise charge-voltage (C/V) converters and multi-channel incremental zoom analog-to-digital converters (ADC), so that capacitance variation between combs induced by mechanical motion is transformed into digital voltage signals. Other circuitry elements, such as loop controlling and accurate demodulation modules, are all implemented in digital logics. Automatic amplitude stabilization is mainly realized by peak detection and proportion-integration (PI) control. Nonlinear digital gain adjustment is designed for rapid establishment of resonance oscillation and linearity improvement. Manufactured in a standard 0.35-&mu, m complementary metal-oxide-semiconductor (CMOS) technology, this design achieves a bias instability of 2.1&deg, /h and a nonlinearity of 0.012% over full-scale range.

Despite the numerous risk factors for atherosclerotic cardiovascular diseases (ASCVD), cumulative evidence shows that electronegative low-density lipoprotein (L5 LDL) cholesterol is a promising biomarker. Its toxicity may contribute to atherothrombotic events. Notably, plasma L5 LDL levels positively correlate with the increasing severity of cardiovascular diseases. In contrast, traditional markers such as LDL-cholesterol and triglyceride are the therapeutic goals in secondary prevention for ASCVD, but that is controversial in primary prevention for patients with low risk. In this review, we point out the clinical significance and pathophysiological mechanisms of L5 LDL, and the clinical applications of L5 LDL levels in ASCVD can be confidently addressed. Based on the previously defined cut-off value by receiver operating characteristic curve, the acceptable physiological range of L5 concentration is proposed to be below 1.7 mg/dL. When L5 LDL level surpass this threshold, clinically relevant ASCVD might be present, and further exams such as carotid intima-media thickness, pulse wave velocity, exercise stress test, or multidetector computed tomography are required. Notably, the ultimate goal of L5 LDL concentration is lower than 1.7 mg/dL. Instead, with L5 LDL greater than 1.7 mg/dL, lipid-lowering treatment may be required, including statin, ezetimibe or PCSK9 inhibitor, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Since L5 LDL could be a promising biomarker, we propose that a high throughput, clinically feasible methodology is urgently required not only for conducting a prospective, large population study but for developing therapeutics strategies to decrease L5 LDL in the blood.

Background To evaluate the safety of resection of anterior mediastinal lesions involving the left innominate vein (LIV) and analyze the risk factors affecting LIV resection safety. Methods Patients who underwent anterior mediastinal lesion and LIV resection from January 2010 to December 2018 in the Department of Thoracic Surgery of Tangdu Hospital, Air Force Medical University, were followed up, and preoperative, intraoperative and postoperative factors were analyzed. Results Forty-eight patients who underwent anterior mediastinal lesion and LIV resection from January 2010 to December 2018, except for 2 who died of lung infection-induced respiratory failure, were followed up, with an average follow-up time of 32 months (range, 6-72 months). Postoperative: in 31 cases (67.39%), patients did not manifest LIV resection-associated complications; in 15 cases (32.61%), patients manifested mild LIV resection-associated complications; no patient manifested severe LIV resection-associated complications. The average operation time, average blood loss and average hospitalization time were 155.17 min, 324.13 mL and 11.83 days, respectively. Univariate analysis showed that the degree of LIV invasion and surgical approach were risk factors for predicting LIV resection safety. Conclusions For anterior mediastinal lesions involving the LIV, LIV resection is a simple, safe and effective surgical procedure.

Background: MicroRNA (miRNA) therapeutics are a promising approach to cancer treatment. However, this method faces considerable challenges to achieve tissue-specific, efficient, and safe delivery of miRNAs in vivo. Methods: Herein, we developed a miRNA delivery system based on the in situ self-assembly of Au-miRNA nanocomplexes (Au-miRNA NCs). Within the cancer microenvironment, we constructed in situ self-assembled Au-miRNA NCs by coincubating gold salt and tumor suppressor mimics, such as let-7a, miRNA-34a, and miRNA-200a. Findings: The in vitro experiments demonstrated that characteristic in situ self-assembled Au-miRNA NCs were present in cancer cells and can be taken up to inhibit the proliferation of cancer cells effectively. Most importantly, as proven in subcutaneous tumor treatment models, Au-miRNA NCs were especially useful for accurate target imaging and tumor suppression, with significantly enhanced antitumor effects for combination therapy. Interpretation: These observations highlight that a new strategy for the in situ biosynthesis of Au-let-7a NCs, Au-miR-34a NCs, and Au-miR-200a NCs is feasible, and this may assist in the delivery of more miRNA to tumor cells for cancer treatment. This work opens up new opportunities for the development of miRNA tumor therapy strategies. Funding: National Natural Science Foundation of China (91753106); Primary Research & Development Plan of Jiangsu Province (BE2019716); National Key Research and Development Program of China (2017YFA0205300). Keywords: Nano-complexes, microRNA delivery, In situ self-assembly, Tumor microenvironment, Cancer treatment

The pleiotropic behavior of mesenchymal stem cells (MSCs) has gained global attention due to their immense potential for immunosuppression and their therapeutic role in immune disorders. MSCs migrate towards inflamed microenvironments, produce anti-inflammatory cytokines and conceal themselves from the innate immune system. These signatures are the reason for the uprising in the sciences of cellular therapy in the last decades. Irrespective of their therapeutic role in immune disorders, some factors limit beneficial effects such as inconsistency of cell characteristics, erratic protocols, deviating dosages, and diverse transfusion patterns. Conclusive protocols for cell culture, differentiation, expansion, and cryopreservation of MSCs are of the utmost importance for a better understanding of MSCs in therapeutic applications. In this review, we address the immunomodulatory properties and immunosuppressive actions of MSCs. Also, we sum up the results of the enhancement, utilization, and therapeutic responses of MSCs in treating inflammatory diseases, metabolic disorders and diabetes.

LiFi is networked, bidirectional wireless communication with light. It is used to connect fixed and mobile devices at very high data rates by harnessing the visible light and infrared spectrum. Combined, these spectral resources are 2600 times larger than the entire radio frequency (RF) spectrum. This paper provides the motivation behind why LiFi is a very timely technology, especially for 6th generation (6G) cellular communications. It discusses and reviews essential networking technologies, such as interference mitigation and hybrid LiFi/Wi-Fi networking topologies. We also consider the seamless integration of LiFi into existing wireless networks to form heterogeneous networks across the optical and RF domains and discuss implications and solutions in terms of load balancing. Finally, we provide the results of a real-world hybrid LiFi/Wi-Fi network deployment in a software defined networking testbed. In addition, results from a LiFi deployment in a school classroom are provided, which show that Wi-Fi network performance can be improved significantly by offloading traffic to the LiFi.

Whether the benefits of early prophylactic anticoagulation by low molecular weight heparin (LMWH) would outweigh its possible harms in patients after minimally invasive cardiac surgery (MICS) remains contentious. The aims of this study were to define the incidence of venous thromboembolism (VTE) and to assess whether early prophylactic anticoagulation by LMWH postoperatively was indeed effective in reducing VTE without increasing risk of complications after MICS.This investigation was a single-center, retrospective, propensity score-matched analysis study. A total of 473 patients underwent MICS, of whom 257 received prophylactic anticoagulation with LMWH (LMWH group) in the early postoperative period and 216 were not treated with LMWH (Control group). The main outcome measurements included the incidence of embolism events and major bleeding events, the volume of erythrocyte transfusion, the volume of drainage and the duration of drainage after MICS. In addition, the incidence of poor wound healing, the mechanical ventilation time, ICU stay time and postoperative hospitalization time were also documented.There were fewer embolic events (P=1.000) and a higher rate of major bleeding events (P=0.008) in the LMWH group than the Control group, and their magnitude and significance were maintained in the propensity matched analysis. In the matched cohorts, there was no significant difference in the total volume of red blood cell transfusion (P=0.552), assisted mechanical ventilation time (P=0.542), and the ICU stay time (P=0.166) between the two groups; while the volume of drainage (P0.001) and the duration of drainage (P0.001) in the LMWH group were significantly more than the Control group, and the incidence of poor wound healing (P=0.009) and the postoperative hospitalization time (P0.001) were significantly increased in the LMWH group.Early prophylactic anticoagulation with LMWH could not reduce the incidence of embolism events after MICS. Instead, it might increase postoperative major bleeding events and prolong drainage tube indwelling time and the length of hospital stay.

Essential tremor (ET) is one of the most common movement disorders and the prototypical disorder for abnormal rhythmic movements. However, the pathophysiology of tremor generation in ET remains unclear. Here, we used autoptic cerebral tissue from patients with ET, clinical data, and mouse models to report that synaptic pruning deficits of climbing fiber (CF)-to-Purkinje cell (PC) synapses, which are related to glutamate receptor delta 2 (GluRδ2) protein insufficiency, cause excessive cerebellar oscillations and might be responsible for tremor. The CF-PC synaptic pruning deficits were correlated with the reduction in GluRδ2 expression in the postmortem ET cerebellum. Mice with GluRδ2 insufficiency and CF-PC synaptic pruning deficits develop ET-like tremor that can be suppressed with viral rescue of GluRδ2 protein. Step-by-step optogenetic or pharmacological inhibition of neuronal firing, axonal activity, or synaptic vesicle release confirmed that the activity of the excessive CF-to-PC synapses is required for tremor generation. In vivo electrophysiology in mice showed that excessive cerebellar oscillatory activity is CF dependent and necessary for tremor and optogenetic-driven PC synchronization was sufficient to generate tremor in wild-type animals. Human validation by cerebellar electroencephalography confirmed that excessive cerebellar oscillations also exist in patients with ET. Our findings identify a pathophysiologic contribution to tremor at molecular (GluRδ2), structural (CF-to-PC synapses), physiological (cerebellar oscillations), and behavioral levels (kinetic tremor) that might have clinical applications for treating ET.