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This article investigates the fin- and finger-number dependence of the total ionizing dose (TID) degradation in 16-nm bulk Si FinFETs at ultrahigh doses. n- and p-FinFETs designed with different numbers of fins and fingers are irradiated up to 500 Mrad(SiO2) and then annealed for 24 h at 100 degrees C. The TID responses of nFinFETs are insensitive to the fin number, as dominated by border and interface trap generation in shallow trench isolation (STI) and/or gate oxide. However, pFinFETs show a visible fin-number dependence with worst tolerance of transistors with the smallest number of fins. The fin number dependence may be related to a larger charge trapping in STI located at the opposite lateral sides of the first and last fins. In addition, both n- and p-FinFETs exhibit an almost TID insensitivity to the finger number. During the design of integrated circuits, the TID tolerance of electronic systems can be enhanced by preferably using transistors with a higher number of fins than fingers.

Due to the complex pathophysiological mechanism, spinal cord injury (SCI) has become one of the most intractable central nervous system (CNS) diseases to therapy. Stem cell transplantation, mesenchymal stem cells (MSCs) particularly, appeals to more and more attention along with the encouraging therapeutic results for the functional regeneration of SCI. However, traditional cell transplantation strategies have some limitations, including the unsatisfying survival rate of MSCs and their random diffusion from the injection site to ambient tissues. The application of biomaterials in tissue engineering provides a new horizon. Biomaterials can not only confine MSCs in the injured lesions with higher cell viability, but also promote their therapeutic efficacy. This review summarizes the strategies and advantages of biomaterials reinforced MSCs transplantation to treat SCI in recent years, which were clarified in the light of various therapeutic effects in pathophysiological aspects of SCI.

In this work, we propose lateral voltage as a new input for use in artificial lipid bilayer systems in addition to the commonly used transmembrane voltage. To apply a lateral voltage to bilayer lipid membranes, we fabricated electrode-equipped silicon and Teflon chips. The Si chips could be used for photodetector devices based on fullerene-doped lipid bilayers, and the Teflon chips were used in a study of the ion channel functions in the lipid bilayer. The findings indicate that the lateral voltage effectively regulates the transmembrane current, in both ion-channel-incorporated and fullerene-incorporated lipid bilayer systems, suggesting that the lateral voltage is a practicable and useful additional input for use in lipid bilayer systems.

Superhard semiconductors have been long sought after for electronic device applications enduring extreme conditions, such as astronautics, due to their intrinsic toughness, high thermal and chemical stability. Here, we report the superhard p-type semiconductor Al2.69B50 single crystal with the determined Vickers hardness of ~ 40.5 GPa under the load of 0.49 N, being one of the hardest semiconductor compounds that have been ever found. With the direct band gap of 2.3 eV, Al2.69B50 exhibits excellent optical transmittance (> 90%,) covering the visible range from 459 nm to 760 nm and part of infrared range, and also shows high intensity of photon emission in the visible light. Al2.69B50 is very stable, thermally and chemically, with ultra-low density of ～2.52 g/cm3, allowing for further extension of its applications. Such an assembly of various excellent properties within one material has great implication for high power electronic design and applications.

BACKGROUND Percutaneous coronary intervention can be challenging for ostial coronary artery lesions due to calcium burden and elastic fiber content. Excimer laser coronary atherectomy (ELCA) is a less common treatment for severe calcified coronary ostium lesions. CASE SUMMARY An 81-year-old male presented to the Cardiology Department of Qingdao Municipal Hospital with a 1-year history of chest pain. Coronary angiography showed severe calcific stenosis (approximately 90%) in the right coronary artery ostium. The right coronary artery ostium was unable to be advanced using a 2.5 mm × 12.0 mm balloon (NC Sprinter, Medtronic, United States) or dilated using a 2.0 mm × 12.0 mm balloon (Sprinter, Medtronic, United States). The patient underwent successful ELCA and balloon dilation of the calcified coronary ostium lesion. CONCLUSION ELCA appears to be a safe and effective treatment for the management of severe calcified coronary ostium lesions.

The spatial distribution of buildings is one of the key factors influencing the local environment within a city. The quantitative measurement of building distribution can provide critical informati...

Traumatic spinal cord injury is a fatal acute event without effective clinical therapies. Following the trauma, immediate neural protection and microenvironment mitigation are vitally important for nerve tissue repair, where stem cell-based therapies could be eclipsed by the deficiency of cells due to the hostile microenvironment as well as the transport and preservation processes. Effective emergency strategies are required to be convenient, biocompatible, and stable. Herein, we assess an emergency cell-free treatment using mesenchymal stem cell-derived exosomes, which have proven capable of comprehensive mitigation of the inhibitory lesion microenvironment. The clinically validated fibrin glue is utilized to encapsulate the exosomes and in-situ gelates in transected rat spinal cords to provide a substrate for exosome delivery as well as nerve tissue growth. The emergency treatment alleviates the inflammatory and oxidative microenvironment, inducing effective nerve tissue repair and functional recovery. The therapy presents a promising strategy for effective emergency treatment of central nervous system trauma., Graphical Abstract Graphical abstract Image, graphical abstract

BackgroundTo compare the clinical efficacy of a femoral neck system (FNS) and cannulated screws (CS) in the treatment of femoral neck fracture in young adults.MethodsData from 69 young adults, who were admitted for femoral neck fracture between March 2018 and June 2020, were retrospectively analyzed. Patients were divided into two groups according to surgical method: FNS and CS. The number of intraoperative fluoroscopies, operative duration, length of hospital stay, fracture healing time, Harris score of hip function, excellent and good rate of hip function, and postoperative complications (infection, cut out the internal fixation, nail withdrawal, and femoral neck shortening) were compared between the two groups. Hip joint function was evaluated using the Harris Hip Scoring system.ResultsAll 69 patients had satisfactory reduction and were followed up for 12–24 months, with a mean follow-up of 16.91 ± 3.01 months. Mean time to fracture healing was13.82 ± 1.59 and 14.03 ± 1.78 weeks in the FNS and CS groups, respectively. There was a statistical difference in the number of intraoperative fluoroscopies between the 2 groups (P = 0.000). There were no significant differences, in operation duration, hospital length of stay, fracture healing time, complications, Harris Hip Score for hip function and excellent and good rate between the two groups (P > 0.05). The incidence of complications was 6.1%(2/33) in the FNS group lower than 25%(9/36) in the CS group, a difference that was statistically significant (P = 0.032). At the last follow-up, the Harris Hip Score of the hip joint in the FNS group was 90.42 ± 4.82and 88.44 ± 5.91 in the CS group.ConclusionsBoth treatment methods resulted in higher rates of fracture healing and excellent hip function. Compared with CS, the FNS reduced the number of intraoperative fluoroscopies, radiation exposure to medical staff and patients, and short-term complications including femoral neck shortening and bone nonunion.

Liquid-phase exfoliation can be developed for the large-scale production of two-dimensional materials for photonic applications. Although atomically thin 2D transition metal dichalcogenides (TMDs) ...

Combined cell vaccines of tumor whole cells and dendritic cells (DCs) provide an effective individualized immunotherapy for malignant tumors. We propose an innovative strategy termed "biomaterial-mediated combined cell vaccines for immunotherapy," which combines tumor cell and DC vaccines with a cyclodextrin-polyethylene glycol hydrogel and a cytosine-phosphate-guanine (CpG) nanoadjuvant. The nanoadjuvant promotes antigen presentation and amplifies immune-eliciting potency by co-delivery of antigens and adjuvants. The hydrogel scaffold provides a better growth microenvironment for injected exogenous DCs and recruits endogenous DCs to maintain their viability for synergistic effect. The results indicated that, relative to live tumor cells, the immunogenically dying tumor cells activated DC maturation effectively with the auxiliary effect of immune adjuvant CpG nanoparticles. The increased T cell percentage, proliferation ability, cytokine secretion, and cytotoxic effect revealed the enhanced immunogenicity of the combined cell vaccines. The combined hydrogel/nanoadjuvant system showed the best efficiency in inhibiting tumor growth. Moreover, vaccination with a single dose of hydrogel-based combined vaccines significantly delayed the development of tumors. The biomaterial-mediated combined cell vaccines remarkably increased the infiltration of effector T cells, alleviated the intratumoral immunosuppressive microenvironment, and maximized the immune effect of the vaccines, thus improving cancer immunotherapy. STATEMENT OF SIGNIFICANCE: Cell-based vaccines, including tumor whole-cell vaccine or DC vaccine, have attracted wide attention as an effective method for cancer immunotherapy. However, it is difficult to gain satisfactory outcomes in clinical trials because of the low immunogenicity of tumor whole cell vaccine and the short-term survival of transferred DC vaccine. Therefore, improving the ability of cell-based vaccines to induce a strong and durable immune response is the primary objective for vaccine development. Biomaterial-mediated combined cell vaccines is an innovative strategy for cancer immunotherapy. The combined hydrogel/ nanoadjuvant system comprises immunogenically dying tumor cells, DCs, and nanoadjuvants. Nanoadjuvant-loaded immunogenically dying tumor cells can induce efficient immune response as the tumor cell vaccine. The hydrogel-based combined tumor cell/DC vaccine could be used for individualized immunotherapy.

Background Linear blisters (LBs) often occur around dressings when negative-pressure wound therapy (NPWT) is used to cover open wounds. Tension blisters may increase the wound infection incidence rate, delay the start of operation, and prolong the duration of hospital stay. Currently, there are no established methods for the prevention of LB formation around dressings, which remains to be a major concern in clinical applications. Therefore, we developed a novel, simple, reproducible, and convenient method for preventing LB formation around NPWT dressings. Method Fifty-three cases of Gustilo type II and III open fractures under NPWT were considered. NPWT was used on every wound after debridement. All patients were divided into a conventional group (27 cases, 33 wounds) and a novel group (26 cases, 27 wounds) based on the difference in the NPWT dressing appearance. A healthy volunteer with intact skin was also included to perform the detailed process of NPWT. LBs occurring on intact skin around the dressings were observed and recorded when the dressing was removed 3 days after the operation. The occurrence of LB formation and wound infection was considered as categorical data and compared between the two groups using a chi-square test. The duration of hospital stay was considered as numerical data and compared between the two groups using two independent t tests. Results The percentage of occurrence of LB formation around dressings in the conventional group was 27.3%, whereas it was merely 3.7% in the novel group (P = 0.037). The infection incidence rate in the conventional group was 30.3%, whereas that in the novel group was 25.9%; however, no statistical difference was observed between the two groups (P = 0.708). The average duration of hospital stay in the conventional group was 14.39 ± 4.55 days, whereas that in the novel group was 11.04 ± 3.47 days (P = 0.003). Conclusion Thus, changing the NPWT dressing appearance can prevent LB formation around dressings, providing an effective method to improve NPWT application. Modified NPWT dressings also shorten the duration of hospital stay, but do not significantly decrease the incidence of wound infection.

With the rapid development of Internet of vehicles (IoV) technology, the distribution of vehicles on the highway becomes more dense and the highly reliable communication between vehicles becomes more important. Nonorthogonal multiple access (NOMA) is a promising technology to meet the multiple access volume and the high reliability communication demands of IoV. To meet the Vehicle-to-Vehicle (V2V) communication requirements, a NOMA-based IoV system is proposed. Firstly, a NOMA-based resource allocation model in IoV is developed to maximize the energy efficiency (EE) of the system. Secondly, the established model is transformed into a Markov decision process (MDP) model and a deep reinforcement learning-based subchannel and power allocation (DSPA) algorithm is designed. An event trigger block is used to reduce computation time. Finally, the simulation results show that NOMA can significantly improve the system performance compared to orthogonal multiaccess, and the proposed DSPA algorithm can significantly improve the system EE and reduce the computation time.

Antimonene, a novel two-dimension (2D) Group-VA material, shows excellent electrical and optical properties. In this work, antimonene nanosheets or nanoparticles were obtained by laser irradiating antimony powder in isopropanol solution and different morphology of antimonene were obtained by adjusting different laser irradiation parameters, including irradiation time and irradiation energy. The nonlinear absorption properties of antimonene with different morphologies under 532 nm nanosecond laser were studied by Z-scan technology. It was found that the reverse-saturation absorption ability was the strongest when the morphology of the sample was nanosheets, which was very suitable for optical limiting. In addition, due to the limitation of the application of the sample in the form of solution, we added it into organosilicon, and obtained the solid antimonene-organosilicon composite with optical limiting function. The results showed that antimonene nanosheets with best optical limiting ability can be prepared by adjusting the laser irradiation parameters, and the products are successfully added into solid matrix to enhance its practicability in protecting people’s eyes and optical equipment from damage caused by high power laser.

Background: To determine whether the Hounsfield Unit (HU) value of no-contrast computer computed tomography (NCCT) might offer better guidance in the selection of RIRS or PCNL in renal stones of 2-3 cm. Methods: A total of 158 patients with kidney stones (2-3 cm) who underwent PCNL/RIRS from March 2016 to January 2019 were enrolled in this study. Age, gender, stone sizes, locations, average HU value of stones, surgery time, hospital stay time, stone-free rate, and complications at the time of hospitalization and 3-month follow-up were measured to identify the surgery efficiency. Results: Upon consideration of the HU value, the mean surgery time was significantly decreased in RIRS comparing to the control RIRS (cRIRS) group (47.73 ± 15.52 vs. 72.41 ± 27.71 min, P < 0.05). Statistically, the surgery time was strongly influenced by the HU values both in RIRS (OR 93.8, P < 0.01) and PCNL (OR 8.21, P < 0.05). HU values proved to have a strong positive relation with surgery time in RIRS while a low positive relation in PCNL (P < 0.05). Conclusion: Overall, for renal stones of 2-3 cm, RIRS might be a safe and efficacious treatment option if the HU value and other parameters could be comprehensively accounted for. Individual precision surgery might provide ideal treatment and prognosis for patients requiring long-term continuous clinical procedures. Keywords: Hounsfield unit, retrograde intrarenal surgery, percutaneous nephrolithotomy, renal stones.

In this study, the direct impact of knowledge about the electricity pricing policies on residents’ electricity saving behaviour and the indirect impact of these pricing strategies on residential co...

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

Luminescence lifetime imaging plays an important role in distinguishing the luminescence decay rates in time-resolved luminescence imaging. However, traditional imaging instruments used for detecting lifetimes within milliseconds would be time-consuming when imaging ultra-long luminescence lifetimes over subseconds. Herein, we present an accessible and simple optical system for detecting lifetimes of persistent luminescence. A smartphone integrated with a UV LED, a dichroic mirror, and a lens was used for recording the persistent luminescence. With only a few seconds of data acquisition, a luminescence lifetime image could be processed from the video by exponential fitting of the gray level of each pixel to the delay time. Since this approach only requires single excitation, no synchronous control is needed, greatly simplifying the apparatus and saving the cost. The apparatus was successfully used for ultra-long luminescence lifetime imaging of mouse tissue dyed with a persistent luminescence molecule. This miniaturized apparatus exhibits huge potentiality in time-resolved luminescence imaging for luminescence study and biological detection.

Spontaneous combustion of dried water-immersed coal (DWIC) wastes many coal resources, and so the effect of water immersion on the characteristic temperature during coal low-temperature oxidation and its possible reasons were investigated. The characteristic temperatures of coal oxidation were obtained by thermogravimetry. The possible causes for the changes in characteristic temperatures were analyzed from the pore structure and microscopic function groups by means of liquid nitrogen adsorption/desorption experiment and in-situ Fourier transform infrared spectroscopy. The results show that, in the early stages of coal low-temperature oxidation, the characteristic temperatures of DWIC samples were lower compared to those of raw coal samples. The differences between the characteristic temperatures of the DWIC and raw coal first increased but then decreased as the temperature rose. When the coal’s temperature rose to the maximum weight gain temperature, the differences had almost disappeared. Water-immersion reduced the coal’s specific surface area but increased the average diameter of its pores and the total pore volume. These changes in the coal pores were beneficial for oxygen migration and transport. During the whole low-temperature oxidation stage, the DWIC hydroxyl concentration is higher compared to that of raw coal, and this made the initial reaction of coal and oxygen more likely to occur. In the late low-temperature oxidation stages, the methyl concentration had a considerable influence on the coal–oxygen reaction.

Objective To evaluate the clinical efficacy of micro‐locking plate through vertical or parallel technique for treatment of Dubberley B‐type capitellar fractures. Methods A retrospective analysis was performed in 24 patients (17 males and seven females, with an average age of 44.9 years, range from 19 to 75 years) with capitellar fractures that were treated with micro‐locking plate using vertical or parallel technique between January 2016 to January 2019. The inclusion criteria include closed capitellar fracture, normal anterior elbow joint movement before injury, and recent capitellar fracture with injury within past 3 weeks. Fractures classified according to Dubberley included four cases of type IB, eight cases of type IIB, and 12 cases of type IIIB. Radiographic evaluation was performed. Surgery time, blood loss, range of motion of the elbow, forearm rotation, and complications were recorded. Elbow joint function was evaluated by Mayo Elbow Performance Score (MEPS). Results The mean follow‐up period was 19.6 months (range, 12–36 months). The average clinical healing time for fractures was 11.2 ± 3.2 weeks (range, 8–20 weeks). Fracture united in all patients. Two patients showed slight delayed union, but union was achieved eventually. The mean time from injury to surgery was 6.3 ± 3.1 days (range, 2–15 days). The average surgical time was 68.1 ± 11.5 min (range, 50–90 min), and the mean blood loss was 75.2 ± 26.5 mL (range, 40–120 mL). The mean range of flexion was 122.5° ± 10.5°(range, 95°–140°). The mean range of extension was 8.5° ± 5.8°(range, 0°–20°). The mean range of pronation was 79.7° ± 8.0°(range, 65°–90°). The mean range of supination was 80.5° ± 7.1°(range, 60°–90°). The mean MEPS at final follow‐up was 89.8 ± 9.0 (range, 60–100). Based on the MEPS, 18 (75%) patients had excellent, five (20.8%) patients had good, and one (4.2%) patient had fair. None of the 24 patients suffered vascular or nerve injury. One patient showed superficial infection, which was treated with surgical dressing. Conclusions The vertical or parallel technique of the micro‐locking plate is an excellent method for treating Dubberley B‐type capitellar fractures., The micro‐locking plate accroding to vertical or parallel technique is an excellent method for Dubberley B‐type capitellar fractures.

Objective To screen serum microRNAs (miRNAs) which could discriminate fracture status in postmenopausal women with or without diabetes. Methods The miRNA expression profile dataset GSE70318 was downloaded from Gene Expression Omnibus (GEO) database. This dataset composed of 74 samples, among these, 55 postmenopausal women was selected for bioinformatics analysis, including 19 osteoporotic fracture patients with type‐2 diabetes, 19 osteoporotic fracture patients without type‐2 diabetes, and 17 healthy control subjects. These samples were divided into two groups: fracture patients with diabetes vs healthy subjects (FH group) and fracture patients without diabetes vs healthy subjects (DFH group). Then, the differentially expressed miRNA (DEMs) in FH group and DFH group were respectively identified. The target genes of DEMs were predicted, followed by functional enrichment analysis. Furthermore, DEMs related to long non‐coding RNAs (lncRNAs) were screened, and DEMs‐lncRNA‐target genes network was constructed. Subsequently, principal component analysis (PCA) of DEMs was performed to further explore the expression characteristics of the selected miRNAs in different types of fracture samples. Finally, the expression level of significant DEMs was calculated by quantitative real‐time polymerase chain reaction (qPCR) to verify the accuracy of the results of bioinformatics analysis. Results A total of 18 and 23 DEMs were identified in FH and DFH groups, respectively. Gene ontology (GO) analysis showed that genes in FH group were significantly enriched in regulation of transcription (GO: 0045449) and genes in DFH group were mainly enriched in cellular response to hormone stimulus (GO: 0032870). Meanwhile, pathway analysis indicated that genes in FH group were primarily enriched in T cell receptor signaling pathway (hsa04660) and genes in DFH group were mainly implicated in neurotrophin‐signaling pathway (hsa04722). Moreover, the miRNA‐lncRNA analysis revealed that miR‐155‐5p regulated by lncRNA MIR155HG was up‐regulated in FH group; in addition, the miR‐181c was significantly up‐regulated and miR‐375 was observably down‐regulated in DFH group. Furthermore, PCA analysis suggested that the screened miRNAs were able to differentiate these two types of fractures in postmenopausal women. The miR‐181c and miR‐375 might be regarded as potential predictors for fracture, while miR‐155‐5p might be a candidate diagnostic biomarker for diabetic fracture. Finally, the results of qPCR were consistent with that of microarray data. Conclusions Overall, these three miRNAs might be regarded as potential diagnostic biomarkers to discriminate fracture status in postmenopausal women with and or without diabetes, and they served a putative role in the pathogenesis of these two diseases. However, these findings were only observed in serum samples and further clinical trials are urgently demanded to validate our results., Identification of miRNAs to distinguish fracture and diabetic fracture in postmenopausal women

Low-dose CT screening for lung cancer provides images of the entire chest and upper abdomen. While the focus of screening is on finding early lung cancer, radiology leadership has embraced the fact that the information contained in the images presents a new challenge to the radiology profession. Other findings in the chest and upper abdomen were not the reason for obtaining the screening CT scan, nor symptom-prompted, but still need to be reported. Reporting these findings and making recommendations for further workup requires careful consideration to avoid unnecessary workup or interventions while still maximizing the benefit that early identification of these other diseases provided. Other potential findings, such as cardiovascular disease and chronic pulmonary obstructive diseases actually cause more deaths than lung cancer. Existing recommendations for workup of abnormal CT findings are based on symptom-prompted indications for imaging. These recommendations may be different when the abnormalities are identified in asymptomatic people undergoing CT screening for lung cancer. I-ELCAP, a large prospectively collected multi-institutional and multi-national database of screenings, was used to analyze CT findings identified in screening for lung cancer. These analyses and recommendations were made by radiologists in collaboration with clinicians in different medical specialties.

We report that atomically thin two-dimensional silicon quantum sheets (2D Si QSs), prepared by a scalable approach coupling chemical delithiation and cryo-assisted exfoliation, can serve as a high-performance brain photonic nanoagent for orthotopic glioma theranostics. With the lateral size of approximately 14.0 nm and thickness of about 1.6 nm, tiny Si QSs possess high mass extinction coefficient of 27.5 L g−1 cm−1 and photothermal conversion efficiency of 47.2% at 808 nm, respectively, concurrently contributing to the best photothermal performance among the reported 2D mono-elemental materials (Xenes). More importantly, Si QSs with low toxicity maintain the trade-off between stability and degradability, paving the way for practical clinical translation in consideration of both storage and action of nanoagents. In vitro Transwell filter experiment reveals that Si QSs could effectively go across the bEnd.3 cells monolayer. Upon the intravenous injection of Si QSs, orthotopic brain tumors are effectively inhibited under the precise guidance of photoacoustic imaging, and the survival lifetime of brain tumor-bearing mice is increased by two fold. Atomically thin Si QSs with strong light-harvesting capability are expected to provide an effective and robust 2D photonic nanoplatform for the management of brain diseases.

Recently, reconfigurable intelligent surface (RIS), which operates with the aim to manipulate multi-path signals, has been widely considered for wireless communications. In this letter, we extend the employment of RIS to indoor positioning, with the aid of ultra-wideband (UWB) technique. Moreover, the Cramer-Rao lower bound of the developed positioning scheme is quantified. Both theoretical analysis and simulation results demonstrate that RIS has the potential to realize accurate positioning with a single access point, due to its ability to mark the channel and replace traditional active positioning anchors. Moreover, it is also depicted that when the number of receive antennas is limited, time-of-arrival based positioning has a higher accuracy than that based on angle-of-arrival, due to the high multipath resolution of UWB signals.

To obtain independent navigation results for autonomous underwater vehicles (AUVs) and construct high-resolution consistent seabed maps, a particle filter-based bathymetric simultaneous localization and mapping (BSLAM) method with the mean trajectory map representation is proposed. To reduce the computational consumption, particles only keep the current estimated position of the vehicle, while all historical states of the vehicle are stored in the mean trajectory map. Using this set-up, only the weights of the particles which closed to the mean trajectory map are calculated with newly collected bathymetric data. A hierarchical clustering procedure is also discussed to identify invalid loop closures. The performance of the proposed method is validated using both the simulated data and the field data collected from sea trails. The results demonstrate that the proposed method is 50% more accurate and 50% faster than a state-of-the-art particle filter-based BSLAM method, and it has similar accuracy but 30% faster compared with a graph-based BSLAM method.

Imaging-guiding and targeted drug delivery to tumors are essential for precision cancer therapy, which is a challenging goal to achieve extraordinary therapeutic efficacy. Functional live cells-based delivery systems are expected to play an important role in imaging-guiding and targeted drug delivery. Herein, we fabricated a delivery system mediated by IR-820 conjugated macrophages for tumor targeted combination therapy under fluorescence imaging guidance. The functional macrophages by nature could cross the barriers and recruit into tumors, and serve as host cells to targeted deliver drugs to tumors. The pH-sensitive doxorubicin nanoparticles were engulfed by the macrophages to enhance the drug loading and decrease the damage on host cells. IR-820 was anchored into macrophages cytoplasm to achieve the dual function of photothermal therapy and fluorescence imaging guidance. With Balb/C mice bearing murine breast tumor (4 T1) as models, the functional macrophages for their innate tumor tropism could targeted transport these therapeutic drugs into tumor site to exert efficient chemo-photothermal combination therapy. Moreover, fluorescence imaging-guided drug delivery was employed as the visible strategy to provide the optimized therapeutic window based on the fluorescence of IR-820. The multi-functional macrophages-mediated delivery system would provide a potential for precise and targeted delivery of combination therapy.

Novel communication technology based on large intelligent surface (LIS) [1] has arisen recently, with the aim to enhance the signal quality at the receiver. In this paper, a practical structure of LIS-based spatial modulation (LIS-SM) is proposed, in order to utilize both transmit and receive antenna indices. Meanwhile, the theoretical average bit error rate (ABER) performance bound of the developed LIS-SM scheme is investigated. For the sake of achieving further spatial diversity gain, we extend its employment to the antenna selection (AS) scenario, and a low-complexity selection algorithm is designed on the basis of minimum squared Euclidian distance and signal-to-leakage-and-noise ratio as well as the idea of greedy elimination algorithm. Performance analysis shows that AS-aided LIS-SM is more robust in terms of ABER compared with conventional LIS-SM. Moreover, complexity analysis also depicts that the proposed fast selection algorithm achieves much lower complexity yet a comparable ABER performance, compared to the traditional exhaustive search.

The discovery of deep bedrock gas reservoirs in Altun forelands in the Qaidam Basin has expanded a new field of natural gas exploration and development in China. Since then, it has always been believed that the storage space of this kind of gas reservoirs is composed of well-developed dual media of matrix pores and fractures, but the practices of such gas reservoir development began to be in contradiction with this cognition. In order to achieve a better understanding of the storage space and the main controlling factors of reservoir formation in this bedrock gas reservoir, it is necessary to investigate the dissolved increased pores characteristics and the forced fractures characteristics in the bedrock gas reservoir. Then, based on the data such as cores and cast thin sections in the bedrock intervals in the Dongping 1 and Jiantan 1 blocks, the main storage space types of deep bedrock gas reservoirs in Altun forelands were analyzed, then the main controlling factors of favorable target reservoirs in these blocks were put forward, and in combination with the regional geological background, the geological understandings of favorable target reservoirs and potential reserves were deepened in this study area. The following research results were achieved. (1) The lithology of the bedrock gas reservoirs in this area consists of calc-alkaline igneous rocks and gneiss suite regional metamorphic rocks. Matrix pores are not developed, and their development degree is mainly controlled by faults. Main effective storage spaces and permeable channels are structural fractures and dissolution fractures. (2) The main controlling factors of target reservoir formation include lithology, tectonic effect, weathering, intrusive dikes, and on the whole the rule of ternary-control is followed, namely prevalent lithology–dominant stresses–hydrocarbon accumulations in the structural higher parts. (3) The potential zones of reservoir formation include the following 5 types: tectonically stress concentrated tension–torsional zones, contact zones between lithologic interfaces of intrusive body, weathering zones of compressing uplift, slope sediment zones near circumscribed erosion area, para-conformity or unconformity interface.

Background: Fulvestrant 500 mg monotherapy is recommended as the first-line endocrine treatment in postmenopausal women with hormone receptor-positive metastatic breast cancer (MBC). It is also used in MBC maintenance treatment. However, few studies have compared the efficacy of fulvestrant during the initial treatment with that during maintenance treatment. Patients and Methods: MBC patients who were treated with fulvestrant either as initial therapy for metastatic disease or after progression following one line of chemotherapy between January 2016 and December 2017 were identified from the database of the Affiliated Hospital of Qingdao University. The primary end point was progression-free survival (PFS). Results: The study included 135 MBC patients who were treated with fulvestrant; 116 patients who received fulvestrant as first-line treatment were divided into 2 groups: the no-chemotherapy treatment (NCT) group received fulvestrant as initial therapy during disease progression, and the chemotherapy treatment (CT) group received fulvestrant as maintenance following disease stabilization or response to previous chemotherapy. The median PFS was 16 months in NCT patients and 8 months in the CT group. Patients who had a longer disease-free survival, no visceral metastasis and one metastasis site, benefited from fulvestrant as first-line treatment during disease progression. Patients with 2 or more metastasis sites benefited from chemotherapy as first-line treatment and fulvestrant as maintenance treatment. Conclusions: Fulvestrant monotherapy showed good clinical activity and safety in patients with MBC who were treated upon disease progression and in those receiving maintenance therapy.

Background This study aimed to analyze and compare the clinical and functional outcomes of distal tibia fractures treated with intramedullary nailing (IMN) using the suprapatellar (SP) and infrapatellar (IP) surgical approaches. Methods A retrospective analysis was performed in 63 patients with distal fractures that were treated with IMN between August 2014 and August 2018. A total of 27 and 36 patients underwent IMN using the SP and IP techniques, respectively. The surgical time, blood loss, closed reduction rate, rate of adjuvant reduction technique, fracture healing time, and complications were reviewed in this study. Anterior knee pain was assessed using the visual analog scale. The Lysholm Knee Scoring Scale and American Orthopaedic Foot and Ankle Society (AOFAS) scale were used as clinical measurements. Results A total of 63 patients, with a minimum follow-up of 12 months, were evaluated. The average surgical time, blood loss, rate of adjuvant reduction technique, closed reduction rate, fracture healing time, and Lysholm Knee Scoring Scale score were insignificantly different (P > 0.05) between the two groups. However, the SP approach was superior to the IP approach in terms of pain score, AOFAS score, and fracture deformity rate (P < 0.05). Conclusions In the treatment of distal tibia fractures, the SP IMN technique is associated with a significantly higher functional outcome, lower knee pain, and lower rate of fracture deformity than the IP IMN technique.

Neuroplasticity and connectivity in the central nervous system (CNS) are easily damaged after hypoxia. Long-term exposure to an anoxic environment can lead to neuropsychiatric symptoms and increases the likelihood of depression. Demyelination is an important lesion of CNS injury that may occur in depression. Previous studies have found that the RhoA/ROCK pathway is upregulated in neuropsychiatric disorders such as multiple sclerosis, stroke, and neurodegenerative diseases. Therefore, the chief aim of this study is to explore the regulatory role of the RhoA/ROCK pathway in the development of depression after hypoxia by behavioral tests, Western blotting, immunostaining as well as electron microscopy. Results showed that HIF-1α, S100β, RhoA/ROCK, and immobility time in FST were increased, sucrose water preference ratio in SPT was decreased, and the aberrant activity of neurocyte and demyelination occurred after hypoxia. After the administration of Y-27632 and fluoxetine in hypoxia, these alterations were improved. Lingo1, a negative regulatory factor, was also overexpressed after hypoxia and its expression was decreased when the pathway blocked. However, fluoxetine had no effect on the expression of Lingo1. Then, we demonstrated that demyelination was associated with failures of oligodendrocyte precursor cell proliferation and differentiation and increased apoptosis of oligodendrocytes. Collectively, our data indicate that the RhoA/ROCK pathway plays a vital role in the initial depression during hypoxia. Blocking this pathway in the early stage of hypoxia can enhance the effectiveness of antidepressants, rescue myelin damage, and reduce the expression of the negative regulatory protein of myelination. The findings provide new insight into the prophylaxis and treatment of depression.

Pulmonary hypertension (PH) is a progressive, potentially fatal disease, difficult to diagnose early due to non-specific nature of symptoms. PH is associated with increased morbidity and death in many respiratory and cardiac disorders, and with all-cause mortality, independent of age and cardiopulmonary disease. The main pulmonary artery diameter (MPA), and ratio of MPA to adjacent ascending aorta (AA), MPA:AA, on Chest CT are strong indicators of suspected PH. Our goal was to determine the prevalence of abnormally high values of these indicators of PH in asymptomatic low-dose CT (LDCT) screening participants at risk of lung cancer, and determine the associated risk factors.We reviewed consecutive baseline LDCT scans of 1949 smokers in an IRB-approved study. We measured the MPA and AA diameter and calculated MPA:AA ratio. We defined abnormally high values as being more than two standard deviations above the average (MPA ≥ 34 mm and MPA:AA ≥ 1.0). Regression analyses were used to identify risk factors and CT findings of participants associated with high values.The prevalence of MPA ≥ 34 mm and MPA:AA ≥ 1.0 was 4.2% and 6.9%, respectively. Multivariable regression demonstrated that BMI was a significant risk factor, both for MPA ≥ 34 mm (OR = 1.07, p 0.0001) and MPA:AA ≥ 1.0 (OR = 1.04, p = 0.003). Emphysema was significant in the univariate but not in the multivariate analysis.We determined that the possible prevalence of PH as defined by abnormally high values of MPA and of MPA:AA was greater than previously described in the general population and that pulmonary consultation be recommended for these participants, in view of the significance of PH.

Two-dimensional ferroelectrics is attractive for synaptic device applications because of its low power consumption and amenability to high-density device integration. Here, we demonstrate that tin monosulfide (SnS) films less than 6 nm thick show optimum performance as a semiconductor channel in an in-plane ferroelectric analogue synaptic device, whereas thicker films have a much poorer ferroelectric response due to screening effects by a higher concentration of charge carriers. The SnS ferroelectric device exhibits synaptic behaviors with highly stable room-temperature operation, high linearity in potentiation/depression, long retention, and low cycle-to-cycle/device-to-device variations. The simulated device based on ferroelectric SnS achieves ∼92.1% pattern recognition accuracy in an artificial neural network simulation. By switching the ferroelectric domains partially, multilevel conductance states and the conductance ratio can be obtained, achieving high pattern recognition accuracy.

Recently, elevated homocysteine was reported to be associated with frailty in cross-sectional studies. However, whether homocysteine is causally associated with frailty is unknown. Here, we explore the inter-relationships between five non-synonymous genetic variants of homocysteine metabolic four genes, plasma homocysteine levels, and frailty. Data of 1480 individuals aged 70–87 years from the ageing arm of Rugao Longevity and Ageing Study were used. Five variants of the four homocysteine metabolic enzyme genes were genotyped. Frailty was defined using Fried’s phenotype criteria. The percentage of high homocysteine (>15μmol/L) is 33.3%. Two functional variants that decrease methylenetetrahydrofolate reductase (MTHFR) activities, C677T (Ala222Val, rs1801133) and A1298C (Glu429Ala, rs1801131), were significantly associated with increased homocysteine levels (β=−1.16, p=0.01; and β=1.46, p

Background We performed a meta-analysis sought to investigate the risk of stroke with antiplatelet and anticoagulant therapies among patients with coronary artery disease (CAD). Methods We searched PubMed, EMBASE, and Cochrane Library for randomized controlled trials from January 1995 to March 2020. Studies were retrieved if they reported data of stroke for patients with CAD and were randomized to receive intensive versus conservative antithrombotic therapies, including antiplatelet and oral anticoagulant (OAC). Analyses were pooled by random-effects modeling. A total of 42 studies with 301,547subjects were enrolled in this analysis. Results Intensive antithrombotic therapy significantly reduced risk of all stroke (RR 0.86, 95% CI 0.80–0.94) and ischemic stroke (RR 0.80, 95% CI 0.71–0.91), but increased risk of hemorrhagic stroke (RR 1.36, 95% CI 1.00–1.86) and intracranial hemorrhage (RR 1.46, 95% CI 1.17–1.81). Subgroup analyses indicated that OAC yields more benefit to all stroke than antiplatelet therapy (OAC: RR 0.73, 95% CI 0.58–0.92; Antiplatelet: RR 0.90, 95% CI 0.83–0.97; Between-group heterogeneity P value = 0.030). The benefit of antiplatelet therapy on all stroke and ischemic stroke were mainly driven by the studies comparing longer versus shorter duration of dual antiplatelet therapy (All stroke: RR 0.86, 95% CI 0.78–0.95; ischemic stroke: RR 0.84, 95% CI 0.75–0.94). Conclusions Among CAD patients who have already received antiplatelet therapy, either strengthening antiplatelet or anticoagulant treatments significantly reduced all stroke, mainly due to the reduction of ischemic stroke, although it increased the risk of hemorrhagic stroke and intracranial hemorrhage. OAC yields more benefit to all stroke than antiplatelet therapy.

Cheng Ren,&ast; Ming Li,&ast; Teng Ma, Yi-Bo Xu, Zhong Li, Han-Zhong Xue, Qian Wang, Yao Lu, Liang Sun, Kun Zhang Department of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Kun ZhangDepartment of Orthopedic Trauma, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of ChinaEmail hhzhangkun@163.comObjective: This study aims to explore the clinical correlation between nonspecific ST-segment or T-wave (NS-STT) changes and perioperative deep vein thrombosis (DVT) in patients with lower extremity fractures.Methods: One thousand four hundred sixty-nine consecutive patients who suffered lower extremity fractures were screened at Xi’an Honghui Hospital between Feb 2016 and Nov 2018. According to the included and excluded criteria, the patients were included in this retrospective study. After collecting the electrocardiogram baseline, the patients were divided into the NS-STT group and the non-NS-STT group. After comparing the demographic and clinical characteristics, multivariate logistic regression models were used to identify the role of NS-STT changes on perioperative DVT. All analyses were performed with R and EmpowerStats software.Results: Nine hundred and sixty-eight patients were included in the study. Ninety-seven patients (10.02%) had NS-STT changes on the electrocardiogram at admission. A total of 303 patients (31.30%) developed perioperative DVT in lower extremities. The univariate analysis showed that NS-STT segment changes were correlated with perioperative DVT significantly (OR = 3.45, 95% CI: 2.25– 5.30, P < 0.0001). In addition, age ≥ 50 (P < 0.0001), female (OR = 1.50, 95% CI: 1.14– 1.97, P = 0.0038), hypertension (OR = 1.54, 95% CI: 1.08– 2.20, P = 0.0161), blood transfusion (OR = 1.78, 95% CI: 1.34– 2.37, P < 0.0001), joint prosthesis (OR = 3.26, 95% CI: 2.21– 4.81, P < 0.0001), and blood loss ≥ 300 mL (OR = 2.12, 95% CI: 1.50– 3.01, P < 0.0001) were associated with perioperative DVT in lower extremities. We identified the confounding factors of age, gender, classification of internal implants, operation time, blood loss, and infusion. After adjustment for potential confounding factors, NS-STT changes were associated with perioperative DVT (OR = 2.13, 95% CI: 1.33– 3.42; P = 0.0017). The sensitive analysis showed that the result was stable.Conclusion: The NS-STT changes on electrocardiograms are associated with an increase in the incidence of perioperative DVT by 2.13-fold in patients with lower extremity fractures under 75 years old. In clinical practice, surgeons should pay more attention to these patients.Keywords: nonspecific ST-segment and T-wave, NS-STT, electrocardiogram, DVT, lower extremity fracture, logistic regression

A portable polarization lidar system based on the division-of-focal-plane scheme has been proposed for all-day accurate retrieval of the atmospheric depolarization ratio. The polarization lidar system has been designed as a T-shaped architecture consisting of a closed transmitter and a detachable large focal receiver, which is capable of outdoor unmanned measurements. The lidar system features low cost, low maintenance and short blind range (∼100 m) by utilizing a 450 nm multimode laser diode as the light source and a polarization image sensor with four polarized channels as the detector. Validation measurements have been carried out on a near horizontal path in ten consecutive days. The linear volume depolarization ratio (LVDR) as well as its measurement uncertainty has been theoretically and experimentally evaluated without employing additional optical components and sophisticated online calibrations. The offset angle can also be accurately retrieved (i.e., −0.06°) from the four-directional polarized lidar profiles with a standard deviation of ±0.02° during the whole measurement period, which contributes negligible influence on the retrieval of the LVDR. It has been found out that the uncertainty of the LVDR was mainly originated from the random noise, which was below 0.004 at nighttime and may reach up to 0.008 during daytime owing to the increasing sunlight background. The performance of the polarization lidar system has been further examined through atmospheric vertical measurements. The low-cost low-maintenance portable polarization lidar system, capable of detecting four-directional polarized lidar signals simultaneously, opens up many possibilities for all-day field measurements of dust, cloud, urban aerosol, oriented particles, etc.

Structural abnormalities and functional changes of renal microvascular networks play a significant pathophysiologic role in the occurrence of kidney diseases. Super-resolution ultrasound imaging has been successfully utilized to visualize the microvascular network and provide valuable diagnostic information. To prevent the burst of microbubbles, a lower mechanical index (MI) is generally used in ultrasound localization microscopy (ULM) imaging. However, high-noise levels lead to incorrect signal localizations in relatively low-MI settings and deep tissue. In this study, we implemented a block-matching threedimensional (BM3D) image-denoising method, after the application of singular value decomposition filtering, to further suppress the noise at various depths. The in vitro flow-phantom results show that the BM3D method helps the significant reduction of the error localizations, thus improving the localization accuracy. In vivo rhesus macaque experiments help conclude that the BM3D method improves the resolution more than other image-based denoising techniques, such as the nonlocal means method. The obtained clutter-filtered images with fewer incorrect localizations can enable robust ULM imaging, thus helping in establishing an effective diagnostic tool.

Acoustic vortex beams, which have both linear and angular momentum, can be used to make precise acoustic tweezers. Limited by the symmetry of a normal vortex beam, these tweezers are usually used for trapping or rotating particles in two dimensions. Here, the three-dimensional spiral motion of two soft particles of different sizes was realized using a vortex beam with a twisted focus, which was synthesized by a silicone binary-phase logarithmic-spiral zone plate. Numerical simulations and experimental measurements demonstrated that the beam had anisotropic focuses of crescent transverse intensity profiles and a screw phase dislocation with a singularity at the center. Experiments showed that a small particle (k0r ≈ 1.3) can follow the twisted intensity of the beam, but a large particle (k0r ≈ 4.7) spirals up away from the twisted field pattern. This is attributed to the dominant gradient force for the small particle, whereas the scattering effect induced a scattering force combined with a gradient force for the large particle. This focused twisted beam, which was generated with a structured silicone plate, and the three-dimensional spiral motion of microparticles, advance the development of simple, compact, and disposable acoustic devices for the precise and diverse manipulation of microparticles.

Asthma is a multifactorial disorder, and microbial dysbiosis enhances lung inflammation and asthma-related symptoms. Probiotics have shown anti-inflammatory effects and could regulate the gut-lung axis. Thus, a 3-month randomized, double-blind, and placebo-controlled human trial was performed to investigate the adjunctive efficacy of probiotics in managing asthma. Fifty-five asthmatic patients were randomly assigned to a probiotic group (n = 29; received Bifidobacterium lactis Probio-M8 powder and Symbicort Turbuhaler) and a placebo group (n = 26; received placebo and Symbicort Turbuhaler), and all 55 subjects provided details of their clinical history and demographic data. However, only 31 patients donated a complete set of fecal and blood samples at all three time points for further analysis. Compared with those of the placebo group, co-administering Probio-M8 with Symbicort Turbuhaler significantly decreased the fractional exhaled nitric oxide level at day 30 (P = 0.049) and improved the asthma control test score at the end of the intervention (P = 0.023). More importantly, the level of alveolar nitric oxide concentration decreased significantly among the probiotic receivers at day 30 (P = 0.038), and the symptom relief effect was even more obvious at day 90 (P = 0.001). Probiotic co-administration increased the resilience of the gut microbiome, which was reflected by only minor fluctuations in the gut microbiome diversity (P > 0.05, probiotic receivers; P

Interferenceless coded aperture correlation holography (I-COACH) is a recently developed technique for indirect 3D imaging without two-wave interference. The CPM calculated using G-S algorithm plays an important role in I-COACH system. However there are some problems with GS algorithm, such as poor convergence and cannot constrain the intensity, thus leading to noise accompany in the reconstructed images. We introduce a modified G-S algorithm to I-COACH in this work to optimize the CPM and enhance the reconstruction images quality. The results show that both the PSH and OH recorded with optimization CPM have lower noise and the reconstructions have better imaging quality.

BackgroundThe purpose of this study was to compare the clinical effects of antibiotic calcium sulfate-loaded hybrid transport (ACSLHT) and traditional Ilizarov bone transport (TIBT) in the treatment of large tibial defects after trauma.MethodsEighty-five patients with large tibial defects after trauma were selected for retrospective study. The range of tibial defects was 6–22 cm. After thorough debridement and infection controlled, bone transport technique was used to reconstruct tibial defects. Forty-four patients were treated with ACSLHT technique (the ACSLHT group), while the other 41 were treated with TIBT technique (the TIBT group). Time in external fixator was evaluated by EFI score. Enneking score was used to evaluate limb functions. SAS score was used to evaluate postoperative anxiety status. In addition, complication incidence was compared, including axis deviation, docking site nonunion, infection recurrence and so on.ResultsThere was no significant difference in preoperative general data between ACSLHT and TIBT group. EFI score in ACSLHT and TIBT group was 0.6 ± 0.1 cm/month and 1.7 ± 0.3 cm/month, respectively (P P P P ConclusionsCompared with TIBT group, ACSLHT group had shorter time in external fixator, better limb functions, lower postoperative anxiety score and lower complication incidence which is worth of clinical promotion.

Psoriasis is a severe skin disease with significant physical and psychological health consequences. As a typical type of immune disease, both innate and adaptive immunity disorders play key roles in the development of psoriasis. Interleukin (IL)-30 was thought as a natural antagonist of gp130-mediated signaling that affects T helper type 1 and 17 cell polarization by inhibiting IL-6 and IL-27 signaling pathways. Here, we found that, in vitro, IL-30 reduced cytokine levels of HaCaT keratinocytes and dendritic cells (DCs), weakened the maturationS of DCs, inhibited DC-mediated T cell proliferation, and blocked the activation of nuclear factor-κB. In vivo, IL-30 inhibited the development of skin disease in two animal models: Krt14-Vegfa and imiquimod (IMQ)-induced psoriasis-like skin disease. Thus, IL-30 may be useful as a therapeutic agent for controlling psoriasis.

The emerging Vehicle to Vehicle (V2V) technology supports the direct communication about road condition information between vehicles, which improves the communication efficiency and driving safety. Network slicing technology can provide network isolation for different users, which can reduce channel interference and save the cost of network resources. However, due to different resource demands and task requirements of each user, how to reasonably allocate resources and reduce the usage cost of resources is still a challenge. In this paper, we study the cost of V2V users to complete the transmission task in the scenario of shared channel with eMBB mobile cellular network users in Radio Access Network (RAN). In addition, we consider the bandwidth resource occupancy rate and the required resource size, and develop a dynamic resource pricing model to ensure the quality of user experience. Under the condition of ensuring the basic rate of cellular users, we divide the cost minimization problem of V2V users transmission tasks into two subproblems: control of transmission power and allocation of slicing bandwidth resources. Then, we propose an Evolutionary Strategy-based Bandwidth Allocation (ESBA) algorithm to complete the transmission tasks within the tolerable delay, which can avoid local minima. Simulation results show that ESBA algorithm has good convergence, and reduce the cost of V2V users transmission tasks effectively.

360-degree video streaming, which is becoming more and more popular as the fast development of VR/AR applications nowadays due to the immersive viewing experience it can offer, poses enormous challenges to the current network infrastructure in terms of high bandwidth and low latency requirements. To address this problem and to ensure the QoE (quality of experience) of end-users, this paper presents CUBIST, a method and system for high-quality 360-degree video streaming in networks with cache nodes at the edge. To the best of our knowledge, it is the first tile-based edge caching solution that incorporates proactive tile prefetching and hierarchical cache organization into reactive caching to maximize the caching benefit while reducing the cost of 360-degree video streaming. Experimental results show that CUBIST can achieve a cache hit ratio of 87 % and improve the effective video bitrate by 12.9 % with most rate transitions being small when compared with the latest FoV-aware edge caching scheme.

Background Simultaneous bilateral distal tibial tubercle high tibial osteotomy (SBDTT-HTO) can result in increased blood loss. The aim of this study is to evaluate the actual hemostatic effect of different tranexamic acid (TXA) treatment regimen in SBDTT-HTO. Methods We conducted a retrospective case–control study including 54 patients who underwent SBDTT-HTO. The single-dose group (n = 18) received 1 g of intravenous TXA 15–30 min before surgery, the two-dose group (n = 18) received an additional 1 g of intravenous TXA 6 h after surgery, and the multiple-dose group (n = 18) received an additional 1 g intravenous TXA per-day until discharge. Blood loss, hemoglobin levels, occurrence of any adverse events,functional analysis, quality of life, and pain assessmentswere compared among the three groups. Results The total blood loss, hidden blood loss, drainage volumes, and haemoglobin level in the multiple-dose group all occupy a significant advantage.(p p < 0.05). Conclusions Based on our results, for patients undergoing SBDTT-HTO, sequential intravenous TXA administration can effectively and safely reduce blood loss,maintain postoperative Hb levels,and with the advantage of accelerating recovery.

Foreign body incarceration of the penis is a rare penis injury occurring primarily in middle-aged and elderly men. Sexual desire is the main cause of the disease. Common incarcerated foreign bodies include rings, plastic bottles, and bearings. Most foreign bodies can be removed by cutting them with tools; however, it is difficult to cut certain wide and thick metal foreign bodies. A case of incarceration caused by putting two metal nuts on the penis for 24 h is reported. The penis presented with pain and swelling, and the patient had dysuria. We carried out multi-point puncturing of the prepuce and hand-pressurizing to squeeze out the fluid causing prepuce edema to reduce the swelling of the penis. Using a plastic film to protect the penis skin and lubricant to reduce resistance, the two metal nuts were gradually moved outward and successfully removed in 50 min without aggravating penis injury. Above mentioned treatment process didn't need special cutting tools, was simple and easy to operate, and did not cause iatrogenic thermal or mechanical damage to the penis. Therefore, it is a good method to treat incarceration of the penis caused by an object that is difficult to cut.

BackgroundNivolumab and pembrolizumab disrupt the programmed cell death-1 immune checkpoint and display promising efficacy and safety results in advanced hepatocellular carcinoma (HCC). However, the benefits remain limited. The preliminary results of lenvatinib (LEN) combined with immune checkpoint inhibitors (ICIs) reveal that the combinations were well-tolerated and encouraging. This study aimed to analyze the safety and efficacy of LEN plus ICIs in a real-world cohort of patients with advanced HCC.MethodBetween June 4, 2017, and June 30, 2019, 16 patients received LEN plus nivolumab, and 13 patients were treated with LEN plus pembrolizumab, with the confirmed advanced HCC retrospectively analyzed. The clinical parameters, as well as the outcomes, were assessed.ResultsAll the patients had Barcelona Clinical Liver Cancer Stage C. LEN with ICIs was used as systemic second-, third-, and fourth-line treatments in seven (24.1%), 14 (48.3%), and eight (27.6%) patients, respectively. At the time of data cutoff, six patients (37.5%) were still receiving LEN with nivolumab, while another six patients (46.2%) were still receiving LEN with pembrolizumab. An objective response was recorded in seven patients (25.9%), while the best overall responses were from one complete response and six partial responses. The 6- and 12-month over survival (OS) rates were 62.6% and 53.7%, respectively. Furthermore, the 6- and 12-month progression-free survival (PFS) rates were 43.5% and 31.8%, respectively. In the subgroup analyses, the 6- and 12-month OS and PFS rates for patients treated with LEN plus nivolumab were 62.5% and 52.1%, respectively, and 43.8% and 30.0%, respectively. The 6- and 12-month OS and PFS rates for patients treated with LEN plus pembrolizumab were 51.3% and 51.3%, respectively, and 49.2% and 49.2%, respectively. A total of 11 (31%) deaths were reported in this study, four of which were attributed to grade 5 adverse events presented as fatal treatment-related hepatitis.ConclusionThe combination of LEN and ICIs is a promising new strategy for the treatment of HCC patients. However, high-grade hepatic toxicity was observed and further evaluation of this combination is still required.

This review summarizes current knowledge regarding clinical epidemiology, pathophysiology, and prognosis for patients with HFmrEF in comparison to HFrEF and HFpEF. Although recommended treatments currently focus on aggressive management of comorbidities, we summarize potentially beneficial therapies that can delay the process of heart failure by blocking the pathophysiology mechanism. More studies are needed to further characterize HFmrEF and identify effective management strategies that can reduce cardiovascular morbidity and mortality of patients with HFmrEF.