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Purpose: To evaluate the role of immediate and definitive management of Gustilo type III A/B tibia fractures with intramedullary nailing and fasciocutaneous flap. Methods: From August 2010 to July 2012, 22 patients with Gustilo Grade III A/B tibia fractures were managed with a single stage treatment of ipsilateral fasciocutaneous flap & reamed intramedullary nailing and were included in the study. The severity of the injury was calculated with Ganga Hospital injury severity score. Results: The mean age of patients was 41 years and the follow-up time ranged from six months to one year. Among the 22 patients, 73% were type III B fractures with upper leg involved in 55% of them. The time interval from injury to completion of surgery was 8–14 h. The incidence of bone infection requiring secondary procedure was 9%; the major and minor soft tissue complication rate was 9% and 14% respectively. The limb salvage rate was 100%. Conclusion: Multidisciplinary management of severe lower limb trauma is important and provides good outcomes. Intramedullary nailing and immediate flap fixation can achieve early bone union and good soft tissue coverage, leading to good outcomes in patient with Grade III A & B tibia fractures.

Empathy involves the processing of complex information related to dynamic interactions between the empathizer and target. One neural signature of empathy is the suppression of electroencephalographic mu rhythm (8–13 Hz) over the sensorimotor region. It is important to consider that few researchers have studied the effects of empathizer feedback on empathy and its underlying neural mechanism, and most previous research has lacked ecological validity due to standardized emotional stimuli and constraints on the experiment environment. Our objective in this study was to investigate the means by which empathizer feedback influences one's own empathy in naturalistic social situations. Our results revealed that empathizer feedback decreases empathic accuracy but does not affect the emotional contagion nor the emotional intensity of the empathizer. We also found that the ability to accurately infer sadness is hindered by empathizer feedback. Empathizers presented lower alpha activity in the sensorimotor cortical areas only while receiving sad narratives and not providing feedback. This study contributes to the emerging research on the influence of empathizer feedback in naturalistic social settings.

A pressure-volume diagram is often used to determine the indicated work of a Stirling engine. In this study, both the laser triangulation and hybrid Harris corner detection methods are proposed. The volume variations in the Stirling engines can be measured directly without complicated calculations. The variations in the pressure of the working fluid in the engine are measured by a piezoresistive pressure sensor. To confirm the proposed methods, a flat alpha-type Stirling engine was tested. In the laser triangulation method, a laser sensor is used to measure the variation in the crank angle of the shaft. In the hybrid Harris corner detection method, the crank angle of the shaft is obtained by analyzing the images of the mechanism recorded by a high-speed camera. The volume of the working spaces is obtained according to the geometry of the driving mechanism as well as the engine speed. In this study, the pressure-volume diagram of the proposed engine under different operating speeds is measured and compared. The results indicate that the difference in the engine speed and phase angle measured by both methods is 2.3 % and 2.9 %, respectively. The indicated powers of the engine measured by both methods with a heating temperature of 500 °C at 765 ± 5 rpm are 5.789 W and 6.904 W, respectively. The relative difference between the volume variations measured by both methods is lower than 0.5 %. The hybrid Harris corner detection method can obtain more precise results than the laser triangulation method.

ObjectiveThis study aimed to provide a realistic observation of survival by major site for 48,866 cancer patients treated at a tertiary cancer hospital in a rural area of China.MethodsPatients with cancer registered between 2007 and 2017 in the Nantong rural area were followed up. The starting date for survival calculation was the date of the first diagnosis of cancer at the Nantong Tumor Hospital, and the closing date was December 31, 2020. Observed survival (OS) was analyzed according to ICD-10 site, sex, age, region, and hospitalization period using the life table method and compared using the Wilcoxon (Gehan) statistic.ResultsThe overall 5-year OS rate was 40.48% for all 48,866 patients, 30.19% for males, and 51.90% for females. The top five cancer sites, accounting for 60.51% of the total cases, were the esophagus, lung, stomach, liver, and cervix, with 5-year OS rates of 33.72%, 18.64%, 32.10%, 19.04%, and 71.51%, respectively. The highest 5-year OS was observed in the thyroid (87.52%) and the lowest was in the pancreas (6.37%). Survival was significantly higher in younger patients than in older patients, with 5-year OSs of 69.26% and 19.84% in those aged 20-29 and 90-99 years, respectively. Five-year OSs improved significantly from 39.35% in 2007-2011 to 41.26% in 2012-2017.ConclusionOverall survival improved over the years, although the improvement at some sites was not significant. The observed survival varies from region to region, reflecting differences in the patterns of major sites, disparities in proportions of hospitalization, and demographic characteristics.

Detecting the early signs of stroke using non-contrast computerized tomography (NCCT) is essential for the diagnosis of acute ischemic stroke (AIS). However, the hypoattenuation in NCCT is difficult to precisely identify, and accurate assessments of the Alberta Stroke Program Early CT Score (ASPECTS) are usually time-consuming and require experienced neuroradiologists. To this end, this study proposes DGA3-Net, a convolutional neural network (CNN)-based model for ASPECTS assessment via detecting early ischemic changes in ASPECTS regions. DGA3-Net is based on a novel parameter-efficient dihedral group CNN encoder to exploit the rotation and reflection symmetry of convolution kernels. The bounding volume of each ASPECTS region is extracted from the encoded feature, and an attention-guided slice aggregation module is used to aggregate features from all slices. An asymmetry-aware classifier is then used to predict stroke presence via comparison between ASPECTS regions from the left and right hemispheres. Pre-treatment NCCTs of suspected AIS patients were collected retrospectively, which consists of a primary dataset (n = 170) and an external validation dataset (n = 90), with expert consensus ASPECTS readings as ground truth. DGA3-Net outperformed two expert neuroradiologists in regional stroke identification (F1 = 0.69) and ASPECTS evaluation (Cohen’s weighted Kappa = 0.70). Our ablation study also validated the efficacy of the proposed model design. In addition, class-relevant areas highlighted by visualization techniques corresponded highly with various well-established qualitative imaging signs, further validating the learned representation. This study demonstrates the potential of deep learning techniques for timely and accurate AIS diagnosis from NCCT, which could substantially improve the quality of treatment for AIS patients.

Under the pressure of rapid urbanization, the spatiotemporal dynamics of urban green spaces (UGS) have enormous impacts on the local ecological system and environment at different scales. In this study, UGS in Hefei City, which has experienced rapid urbanization from 1995 to 2015, were extracted based on time-series Landsat-5 TM and Landsat-8 OLI images, and different types of parks were mapped based on GF-2 images combined with multi-source metadata. Dynamic patterns of green space were examined by drawing the spatial variations of green space at the city, inner city, and park scales. Results revealed that: (1) At the city level, UGS decreased with the rapid urbanization, especially farmland sharply lost in areas around existing urban areas and along the transportation corridors. (2) At the inner-city level, concentric analyses showed that UGS changes in different rings had unique trends, and the dynamic changes were the most significant in Rings 2 and 3. Comparative analysis of old and new districts showed that the common characteristics of UGS changes were the transfer-out of farmland and the transfer-in of built-up land, and the newer the region, the more intense the changes. (3) At the park level, the number and area of urban parks were increasing from the center to the periphery, and the type of park gradually changed from single to rich. Significant spatial heterogeneity was identified in the landscape patterns of urban parks based on fishnet cell analysis. It is fundamental to assign urban construction land for socio-economic development, while planning UGS at different scales; moreover, integrating different green space-related policies could protect the UGS and maintain its stability. Only in this way can UGS combine economic, social, and ecological benefits under the background of rapid urbanization.

Aiming at the problem of how edge computing and Content Delivery Network (CDN) edge nodes implementing the resource coordination, the technology and method of CDN cache software adapting to virtual machines and containers are proposed. By comparing and analyzing the performance test data of CDN in three deployment modes of physical machine, container and virtual machine, the performance loss caused by CDN virtualization is evaluated. The performance loss of the container mode is small, and its performance is comparable to the physical machine. The performance loss of the virtual machine mode is large, and its performance is equivalent to about 75%of the physical machine. According to the nominal value of performance, the virtualized CDN edge node can release most of the central processing unit, memory and disk resources, and achieve resource sharing with edge computing.

Euphorbiaceae, a family of plants mainly grown in the tropics and subtropics, is also widely distributed all over the world and is well known for being rich in rubber, oil, medicinal materials, starch, wood and other economically important plant products. Glutathione S-transferases (GSTs) constitute a family of proteins encoded by a large supergene family and are widely expressed in animals, bacteria, fungi and plants, but with few reports of them in Euphorbiaceae plants. These proteins participate in and regulate the detoxification and oxidative stress response of heterogeneous organisms, resistance to stress, growth and development, signal transduction and other related processes. In this study, we identified and analyzed the whole genomes of four species of Euphorbiaceae, namely Ricinus communis, Jatropha curcas, Hevea brasiliensis, and Manihot esculenta, which have high economic and practical value. A total of 244 GST genes were identified. Based on their sequence characteristics and conserved domain types, the GST supergene family in Euphorbiaceae was classified into 10 subfamilies. The GST supergene families of Euphorbiaceae and Arabidopsis have been found to be highly conserved in evolution, and tandem repeats and translocations in these genes have made the greatest contributions to gene amplification here and have experienced strong purification selection. An evolutionary analysis showed that Euphorbiaceae GST genes have also evolved into new subtribes (GSTO, EF1BG, MAPEG), which may play a specific role in Euphorbiaceae. An analysis of expression patterns of the GST supergene family in Euphorbiaceae revealed the functions of these GSTs in different tissues, including resistance to stress and participation in herbicide detoxification. In addition, an interaction analysis was performed to determine the GST gene regulatory mechanism. The results of this study have laid a foundation for further analysis of the functions of the GST supergene family in Euphorbiaceae, especially in stress and herbicide detoxification. The results have also provided new ideas for the study of the regulatory mechanism of the GST supergene family, and have provided a reference for follow-up genetics and breeding work.

PurposeBladder cancer is a common malignant tumor of the urinary system, with the fourth-highest incidence of male malignant tumors in Europe and the United States. So far, the mechanism of bladder cancer progression and metastasis has not been clarified. The aim of our study was to validate the way of long noncoding RNA (lncRNA) KCNMB2-AS1 on the metabolism and growth of bladder cancer cells by miR-3194-3p/SMAD5.Patients and MethodsThe Gene Expression was analyzed by qRT-PCR in bladder cancer tissues and cell lines, with the highly expressed KCNMB2-AS1 screened out. Cell proliferation was detected by Edu staining and clone formation assay, cell migration, and invasion by wound healing and transwell assays. Cell stemness was determined by assessing sphere-forming ability and stemness marker. Correlation between miRNA and lncRNA/gene was verified by dual‐luciferase assay and RIP, and the effect of KCNMB2-AS1 on bladder cancer growth by nude mice tumor formation experiment.ResultsHere, we revealed the increased level of KCNMB2-AS1 in bladder cancer for the first time. Knockdown of KCNMB2-AS1 in vitro prevented the ability of proliferation, metastasis, and stemness of cancer cells. In vivo, the silencing of KCNMB2-AS1 also prevented tumor growth in vivo. Next, we revealed that KCNMB2-AS1 could interact with miR-3194-3p and uncovered that SAMD5 was a downstream target of miR-3194-3p.ConclusionIn conclusion, KCNMB2-AS1 mediated the bladder cancer cells progress by regulating the miR-3194-3p/SAMD5 signal pathway, which would provide a new target for bladder cancer research.

Objective The association between ABO blood group and risk of liver cancer is unclear, although few studies have reported positive results. This study examined the relationship between ABO blood group and liver cancer in hepatitis B surface antigen (HBsAg)-positive individuals.Design A high-risk population-based cohort study.Setting The study was started in 2007 and closed in 2019; the number of observed person-years as obtained by ABO blood group.Participants The study included 3663 individuals with positive HBsAg, including men aged 30–70 and women aged 40–70.Outcome measures The frequencies of ABO group in the cohort population and patients with liver cancer were calculated, respectively. χ2 test was used to compare differences, and the relative risk (95% CI) for development of liver cancer was evaluated.Results The frequency distribution of blood types A, B, O and AB was 1118 (30.52%), 1073 (29.29%), 1104 (30.14%) and 368 (10.05%), respectively, among 3663 cohort individuals. In the cohort, patients with liver cancer (n=336) were of the following frequencies: type A: 104 (30.95%); type B: 97 (28.87%); type O: 95 (28.27%); and type AB: 40 (11.90%). No significant difference was found between patients with liver cancer and other individuals. The annual incidence rate of liver cancer was 906.34 per 100 000 person-years, and for blood type A, B, O and AB the rates were 917.76, 893.78, 846.02 and 1093.43 per 100 000 person-years, respectively. The relative risk (95% CI) was 0.97 (0.74 to 1.29), 0.92 (0.70 to 1.22) and 1.19 (0.82 to 1.72) for blood types B, O and AB, respectively, compared with blood type A.Conclusion There were no significant differences in the frequency distribution of ABO blood groups in patients with liver cancer within this high-risk cohort, which demonstrates lack of positive association between ABO blood group and risk of liver cancer.

Background and aims: Liver cancer is one of the most dominant malignant tumors in the world. The trends of liver cancer mortality over the past six decades have been tracked in the epidemic region of Qidong, China. Using epidemiological tools, we explore the dynamic changes in age-standardized rates to characterize important aspects of liver cancer etiology and prevention. Methods Mortality data of liver cancer in Qidong from 1958 to 1971 (death retrospective survey) and from 1972 to 2017 (cancer registration) were tabulated for the crude rate (CR), and age-standardized rate and age-birth cohorts. The average annual percentage change was calculated by the Joinpoint Regression Program. Results The natural death rate during 1958–2017 decreased from 9‰ to 5.4‰ and then increased to 8‰ as the population aged; cancer mortality rates rose continuously from 57/105 to 240/105. Liver cancer mortality increased from 20/105 to 80/105, and then dropped to less than 52/105 in 2017. Liver cancer deaths in 1972–2017 accounted for 30.53% of all cancers, with a CR of 60.48/105, age-standardized rate China (ASRC) of 34.78/105, and ASRW (world) of 45.71/105. Other key features were the CR for males and females of 91.86/105 and 29.92/105, respectively, with a sex ratio of 3.07:1. Period analysis showed that the ASRs for mortality of the age groups under 54 years old had a significant decreasing trend. Importantly, birth cohort analysis showed that the mortality rate of liver cancer in 40–44, 35–39, 30–34, 25–29, 20–24, 15–19 years cohort decreased considerably, but the rates in 70–74, and 75+ increased. Conclusions The crude mortality rate of liver cancer in Qidong has experienced trends from lower to higher levels, and from continued increase at a high plateau to most recently a gradual decline, and a change greatest in younger people. Many years of comprehensive prevention and intervention measures have influenced the decline of the liver cancer epidemic in this area. The reduction of intake levels of aflatoxin might be one of the most significant factors as evidenced by the dramatic decline of exposure biomarkers in this population during the past three decades.