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Abstract Sensors with a small footprint and real-time detection capabilities are crucial in robotic surgery and smart wearable equipment. Reducing device footprint while maintaining its high performance is a major challenge and a significant limitation to their development. Here, we proposed a monolithic integrated micro-scale sensor, which can be used for vector force detection. This sensor combines an optical source, four photodetectors, and a hemispherical silicone elastomer component on the same sapphire-based AlGaInP wafer. The chip-scale optical coupling is achieved by employing the laser lift-off techniques and the flip-chip bonding to a processed sapphire substrate. This hemispherical structure device can detect normal and shear forces as low as 1 mN within a measurement range of 0–220 mN for normal force and 0–15 mN for shear force. After packaging, the sensor is capable of detecting forces over a broader range, with measurement capabilities extending up to 10 N for normal forces and 0.2 N for shear forces. It has an accuracy of detecting a minimum normal force of 25 mN and a minimum shear force of 20 mN. Furthermore, this sensor has been validated to have a compact footprint of approximately 1.5 mm2, while maintaining high real-time response. We also demonstrate its promising potential by combining this sensor with fine surface texture perception in the fields of compact medical robot interaction and wearable devices.

Abstract Purpose This study aimed to systematically compare the efficacy and safety of arthroscopic wafer procedure (AWP) versus ulnar shortening osteotomy (USO) for ulnar impaction syndrome (UIS) treatment. Methods All the studies included in this meta-analysis compared the efficacy of AWP to USO for UIS and were acquired through a comprehensive search across multiple databases. The meta-analysis was performed by calculating the effect sizes with the Cochrane Collaboration’s RevMan 5.4 software. Results A total of 8 articles were included in this analysis, comprising 148 cases in the AWP group and 163 cases in the USO group. The pooled estimates indicated no significant differences in combined Darrow’s Criteria or Modified Mayo Wrist Score, Modified Mayo Wrist Score, DASH scores, grip strength, VAS score, and postoperative ulnar variation. On the other hand, the patients in the AWP group exhibited fewer complications (OR = 0.17, 95%CI 0.05–0.54, P = 0.003) and a lower reoperation rate (OR = 0.12, 95%CI 0.05–0.28, P

Tick-borne rickettsial disease (TBRD) is a perilous acute infection that often eludes diagnosis in its early stages. The triad of knowledge, attitudes, and practices (KAPs) among medical professionals is key to reducing missed diagnosis rates. Therefore, a meticulous evaluation of KAPs is imperative. This study aimed to delve into the understanding of TBRD and explore the beliefs and practices related to personal prevention methods among individuals in Lu’an, a hotspot for TBRD. During the summer months of 2023, convenience sampling was employed by circulating a confidential questionnaire to 1,206 participants in the endemic regions of China. This questionnaire painted a comprehensive picture of the participants’ sociodemographic profiles and their KAPs levels vis-à-vis TBRD. The findings revealed that participants scored a mere 55.78% in knowledge, while their attitudes and practices garnered impressive scores of 90.09% and 90.83%, respectively. Upon further analysis using multiple linear regression, several intriguing patterns emerged. Male participants, employed in the Infectious Disease Department, held vice-senior or higher titles, or had prior medical training demonstrated superior knowledge scores. On the other hand, medical personnel who were younger than 30, possessed graduate degrees or higher qualifications, and had training excelled in attitudes and practices. Notably, when employing the Boston Consulting Group (BCG) matrix, a significant distribution of medical personnel was observed across the four quadrants. Specifically, 37.43%, 13.19%, 19.61%, and 29.77% fell into the first, second, third, and fourth quadrants. This survey underscores the commendable attitudes and practices of medical staff towards TBRD in endemic regions of China. However, their knowledge level remains wanting and demands urgent improvement.

Objective: The goal of the research is to investigate the link between serum potassium levels and death after 28 days in sepsis patients, utilizing an extensive sample of patients from the multi-center Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Current research on serum potassium levels and 28-day mortality in sepsis patients is questionable. This study adds to the growing body of evidence linking serum potassium levels to the 28-day possibility of death in patients with sepsis. Methods: We collected 349,08 patients with sepsis from the retrospective cohort MIMIC-IV database, using serum potassium level on the first day of admission to the intensive care unit as the exposure variable and mortality at 28 days as the outcome variable. And controlled for confounding characteristics including gender, age, ethnicity, and vital signs during admission. Results: Serum potassium has a U-shaped connection with 28-day mortality in patients suffering from sepsis. The turning point was 4.10 mmol/L (95 % confidence interval: 4.03 to 4.22). Serum potassium and 28-day mortality were negatively linked on the inflection point’s left side (OR: 0.72; 95 % CI: 0.63 to 0.83, P

AbstractIn this work, Cu (II) ion was chosen as an analyte because it is an important trace element in the human body to maintain organism health. AuNCs (gold nanoclusters) with a mean diameter of ∼2 nm were prepared by a microwave-assisted method, using homocysteine (Hcy) as a reducer and stabilizer. The optimal sample showed a red emission peaking at 624 nm with an emission quantum yield of 17.1%, which was assigned as a ligand to metal nanoparticle core charge transfer (LMNCT). This red emission was effectively quenched by Cu (II) but immune to competing metal cations and anions, showing good selectivity. The quenching mechanism was found as the Cu (II) quenching on the LMNCT procedure to AuNCs. The primary advantage of Hcy-modified AuNCs was the easy and quick synthetic procedure, along with acceptable sensing performance, including good selectivity, linear response, and wide working region.

IntroductionBreast cancer is the most common malignant tumor in women, seriously threatening health and survival. TP-dependent DNA helicase Q1 (RECQL) is a breast cancer susceptibility gene with possible familial links. However, RECQL gene mutations among Chinese women with breast cancer have not been evaluated. Therefore, this study assessed RECQL mutations and their relationships with clinicopathological and epidemiological characteristics in Chinese women with breast cancer.MethodClinical information was also obtained via the hospital information system and a follow-up questionnaire. Peripheral venous blood (2 mL) was extracted from all patients and stored at –80°C for future use; the early venous blood samples were from our hospital’s sample bank. RECQL gene sequencing were performed by the Shanghai Aishe Gene Company (China).ResultsWe found that a RECQL mutation is a susceptibility factor for breast cancer. Moreover, patients with RECQL mutations were more likely to have a family history of breast cancer than those without. Also, patients with RECQL variants of uncertain significance (VUS) were less likely to develop invasive ductal carcinoma than those without. In addition, unexplained RECQL mutations occurred more often in patients with human epidermal growth factor receptor 2+ breast cancer than in those with other subtypes.DiscussionThese results provide a basis for creating screening criteria specific to Chinese women. However, the frequency of RECQL mutations was low, and the number of pathogenic mutations was too small and could not be analyzed. Thus, more extensive, long-term studies that include other functional experiments are needed to verify these results.

Abstract Purpose To explore whether combining the Hounsfield unit (HU) values and vertebral bone quality (VBQ) scores can improve the BMD assessment in patients with lumbar degenerative diseases. Methods The HU values were measured by CT image, and VBQ scores were calculated by lumbar MRI image. The correlations of the opportunistic imaging parameters to the lowest T-scores were analyzed. Receiver-operating characteristic curve (ROC) analysis was used to evaluate the accuracy in detecting osteoporosis. Finally, the specificity and sensitivity of different combined methods of the HU values and VBQ scores in the diagnosis of osteoporosis were compared. Results Patients with osteoporosis had the lowest HU values and the highest VBQ scores. The correlation coefficients between the VBQ scores and the T-scores were smaller than HU values (L1 HU value: 0.702; average HU value:0.700; L1 VBQ score: -0.413; VBQ score: -0.386). The areas under the curve (AUCs) of the HU values were greater than those of the VBQ scores, and the AUCs of the L1 VBQ score were similar to the VBQ score (L1 HU value: 0.850; average HU value:0.857; L1 VBQ score: 0.704; VBQ score: 0.673). When combining the two imaging parameters in series, the specificity of the detection of osteoporosis was improved (L1 HU value and L1 VBQ score: 87.3%; Average HU value and VBQ score: 85.9%). When combining the two imaging parameters in parallel, the sensitivity of the detection of osteoporosis was improved (L1 HU value or L1 VBQ score: 88.1%; Average HU value or VBQ score: 91.5%). Conclusions Combinations of the HU values and VBQ scores could improve the diagnostic performance of osteoporosis. In addition, considering the same diagnostic performance but easier measurement, parameters at the single-segment level were recommended to assist in the diagnosis of osteoporosis.

Miniature loudspeakers exhibit pronounced nonlinear characteristics due to physical size limitations and the demand for sufficient sound pressure. The primary nonlinear properties, including the force factor, mechanical stiffness, and mechanical resistance, depend on the displacement or velocity of the voice coil. The creep effect in the loudspeaker’s suspension system, which significantly affects low-frequency displacement, is often neglected in existing studies on nonlinear dynamics. This study enhances the modeling of miniature loudspeakers by incorporating the creep effect into an extended nonlinear model. The voice coil displacement and total harmonic distortion (THD) predicted by the extended model were validated against experimental data. The displacement and THD values predicted by the nonlinear model in consideration of the creep effect corresponded closely to the actual measurement values, substantiating the effectiveness and precision of the model.

Ferrochelatase (FECH) is the terminal enzyme in human heme biosynthesis, catalyzing the insertion of ferrous iron into protoporphyrin IX (PPIX) to form protoheme IX (Heme). Phosphorylation increases the activity of FECH, and it has been confirmed that the activity of FECH phosphorylated at T116 increases. However, it remains unclear whether the T116 site and other potential phosphorylation modification sites collaboratively regulate the activity of FECH. In this study, we identified a new phosphorylation site, T218, and explored the allosteric effects of unphosphorylated (UP), PT116, PT218, and PT116 + PT218 states on FECH in the presence and absence of substrates (PPIX and Heme) using molecular dynamics (MD) simulations. Binding free energies were evaluated with the MM/PBSA method. Our findings indicate that the PT116 + PT218 state exhibits the lowest binding free energy with PPIX, suggesting the strongest binding affinity. Additionally, this state showed a higher binding free energy with Heme compared to UP, which facilitates Heme release. Moreover, employing multiple analysis methods, including free energy landscape (FEL), principal component analysis (PCA), dynamic cross-correlation matrix (DCCM), and hydrogen bond interaction analysis, we demonstrated that phosphorylation significantly affects the dynamic behavior and binding patterns of substrates to FECH. Insights from this study provide valuable theoretical guidance for treating conditions related to disrupted heme metabolism, such as various porphyrias and iron-related disorders.

One of the limitations of the dung beetle optimization (DBO) is its susceptibility to local optima and its relatively low search accuracy. Several strategies have been utilized to improve the diversity, search precision, and outcomes of the DBO. However, the equilibrium between exploration and exploitation has not been achieved optimally. This paper presents a novel algorithm called the ODBO, which incorporates cat map and an opposition-based learning strategy, which is based on symmetry theory. In addition, in order to enhance the performance of the dung ball rolling phase, this paper combines the global search strategy of the osprey optimization algorithm with the position update strategy of the DBO. Additionally, we enhance the population’s diversity during the foraging phase of the DBO by incorporating vertical and horizontal crossover of individuals. This introduction of asymmetry in the crossover operation increases the exploration capability of the algorithm, allowing it to effectively escape local optima and facilitate global search.

Objective: The concept of “compensatory belief” pertains to an individual's conviction that the negative consequences of a specific behavior can be counteracted by engaging in a subsequent positive behavior. This study sought to devise a scale tailored to gauge compensatory beliefs concerning internet instant gratification behaviors. Methods: Utilizing the Credamo online questionnaire platform, data were amassed from two distinctive cohorts: organizational employees and college students. A collective 1064 responses were amassed. Results: The newly created Compensatory Belief Scale for Internet Instant Gratification Behavior was bifurcated into two versions: one tailored for employees (CBS-IIGB-E) and the other for college students (CBS-IIGB-S). Through an exploratory factor analysis, two factors were discerned, namely “Compensatory Beliefs for Working/Studying '' and “Compensatory Beliefs for Resting”. A confirmatory factor analysis validated this two-factor model with the following metrics for the employee version: SBχ2 = 54.88, df = 32, CFI = 0.974, TLI = 0.964, RMSEA = 0.064, SRMR = 0.047, and for the student version: SBχ2 = 19.26，df = 19，CFI = 0.999，TLI = 0.999，RMSEA = 0.008，SRMR = 0.033. The scores on the Internet Addiction Scale and the Smartphone Addiction Scale showed a positive correlation with the overall scores of the CBS-IIGB-E and the scores of its two factors. Conversely, the scores on the Self-control Scale exhibited a negative correlation with the total scores of the CBS-IIGB-E and the scores of its two factors. The correlation pattern with the criterion scales for the CBS-IIGB-S mirrored that of the CBS-IIGB-E, with the exception that the Self-control Scale only correlated with the two factors and not the overall score of the CBS-IIGB-S. The McDonald's Omega coefficients for the two factors of the CBS-IIGB-E were 0.84 and 0.86 respectively, and those for the CBS-IIGB-S were 0.82 and 0.87 respectively. Both scales demonstrated a test-retest reliability of 0.76. Significant differences in the scale scores across diverse target groups were observed in the simulation game of internet instant gratification behavior, thereby validating the predictive validity of the developed scales. Conclusion: The Compensatory Belief Scale for Internet Instant Gratification Behavior (CBS-IIGB) is a reliable and valid tool for measuring compensatory belief in situations where the allure of immediate internet gratification comes into conflict with long-term objectives, among both organizational employees (CBS-IIGB-E) and college students (CBS-IIGB-S).

Various regions often adopt punish strategies to solve traffic congestion problems. Punishing defectors is an effective strategy to solve the first-order free-rider problem in a public goods game. But this behavior is costly because the punisher is often also involved in the original joint venture and therefore vulnerable, which jeopardizes the effectiveness of this incentive. As an option, we could hire special players whose sole duty would be to monitor the population and punish defectors. The fines collected by various regions will also be used to subsidize the construction of public transportation. Thereby, we derive inspiration, and propose an improved public goods game model based on bonus and mercenary punishment. Research has shown that after cooperator gives the punisher an appropriate bonus, cooperators can strengthen the punisher, thereby weakening the defector's advantage and indirectly promoting cooperation by stabilizing the punisher's position in the system. In addition, the mechanism of reusing the fines collected from defectors and then subsidize to other players in the system can directly promote the emergence of cooperation.

ABSTRACT: Adenovirus serves as an excellent viral vector and is employed in vector vaccine research. Duck hepatitis A virus type 1 (DHAV1) and duck adenovirus type 3 (DAdV3) cause significant economic losses in the Chinese duck industry. In this study, we found an excellent exogenous gene insertion site in DAdV3 genome of CH-GD-12-2014 strain, within 3 intergenic regions (IGR). Subsequently, we generated a recombinant duck adenovirus named rDAdV3-VP1-188, which exhibits excellent replication characteristics and immunogenicity of DAdV3 and DHAV1. Animal experiments showed that rDAdV3-VP1-188 can provide 100% protection against the DAdV3 and 80% protection against DHAV1. These results showed that rDAdV3-VP1-188 could induce protection against DAdV3 and DHAV1 in ducks, thus indicating the feasibility of DAdV3 as a vector for the development of avian vector vaccines. These insights contribute to the further development of DAdV3 vectors and other adenovirus vectors.

BackgroundClonorchiasis, caused by the infection of Clonorchis sinensis (C. sinensis), is a kind of neglected tropical disease, but it is highly related to cholangiocarcinoma. It has been well known that NO from chronic inflammation responses are thought to be a major component of the damage and ultimate carcinogenesis ESPs such as nitric oxide synthase interacting protein (NOSIP) are thought to enhance the damage. The objective of this study was to identify the protein candidates interact with recombinant CsNOSIP (rCsNOSIP) and explore their role involved in CCA development or progression.MethodsWe applied HuProt microarray containing 21,000 probe sets for a systematic identification of rCsNOSIP-binding proteins and grouped binding hits by gene function. Pull-down assays were used to confirm the interaction of rCsNOSIP with alveolar soft part sarcoma (ASPSCR-1) and sirtuins 5 (Sirt-5). ASPSCR-1/Sirt-5 over-expression and siRNA knockdown experiments were employed for obtain of ASPSCR-1/Sirt-5 high or low expression (ASP-oe/Sirt5-oe or ASP-si/Sirt5-si) cholangiocarcinoma cell line (CCLP-1) cells. Nitric oxide (NO) and reactive oxygen species assay (ROS) as well as cell proliferation and wound-healing assays were performed to observe the effect of rCsNOSIP on ASP-oe/Sirt5-oe or ASP-si/Sirt5-si CCLP-1 cells.ResultsSeventy candidate proteins protein "hits" were detected as rCsNOSIP-binding proteins by HuProt microarray and bioinformatics analysis. Pull down assay showed that ASPSCR-1 and Sirt-5 could interact with rCsNOSIP. In addition, endotoxin-free-rCsNOSIP could increase the production of NO and ROS and promote the migration of CCLP-1 cells, while its effect on enhancing cell proliferation was not significant. Furthermore, ROS/NO production, proliferation, or migration were increased in ASP-si or Sirt5-si CCLP-1 cells but decreased in Asp-oe or Sirt5-oe CCLP-1 cells when stimulated with rCsNOSIP.ConclusionsOur findings suggest that CsNOSIP as a component of CsESPs might promote the development and invasion of CCA and Sirt5/ ASPSCR1 as host molecules might play a novel protective role against adverse stimulus during C. sinensis infection. This work supports the idea that CsESPs induce the occurrence and progression of CCA through ROS/RNS-induced oxidative and nitrative DNA damage.

Abstract Background Hidden blood loss (HBL) is of increasing interest to spine surgeons. This retrospective study aimed to evaluate perioperative HBL and its risk factors in patients undergoing one-segment posterior circumferential decompression surgery on thoracic ossification of the posterior longitudinal ligament (T-OPLL). Method We retrospectively studied 112 patients diagnosed with T-OPLL following posterior circumferential decompression surgery from August 2015 to June 2020. Patient demographics, blood loss-related parameters, surgery-related data and imaging parameters were extracted. Postoperative complications were also recorded. Pearson or Spearman correlation analysis was used to investigate the correlation between patient demographics and HBL. Multivariate linear regression analysis was performed to determine the independent risk factors associated with HBL. Results Forty-five men and 67 women were involved in this research, with an average age of 56.4 ± 10.2 years. The mean HBL was 459.6 ± 275.4 ml, accounting for 56.5% of the total blood loss. Multiple linear regression analysis showed that double-layer sign (P = 0.000), ossification occupancy ratio (OOR) > 60% (P = 0.030), age (P = 0.010), hematocrit (Hct) loss (P = 0.034), and postoperative Hct (P = 0.016) were independent risk factors for HBL. However, OPLL morphology (P = 0.319), operation time (P = 0.587), hemoglobin (Hb) loss (P = 0.644), and postoperative Hb (P = 0.952) were not significantly different from HBL. Conclusion A high proportion of HBL was found after posterior circumferential decompression surgery on T-OPLL during the perioperative period, which should not be overlooked. Double-layer sign, OOR > 60%, age, Hct loss and postoperative Hct are independent risk factors for HBL.

Abstract Background CSF-soluble platelet-derived growth factor receptor beta (sPDGFRβ) is closely associated with pericyte damage. However, the changes in CSF sPDGFRβ levels and their role in blood–brain barrier (BBB) leakage at different stages of Alzheimer’s disease (AD), with or without cerebral small vessel disease (CSVD) burden, remain unclear. Methods A total of 158 individuals from the China Aging and Neurodegenerative Disorder Initiative cohort were selected, including 27, 48, and 83 individuals with a clinical dementia rating (CDR) score of 0, 0.5, and 1–2, respectively. CSF total tau, phosphorylated tau181 (p-tau181), Aβ40, and Aβ42 were measured using the Simoa assay. Albumin and CSF sPDGFRβ were measured by commercial assay kits. CSVD burden was assessed by magnetic resonance imaging. Results CSF sPDGFRβ was the highest level in the CDR 0.5 group. CSF sPDGFRβ was significantly correlated with the CSF/serum albumin ratio (Q-alb) in the CDR 0–0.5 group (β = 0.314, p = 0.008) but not in the CDR 1–2 group (β = − 0.117, p = 0.317). In the CDR 0–0.5 group, CSF sPDGFRβ exhibited a significant mediating effect between Aβ42/Aβ40 levels and Q-alb (p = 0.038). Q-alb, rather than CSF sPDGFRβ, showed a significant difference between individuals with or without CSVD burden. Furthermore, in the CDR 0.5 group, CSF sPDGFRβ was higher in subjects with progressive mild cognitive impairment than in those with stable mild cognitive impairment subjects (p < 0.001). Meanwhile, CSF sPDGFRβ was significantly associated with yearly changes in MMSE scores in the CDR 0.5 group (β = − 0.400, p = 0.020) and CDR 0.5 (A+) subgroup (β = − 0.542, p = 0.019). Conclusions We provide evidence that increased CSF sPDGFRβ is associated with BBB leakage in the early cognitive impairment stage of AD, which may contribute to cognitive impairment in AD progression.

Background: Cervical local kyphosis (CLK) is a common degenerative disorder with a potentially debilitating and intractable condition. Currently, there is still debate on the optimal treatment of local kyphotic cervical spondylotic myelopathy (LKCSM) via different anterior approaches. Objective: The objective of this study was to evaluate the surgical efficacy of anterior cervical discectomy and fusion (ACDF) vs. anterior cervical corpectomy and fusion (ACCF) for the treatment of LKCSM. In addition, the cervical sagittal alignment parameters and axial symptoms (AS) severity after CLK correction were analyzed. Materials and methods: From January 2016 and December 2020, 104 patients who suffered LKCSM were retrospectively reviewed. These patients underwent ACDF (n = 53) and ACCF (n = 51). Pre- and postoperatively, cervical sagittal alignment parameters were measured on the lateral X-rays, including local kyphotic angles (LKA), C2-7 Cobb angle, T1 slope, and C2-7 sagittal vertical axis (C2-7 SVA). The neurological recovery rate was calculated according to the Japanese Orthopedic Association (JOA) score. The AS severity was evaluated using Neck Disability Index (NDI). Results: Significant differences (P 0.05) existed in JOA score, recovery rate, and neurological recovery rate grade. In both groups, significant differences (P

Abstract Objective The objective of this study was to explore the morphological characteristics of paraspinal muscles in young patients with unilateral neurological symptoms of lumbar disc herniation. Methods This study retrospectively analyzed young patients aged 18–40 years who were hospitalized for lumbar disc herniation in our hospital from June 2017 to June 2020. Data on sex, age, body mass index (BMI), subcutaneous fat tissue thickness (SFTT) at the L1-L2 level, duration of symptoms, degree of lumbar disc herniation, visual analog scale (VAS) for the lower back, Mo-fi-disc score, relative cross-sectional area (RCAS) of the paravertebral muscles (psoas major [PM], multifidus [MF], and erector spinae [ES]), and degree of fat infiltration (DFF) of the paravertebral muscles were collected. The VAS was used to evaluate the intensity of low back pain. Patients with VAS-back >4 points were defined as the low back pain group, and patients with ≤4 points were defined as the control group. The demographic characteristics, as well as the bilateral and ipsilateral paravertebral muscles, of the two groups were compared and analyzed. Result A total of 129 patients were included in this study (52 patients in the LBP group and 77 patients in the control group). There were no significant differences in sex, BMI, or Pfirrmann grade of lumbar disc herniation between the two groups (P > 0.05). The age of the LBP group (33.58 ± 2.98 years) was greater than that of the control group (24.13 ± 2.15 years) (P = 0.002), and the SFTT at the L1-L2 level (13.5 ± 7.14 mm) was higher than that of the control group (7.75 ± 6.31 mm) (P 0.05). In the control group, the RCSA of the MF muscle on the diseased side was smaller than that on the normal side (P 0.05). At L4/5, the RCSA of the MF muscle on the normal side was significantly smaller in the LBP group than in the control group (P 0.05). Conclusion In young patients with unilateral neurological symptoms of lumbar disc herniation, symmetrical atrophy of the bilateral MF muscle is more prone to causing low back pain. Older age, higher SFTT at the L1-L2 levels, longer symptom duration, higher Mo-fi-di score, and greater muscle atrophy on the normal side of the MF increased the incidence of low back pain in young patients with unilateral lumbar disc herniation.

The behavior of a photovoltaic (PV) system can be derived from its current–voltage characteristics, depending on its unknown circuit model parameters. It is significant to accurately and efficiently extract the parameters of the PV model because of the nonlinear, multivariable, and multimodal characteristics. Many meta-heuristic algorithms have been proposed, in which differential evolution (DE) is known for simple structure, ease of use, and fast convergence. However, the performance of DEs still has room for further improvement because exploration and exploitation are highly coupled during the iterative process for most DE variants. To solve this problem, in this paper, a novel heterogeneous differential evolution algorithm (HDE) is presented to extract the parameters of PV. By proposing a concise heterogeneous mechanism, introducing two new mutation strategies, and establishing an implicit information exchange mechanism, exploration and exploitation processes of the HDE are simultaneously enhanced without one process crippling the other. The efficiency of the HDE has been demonstrated by considering six different PV modules models including the single diode model, the double diode model, the triple diode model, and three different PV modules. The statistical results indicate that the HDE is a representative DE variant in terms of robustness, reliability, solution accuracy, and execution efficiency compared with other 14 state-of-the-art algorithms for the estimation of PV model parameters.

Apples are deeply loved by people because of their rich nutritional value, but they are susceptible to rotting. The use of antagonistic yeast is a promising method for controlling postharvest fruit diseases, but biocontrol efficacy of yeast will be weakened in environmental stress. In this study, the effects of glycine (Gly) on the oxidative stress tolerance and the biocontrol efficacy of Sporidiobolus pararoseus (S. pararoseus) against Aspergillus niger (A. niger) are discussed. Under the stimulation of H2O2, the yeast cells treated with Gly (1 mM) showed lower ROS content, less mitochondrial impairment and cellular oxidative damage, and the cell survival rate was significantly higher than Gly-untreated yeast. The yeast cells exposed to Gly significantly increased the activities of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and the content of glutathione (GSH). Notably, Gly-treated yeast cells had better biocontrol efficacy against A. niger in postharvest apples. The lesion diameter and decay incidence were reduced by 17.67 mm and 79.63% compared to the control, respectively, when S. pararoseus was treated with 1 mM Gly. Moreover, Gly-treated yeast increased the antioxidant enzymes activities and their gene expression were up-regulated in apples. These results indicated that 1 mM Gly not only reduced the oxidative damage of yeast, but also induced resistance-related enzymes of apples under oxidative stress, which contributed to enhancing the biocontrol efficacy of S. pararoseus against A. niger in apples.

An explosion of interest has arisen using organic-based materials, specifically cyclic organic hydrogen carriers for hydrogen storage due to their high hydrogen storage capacity, high volumetric energy density, reversibility, and non-toxicity. However, the unfavourable thermodynamic properties and high kinetic barriers of hydrogen desorption from these cyclic organic hydrogen carriers make them to be difficult in large-scale applications. In the past decades, tremendous efforts have been devoted to tailor both thermodynamic and kinetic properties of hydrogen absorption and desorption from such materials. Therefore, in this review, methods of fabrication of new materials in order to modify the dehydrogenation thermodynamic properties are discussed, which include the fusion of multiple organic rings, attachment of electron-donating substituents, incorporation of N/O/S atom into the aromatic rings, and introduction of alkali or alkaline earth metals to replace the protic H atom of O–H or N–H groups. Additionally, demonstrations for potential applications via using organic hydrogen carriers such as toluene, N-ethylcarbazole, and dibenzyl toluene are also described. The challenges and perspectives for the cyclic organic hydrogen storage materials are discussed at the end. It is expected that this review could provide new inspiration to expedite the development of cyclic organic hydrogen carriers with high hydrogen capacity and optimum thermodynamics for hydrogen storage.

Summary: Complement-dependent microglia pruning of excitatory synapses has been widely reported in physiological and pathological conditions, with few reports concerning pruning of inhibitory synapses or direct regulation of synaptic transmission by complement components. Here, we report that loss of CD59, an important endogenous inhibitor of the complement system, leads to compromised spatial memory performance. Furthermore, CD59 deficiency impairs GABAergic synaptic transmission in the hippocampal dentate gyrus (DG). This depends on regulation of GABA release triggered by Ca2+ influx through voltage-gated calcium channels (VGCCs) rather than inhibitory synaptic pruning by microglia. Notably, CD59 colocalizes with inhibitory pre-synaptic terminals and regulates SNARE complex assembly. Together, these results demonstrate that the complement regulator CD59 plays an important role in normal hippocampal function.

The use of nitrogen (N)-efficient rice (Oryza sativa L.) varieties could reduce excessive N input without sacrificing yields. However, the plant traits associated with N-efficient rice varieties have not been fully defined or comprehensively explored. Here, three japonica N-efficient varieties (NEVs) and three japonica N-inefficient varieties (NIVs) of rice were grown in a paddy field under N omission (0 N, 0 kg N ha–1) and normal N (NN, 180 or 200 kg N ha−1) treatments. Results showed that NEVs exhibited higher grain yield and nitrogen use efficiency (NUE) than NIVs under both treatments, due to improved sink size and filled-grains percentage in the former which had higher root oxidation activity and greater root dry weight, root length and root diameter at panicle initiation (PI), as well as higher spikelet–leaf ratio and more productive tillers during the grain-filling stage. Compared with NIVs, NEVs also exhibited enhanced N translocation and dry matter accumulation after heading and improved flag leaf morpho–physiological traits, including greater leaf thickness and specific leaf weight and higher contents of ribulose-1,5-bisphosphate carboxylase/oxygenase, chlorophyll, nitrogen, and soluble sugars, leading to better photosynthetic performance. Additionally, NEVs had a better canopy structure, as reflected by a higher ratio of the extinction coefficient for effective leaf N to the light extinction coefficient, leading to enhanced canopy photosynthesis and dry matter accumulation. These improved agronomic and physiological traits were positively and significantly correlated with grain yield and internal NUE, which could be used to select and breed N-efficient rice varieties.

Abstract Background Oxidative stress plays a critical role on the processes of sepsis, and several microRNAs have been identified that may regulate the occurrence of oxidative stress. However, the relation between oxidative stress-related microRNA 27a (miR-27a) and sepsis is unknown. The present study aimed to determine the value of circulating miR-27a for the diagnosis and prognosis of sepsis. Methods This retrospective study included 23 patients with sepsis and 25 without sepsis treated at the emergency intensive care unit (EICU) or our institution between January 2019 and January 2020. Levels of circulating miR-27a and levels of oxidative stress-related indicators were measured and compared between sepsis and non-sepsis patients. Receiver operating characteristic (ROC) curve analysis was used to determine diagnostic efficiency of miR-27a. Results Circulating miR-27a levels in sepsis patients were higher than those in non-sepsis patients (p

Abstract Background The factors affecting neurological outcomes with unilateral open-door laminoplasty have been controversial. The purpose of this study was to evaluate the impact of the characteristics of ectopic bone on poor neurological outcomes after unilateral open-door laminoplasty. Methods We retrospectively analyzed the clinical data of 112 patients who underwent unilateral open-door laminoplasty from September 2017 to September 2020. According to the Japanese Orthopedic Association score recovery rate after surgery (Japanese Orthopedic Association recovery rate ≥ 50% and 60% (p = 0.000), ossification extending to C2 (p = 0.006), lateral ossification (p = 0.032) and opening side on the ipsilateral side of the ectopic bone (p = 0.011). Multivariate logistic regression analysis revealed that the occupation rate of spinal canal > 60% (P = 0.003), ossification extending to C2 (P = 0.041) and opening the door on the ipsilateral side for lateral ossification (P = 0.013) were independent risk factors for poor prognosis of neurological function. Conclusions An occupation ratio > 60% is the most important risk factor. Another one is ossification of the posterior longitudinal ligament extending to C2. Meanwhile, opening the door on the ipsilateral side is indeed a risk factor for lateral ossification. Better neurological function may be obtained by choosing the opposite side of the heterotopic bone as the open side. Therefore, the design of the surgical plan should comprehensively consider these factors.

Objectives This retrospective study aimed to determine the impact of Modic changes (MCs) on cage subsidence (CS) and intervertebral fusion after anterior cervical corpectomy and fusion (ACCF). Methods This study enrolled 61 patients with MCs who underwent single-level ACCF between January 2010 and December 2015 at our institution. The control group included 63 age-matched patients without MCs treated during the same period. The results from clinical and radiological assessments were reviewed, and radiographic CS was defined by an intervertebral height at the final follow-up that was less than the postoperative intervertebral height. Results No significant differences in gender, age, operative time, blood loss, or follow-up results were observed between the MCs and control groups. Significantly more patients experienced CS in the MCs group than in the control group (41.0% vs. 15.9%; p = 0.003). The frequencies of CS among patients with type I MCs (40.0%, 8/20) and type II MCs (41.5%, 17/41) were significantly higher than that in the control group (15.9%, 10/63; p

Abstract Objective The objective of this study was to explore the impact of sarcopenia and sagittal parameters on the residual back pain (RBP) after percutaneous vertebroplasty (PVP) for treatment of osteoporotic vertebral compression fracture (OVCF). Methods This retrospective study included elderly patients (age range 60–90 years) with OVCF treated with PVP from January 2015 and December 2020 in our hospital. The skeletal muscle mass index (SMI) was calculated by dividing the T12 pedicle level muscle cross-sectional area by the square of body height from chest CT to diagnose sarcopenia. The radiological parameters for measuring the sagittal alignment were included: C7-sagittal vertical axis (SVA), T1 pelvic angle (TPA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI). Result According to whether the VAS score > 4, patients were divided into RBP group (56 patients) and Control group (100 patients). There was no difference in age, gender, body mass index, BMD, surgical segment, bone cement usage between the groups (P > 0.05). The SMI in RBP group (27.3 ± 5.1) was significantly lower compared to that in Control group (36.8 ± 3.2) (P 0.05). Conclusion Poor sagittal parameters and sarcopenia in OVCF patients after PVP were more prone to residual back pain. Larger C7-SVA, TPA and PI-LL mismatch could increase the incidence of RBP in elderly patients with single-segment osteoporotic compression fractures.

Internet gratification behaviors (IGB) may lead to sub-optimal performance in schools and workplace as well as mental health problems such as Internet addiction. The present research examines this phenomenon, focusing on the compensatory belief (CB)—a belief that the negative impact of a certain behavior can be compensated or neutralized by another positive behavior—as a potential psychological mechanism for IGB. An interactive-narrative-style game-based assessment was designed and responses from a random-sampled population of 1,298 participants including college students and organizational employees were collected online. It was found that around 40% of college students and organizational employees would activate some kind of compensatory beliefs when facing with the internet temptation. Those who failed to perform compensatory behaviors afterwards were more likely to regret than those who were able to perform them, which was consistent with the prediction of the CB theory. This study expands the applicability of the CB theory to the field of internet addiction, enriches the understanding of the psychological mechanisms of internet addiction, and suggests that the interactive-narrative-style game-based assessment may be a practical method to study the CB.

ObjectiveExplore the feasibility and safety of thoracoscopy in the treatment of esophageal atresia under high-frequency oscillatory ventilation (HFOV) mode.MethodsThis was a single-center retrospective analysis. A total of 24 children were divided into the HFOV and the No-HFOV group. The demographic information, surgical results and relevant experience were analyzed.ResultsAll patients in the HFOV group underwent thoracoscopic esophageal atreplasty with a mean operation duration of 165.8 ± 33.9 min. Two patients had postoperative anastomotic leakage, which was cured after conservative treatment. One child had a recurrent tracheoesophageal fistula, which was closed after endoscopic cauterization. The mean postoperative mechanical ventilation time was 8.83 ± 8.02 days. There was no return of anastomotic leakage or r-TEF after oral feeding. Furthermore, there was no significant difference between the NO-HFOV and the HFOV groups except for the operation time where the HFOV group was shorter than that of the NO-HFOV group.ConclusionThoracoscopic esophageal atresia anastomosis under HFOV ventilation is feasible for patients with severe pulmonary infection, heart malformation, such as patent ductus arteriosus, ventricular septal defect, and poor anesthesia tolerance, but the long-term prognosis still needs further study in a large sample size.

As quantum computing techniques develop rapidly, the security of classical communication, which is usually based on public key encryption algorithm, is under great threat. Therefore, a key establishment method with physics base is demanding, especially for Internet of Things devices, where energy and computational power is quite limited. In this article, we present a flexible continuous-wave quantum cryptography scheme for Internet of Things systems. In this configuration, the IoT controller contains a narrow linewidth laser as a real local oscillator. Thus, it is capable of working as either a host or a client in quantum key distribution with remote servers, and efficiently generating quantum random numbers for quantum key distribution, as well as one time pad communication with deployed sensors. The security of the scheme is analyzed under the assumption of collective attacks in the asymptotic regime, and feasibility is theoretically verified with typical channel and commercial device parameters.

Background contextCervical kyphosis is a common but potentially debilitating and challenging condition. There is controversy on the optimal surgical strategy for the treatment of kyphotic cervical spondylotic myelopathy (KCSM) using either anterior approach or posterior approach.IntroductionThe purpose of this study was to investigate the surgical efficacy of anterior decompression with fusion (ADF) vs. posterior decompression with fixation (PDF) for the treatment of KCSM, and to further analyze the changes of cervical spinal alignment parameters and axial symptoms (AS) severity after kyphotic correction.Materials and methodsWe retrospectively reviewed 117 patients with KCSM who had undergone ADF (58 patients) and PDF (59 patients) between January 2016 and December 2020. Cervical spinal alignment parameters, including curvature index (CI) and C2-7 Cobb angle, were measured on the PreOP and PostOP lateral radiographs. Recovery rate was calculated based on the Japanese Orthopedic Association (JOA) score. AS severity was quantified by Neck Disability Index (NDI). A P-value less than 0.05 was considered to be significant.ResultsThe patient mean age, gender, presenting symptoms and follow-up time were similar between the two groups (P > 0.05). However, there were statistically significant differences (P < 0.001) between the two groups regarding the operation levels, operating time and intraoperative blood loss. Analysis of PostOP follow-up data showed significant differences (P < 0.001) in CI, correction of CI, C2-7 Cobb angle, and NDI between the two groups, whereas no significant differences in JOA score (P = 0.16) and recovery rate (P = 0.14). There were significant differences (P < 0.001) in CI, C2-7 Cobb angle, JOA score, and NDI between PreOP and PostOP follow-up in each group. Correction of CI showed positive correlation with recovery of NDI in Group ADF (r = 0.51, P < 0.001), and in Group PDF (r = 0.45, P < 0.001).ConclusionSatisfied neurological improvement was obtained by ADF and PDF for patients with KCSM. Cervical kyphotic correction caused significant improvement of AS, and was more favorable with ADF than with PDF. Surgeons should pay full consideration of the merits and shortcomings of each approach when deciding on a surgical plan.

Abstract The incidence of frequent foodborne disease outbreaks due to Staphylococcus aureus contamination necessitates the urgent searching for effective methods to monitor S. aureus. This research aims to construct model with a dynamic survival curve and some static growth curves to predict the behavior of S. aureus in raw pork. Lack of research about S. aureus kinetics in pork under fluctuating temperature conditions across freezing and thawing necessitates this study. One‐step analysis was used to determine the model parameters, which was more efficient than conventional model analysis with two steps. The results of kinetic analysis showed that Tmin (minimum growth temperature) was 6.85°C, which is close to the estimated values in previous reports. Subsequently, validation results indicated the integrated model can accurately predict the behavior of S. aureus regardless of isothermal or nonisothermal conditions with the root‐mean‐square errors (RMSE

Floating offshore wind platform (FOWP) has become the economically favored option for supporting wind turbines in deep waters. It is urgent to propose new concept designs for FOWPs that can be effectively deployed. Additionally, the extensive use of steel in such platforms significantly escalates costs, necessitating the optimization of steel utilization. Motivated by these challenges, a V-shaped floating semi-submersible platform equipped with NREL 5 MW wind turbine is designed and analyzed based on the potential flow theory and the blade element momentum theory. Fully coupled time-domain simulations are conducted using the F2A program, which couples NREL FAST and ANSYS AQWA via a Dynamic Link Library (DLL), to compare the hydrodynamic performance and stability of the V-shaped floating platform with the original triangle-shaped model of “Fuyao”. Various sea conditions have been considered, including combined wind-wave action and wind-wave-current action at different incidence angles. The results show that the V-shaped floating platform has better economic and hydrodynamic performance (e.g., a reduction of 40.4% and 12.9%, respectively, in pitch and yaw motions, and a 17.4% reduction in maximum mooring tension), but lower stability than its triangle-shaped counterpart.

Objective To evaluate the effect of coronal alignment on: (1) surgical invasiveness and operative complexity and (2) postoperative complications. Methods A retrospective, cohort study of adult spinal deformity patients was conducted. Alignment groups were: (1) neutral alignment (NA): coronal vertical axis (CVA) ≤ 3 cm and sagittal vertical axis (SVA) ≤ 5 cm; (2) coronal malalignment (CM) only: CVA > 3 cm; (3) Sagittal malalignment (SM) only: SVA > 5 cm; and (4) coronal and sagittal malalignment (CCSM): CVA > 3 cm and SVA > 5 cm. Results Of 243 patients, alignment groups were: NA 115 (47.3%), CM 48 (19.8%), SM 38 (15.6%), and CCSM 42 (17.3%). Total instrumented levels (TILs) were highest in CM (14.5±3.7) and CCSM groups (14±4.0) (p

Abstract Background Caudal block is one of the most preferred regional anesthesia for sub-umbilical region surgeries in the pediatric population. However, few studies are available on caudal block performed in laparoscopic-assisted Soave pull-through of Hirschsprung disease (HD). We aimed to compare general anesthesia (GA) and general anesthesia combined with caudal block (GA + CA) in laparoscopic-assisted Soave pull-through of HD. Methods A retrospective review was performed in children with HD operated in our hospital between 2017 and 2020. Patients were divided into the GA and GA + CA group. The primary outcome was the duration of operation, and secondary outcomes included intraoperative hemodynamic changes, the Face, Legs, Activity, Cry, Consolability (FLACC) scale, dose of anesthetics, and incidence of side effects. Results A total of 47 children with HD were included in the study, including 20 in the GA group and 27 in the GA + CA Group. The two groups were similar in age, gender, weight and type of HD (P > 0.05). The GA + CA group had significantly shorter duration of operation (especially the transanal operation time) (median 1.20 h vs. 0.83 h, P

Genetic mechanisms underlying fetal hemoglobin (HbF) regulation and switching are not fully understood. Here, the authors develop a single-cell genome editing functional assay to model how effects of mutation-harbouring functional elements contribute to HbF expression.

BackgroundThe prognosis of hypertensive intracerebral hemorrhage (HICH) is poor at high altitudes. The objective of this study was to explore whether hyperbaric oxygen (HBO) can improve the results of computed tomography perfusion (CTP) imaging and the neurological function of patients with HICH, and influence the hemoglobin concentration.MethodThe patients with HICH were treated with puncture and drainage. Twenty-one patients (51.22% of 41 patients in total) were treated with HBO after the operation, and the other patients received conventional treatment. CTP was performed twice, and all indices were measured. Scatter plots were used to determine the effect of hemoglobin concentration on CTP imaging. Receiver operating characteristic (ROC) curves were plotted to analyze the effects of hemoglobin concentration and hematoma volume on recovery results. The patients were followed up for 6 months.ResultsForty-one patients with HICH were treated with puncture and drainage. In total, 21 were treated with HBO after the operation, and 20 received conventional treatment as the control group. No significant differences in the CBV and CBF values of the two groups were noted before treatment. After 10 days, the values of CBV and CBF in the HBO group were significantly higher than those in the control group. A scatter diagram showed there was no significant in the HBO group, but significant correlation for the CBV and CBF values in the control group’s hematoma center and margin. The ROC curves showed that hematoma volume had an influence on prognosis of the control group. The Glasgow Coma Scale (GOS) scores of the HBO group were significantly higher than those of the control group (p < 0.05).ConclusionsHBO therapy can improve the postoperative CBV and CBF values of patients with HICH and ameliorate their prognoses. There was no significant correlation between HBO group and hemoglobin concentration on admission.

In order to analysing the oil and Liquefied Natural Gas (LNG) import and consumption changing trends, the Occurrence Period (OP), Growth Period (GP) and Maturation Period (MP) of oil and LNG import and consumption in China, and studying how the oil and LNG import and consumption changing trends influence the development of China–Pakistan oil and LNG transportation corridor (CPOLTC), in this paper we apply a Growth Curve Model (GCM) based approach to solve the problems mentioned above. First, the Chinese oil and LNG import and consumption changing trends are analysed by applying the GCM. The results show that oil and LNG consumption and import belong to the GP because of the fast industrialization and urbanization development, so the oil and LNG import and consumption demand will increase fast; Then, the External Dependence (ED) is applied to describe the oil and LNG consumption dependence degree in China, the results show that import will remain high ED value, especially for the oil import (over 70%), which means the security of the energy supply chain still remains the central idea of Chin’s energy policies. Finally, the challenges and key issues of CPOLTC is analysed. Challenges are: domestic political struggles and institutional defects in Pakistan make the CPOLTC projects lacking of implementation, security along the corridor, influence and competition from external forces, impacts of western project culture, the comprehensive projects establishment ability in Pakistan, etc. The key issues are: Value Engineering (VE) researches for projects, Chinese element such as project construction, management, standards and specifications, assessment of the projects’ life cycle and so on.

In this study, we utilized a simple and efficient microwave heating method with polyethyleneimine (PEI) and phosphate as raw materials to synthesize room temperature persistent luminescence (RTPL) materials that emit phosphorescent light for up to 10 s. Our investigation revealed that the optimal synthesis conditions were a microwave radiation power of 560 W and a heating time of 5 min. The synthesized RTPL materials had an average particle size of 2 nm and exhibited excellent RTPL performance, with optimal excitation and emission wavelengths of 360 nm and 544 nm, respectively. Additionally, these materials displayed good water solubility. We conducted mapping experiments and in situ phosphorescent imaging of plants to showcase the potential applications of RTPL materials in the fields of biological imaging and anti-counterfeiting. Overall, our findings demonstrate the promising potential of these RTPL materials as versatile tools for various practical applications.

From the perspective of the differential phase delay experienced by the two counterpropagating optical fields, the self-starting of the mode-locked fiber laser with a non-linear amplifying loop mirror (NALM) is theoretically studied. Although it is generally believed that NALM shows a saturable absorption effect on both continuous wave (CW) light and pulses, we find a counter-intuitive fact that cross-phase modulation (XPM) leads to opposite signs of differential non-linear phase shifts (NPSs) in these two cases, resulting in inverse saturable absorption (ISA) during the pulse formation process. The ISA is not helpful for the self-starting of laser mode-locking and can be alleviated by introducing a non-reciprocal phase shifter into the fiber loop. These results are helpful for optimizing the design of NALM and lowering the self-starting threshold of the high-repetition-rate mode-locked fiber laser.

Abstract Background Tandem spinal stenosis (TSS) has a complex clinical presentation, and there is no consensus on the optimal surgical strategy. This study retrospectively compared the efficacy of different staged operations and simultaneous decompression for patients with TSS. Methods We reviewed data from 132 patients with TSS who received surgical procedures from January 2011 to June 2018. Patients were classified into three groups according to the most symptomatic area of compression (group C: first-stage surgery for cervical compression; group L: first-stage surgery for lumbar compression; group CL: simultaneous surgery for both). Medical records were reviewed for age, gender, comorbidities, operation time, combined estimated blood loss, and time of hospitalization. The JOA-C, JOA-L, NDI, and ODI scores, and complications were also examined. Results Postoperative outcomes were followed for 32.1 ± 5.4 months. There were significant differences in the re-operation rate and the interval time between the two types of staged operations (p = 0.005 and p = 0.001, respectively). There were no significant differences in gender (p = 0.639), operation time (p = 0.138), combined estimated blood loss (p = 0.116), or complications (p = 0.652) among the three groups, while the simultaneous group was significantly younger (p = 0.027), with fewer comorbidities (p < 0.001) and a shorter hospitalization time (p < 0.001). At the final follow-up, the JOA-C and JOA-L scores were increased, while the NDI and ODI scores were decreased, compared with the preoperative scores. Conclusions TSS can be effectively managed by either simultaneous or staged decompressions. First-stage surgery for cervical stenosis significantly lowers the requirement for second-stage lumbar surgery. One-stage simultaneous decompression is safe and effective with the advantage of reduce hospitalization time, without an increase in operative time or bleeding. However, the surgical indications should be strictly controlled and is recommended for younger patients with fewer comorbidities.

Abstract Background Whether a sequential or concurrent regimen of anthracyclines and taxanes is superior for breast cancer is controversial. We compared the efficacy of two regimens in patients with operable breast cancer based on all relevant published data of phase III randomized controlled trials. Methods A comprehensive literature search on PubMed, Web of Science, Embase, ScienceDirect, Google Scholar, and ClinicalTrials.gov databases was performed up to May 2020. Meta-analysis was performed to evaluate the different efficacy on disease-free survival (DFS) and overall survival (OS) for the two chemotherapy regimens. Subgroup analyses were further carried out in terms of node status and anthracycline selection. Results Compared to the concurrent regimen, the sequential regimen did not improve the DFS or OS in the population studied. Subgroup analysis showed that in node-positive patients, the sequential regimen had better DFS, but not OS, than the concurrent regimen. In sequential regimen, patients who received doxorubicin and taxanes had improved DFS and OS than patients who were administered epirubicin and taxanes. Furthermore, for patients who received doxorubicin and taxanes, compared to the sequential regimen, fewer cycles (4 cycles) of concurrent treatment resulted in a worse DFS and OS, which can be rescued by more cycles (6 cycles). Conclusions The sequential regimen of anthracyclines and taxanes for patients with operable breast cancer did not yield a significant benefit in DFS or OS over the concurrent regimen. The sequential regimen, however, provided a better DFS than concurrent regimen for node-positive patients. Interestingly, further subgroup analysis showed that for node-positive patients who were given doxorubicin and taxanes, more cycles (6 cycles) of the concurrent regimen may rescue the efficacy for fewer cycles (4 cycles).

Abstract. Rationale:. A coronary artery fistula (CAF) is an anomalous communication between a coronary artery and a cardiac chamber or great vessel. It is a rare congenital anomaly that is often small and asymptomatic, occurring in only 0.002% of the general population. Most CAFs originate from the right coronary artery and flow into the right cardiac system. Although extremely rare, some cases may originate from the bilateral coronary arteries and flow into the left ventricle. Patient concerns:. Herein, we report a rare case of a 55-year-old male smoker with no history of heart disease or cardiac surgery, who presented with a 5-year history of recurrent chest congestion, palpitations, and shortness of breath. On physical examination, his heart and lungs revealed normal findings without cardiac murmurs and no systemic or pulmonary edema. Moreover, 24-hour ambulatory electrocardiography showed no signs of ischemia but exhibited a short array of ventricular tachycardia and short atrial tachycardia. Chest computed tomography showed left apical emphysema without cardiomegaly and pulmonary congestion. Furthermore, coronary angiography revealed dual congenital coronary cameral fistula, a complex CAF with a left circumflex artery–left ventricle fistula and a right coronary artery–left ventricle fistula, complicated with a myocardial bridge. Diagnosis and interventions:. A diagnosis of left circumflex artery–left ventricle fistula complicated with a right coronary artery–left ventricle fistula and myocardial bridge was made. Since the patient refused surgery, medical management with enteric-coated aspirin, sustained-release metoprolol, and atorvastatin calcium was initiated. Outcomes and lesson:. Currently, the patient is now asymptomatic and in good condition since 6 months after undergoing conservative treatment with β-blockers.

BackgroundThe immune response and the complement system are associated with cognitive impairment and diabetes mellitus, respectively. Activation of the complement system in these diseases occurs mainly through either the classical pathway or the alternative pathway. However, the specific complement proteins involved in the development of the type 2 diabetes mellitus (T2DM) and cognitive impairment are still unclear. Here, we investigated complement proteins in serum from patients with T2DM, cognitive impairment, or both T2DM and cognitive impairment.ObjectiveTo investigate the levels of serum immune complement proteins in patients with T2DM, cognitive impairment, or T2DM combined with cognitive impairment and the associations between these complement proteins and risk factors for T2DM or cognitive impairment.MethodsClinical markers were collected from blood samples of 264 participants. Luminex multiplex assays were used to detect serum complement proteins. All statistical analyses were performed using Prism or R studio.ResultsThere was a difference in serum levels of the complement proteins C1q, C3, C3b, and FH between the three different groups. Hyperglycemia was significantly correlated with elevated C3b or reduced C3, C1q, and FH. In addition, hyperlipidemia was positively correlated with elevated levels of C3, C4, C1q, and FH proteins. There was an association between C1q, C3, C4, and FH and β-pancreas cell function, whereas only FH was associated with insulin resistance. Higher serum C1q was significantly associated with an increased risk of cognitive impairment.ConclusionSerum levels of complement proteins were closely associated with hyperglycemia and hyperlipidemia. We found that classical complement pathway activation mainly occurred in the cognitive impairment only group, whereas the alternative pathway may reflect T2DM and T2DM with cognitive impairment.

Abstract Background The K-line is a virtual straight line that connects the midpoints of the anteroposterior spinal canal diameter from C2 to C7 on a cervical lateral X-ray film. Patients with cervical ossification of the posterior longitudinal ligament (OPLL), in which the peak of the OPLL exceeds the K-line (K-line [-]), are less likely to experience sufficient decompression after laminoplasty compared with patients for whom the OPLL does not exceed the K-line (K-line [+]). This retrospective study investigated the influence of K-line position relative to the OPLL on intraoperative and hidden blood loss during unilateral open-door laminoplasty for OPLL. Methods Data were retrospectively analyzed of 108 patients with OPLL who underwent unilateral open-door laminoplasty between April 2015 and March 2018. Patient cases were categorized as K-line (+) or (-). The evaluated perioperative parameters were haematocrit, haemoglobin, intraoperative and hidden blood loss, surgical time, postoperative drainage, and complications. Radiological parameters included ossification occupancy ratio and C2-7 lordosis. Results The K-line (+) and K-line (-) groups were statistically comparable with regard to age, gender, body mass index, OPLL classification, medication history, C2-7 lordosis, postoperative haemoglobin and haematocrit, postoperative drainage, hidden blood loss, and complications. The occupying ratio of the K-line (-) group was significantly greater than that of the K-line (+) group (49.5 ± 15.3% cf. 42.3 ± 10.1%; P = 0.006), and the intraoperative blood loss was also significantly higher (286 ± 110.5 mL cf. 205.5 ± 98.3 L, P = 0.003). The hidden blood loss of the K-line (-) group was higher than that of the K-line (+), but not significantly (295.5 ± 112.6 mL cf. 265.6 ± 103.8 mL; P = 0.072). Conclusion Intraoperative and hidden blood loss associated with unilateral open-door laminoplasty can be predicted by the spatial relationship of the K-line and osteophyte. This relationship is a simple and practical index that may help surgeons determine the appropriate surgical strategy for patients with OPLL.

Hydrazine borane (HB) is a chemical hydrogen storage material with high gravimetric hydrogen density of 15.4 wt%, containing both protic and hydridic hydrogen. However, its limitation is the formation of unfavorable gaseous by-products, such as hydrazine (N2H4) and ammonia (NH3), which are poisons to fuel cell catalyst, upon pyrolysis. Previous studies proved that confinement of ammonia borane (AB) greatly improved the dehydrogenation kinetics and thermodynamics. They function by reducing the particle size of AB and establishing bonds between silica functional groups and AB molecules. In current study, we employed the same strategy using MCM-41 and silica aerogel to investigate the effect of nanosizing towards the hydrogen storage properties of HB. Different loading of HB to the porous supports were investigated and optimized. The optimized loading of HB in MCM-41 and silica aerogel was 1:1 and 0.25:1, respectively. Both confined samples demonstrated great suppression of melting induced sample foaming. However, by-products formation was enhanced over dehydrogenation in an open system decomposition owing to the presence of extensive Si-O···BH3(HB) coordination that further promote the B-N bond cleavage to release N2H4. The Si-OH···N(N2H4) hydrogen bonding may further promote N-N bond cleavage in the resulting N2H4, facilitating the formation of NH3. As temperature increases, the remaining N-N-B oligomeric chains in the porous silica, which are lacking the long-range structure may further undergo intramolecular B-N or N-N cleavage to release substantial amount of N2H4 or NH3. Besides open system decomposition, we also reported a closed system decomposition where complete utilization of the N-H from the released N2H4 and NH3 in the secondary reaction can be achieved, releasing mainly hydrogen upon being heated up to high temperatures. Nanosizing of HB particles via PMMA encapsulation was also attempted. Despite the ester functional group that may favor multiple coordination with HB molecules, these interactions did not impart significant change towards the decomposition of HB selectively towards dehydrogenation.

Starmerella bacillaris is often isolated from environments associated with grape and winemaking. S. bacillaris has many beneficial properties, including the ability to improve the flavor of wine, the production of beneficial metabolites, and the ability to biocontrol. S. bacillaris CC-PT4 (CGMCC No. 23573) was isolated from grape and can inhibit methicillin-resistant Staphylococcus aureus and adaptability to harsh environments. In this paper, the whole genome of S. bacillaris CC-PT4 was sequenced and bioinformatics analyses were performed. The S. bacillaris CC-PT4 genome was finally assembled into five scaffolds with a genome size of 9.45 Mb and a GC content of 39.5%. It was predicted that the strain contained 4150 protein-coding genes, of which two genes encoded killer toxin and one gene encoded lysostaphin. It also contains genes encoding F1F0-ATPases, Na(+)/H(+) antiporter, cation/H(+) antiporter, ATP-dependent bile acid permease, major facilitator superfamily (MFS) antiporters, and stress response protein, which help S. bacillaris CC-PT4 adapt to bile, acid, and other stressful environments. Proteins related to flocculation and adhesion have also been identified in the S. bacillaris CC-PT4 genome. Predicted by antiSMASH, two secondary metabolite biosynthesis gene clusters were found, and the synthesized metabolites may have antimicrobial effects. Furthermore, S. bacillaris CC-PT4 carried genes associated with pathogenicity and drug resistance. Overall, the whole genome sequencing and analysis of S. bacillaris CC-PT4 in this study provide valuable information for understanding the biological characteristics and further development of this strain.

Abstract Study design Prospective study. Objective To identify the radiographic differences between the standard upright position and the natural and comfortable upright position. Methods The radiographic data of 50 young and healthy adults were evaluated, and parameters including the global cervical angle (GCA), global thoracic angle (GTA), global lumbar angle (GLA) were used to depict the spine profile; the distance from the cranial center to the posterior corner of S1 (CSVA-S), the center of the hip (CSVA-H), the center of the knee (CSVA-K) and the center of the ankle (CSVA-A) were measured in both the standard and the natural and comfortable upright positions to assess whole-body balance. Results Significant differences were observed in the GCA (17.39 ± 6.90 vs. 10.90 ± 3.77, p

The H9N2 avian influenza virus has been widely spread in poultry around the world. It is proved to the world that the avian influenza virus can directly infect human beings without any intermediate host adaptation in “1997 Hong Kong avian influenza case,” which shows that the avian influenza virus not only causes significant losses to the poultry industry but also affects human health. In this study, we aimed to address the problem of low protection of avian H9N2 subtype influenza virus vaccine against H9N2 wild-type virus. We have rescued the H9.4.2.5 branched avian influenza virus isolated in South China by reverse genetics technology. We have recombined these virus (rHA/NA-GD37 and rHA/NA-GD38) which contain hemagglutinin and neuraminidase genes from the H9N2 avian influenza virus (MN064850 or MN064851) and 6 internal genes from the avian influenza virus (KY785906). We compared the biological properties of the virus for example virus proliferation, virus elution, thermostability, and pH stability. Then, we evaluated the immune effects between rHA/NA-GD37 and GD37, which show that the recombinant avian influenza virus–inactivated vaccine can stimulate chickens to produce higher antibody titers and produce little inflammatory response after the challenge. It is noticeable that the recombinant virus-inactivated vaccine had better immune impact than the wild-type inactivated vaccine. Generally speaking, this study provides a new virus strain for the development of a H9N2 vaccine.