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To investigate the overall damage characteristics and failure modes of a warship subjected to an underwater non-contact near-field explosion, a hull girder with a trapezoidal cross-section was designed, manufactured, and tested. The design criteria and parameters were determined according to the similarity criterion. Dynamic responses of the girder freely floating on water were obtained under varying conditions, including stand-off distance, charge mass, and position of attack. Damage morphologies of the girder model were obtained. Based on our analysis, basic conditions for sagging damage of the hull girder are proposed. The aim of this study was to determine an efficient method of attack resulting in the most severe damage to the ship hull. The experimental results show that the girder mainly exhibits a first-order response when the first wet frequency of the girder is close to the frequency of the explosion bubble pulsation. The largest deformation was observed when the underwater explosion occurred directly below the midspan of the girder compared to other explosions of the same intensity at different attack positions. When the ratio of stand-off to maximum bubble radius (λ) satisfies 0.7 ≤ λ＜2, the bubble mainly causes sagging damage instead of hogging. As λ decreases (1≤ λ＜2), the sagging damage increases under the same charge mass. However, as λ decreases further (0.7≤ λ＜1), the sagging deformation decreases. This is likely due to the impact of the liquid jet formed by the collapsing bubble, which causes the girder deformation to shift from sagging back to hogging deformation. The initial shock wave excites the high-frequency response of the girder structure but contributes very little to the overall velocity and displacement. However, bubble pulsation typically causes a low-frequency response, which will affect the velocity and displacement of the girder. The low-pressure region of the flow field formed by bubble pulsation and resonant coupling between the girder and the bubble are the predominant causes of damage to the overall girder structure.

OBJECTIVE To clarify whether systemic lymph node dissection (LND) influences the safety of surgery and the survival of patients with locally advanced esophageal squamous cell carcinoma (ESCC) after neoadjuvant chemoradiotherapy (nCRT). SUMMARY BACKGROUND DATA Prognostic impact of systemic lymphadenectomy during surgery after nCRT for ESCC is still uncertain and requires clarification. METHODS This is a secondary analysis of NEOCRTEC5010 trial which compared nCRT followed by surgery versus surgery alone for locally advanced ESCC. Relationship between number of LND and perioperative, recurrence and survival outcomes were analyzed in the nCRT group. RESULTS Three-year overall survival was significantly better in the nCRT group than the S group (75.2% vs 61.5%; P=0.011). In the nCRT group, greater number of LND was associated with significantly better overall survival (HR, 0.358; P < 0.001) and disease-free survival (HR, 0.415; P=0.001), but without any negative impact on postoperative complications. Less LND (< 20 vs ≥ 20) was significantly associated with increased local recurrence (18.8% vs 5.2%, P=0.004) and total recurrence rates (41.2% vs 25.8%, P=0.027). Compared to patients with persistent nodal disease, significantly better survival was seen in patients with complete response and with LND ≥ 20, but not in those with LND < 20. CONCLUSIONS Systemic lymph node dissection does not increase surgical risks after nCRT in ESCC patients. And it is associated with better survival and local disease control. Therefore, systemic lymphadenectomy should still be considered as an integrated part of surgery after nCRT for ESCC.

Secure and usable user authentication is the first line of defense against cyber attacks on smart end-user devices. Advanced hacking techniques pose severe threats to the traditional authentication systems based on the password/PIN/fingerprint. We propose MagAuth, a secure and usable two-factor authentication scheme with commercial off-the-shelf (COTS) wrist wearables with magnetic strap bands to enhance the security and usability of password-based authentication for mobile touchscreen devices. In MagAuth, a user enrolls a self-chosen unlock pattern or touch gesture into his touchscreen device by performing it with the same hand the magnetic wrist wearable is on. The chosen unlock pattern or touch gesture serves as the first authentication factor, and the user's behavioral features manifested in the magnetic field changes during his finger movement correspond to the second factor. The user can unlock his touchscreen device only when both authentication factors can be validated. Comprehensive user experiments confirm the high security and usability of MagAuth. In particular, MagAuth achieves an average true-positive rate up to 96.3% and a false-positive rate no larger than 8.4%. Moreover, we show that MagAuth is highly resilient to various attacks.

Acoustic fingerprinting aims to identify a mobile device based on its internal microphone(s) and speaker(s) which are unique due to manufacturing imperfection. This paper seeks a thorough understanding of the (in)security of exploring acoustic fingerprints for achieving distributed mobile authentication. Our contributions are threefold. First, we present a new acoustic fingerprint-emulation attack and demonstrate that it is a common vulnerability of acoustic mobile authentication systems. Second, we propose a dynamic challenge-response defense to secure acoustic mobile authentication systems against the acoustic fingerprint-emulation attack. Finally, we thoroughly investigate existing acoustic fingerprinting schemes and identify the best option for accurate, secure, and deployable acoustic mobile authentication systems.

Real-time traffic state estimation and prediction are of importance to the traffic management systems. New opportunities are enabled by the emerging sensing and automation technologies to manage connected and automated traffic, particularly in terms of controlling trajectories of automated vehicles. Traffic information from connected and automated vehicles (CAV) and roadside detectors (RSD) can be fused and has great potential for providing detailed microscopic traffic states (i.e., vehicle speeds, positions) of all vehicles. In this paper, we propose a cooperative perception framework for this purpose. The proposed framework based on particle filtering is developed to provide an accurate estimation and prediction of the microscopic states of partially observed traffic systems, while accounting for different sources of errors that intrinsically exist in the system, including those from sensor data, vehicle movement, and process models. Selected freeway and arterial vehicle trajectory datasets from the Next Generation Simulation (NGSIM) program and CAV traffic simulation are applied to test the proposed methodological framework. The accuracy of position and speed estimation is between 50% and 70% when the CAV market penetration rate (MPR) is 12.5%, and between 80% and 90% when the MPR is 50%. The incorporation of RSD data can further increase the accuracy by up to 10% under low CAV MPRs. The framework can also provide an accurate short-term prediction (i.e., 5 - 15 seconds) of position and speed with 60% to 90% accuracy. The proposed framework provides efficient and accurate estimations and predictions of detailed microscopic traffic states, even at low CAV MPRs, creating dynamic traffic environment world models to enable fine control and management of the connected and automated traffic systems.

The recent development of tough tissue adhesives has stimulated intense interests among material scientists and medical doctors. However, these adhesives have seldom been tested in clinically demanding surgeries. Here we demonstrate adhesive anastomosis in organ transplantation. Anastomosis is commonly conducted by dense sutures and takes a long time, during which all the vessels are occluded. Prolonged occlusion may damage organs and even cause death. We formulate a tough, biocompatible, bioabsorbable adhesive that can sustain tissue tension and pressurized flow. We expose the endothelial surface of vessels onto a gasket, press two endothelial surfaces to the adhesive using a pair of magnetic rings, and reopen the bloodstream immediately. The time for adhesive anastomosis is shortened compared to the time for sutured anastomosis. We have achieved adhesive anastomosis of a great vein in transplanting the liver of a pig. After the surgery, the adhesive is absorbed, the vein heals, and the pig lives for over one month.

Blockchain-based Internet of Things (BC-IoT) brings the advantages of blockchain into traditional IoT systems. In BC-IoT, the smart contract has been widely used for automatic, trusted and decentralized applications. Smart contracts require frequently adjust and fast update due to various reasons such as inevitable code bugs, changes of applications or security requirements. However, previous smart contract architecture and updating mechanism are low speed and cause high overhead, because they are based on recompilation and redeployment in BC-IoT. Meanwhile, smart contract execution is so timeconsuming due to contract instruction dispatching and operand loading in the stack-based Ethereum Virtual Machine (EVM). To address these issues, we propose a new smart contract architecture and optimization mechanism for blockchain-based Internet of Things, ATOM, which provides architectural supports to update contract economically and fast executing in instructionwise for the first time, to the best of our knowledge. We design a compact Application-oriented Instruction (AoI) set to describe application operations. We can construct the bytecode of smart contract from application by directly assembling templates prebuilt upon the AoIs rather than by compilation. We also present an optimized mechanism for AoI execution to enable access addressable storage place rather than the indirect access through stack. We perform ATOM on a BC-IoT testbed based on private Ethereum and Hyperledger Burrow. The experimental results highlight that, ATOM is more efficient than state-of-the-art approaches. ATOM can reduce update latency by 62.7%, ledger size by 70% and gas usage by 90% on average, respectively. Compared with the traditional smart contract architecture, ATOM can improve EVM Memory access efficiency significantly by up to 10x and achieve improvement of execution efficiency with up to 1:6x.

Offloading the unprecedented growing data to the edge exhibits a mainstream trend in the Industrial Internet of Things (IIoT) era, delivering far-reaching impacts in all aspects of our daily lives, including transportation, healthcare, and entertainment. However, voluminous data analyses and processing at the edge will unavoidably raise the edge processor's burden and dramatically expand its design complexity and energy dissipation. This study proposes a flexible bit-adjustment-based energy-efficient convolution module with an approximate divide-and-conquer (ADC) multiplier for compact and low-power edge processor design. The maximum distribution search technique is utilized to exploit the optimal fixed-point representation format for both input and output of the convolution module. The neural network manifests the same precision as a 32-bit floating-point multiplication deploying the determined representation formats. An ADC multiplier is proposed to realize the convolution module by eliminating the high-bit multiplication between weights and feature maps. The dynamic power consumption of the ADC multiplier-based convolution module with the Q(6, 9) input and Q(7, 8) output representation formats is 3.85% lower than that of the 16-bit signed multiplication circuit. Furthermore, the dynamic power consumption with Q(6, 9) input is capable of being decreased by 15.38% for the 16-bit convolution if the output is represented by the Q(1, 14) format and by up to 39.93% for the 64-bit multiplication. The practical verification system of the convolution module working on a field-programmable gate array evaluation board exhibits an outstanding low-power characteristic.

Objective: Summarize the experience of transporting patients in the pre-hospital emergency center of our hospital from January 20, 2020 to May 2020 during the outbreak of novel coronavirus pneumonia in Zhuzhou City, and formulate a series of transport strategies. Methods: During the novel coronavirus pneumonia epidemic, review the relevant experience of the medical staff and drivers in the pre-hospital emergency center of Zhuzhou Central Hospital to improve the procedures for the transfer of patients during the epidemic. Results: As of the time when patients with novel coronavirus pneumonia in our city are cleared, none of the medical staff in the pre-hospital emergency center of Zhuzhou Central Hospital has been infected, and the city's patients in need of pre-hospital emergency treatment have been treated in an orderly manner. In conjunction with our hospital's epidemic prevention and control expert team, combined with the actual situation in the region, we jointly formulated a series of transfer procedures for Zhuzhou Central Hospital to comply with the region during the epidemic. Conclusion: During the novel coronavirus pneumonia epidemic, all patients received by the pre-hospital emergency center of our hospital were transferred in a timely and safe manner, and a series of transfer procedures were developed.

With the rapid development of modern industry, high-grade paving asphalt is massively required to meet the demands for modern transportation. As one of additives, natural asphalt is indispensable since it can improve the performance of paving asphalt in all aspects. However, the application of non-renewable natural asphalt is increasingly restricted by its limited reserves. It is imperative to find alternative approaches to produce high-grade paving asphalt. Fluid catalytic cracking (FCC) slurry oil is an ideal soft component for producing paving asphalt due to its high content of aromatics and resins. However, its bad ageing resistance limits its application to only low-grade paving asphalt. In the present work, a novel approach for producing high-grade paving asphalt was investigated using chemically modified FCC slurry oil and deoiled asphalt (DOA). The FT-IR and NMR results showed that dehydrogenation and condensation reaction occurred during the ageing process. From a series of aliphatic alcohols and aldehydes, propanal was selected as a proper modifier to improve the ageing resistance of FCC slurry oil. The propanal-modified slurry oil possessed more substituted aromatic units and less aromatic hydrogen atoms than other modified slurry oils, thus showing better ageing resistance. With the increase of length of aliphatic chains in modifier, the modified slurry oil contained more and longer alkyl substituent group on aromatics. Compared with the cross-linked oil (slurry oil modified by cross-linking agent), modified slurry oil possessed similar ageing resistance but higher flowing ability. Also, the effect of operation conditions on the kinematic viscosity of modified slurry oil were investigated. Blended with modified slurry oil, the penetration ratio of asphalt product increased from 53.7 to 66.2, which met the standard of 70# paving asphalt. Both the microscopic observations and FT-IR results indicated that modification process effectively reduced the oxidation degree of asphalt product, thus increasing the ageing resistance. Consequently, with aid of this process, high-grade paving asphalt was readily produced from low value oil from downstream products of refinery, instead of the depleting natural asphalt.

We firstly propose a roadmap for the design of high repetition rate (~100 MHz) Tm-doped ultrafast fiber laser with an emission wavelength above 2000 nm. This roadmap is confirmed by both theoretical simulation and experimental verification. The designed Tm-doped fiber oscillator not only operates in continuous wave regime with a broad tunable wavelength range of ~ 100 nm, but also in mode-locking regime with an emission wavelength > 2000 nm (up to 2020 nm). A 470-fs laser pulse with a pulse repetition rate of ~96 MHz and the maximum average power of 50 mW are achieved at the output wavelength of 2007 nm, matching well with the theoretical prediction. In a further step, the seed laser pulse is amplified to 3.3 W, accompanied by a Raman frequency shift of the output wavelength to 2346 nm. The homogeneous intense broadband spectrum with a bandwidth of 240-nm centered at 2200 nm is also observed.

Recently, functional homotopy (FH) architecture, defined as robust functional connectivity (FC) between homotopic regions, has been frequently reported to be altered in MDD patients (MDDs) but with divergent locations.In this study, we obtained resting-state functional magnetic resonance imaging (R-fMRI) data from 1004 MDDs (mean age, 33.88 years; age range, 18-60 years) and 898 matched healthy controls (HCs) from an aggregated dataset from 20 centers in China. We focused on interhemispheric function integration in MDDs and its correlation with clinical characteristics using voxel-mirrored homotopic connectivity (VMHC) devised to inquire about FH patterns.As compared with HCs, MDDs showed decreased VMHC in visual, motor, somatosensory, limbic, angular gyrus, and cerebellum, particularly in posterior cingulate gyrus/precuneus (PCC/PCu) (false discovery rate [FDR] q 0.002, z = -7.07). Further analysis observed that the reduction in SMG and insula was more prominent with age, of which SMG reflected such age-related change in males instead of females. Besides, the reduction in MTG was found to be a male-special abnormal pattern in MDDs. VMHC alterations were markedly related to episode type and illness severity. The higher Hamilton Depression Rating Scale score, the more apparent VMHC reduction in the primary visual cortex. First-episode MDDs revealed stronger VMHC reduction in PCu relative to recurrent MDDs.We confirmed a significant VMHC reduction in MDDs in broad areas, especially in PCC/PCu. This reduction was affected by gender, age, episode type, and illness severity. These findings suggest that the depressive brain tends to disconnect information exchange across hemispheres.

In0.75Ga0.25As and In0.83Ga0.17As 320×256 short-wave infrared focal plane arrays (SWIR FPAs) with pixel pitches of 24 and 30 μm, extended cutoff wavelengths of 2.2 and 2.5 μm, low dark current densities of 5.2 and 21 nA/cm2, and high peak detectivities of 6×1011 and 6×1012 cmHz1/2W−1 are attained at 180 K, respectively. Lower 1/f noises and smaller knee frequencies are observed for the 2.2 μm FPA, indicates the dislocation defect-related trap states act as the major contributor for the 1/f noise. The non-uniformities of the dark signal and the dark noise are roughly the same for both FPAs at a short integration time of 1 ms (29% and 25% at 180 K, respectively) whereas are much smaller for the 2.2 μm FPA at longer integration times. Moreover, the dark current shot noise dominant integration time ranges are determined to be >20 and >2 ms for the 2.2 and 2.5 μm FPAs, respectively. Enhanced heat signature recording capability is also observed for wider SWIR spectral range while more effective suppression routes of dislocation defect must be incorporated for further improved sensitivity.

For organic optoelectronic devices, precise tuning of the electrical property of both active layers and interfaces is crucial to achieve enhanced device performance. Herein, we developed a facile m...

Clinically, the renin-angiotensin-aldosterone system is activated intensely in patients with moderate to severe traumatic brain injury (TBI). Increased angiotensin II in circulatory blood after TBI can enter the brain through the disrupted blood-brain barrier. Angiotensin-converting enzyme 2 (ACE2) is an enzyme that metabolizes angiotensin II into angiotensin (1-7), which has been shown to have neuroprotective results. The expression and role of ACE2 in the brain after TBI remains elusive, however. We found that ACE2 protein abundance was downregulated around the contusional area in the brains of both humans and mice. Endogenous ACE2 was expressed in neurons, astrocytes, and microglia in the cortex of the mouse brain. Administration of recombinant human ACE2 intracerebroventricularly alleviated neurological defects after TBI in mice. Treatment of recombinant human ACE2 suppressed TBI-induced increase of angiotensin II and the decrease of angiotensin (1-7) in the brain, mitigated neural cell death, reduced the activation of NLRP3 and caspase3, decreased phosphorylation of mitogen-activated protein kinases, and nuclear factor kappa B, and reduced inflammatory cytokines tumor necrosis factor alpha and interleukin-1β. Administration of ACE2 enzyme activator diminazene aceturate intraperitoneally rescued downregulation of ACE2 enzymatic activity and protein abundance in the brain. Diminazene aceturate treatment once per day in the acute stage after TBI alleviated long-term cognitive defects and neuronal loss in mice. Collectively, these results indicated that restoration of ACE2 alleviated neurological deficits after TBI by mitigation of pyroptosis and apoptosis.

Hepatocellular carcinoma (HCC), a heterogeneous cancer with high mortality, is resistant to single targeted therapy; thus, combination therapy based on synthetic lethality is a promising therapeutic strategy for HCC. Poly (adenosine diphosphate [ADP]-ribose) polymerase 1 (PARP1) is the most recognized target for synthetic lethality; however, the therapeutic effect of PARP1 inhibition on HCC is disappointing. Therefore, exploring new synthetic lethal partners for the efficient manipulation of HCC is urgently required. In this study, we identified Src and PARP1 as novel synthetic lethal partners, and the combination therapy produced significant anti-tumor effects without causing obvious side effects. Mechanistically, Src interacted with PARP1 and phosphorylated PARP1 at the Y992 residue, which further mediated resistance to PARP1 inhibition. Overall, this study revealed that Src-mediated PARP1 phosphorylation induced HCC resistance to PARP1 inhibitors and indicated a therapeutic window of the Y992 phosphorylation of PARP1 for HCC patients. Moreover, synthetic lethal therapy by co-targeting PARP1 and Src have the potential to broaden the strategies for HCC and might benefit HCC patients with high Src activation and resistance to PARP1 inhibitors alone.

A photo-assisted frequency conversion and self-interference cancellation approach is proposed and experimentally demonstrated for in-band full-duplex (IBFD) communication. Carrier suppressed single sidebands (CS-SSB) of the intermediate frequency (IF) signal and the local oscillator (LO) signal are simultaneously obtained through the X-DPMZM in a dual-polarization dual-parallel Mach-Zehnder (DP-DPMZM) modulator. A transmit signal with high purity is produced, and a shared LO optical sideband is also provided for the subsequent downconversion. The carrier suppressed double sideband (CS-DSB) modulation for the signal of interest (SOI) is achieved via the Y-DPMZM. The self-interference signal is suppressed by adjusting the bias voltage of its main MZM. An optical bandpass filter (OBPF) is combined to realize frequency downconversion. The experimental results show that the spurious-free dynamic range (SFDR) is 102.6 dB/Hz2/3 for frequency upconversion, a cancellation depth of more than 50 dB for single-frequency self-interference cancellation (SIC), and more than 22 dB for wideband SIC. The proposed link has superiority in multifunctionality, including in-band transmission, reception, and self-interference cancellation, with a shared LO.

To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) in the literature to ascertain the extent to which platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) improved patient outcomes in arthroscopic rotator cuff repair.Two independent reviewers performed the literature search based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a third author resolving any discrepancies. RCTs comparing PRP or PRF to a control in rotator cuff repair were included. Quality of evidence was assessed using the Cochrane Collaboration risk of bias tool. Clinical outcomes were compared using the risk ratio for dichotomous variables and the mean difference for continuous variables. A P value.05 was deemed statistically significant.Included in this review are 23 RCTs with 1440 patients. PRP resulted in significantly decreased rates of retear (15.9% versus 29.0%, respectively; P.0001). Significant results were noted in favor of PRP compared with control based on the Constant score (83.9 versus 81.2, respectively; P = .0006); the University of California, Los Angeles score (31.1 versus 30.2; P.00001); the American Shoulder and Elbow Surgeons score (87.3 versus 84.5; P = .04); and the visual analog scale score (1.3 versus 1.6; P = .01). PRF resulted in an improved Constant score (80.1 versus 80.0, respectively; P = .04) compared with control.The current evidence shows that using PRP in arthroscopic rotator cuff repair can improve pain levels and functional outcome scores while reducing the retear rate after surgery. PRF injection, on the other hand, improves only the Constant score.II; systematic review and meta-analysis of level I and II evidence.

Background: Acute changes in glomerular filtration rate (GFR) can occur following initiation of interventions for chronic kidney disease (CKD) progression. These complicate the interpretation of treatment effects on long term progression of (CKD). We sought to assess the magnitude and consistency of acute effects in randomized clinical trials (RCT) and explore factors that might impact them. Methods: We performed a meta-analysis of 53 RCTs for CKD progression enrolling 56,413 participants that had at least one estimated GFR measurement by six months following randomization. We defined acute treatment effects as the mean difference in GFR slope from baseline to 3 months between randomized groups. We performed univariable and multivariable meta-regression to assess the impact of intervention type, disease state, baseline GFR and albuminuria on the magnitude of acute effects. Results: The mean acute effect across all studies was -0.21 mL/min/1.73m2 (95% CI -0.63 to 0.22) over three months, with substantial heterogeneity across interventions (95% coverage interval across studies, -2.50 to +2.08 mL/min/1.73m2). Negative average acute effects were observed in renin angiotensin system blockade, blood pressure lowering and sodium-glucose cotransporter 2 inhibitor trials while positive acute effects were observed in trials of immunosuppressive agents. Larger negative acute effects were observed in trials with higher mean baseline GFR. Conclusion: The magnitude and consistency of acute GFR effects varies across different interventions, and is larger at higher baseline GFR. Understanding the nature and magnitude of the acute effects can help inform the optimal design of RCTs in CKD evaluating kidney disease progression.

Abstract: Alzheimer’s disease (AD) is one of the most common neurodegenerative diseases with chronic, progressive, and irreversible characteristics, affecting nearly 50 million older adults worldwide. The pathogenesis of AD includes the formation of senile plaques, the abnormal aggregation of tau protein and the gradual degeneration and death of cerebral cortical cells. The main symptoms are memory loss, cognitive decline and behavioral disorders. Studies indicate that cannabidiol (CBD) possesses various pharmacological activities, including anti-inflammatory, anti-oxidation and neuroprotective activities. It has been suggested as a potential multi-target medicine for the treatment of AD. In this review, we aim to summarize the underlying mechanisms and protective effects of CBD on signaling pathways and central receptors involved in the pathogenesis of AD, including the endocannabinoid system (eCBs), the Transient receptor potential vanilloid type 1(TRPV1) receptor, and the Peroxisome proliferator-activated receptor (PPAR) receptor.

Background The symptoms that patients with major depressive disorder (MDD) experience are the dominant contributing factors to its heavy disease burden. This study sought to identify key symptoms leading to disability in patients with MDD. Methods Subjects consisted of patients who had a 12-month MDD diagnosis based on the China Mental Health Survey (CMHS). World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess the degree of disability. The associations between depressive symptoms and disability were analyzed using a linear regression and logistic regression with a complex sampling design. Results Of the 32,552 community residents, 655 patients were diagnosed with 12-month MDD. The disability rate due to MDD was 1.06% (95% CI: 0.85%–1.28%) among adults in Chinese community and 50.7% (95% CI: 44.3%–57.1%) among MDD patients. Depression was associated with all functional losses measured by the WHODAS. Feelings of worthlessness in life or inappropriate guilt, and psychomotor agitation or retardation were the key symptoms related to disability. Economic status, co-morbidity of physical diseases or anxiety disorders were correlates of disability scores. Limitations The disability rate might be underestimated due to the exclusion of MDD patients living in hospitals. The effect of treatments on disability was excluded. Conclusions Psychological symptoms, not somatic symptoms, contribute to disability in MDD patients. Disability worsens when physical diseases or anxiety disorders are present. More attention could be paid to psychological symptoms, physical diseases, and anxiety disorders in MDD patients with disabilities.

Although previous studies explored the relationship between high-speed rail (HSR) and civil aviation, most of them focus on the negative effects of HSR on civil aviation, including the competition between them. However, studies exploring the positive effects of HSR on civil aviation remain limited. This study demonstrates that a high-speed rail network (HSRN) has a spatiotemporally complementary effect (CE) on the robustness of aviation networks (ANs) against different types of hazards. First, we describe the AN as a multiple weighted network with the CE of HSRN based on the operating routes of flights and trains, instead of an independent network. Then, a novel framework for assessing the robustness of AN is developed considering travel time and service frequency as its metrics and considering the coverage distance of the CE. We find that the CE can obviously reduce the loss of the AN’s performance under various disaster scenarios by analyzing the robustness of the AN of Mainland China complemented by HSRN; different levels of CE have different effects on the robustness of AN. Besides the airports located in Eastern China, some non-hub airports such as Changzhou, Wuxi, and Shaorao, are easily complemented by the HSRN. Further, the CE at different times exerts different effects on the robustness of AN, which reach a peak at 16:00 and 07:00. These findings can help broaden the ideas and approaches for enhancing the robustness of the AN.

Phase picking is a critical step in the analysis of microseismic data. However, there is a lack of relevant methods for S-phase picking. In this letter, we pick the P-phase and extract the data around the S-phase arrival firstly based on previous studies. Then, we propose a method called time series segmentation clustering (TSSC) which is based on the K-means algorithm to pick the S-phase. In the TSSC method, we construct a feature vector of the microseismic signal and standardize the feature vector first. Then, we modify the K-means objective function into a function of time. We subsequently obtain the S-phase arrival corresponding to the minimum value of the objective function. We tested the objective function of the TSSC method on synthetic signals and microseismic signals, and the results show that the method is reliable. This automatic picking algorithm has been used to pick 1763 S-phase arrivals from microseismic signals. In comparison with manual picking results, a statistical analysis shows that this method is feasible.

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and reengagement in life, including emphasis on the patient being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of “Living Well with Kidney Disease” in an effort to increase education about and awareness of the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for patients with kidney disease, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures across populations, professionals, and policy makers, applicable to both developed and developing countries.

Purpose: The purpose of this study was to investigate the influencing factors for chest CT hysteresis and severity of coronavirus disease 2019 (COVID-19). Methods: The chest CT data of patients with confirmed COVID-19 in 4 hospitals were retrospectively analyzed. An independent assessment was performed by one clinician using the DEXIN FACT Workstation Analysis System, and the assessment results were reviewed by another clinician. Furthermore, the mean hysteresis time was calculated according to the median time from progression to the most serious situation to improve chest CT in patients after fever relief. The optimal scaling regression analysis was performed by including variables with statistical significance in univariate analysis. In addition, a multivariate regression model was established to investigate the relationship of the percentage of lesion/total lung volume with lymphocyte and other variables. Results: In the included 166 patients with COVID-19, the average value of the most serious percentage of lesion/total lung volume was 6.62, of which 90 patients with fever had an average hysteresis time of 4.5 days after symptom relief, with a similar trend observed in those without fever. Multivariate analysis revealed that lymphocyte count in peripheral blood and transcutaneous oxygen saturation decreased with the increase of the percentage of lesion/total lung volume. Conclusion: There is a hysteresis effect in the improvement of chest CT image relative to fever relief in patients with COVID-19. The pulmonary lesions may be related to the severity as well as decreased lymphocyte count or percutaneous oxygen saturation.

EML4-ALK rearrangement is common in lung adenocarcinoma. The ALK inhibitors remarkably inhibit lung adenocarcinoma and reveal long-term beneficial effects in several patients. Advanced genetic testing technology reveals that EML4-ALK rearrangement has been observed in patients with lung squamous cell carcinoma. In the present study, we report a case of a 53-year-old patient with EML4-ALK rearranged in lung squamous carcinoma; PET/CT scan revealed brain and multiple bone metastases. First-line ALK-TKI combined with local stereotactic body radiation therapy indicated progression-free survival of 9 months. After progressive disease, treatment was switched to lorlatinib, with little efficacy and a total overall survival of 11 months. The emergence of drug resistance revealed that the genetic test result was EML4-ALK fusion (V3a/b variants), indicating a poor prognosis. In this study, we analyzed the treatment efficacy of ALK inhibitors and provided a research basis for the treatment of EML4-ALK rearranged in lung squamous cell carcinoma patients.

The protection of earthen sites plays an important role in the context of preservation of cultural heritage, especially in the inheritance and promotion of history and culture. The aim of the paper is to present the essential results of an ongoing research on a reinforced rammed earthen wall in Suoyang City (Guazhou, China). The wall vibrations caused by ambient actions were analyzed using the stochastic subspace algorithm to estimate the modal parameters of the wall. The frequencies of the first three orders are 3.566 Hz, 5.003 Hz, and 6.250 Hz, and the corresponding modes are first-order transverse bending, second-order left and right torsion, and third-order vertical bending, respectively. Then, according to the data of elastic modulus obtained in the lab, the finite element calculation is carried out, and referring to the results of field measurement, the revised elastic modulus value is 205.90 MPa. It is worth mentioning that the revised value is significantly improved from the original laboratory value, and it is also indicated that the seismic performance of the reinforced wall has been significantly improved. The present work is expected to provide a theoretical basis for reinforcement, protection, and seismic control of earthen ruins.

Cadmium (Cd) is a widespread environmental contaminant that has a wide range of adverse effects on human health. We described the distribution of blood Cd levels (BCLs) and urinary Cd levels (UCLs) in US adults aging ≥ 18 years over a 30-year period by using data from the National Health and Nutrition Examination Survey (NHANES) III and continuous NHANES (1999–2018). Geometric mean (GM) and 95% confidence intervals (CI) were calculated among participants with valid BCLs (n=47889) or UCLs (n=33003). The prevalence of BCLs ≥ 0.5, ≥ 1.0 ug/L and UCLs ≥ 0.5, ≥ 1.0 ug/g creatinine were estimated. The results showed that for men and women, respectively, GM BCLs declined from 0.458 and 0.472 ug/L in 1999–2000 to 0.252 and 0.330 ug/L in 2017–2018, while GM UCLs declined from 0.266 and 0.376 ug/g creatinine in 1988–1991 to 0.145 and 0.231 ug/g creatinine in 2015–2016. The estimated prevalence of UCLs ≥ 0.5 ug/g creatinine among men and women declined from 31.96 and 45.34% during 1988–1991 to 7.88 and 18.73% in 2015–2016. Higher Cd exposure was associated with females, older age, poverty, lower education, and smoking. These results indicate that Cd exposure in US adults has declined over the past 30 years. However, there are still approximately 7.88% US men and 18.73% US women being exposed to Cd at levels reported to show toxic effects on kidneys.

Preliminary studies have suggested that soluble programmed death-1 (sPD-1) and soluble programmed cell death ligand-1 (sPD-L1) have prognostic implications in many malignant tumors. However, the correlation between sPD-1/sPD-L1 level and prognosis of hepatocellular carcinoma (HCC) is still unclear. We searched several electronic databases from database inception to October 7, 2021. Meta-analyses were performed separately for overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), time to progression (TTP), and tumor-free survival (TFS). Random effects were introduced to this meta-analysis. The correlation between sPD-1/sPD-L1 level and prognosis was evaluated using hazard ratios (HRs) with 95% confidence intervals (95%CIs). A total of 11 studies (1291 patients) were incorporated into this meta-analysis, including seven on sPD-L1, two on sPD-1, and two about both factors. The pooled results showed that high sPD-L1 level was associated with worse OS (HR = 2.46, 95%CI 1.74–3.49, P

Summary Background In China, depressive disorders have been estimated to be the second leading cause of years lived with disability. However, nationally representative epidemiological data for depressive disorders, in particular use of mental health services by adults with these disorders, are unavailable in China. The present study, part of the China Mental Health Survey, 2012–15, aims to describe the socioeconomic characteristics and the use of mental health services in people with depressive disorders in China. Methods The China Mental Health Survey was a cross-sectional epidemiological survey of mental disorders in a multistage clustered-area probability sample of adults of Chinese nationality (≥18 years) from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Trained investigators interviewed the participants with the Composite International Diagnostic Interview 3.0 to ascertain the presence of lifetime and 12-month depressive disorders according to DSM-IV criteria, including major depressive disorder, dysthymic disorder, and depressive disorder not otherwise specified. Participants with 12-month depressive disorders were asked whether they received any treatment for their emotional problems during the past 12 months and, if so, the specific types of treatment providers. The Sheehan Disability Scale (SDS) was used to assess impairments associated with 12-month depressive symptoms. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted according to the age–sex–residence distribution data from China's 2010 census population survey to adjust for differential probabilities of selection and differential response, as well as to post-stratify the sample to match the population distribution. Findings 28 140 respondents (12 537 [44·6%] men and 15 603 [55·4%] women) completed the survey between July 22, 2013, and March 5, 2015. Ethnicity data (Han or non-Han) were collected for only a subsample. Prevalence of any depressive disorders was higher in women than men (lifetime prevalence odds ratio [OR] 1·44 [95% CI 1·20–1·72] and 12-month prevalence OR 1·41 [1·12–1·78]), in unemployed people than employed people (lifetime OR 2·38 [95% CI 1·68–3·38] and 12-month OR 2·80 [95% CI 1·88–4·18]), and in people who were separated, widowed, or divorced compared with those who were married or cohabiting (lifetime OR 1·87 [95% CI 1·39–2·51] and 12-month OR 1·85 [95% CI 1·40–2·46]). Overall, 574 (weighted % 75·9%) of 744 people with 12-month depressive disorders had role impairment of any SDS domain: 439 (83·6%) of 534 respondents with major depressive disorder, 207 (79·8%) of 254 respondents with dysthymic disorder, and 122 (59·9%) of 189 respondents with depressive disorder not otherwise specified. Only an estimated 84 (weighted % 9·5%) of 1007 participants with 12-month depressive disorders were treated in any treatment sector: 38 (3·6%) in speciality mental health, 20 (1·5%) in general medical, two (0·3%) in human services, and 21 (2·7%) in complementary and alternative medicine. Only 12 (0·5%) of 1007 participants with depressive disorders were treated adequately. Interpretation Depressive disorders in China were more prevalent in women than men, unemployed people than employed, and those who were separated, widowed, or divorced than people who were married or cohabiting. Most people with depressive disorders reported social impairment. Treatment rates were very low, and few people received adequate treatment. National programmes are needed to remove barriers to availability, accessibility, and acceptability of care for depression in China. Funding National Health Commission and Ministry of Science and Technology of People's Republic of China. Translation For the Chinese translation of the abstract see Supplementary Materials section.

Mild Cognitive Impairment (MCI) is a preclinical stage of Alzheimer's Disease (AD) and is clinical heterogeneity. The classification of MCI is crucial for the early diagnosis and treatment of AD. In this study, we investigated the potential of using both labeled and unlabeled samples from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort to classify MCI through the multimodal co-training method. We utilized both structural magnetic resonance imaging (sMRI) data and genotype data of 364 MCI samples including 228 labeled and 136 unlabeled MCI samples from the ADNI-1 cohort. First, the selected quantitative trait (QT) features from sMRI data and SNP features from genotype data were used to build two initial classifiers on 228 labeled MCI samples. Then, the co-training method was implemented to obtain new labeled samples from 136 unlabeled MCI samples. Finally, the random forest algorithm was used to obtain a combined classifier to classify MCI patients in the independent ADNI-2 dataset. The experimental results showed that our proposed framework obtains an accuracy of 85.50 percent and an AUC of 0.825 for MCI classification, respectively, which showed that the combined utilization of sMRI and SNP data through the co-training method could significantly improve the performances of MCI classification.

Quantitatively studying the biodistribution and transformation of nanomaterials is of great importance for nanotoxicological evaluation. Recently, laser ablation inductively coupled plasma mass spectrometry has been employed to distinguish nanoparticles (NPs) with their dissolved ions in biological samples. The principle of the proposal is based on a hypothesis that the intact NPs sampled by laser ablation will generate discrete sharp pulses of signals in ICP-MS measurement, being totally different from the continuous, relatively lower signals generated by ions. However, it is still a controversy whether NPs could maintain their intactness during the laser ablation. This work found a way to exactly determine the number of NPs sampled for each LA-ICP-MS measurement. It made possible to reveal the signal profile of a single NP in LA-ICP-MS analysis. The results suggest that AuNR, AgNP and TIO2 NP were broken into much smaller secondary NPs during the laser ablation, therefore generating continuous signals in the analyzer. There was a certain probability that the fragmentation of large-sized NP or multiple NPs by laser ablation was not sufficient, leaving some NPs unbroken or some secondary NPs with relatively large sizes to generate discrete pulses of signals in the analyzer. When the intactness of NPs during laser ablation cannot be assured, it is impossible to determine the attribution of mass spectrum signals. These findings compromise the reliability of distinguishing NPs from their dissolved ions by LA-ICP-MS.

Wenjing She, Tao Li, Yan Liu, Xinru Liu West China Second Hospital of Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu City, 610041, People’s Republic of ChinaCorrespondence: Xinru LiuWest China Second Hospital of Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 20, Section, 3, Renmin South Road, Wuhou District, Chengdu City, 610041, People’s Republic of ChinaTel +86-028-85503067Email xinruliudisease@163.comBackground: Circular RNA vascular endothelial growth factor C (circVEGFC) is a novel regulator of glucose metabolism, while its role in gestational diabetes mellitus (GDM) is unclear. This study aimed to detect the expression of circVEGFC in GDM and explore its clinical values.Methods: This study enrolled 220 pregnant women (gestational age less than 5 weeks) with normal blood glucose level on the day of admission. The expression of circVEGFC in plasma samples of these participants was determined by RT-qPCR. The participants were divided into high and low circVEGFC level groups with the median expression level of plasma circVEGFC as the cutoff value. The development of GDM was monitored until delivery. Adverse events were also monitored.Results: Compared to low circVEGFC level group, GDM-free curve analysis revealed significantly higher incidence of GDM in high circVEGFC level group. In addition, plasma expression levels of circVEGFC were also higher in GDM patients than that in non-GDM patients on the day of admission and at 1 month before and after delivery. ROC curve analysis revealed that high expression levels of circVEGFC on the day of admission showed higher sensitivity and specificity in the early diagnosis of GDM. Moreover, high circVEGFC level group showed higher incidence rates of fetal malformation and hypertension.Conclusion: Therefore, circVEGFC is highly expressed in GDM, and it is correlated with multiple adverse events.Keywords: circVEGFC, gestational diabetes mellitus, adverse events

Streamflow estimation is highly significant for water resource management. In this work, we improve the accuracy and stability of streamflow estimation through a novel hybrid decompose-ensemble model that employs variational mode decomposition (VMD) and back-propagation neural networks (BPNN). First, the latest decomposition algorithm, namely, VMD, was used to extract multiscale features that were subsequently learned and ensembled by the BPNN model to obtain the final estimate streamflow results. The historical daily streamflow series of Laoyukou and Wushan hydrological stations in China were analysed by VMD-BPNN, by a single GBRT and BPNN model, ensemble empirical mode decomposition (EEMD) models. The results confirmed that the VMD outperformed a single-estimation model without any decomposition and EEMD-based models; moreover, ensemble estimations using the BPNN model development technique were consistently better than a general summation method. The VMD-BPNN model’s estimation performance was superior to that of five other models at the Wushan station (GBRT, BPNN, EEMD-BPNN-SUM, VMD-BPNN-SUM, and EEMD-BPNN) using evaluation criteria of the root-mean-square error (RMSE = 2.62 m3/s), the Nash–Sutcliffe efficiency coefficient (NSE = 0. 9792) and the mean absolute error (MAE = 1.38 m3/s). The proposed model also had a better performance in estimating higher-magnitude flows with a low criterion for MAE. Therefore, the hybrid VMD-BPNN model could be applied as a promising approach for short-term streamflow estimating.

At present, the deep learning super-resolution (SR) method has achieved excellent results, but it also faces problems such as large models, high computational cost, a large amounts of training data, and poor interpretability. However, traditional machine learning-based methods still have room for improvement in feature extraction and model structure. This paper constructs a gradient embedding cascade forest structure on the basis of random forest and proposes a limit gradient embedding cascaded forest SR (LGECFSR) model. In feature construction, we not only adopt the first-order gradient, the second-order gradient, and other features of the image but also fuse the information of the original LR image. In addition, image blocks of different sizes are used for training, which increases the model’s generalization ability. Compared with the state-of-the-art machine learning-based methods, our method achieves the best performance and the second-best computational speed. In addition, compared with some deep learning-based methods, our model has a similar reconstruction effect and the best computational speed. In detail, for some reconstruction tasks, the Multi-Adds of LGECFSR is one-tenth to one-4000th of that of some current models. However, the SR performance of LGECFSR is the same or slightly better than that of some current classical algorithms.

Early studies have indicated that the risk of migraine is contributed by both genetic and environmental factors. We aimed to evaluate the association between the risk of migraine and genetic polymorphisms in the ANKDD1B gene in a large sample of Chinese Han populations. A total of 882 patients with MO and 1,784 age-matched controls were recruited. A list of 12 tag SNPs located within the ANKDD1B gene region was genotyped. Distributions of SNP genotypes and alleles between patients and controls were examined to investigate the associations between the risk of migraine and genetic polymorphisms. The GTEx database was used to examine the effects of the significant SNPs on gene expressions. A stop-gain SNP, rs34358, was discovered to be significantly related with the risk of migraine (χ2 = 25.02, P = 5.66 × 10−7). The A allele of this SNP was significantly associated with a decreased risk of migraine (OR [95% CI] = 0.73 [0.65–0.83]). A dose-dependent pattern was identified in the genotypic analyses. The OR with 95% confidence interval for genotype AA versus GG was 0.55 [0.42–0.72], while for AG versus GG it was 0.74 [0.62–0.88]. Further bioinformatics analysis showed multiple significant signals (20 out of 47) for the association between SNP rs34358 and gene expression levels of ANKDD1B. In conclusion, we have provided population-based evidence for the association between genetic polymorphisms of the ANKDD1B gene and the risk of migraine. A protein-truncating variant was significantly associated with a decreased risk of migraine in the samples recruited from the Chinese Han population.

Metasurfaces have manifested unprecedented capabilities in manipulating light by subwavelength unit cells, facilitating the miniaturization and multifunctions of optical systems. On the other hand, lithium niobate on insulator (LNOI) technology is revolutionizing the integrated photonics, enabling multifunctional devices and applications. Yet the optical interface for coupling and manipulation is not sufficient and versatile. Here, we developed a geometric metasurface interface for LNOI waveguide and demonstrated several on-chip integrated devices for free space light field manipulations. By decorating waveguides with subwavelength optical antennas, we manipulated the guided waves into desired wavefronts in space, achieved complex free-space functions, such as focusing, multichannel vortex beam generation, and holography. Our architecture goes beyond the conventional gratings and enriches the functionalities of metasurface, which would open up a new perspective for future versatile guided-wave driven optical devices.

BACKGROUND Hemorrhagic shock is the important factor for causing death of trauma and war injuries. However, pathophysiological characteristics and underlying mechanism in hemorrhagic shock with hot environment remain unclear. METHODS Hemorrhagic shock in hot environment rat model was used to explore the changes of mitochondrial and vital organ functions, the variation of the internal environment, stress factors, and inflammatory factors; meanwhile, the suitable treatment was further studied. RESULTS Above 36°C hot environment induced the increase of core temperature of rats, and the core temperature was not increased in 34°C hot environment, but the 34°C hot environment aggravated significantly hemorrhagic shock induced mortality. Further study showed that the mitochondrial functions of heart, liver, and kidney were more damaged in hemorrhagic shock rats with 34°C hot environment as compared with room environment. Moreover, the results showed that in hemorrhagic shock rats with hot environment, the blood concentration of Na+, K+, and plasma osmotic pressure, the expression of inflammatory factors tumor necrosis factor-α and interleukin-6 in the serum, as well as the stress factors Adrenocorticotropic Hormone and Glucocorticoid were all notably enhanced; and acidosis was more serous; oxygen supply and oxygen consumption were remarkably decreased. In addition, the present study demonstrated that mild hypothermia (10°C) fluid resuscitation could significantly improve the survival rate in hemorrhagic shock rats with hot environment as compared with normal temperature fluid resuscitation. CONCLUSIONS Hot environment accelerated the death of hemorrhagic shock rats, which was related to the disorder of internal environment, the increase of inflammatory and stress factors. Furthermore, moderate hypothermic (10°C) fluid resuscitation was suitable for the treatment of hemorrhagic shock in hot environment.

We propose a progressive hierarchical analysis model to perceive the collective activities. Compared with previous activity recognition works, it not only recognizes the collective activities, but also perceives the location and the action category of each individual. At first, we perform the person temporal consistency detection procedure for each individual of the collective activities. A person detection network and conditional random field are used to receive the bounding box sequences of the activity participators. Then, we recognize the individual actions using the learned spatial features and the motion features based on LSTM. At last, the combination of the recognized person-level action category vector, the scene context features and the interaction Context features are used to recognize the collective activities. We evaluate the proposed approach on benchmark collective activity datasets. Extensive experiments demonstrate the effects of the progressive hierarchical analysis model.

Hyperspectral images (HSI) classification has been a research hotspot in the remote sensing field. Deep learning methods such as Cube-CNN have been applied to address the HSI classification problem. However, mainstream frameworks exist a performance gap to train Cube-CNN, since they are not designed for processing high dimensional data like HSI. To close this gap, we propose a Multi-GPU Training Framework (MTFC) for Cube-CNN-based HSI classification. We first design a Parallel Neighbor Pixel Extraction (PNPE) algorithm for efficiently generating 3-dimensional cube samples from raw data. Then, to fully exploit massive GPU parallelism and realize unique characteristics of HSI and Cube-CNN, we employ optimizations in MTFC such as task division, fine-grained mapping between tasks and GPU thread blocks, shared memory usage reduction, etc. Finally, to further improve training speed, we take advantage of CUDA streams and multiple GPUs to train a mini-batches of data samples simultaneously. An extensive set of experiments highlights that MTFC constantly outperforms the two baselines Caffe and Theano for all measured metrics across all system configurations, while offering the same level of classification accuracy. The speedup is up to 3.6x when using a single GPU and MTFC can achieve a rough linear scaling on multiple GPUs.

Blockchain technology has the characteristics of decentralization and tamper resistance, which can store data safely and reduce the cost of trust effectively. However, the existing blockchain system has weak performance in data management, and only supports traversal queries with transaction hashes as keywords. The query method based on the account transaction trace chain (ATTC) improves the query efficiency of historical transactions of the account. However, the efficiency of querying accounts with longer transaction chains has not been effectively improved. Given the inefficiency and single method of the ATTC index in the query, we propose a subchain-based account transaction chain (SCATC) index structure. First, the account transaction chain is divided into subchains, and the last block of each subchain is connected by a hash pointer. The block-by-block query mode in ATTC is converted to the subchain-by-subchain query mode, which shortens the query path. Multiple transactions of the same account in the same block are merged and stored, which simplifies the construction cost of the index and saves storage resources. then, the construction algorithm and query algorithm is given for the SCATC index structure. Simulation analysis shows that the SCATC index structure significantly improves query efficiency.

In order to reduce the energy consumption of the cloud computing system while ensuring the response performance of the cloud users, a task scheduling strategy is proposed. In the strategy, the local processor of the mobile device continues to work, the virtual machines in a physical machine sleep synchronously, and the virtual machines in different physical machine sleep asynchronously. For the heterogeneous physical machines in cloud computing, a queueing model with a synchronous multiple vacation is established. By using the quasi-birth-death process and the matrix geometric solution, the steady-state distribution of the queueing model is given, and the expressions of the average response time of the tasks and the average power of the system are derived. The numerical results show that there is a power-performance trade-off for cloud computing when setting the assigning probability of the tasks to the local processor. Through the improved whale optimization algorithm, the task scheduling strategy is optimized with the minimum system cost.

Wireless networks of different technologies may interfere with each other when they are deployed at proximity. Such cross-technology interference (CTI) has become prevalent with the surge of IoT devices. In this paper, we exploit CTI in coexisting WiFi-Zigbee networks and propose DeepJam, a new stealthy jamming strategy, to jam Zigbee traffic. DeepJam relies on deep learning techniques to capture the temporal pattern of the past wireless traffic and predict the future wireless traffic. By only jamming the victim’s transmissions that are not disrupted by CTI, DeepJam can significantly reduce the victim’s throughput with far fewer jamming signals and is thus much more stealthy than conventional jamming strategies. Detailed evaluations show that DeepJam can converge within 10 sec and achieve the jamming-efficiency gains of up to 742% and 285% over conventional random and reactive jamming strategies, respectively, in practical scenarios. We also propose a simple yet effective countermeasure against DeepJam.

Charging station that incorporates renewable energy resource and energy storage is a promising solution to meet the growing charging demand of electric vehicles (EVs) without the need to expand the distribution network. The aggregation of multiple energy resources and EVs requires an efficient and flexible energy management strategy. This article presents a two-stage scheme to solve the power allocation and charging coordination of plugged-in EVs. Game-theory-based control is utilized to address the interaction among different components for respecting their individual preferences. The first stage determines the power allocation of photovoltaic, battery, and the grid as well as total charging power for EVs. In the second stage, charging power dispatch among individual EVs is coordinated based on the available total charging power determined in the first stage. As a result, the two energy management problems of charging station are addressed sequentially. The proposed solution is validated via simulation and experiment, and the comparisons with benchmarks show its advantages.

Background There is still a lack of clinical data in arthroscopic treatment for treating multiple ligament injuries. This study aims to evaluate the clinical outcomes of patients with multiple ligament injuries undergoing treatment based on the classification stage and type of injury. Methods A prospective, clinical trial on multiple ligament injuries was planned, which included 95 patients (58 men and 37 women; age: 42.8 ± 11.9 [range, 18–63] years) from October 2017 to June 2018. Injuries were classified into three stages (emergency stage 3 weeks) and six types (KD I–VI) based on injuries time and structures, which indicated appropriate treatments. The clinical outcomes were evaluated at 2, 4, 6, 8, and 12 weeks and at 6, 9, 12 months and 24 months after surgery. The final choices in efficacy index included International Knee Documentation Committee (IKDC) score, Lysholm score, visual analog scale (VAS) score, and range of motion. Results During the follow-up, all patients exhibited statistically significant functional improvement in the injured limb compared with their preoperative situation. The mean postoperative scores of acute stage patients at 2-year follow-up were IKDC subjective score, 77.54 ± 11.53; Lysholm score, 85.96 ± 9.39; Tegner score, 4.13 ± 1.08; and VAS score, 1.21 ± 0.76. The mean postoperative scores of chronic stage patents at 2-year follow-up were IKDC subjective score, 74.61 ± 12.38; Lysholm score, 81.71 ± 10.80; Tegner score, 3.96 ± 1.14; and VAS score, 1.71 ± 0.60. The IKDC subjective score, Lysholm score, and Tegner score were significantly improved (P P < 0.01) at 2-year follow-up. Regarding the multiple ligament injuries classification, patients with more structural damage in stages V and VI showed less progress in functional recovery than those in stages I–IV. Conclusions This new classification with three stages and six types helps to identify the severity of injury and plan the management effectively. The outcomes were encouraging and the subjective functional results showed significant improvement at 2-year follow-up. Study design Prospective clinical trial. Level of evidence II

Aberrations in intracortical myelination are increasingly being considered as a cardinal feature in the pathophysiology of schizophrenia. We investigated the network-level distribution of intracortical myelination across various cortex depths. We enrolled 126 healthy subjects and 106 first-episode drug-naïve schizophrenia patients. We used T1w/T2w ratio as a proxy of intracortical myelination, parcellated cortex into several equivolumetric surfaces based on cortical depths and mapped T1w/T2w ratios to each surface. Non-negative matrix factorization was used to generate depth-dependent structural covariance networks (dSCNs) of intracortical myelination from 2 healthy controls datasets—one from our study and another from 100-unrelated dataset of the Human Connectome Project. For patient versus control comparisons, partial least squares approach was used; we also related myelination to clinical features of schizophrenia. We found that dSCNs were highly reproducible in 2 independent samples. Network-level myelination was reduced in prefrontal and cingulate cortex and increased in perisylvian cortex in schizophrenia. The abnormal network-level myelination had a canonical correlation with symptom burden in schizophrenia. Moreover, myelination of prefrontal cortex correlated with duration of untreated psychosis. In conclusion, we offer a feasible and sensitive framework to study depth-dependent myelination and its relationship with clinical features.

Source location privacy (SLP) protection is an emerging research topic in wireless sensor networks (WSNs). Because the source location represents the valuable information of the target being monitored and tracked, it is of great practical significance to achieve a high degree of privacy of the source location. Although many studies based on phantom nodes have alleviates the protection of source location privacy to some extent. It is urgent to solve the problems such as complicate the ac path between nodes, improve the centralized distribution of Phantom nodes near the source nodes and reduce the network communication overhead. In this paper, PSSPR routing is proposed as a visable approach to address SLP issues. We use the coordinates of the center node V to divide sector-domain, which act as important role in generating a new phantom nodes. The phantom nodes perform specified routing policies to ensure that they can choose various locations. In addition, the directed random route can ensure that data packets avoid the visible range when they move to the sink node hop by hop. Thus, the source location is protected. Theoretical analysis and simulation experiments show that this protocol achieves higher security of source node location with less communication overhead.

Large congenial melanocytic nevus (LCMN) on the head and face can have negative psychological effects on children and possibly also parents. Patients and their families experience prolonged periods of stress during tissue expansion treatment. The purpose of this study was to evaluate the psychological impact of LCMN on children and parents and explore their fluctuations of psychological status during treatment. Psychosocial status was evaluated in 30 children with LCMN on the head and face and a control group of 56 sex- and age-matched children using the Child Behavior Checklist and the Inventory of Subjective Life Quality for Child and Adolescents. The parents of both groups were also evaluated using the Symptom Checklist-90, the Hospital Anxiety and Depression Scale, and the Perceived Stress Scale. Psychological assessments were performed before expander implantation, before lesion resection, and after operation. Results indicated that children with LCMN were more prone to social problems, withdrawal, and aggressive behavior. Furthermore, their psychological problems increased after entering to school. Parents of children with LCMN had high levels of emotional problems and stress. Continuous expansion resulted in the psychosocial status of both children and parents to reach the worst levels during the period before lesion resection. Six months after surgery, most of these psychosocial effects reduced to levels lower than before surgery. Additionally, we identified several risk factors, namely sex, number of operations, being in education, employment status of mother, and family pressures. Large congenial melanocytic nevus on head and face have considerable psychological impact on children and their parents throughout the tissue expansion treatment. This study demonstrates the need for appropriate psychological screening and interventions.

BACKGROUND Syphilis is a chronic, classic sexually transmitted disease caused by Treponema pallidum, which can invade almost all organs of the body and produce various symptoms and signs. Although there are some cases of colorectal bleeding caused by syphilis, small intestinal bleeding caused by syphilis is still rare. CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years. Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions. During the same admission, multiple intestinal ulcers were found by capsule endoscopy, and syphilis was also diagnosed. With a history of atrial fibrillation and chronic pancreatitis, he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease. After anti-syphilis treatment, the melena and abdominal pain disappeared and his hemoglobin gradually increased. It is considered that gastrointestinal bleeding, chronic pancreatitis, atrial fibrillation, and heart valvular disease may have been caused by syphilis. CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding. In addition, treatment of the disease requires both sexual partners to be treated. Finally, although syphilis is easy to treat, it is more important to consider that bleeding could be caused by syphilis.