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The study aimed to investigate whether serum sFlt-1 (soluble fms-like tyrosine kinase-1) at 11-13 weeks’ gestation in pregnancies that subsequently developed preeclampsia was different from those without preeclampsia and compare screening performance of the International Prediction of Pregnancy Complications (IPPIC) reported models, which include various combinations of maternal factors, systolic blood pressure, diastolic blood pressure, PlGF (placental growth factor) and sFlt-1 and the competing risk (CR) models, which include various combinations of maternal factors, mean arterial pressure (MAP) and PlGF for predicting any-onset, early-onset, and late-onset preeclampsia. This was a prospective multicenter study in 7877 singleton pregnancies. The differences of the predictive performance between the IPPIC and CR models were compared. There were 141 women (1.79%) who developed preeclampsia, including 13 cases (0.17%) of early-onset preeclampsia and 128 cases (1.62%) of late-onset preeclampsia. In pregnancies that developed preeclampsia compared to unaffected pregnancies, median serum sFlt-1 levels and its MoMs were not significantly different ( p >0.05). There was no significant association between gestational age at delivery and log 10 sFlt-1 and log 10 sFlt-1 MoM ( p >0.05). The areas under the curve of CR models were significantly higher than the IPPIC models for the prediction of any-onset and late-onset preeclampsia but not for early-onset preeclampsia. In conclusion, there are no significant differences in the maternal serum sFlt-1 levels at 11-13 weeks’ gestation between women who subsequently develop preeclampsia and those who do not. Moreover, the CR models for the prediction of any-onset and late-onset preeclampsia perform better than the IPPIC reported model.

Purpose To evaluate the contralateral lymph node recurrence rate (clLNRR) of stage IVA to IVB well-lateralized oral cavity cancer. To evaluate the risk factors of clLNRR. Materials and methods Pathologic stage IVA-B squamous cell carcinoma of oral cavity, originating from buccal mucosa, gingiva, or retromolar trigone were retrospectively recruited. Those who did not receive definitive surgery, with previous cancer history, or with contralateral nodal metastasis at diagnosis were excluded. Results From 2010 to 2017, 120 cases were enrolled, including 103 pT4 and 38 pN2. Thirty-one patients underwent contralateral neck dissection, and 18 had contralateral elective nodal irradiation. After median follow up of 35.1 months, the 3-year clLNRR was 15.7% (95% CI: 8.8 - 22.6%) as first event and was 17.1% (95% CI: 9.8 - 24.4%) for overall recurrences. The 3-year disease-free survival and overall survival were 52.8% and 63.1%, respectively. In multivariate analysis, positive nodal metastasis, gingival origin, and perineural invasion were associated with significantly higher clLNRR. Nodal metastasis was the strongest prognostic factor for clLNRR (pN1, HR: 17.1, p = 0.010; pN2, HR: 16.7, p = 0.004, comparing to pN0). The 3-year clLNRR were 2.9% for pN0 (n = 71, 95% CI: 0 - 6.8%), 37.7% for pN1 (n = 11, 95% CI: 8.3 - 67.1%), and 38.4% for pN2 (n = 38, 95% CI: 19.2 - 57.6%). Advanced T classification, elective contralateral neck dissection, and contralateral nodal irradiation did not have significant impact on clLNRR. Conclusions Positive homolateral nodal metastasis, gingival origin, and perineural invasion were risk factors correlated with significantly higher clLNRR. For patient without nodal metastasis, the clLNRR was low and elective contralateral neck management might be safely omitted. For patients with homolateral nodal disease, the contralateral nodal recurrence was not unusual. The optimal treatment for these high risk patients warrant further research.

BACKGROUND The ATP6AP1 gene coding for the accessory protein Ac45 of the vacuolar-type adenosine triphosphatases (V-ATPase) is located on chromosome Xq28. Defects in certain subunits or accessory subunits of the V-ATPase can lead to congenital disorders of glycosylation (CDG). CDG is a group of metabolic disorders in which defective protein and lipid glycosylation processes affect multiple tissues and organs. Therefore, the clinical presentation of patients with ATP6AP1-CDG varies widely. In this report, we present a case of ATP6AP1-CDG in a Chinese infant, with clinical features and genotype. CASE SUMMARY An 8-mo-old boy was admitted to our hospital because unexplained hepatosplenomegaly and elevated transaminases that had been noted while he was being treated for a cough at a local hospital. A post-admission examination at our hospital revealed abnormalities in the infant’s liver, brain, and immune system. Trio-based whole exome gene analysis identified a hemizygous pathogenic mutation c.1036G>A (p.E346K) in exon 9 of the ATP6AP1 gene. This variant of the ATP6AP1 gene has not been reported in East Asian countries until now. CONCLUSION Based on the infant’s clinical manifestations and the results of genetic detection, he was clearly diagnosed with ATP6AP1-CDG. The clinical manifestations of children with CDG vary widely. Genetic testing analysis helps in the clinical diagnosis of children with CDG.

Background Robot-assisted gait training (RAGT) is a practical treatment that can complement conventional rehabilitation by providing high-intensity repetitive training for patients with stroke. RAGT systems are usually either of the end-effector or exoskeleton types. We developed a novel hybrid RAGT system that leverages the advantages of both types. Objective This single-blind randomized controlled trial evaluated the beneficial effects of the novel RAGT system both immediately after the intervention and at the 3-month follow-up in nonambulatory patients with subacute stroke. Methods We recruited 40 patients with subacute stroke who were equally randomized to receive conventional rehabilitation either alone or with the addition of 15 RAGT sessions. We assessed lower-extremity motor function, balance, and gait performance by using the following tools: active range of motion (AROM), manual muscle test (MMT), the Fugl–Meyer Assessment (FMA) lower-extremity subscale (FMA-LE) and total (FMA-total), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), Tinetti Performance-Oriented Mobility Assessment (POMA) balance and gait subscores, and the 3-m and 6-m walking speed and Timed Up and Go (TUG) tests. These measurements were performed before and after the intervention and at the 3-month follow-up. Results Both groups demonstrated significant within-group changes in the AROM, MMT, FMA-LE, FMA-total, PASS, BBS, POMA, TUG, and 3-m and 6-m walking speed tests before and after intervention and at the 3-month follow-up (p p = 0.014) and total (p = 0.002) assessments. Conclusion Although the novel hybrid RAGT is effective, strong evidence supporting its clinical effectiveness relative to controls in those with substantial leg dysfunction after stroke remains elusive. Trial registration The study was registered with an International Standard Randomized Controlled Trial Number, ISRCTN, ISRCTN15088682. Registered retrospectively on September 16, 2016, at https://www.isrctn.com/ISRCTN15088682

The solid state incandescent light emission device (SSI-LED), which can emit the broadband warm white light, is made from the high-k MOS capacitor after the dielectric breakdown [1-4]. Electrical properties of the capacitor, such as interface defect density (Dit ), oxide trapped charge density (Qot ), equivalent oxide thickness (EOT), and leakage current density (Jleakage ) are important to the dielectric breakdown process and eventually the optical properties of the emitted light. Since the zirconium hafnium oxide (ZrHfO) high-k material has superb gate dielectric properties, e.g., high crystallization temperature, low interface state density, oxide trapped charges, and high effective k value, it has been used as the gate dielectric layer of the MOS capacitor [5,6]. On the other hand, the WOx dielectric-based MOS capacitor and SSI-LED has been studied. The latter emitted light with relative high intensity due to the high emissivity coefficient of the W component [7]. However, the capacitor has a high leakage current which can be a reliability concern. In this paper, three types of MOS capacitors, i.e., with gate dielectrics made of ZrHfO, WOx, and ZrHfO/WOx/ZrHfO/WOx/ ZrHfO/WOx/ZrHfO, separately, have been fabricated into SSI-LEDs and studied for electrical and optical properties. MOS capacitors were prepared on a DHF pre-cleaned p-type silicon (1015 cm-3) wafer. For the ZrHfO capacitor, the gate dielectric layer was sputter-deposited from the Zr/Hf (12/88 wt%) target in Ar/O2 (100:100 sccm) at 5 mTorr and 60 W for 12 min. The WOx layer was sputter-deposited from the W target (99.999 %) in Ar/O2 (40:100 sccm) at 5 mTorr and 60 W for 12 min. For the WOx embedded capacitor, the ZrHfO (2 min)/WOx (2 min)/ZrHfO (2 min)/WOx (2 min)/ ZrHfO (2 min)/WOx (2 min)/ZrHfO (2 min) stack was deposited in one pump down under the same conditions as each individual layer. The post-deposition annealing (PDA) was conducted at 900 ̊C under the O2 atmosphere for 5 min in furnace. An 80 nm thick ITO was sputter deposited and wet etched into round gate electrodes using an aqua regia solution. Then, the backside of the wafer was deposited with an aluminum thin film and annealed at 400 ̊C under H2/N2 (10/90) for 5 min. The dielectric breakdown voltage of the capacitor was determined from the current density-gate voltage (J-V) curve. The light emission characteristics the SSI-LED were measured from an optical emission spectrometer (OES, StellarNet). Electrical characteristics of the capacitors before and after the dielectric breakdown were discussed with respect to the gate dielectric material properties. Figure 1 shows the emission spectra of the 3 SSI-LEDs. They all emit broad band light in the range of UV to near IR. They are similar to the visible wavelength region of the solar light. The peak lengths λpeak’s of the ZrHfO, WOx, and WOx embedded devices are 638 nm, 687.15 nm, and 663 nm, respectively. The WOx SSI-LED has the highest emission intensity. It was reported that the emissivities of the pure (99.99 %) tungsten and the hafnium-3 wt% zirconium materials were 0.434 [8] and 0.30 [9] at 2000 K, respectively. Therefore, the inclusion of W component in conductive path may increase the light emission intensity of SSI-LED. According to the emission spectra, the CIE chromaticity chart has been prepared. The color correlation temperatures (CCT’s) and color rendering indices (CRI’s) were calculated. Y. Kuo, ECS Trans., 69, 23-29 (2015). C.-C. Lin and Y. Kuo, ECS J. Solid State Sci. Technol., 3, Q182 (2014). C.-C. Lin and Y. Kuo, J. Vac. Sci. Technol. B, 32, 011208 (2014). Y. Kuo and C.-C. Lin, Appl. Phys. Lett., 102, 031117 (2013). T.-C. Chang, F.-Y. Jian, S.-C. Chen and Y.-T. Tsai, Materials today, 14, 608-615 (2011). G. E. Moore, Cramming more components onto integrated circuits, McGraw-Hill New York, NY, USA (1965). M. Lorenz, H. von Wenckstern and M. Grundmann, Adv. Mater., 23, 5383-5386 (2011). R. D. Larrabee, JOSA, 49, 619-625 (1959). P.-F. Paradis, T. Ishikawa and S. Yoda, Int. J. Thermophys., 24, 239-258 (2003). Figure 1

It is of great clinical importance to explore more efficacious treatments for OCD. Recently, cognitive-coping therapy (CCT), mainly focusing on recognizing and coping with a fear of negative events, has been reported as an efficacious psychotherapy. However, the underlying neurophysiological mechanism remains unknown. This study of 79 OCD patients collected Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and resting-state functional magnetic resonance imaging (rs-fMRI) scans before and after four weeks of CCT, pharmacotherapy plus CCT (pCCT), or pharmacotherapy. Amygdala seed-based functional connectivity (FC) analysis was performed. Compared post- to pretreatment, pCCT-treated patients showed decreased left amygdala (LA) FC with the right anterior cingulate gyrus (cluster 1) and with the left paracentral lobule/the parietal lobe (cluster 2), while CCT-treated patients showed decreased LA-FC with the left middle occipital gyrus/the left superior parietal/left inferior parietal (cluster 3). The z-values of LA-FC with the three clusters were significantly lower after pCCT or CCT than pretreatment in comparisons of covert vs. overt and of non-remission vs. remission patients, except the z-value of cluster 2 in covert OCD. CCT and pCCT significantly reduced the Y-BOCS score. The reduction in the Y-BOCS score was positively correlated with the z-value of cluster 1. Our findings demonstrate that both pCCT and CCT with large effect sizes lowered LA-FC, indicating that FCs were involved in OCD. Additionally, decreased LA-FC with the anterior cingulate cortex (ACC) or paracentral/parietal cortex may be a marker for pCCT response or a marker for distinguishing OCD subtypes. Decreased LA-FC with the parietal region may be a common pathway of pCCT and CCT. Trial registration: ChiCTR-IPC-15005969.

To compare the treatment outcome and severe late adverse effects (AEs) between conventional volume and dose (CVD) and simultaneously reduced volume and dose (SRVD) of clinical target volume treatments in patients with nasopharyngeal carcinoma.This retrospective cohort study enrolled patients with nonmetastatic stage II to IV nasopharyngeal cancer from a single institute. Survival endpoints and severe (≥grade 3) late AEs and comorbidity were compared between groups. The correlation of severe late AEs, comorbidity, and overall survival (OS) were evaluated using Kaplan-Meier and Cox regression methods.From January 2012 to June 2017, this study enrolled 178 patients, 64 in the CVD group and 114 in the SRVD group. The 2 groups did not differ significantly in patient characteristics except for mean follow-up time (37.6 vs 48.8 months; P = .01). The SRVD group did not significantly differ from the CVD group in local control survival (82.0% vs 78.4%; P = .85), regional control survival (89.9% vs 86.0%; P = .62), or disease-free survival (76.4% vs 66.9%; P = .67). The SRVD group had significantly better OS (93.9% vs 67.0%; P.001) and salvage survival (79.3% vs 20.7%; P.01) and a significantly lower ratio of severe lung infection (1 of 113 vs 5 of 59; P = .02). The SRVD group had a significantly lower risk of mortality (hazard ratio [HR], 0.3; P = .03). The factors associated with a significantly higher risk of mortality were N3 (regional lymph node stage status of N3) (HR, 3.0; P = .02); comorbidities of diabetes, coronary artery disease, or chronic kidney disease (grades 2-3) (HR, 3.8; P = .009), and severe lung infection (HR, 6.3; P = .007).Simultaneously reduced volume and dose of clinical target volumes did not impair locoregional control or disease-free survival. The benefits of SRVD treatment may include significant reduction in severe late AEs, particularly lung infection, dysphagia, and xerostomia. However, additional studies with longer patient follow-up are required to confirm these benefits.

This paper aims to investigate the antecedents of how crowdfunded projects succeed over crowdsourcing platforms (CFPs) on the Internet. As CFPs make quite a large number of open innovations feasibl...

Background To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection. Methods In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were included between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival (DSS) among different quality of neck dissection. Results Of the 1765 patients identified, 1108 (62.8%) had oral cancer, 1141 (64.6%) were men, and 1067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval [CI] 0.49–0.84) in those with Conclusion Radiotherapy was associated with improved survival in pT1-2N1M0 oral and oropharyngeal cancer patients without adequate neck dissection.

The WHO declared the coronavirus disease 2019 (COVID-19) a global pandemic on 11 March 2020. Lessons from SARS epidemic led Singapore to develop stringent infection control protocols in preparation for future pandemics. However, unlike SARS, COVID-19 appears to be more transmissible and is predicted to continue for longer. As of 14 June 2020, there have been 40,197 positive cases with 26 deaths in Singapore, and KK Women’s and Children’s Hospital (KKH) has managed a total of 73 cases. Obstetrics ultrasound is an indispensable medical service and must continue to operate during a pandemic. A key balance must be struck between keeping patients and healthcare workers safe while being able to provide quality and prompt obstetric care. Our Antenatal Diagnostic Centre (ADC) in KKH developed new strategies to adapt to the pandemic when the national Disease Outbreak Response System Condition (DORSCON) was raised from yellow to orange on 7 February 2020. In this paper, we discuss our clinical workflow to reduce the risk of transmission amongst patients and staff while minimising disruption to our services.

Alcoholic liver disease (ALD) is the major cause of chronic liver disease and a global health concern. ALD pathogenesis is initiated with liver steatosis, and ALD can progress to steatohepatitis, fibrosis, cirrhosis and even hepatocellular carcinoma. Salvianic acid A (SAA) is a phenolic acid component of Danshen, a Chinese herbal medicine with possible hepatoprotective properties. The purpose of this study was to investigate the effect of SAA on chronic alcoholic liver injury and its molecular mechanism. We found that SAA significantly inhibited alcohol‐induced liver injury and ameliorated ethanol‐induced hepatic inflammation. These protective effects of SAA were likely carried out through its suppression of the BRD4/HMGB1 signalling pathway, because SAA treatment largely diminished alcohol‐induced BRD4 expression and HMGB1 nuclear translocation and release. Importantly, BRD4 knockdown prevented ethanol‐induced HMGB1 release and inflammatory cytokine production in AML‐12 cells. Similarly, alcohol‐induced pro‐inflammatory cytokines were blocked by HMGB1 siRNA. Collectively, our results reveal that activation of the BRD4/HMGB1 pathway is involved in ALD pathogenesis. Therefore, manipulation of the BRD4/HMGB1 pathway through strategies such as SAA treatment holds great therapeutic potential for chronic alcoholic liver disease therapy.

Human Leukocyte Antigen (HLA)-DQ2 and HLA-DQ8 are genetic risk factors for Type 1 Diabetes Mellitus (T1DM) and Celiac disease (CD) in Caucasians, but their association with Taiwanese Han population is unknown. We screened 532 Taiwanese T1DM patients for CD biomarkers including anti-tissue transglutaminase (TGM2), anti-gliadin and anti-neoepitope antibodies (Abs), sequencing DQB1 genotypes, and characterized the TGM2 Abs. We report that 3.76% of Taiwanese patients had TGM2-Abs and all had no CD's symptoms. In contrast to Caucasian's CD patients, DQ2/DQ8 only constituted ~4/5 of TGM2-Abs positive patients, while the other ~1/5 patients belonged to different HLA genotypes. Either anti-gliadin or anti-neoepitope Abs coexisted with ~3/4 of TGM2-Abs positive patients that were likely due to gluten-ingestion, while the cause of TGM2-Abs production for other ~1/4 of patients was unknown. Purified anti-TGM2 IgA (TGA) and anti-TGM2 IgG (TGG) could bind on endothelial cells surface, recognized native better than denatured forms of TGM2, and TGA inhibited TGM2's transamidation activity by up to 80% but TGG had no effects. Epitope mapping of all TGM2-Abs positive sera demonstrated that TGM2-Abs had heterogeneity in specificities. This is the first study on the differences between Taiwanese Han group and Caucasian in HLA genotypes and properties of TGM2-Abs.

The penetration of renewable energy is gradually increasing. Therefore, power system flexibility, which is required to maintain system security and to cope with renewable generation uncertainty, becomes more important. Various technologies, such as flexible generators, demand management, energy storage, network reconfiguration, and even efficient system operations, are capable of improving power system flexibility. Nevertheless, among them, flexible generation resources can provide a direct way to enhance the power system flexibility. This article first applies the fuzzy analytic hierarchy process to calculate the flexibility index of generation resources. Then, the process of unit scheduling is implemented under various operation scenarios to investigate the relationship between the generation flexibility and the cost of unit scheduling. Finally, the required flexibility and the corresponding capacity of flexible generators under a specified penetration of renewable power generation are investigated under different operation scenarios.

The hafnium oxide based high-k dielectric material has been used to replace SiO2 in advanced MOSFETs to lower down the leakage current based on the same equivalent oxide thickness (EOT) of SiO2 [1,2]. The Zr-doped HfO2 (ZrHfO) thin film has many advantages over the undoped HfO2 thin film with respect to the higher permittivity, higher crystallization temperature, lower interface thickness, and lower interface density of states [3-6]. MOS capacitors with EOT less than 1 nm has been successfully prepared using the sputter deposited ZrHfO [5]. The metal electrode material is crucial to the device performance because it could diffuse into the structure to introduce dipoles or new charge trapping sites [7,8]. In this paper, electrical properties of MOS capacitors made of two different gate electrode materials, i.e., copper (Cu) and molybdenum (Mo), were investigated. MOS capacitors were fabricated on p-type Si (100) 1015 cm-3 wafers. The ZrHfO film was sputtered deposited from a Zr/Hf (12/88 wt. %) target under Ar/O2 (1:1 sccm) at 10 mTorr and 80 W for 12 min. The sample was subsequently annealed at 800°C in N2 for 5 min. Then, a 200 nm thick Cu or Mo electrode film was sputter deposited at 10 mTorr and 80 W, i.e., 20 min for the former and 120 min for the latter. They were etched into round gate electrodes of 200 µm, 300 µm and 400 µm diameters. The Mo electrode was wet etched with a H3PO4/HNO3/CH3COOH/H2O (80:5:5:10) solution. The Cu electrode was etched with a plasma-based etch process of which the detailed process condition can be found in refs [9]. Then, the sample was treated with a post metal annealing (PMA) step at 250°C in N2 for 10 min. Samples without the PMA treatment, i.e., controlled samples, were also prepared and measured for comparison. Electrical properties, e.g., EOT, VFB , Dit , and Qot , of the sample were extracted from the C-V curve using the method described in ref 10. Figure 1 shows the C-V hysteresis curves of Mo gated capacitors (a) before and (b) after PMA. The samples were measured with the gate voltage (Vg ) swept from -3 V to 3 V (forward) and then back to -3 V (backward). The control sample shows a large flat-band voltage shift ( ) of 1.4881 V while the annealed sample shows a much smaller ’s of 0.083 V. Also, the Qot is decreased from 9.611011 to 1.091011 cm-2 for the control and annealed samples [10]. The long Mo sputtering time may induce hole-trapping defects in the high-k film or at the high-k/Si interface. In addition, it was reported that the Mo gate could react with high-k film to form new bonds that reduced the work function [11]. The 250˚C annealing step can effectively reduce defects in various parts of the capacitor. Figure 2 shows the C-V hysteresis curves of Cu gated capacitors (a) before and (b) after PMA. Before PMA, the C-V curve is similar to that of a good capacitor with a low of 0.012 V, which corresponds to a low charge trapping density [10]. However, after PMA, the C-V curve distorted. It shows the strong inversion phenomenon, which indicates the possible high electron concentration at the interface exceeding the dopant concentration near the wafer interface [12]. Since Cu can easily diffuse through a dielectric film [13], it is possible that Cu diffuses through the high-k gate dielectric during the PMA step. Cu in the high-k film may exist in the CuOx form, which changed the charge trapping states and locations. More discussions on the above mechanism will be presented. Lingguang Liu acknowledges the financial support of National Natural Science Foundation of China (Grant Number:61771382), China Scholarship Council (No. 201806280283) and the Shaanxi International Science and Technology Cooperation and Exchange Program (2018KW-034). 1. Kang, et al., IEEE EDL, 21, 181 (2000). 2. I. Hegde, et al., JAP, 101, 074113 (2007). 3. Kuo, ECST, 3, 253 (2006). 4. Kuo, et al., ECST, 1, 447 (2006). 5. Yanet al., ECS SSL, 10, H199 (2007). 6. Luo, et al., APL, 89,072901 (2006). 7. Ravindran, et al., APL, 89, 263511 (2006). 8. C. Vezzoli, et al., Ceram. Int., 23, 105 (1997). 9. Kuo and S. Lee,APL, 78, 1002 (2001). 10. H. Nicollian and J. R. Brews, MOS Physics and Technology, p424, Wiley, New York (1982). 11. Ha, et al., JJAP, 42, 1979-1982 (2003). 12. Ytterdal, et al., Device Modeling for Analog and RF CMOS Circuit Design, p4, Wiley (2003). 13. D. McBrayer, et al.,JES, 133, 6,1242 (1986). Figure 1

Background/Aim: Whole-body positron-emission tomography/computed tomography with the glucose analog 2-[(18)F]fluoro-2-deoxy-D-glucose (FDG-PET/CT) has been used to screen examinees for underlying malignancy in many countries. The aim of this study was to compare the potential value of FDG-PET/CT application in asymptomatic individuals with those with suspected malignancy. Patients and Methods: A total of 9,408 examinees underwent whole-body FDG-PET/CT at our hospital from July 2006 to August 2013. Three thousand and seven hundred asymptomatic individuals and 848 individuals with laboratory and clinical/radiologicaI suspicion of malignancy who had undergone FDG-PET/CT for cancer screening were recruited. The final confirmation of cancer and outcomes were based on a pathological report and continuous follow-up. Results: Forty-five out of 3,700 asymptomatic individuals (1.2%) had proven malignancy, and 42 of them (93.3%) were found by FDG-PET/CT. Two hundred and twelve out of 848 with suspected malignancy (25%) had proven malignancy, and 196 of them (92.5%) were detected by FDG-PET/CT. Most of these cancers in asymptomatic individuals were clinically at an early stage. The discovery rate in asymptomatic individuals and those with suspected malignancy was 1.1% and 23.1%, respectively. The overall survival of patients with cancer diagnosed with PET/CT was higher than those with suspected malignancy (78.6% vs. 48.5%, p

Purpose This study aims to report the clinical features of an infant with CGL in a Chinese Zhuang ethnic family, whose family members were discovered to carry new pathogenic mutations in the BSCL2. Patients and methods In this study, we report clinical and molecular investigations of CGL disease in a family of 4 members (parents and two sons). We used whole exome sequencing (WES) in the family to examine the genetic cause of the disease. Results The proband presented with skin pigmentation, hypertriglyceridemia and diabetes. WES identified a previously unreported compound heterozygous mutation in the BSCL2 (c.545_546insCCG heterozygous mutation and exon 3 heterozygous deletion) in the proband. His mother is a heterozygous carrier of the c.545_546insCCG mutation and his father and brother are carriers of the exon 3 heterozygous deletion. Conclusion Compound heterozygous mutation of the BSCL2 (new c.545_546insCCG heterozygous mutation and new exon 3 heterozygous deletion) was detected in the proband with characteristic clinical manifestations of CGL2.

An overreliance on commercial, kit-based RNA extraction in the molecular diagnoses of infectious disease presents a challenge in the event of supply chain disruptions and can potentially hinder testing capacity in times of need. In this study, we adapted a well-established, robust TRIzol-based RNA extraction protocol into a high-throughput format through miniaturization and automation. The workflow was validated by RT-qPCR assay for SARS-CoV-2 detection to illustrate its scalability without interference to downstream diagnostic sensitivity and accuracy. This semi-automated, kit-free approach offers a versatile alternative to prevailing integrated solid-phase RNA extraction proprietary systems, with the added advantage of improved cost-effectiveness for high volume acquisition of quality RNA whether for use in clinical diagnoses or for diverse molecular applications.

Transition metal-doped Sb2Se3 has become a heated topic caused by the strong nonlinear optical response and the ultrafast response time at high laser excitation. In this paper, the Co-doped Sb2Se3 with different doping amount (0.5, 1.0, and 1.5 W) nanofilms were prepared by magnetron sputtering technology, and the nonlinear behavior of Co-doped Sb2Se3 nanofilms at near infrared were systematically studied. The results of the femtosecond Z-Scan experiment indicate that the Co-doped Sb2Se3 nanofilms exhibit broadband nonlinear response properties owing to the free carrier absorption, the Kerr refraction, the two-photon absorption, and the free carrier refraction. The nonlinear absorption coefficients of Co-doped Sb2Se3 nanofilms are from 3.0 × 10−9 to 2.03 × 10−8 m/ W under excitation at 800, 980, and 1,030 nm, and the nonlinear refractive index of the Co-doped Sb2Se3 nanofilms is from 4.0 × 10−16 to -3.89 × 10−15 m2/ W at 800, 980, and 1,030 nm. More importantly, Co-doped Sb2Se3 (1.5 W) nanofilm exhibits ultrafast carrier absorption ( 6.3. The Co-doping content can controllably tune the crystalline degree, the ultrafast carrier absorption, the intensity of the reverse saturation absorption, the broadband nonlinear optical response, and the carrier relaxation time of Co-doped Sb2Se3 nanofilms. These results are sufficient to support their applications in broadband nonlinear photonic devices.

Graphene/MoS2/Ag thin films were successfully prepared by the magnetron sputtering technique and liquid phase exfoliation. Structure, morphology, optical properties, and nonlinear optical characteristics of the graphene/MoS2/Ag and graphene/MoS2 thin films were studied by X-ray diffractometer, spectrophotometer, field-scanning electron microscope, and femtosecond (fs) Z-scan technique. The results of the fs Z-scan experiment indicate that the graphene/MoS2/Ag thin films exhibit reverse saturable absorption properties due to the free carrier absorption and two-photon absorption. More importantly, with the increase of DC magnetron sputtering power (from 5 to 15 W), the local surface plasmon resonance effect of the Ag thin films increases, which leads to the enhancement of nonlinear optical properties of the graphene/MoS2/Ag thin films. The nonlinear absorption coefficients of the graphene/MoS2/Ag thin films are increased from 1.14 × 10–10 to 1.8 × 10–10 m/W at 800 nm and from 4.79 × 10–11 to 6.79 × 10–11 m/W at 1,030 nm, and the nonlinear refraction index of the graphene/MoS2/Ag thin films is -4.37 × 10–17∼−4.18 × 10–16 m2/W under the excitation of 800 and 1,030 nm, respectively. Moreover, when the graphene/MoS2/Ag thin films were excited at 800 and 1,030 nm, respectively, the nonlinear figure of merit values of the graphene/MoS2/Ag thin films are increased from 1.23 to 2.91 and from 1.30 to 1.47, which are enough to support the application of the graphene/MoS2/Ag thin films in the field of all-optical switching applications.

Background:. Facial thread lifting technology has been applied for more than 30 years, with relatively few complications. In 2014, China approved polydioxanone thread (an absorbable barbed thread) for large-scale nonsurgical facial lifting. However, due to surgeons’ lack of overall experience, the complications of polydioxanone thread facelift have been relatively high. Methods:. From April 2014 to January 2020, a total of 190 patients with postoperative complications of facelifts were treated after they underwent thread lifting in other hospitals. Of these, 189 patients were women and one was a man; the age of patients ranged from 28 to 62 years, with an average age of 37.4 years. Results:. Patients were mainly treated in our outpatient clinic for the following complications: skin dimpling (77 cases, 40.5%); contour irregularity (32 cases, 16.8%); visible threads (31 cases, 16.3%); thread extrusion (10 cases, 5.3%); infection (17 cases, 8.9%); swelling (nine cases, 4.7%); incomplete facial paralysis (five cases, 2.6%); hyperpigmentation (four cases, 2.1%); hematoma (four cases, 2.1%); allergy (one case, 0.05%). Follow-up was scheduled 1–24 weeks after treatment. Conclusions:. The most common complications of facial thread lifting are, in the following order, skin dimpling, contour irregularity, visible threads, and thread extrusion. The reasons for complications are mainly unfamiliarity with facial anatomy, unskilled surgical operation, and misunderstanding of the facial aesthetics of Asian women.

Potent, cell-permeable, and subtype-selective sialyltransferase inhibitors represent an attractive family of substances that can potentially be used for the clinical treatment of cancer metastasis. These substances operate by specifically inhibiting sialyltransferase-mediated hypersialylation of cell surface glycoproteins or glycolipids, which then blocks the sialic acid recognition pathway and leads to deterioration of cell motility and invasion. A vast amount of evidence for the in vitro and in vivo effects of sialyltransferase inhibition or knockdown on tumor progression and tumor cell metastasis or colonization has been accumulated over the past decades. In this regard, this review comprehensively discusses the results of studies that have led to the recent discovery and development of sialyltransferase inhibitors, their potential biomedical applications in the treatment of cancer metastasis, and their current limitations and future opportunities.

To develop a noninvasive model to predict significant fibrosis in children with chronic hepatitis B (CHB). A total of 116 CHB pediatric patients who underwent liver biopsy were included in the study. Liver histology, which is the gold standard for assessing fibrosis, was performed. Blood routine examination, coagulation function, liver biochemistry, viral serology, and viral load were analyzed. Receiver operating characteristic curve analysis was used to analyze the sensitivity and specificity of all possible cut-off values. Based on the correlation and difference analyses, 7 available clinical parameters (total bile acid, gamma-glutamyl transpeptidase [GGT], aspartate transaminase, direct bilirubin to total bilirubin ratio, alanine aminotransferase, prealbumin [PA], and cholinesterase) were included in the modeling analysis. A model to predict significant liver fibrosis was derived using the 2 best parameters (PA and GGT). The original model was Y=−1.803 ln PA(mg/L)+0.769lnGGT(U/L)+6.436. After the mathematical calculation, the G index=600 × GGT/PA2 predicted significant fibrosis, with an area under the receiving operating characteristics (AUROC) curve of 0.733, 95% confidence interval (0.643–0.811). The AUROC of the G index (0.733) was higher than that of aminotransferase to platelet ratio index (APRI) (0.680) and Fibrosis index based on 4 factors (FIB-4) (0.601) in predicting significant fibrosis in children with CHB. If the values of the G index were outside the range of 0.28 to 1.16, 52% of children with CHB could avoid liver biopsy, with an overall accuracy of 75%. The G index can predict and exclude significant fibrosis in children with CHB, and it may reduce the need for liver biopsy in children with CHB.

The application of artificial intelligence (AI) to health has increased, including to COVID-19. This study aimed to provide a clear overview of COVID-19-related AI publication trends using longitudinal bibliometric analysis. A systematic literature search was conducted on the Web of Science for English language peer-reviewed articles related to AI application to COVID-19. A search strategy was developed to collect relevant articles and extracted bibliographic information (e.g., country, research area, sources, and author). VOSviewer (Leiden University) and Bibliometrix (R package) were used to visualize the co-occurrence networks of authors, sources, countries, institutions, global collaborations, citations, co-citations, and keywords. We included 729 research articles on the application of AI to COVID-19 published between 2020 and 2021. PLOS One (33/729, 4.52%), Chaos Solution Fractals (29/729, 3.97%), and Journal of Medical Internet Research (29/729, 3.97%) were the most common journals publishing these articles. The Republic of China (190/729, 26.06%), the USA (173/729, 23.73%), and India (92/729, 12.62%) were the most prolific countries of origin. The Huazhong University of Science and Technology, Wuhan University, and the Chinese Academy of Sciences were the most productive institutions. This is the first study to show a comprehensive picture of the global efforts to address COVID-19 using AI. The findings of this study also provide insights and research directions for academic researchers, policymakers, and healthcare practitioners who wish to collaborate in these domains in the future.

Subchondral bone lesions, as the crucial inducement for accelerating cartilage degeneration, have been considered as the initiating factor and the potential therapeutic target of knee osteoarthritis (KOA). Acupotomy, the biomechanical therapy guided by traditional Chinese meridians theory, alleviates cartilage deterioration by correcting abnormal mechanics. Whether this mechanical effect of acupotomy inhibits KOA subchondral bone lesions is indistinct. This study aimed to investigate the effects of acupotomy on inhibiting subchondral bone resorption and to define the possible mechanism in immobilization-induced KOA rabbits. After KOA modeling, 8 groups of rabbits (4w/6w acupotomy, 4w/6w electroacupuncture, 4w/6w model, and 4w/6w control groups) received the indicated intervention for 3 weeks. Histological and bone histomorphometry analyses revealed that acupotomy prevented both cartilage surface erosion and subchondral bone loss. Further, acupotomy suppressed osteoclast activity and enhanced osteoblast activity in KOA subchondral bone, showing a significantly decreased expression of tartrate-resistant acid phosphatase (TRAP), matrix metalloproteinases-9 (MMP-9), and cathepsin K (Ctsk) and a significantly increased expression of osteocalcin (OCN); this regulation may be mediated by blocking the decrease in osteoprotegerin (OPG) and the increase in NF- κ B receptor activated protein ligand (RANKL). These findings indicated that acupotomy inhibited osteoclast activity and promoted osteoblast activity to ameliorate hyperactive subchondral bone resorption and cartilage degeneration in immobilization-induced KOA rabbits, which may be mediated by the OPG/RANKL signaling pathway. Taken together, our results indicate that acupotomy may have therapeutic potential in KOA by restoring the balance between bone formation and bone resorption to attenuate subchondral bone lesions.

Several electromagnetic bandgap (EBG) structures have been designed to mitigate simultaneous switching noise (SSN) problems in dual bands in wireless local area networks (WLANs). In order to be applicable to two-layer printed circuit boards (PCBs), a novel flipped structure is introduced, which also creates slots for a wide stopband. This article proposes a $2 \times 2$ nonperiodic flipped-EBG (FEBG) for dual-band SSN mitigation in the WLAN, exhibiting noise suppression of 21 and 26 dB in 2.4–2.6 and 5–6 GHz bands, respectively. The simulation results are in good agreement with the experimental data. In addition, a method of positioning optimization is introduced as well to demonstrate the application of the FEBG on a two-layer PCB.

The solid-state incandescent light emitting device (SSI-LED) emits the broadband warm white light [1-5]. The light emission principle is the thermal excitation of the nano-resistors formed from the dielectric breakdown of a MOS capacitor with a nm-thick high-k gate dielectric layer [5]. Besides the light emission, the nano-resistor device shows the diode-like characteristics, i.e., current flow in one direction but not the other direction [1]. Since the nano-sized structures are easily subject to the environmental effect, e.g., oxidation in air [6,7], it is important to understand how the temperature and high humidity affect the electric resistance of the nano-resistors in the SSI-LED. MOS capacitors of 50 μm, 100 μm, 200 μm, 300 μm, and 400 μm diameters were fabricated on a pre-cleaned p-type (10-5 cm-3) (100) Si wafer. Each capacitor contains 1) a 9 nm thick zirconium-doped hafnium oxide (ZrHfO) high-k gate dielectric (including the interface layer with Si), 2) an 80 nm thick ITO gate electrode, and 3) a Mo back side contact layer. Nano-resistors, as shown in Figure 1, were formed after the gate dielectric was broken. The current density vs. voltage (J-V) curve of the nano-resistor device was measured between Vg = 0 V and -20 V at room temperature, 50˚C, 80˚C, 100˚C, and 120˚C. The resistance was extracted from the linear portion of the curve, i.e., between -10 V and -18 V. Then, the sample was loaded in an environmental chamber (Associated Environment System BHD-403 7136) under relative humidity 80% at 80 ̊C for 1 hour. The J-V curve was measured in air at room temperature. Figure 2 shows resistances of various sized nano-resistor devices at 50ºC, 80ºC, 100ºC, and 120ºC. With the increase of temperature, the resistance increases. Since the resistance is contributed by elements in the current path, i.e., the ITO gate electrode, nano-resistors, interfaces, and the Si wafer, each of which can affect the result. Although the Mo resistance is affected by the temperature [8], the value is much smaller than that of the nano-resistor device in Fig. 2. The resistance of the p-type Si (1015 cm3) changes little in the room temperature to 120ºC range [9]. The resistance of ITO also remains in the same temperature range [10]. Therefore, the temperature effect must be contributed by nano-resistors and interfaces. Figure 3 shows the size effect on the resistance after the 80% humidity and 80℃ annealing. The resistance decreases nonlinearly with the increase of the diameter. Assuming that all nano-resistors are of the same dimension and evenly distributed underneath the gate electrode of area, the resistance vs. device size relationship should follow the Pouillet’s law of R = ρ⋅L/A [1] where R is the resistance, ρ is the resistivity, L is the length, and A is the cross-sectional area. The prediction curve in Fig. 3 was calculated based on the resistance of a 400 µm diameter device. It deviates from the measured data especially in the small diameter range. It was reported that the density of nano-resistors near the edge of the gate is larger than that in the center region [1]. As the device diameter is reduced, the area ratio of the edge region to the total gate electrode increases. Therefore, the density of the nano-resistors increases with the shrinking of the device size, which results in the reduction of the resistance. Also, nano-resistors near the gate electrode edge may be of different sizes from those away from the edge. Moe detailed discuss of the environmental effect will be presented. Lingguang Liu acknowledges the financial support of National Natural Science Foundation of China (Grant Number 61771382) and the Shaanxi International Science and Technology Cooperation and Exchange program (2018KW-034). [1] Y. Kuo and C.-C. Lin, Appl. Phys. Lett., 102, 031117 (2013). [2] Y. Kuo and C.-C. Lin, ECS. Solid-State Lett., 2, Q59 (2013). [3] Y. Kuo and C.-C. Lin, Solid-State Electron., 89, 120 (2013). [4] C.-C. Lin and Y. Kuo, J. Vac. Sci. Technol. B, 32, 011208 (2014). [5] C.-C. Lin and Y. Kuo, ECS J. Solid State Sci. Technol., 3, Q182 (2014). [6] H. Matsubara, T. Sasada, M. Takenaka and S. Takagi, Appl. Phys. Lett., 93, 032104 (2008). [7] S. A. Moiz, M. M. Ahmed and K. S. Karimov, Jpn. J. Appl. Phys., 44, 1199 (2005). [8] R. A. Holmwood and R. Glang, J. Chem. Eng. Data, 10, 162 (1965). [9] W. D. Callister and D. G. Rethwisch, Mat. Sci. Eng.: an introduction, Wiley & Sons New York (2007). [10] Z. Ovadyahu, B. Ovryn and H. Kraner, J. Electrochem. Soc., 130, 917 (1983). Figure 1

Background To date, there are just several studies comparing distal locked nails with distal unlocked nails in treating intertrochanteric fractures. We report the first meta-analysis about this issue. Methods Systematic search was conducted for studies in PubMed, Embase and Cochrane Library. Meta-analyses were performed regarding intra operative outcomes, complications and functional outcomes. Results Pooled results showed insignificant difference between distal locking group and distal unlocking group in hip pain (relative risk (RR) 1.14, 95% confidence interval (CI) 0.59-2.19), distal tip fracture (RR 1.08, 95% CI 0.37-3.11), lag screw cut-out (RR 1.60, 95% CI 0.54-4.78), delayed or nonunion (RR 1.32, 95% CI 0.25-7.06), deep vein thrombosis (RR 1.06, 95% CI 0.23-4.84), wound infection (RR 0.58, 95% CI 0.28-1.22), Harris hip score (standard mean deviation (SMD) 0.03, 95% CI -0.15 to 0.21) and walking ability. However, significant difference was detected in operation time (SMD 0.77, 95% CI 0.36-1.17), fluoroscopy exposure time (SMD 1.02, 95% CI 0.52-1.52), blood loss (SMD 0.80, 95% CI 0.62-0.99) and total incision length (SMD 1.16, 95% CI 0.86-1.47). Result of trial sequential analysis indicated conclusive evidence. Conclusion Current evidence indicates that the distal locked intramedullary nails should not be recommended as routine choice for stable intertrochanteric fractures.

One of the most intricate optimisation problems in power systems is generation scheduling. It determines the schedule and dispatch of electrical power generation to meet the load demand under various technical and operating constraints. Generation scheduling is a vivid problem, particularly in recent years, due to the aggressive integration of renewable energy, with stochastic nature, into power grids. As the literature size has swollen substantially in the past several years, this study critically looks into uncertainty modelling and the formulation of various techniques that were implemented in stochastic optimisation-based generation scheduling. The strengths and weaknesses of existing methods are fully exposed. Market operation policies that significantly affect the scheduling of renewable energy generation in different timescales are elaborated. Potential applications and future trends in terms of modelling, computational performance, and incorporation of flexibility and resilience notions are thoroughly discussed.

Prompt and effective treatment of maternal depression during pregnancy is important as it is an independent predictor of negative maternal and fetal outcomes. Yoga is an increasingly popular non-pharmacological modality. This study thus aimed to undertake a meta-analysis of the efficacy of yoga-based interventions for maternal depression during pregnancy. A total of 8 clinical studies were systematically reviewed, and 6 studies with a total of 405 pregnant mothers were included in the final meta-analysis. Applying per-protocol analysis and a random-effects model, the pooled standardized mean difference (SMD) from baseline depressive score was −0.452 (95% CI: −0.816 to −0.880, P = 0.015), supporting a statistically significant beneficial effect of yoga-based interventions on mood. Overall, yoga-based interventions are a promising non-pharmacological option, however, most trials examined were preliminary, recruited only participants with mild depression, did not blind study participants and had relatively small sample sizes. Larger randomized, controlled trials should be encouraged.

Background The development of telecommunication has strongly affected comprehensive scientific disciplines, including medical sciences. Objective This study aims to assess the patient satisfaction of the teleconsultation system used for the consultation of dermatological follow-up care. Methods The study was performed cross sectional patient satisfaction survey method conducted between February and April 2017 to determine patient satisfaction using MedX teleconsultation system. The patient sample of the current study was recruited from cosmetic laser clinic, Wanfang and Taipei Medical University hospital. The study was performed on 32 patient (n = 32) participants. All of them were at least university graduate. Consultants and patients were handled using the Android-based MedX mobile application, which is available through an application for Google Android cellular telephones. Its application consists of a demographic information, structured step-by-step questionnaire, essential medical information about each patient, and digital images of skin lesions. Results 28 patients completed the questionnaire. The mean ± SD age of the patients was 27.25 ± 4.039 years; 78.6% were women. The study shows that respondents have reported a high level (85.8%) of mean overall satisfaction for the teleconsultation service. The usability of the system has highest satisfaction rate of 90.5% among the other subscales especially in terms of data transfer and data displayed. Responses of the patient satisfaction questionnaire were analyzed by age and gender, no statistically significant difference between the variables was found. Conclusion Patients have shown high satisfaction with teleconsultation service and it is well accepted in the management of cosmetic dermatology service. In the future, MedX application can be integrated into other instant messaging applications such as Line, thus allowing doctors and patients to easily communicate with each other.

The number of migrant workers in Taiwan increases annually. The majority is from Indonesia and most of them are female caregivers. This study aims to determine the access to health services and the associated factors among Indonesian female domestic workers in Taiwan. In this cross-sectional study, data were collected from February to May 2019, using a structured questionnaire. Subsequently, multiple logistic regression was used to examine the association between socio-demographic factors and health service access. Two hundred and eighty-four domestic migrant workers were interviewed. Eighty-five percent of the respondents declared sickness at work, but only 48.8% seek health care services. Factors associated with health service access were marital status, income, and the availability of an attendant to accompany the migrant workers to the healthcare facilities. Language barrier and time flexibility were the main obstacles. Further research and an effective health service policy are needed for the domestic migrant workers to better access health care services.

Background Healthcare workers are usually the first responders during outbreaks and are instrumental in educating the populace about the prevention of different diseases and illnesses. The aim of this study was to assess the association between healthcare workers’ characteristics and knowledge, attitudes and practices toward Zika virus. Methods This was a cross-sectional study that collected data from healthcare workers at 3 medical facilities using a validated self-administered questionnaire between July 2017 – September 2017. Logistic regression models were used to examine the association between sociodemographic and knowledge, attitudes, and practices. Results A total of 190 healthcare workers were analyzed. Of these, 60, 72.6 and 64.7% had good knowledge, positive attitudes, and good practices toward Zika virus, respectively. Healthcare workers without a formal degree were less likely to have good knowledge of Zika virus (adjusted odds ratio (AOR) = 0:49; 95% confidence interval (CI) = 0.24–0.99) compared to those with a formal degree. Reduced odds for positive attitude towards Zika virus were observed in healthcare workers with low income as compared to those with high income (AOR = 0.31; 95% CI =0.13–0.75). Being younger than 40 years old was associated with poor Zika virus practices (AOR = 0:34; 95% CI = 0.15–0.79). Conclusions Significant association between healthcare workers’ sociodemographic characteristics and Zika virus knowledge, attitudes and practices were observed. Public health interventions that seek to increase Zika virus awareness should aim to train healthcare workers who are younger, without formal degree and those earning low income.

Synthetic biology research and technology translation has garnered increasing interest from the governments and private investors in Asia, where the technology has great potential in driving a sustainable bio-based economy. This Perspective reviews the latest developments in the key enabling technologies of synthetic biology and its application in bio-manufacturing, medicine, food and agriculture in Asia. Asia-centric strengths in synthetic biology to grow the bio-based economy, such as advances in genome editing and the presence of biofoundries combined with the availability of natural resources and vast markets, are also highlighted. The potential barriers to the sustainable development of the field, including inadequate infrastructure and policies, with suggestions to overcome these by building public-private partnerships, more effective multi-lateral collaborations and well-developed governance framework, are presented. Finally, the roles of technology, education and regulation in mitigating potential biosecurity risks are examined. Through these discussions, stakeholders from different groups, including academia, industry and government, are expectantly better positioned to contribute towards the establishment of innovation and bio-economy hubs in Asia.

Coronavirus disease 2019 (COVID-19) has already raised serious concern globally as the number of confirmed or suspected cases have increased rapidly. Epidemiological studies reported that obesity is associated with a higher rate of mortality in patients with COVID-19. Yet, to our knowledge, there is no comprehensive systematic review and meta-analysis to assess the effects of obesity and mortality among patients with COVID-19. We, therefore, aimed to evaluate the effect of obesity, associated comorbidities, and other factors on the risk of death due to COVID-19. We did a systematic search on PubMed, EMBASE, Google Scholar, Web of Science, and Scopus between January 1, 2020, and August 30, 2020. We followed Cochrane Guidelines to find relevant articles, and two reviewers extracted data from retrieved articles. Disagreement during those stages was resolved by discussion with the main investigator. The random-effects model was used to calculate effect sizes. We included 17 articles with a total of 543,399 patients. Obesity was significantly associated with an increased risk of mortality among patients with COVID-19 (RRadjust: 1.42 (95%CI: 1.24–1.63, p < 0.001). The pooled risk ratio for class I, class II, and class III obesity were 1.27 (95%CI: 1.05–1.54, p = 0.01), 1.56 (95%CI: 1.11–2.19, p < 0.01), and 1.92 (95%CI: 1.50–2.47, p < 0.001), respectively). In subgroup analysis, the pooled risk ratio for the patients with stroke, CPOD, CKD, and diabetes were 1.80 (95%CI: 0.89–3.64, p = 0.10), 1.57 (95%CI: 1.57–1.91, p < 0.001), 1.34 (95%CI: 1.18–1.52, p < 0.001), and 1.19 (1.07–1.32, p = 0.001), respectively. However, patients with obesity who were more than 65 years had a higher risk of mortality (RR: 2.54; 95%CI: 1.62–3.67, p < 0.001). Our study showed that obesity was associated with an increased risk of death from COVID-19, particularly in patients aged more than 65 years. Physicians should aware of these risk factors when dealing with patients with COVID-19 and take early treatment intervention to reduce the mortality of COVID-19 patients.

Background: Glioma one of the most frequently occurring and lethal primary malignant tumors in adults. Micro (mi)RNAs) are a newly identified modulator involved in the occurrence and progression of glioblastoma multiforme (GBM). Previous studies found that miR-548ac had a role in suppressing laryngeal and breast cancer. This study investigated the role of mir-548ac in glioma progression.Methods: The function of miR-548ac was studied by stable knockdown or overexpression of miR-548ac in GBM cells. Luciferase reporter constructs were used to investigate the correlation between Wnt5a and miR-548ac. Cell Counting Kit-8, Transwell, and colony formation assays were used to investigate Wnt5a and miR-548ac activity in glioma cells. Flow cytometry was used to describe the cell cycle. Xenograft experiments were used to evaluate tumor growth and metastasis in vivo. Western blotting was used to assess the function of the Wnt/β-catenin pathway.Results: Downregulation of miR-548ac promoted cell proliferation, migration, and invasion during GBM progression. Silencing of miR-548ac promoted expression of Wnt5a, a direct target of miR-548ac, which plays an oncogenic role in glioblastoma stem cells. Inhibiting the expression of Wat5a partially rescued the consequences of increased cell proliferation, migration, and invasion caused by miR-548ac. Tumor growth was suppressed by Wnt5a knockdown in vivo.Conclusions: miR-548ac suppressed GBM progression by targeting Wnt5a. The miR-548ac/Wnt5a axis may be a new potential strategy for glioma therapy.

Background High quality lymph node (LN) yield could increase survival, however strategies to improve LN yield have been seldom reported. This study aimed to assess the multiple-step action to promote quality of neck dissection in oral cancer. Methods A total of 400 patients with oral cancer who underwent primary tumor resection and neck dissection, including elective and radical neck dissection, were recruited after propensity score matching by clinical T and N categories between January 2009 and September 2018. Patients were treated by two independent departments in our institute. A multiple-step action was initiated in October 2015 in one department, and another department was as a control group. The impact of multiple-step action on LN yield and regional recurrence were analyzed using multivariate analysis and difference-in-differences (DID) linear regression analysis. Results The mean patient age was 55.2 + 11.1 years, and 92% were male. A total of 180 (45%) patients had T3-4 disease, and 129 (32%) patients had N2-3 disease. The multivariate linear regression and DID analyses revealed that multiple-step action had a positive effect on LN yield. A net improvement of LN yield with a coefficient of 13.78 (p p = 0.072) through DID analysis was noted. Conclusions Multiple-step action was associated with increased LN yield and decreased regional recurrence in patients with oral cancer. The observed activity may promote surgeons to improve the quality of neck dissections, is feasible, and could be applied to a widespread patient population.

Alcohol-associated liver disease (ALD) is a liver system disease caused by alcohol abuse, and it involves complex processes ranging from steatosis to fibrosis, cirrhosis and hepatocellular carcinoma. Steatosis and inflammation are the main phenomena involved in ALD. Ubiquitin-specific protease 22 (USP22) plays an important role in liver steatosis; however, its functional contribution to ALD remains unclear. USP22-silenced mice were fed a Lieber-DeCarli liquid diet. AML-12 and HEK293T cells were used to detect the interaction between USP22 and BRD4. Here, we report that hepatic USP22 expression was dramatically upregulated in mice with ALD. Inflammation and steatosis were significantly ameliorated following USP22 silencing in vivo, as indicated by decreased IL-6 and IL-1β levels. We further showed that the overexpression of USP22 increased inflammation, while knocking down BRD4 suppressed the inflammatory response in AML-12 cells. Notably, USP22 functioned as a BRD4 deubiquitinase to facilitate BRD4 inflammatory functions. More importantly, the expression levels of USP22 and BRD4 in patients with ALD were significantly increased. In conclusion, USP22 acts a key pathogenic factor in ALD by deubiquitinating BRD4, which facilitates the inflammatory response and aggravates ALD.

Fine-grained images classification aims to analyze visual objects from subordinate categories, e.g., models of cars or species of dogs, which is challenging due to the small inter-class variations and the large intra-class variations. Recent research has focused on extracting distinguishable local features via part-based model or attention networks to locate discriminative regions/parts, which highly relies on the part annotation, incurs high background noise and ignores the semantic information during the learning. In this paper, we present a fine-grained image classification model, RPN-SCA-BCNN (RSCAB), based on target acquisition and feature fusion. In RSCAB, we first adopt a new Soft-NMS enhanced Region Proposal Network (RPN) for weak supervised object detection to separate the distinguishable object and its background to remove the background noise and costly annotation requirement. Then, we provide a new attention mechanism Spatial-Channel Attention (SCA) to focus on the spatial discriminative parts of the image to reduce the feature redundancy. Based on SCA, we further construct a Bilinear Convolutional Neural Network (BCNN) to fuse the high and low dimensional features by leveraging two networks obtaining more abundant multi-dimensional attention features for classification. The experimental results show that the proposed RSCAB model achieves higher classification accuracy over the state-of-the-art algorithms.

This paper proposes a design of 2 × 1 printed monopole antenna array for 5G C-Band (3.3 — 4.2 GHz) applications. The size of the printed monopole antenna array is 95 × 47.5 × 0.8 mm3, which is fabricated on an FR4 substrate of permittivity of 4.4, and loss tangent of 0.0245. Also a 5 × 3 H-type EBG is integrated to the antenna array placed at 8 mm below, and the size of single H-type EBG is 20 × 20 × 1.6 mm3, which is also implemented on FR4 substrate. The simulated antenna gain of 2 × 1 printed monopole array can be achieved to 12.8 dBi by integrating the H-type EBG. Compared with the original 2 × 1 printed monopole antenna array, the gain can be improved by 8.8 dBi.

Background and Objective: Coronavirus disease 2019 (COVID-19) characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created serious concerns about its potential adverse effects. There are limited data on clinical, radiological, and neonatal outcomes of pregnant women with COVID-19 pneumonia. This study aimed to assess clinical manifestations and neonatal outcomes of pregnant women with COVID-19.Methods: We conducted a systematic article search of PubMed, EMBASE, Scopus, Google Scholar, and Web of Science for studies that discussed pregnant patients with confirmed COVID-19 between January 1, 2020, and April 20, 2020, with no restriction on language. Articles were independently evaluated by two expert authors. We included all retrospective studies that reported the clinical features and outcomes of pregnant patients with COVID-19.Results: Forty-seven articles were assessed for eligibility; 13 articles met the inclusion criteria for the systematic review. Data is reported for 235 pregnant women with COVID-19. The age range of patients was 25–40 years, and the gestational age ranged from 8 to 40 weeks plus 6 days. Clinical characteristics were fever [138/235 (58.72%)], cough [111/235 (47.23%)], and sore throat [21/235 (8.93%)]. One hundred fifty six out of 235 (66.38%) pregnant women had cesarean section, and 79 (33.62%) had a vaginal delivery. All the patients showed lung abnormalities in CT scan images, and none of the patients died. Neutrophil cell count, C-reactive protein (CRP) concentration, ALT, and AST were increased but lymphocyte count and albumin levels were decreased. Amniotic fluid, neonatal throat swab, and breastmilk samples were taken to test for SARS-CoV-2 but all found negativ results. Recent published evidence showed the possibility of vertical transmission up to 30%, and neonatal death up to 2.5%. Pre-eclampsia, fetal distress, PROM, pre-mature delivery were the major complications of pregnant women with COVID-19.Conclusions: Our study findings show that the clinical, laboratory and radiological characteristics of pregnant women with COVID-19 were similar to those of the general populations. The possibility of vertical transmission cannot be ignored but C-section should not be routinely recommended anymore according to latest evidences and, in any case, decisions should be taken after proper discussion with the family. Future studies are needed to confirm or refute these findings with a larger number of sample sizes and a long-term follow-up period.

The current COVID-19 pandemic is probably the worst the world has ever faced since the start of the new millennium. Although the respiratory system is the most prominent target of SARS-CoV-2 (the contagion of COVID-19), extrapulmonary involvement are emerging as important contributors of its morbidity and lethality. This article summarizes the impact of SARS-CoV and SARS-CoV-2 on the endocrine system to facilitate our understanding of the nature of coronavirus-associated endocrinopathy. Although new data are rapidly accumulating on this novel infection, many of the endocrine manifestations of COVID-19 remain incompletely elucidated. We, hereby, summarize various endocrine dysfunctions including coronavirus-induced new onset diabetes mellitus, hypocortisolism, thyroid hormone, and reproductive system aberrations so that clinicians armed with such insights can potentially benefit patients with COVID-19 at the bedside.

Background: The pathophysiologic changes during critical illness and high minimal inhibitory concentration (MIC) pathogens are important risk factors of mortality and bacterial eradication in critical care. Beta-lactam antibiotics have a time-dependent effect on bactericidal activity. The continuous infusion (CIF) of beta-lactam antibiotics achieves sufficient drug concentration above the MIC, especially for critically ill patients. However, the superiority of CIF over intermittent infusion (IIF) of beta-lactam antibiotics is yet to be clearly established. Thus, we aimed to investigate the effects on mortality of CIF of beta-lactams antibiotics in comparison to those of IIF of beta-lactams antibiotics in patients with sepsis admitted to the intensive care unit (ICU).Methods: We systematically searched PUBMED, MEDLINE, Cochrane Library, EMBASE, Web of Science, and ICTRP for randomized controlled trials (RCTs) comparing CIF with IIF of beta-lactam antibiotics in critically ill populations. All RCTs published until October 2019 were eligible. The primary outcome measure was the relative risk (RR) of mortality, while the secondary outcome measures were bacterial eradication rate, length of ICU stay, and length of admission. Results: In total, 6 RCTs comprising 974 patients were analyzed. We found a significantly lower mortality for critically ill patients on CIF (RR: 0.79; 95% CI: 0.63, 0.98) compared with those on IIF of beta-lactam antibiotics. The pooled RR for the bacterial eradication rate was 1.16 (95% CI: 1.03, 1.29) for CIF compared with IIF administration. Conclusion: CIF of beta-lactam antibiotics for critically ill patients significantly reduces mortality and yields a better bacterial eradication rate than IIF. These findings support the clinical and bacterial eradication benefits in adult critically ill patients, and may guide clinical discussions and decisions.

Background: To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection.Methods: In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were enrolled between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival(DSS).Results: Of the 1,765 patients identified, 1,108 (62.8%) had oral cancer, 1,141 (64.6%) were men, and 1,067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval[CI], 0.49-0.84) in those with >25 lymph nodes removed (aHR, 0.96; 95% CI, 0.75-1.24). For 5-year DSS, similar effect was observed. The adjusted hazard ratio was 0.66 (95% confidence interval, 0.45-0.97) in those with >25 lymph nodes (aHR, 1.12; 95% CI, 0.81-1.56). Sensitivity testing also showed a robust protective effect of postoperative radiotherapy in patients with Conclusion: Radiotherapy significantly improved survival in patients with pT1-2N1M0 oral and oropharyngeal cancer without adequate neck dissection.

Peer-to-peer (P2P) energy trading allows surplus energy to be traded between distributed energy resources (DER) and prosumers in the community microgrid. In Malaysia, P2P energy trading is still under development, where it is expected to be exclusively participated by commercial and industrial prosumers. This paper proposes how a motivational psychology framework can be used effectively to design P2P energy trading to increase user participation for residential prosumer. All the data such as power consumption and solar energy value are adjusted and modelled in such a way to facilitate the calculation of P2P energy trading in Malaysia. An auction-based P2P market clearing model is then proposed and solved by using the Linear Programming optimization approach. The numerical results show the sustainability and the potential of the proposed P2P energy trading model to attract residential customers to participate in energy trading.

Sorafenib is the standard treatment for advanced hepatocellular carcinoma (HCC) patients. This study aims to determine whether combining radiotherapy with sorafenib administration increases its efficacy. The study cohort included 4763 patients with diagnosed advanced HCC who received sorafenib between January 2012 and December 2015, as reported in medical records in the Taiwan Cancer Registry database. The effect of sorafenib with or without radiotherapy on survival was calculated using the Kaplan–Meier method and compared using the log-rank test. A Cox proportional hazards model was used for multivariate analysis. Patients receiving sorafenib plus radiotherapy had greater 1-year survival than did those receiving sorafenib alone (P

The paper proposes a design of MIMO antennas with broadband effect for laptop computers. The antenna is a use stereoscopic bending-coupled of architecture. The coupled-fed antenna is composed of a grounded inverted L-shaped arm, two short metal arms connected to the feed. The structure of isolation mechanism is a T-type metal strip with multi-arms to reduce the interaction between the two antennas. The overall size of the design is (LxWxH) is 6.2 × 50 × 4.2 mm3. The design antennas and isolation element made of 0.8mm FR-4 substrate is placed on upper left corner of the system ground with a size of (L× W) 200 × 260mm2. From the results, this design of MIMO antennas can be applied to the bands of WLAN2.4/5.2 /5.8GHz (2.4-2.484 GHz, 5.15-5.35 GHz, 5.725-5.825 GHz), and 5G NR SUB-6GHz (3.3- 4.2 GHz, 4.8-5 GHz).

Intestinal myiasis caused by fly larvae parasitic in gastrointestinal tract was rare reported in children. We reported an infant with bloody diarrhea caused by intestinal myiasis. A 1 year and 7 months old boy presented with the only symptom of bloody diarrhea of unknown origin. In the second week of onset, numerous moving worms were observed in the bloody stool after bowel preparation with polyethylene glycol for colonoscopy. The bloody diarrhea disappeared after 1 week of combined therapy with albendazole and metronidazole. On follow-up after 6 months, the patient remained well without bloody diarrhea. In conclusion, intestinal myiasis being a rare disease that is very challenging to diagnose, physicians should remember it when they receive cases of bloody diarrhea with non-specific symptoms without any apparent cause.