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On-target–off-tissue drug engagement is an important source of adverse effects that constrains the therapeutic window of drug candidates1,2. In diseases of the central nervous system, drugs with brain-restricted pharmacology are highly desirable. Here we report a strategy to achieve inhibition of mammalian target of rapamycin (mTOR) while sparing mTOR activity elsewhere through the use of the brain-permeable mTOR inhibitor RapaLink-1 and the brain-impermeable FKBP12 ligand RapaBlock. We show that this drug combination mitigates the systemic effects of mTOR inhibitors but retains the efficacy of RapaLink-1 in glioblastoma xenografts. We further present a general method to design cell-permeable, FKBP12-dependent kinase inhibitors from known drug scaffolds. These inhibitors are sensitive to deactivation by RapaBlock, enabling the brain-restricted inhibition of their respective kinase targets.

Background Due to negative results in clinical trials of postoperative chemoradiation for gastric cancer, at present, there is a tendency to move chemoradiation therapy forward in gastric and gastroesophageal junction (GEJ) adenocarcinoma. Several randomized controlled trials (RCTs) are currently recruiting subjects to investigate the effect of neo-adjuvant radiotherapy (NRT) in gastric and GEJ cancer. Large retrospective studies may be beneficial in clarifying the potential benefit of NRT, providing implications for RCTs. Methods We retrieved the clinicopathological and treatment data of gastric and GEJ adenocarcinoma patients who underwent surgical resection and chemotherapy between 2004 and 2015 from Surveillance, Epidemiology, and End Results (SEER) database. We compared survival between NRT and non-NRT patients among four clinical subgroups (T1–2N−, T1–2N+, T3–4N−, and T3–4N+). Results Overall, 5272 patients were identified, among which 1984 patients received NRT. After adjusting confounding variables, significantly improved survival between patients with and without NRT was only observed in T3–4N+ subgroup [hazard ratio (HR) 0.79, 95% confidence interval (CI): 0.66–0.95; P = 0.01]. Besides, Kaplan-Meier plots showed significant cause-specific survival advantage of NRT in intestinal type (P P = 0.11) for T3–4N+ patients. In the multivariate competing risk model, NRT still showed survival advantage only in T3–4 N+ patients (subdistribution HR: 0.77; 95% CI: 0.64–0.93; P = 0.006), but not in other subgroups. Conclusions NRT might benefit resectable gastric and GEJ cancer patients of T3–4 stages with positive lymph nodes, particularly for intestinal-type. Nevertheless, these results should be interpreted with caution, and more data from ongoing RCTs are warranted.

The aim of our study was to elucidate the characteristic of fasciculation distributions in amyotrophic lateral sclerosis (ALS) using a fasciculation score (FS) of muscle ultrasound (MUS) and to compare the diagnostic values of three MUS fasciculation parameters in patients. Thirty ALS patients, 16 ALS mimics, and 10 healthy subjects were involved. MUS of unilateral 10 muscles in each patient and needle electromyography (EMG) of total 204 muscles were performed to detect fasciculations and spontaneous activity respectively in ALS. Control groups underwent only MUS. Fasciculation was graded semiquantitatively with FS. Three hundred fifty muscles in ALS and 260 in controls were examined. The fasciculation detection rates, total FS, the number of muscles with fasciculation, and the total number of fasciculations in ALS were all significantly higher than those of controls (P < 0.001). ALS patients exhibited a multifocal continuous pattern of fasciculation in limbs, whereas there were few fasciculations in controls. Compared with other parameters, total FS had the largest area under the curve (AUC) (AUC = 0.899, P < 0.001) in ALS diagnosis. The detection rates of lower motor neuron (LMN) acute lesions by MUS (70.6%) and EMG (72.1%) were nearly the same, and a positive correlation between the FS and spontaneous activity grades (P < 0.001, r = 0.359) was proved. ALS patients exhibited the multifocal continuous pattern of fasciculation in limbs. FS showed high sensitivity and specificity in differentiating ALS from non-ALS patients, and the optimal cut-off value was determined as 4. The combination of MUS and EMG can provide additional information about specific muscles.

Consumer behavior, by definition, is concerning with various actions adopted by a person to acquire, use and dispose of consumer goods and services, including the decision-making process that precedes and determines these actions. In real practice, such behavior can be altered with the introduction of various internet-based financing services. Especially for college students, who have relatively weak knowledge of personal finance and insufficient vigilance of excessive consumption, their consumption behavior can be easily manipulated by internet-based financing service providing firms. In this paper, the objective is to determine the dominant factors adopted by internet-based financing service providers to modify the consumption behavior of college students. From 571 college students’ questionnaires, the collected data are subjected to factor and logistic regression analysis to verify what factors are likely to stimulate the willingness of college students to actively employing the internet-based financing services to fulfill their advanced consumption demands. The obtained result indicates the service and convenience factors are likely to influence and alter their consumption behavior, and the corresponding recommendations on how to refine and regulate such market are proposed at the end of this paper.

Miniaturization and integration of optical tweezers are attractive. Optical fiber-based trapping systems allow optical traps to be realized in miniature systems, but the optical traps in these systems lack reliability or mobility. Here, we present the all-fiber modular optical tweezers (AFMOTs), in which an optical trap can be reliably created and freely moved on a sample substrate. Two inclined optical fibers are permanently fixed to a common board, rendering a modular system where fiber alignments are maintained over months. The freely movable optical trap allows particles to be trapped in their native locations. As a demonstration, we applied AFMOTs to trap and deform freely floating individual cells. By the cell mechanical responses, we differentiated the nontumorigenic breast epithelial cell line (MCF10A) from its cancerous PTEN mutants (MCF10 PTEN-/-). To further expand the functionalities, three modalities of AFMOTs are demonstrated by changing the types of fibers for both the optical trap creation and particle position detection. As a miniature and modular system that creates a reliable and mobile optical trap, AFMOTs can find potential applications ranging from point-of-care diagnostics to education, as well as helping transition the optical trapping technology from the research lab to the field.

Young donors are associated with a lower cumulative incidence of acute graft‐vs‐host disease (aGVHD) after allogenic haematopoietic stem cell transplantation (allo‐HSCT) than old donors. Although grafts are harvested from healthy donors, it is unclear whether donor age is associated with aGVHD occurrence owing to its effect on cell compositions in grafts. Moreover, the differences in monocyte subsets in grafts between young and old donors and the association between monocyte subsets in bone marrow (BM) grafts and aGVHD remain to be elucidated. In the current study, non‐classical monocytes and the CD4+/CD8+ T cell ratio were remarkably decreased in BM grafts in donors

Background To investigate the loco-regional progression-free survival (LPFS) of intensity-modulated radiotherapy (IMRT) with different fraction sizes for locally advanced non-small-cell lung cancer (LANSCLC), and to apply a new radiobiological model for tumor control probability (TCP). Methods One hundred and three LANSCLC patients treated with concurrent radiochemotherapy were retrospectively analyzed. Factors potentially predictive of LPFS were assessed in the univariate and multivariate analysis. Patients were divided into group A (2.0 ≤ fraction size Results With a median follow-up of 22.1 months, the median LPFS was 23.8 months. Fraction size was independently prognostic of LPFS. The median LPFS of group A, B and C was 13.8, 35.7 months and not reached, respectively. Using the new LQRG/TCP model, the average absolute and relative fitting errors for LPFS were 6.9 and 19.6% for group A, 5.5 and 8.8% for group B, 6.6 and 9.5% for group C, compared with 9.5 and 29.4% for group A, 16.6 and 36.7% for group B, 24.8 and 39.1% for group C using the conventional LQ/TCP model. Conclusions Hypo-fractionated IMRT could be an effective approach for dose intensification in LANSCLC. Compared with conventional LQ model, the LQRG model showed a better performance in predicting follow-up time dependent LPFS.

Objective The purpose of this study was to explore the role of different undifferentiated components in the lymph node metastasis (LNM) of early mixed gastric cancer. Methods A total of 1596 patients with EGC who underwent gastrectomy were divided into four types: pure differentiated (PD), pure poorly differentiated (Poorly D), pure signet ring cell carcinoma (SRC), and mixed. Mixed type was classified into four subtypes: differentiated-predominant type mixed with poorly differentiated component (MD-P), poorly differentiated-predominant type mixed with differentiated component (MP-D), differentiated-predominant type mixed with SRC component (MD-S), and poorly differentiated-predominant type mixed with SRC component (MP-S). We analyzed the clinicopathological differences between all types and the rates of LNM of patients fulfilling endoscopic submucosal dissection (ESD) criteria. Results LNM was more common in mixed (21.9%) than in PD (7.5%, P P P = 0.003). LNM in MD-S (7.4%, P = 1.000) was not higher than in PD. MP-S (24.5%) showed a higher rate of LNM than SRC (11.3%, P P = 0.681). For lesions satisfying ESD criteria, MD-S (0%, P = 1.000), and MD-P (5.9%, P = 0.12) did not have higher rates of LNM than PD (1.4%). Conclusion The presence of poorly differentiated component but not SRC increases the LNM rate of mixed type. ESD is recommended for the treatment of MD-S and MD-P consistent with ESD criteria.

This paper empirically studies the impact of female proportion and the background of the board on corporate social responsibility (CSR) disclosure of Taiwanese listed firms. The different groups of board size are detected by the structural break test, which is used as the threshold for dividing subsamples. The results show that the higher proportion of women and accounting background of board of directors, the more CSR disclosure for firms with more than 11 directors in the board, implying that women and accounting background directors can only promote their compassionate and reciprocal in CSR decision-making in large board firms. Overall, the empirical results poorly support the efficiency hypothesis suggesting that the board of directors is more powerful when it has high gender diversity. This study also confirms that the linear regression method may not be able to fully present the various possible relationships between the variables.

Reperfusion of the ischemic intestine often leads to drive distant organ injury, especially injuries associated with hepatocellular dysfunction. The precise molecular mechanisms and effective multiple organ protection strategies remain to be developed. In the current study, significant remote liver dysfunction was found after 6 hours of reperfusion according to increased histopathological scores, serum lactate dehydrogenase (LDH), alanine aminotransferase (ALT)/aspartate aminotransferase (AST) levels, as well as enhanced bacterial translocation in a rat intestinal ischemia/reperfusion (I/R) injury model. Moreover, receptor-interacting protein kinase 1/3 (RIP1/3) and phosphorylated-MLKL expressions in tissue were greatly elevated, indicating that necroptosis occurred and resulted in acute remote liver function impairment. Inhibiting the necroptotic pathway attenuated HMGB1 cytoplasm translocation and tissue damage. Meanwhile, macrophage-depletion study demonstrated that Kupffer cells (KCs) are responsible for liver damage. Blocking HMGB1 partially restored the liver function via suppressed hepatocyte necroptosis, tissue inflammation, hepatic KCs, and circulating macrophages M1 polarization. What's more, HMGB1 neutralization further protects against intestinal I/R-associated liver damage in microbiota-depleted rats. Therefore, intestinal I/R is likely associated with acute liver damage due to hepatocyte necroptosis, and which could be ameliorated by Nec-1 administration and HMGB1 inhibition with the neutralizing antibody and inhibitor. Necroptosis inhibition and HMGB1 neutralization/inhibition, may emerge as effective pharmacological therapies to minimize intestinal I/R-induced acute remote organ dysfunction.

Background Patients undergoing major non-cardiac surgery are at risk of cardiovascular complications. Raised levels of high-sensitivity troponin are frequently detected before operation among these patients. However, the prognostic value of high-sensitivity troponin in predicting postoperative outcomes remains unclear. Methods A systematic search of PubMed, Embase and Science Citation Index Expanded was undertaken for observational studies published before March 2018 that reported associations between raised preoperative levels of high-sensitivity troponin and postoperative major adverse cardiac events and/or mortality after non-cardiac surgery. Meta-analyses were performed, where possible, using random-effects models. Results Seven cohort studies with a total of 4836 patients were included. A raised preoperative high-sensitivity troponin level was associated with a higher risk of short-term major adverse cardiac events (risk ratio (RR) 2·92, 95 per cent c.i. 1·96 to 4·37; I2 = 82·6 per cent), short-term mortality (RR 5·39, 3·21 to 9·06; I2 = 0 per cent) and long-term mortality (RR 2·90, 1·83 to 4·59, I2 = 74·2 per cent). The addition of preoperative high-sensitivity troponin measurement provided improvements in cardiovascular risk discrimination (increase in C-index ranged from 0·058 to 0·109) and classification (quantified by continuous net reclassification improvement) compared with Lee's Revised Cardiac Risk Index alone. There was substantial heterogeneity and inadequate risk stratification analysis in the included studies. Conclusion Raised preoperative levels of high-sensitivity troponin appear to represent a risk for postoperative major adverse cardiac events and mortality. Further study is required before high-sensitivity troponin can be used to predict risk stratification in routine clinical practice.

Inflammation plays a major role in etiology of multiple diseases and it has become an imperative therapeutic target in pharmacological interventions. Over the years, natural products originating fr...

Evidence shows a positive association between the use of statins and new-onset diabetes. There is, however, contradictory evidence as to whether a similar association exists for the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. The aim of this study was to investigate the safety of PCSK9 monoclonal antibodies (PCSK9-mAbs) in regard to incident diabetes. Randomized controlled trials that reported data on the incidence of new-onset diabetes mellitus or the worsening of pre-existing diabetes were searched, and risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to compare the endpoints. Twenty-three studies including 65,957 participants were identified. Compared with controls, PCSK9-mAb treatment was not associated with the adverse event of diabetes (RR 0.97, 95% CI 0.91–1.02; p = 0.22). When we analysed the trials in terms of PCSK9-mAb type, alirocumab was associated with a significant reduction in the risk of diabetes (RR 0.91, 95% CI 0.85–0.98; p = 0.01), whereas no significant reduction was observed in participants receiving evolocumab or bococizumab. Interestingly, compared with ezetimibe, which was actively used as lipid-modifying therapy in the control group, PCSK9-mAbs seem to have a lower risk of incident diabetes (RR 0.60, 95% CI 0.37–0.99; p = 0.04). This meta-analysis also revealed a noticeable increase in the risk of incident diabetes in the evolocumab and alirocumab pool (RR 2.14, 95% CI 1.12–4.07; p = 0.02) when the use of statins was equivalent between the experimental and active comparator arms. Compared with placebo or any other comparator, PCSK9-mAb treatment was not associated with the adverse event of diabetes. However, evolocumab and alirocumab show high risk of incident diabetes when there is no interference from unbalanced use of statins. The imbalance in background lipid modifying therapy or different comparators used in the control arms of the studies might have masked the effect of PCSK9-mAb therapy on diabetes.

Nemaline myopathy, a rare congenital myopathy, is characterized by generalized muscle weakness, hypotonia, respiratory insufficiency, and the presence of rod structures on muscle biopsy, which is caused by mutations in at least 13 known genes. A patient showing gradually deteriorated proximal muscle weakness and rod-shaped structures found in muscle fibers was suspected of having nemaline myopathy, following by the next-generation sequencing. We report two novel compound heterozygous variants in nebulin gene in a family residing in China. One is an intron event caused by an underlying variant at the + 3 position of the donor site. Another is a novel nonsense variant, which may lead to the end of protein translation and have a significant impact on protein function. The pathogenicity of this novel compound heterozygous variant remains to be verified. Variants reported here could help to diagnose NM for clinicians.

This study examined whether the temporal patterns of energy and macronutrient intake in early and late eating windows were associated with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) among non-shift workers. A total of 299 overweight/obese non-shift workers (Age: 40.3 ± 6.9 years; 73.6% women; BMI: 31.7 ± 5.0 kg/m2) were recruited in the Klang Valley area of Malaysia. The biochemical parameters were determined from fasting blood samples, whereas information on dietary intake and timing was obtained from a 7-day diet history questionnaire. The midpoint of eating was used to determine the early and late windows. Compared to MHO non-shift workers (n = 173), MUO non-shift workers (n = 126) had lower energy intake from carbohydrates and protein during the early window. In contrast, MUO participants had greater energy intake from carbohydrates and fat during the late window. Participants with unhealthy metabolic status (regardless of their chronotypes) had similar temporal patterns of energy intake characterized by smaller energy intake during the early window and greater energy intake during the late window compared with participants with healthier metabolic status. Overall, the lowest percentile of energy intake during the early window was associated with an increased risk of MUO, after adjustment for potential confounders [odds ratio (OR) = 4.30, 95% confidence interval (CI) 1.41–13.11]. The greater the energy intake during the late window, the greater the risk of MUO (OR = 2.38, 95% CI 1.11–5.13) (OR = 2.33, 95% CI 1.03–5.32) (OR = 4.45, 95% CI 1.71–11.56). In summary, consuming less energy earlier in the day and more energy and carbohydrate later in the day was associated with a greater risk of MUO. Thus, a prospective study is needed to explore the potential role of chrono-nutrition practices in modifying risk factors to delay the transition of MHO to MUO.

Microporous organic polymers (MOPs) are a new class of microporous materials. Due to their high porosity, large pore volume, and large surface area, MOPs exhibit excellent performance in gas adsorption and storage, membrane separation, ion capture, heterogeneous catalysis, light energy conversion and storage, capacitance, and other fields. However, selecting high-performance materials for specific applications from thousands of candidate MOPs is a key problem. Traditional design strategies for new materials with targeted properties, including trial-and-error and relying on the experiences of domain experts, are time- and cost-consuming. With the rapid development of computation technology and theoretical chemistry, the discovery of new materials is no longer a purely experimental subject. Breaking away from the traditional trial-and-error strategy for materials discovery, materials design is emerging and gaining increasing attention. In addition, the ability to collect “big data” has greatly improved and has further stimulated the development of new methods for materials design and discovery. In this perspective, we examine how data-driven techniques combine artificial intelligence (AI) and human expertise, playing a significant role in the design of MOPs. Such analytics can significantly reduce time-to-insight and accelerate the cost-effective materials discovery, which is the goal for designing future MOPs.

The in-service prefabricated slab-on-girder bridge, one of the most widely used structural types, is currently being characterized by the large quantities and the typical single beam (slab)-bearing disease. The large number of this kind of bridge is difficult to be effectively dealt with according to the traditional manual methods, such as the full-scale load test presented in the previous studies. The single beam (slab)-bearing disease, to be specific, is mainly corresponding to the heavy vehicle lanes rather than all the precast beams (slabs). The traditional manual methods can also not be employed for the further continuous analysis and timely decision. Thus, this kind of bridge is in urgent of a more practical and targeted maintenance management, and this can be further expected by the SHM-based intelligent solution proposed herein. However, in contrast to the vibration monitoring data, the physical response data are rarely considered in the previous studies. Even though it can be more directly analyzed in comparison with the corresponding design and ultimate value that queried from the current specifications or codes. In this study, the idea of inverse analysis in structural dynamics is innovatively employed. With consideration of the essential characteristics of the SHM data itself, the time-space distribution and correlation analysis methods are then proposed. An in-service prefabricated slab-on-girder bridge is also carried out as a case study, and the deflection response data are also considered. It is indicated that the different precast beams (slabs) are still in the normal service, and the schedule of the travel people is also observed. More importantly, the single beam (slab)-bearing disease corresponding to the heavy vehicle lanes is significant than other vehicle lanes. It is also consistent with and verified by the traditional analysis and engineering experience. Some more practical references can also be provided for the travel people and the maintenance department. The correlation monitoring of different precast beams (slabs) corresponding to the heavy vehicle lanes can then be performed. The more targeted and timely management of this kind of bridge of a whole transport line is then achieved and can be expected.

In recent years, the development of adjunctive therapeutic hyperthermia for cancer therapy has received considerable attention. However, the mechanisms underlying hyperthermia resistance are still poorly understood. In this study, we investigated the roles of cold-inducible RNA binding protein (Cirbp) in regulating hyperthermia resistance and underlying mechanisms in nasopharyngeal carcinoma (NPC). Our results firstly revealed that hyperthermia significantly attenuated the stemness property of NPC cells, while combination treatment of hyperthermia and oridonin dramatically increased the killing effect on NPC cells and cancer stem cell (CSC)-like population. Moreover, hyperthermia substantially improved the sensitivity of radiation-resistant NPC cells and CSC-like cells to radiotherapy. Hyperthermia noticeably suppressed Cirbp expression in NPC cells and xenograft tumor tissues. Furthermore, Cirbp inhibition remarkably boosted anti-tumor-killing activity of hyperthermia against NPC cells and CSC-like cells, whereas ectopic expression of Cirbp compromised tumor-killing effect of hyperthermia on these cells, indicating that Cirbp overexpression induces hyperthermia resistance. ThermomiR-377–3p improved the sensitivity of NPC cells and cancer stem-like cells to hyperthermia in vitro by directly suppressing Cirbp expression. More importantly, our results displayed the significantly boosted sensitization of tumor xenografts to hyperthermia by Cirbp silencing in vivo, but ectopic expression of Cirbp nearly completely counteracted hyperthermia-mediated tumor cell-killing effect against tumor xenografts in vivo. Mechanistically, Cirbp silencing-induced inhibition of DNA damage repair by inactivating ATM-Chk2 and ATR-Chk1 pathways, decrease in stemness and increase in cell death contributed to hyperthermic sensitization; conversely, Cirbp overexpression-induced promotion of DNA damage repair, increase in stemness and decrease in cell apoptosis contributed to hyperthermia resistance. Taken together, these findings reveal a previously unrecognized role for Cirbp in positively regulating hyperthermia resistance and suggest that thermomiR-377–3p and its target gene Cirbp represent promising targets for therapeutic hyperthermia.

Posttraumatic epilepsy (PTE) is a prevalent complication of brain trauma. Current anti-epileptic drugs available do not have satisfactory response to PTE. It is of desperate need to explore novel therapeutic approaches for curing PTE. Our prior work revealed that ferroptosis, a recently discovered mode of cell death, occurs in rodent model of PTE. In the present study, we aimed to further investigate the effect of ferrostatin-1 (Fer-1), a specific ferroptosis inhibitor, on seizure behavior and cognitive deficit in a mouse model of PTE. The preparation of PTE was performed by stereotaxical injection in the somatosensory cortex region of 50 mM FeCl 3 . Seizure activity was assessed via Racine scoring and electroencephalogram analysis. PTE-related cognitive function was evaluated by novel object recognition and Morris water maze tests. Ferroptosis-related indices including glutathione peroxidase (GPx) activity and protein expressions of 4-hydroxynonenal (4-HNE) were detected using a commercial kit and immunofluorescence, respectively. It was found that treatment with Fer-1 significantly exerted protective effects against acute seizure and memory decline, although no evident effect on epileptic progression. Fer-1 also exhibited good tolerability and safety as we observed that it hardly influenced the body weight. Furthermore, it was noted that administration of Fer-1 suppressed ferroptosis-related indices including GPx activity and protein expressions of 4-HNE in hippocampus. These data altogether indicate that Fer-1 has potent therapeutic effects against seizures and cognitive impairment following PTE-induced brain insult. Fer-1 may act as a promising drug for curing PTE patients.

Chinese character style transfer is a very challenging problem because of the complexity of the glyph shapes or underlying structures and large numbers of existed characters, when comparing with English letters. Moreover, the handwriting of calligraphy masters has a more irregular stroke and is difficult to obtain in real-world scenarios. Recently, several GAN-based methods have been proposed for font synthesis, but some of them require numerous reference data and the other part of them have cumbersome preprocessing steps to divide the character into different parts to be learned and transferred separately. In this paper, we propose a simple but powerful end-to-end Chinese calligraphy font generation framework ZiGAN, which does not require any manual operation or redundant preprocessing to generate fine-grained target-style characters with few-shot references. To be specific, a few paired samples from different character styles are leveraged to attain a fine-grained correlation between structures underlying different glyphs. To capture valuable style knowledge in target and strengthen the coarse-grained understanding of character content, we utilize multiple unpaired samples to align the feature distributions belonging to different character styles. By doing so, only a few target Chinese calligraphy characters are needed to generated expected style transferred characters. Experiments demonstrate that our method has a state-of-the-art generalization ability in few-shot Chinese character style transfer., Accepted at ACM MM 2021

Background: Previous studies have shown conflicting results about the benefits of pretreatment with intravenous thrombolysis before endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) with large vessel occlusions (LVOs). This study aimed to investigate the clinical efficacy and safety of EVT alone vs. bridging therapy (BT) in patients with AIS with LVOs.Methods: A systematic review with meta-analysis of all available studies comparing clinical outcomes between BT and EVT alone was conducted by searching the National Center for Biotechnology Information/National Library of Medicine PubMed and Web of Science databases for relevant literature from database inception to October 20, 2020.Results: A total of 93 studies enrolling 45,190 patients were included in the present analysis. In both unadjusted and adjusted analyses, BT was associated with a higher likelihood of 90-day good outcome (crude odds ratio [cOR] 1.361, 95% confidence interval [CI] 1.234–1.502 and adjusted OR [aOR] 1.369, 95% CI 1.217–1.540) and successful reperfusion (cOR 1.271, 95% CI 1.149–1.406 and aOR 1.267, 95% CI 1.095–1.465) and lower odds of 90-day mortality (cOR 0.619, 95% CI 0.560–0.684 and aOR 0.718, 95% CI 0.594–0.868) than EVT alone. The two groups did not differ in the occurrence of symptomatic intracranial hemorrhage (sICH) (cOR 1.062, 95% CI 0.915–1.232 and aOR 1.20, 95% CI 0.95–1.47), 24-h early recovery (cOR 1.306, 95% CI 0.906–1.881 and aOR 1.46, 95% CI 0.46–2.19), and number of thrombectomy device passes ≤ 2 (aOR 1.466, 95% CI 0.983–2.185) after sensitivity analyses and adjustment for publication bias.Conclusions: BT provides more benefits than EVT alone in terms of clinical functional outcomes without compromising safety in AIS patients with LVOs.

With advancements in technology, huge volumes of valuable data have been generated and collected at a rapid velocity from a wide variety of rich data sources. Examples of these valuable data include healthcare and disease data such as privacy-preserving statistics on patients who suffered from diseases like the coronavirus disease 2019 (COVID-19). Analyzing these data can be for social good. For instance, data analytics on the healthcare and disease data often leads to the discovery of useful information and knowledge about the disease. Explainable artificial intelligence (XAI) further enhances the interpretability of the discovered knowledge. Consequently, the explainable data analytics helps people to get a better understanding of the disease, which may inspire them to take part in preventing, detecting, controlling and combating the disease. In this paper, we present an explainable data analytics system for disease and healthcare informatics. Our system consists of two key components. The predictor component analyzes and mines historical disease and healthcare data for making predictions on future data. Although huge volumes of disease and healthcare data have been generated, volumes of available data may vary partially due to privacy concerns. So, the predictor makes predictions with different methods. It uses random forest With sufficient data and neural network-based few-shot learning (FSL) with limited data. The explainer component provides the general model reasoning and a meaningful explanation for specific predictions. As a database engineering application, we evaluate our system by applying it to real-life COVID-19 data. Evaluation results show the practicality of our system in explainable data analytics for disease and healthcare informatics.

Background: The metabolic syndrome (MS) is significantly associated with the risk of incident heart failure (HF). However, there are still great controversies about the impact of MS on the prognosis in patients with established HF. This meta-analysis aimed to ascertain the effect of MS on the prognosis in patients with HF.Methods: We searched multiple electronic databases, including PubMed, Opengrey, EMBASE, and Cochran Library, for potential studies up to February 15, 2021. Observational studies that reported the impact of MS on the prognosis in patients with established HF were included for meta-analysis.Results: Ten studies comprising 18,590 patients with HF were included for meta-analysis. The median follow-up duration of the included studies was 2.4 years. Compared with HF patients without MS, the risk of all-cause mortality and cardiovascular mortality was not increased in HF with MS (HR = 1.04, 95% CI = 0.88–1.23 for all-cause mortality; HR = 1.66, 95% CI = 0.56–4.88 for cardiovascular mortality, respectively). However, there was a significant increase in composited cardiovascular events in the HF patients with MS compared with those without MS (HR = 1.73, 95% CI = 1.23–2.45).Conclusions: In patients with established HF, the presence of MS did not show an association on the risk of all-cause mortality or cardiovascular mortality, while it may increase the risk of composite cardiovascular events.

BackgroundReports have proven that shorter door-to-needle time (DTN time) indicates better outcomes in AIS patients received intravenous thrombolysis. Efforts have been made by hospitals and centers to minimize DTN time in many ways including introducing a stroke nurse. However, there are few studies to discuss the specific effect of stroke nurse on patients’ prognosis. This study aimed to compare consecutive AIS patients before and after the intervention to analyze the effect of stroke nurse on clinical outcome of AIS patients.MethodsIn this retrospective study, we observed 1003 patients from November 2016 to December 2020 dividing in two groups, collected and analyzed AIS patients’ medical history, clinical assessment information, important timelines, 90 mRS score, etc. Comparative analysis and mediation analysis were also used in this study.ResultsA total of 418 patients was included in this study, and 199 patients were enrolled in the stroke nurse group and 219 was in the preintervention group. Baseline characteristics of patients showed no significant difference except there seems more patients with previous ischemic stroke history in the group of stroke nurse. (p = 0.008). The median DTN time significantly decreased in the stroke nurse group (25 min versus 36 min,p p = 0.001). Mediation analysis indicated the reduction of DTN time plays a partial role on the 90 days mRS score and the stroke nurse has some direct effect on the improvement of clinical outcome (p = 0.006).ConclusionsThe introduction of stroke nurse is beneficial to clinical outcome of AIS patients and can be use of reference in other hospitals or centers.

Guidelines have differed in their opinion regarding the indications for endoscopic resection of gastric-neuroendocrine neoplasms (g-NENs) and duodenal-NENs (d-NENs). We examined the association between size and lymph node metastasis (LNM) to identify candidates most suitable for endoscopic resection. We identified 706 patients with T1/T2 g-NENs and 621 patients with T1/T2 d-NENs from the SEER database. The prevalence of LNM and risk factors associated with LNM were analyzed. LNM was present in 8.1% of patients with gastroduodenal neuroendocrine tumors (NETs) and 31.6% of patients with neuroendocrine carcinomas (NECs). Multivariate logistic regression indicated that tumor size >10mm, greater invasion depth, and poor differentiation were independently associated with LNM. In addition, the percentage of g-NETs invading submucosa with LNM increased with tumor size (≤10 mm,3.9%;11–20 mm,8.6%;>20 mm,16.1%). However, in contrast to the low LNM risk in patients with small g-NETs (≤10 mm), we found that LNM rate exceeded 5% even for patients with small submucosal-infiltrating d-NETs. Among patients with nodal-negative g-NETs, the cause specific survival (CSS) was similar for those who received surgical resection and endoscopic resection. Among patients with d-NETs, the CSS was better for those who received endoscopic resection. In conclusion, patients with d-NETs had a higher probability of LNM than those with g-NETs. Endoscopic resection can be utilized for curative treatment of submucosa-infiltrating g-NETs and intramucosal d-NETs when the size is 10 mm or less. These results reinforce the need to search for LNM in lesions that are larger than 10 mm.

In order to better apply the target detection technology to the actual production environment of domestic garbage detection, this paper proposes a lightweight domestic garbage detection method based on improved FPN. This method takes the one-stage target detection method RetinaNet as the baseline, firstly it replaces the backbone network from Resnet50 to MobilenetV1, to improve the timeliness of feature extraction in detection. Then, based on the original top-down fusion feature pyramid method, a bidirectional fusion feature pyramid method called garfpn is proposed to improve the detection accuracy. The experiments show that our method can detect domestic garbage accurately and quickly, and has good robustness and practicability.

Qi-Wen Deng,1,&ast; Shi Huang,1,&ast; Shuo Li,2,&ast; Qian Zhai,1 Qing Zhang,1 Zhen-Jie Wang,1 Wen-Xia Chen,1 Huiling Sun,3 Min Lu,1 Junshan Zhou1 1Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, People’s Republic of China; 2Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, People’s Republic of China; 3General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Junshan Zhou; Min Lu Department of Neurology, Nanjing First Hospital, Nanjing Medical University, 210006, People’s Republic of China Email zhjsh333@126.com; luminnfhsjk@126.comBackground and Purpose: This study aimed to explore several peripheral blood-based markers related to the inflammatory response in a total of 210 patients with acute ischemic stroke (AIS) caused by large artery occlusion in the anterior circulation who received endovascular therapy (EVT) from an observational study of clinical significance of circulating non-coding RNA in acute ischemic stroke (AISRNA).Methods: We collected baseline characteristics of 210 AIS patients participating in an observational acute stroke cohort: the AISRNA study. The following inflammatory factors were measured in these participants: interleukin-2 [IL-2], IL-4, IL-6, IL-10, tumor necrosis factor-α [TNF-α], and interferon-γ [IFN-γ]. The National Institute of Health Stroke Scale score increase of ≥ 4 within 24 hours after EVT defined as early neurological deterioration (END).Results: Compared with patients without END, patients with END had a higher incidence of atrial fibrillation (P=0.012), and also had higher levels of IL-6 and IL-10 (P< 0.01). Furthermore, we found that the area under the curves (AUCs) of IL-6 and IL-10 for predicting END were 0.768 (0.697– 0.829), and 0.647 (0.570– 0.719), respectively. Adjusting for age, sex, and atrial fibrillation, the odds ratios (ORs; 95% confidence interval) for incident END for IL-6 and IL-10 were 1.98 (1.05– 6.69) and 1.18 (1.04– 1.33), respectively. Additionally, we found significant changes over time in the expression levels of IL-4, IL-6, and IL-10 in patients with END compared with patients without END (P< 0.05).Conclusion: IL-6 and IL-10 levels at admission may be potential markers of END after EVT, and the time course of IL-4, IL-6, and IL-10 is correlated with stroke progression. Further larger studies are needed to confirm the current findings.Trial Registration: ClinicalTrials.gov NCT04175691. Registered November 21, 2019, https://www.clinicaltrials.gov/ct2/show/NCT04175691Keywords: acute ischemic stroke, early neurological deterioration, endovascular therapy, inflammatory factors, IL-6

Current evidence on cigarette smoking associated with pancreatic cancer mortality is limited. We searched MEDLINE, Web of Science, and Embase databases to identify relevant studies published through January 31, 2018. A random-effects model was used to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 20 studies were retrieved, involving 2,517,623 participants. Of these, more than 15,341 patients with pancreatic cancer died. Compared with never smokers, current (summary HR, 1.56; 95% CI, 1.34-1.83) and former (summary HR, 1.15; 95% CI, 1.06-1.26) smokers had elevated risk of total mortality in patients diagnosed with pancreatic cancer. This effect of cigarette smoking is observed both in the Western regions and the Asia-Pacific regions. This effect of smoking is independent of alcohol use, body mass index, and history of diabetes but is modified by tumor stage and study settings. Dose-response associations between smoking and pancreatic cancer mortality were revealed for smoking intensity, cumulative amount of cigarettes smoked, and duration of smoking. Cigarette smoking was associated with an increase in total mortality for patients with pancreatic cancer. Future studies should further clarify the role of smoking as an effect modifier in treatment trials of pancreatic cancer.

Supplemental Digital Content is available in the text, Background: Recent genome-wide association studies have identified an important role of T-cell receptor α (TRA) gene in the development of narcolepsy type 1. However, the role of TRA haplotype polymorphisms in the symptomatic diversity of narcolepsy remains unclear. This study aimed to investigate whether TRA polymorphisms can influence the symptomatic diversity of narcolepsy. Methods: Totally, 903 patients with narcolepsy type 1 were included in the study. Patients were divided into different groups according to their symptoms. First, 13 genotyped single nucleotide polymorphisms in the TRA were assessed for their association with symptoms of narcolepsy. We used the Chi-square test to determine differences in genotype frequencies in patients with narcolepsy. Further, we identified the haplotypes and variations of the TRA and tested their association with the symptoms of narcolepsy using a logistic regression model. Results: According to the results of the logistic regression, TRA haplotypes TG and CT were significantly associated with auditory hallucination, with odds ratios of 1.235 (95% confidence interval [CI], 1.012–1.507) and 1.236 (95% CI, 1.012–1.511), respectively (P

In the information economy, individuals’ work performance is closely associated with their digital communication strategies. This study combines social network and semantic analysis to develop a method to identify top performers based on email communication. By reviewing existing literature, we identified the indicators that quantify email communication into measurable dimensions. To empirically examine the predictive power of the proposed indicators, we collected 2 million email archive of 578 executives in an international service company. Panel regression was employed to derive interpretable association between email indicators and top performance. The results suggest that top performers tend to assume central network positions and have high responsiveness to emails. In email contents, top performers use more positive and complex language, with low emotionality, but rich in influential words that are probably reused by co-workers. To better explore the predictive power of the email indicators, we employed AdaBoost machine learning models, which achieved 83.56% accuracy in identifying top performers. With cluster analysis, we further find three categories of top performers, ‘networkers’ with central network positions, ‘influencers’ with influential ideas and ‘positivists’ with positive sentiments. The findings suggest that top performers have distinctive email communication patterns, laying the foundation for grounding email communication competence in theory. The proposed email analysis method also provides a tool to evaluate the different types of individual communication styles.

AIM: To investigate microvascular changes in eyes with central retinal vein occlusion (CRVO) complicated by macular edema before and after intravitreal conbercept injection and evaluate correlations between these changes and best-corrected visual acuity (BCVA) and retinal thickness. METHODS: Twenty-eight eyes of 28 patients with macular edema caused by CRVO were included in this retrospective study. All patients received a single intravitreal conbercept injection to treat macular edema. BCVA and the results of optical coherence tomography angiography (OCTA) automatic measurements of the vessel density in the superficial (SCP) and deep retinal capillary plexus (DCP), the foveal avascular zone (FAZ) area, the FAZ perimeter (PERIM), the vessel density within a 300-μm wide ring surrounding the FAZ (FD-300), the acircularity index (AI), the choriocapillaris flow area, and retinal thickness were recorded before and at one month after treatment and compared with the results observed in age- and sex- matched healthy subjects. RESULTS: The vessel density in the SCP and DCP, the FD-300, and the flow area of the choriocapillaris were all significantly lower in CRVO eyes than in healthy eyes, while the AI and retinal thickness were significantly higher (all P

Project ending phase is strategically important for organizations, but it has been largely neglected in previous research and practice. In this phase, the project manager is the executor of strategic moves and plays a paramount role in completing projects efficiently and other summarizing work, but the issues related to complicated work content, future career path, and work-family conflicts may rapidly increase the pressure on project managers at the same time. These stressors affect project managers psychologically, physiologically, and behaviorally and inhibit project managers' capability from functioning well. Under this scenario, the purpose of the study is to empirically figure out the impact of project managers' participation in project ending, and their capability's contribution to project ending performance under pressure. This research identified six factors of project ending stressor, namely skill discretion, decision authority, job demands, job insecurity, job readjustment, and family support. A sample of 214 experienced project managers from different industries was collected, and structural equation modeling (SEM) was used. The results show that project managers play as coordinators among stakeholders in completing product handover and accumulating knowledge asset, thus indirectly enhancing organizational strategic value integration in project ending. Completing product handover is more efficient in terms of strategic integration than accumulating knowledge assets. When the stressors begin to pile up, the contribution of project managers' capability will be hindered, but only the process of accumulating knowledge assets is affected. Thereby, project managers under pressure tend to first lose control of the task with less strategic importance. This study supplements insights to related theory in project management and human resource management fields and also provides practical suggestions for project management and personnel management in project-based organizations.

Tunnelling induced ground movement may affect adjacent jointed pipelines. Leakage may occur at the joints due to excessive rotation. As Winkler models are popular in practical design, a Winkler solution based on an improved Winkler modulus is proposed to analyze the response of jointed pipelines due to tunnelling. The solution is verified against the reported elastic continuum solution, the data from field measurement and centrifuge tests. The results of parametric studies establish the variation between joint rotation and general pipe-soil relative stiffness due to Greenfield deformations, joint and pipe segment stiffness and configurations of joints relative to tunnel center. In terms of the parametric studies, a design chart is established to predict the maximum joint rotation based on the improved Winkler modulus as a tool for preliminary risk assessment. The applicability is verified by compared with the results from the field case and centrifuge tests.

The ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) is an objective approach to predicting poor outcomes in acute ischemic stroke (AIS). The impact of TG/HDL-C on hemorrhagic transformation (HT) after AIS remains unknown. The aim of this study was to explore the accurate effect of TG/HDL-C on HT after AIS. We enrolled a total of 1423 patients with AIS in the training cohort from a prospective, consecutive hospital-based stroke registry. Of the 1423 patients, HT occurred in 155 (10.89%) patients. The incidence of HT after AIS was significantly increased when there were low levels of TG (P=0.016) and TG/HDL-C (P=0.006) in patients with AIS attributable to large artery atherosclerosis (LAA), but not in those who suffered from cardioembolic stroke. After adjustment for covariates, a lower TG/HDL-C (OR=0.53, 95%CI=0.20-0.93) that was more than TG alone (OR=0.61, 95%CI=0.27-0.98) independently increased the risk of HT in LAA. Furthermore, our established nomogram indicated that lower TG/HDL-C was an indicator of HT. These findings were further validated in the test cohort of 558 patients with AIS attributable to LAA. In summary, a low level of TG/HDL-C is correlated with greater risk of HT after AIS attributable to LAA.

Microvesicles (MVs), which are cell‐derived membrane vesicles present in body fluids, are closely associated with the development of malignant tumours. Saliva, one of the most versatile body fluids, is an important source of MVs. However, the association between salivary MVs (SMVs) and oral squamous cell carcinoma (OSCC), which is directly immersed in the salivary milieu, remains unclear. SMVs from 65 patients with OSCC, 21 patients with oral ulcer (OU), and 42 healthy donors were purified, quantified and analysed for their correlations with the clinicopathologic features and prognosis of OSCC patients. The results showed that the level of SMVs was significantly elevated in patients with OSCC compared to healthy donors and OU patients. Meanwhile, the level of SMVs showed close correlations with the lymph node status, and the clinical stage of OSCC patients. Additionally, the ratio of apoptotic to non‐apoptotic SMVs was significantly decreased in OSCC patients with higher pathological grade. Consistently, poorer overall survival was observed in patients with lower ratio of apoptotic to non‐apoptotic SMVs. In conclusion, the elevated level of SMVs is associated with clinicopathologic features and decreased survival in patients with OSCC, suggesting that SMVs are a potential biomarker and/or regulator of the malignant progression of OSCC.

The management of bridges has major influence on the safety of transport system. Bridge management (BM) practices are carried out in compliance with policies and regulations. This study aims to identify the major aspects of BM from policy documents. We conducted a two-round retrieve to construct a comprehensive dataset of 263 related policies and regulations issued in the 31 provinces/municipalities of mainland China in recent 30 years. The Author-Topic Model (ATM) text mining approach was adopted to identify the key topics in the policies. The revealed 12 topics correspond to 12 major aspects of BM. Some topics, such as bridge maintenance and safety responsibility system , are gaining increasing attention in recent years, while the prevalence of some topics, such as bridge maintenance department configuration , is decreasing. The Granger causality tests suggest that remedial measures attract immediate regulatory attention in response to accidents, while proactive measures contribute to bridge collapse accident reduction, however, in a relatively long term. These findings provide practical implications for policy makers by reminding them that proactive measures should be emphasized alongside remedial measures.

Background Whether goal-directed fluid therapy based on dynamic predictors of fluid responsiveness (GDFTdyn) alone improves clinical outcomes in comparison with standard fluid therapy among patients undergoing surgery remains unclear. Methods PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov were searched for relevant studies. Studies comparing the effects of GDFTdyn with that of standard fluid therapy on clinical outcomes among adult patients undergoing surgery were considered eligible. Two analyses were performed separately: GDFTdyn alone versus standard fluid therapy and GDFTdyn with other optimization goals versus standard fluid therapy. The primary outcomes were short-term mortality and overall morbidity, while the secondary outcomes were serum lactate concentration, organ-specific morbidity, and length of stay in the intensive care unit (ICU) and in hospital. Results We included 37 studies with 2910 patients. Although GDFTdyn alone lowered serum lactate concentration (mean difference (MD) − 0.21 mmol/L, 95% confidence interval (CI) (− 0.39, − 0.03), P = 0.02), no significant difference was found between groups in short-term mortality (odds ratio (OR) 0.85, 95% CI (0.32, 2.24), P = 0.74), overall morbidity (OR 1.03, 95% CI (0.31, 3.37), P = 0.97), organ-specific morbidity, or length of stay in the ICU and in hospital. Analysis of trials involving the combination of GDFTdyn and other optimization goals (mainly cardiac output (CO) or cardiac index (CIx)) showed a significant reduction in short-term mortality (OR 0.45, 95% CI (0.24, 0.85), P = 0.01), overall morbidity (OR 0.41, 95% CI (0.28, 0.58), P

Purpose The treatment of malignant parotid tumors with 125I brachytherapy is rarely reported. This study evaluated the efficacy and dose and response of 125I brachytherapy in patients with malignant tumors. Materials and Methods From July 2014 through August 2017, 39 patients with malignant parotid tumors were treated with 125I brachytherapy. Thirty-five patients were treated with conservative surgical resection before brachytherapy. Four patients were treated with brachytherapy alone. Clinical outcomes and side effects were evaluated. Clinical factors were investigated to determine correlations with local control (LC) and side effects. Results Mean follow-up was 25 months (range, 7 to 47 months). The LC rate was 87.2% and the overall survival rate was 97.4%. High tumor grade and large tumor showed a propensity for local recurrence. Acute skin toxicity occurred in 87.2% of patients and grade 3 and 4 radioepidermitis was found in 20.5% of patients. In total, 89.7% of patients with facial nerve dysfunction recovered within 12 months. Conclusions 125I brachytherapy was a feasible treatment option for patients with malignant parotid tumors. Although side effects were minimal, strict follow-up was necessary for patients treated with a high dose.

HgCdTe avalanche photodiode (APD) is a frontier research on infrared focal plane technology, High-precision time stamp readout circuit is the basis of the APD focal plane at 77 K, which directly affects APD infrared focal plane performance. Time-to-digital conversion circuit (TDC) is one of the methods to achieve high-precision time stamping. Based on the analysis of MOSFET at low temperature, our design a vernier TDC circuit, which uses a synchronous counter to quantize an integer multiple of the period to achieve a coarse count of 6 bits; The on-chip PLL multiplied high-frequency clock has high-precision and high PVT characteristics, using it to quantify the part that is less than one clock cycle to achieve a fine-count of 6 bits output. The circuit adopts standard CMOS process tape out, our circuit works at a master-frequency of 120 MHz. At 77 K, the circuit test can distinguish the time resolution of 236.280 ps. The DNL is within -0.54~0.71 LSB, and INL is within -1.32~1.21 LSB.

Gastric cancer is one of the most common cancers, while the current treatment options for gastric cancer are relatively scarce due to insufficient understanding of molecular characteristics and subtypes of gastric cancer. Different gene rearrangements of anaplastic lymphocyte kinase (ALK) have been reported in several types of cancer, especially in NSCLC. The first-generation ALK tyrosine kinase inhibitor (TKI) crizotinib, second-generation (ceritinib, alectinib, and brigatinib) and third-generation (lorlatinib) ALK-TKIs have been widely used for NSCLC patients with ALK rearrangement. However, little was reported about ALK mutation in gastric cancer (GC). Here we identified a novel form of ALK fusion, a case of GC with RAB10-ALK fusion, and this is the first report of ALK fusion in gastric cancer.

Currently, the main treatment for familial adenomatous polyposis (FAP) is surgery, however, surgery is far from ideal as there are many complications such as uncontrollable bowel movements, pouch inflammation, anastomotic stricture, and secondary fibroids. Therefore, it is necessary to further expand the understanding of FAP and develop new treatments for FAP. The immune microenvironment including immune cells and cytokines, plays an important role in FAP and the progression of FAP to adenocarcinoma, thus it may be a promising treatment for FAP. In the current review, we summarized the recent progress in the immune microenvironment of FAP.

Technological advancements have led to generation and collection of big data from various data sources including mobile devices. For instance, to prevent, combat and detect COVID-19, citizens of many countries were encouraged to use contact tracing apps on their mobile devices. Collection of their trajectories can be analyzed and mined for social goods. At the same time, their privacy also needs to be preserved. In other words, the advent of COVID-19 has made releasing of patient records become imperative and yet privacy of individuals must be protected. Releasing spatio-temporal COVID-19 data plays a significant role in contact tracing and may help in reducing the spread of the disease due to likelihood of increasing adherence to social distancing and other health related guidelines by the people around the cluster of the released data. In this paper, we examine the problem of preserving privacy of spatio-temporal trajectory data and introduce a hierarchical temporal representative point (HTRP) differential privacy model. We evaluate our framework using a South Korean COVID-19 patient route dataset. Empirical results show a balance of utility and privacy provided by our framework with our HTRP for privacy-preserving healthcare data analytics.

The present case study reported a rare case of duodenal metastasis from a lung adenocarcinoma. A 62-year-old male, who underwent radical lung cancer surgery two years ago, was readmitted to Guangzhou Red Cross Hospital complaining of epigastric pain. The esophagogastroduodenoscopy identified a 2.5x3.5 cm ulcerative lesion at the duodenum. Histopathological and immunohistochemical staining results confirmed that the lung adenocarcinoma had metastasized to the duodenum. The tumor cells were positive for cytokeratin-7, thyroid transcription factor-1 and napsin-A expression, but negative for caudal-related homeobox 2 expression. Prior to the second cycle of targeted treatment with anlotinib, the patient reported severe hematochezia. Therefore, an angiography and artery embolization were subsequently performed. However, the patient succumbed to acute kidney injury three days after the operation. The metastasis of lung cancer to the gastrointestinal tract is extremely rare and usually asymptomatic. However, when treating patients with lung cancer presenting with digestive symptoms or other distant metastatic sites, clinicians should consider the possibility of gastrointestinal metastasis so that it can be identified in a timely manner. If lesions exist, doctors should locate these and perform biopsies to conduct histopathological and immunohistochemical examinations to make a clear diagnosis.

In the process of UAV line inspection, there may be raindrops on the camera lens. Raindrops have a serious impact on the details of the image, reducing the identification of the target transmission equipment in the image, reducing the accuracy of the target detection algorithm, and hindering the practicability of UAV line inspection technology in cyber-physical energy systems. In this paper, the principle of raindrop image formation is studied, and a method of raindrop removal based on generation countermeasure network is proposed. In this method, the attention recurrent network is used to generate the raindrop attention map, and the context code decoder is used to generate the raindrop image. The experimental results show that the proposed method can remove the raindrops in the image and repair the background image of raindrop coverage area and can generate a higher quality raindrop removal image than the traditional method.