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Over the past few years, semiconductor materials (especially bismuth tungstate) exhibiting unique environment purification and energy conversion capacities arouse huge attention as impacted by issues of environmental pollution and energy shortage, whereas its application is restricted by the problems of high carrier recombination rate and unsatisfactory degradation efficiency. In this study, Eu:Bi2WO6 nanostructures containing Eu ions of different concentrations were synthesized with a chemical solution method, and CdS was generated on the surface of Eu:Bi2WO6 nanostructures in situ epitaxial to synthesize the Eu:Bi2WO6/CdS composites. The effects of Eu doping concentration on the crystal structure, chemical composition, local structure, optical properties and visible-light photocatalytic properties exhibited by Eu:Bi2WO6/CdS nanostructures were studied more specifically, and the Eu doping behavior on the improvement mechanisms for optical and photocatalytic performance exhibited by Eu:Bi2WO6/CdS nanostructures was clarified. The robust PL emission peak at about 390 nm and weak emission peak at nearly 450 nm are attributed to the exciton emission and defect state of Bi2WO6/CdS nanostructure, respectively. As indicated from the mechanism insights, the reasonable introduction of Eu3+ could alter the band gap of the photocatalyst, and the epitaxial CdS could decrease the recombination probability of electron and hole in the Bi2WO6/CdS, while improving the photocatalytic activity. This study supplies new occasions for rational excogitation and better comprehending of atomic-scale complicated structures for applications in numerous fields (e.g., energy and environmental protection).

This study focuses on the development and analysis of a real-time updated operations strategy of a distributed energy system (DES). Owing to the relevant Chinese policy of electrical transmission and distribution, combined cooling, heating, and power system (CCHP) and photovoltaic (PV) systems are not currently allowed. However, with the Chinese supply-side power grid reform, the permissions for connections between DESs and utilities are gradually evolving. By performing building simulation and using mixed integer linear programming (MILP), a real-time updated operation strategy of a DES is established. Then, considering the DES from Tianjin Eco-city as a case study, a comparative analysis between this updated strategy and the current operation strategy is performed by evaluating three factors: economic efficiency, energy consumption, and CO2 emission. The results show that the updated strategy can reduce 29.12% of electricity time-of-use cost, 10.11% of total fuel consumption, and 18.40% of CO2 emission during the cooling season. Besides, a method of “rolling load forecasting” for DES by using Support vector regression machine (SVR) is proposed and discussed. The testing shows that the Mean Absolute Percentage Error (MAPE) is below 7.5%. And when the training sample is large, the particle swarm optimization algorithm can be used to shorten the modeling time of the air conditioning load forecasting model.

The link flooding attack (LFA) has emerged as a new category of Distributed Denial of Service (DDoS) attacks in recent years. Along with the massive deployment of low-cost insecure Internet of Things (IoT) devices, the fast proliferation of IoT botnets dramatically increases the risk of LFAs. However, how to efficiently defend against LFAs in IoT still remains as an open problem. To overcome this challenge, we model the interaction between an LFA attacker and the network manager as a two-person Bayesian game in this paper to precisely characterize the behaviors of both sides. Then, the rational behaviors of the attacker and the optimal strategies of the defender are unveiled by deriving the Bayesian Nash Equilibrium (BNE). Inspired by the obtained BNEs, a cost-effective decision framework is proposed for the defender to make defense decisions. Furthermore, we numerically analyze the effect of all the related factors and present feasible suggestions to deter attack motivations fundamentally. Experimental results demonstrate that the proposed method not only consistently outperforms baseline methods in terms of the defender’s utilities under different attack intensities, but also is robust to the changes in important parameters, including the value of benign traffic and the latency of traffic scrubbing.

With the development of new active deception jamming, radar anti-jamming has become a major research hotspot, and the recognition of jamming type is one of its key steps. In recent years, deep learning has been successfully applied in the field of radar jamming recognition, such as convolutional neural networks (CNN). However, it is difficult to effectively improve the accuracy of deep learning algorithms in the case of small sample. Furthermore, ensemble learning and transfer learning can effectively improve the model generalization performance. For the small sample problem, this article proposes a weighted ensemble CNN with transfer learning (WECNN-TL)-based radar active deception jamming recognition algorithm. The main idea of this method is to obtain the time-frequency distribution maps of jamming signals by short-time Fourier transform (STFT), and then, their real parts, imaginary parts, moduli, and phases are combined differently to construct multiple datasets. Finally, an ensemble CNN model with weighted voting and transfer learning is constructed to realize jamming recognition. Experiments on the simulated and measured mixed dataset (including 12 types of samples) show that the proposed method can get better recognition performance than random forest (RF), support vector machine (SVM), and some CNN-based methods.

SUMMARY Background Multidrug-resistant (MDR) gram-negative bacterial (GNB) infections remain a significant cause of morbidity and mortality among surgical patients. The objective of our study was to recognize the risk factors for MDR GNB infection in patients with abdominal surgery and determine the predictors independently associated with death. Methods From 2010 to 2017, a retrospective cohort study was conducted among patients with abdominal surgery admitted in surgical intensive care unit (ICU). Patients with GNB infections were included for analyses. Results A total of 364 patients with abdominal surgery experienced GNB infections, among them, 117 (32.1%) were MDR GNB infection. Of 133 MDR GNB isolates, the most frequent isolate was Escherichia coli (45.1%). Patients with MDR GNB infection had significantly longer ventilator days and hospital stay, as well as higher 30-day and in-hospital mortality compared to non-MDR GNB patients. Multivariable analysis showed longer length of pre-ICU stay, surgical re-exploration, receipt of group 2 carbapenems (e.g. imipenem, meropenem and doripenem) and fluoroquinolones, and higher total bilirubin were independent risk factors for the acquisition of MDR GNB infection. Predictors for 30-day mortality among patients with MDR GNB infection were chronic kidney disease, receipt of group 2 carbapenems and inappropriate empirical antimicrobial therapy. Conclusions This study provides important information about the risk factors for subsequent MDR GNB infection and 30-day mortality among the patients with abdominal surgery.

OBJECTIVE: Electroacupuncture (EA) has been clinically utilized to manage interstitial cystitis (IC), but its related mechanism research is remained to be researched. This study aimed to explore the role of EA in inhibiting the inflammatory response of IC rats, and research the possible mechanism based on the changes of urodynamics, mast cell tryptase expression and the content of inflammatory substances. METHODS: EA (continuous wave, 30 Hz, 1 mA) was applied to stimulate the Ciliao point (BL32) and the Huiyang point (BL35) of rats. Changes of urodynamics, mast cell tryptase expression and the content of IL-6 and TNF-α were detected after 24 hours of the treatment. RESULTS: The results showed that after EA treatment, compared with the model group, the initial urination time of the rats was prolonged (3.23 ± 0.60 to 5.27 ± 0.27 min), the bladder capacity was increased (0.80 ± 0.15 to 1.31 ± 0.07 ml), and the degree of bladder mucosal damage was restored. The expression of mast cell tryptase, and the content of IL-6 and TNF-α in its bladder tissue and urine were reduced. CONCLUSION: These findings suggested that EA could suppress bladder overactivity and inhibit inflammatory response of IC rats, and its mechanism was proved to be related to the inhibition of mast cell degranulation and the down-regulation of inflammatory substances IL-6 and TNF-α in bladder tissue.

Background Transdermal glyceryl trinitrate (GTN) has potential beneficial properties in acute stroke including intracerebral hemorrhage (ICH) and possible clinical benefits suggested in ultra-early stroke (≤ 6 hours). Our meta-analysis updated the evidence on its safety and benefits in acute stroke. Methods We searched major electronic databases for randomised trials comparing transdermal GTN vs placebo/control in acute stroke. Primary outcomes were mortality, 90-day modified Rankin Scale (mRS) and blood pressure (BP) effects. Secondary outcomes included early, late, resource utilisation and surrogate outcomes. Safety outcomes were adverse events. Reviewers identified studies, extracted data, assessed risk of bias (RoB) using a modified Cochrane RoB instrument and quality of evidence (QoE) using GRADE. We also performed a priori subgroup and trial sequential analyses (TSA) on primary outcomes. These subgroup analyses were; ICH vs ischemic stroke; minor (NIHSS ≤ five) vs major (NIHSS > five) ischemic stroke; ischemic stroke with vs without thrombolysis; prehospital vs non prehospital settings; time from stroke to randomization ≤ six vs > six hours and high vs low overall RoB studies. Results 7 eligible primary trials enrolled 5363 patients. GTN reduced systolic BP [mean difference (MD) -4.74; 95% CIs -6.03 to -3.45 mmHg] and diastolic BP (MD -2.94; 95% CIs -3.74 to -2.13 mmHg) 24 hours post treatment but did not affect 4-10-day mortality [relative risk (RR) 1.11; 95% CIs 0.82 to 1.49], 90-day mortality [RR 0.96; 95% CIs 0.77 to 1.19] and 90-day mRS >2 (RR 0.98; 95% CIs 0.93 to 1.03) compared to control/placebo. The QoE was high for primary outcomes with no subgroup effects detected. GTN did not affect secondary outcomes and increased risk of headache and hypotension. TSA generally supported our conclusions regarding primary outcomes. Conclusions Transdermal GTN reduces BP in acute stroke but does not alter clinical outcomes even in ultra-early stroke (≤ 6 hours).

Background Patients with primary lung adenocarcinoma are at increased risk of venous thromboembolism (VTE). However, lung adenocarcinoma characteristics differ across histological subtypes. Therefore, we performed comprehensive analyses on the clinicopathological characteristics of lung adenocarcinoma and risk of VTE. Methods A total of 952 surgically resected lung adenocarcinoma cases were reviewed and classified according to criteria of the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS) /European Respiratory Society (ERS). The correlation between this classification and VTE risk was retrospectively analyzed. The risks of other clinicopathological features including pleural invasion, vascular invasion and associated surgical intervention risks were also assessed. Results Of the 952 patients, 100 (10.4%) cases experienced VTE events during the follow‐up period. Among those with VTE, 28 (28%) were found before surgery, 47 (47%) were found within 1 month after surgery, and 91 (91%) were found in hospital. Univariate analysis revealed that ages, extent of resection and presence of micropapillary features were predictive of VTE risk. Furthermore, multivariable analysis demonstrated that the presence of micropapillary features (subdistribution hazard ratio [SHR] 1.560, 95% CI: 1.043–2.330) and age >60 (SHR: 2.270, 95% CI:1.491–3.470) were associated with increased risk of VTE. After one year, the probability of developing VTE was 13.1% and 8.3% in patients with micropapillary features and those without, respectively. Conclusions VTE is a common complication for lung adenocarcinoma patients who undergo surgery, especially during the perioperative process and hospitalization. Presence of micropapillary subtype and age are positively associated with VTE risk., VTE is a common complication in lung adenocarcinoma patients who undergo surgery, especially during the perioperative process and hospitalization. Presence of micropapillary subtype and age are positively associated with VTE risk.

Background The Interaction between anti-tuberculous and immunosuppressive drugs which may increase the risk of graft rejections is a major challenge in managing transplant recipients with tuberculosis (TB). Instead of rifampicin (RFM), most guidelines recommended the use of rifabutin (RFB) because of its reduced capacity to induce immunosuppressant metabolism while maintaining the same efficacy as RFM against TB. However, there has been no available data directly comparing the outcome of RFB from RFM-based anti-TB regimens in liver transplant patients with TB. This study aimed to compare the effects of RFB from RFM-based treatment in terms of the drug interaction with immunosuppressants, as well as the safety, efficacy and clinical outcomes of living donor liver transplant (LDLT) recipients with active TB. Patients and methods A retrospective study was conducted on all adult LDLT recipients diagnosed with active TB from June 1994 to May 2016 that had concurrently and continuously received either RFB or RFM-based treatment and immunosuppressants. Results Twenty-two patients were included. Twelve (55%) patients were in the RFM group. Ten (45%) patients were in the RFB group. RFB group showed a lesser rate of immunosuppressant trough level reduction (20% vs 50%, p = 0.009) during TB treatment. There was no TB recurrence and no significant change in platelet or leukocyte count in either group. Acute cellular rejection (ACR), rate of TB-treatment completion and overall survival, rates were excellent and statistically similar in both groups. Conclusion The use of RFB in LDLT recipients with active TB, had a lesser drug interaction than when RFM was used. However, RFB did not significantly reduced the rate of ACR. RFB and RFM are both effective and safe to use in LDLT recipients with active TB.

Background Isthmus-originating papillary thyroid carcinoma has unique clinicopathological characteristics. There are no specific guidelines regarding the extent of surgery for isthmic papillary thyroid carcinoma. We aimed to evaluate the characteristics of clinically lymph node–negative patients with solitary isthmic papillary thyroid carcinoma and to determine the best surgical protocol for these patients. Methods A total of 904 patients diagnosed with solitary papillary thyroid carcinoma who underwent surgery were retrospectively reviewed. These patients were divided into the isthmic group (246 patients) or lobar group (658 patients). We compared the 2 groups and conducted a multivariate analysis to assess risk factors for ipsilateral and contralateral central lymph node metastasis in isthmic papillary thyroid carcinoma patients. Nomograms for predicting central lymph node metastasis in isthmic papillary thyroid carcinoma patients were developed and internal calibration was performed for these models. Results Isthmic papillary thyroid carcinoma patients have a significantly higher incidence of extrathyroidal extension and central lymph node metastasis than do lobar papillary thyroid carcinoma patients. For isthmic papillary thyroid carcinoma patients, sex, BRAF V600E mutation, chronic lymphocytic thyroiditis, tumor size, margin, and extrathyroidal extension were independent risk factors of ipsilateral central lymph node metastasis. Body mass index, BRAF V600E mutation, tumor size, location, and extrathyroidal extension were independent risk factors of contralateral central lymph node metastasis. All the above factors were incorporated into nomograms, which showed the perfect discriminative ability. Conclusion Based on the predictive nomograms, we proposed a risk stratification scheme and corresponding individualized surgical treatment based on different nomogram scores. In the debate about prophylactic central neck dissection among clinically lymph node-negative patients with solitary isthmic papillary thyroid carcinoma, our nomograms provide the balance to avoid overtreatment and undertreatment through personal risk assessment.

PURPOSE To evaluate the prevalence and extension of macrovascular invasion (MaVI) in a large cohort of hepatocellular carcinoma (HCC) patients and analyze the association between MaVI and overall survival (OS). METHODS From 2011 to 2018, 2540 patients with newly diagnosed HCC who were managed in our institution were enrolled in this retrospective study. Tumor invasion of the intrahepatic branches of the portal or hepatic veins was defined as peripheral MaVI. Tumor invasion of the main portal vein or inferior vena cava was defined as central MaVI. RESULTS MaVI prevalence was 16.2% (n = 411). Among patients with Barcelona Clinic Liver Cancer (BCLC) stage C and Child-Pugh class A, 165 patients presented with peripheral MaVI and 89 patients with central MaVI. The median OS was 13.2 months (95% confidence interval [CI]: 11.4-15.4) in the peripheral MaVI group and 6.6 months (95% CI: 3.6-9.5) in the central MaVI group (p

Background Buyang Huanwu Decoction (BHD) is a classical Chinese Medicine formula empirically used for diabetic nephropathy (DN). However, its therapeutic efficacies and the underlying mechanisms remain obscure. In our study, we aim to evaluate the renoprotective effect of BHD on a streptozotocin (STZ)-induced diabetic nephropathy mouse model and explore the potential underlying mechanism in mouse mesangial cells (MCs) treated with high glucose in vitro, followed by screening the active compounds in BHD. Methods Mice were received 50 mg/kg streptozotocin (STZ) or citrate buffer intraperitoneally for 5 consecutive days. BHD was intragastrically administrated for 12 weeks starting from week 4 after the diabetes induction. The quality control and quantitative analysis of BHD were studied by high-performance liquid chromatography (HPLC). Renal function was evaluated by urinary albumin excretion (UAE) using ELISA. The mesangial matrix expansion and renal fibrosis were measured using periodic acid-schiff (PAS) staining and Masson Trichrome staining. Mouse mesangial cells (MCs) were employed to study molecular mechanisms. Results We found that the impaired renal function in diabetic nephropathy was significantly restored by BHD, as indicated by the decreased UAE without affecting the blood glucose level. Consistently, BHD markedly alleviated STZ-induced diabetic glomerulosclerosis and tubulointerstitial injury as shown by PAS staining, accompanied by a reduction of renal inflammation and fibrosis. Mechanistically, BHD inhibited the activation of TGF-β1/Smad3 and NF-κB signaling in diabetic nephropathy while suppressing Arkadia expression and restoring renal Smad7. We further found that calycosin-7-glucoside (CG) was one of the active compounds from BHD, which significantly suppressed high glucose-induced inflammation and fibrosis by inhibiting TGF-β1/Smad3 and NF-κB signaling pathways in mesangial cells. Conclusion BHD could attenuate renal fibrosis and inflammation in STZ-induced diabetic kidneys via inhibiting TGF-β1/Smad3 and NF-κB signaling while suppressing the Arkadia and restoring renal Smad7. CG could be one of the active compounds in BHD to suppress renal inflammation and fibrosis in diabetic nephropathy.

Background Malignant pleural effusion (MPE) is common in malignant pleural mesothelioma (MPM). The survival of patients with MPM and MPE is heterogeneous. The LENT and BRIMS scores using routine clinical parameters were developed to predict the survival of patients with unselected MPE and MPM, respectively. This study aimed to stratify the survival of selected MPM patients with MPE. Methods Data were collected from subjects diagnosed with MPM and MPE. The LENT and BRIMS scores were applied using a combination of clinical variables to stratify subjects and compare survival characteristics. Results In total, 101 patients with MPM complicated by MPE were included in the study. The median follow‐up time was 71 months (interquartile range: 24–121 months). Overall median survival was 24 (interquartile range: 12–52 months). Based on the LENT score, the low‐, moderate‐, and high‐risk groups accounted for 65.3% (66 cases), 34.7% (35 cases), and 0%, respectively. The cumulative survival rates of the two groups were statistically significant (p = 0.031). The area under the curve (AUC) of the LENT score was 0.662. Based on the BRIMS score, the first, second, third, and fourth risk groups accounted for 1.0% (1 case), 42.9% (35 cases), 28.7% (29 cases), and 19.4% (36 cases), respectively. Survival was significantly higher in patients in the risk groups 1 and 2 than in patients in the risk groups 3 and 4 (p = 0.037). The AUC of the BRIMS score was 0.605. Conclusions Using routinely available clinical variables, both LENT and BRIMS scores could stratify selected MPM and MPE patients into risk groups with statistically different survival., The individual survival of patients with MPM combined with MPE varied greatly in this study. Both LENT and BRIMS scores could help stratify the survival risk of patients with MPM complicated by MPE with fair‐to‐good performance. More effective predictive models should be established in adequately designed prospective studies.

Few pharmaceutical agents for slowing Parkinson’s disease (PD) progression existed, especially for perimenopause females. The current general medications are mostly hormone replacement therapy and may have some side effects. Therefore, there is an urgent need for a novel treatment for PD. This study examined the possibility of estradiol plus lithium chloride (LiCl), one of the metal halides used as an alternative to salt. We showed that the combination of LiCl and estradiol could enhance neurogenesis proteins GAP-43 and N-myc in the human neuronal-like cells. We also further confirmed the neurogenesis activity in zebrafish. LiCl and LiCl plus estradiol could enhance 6-OHDA-induced upregulation of TGase-2b and Rho A mRNA expression. Besides, LiCl plus estradiol showed a synergic effect in anti-apoptotic activity. LiCl plus estradiol protected SH-SY5Y cells and zebrafish against 6-OHDA-induced damage on neurons than LiCl or estradiol alone groups via p-P38, p-Akt, Bcl-2, and caspase-3 cascade. The potential for developing this combination as a candidate treatment for PD is discussed.

Background: The association between preoperative overt hypothyroidism and early outcomes after coronary artery bypass grafting (CABG) is unclear. This study aimed to evaluate the influence of overt hypothyroidism on the outcomes of CABG. Methods: The series included 189 overt hypothyroid patients, who underwent CABG at Fuwai Hospital. These patients were 1:4 matched with 737 euthyroid patients using propensity score matching. The early postoperative outcomes were compared. Results: After propensity score matching, the incidences of impaired wound healing, reintubation, and the total complications were higher in hypothyroid patients than euthyroid patients (11.8% vs. 0.9%, P < 0.001; 2.1% vs. 0.4%, P = 0.03; 39.6% vs. 30.3%, P = 0.015, respectively). Multivariate analysis showed overt hypothyroidism was significantly associated with the occurrence of impaired wound healing (odds ratio [OR]=12.29, P < 0.001), reintubation (OR=5.71, P = 0.047), and the total complications (OR=1.31, P = 0.049). The OR of the total complications was 1.43 (P = 0.03) in hypothyroid patients with abnormal thyroid-stimulating hormone compared with euthyroid patients. The proportions of the use of dopamine, adrenaline, milrinone, and dobutamine in hypothyroid patients were higher than euthyroid patients (75.4% vs. 67.6%, P = 0.038; 10.7% vs. 6.1%, P = 0.028; 3.2% vs. 0.3%, P = 0.001; 4.8% vs. 1.2%, P = 0.004, respectively). The total duration of inotropic support and mechanical ventilation time in hypothyroid patients were longer than euthyroid patients (median duration: 4 days vs. 3 days, P = 0.003; 17 hours vs. 15 hours, P < 0.001, respectively). Conclusions: CABG in overt hypothyroid patients is associated with a higher incidence of postoperative complications, stronger postoperative inotropic support, and longer mechanical ventilation time.

Background: Vein graft occlusion is deemed a major challenge in coronary artery bypass grafting. Previous studies implied that the no-touch technique for vein graft harvesting could reduce occlusion rate compared with the conventional approach; however, evidence on the clinical benefit and generalizability of the no-touch technique is scare. Methods: From April 2017 to June 2019, we randomly assigned 2655 patients undergoing coronary artery bypass grafting at 7 hospitals in a 1:1 ratio to receive no-touch technique or conventional approach for vein harvesting. The primary outcome was vein graft occlusion on computed tomography angiography at 3 months and the secondary outcomes included 12-month vein graft occlusion, recurrence of angina, and major adverse cardiac and cerebrovascular events. The generalized estimate equation model was used to account for the cluster effect of grafts from the same patient. Results: During the follow-up, 2533 (96.0%) participants received computed tomography angiography at 3 months after coronary artery bypass grafting and 2434 (92.2%) received it at 12 months. The no-touch group had significantly lower rates of vein graft occlusion than the conventional group both at 3 months (2.8% versus 4.8%; odds ratio, 0.57 [95% CI, 0.41–0.80]; P P P P Conclusions: Compared with the conventional vein harvesting approach in coronary artery bypass grafting, the no-touch technique significantly reduced the risk of vein graft occlusion and improved patient prognosis. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03126409.

We studied the value of circulating tumor DNA (ctDNA) in predicting early postoperative tumor recurrence and monitoring tumor burden in patients with hepatocellular carcinoma (HCC). Plasma‐free DNA, germline DNA, and tissue DNA were isolated from 41 patients with HCC. Serial ctDNAs were analyzed by next‐generation sequencing before and after operation. Whole‐exome sequencing was used to detect the DNA of HCC and adjacent tissues. In total, 47 gene mutations were identified in the ctDNA of the 41 patients analyzed before surgery. ctDNA was detected in 63.4% and 46% of the patient plasma pre‐ and postoperation, respectively. The preoperative ctDNA positivity rate was significantly lower in the nonrecurrence group than in the recurrence group. With a median follow‐up of 17.7 months, nine patients (22%) experienced tumor recurrence. ctDNA positivity at two time‐points was associated with significantly shorter recurrence‐free survival (RFS). Tumors with NRAS, NEF2L2, and MET mutations had significantly shorter times to recurrence than those without mutations and showed high recurrence prediction performance by machine learning. Multivariate analyses showed that the median variant allele frequency (VAF) of mutations in preoperative ctDNA was a strong independent predictor of RFS. ctDNA is a real‐time monitoring indicator that can accurately reflect tumor burden. The median VAF of baseline ctDNA is a strong independent predictor of RFS in individuals with HCC., Here, we studied the value of circulating tumor DNA (ctDNA), in combination with germline and tissue DNA by whole‐exome sequencing in patients withhepatocellular carcinoma (HCC). Our analysis demonstrated that ctDNA may serve as a real‐time monitoring indicator by accurately reflecting tumor burden, and as a strong independent predictor of recurrence‐free survival in HCC.

Understanding the neural correlates of cognitive problems in patients with breast cancer (BC) after systemic treatment have been a topic of increasing investigation. The heterogeneity of the systemic treatment regimens may undermine our ability to identify brain microstructural alterations resulting from any given regimen. We investigated the detrimental effects of the anthracycline-based systemic treatment (AST) regimen (epirubicin and cyclophosphamide + docetaxel + tamoxifen) on brain gray matter (GM) and white matter (WM) microstructural alteration in long-term BC survivors. We performed a battery of neuropsychological tests and structural magnetic resonance imaging (MRI) to 31 long-term BC survivors who had received the AST regimen (AST group) and 43 healthy controls (HC group). Voxel-based morphometry evaluated the whole-brain voxel-wise GM volume, while diffusion tensor imaging technique with tract-based spatial statistics analysis evaluated whole-brain WM microstructural alteration. Partial least squares regression (PLSR) was used to evaluate the relationship between cognitive impairment and brain microstructural alteration in BC survivors. Compared with the HC group, the AST group exhibited a significantly poorer performance in attention, as well as a marginal significantly poorer performance in verbal working memory and executive function. Significantly lower fractional anisotropy (FA), higher radial diffusivity (RD), and lower axial diffusivity (AD) in multiple brain WM regions were showed in AST group compared with the HC group. Overlap of lower FA and higher RD was found in the body of corpus callosum (CC) and bilateral superior corona radiata (SCR), whereas overlap of lower FA and AD was found in the body of CC and right SCR. The PLSR results showed that the WM regions with overlap of lower FA and AD were significantly associated with executive and verbal working memory decline. No significant difference was observed in the GM volume between groups. Our results suggest that microstructural abnormalities of certain vulnerable WM regions in the AST regimen-exposed brain may provide neuroimaging evidence for the identification of brain injury and cognitive impairment induced by specific chemotherapy regimens.

In this paper, an adaptive semi-supervised rotation forest (SSRoF) algorithm is proposed for the classification of hyperspectral images with limited training data. Our proposition is based on Rotation Forest (RoF), a classifying technique that has proved to be remarkably accurate in the context of high-dimensional data. It is adapted to the semi-supervised context, by increasing the number of training instances in the learning stage, with high-quality unlabeled samples mined using ensemble margin. SMOTE is adopted to overcome the class imbalance problem . Out-Of-Bag (OOB) instances are used in a second phase to figure out the optimal number of samples to be added to the training set. Five ensemble methods and five semi-supervised methods are employed as comparisons. The results on three real hyperspectral remote sensing datasets demonstrate the effectiveness of the proposed method.

Summary Fabricating an intelligent and tactile-sensitive untethered soft robot is a major challenge. In this study, we used 4D printing to manufacture a liquid crystal elastomer-based robot that can realize untethered self-propelled rolling when heated to above 160°C after morphing into a tubule. The curvature of the tubule renders a sustainable directional rolling movement to the robot. A 10-cm-long robot can attain a maximum velocity of more than 48 cm/min on the horizontal plane and climb a slope of approximately 20°. Longer tubules roll faster with improved stability, which ensures the robot's adaptability to complex terrains. Given the flexibility of the material and structure, the tactile sensing ability of the robot is similar to that of the antennae in insects. In addition, the robot can carry a load that is 40 times its own weight, which increases the potential applicability of the proposed robot in the transportation industry.

The conventional machine learning algorithm for analyzing ultrasonic signals to detect structural defects necessarily identifies and extracts either time- or frequency-domain features manually, which has problems in reliability and effectiveness. This work proposes a novel approach by combining convolutional neural networks (CNNs) and wavelet transform to analyze the laser-generated ultrasonic signals for detecting the width of subsurface defects accurately. The novelty of this work is to convert the laser ultrasonic signals into the scalograms (images) via wavelet transform, which are subsequently utilized as the image input for the pretrained CNN to extract the defect features automatically to quantify the width of defects, avoiding the necessity and inaccuracy induced by artificial feature selection. The experimentally validated numerical model that simulates the interaction of laser-generated ultrasonic waves with subsurface defects is first established, which is further utilized to generate adequate laser ultrasonic signals for training the CNN model. A total number of 3104 data are obtained from simulation and experiments, with 2480 simulated signals for training the CNN model and the remaining 620 simulated data together with 4 experimental signals for verifying the performance of the proposed algorithm. This approach achieves the prediction accuracy of 98.5% on validation set, particularly with the prediction accuracy of 100% for the four experimental data. This work proves the feasibility and reliability of the proposed method for quantifying the width of subsurface defects and can be further expanded as a universal approach to various other defects detection, such as defect locations and shapes.

Osimertinib is the standard treatment for advanced non-small cell lung cancer (NSCLC) patients with T790M mutation after the failure of first-/second-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI). We comprehensively analyzed factors that affect the therapeutic efficacy of the osimertinib treatment in NSCLC patients. 351 NSCLC patients with T790M mutation receiving osimertinib treatment were included. We investigated the value of different factors in predicting the clinical outcomes of the osimertinib therapy, including progression-free survival (PFS), overall survival (OS) and objective response rate (ORR). Logistic and COX regression were used to identify prognosticators. In osimertinib therapy, EGFR mutation status (19Del/L858R) at initial diagnosis and the therapeutic choice of prior EGFR-TKI agent was not associated with patients’ prognosis. Notably, the PFS of the prior EGFR-TKI was independently related to ORR (OR, 95% CI 0.98, 0.96–1.00, p = 0.030), PFS (HR, 95% CI 0.98, 0.97–1.00, p = 0.009) and OS (HR, 95% CI 0.96, 0.93–0.98, p

Background and ObjectivesTo explore efficacy/safety of natalizumab, a humanized monoclonal anti–α4-integrin antibody, as adjunctive therapy in adults with drug-resistant focal epilepsy.MethodsParticipants with ≥6 seizures during the 6-week baseline period were randomized 1:1 to receive natalizumab 300 mg IV or placebo every 4 weeks for 24 weeks. Primary efficacy outcome was change from baseline in log-transformed seizure frequency, with a predefined threshold for therapeutic success of 31% relative reduction in seizure frequency over the placebo group. Countable seizure types were focal aware with motor signs, focal impaired awareness, and focal to bilateral tonic-clonic. Secondary efficacy endpoints/safety were also assessed.ResultsOf 32 and 34 participants dosed in the natalizumab 300 mg and placebo groups, 30 (94%) and 31 (91%) completed the placebo-controlled treatment period, respectively (one participant was randomized to receive natalizumab but not dosed due to IV complications). Estimated relative change in seizure frequency of natalizumab over placebo was −14.4% (95% confidence interval [CI] –46.1%–36.1%; p = 0.51). The proportion of participants with ≥50% reduction from baseline in seizure frequency was 31.3% for natalizumab and 17.6% for placebo (odds ratio 2.09, 95% CI 0.64–6.85; p = 0.22). Adverse events were reported in 24 (75%) and 22 (65%) participants receiving natalizumab vs placebo.DiscussionAlthough the threshold to demonstrate efficacy was not met, there were no unexpected safety findings and further exploration of possible anti-inflammatory therapies for drug-resistant epilepsy is warranted.Trial Registration InformationThe ClinicalTrials.gov registration number is NCT03283371.Classification of EvidenceThis study provides Class I evidence that IV natalizumab every 4 weeks, compared to placebo, did not significantly change seizure frequency in adults with drug-resistant epilepsy. The study lacked the precision to exclude an important effect of natalizumab.

KIFs have been reported to play a critical role in a variety of tumors, and KIF20B is a protein in KFIs. In this research, KIF20B was highly expressed in the GEO database and our hospital’s data, and high expression of KIF20B suggested poor prognosis. We detect the expression of KIF20B in pancreatic cancer and adjacent normal tissues using immunohistochemistry. Knockdown of KIF20B in pancreatic cancer cell lines, PANC-1 and BxPC-3 cells, inhibited cell proliferation which are detected by colony formation assays, CCK8, and western bolt of Ki-67 and PCNA. Xenograft assay showed a similar result in vivo. KIF20B is a potential therapeutic target in pancreatic cancer.

Introduction and Aims: Elevated plasma levels of C-reactive protein (CRP) are closely associated with progressive renal injury in patients with chronic kidney disease (CKD). Here, we tested a hypothesis that CRP may promote renal fibrosis and inflammation via a TGF-β/Smad3-dependent mechanism. Methods: Role and mechanisms of TGF-β/Smad3 in CRP-induced renal fibrosis and inflammation were examined in a mouse model of unilateral ureteral obstruction (UUO) induced in CRP Tg/Smad3 KO mice and in a rat tubular epithelial cell line in which Smad3 gene is stably knocked down (S3KD-NRK52E). Results: We found that mice overexpressing the human CRP gene were largely promoted renal inflammation and fibrosis as evidenced by increasing IL-1β, TNF-α, MCP-1 expression, F4/80+ macrophages infiltration, and marked accumulation of α-smooth muscle actin (α-SMA), collagen I and fibronectin in the UUO kidney, which were blunted when Smad3 gene was deleted in CRPtg-Smad3KO. Mechanistically, we found that the protection of renal inflammation and fibrosis in the UUO kidney of CRPtg-Smad3KO mice was associated with the inactivation of CD32-NF-κB and TGF-β/Smad3 signaling. Conclusion: In conclusion, Smad3 deficiency protects against CRP-mediated renal inflammation and fibrosis in the UUO kidney by inactivating CD32-NF-κB and TGF-β/Smad3 signaling.

Background & Aims: Chronic hepatitis B (CHB) can cause liver fibrosis and lead to cirrhosis even cancer, antiviral therapy can reverse liver fibrosis with limited effect, thus we aimed to evaluate the effect of An-Luo-Hua-Xian pill (ALHX) on fibrosis regression in CHB patients treated with ETV.Methods: Treatment naïve patients with CHB from Oct 1st, 2013 to Dec 31st, 2020 were randomly treated with ETV alone or combined with ALHX (ETV+ALHX). Patients’ demographic, laboratory and liver histology data before and after 78 weeks of treatment were collected. Ishak fibrosis score (F) was used and fibrosis regression means F decreased ≥1 after treatment.Results: In total, 394 patients with a second liver biopsy after treatment were included in per-protocol population: 132 patients in ETV group and 262 patients in ETV+ALHX group. After 78 weeks of treatment, the fibrosis regression rate in the ETV+ALHX group were significantly higher than ETV group in baseline F≥3 patients: 124/211 (58.8%) verse 45/98 (45.9%), p=0.035. The degradation rate of liver stiffness measurement (LSM) is also consistent with it: 154/262 (73.0%) in ETV+ALHX group and 60/132 (61.2%) in ETV group, p=0.037. Logistic regression analysis showed that combined with ALHX was related to fibrosis regression (OR=1.94, p=0.018), and family history of hepatocellular carcinoma was on the contrary (OR=0.41, p=0.031).Conclusions: ETV combined with ALHX can significantly increase liver fibrosis regression in CHB patients.

Given that the passive performance simulation of buildings based on typical meteorological year data and specific design schemes makes it challenging to respond to climate change and refine design requirements on time, this article established a passive performance prediction model for future buildings considering multi-dimensional variables including climate change, building design, and operational characteristics. For high thermal insulation buildings under future climates, the mild climate zone is more sensitive than the others, cooling energy demand is more sensitive than heating demand, apartments are more sensitive than office buildings, and passive survivability is more sensitive than energy performance; for buildings of the same type located in the same climate zone, thermal design solutions determine the increase rate of cooling demand. The potential benefits of climate warming on heating demand reduction are almost zero, but the cooling demand increases significantly, with apartments and office buildings increasing up to 22.1% and 5.0%, respectively. Buildings generally overheat in the future, and the increase rate of the mild zone far exceeds other zones with duration and severity being 3004.8% and 877.7% for apartments, and 884.3% and 288.9% for office buildings, respectively.

Worldwide Interoperability for microwave access (WiMAX) based on the IEEE 802.16 standard has become one of the most promising wireless technologies and been widely applied for the provision of broadband wireless access in the fourth-generation communication networks. In this paper, we investigate the performance of IEEE 802.16 wireless networks with the contention-based bandwidth (BW) request scheme in non-saturation mode. Taking into account the buffer content as well as the backoff stage and backoff counter processes , we model the dynamics of the contention BW request scheme by a 3-dimensional Markov chain. We derive its steady state probability using the spectral analysis method and obtain some key performance measures such as system efficiency, loss probability, mean number of packets in the buffer and mean head-of-line (HoL) delay. These results are useful in determining an optimization configuration for the efficient operation of the IEEE 802.16 wireless networks. Insert your abstract here. Include keywords, PACS and mathematical subject classification numbers as needed.

Benefiting from high flexibility and weavability, the wire-shaped supercapacitors (SCs) arouse tremendous interests for the applications in wearable/portable electronics. Graphene fiber (GF) is considered as a promising linear electrode for wire-shaped SCs. However, the bottleneck is how to develop the GF-based linear electrode with facile fabrication process while well-maintaining satisfactory electrochemical performance. Herein, a novel Fe3O4@GF composite linear electrode is proposed via a chemical reduction-induced assembly approach, in which the GO and Fe3O4 nanoparticles (NPs) realize the efficient self-assembly owing to the electrostatic and van der Waals interactions, as well as the sufficient reduction of GO during the preparation process. The resultant fiber-shaped architecture shows boosted charge-transfer kinetics, high flexibility and structural integrity. Such Fe3O4@GF linear electrode exhibits excellent electrochemical behaviors including a large volumetric specific capacitance (∼250.75 F cm−3), remarkable rate capability and favorable electrochemical kinetics in aqueous electrolyte, superior than previously reported GF-based linear electrodes. For real application, a high-performance wire-shaped SC with excellent flexibility and weavability is fabricated based on such Fe3O4@GF linear electrode and gel electrolyte, demonstrating ultrahigh volumetric energy density (18.8 mWh cm−3), power density (4000 mW cm−3) and strong durability (∼93.5% retention after 10000 cycles). Prospectively, the fabricated wire-shaped SC can maintain reliable electrochemical behaviors in various deformation states, showing its potentials in future portable and wearable devices.

As the global energy policy gradually shifts from fossil energy to renewable energy, lithium batteries, as important energy storage devices, have a great advantage over other batteries and have attracted widespread attention. With the increasing energy density of lithium batteries, promotion of their safety is urgent. Thermal runaway is an inevitable safety problem in lithium battery research. Therefore, paying attention to the thermal hazards of lithium battery materials and taking corresponding preventive measures are of great significance. In this review, the heat source and thermal hazards of lithium batteries are discussed with an emphasis on the designs, modifications, and improvements to suppress thermal runaway based on the inherent structure of lithium batteries. According to the source of battery heat, we divide it into reversible heat and irreversible heat. Additionally, superfluous heat generation has profound effects, including thermal runaway, capacity loss, and electrical imbalance. Thereafter, we emphatically discuss the design and modification strategies for various battery components (anodes, cathodes, electrolytes, and separators) to suppress thermal runaway. Preparation of solid electrolyte interphase layers with excellent thermal stability and mechanical properties is the core of the modification strategy for anode materials. Additives, stable coatings, elemental substitution, and thermally responsive coating materials are commonly used to improve the safety of cathodes. Novel electrolyte additives, solid-state electrolytes, and thermally stable separators provide a good opportunity to solve the thermal runaway problem of next-generation high-performance electrochemical storage devices.

Objective: To analyze and explore the clinical value of arthroscopy in traumatic sports ankle arthritis. Methods: The study period was from June 2016 to June 2020. A selected sample of 25 patients with traumatic sports ankle arthritis in Qingyang People’s Hospital were treated. All patients underwent arthroscopy and the specific treatment effects were analyzed. Results: Comparing the preoperative and postoperative ankle-hindfoot scores, the distance of talus advancement, modified Mcguire’s ankle scoring system, and visual analog scale (VAS) pain scores, the postoperative results were significantly better than those of the preoperative (P < 0.05). Conclusion: Arthroscopy in traumatic sports ankle arthritis has a significant effect, with minor trauma and rapid postoperative recovery which improves various discomfort symptoms. It is worthy of promotion and application.

Permissionless blockchain, as a kind of distributed ledger, has gained considerable attention because of its openness, transparency, decentralization, and immutability. Currently, permissionless blockchain has shown a good application prospect in many fields, from the initial cryptocurrency to the Internet of Things (IoT) and Vehicular Ad-Hoc Networking (VANET), which is considered as the beginning of rewriting our digital infrastructure. However, blockchain confronts some privacy risks that hinder its practical applications. Though numerous surveys reviewed the privacy preservation in blockchain, they failed to reveal the latest advances, nor have they been able to conduct a unified standard comprehensive classification of the privacy protection of permissionless blockchain. Therefore, in this paper, we analyze the specific characteristics of permissionless blockchain, summarize the potential privacy threats, and investigate the unique privacy requirements of blockchain. Existing privacy preservation technologies are carefully surveyed and evaluated based on our proposed evaluation criteria. We finally figure out open research issues as well as future research directions from the perspective of privacy issues.

Background Tumor mutation burden (TMB) is an emerging prognostic biomarker of immunotherapy for bladder cancer (BLCA). We aim at investigating radiomic features’ value in predicting the TMB status of BLCA patients. Methods Totally, 75 patients with BLCA were enrolled. Radiomic features extracted from the volume of interest of preoperative pelvic contrast-enhanced computed tomography (CECT) were obtained for each case. Unsupervised hierarchical clustering analysis was performed based on radiomic features. Sequential univariate Logistic regression, the least absolute shrinkage and selection operator (LASSO) regression and the backward stepwise regression were used to develop a TMB-predicting model using radiomic features. Results The unsupervised clustering analysis divided the total cohort into two groups, i.e., group A (32.0%) and B (68.0%). Patients in group A had a significantly larger proportion of having high TMB against those in group B (66.7% vs. 41.2%, p = 0.039), indicating the intrinsic ability of radiomic features in TMB-predicting. In univariate analysis, 27 radiomic features could predict TMB. Based on six radiomic features selected by logistic and LASSO regression, a TMB-predicting model was built and visualized by nomogram. The area under the ROC curve of the model reached 0.853. Besides, the calibration curve and the decision curve also revealed the good performance of the model. Conclusions Our work firstly proved the feasibility of using radiomics to predict TMB for patients with BLCA. The predictive model based on radiomic features from pelvic CECT has a promising ability to predict TMB. Future study with a larger cohort is needed to verify our findings.

Opposed multi-burner (OMB) gasification technology is the first large-scale gasification technology developed in China with completely independent intellectual property rights. It has been widely used around the world, involving synthetic ammonia, methanol, ethylene glycol, coal liquefaction, hydrogen production and other fields. This paper summarizes the research and development process of OMB gasification technology from the perspective of the cold model experiment and process simulation, pilot-scale study and industrial demonstration. The latest progress of fundamental research in nozzle atomization and dispersion, mixing enhancement of impinging flow, multiscale reaction of different carbonaceous feedstocks, spectral characteristic of impinging flame and particle characteristics inside gasifier, and comprehensive gasification model are reviewed. The latest industrial application progress of ultra-large-scale OMB gasifier and radiant syngas cooler (RSC) combined with quenching chamber OMB gasifier are introduced, and the prospects for the future technical development are proposed as well.

Hypoxia occurs in various pathophysiological conditions. Especially, brain can be seriously affected by the oxygen deficiency. However, challenges exist in optically monitoring cerebral hemodynamics with high resolution. As an easily-detected vessel bed, peripheral skin is a potential target for predicting cerebrovascular hemodynamic changes. However, the similarities and differences between cerebral and cutaneous hemodynamics during hypoxia are still unclear. One of the main reasons is that optical imaging techniques are fundamentally depth/resolution-limited due to high scattering properties of turbid tissue. Fortunately, in vivo tissue optical clearing techniques can efficiently overcome these problems, and avoid the side-effects of surgical windows. In this work, we simultaneously monitor the changes in cortical and cutaneous microvascular blood oxygen and blood flow under the assistance of in vivo skull and skin optical clearing techniques, and quantitatively compared the differences between cerebral and cutaneous arteriovenous functional responses to the hypoxic stimulus. The results indicated that the variation tendency of blood oxygen response might be more similar, and cutaneous vascular blood oxygen response has the potential to serve as an accessible indicator for revealing cerebrovascular dysfunction. Moreover, it provides a feasible approach to realize visualization of in vivo monitoring cerebral and cutaneous microvascular reactivity with minimal invasiveness.

Background Functional mitral regurgitation (FMR) is one of the most common heart valve diseases in diabetes and may increase left ventricular (LV) preload and aggravate myocardial stiffness. This study aimed to investigate the aggravation of FMR on the deterioration of LV strain in type 2 diabetes mellitus (T2DM) patients and explore the independent indicators of LV peak strain (PS). Materials and methods In total, 157 T2DM patients (59 patients with and 98 without FMR) and 52 age- and sex-matched healthy control volunteers were included and underwent cardiac magnetic resonance examination. T2DM with FMR patients were divided into T2DM patients with mild (n = 21), moderate (n = 19) and severe (n = 19) regurgitation. LV function and global strain parameters were compared among groups. Multivariate analysis was used to identify the independent indicators of LV PS. Results The T2DM with FMR had lower LV strain parameters in radial, circumferential and longitudinal direction than both the normal and the T2DM without FMR (all P P Conclusion FMR may aggravate the deterioration of LV stiffness in T2DM patients, resulting in decline of LV strain and function. The regurgitation degree and months with diabetes were independently correlated with LV global PS in T2DM with FMR.

Introduction BEYOND 7 demonstrated that a higher starting dose (0.3 U/kg) of insulin glargine 100 U/mL (Gla-100) is as safe as the standard starting dose (0.2 U/kg) in Chinese individuals with type 2 diabetes who had uncontrolled hyperglycaemia despite receiving oral antihyperglycaemic drugs. This post hoc analysis determined the effect of baseline characteristics on hypoglycaemia risk in these individuals. Methods Participants from BEYOND 7 were assessed based on their age at baseline (

Intestinal ischemia/reperfusion is a grave condition with high morbidity and mortality in perioperative and critical care settings and causes multiple organ injuries beyond the intestine, including brain injury. Exosomes act as intercellular communication carriers by the transmission of their cargo to recipient cells. Here, we investigate whether exosomes derived from the intestine contribute to brain injury after intestinal ischemia/reperfusion via interacting with microglia in the brain. Intestinal ischemia/reperfusion was established in male C57/BL mice by clamping the superior mesenteric artery for 30 min followed by reperfusion. The sham surgery including laparotomy and isolation of the superior mesenteric artery without occlusion was performed as control. Male C57 mouse was intracerebral ventricular injected with intestinal exosomes from mice of intestinal ischemia/reperfusion or sham surgery. Primary microglia were cocultured with intestinal exosomes; HT-22 cells were treated with intestinal exosomes or microglia conditioned media. Intestinal ischemia/reperfusion-induced microglial activation, neuronal loss, synaptic stability decline, and cognitive deficit. Intracerebral ventricular injection of intestinal exosomes from intestinal ischemia/reperfusion mice causes microglial activation, neuronal loss, synaptic stability decline, and cognitive impairment. Microglia can incorporate intestinal exosomes both in vivo and in vitro. Microglia activated by intestinal exosomes increases neuron apoptotic rate and decreases synaptic stability. This study indicates that intestinal exosomes mediate memory impairment after intestinal ischemia/reperfusion via activating microglia. Inhibiting exosome secretion or suppressing microglial activation can be a therapeutic target to prevent memorial impairment after intestinal ischemia/reperfusion.

The contradiction between the shortage of urban land and the demand for urban green space needs to be solved reasonably. Different from urban parks, the cooling effect of small green space (SGs) has not been paid enough attention or fully evaluated. The major objective of this research was to explore the cooling and energy saving benefits of SGs with administrative units. The ENVI-met and EnergyPlus models were built based on field measurements on the green space of Xi’an Jiaotong University Qujiang Campus. Field measurement shows that the closer an area to the green space, the lower the air temperature and the higher the relative humidity, especially in the daytime. The ENVI-met results showed that the SGs can reduce the temperature by 0.66 °C within the range of 1260 m × 1350 m compared with the building scene at noon, the EnergyPlus simulation results showed that the building 100 m away from the SGs can reduce the air conditioning energy consumption by 2.1% compared with the distance of 150 m. The research can improve the planning and design standards of urban green space, clarify the cooling and energy saving benefits of SGs, and promote the ecological urban design.

Fibrosis serves a critical role in driving atrial remodelling‐mediated atrial fibrillation (AF). Abnormal levels of the transcription factor PU.1, a key regulator of fibrosis, are associated with cardiac injury and dysfunction following acute viral myocarditis. However, the role of PU.1 in atrial fibrosis and vulnerability to AF remain unclear. Here, an in vivo atrial fibrosis model was developed by the continuous infusion of C57 mice with subcutaneous Ang‐II, while the in vitro model comprised atrial fibroblasts that were isolated and cultured. The expression of PU.1 was significantly up‐regulated in the Ang‐II‐induced group compared with the sham/control group in vivo and in vitro. Moreover, protein expression along the TGF‐β1/Smads pathway and the proliferation and differentiation of atrial fibroblasts induced by Ang‐II were significantly higher in the Ang‐II‐induced group than in the sham/control group. These effects were attenuated by exposure to DB1976, a PU.1 inhibitor, both in vivo and in vitro. Importantly, in vitro treatment with small interfering RNA against Smad3 (key protein of TGF‐β1/Smads signalling pathway) diminished these Ang‐II‐mediated effects, and the si‐Smad3‐mediated effects were, in turn, antagonized by the addition of a PU.1‐overexpression adenoviral vector. Finally, PU.1 inhibition reduced the atrial fibrosis induced by Ang‐II and attenuated vulnerability to AF, at least in part through the TGF‐β1/Smads pathway. Overall, the study implicates PU.1 as a potential therapeutic target to inhibit Ang‐II‐induced atrial fibrosis and vulnerability to AF.

Exploring lightweight electromagnetic wave absorption materials is urgently needed to satisfy the miniaturization and integration of artificial intelligence and 5G technologies. Herein, nitrogen-doped graphene (N-GN) is successfully fabricated through a simple hydrothermal method, which can float in the water. Except for keeping the sheet-like structure of GO, nitrogen-doped graphene shows a reticular-like structure with more wrinkles and crinkles, which is crossed and interconnected to each other. The introduced nitrogen heteroatoms may induce dipole polarization, and the special interconnected reticular-like structure may improve the energy dissipation capacity. These features make nitrogen-doped graphene process improved dielectric loss and enhanced electromagnetic wave absorption performance. When the mass fraction of N-GN is only 10 wt%, N-GN shows a maximum reflection loss value of − 21.7 dB at 14.3 GHz with an absorber thickness of only 1.78 mm. This work indicates that nitrogen-doped graphene is a good candidate of lightweight dielectric materials.

Objective To investigate whether the periprosthetic bone environment could be affected by activity during the early rehabilitation period after primary total hip arthroplasty (THA) and to evaluate the safety and efficacy of activity during the early rehabilitation period. Methods This random clinical trial was conducted from January 2017 to July 2017. A total of 22 selected patients with advanced osteonecrosis of the femoral head (ONFH) who underwent primary unilateral THA were randomized (1:1) to a high activity level group (HA group) or a low activity level group (LA group). The HA group included nine men and two women, aged 53.18 ± 13.29 years. The LA group included five men and six women, aged 55.73 ± 11.73 years. The intervention was different postoperative daily walking distances guided by researchers: 1727.27 ± 564.08 m 0–2 months and 4272.73 ± 904.53 m 3–6 months postoperation for the HA group and 909.09 ± 583.87 m 0–2 months and 2409.09 ± 1068.13 m 3–6 months postoperation for LA group. The primary outcomes were radiographic evaluation (prosthetic stability and stress shielding based on the Engh scale) and bone mineral density (BMD) with a femoral prosthesis (individual and intergroup comparison using seven Gruen zones) at 6 months postoperatively. Secondary outcomes were set to confirm the safety and efficacy of activity during early rehabilitation, including day 1 erythrocyte sedimentation rate (ESR), day 1 hypersensitive C‐reactive protein (CRP), length of hospital stay (LOS), and the Harris hip score (HHS) at discharge, 2 months postoperatively, and 6 months postoperatively. Results Patients were followed up for 6 months after surgery. Regarding primary outcomes, all prostheses were assessed as stable, with bone in‐growth. There were no adverse events in any cases. The HA group had a higher incidence of stress shielding than the LA group, but there was no statistical significance (63.64% vs 18.18%; P > 0.05). The degree of stress shielding had a different distribution for the two groups (P 0.05). The HHS on day of discharge was higher in the HA group than in the LA group (60.73 ± 5.37 points vs 51.18 ± 8.05 points, P 0.05) and 6 months (90.45 ± 5.24 points vs 91.55 ± 4.03 points, P > 0.05). Conclusion High activity levels during early rehabilitation after primary THA accelerate the process of bone remodeling and aggravate stress shielding, with no significant benefits for functional recovery., X‐rays of three patients with osteonecrosis of the femoral head (ONFH). Femoral collapse and acetabular arthritis were evident in preoperative X‐rays (A1, B1, and C1). Stress shielding levels of 0, 1, and 2 were apparent on X‐rays 6 months postoperatively (A2, B2, and C2).

With the rapid development of marine activities, there has been an increasing number of maritime mobile terminals, as well as a growing demand for high-speed and ultra-reliable maritime communications to keep them connected. Traditionally, the maritime Internet of Things (IoT) is enabled by maritime satellites. However, satellites are seriously restricted by their high latency and relatively low data rate. As an alternative, shore & island-based base stations (BSs) can be built to extend the coverage of terrestrial networks using fourth-generation (4G), fifth-generation (5G), and beyond 5G services. Unmanned aerial vehicles can also be exploited to serve as aerial maritime BSs. Despite of all these approaches, there are still open issues for an efficient maritime communication network (MCN). For example, due to the complicated electromagnetic propagation environment, the limited geometrically available BS sites, and rigorous service demands from mission-critical applications, conventional communication and networking theories and methods should be tailored for maritime scenarios. Towards this end, we provide a survey on the demand for maritime communications, the state-of-the-art MCNs, and key technologies for enhancing transmission efficiency, extending network coverage, and provisioning maritime-specific services. Future challenges in developing an environment-aware, service-driven, and integrated satellite-air-ground MCN to be smart enough to utilize external auxiliary information, e.g., sea state and atmosphere conditions, are also discussed.

The phase induced intensity noise (PIIN) may seriously reduce the signal-to-noise ratio (SNR) of continuous-wave coherent Doppler lidar (CW-CDL), thereby limiting its performance in practical applications. In this paper, we propose to use optical frequency domain reflectometry (OFDR) technique to locate the PIIN sources and evaluate their intensities. According to the OFDR information, we demonstrate that the PIIN in our CW-CDL system is mainly induced by the crosstalk of polarization beam splitter. Then, the PIIN is reduced by setting fiber delay line, polarization control, and AR-coating. Finally, a wind Doppler signal at a distance of 80 meters is obtained on a clear day, and a typical SNR of 19.4 dB is achieved.

Objective At present, there are several guidelines for cancer complicated with VTE, but there is no specific recommendation for the treatment of lung cancer complicated with VTE. Whether is necessary to explore treatment and prevention of VTE in lung cancer. Background Venous thromboembolism (VTE) is a common complication of severe lung cancer that can entail many adverse effects for patients. The incidence of VTE is higher in patients with lung cancer than in those with other kinds of solid tumors, and it is especially high among patients with lung adenocarcinoma, at advanced tumor-node-metastasis (TNM)stages, or with a history of central venous catheter (CVC) or chemotherapy. However, the clinical symptoms of VTE in patients with lung cancer are not typical and cannot be detected easily, and the clinical prevention rate is low. In the acute phase of VTE in lung cancer, the Eastern Cooperative Oncology Group (ECOG) performance status score of patients typically ranges from 2 to 4 points, leaving end-stage maintenance therapy as the only treatment option. Methods Here, we analyze the existing literature and discuss the current status (including epidemiology, clinical manifestations, and risk factors), risk assessment tools, and the treatment and prevention of VTE in severe lung cancer. We focus particularly on the use of low-molecular-weight heparin and new oral anticoagulants (including in the management of thrombocytopenia after antitumor therapy) in lung cancer patients with VTE. Conclusions Large-scale prospective multicenter studies on the treatment and prevention of VTE in lung cancer are necessary.

The air-gap eccentricity will produce unbalanced magnetic pull and cause vibrations and noises in a motor. In this study, the dynamic behavior of a synchronous motorized spindle with inclined eccentricity is investigated. A semi-analytical method is proposed to model the unbalanced magnetic pull and the electromagnetic torque of a rotor with inclined eccentricity, and the semi-analytical method is verified by the finite element method. The dynamic model of a spindle-bearing system is built by taking the centrifugal force and gyroscopic effects into account. Then, the vibration response of dynamic displacement eccentricity, inclined eccentricity including displacement eccentricity and angle eccentricity, rotating speed, and unbalanced mass eccentricity in both time domain and frequency domain are simulated and analyzed. The results show that the eccentricities can lead to fluctuations in amplitudes of the dynamic displacement response and the angle response. The frequency components of the dynamic responses are the combination of rotating frequency, VC frequency, and power frequency. It is indicated that the coupling interactions of bearing forces, unbalanced mass force, and unbalanced magnetic pull have an obvious effect on the spindle-bearing system.

Mobile crowdsourcing (MCS) has become an effective data collection method due to its mobility, low cost, and flexibility. However, since centralized MCS confronts severe security and privacy risks in reality, many researchers are devoted to building a decentralized MCS system based on blockchain. Despite the effectiveness of these schemes, they fail to offer anonymous authentication on the trust of MCS nodes, although privacy is a main concern in MCS and trust plays an important role in a series of MCS activities such as worker selection and truth discovery. Nevertheless, anonymous authentication on trust is not a trivial issue since trust evaluation usually conflicts with anonymity, which is a necessary privacy requirement in an open MCS environment. To tackle this problem, we leverage Intel Software Guard Extension (SGX) and propose a scheme to anonymously authenticate trust with trustworthy trust evaluation in a blockchain-based MCS system. The scheme employs an SGX-enabled cloud server to periodically alter user public/private key pairs and mix newly altered keys among a number of faked keys in order to ensure unlinkability. Besides, we consider the unique features of MCS and work out a novel trust evaluation method by aggregating both subjective feedback and objective behaviors. Finally, we conduct several analyses and experiments to illustrate its security and efficiency.

We investigated the effects of the transverse components of a tendon core suture on tensile resistance and strength of 4-strand repairs. Forty-four pig flexor tendons were repaired with one of the following four methods: double Tsuge, U-shaped, 4-strand cross and 4-strand rectangular repairs. We recorded the number of the repaired tendons that formed a 2 mm gap between the tendon ends during cyclic loading for 20 cycles, stiffness of the tendon at the 1st and 20th cycle, gap distance at the repair site and ultimate strength of the repair at the 20th cycle. When transverse components were added to the core suture, a greater number of tendons formed a 2 mm gap during cyclic loading. The stiffness gradually decreased, and the repair site's gap distance after cyclic loading increased with the presence of transverse components of the sutures. We conclude that the core suture's transverse components negatively impact the tensile resistance of 4-strand tendon repairs.

This study aims to explore the effect of Tectorigenin in chronic cerebral ischemia (CCI)-induced cognitive impairment mice model. Cognitive impairment, hippocampal tissue histopathology, and myelin density in CCI mice were detected. HT22 cells were used to induce oxygen–glucose deprivation/reperfusion (OGD/R) injury. Cell viability and apoptosis of transfected HT22 cells and toll-like receptor-4 (TLR4)/nuclear factor-kappaB (NF-κB) pathway–related factor levels in hippocampal tissue and OGD/R models were detected. CCI caused cognitive impairment, hippocampal damage, and decreased myelin density in mice while promoting interleukin-1β, tumor necrosis factor-alpha, TLR4, myeloid differentiation primary response gene 88, p-p65, NLRP3, and ASC levels. Tectorigenin reversed the effects of CCI in mice and reversed the promoting effects of OGD/R on apoptosis and TLR4/NF-κB pathway–related factors levels, while overexpressed TLR4 reversed the effects of Tectorigenin in OGD/R-induced HT-22 cells. Tectorigenin alleviated cognitive impairment in CCI mice by inhibiting the TLR4/NF-κB signaling pathway.