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Abstract Background Cutaneous squamous cell carcinoma (CSCC) is one of the most common types of skin cancer worldwide. Therefore, the identification of biomarkers associated with CSCC progression could aid in the early detection of high-risk squamous cell carcinoma and the development of novel therapeutic strategies. Objective This study aimed to investigate the expression patterns of silent mating type Information Regulation 2 homolog 6 (SIRT6) in CSCC and its clinical significance. Methods The protein expression level of SIRT6 in tissues was detected by immunohistochemistry, and the correlation between SIRT6 expression and clinicopathological parameters in CSCC patients was analyzed. The relative expression of SIRT6 in CSCC cell lineage and tissue specimens was determined by western blotting and PCR. The effect of SIRT6 silencing on cell proliferation was evaluated using cell counting kit 8. Wound healing, transwell method, and flow cytometry were used to investigate the migration, invasion, and cell cycle distribution/apoptosis of CSCC cells after SIRT6 silencing, respectively. Western blot was used to detect the expression of EMT (Epithelial-Mesenchymal Transition), cycle, apoptosis, and other related proteins. Results The high expression of SIRT6 was correlated with the location of cancer tissue and Broder staging in CSCC patients. Knockdown of SIRT6 inhibited the proliferation, migration, invasion and EMT of CSCC cells, and promoted their apoptosis, with cells blocked in G1 phase. Study limitations No animal experiments were conducted to further verify the results. Conclusion Decreased expression of SIRT6 can inhibit the occurrence and development of CSCC.

Abstract Purpose To compare the rotational stability of a monofocal and a diffractive multifocal toric intraocular lens(IOLs) with identical design and material. Methods This prospective study enrolled patients who underwent plate-haptic toric IOL (AT TORBI 709 M and AT LISA 909 M) implantation. Propensity score matching (PSM) was performed to balance baseline factors. Follow-up examinations were conducted at 1 h, 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months postoperatively. A linear mixed model of repeated measures was used to investigate the changes in IOL rotation over time. A 2-week timeframe was utilized to assess differences in IOL rotation between the two groups. Result After PSM, a total of 126 eyes were selected from each group for further analysis. Postoperatively, the time course of IOL rotation change in the two groups remained consistent, with the greatest rotation occurring between 1 h and 1 day postoperatively. At the 2-week postoperative mark, the monofocal toric IOL exhibited a higher degree of rotation compared to the multifocal toric IOL (5.40 ± 7.77° vs. 3.53 ± 3.54°, P = 0.015). In lens thickness(LT) ≥ 4.5 mm and white-to-white distance(WTW) ≥ 11.6 mm subgroups, the monofocal toric IOL rotated greater than the multifocal toric IOL (P = 0.026 and P = 0.011, respectively). Conclusion The diffractive multifocal toric IOL exhibits superior rotational stability compared to the monofocal toric IOL, especially in subgroups LT ≥ 4.5 mm and WTW ≥ 11.6 mm. Moreover, the time course of IOL rotation change is consistent for both, with the maximum rotation occurring between 1 h and 1 day postoperatively.

Climatic droplet keratopathy (CDK) is a corneal diseases, which is characterized by increased oil-like deposits on the anterior elastic lamina and anterior stromal layer. Severe CDK can even cause blindness, with no specific available treatment. Besides. CDK is poorly understood in terms of its pathogenic mechanisms. Thus, to determine potential biomarkers for CDK, we analyzed the microRNA expression profile in tear samples from CDK patients and investigated their putative roles in the pathogenesis of CDK. Herein, miRNA sequencing and following bioinformatics analysis was performed to explore the roles of their target genes in CDK. A total of 67 differentially expressed miRNAs were identified, of which 25 were upregulated and 42 were downregulated. qPCR verification showed that among the up- and down-regulated miRNAs, expression of five and six, respectively, was most significantly different.The target genes of the differentially expressed miRNAs are involved in the FoxO signaling pathway, tumor necrosis factor (TNF) signaling pathway, and steroid hormone biosynthesis. Protein–protein interaction network analyses identified 20 hub genes, including PTEN, GSK3B, and SMAD3. In conclusion, the panel of differentially expressed miRNAs identified may have potential utility as early diagnostic biomarkers for CDK. Moreover, the TNF signaling pathway is a new potential target in CDK for the development of treatments.

IntroductionAstigmatism reduces the postoperative visual performance after non-toric intraocular lenses (IOLs) implantation, and limits the use of refractive IOLs in cataract surgery. The purpose of this study was to compare the efficacy in astigmatism correction and the postoperative visual outcomes between the implantation of a trifocal IOL with femtosecond laser-assisted arcuate keratotomy (FSAK) in one eye and a bifocal toric IOL (TIOL) in the other, in patients with cataract and moderate astigmatism.MethodsThis prospective observational paired-eye study enrolled patients with cataract and corneal astigmatism (CA) between 0.75 and 2.25 D in both eyes. The patients underwent a mix-and-match treatment comprising trifocal IOL implantation with FSAK and bifocal TIOL implantation. We compared the visual acuity (VA) at all distances, defocus curve, postoperative refractive astigmatism (RfA), CA, high-order aberrations, modulation transfer function (MTF) curve, and Strehl ratio between the two eye groups.ResultsIn total, 41 patients (82 eyes) were enrolled and completed a 6-month follow-up. The 1- and 3-month uncorrected distance VA and 3-month uncorrected near VA were greater in eyes with bifocal TIOLs than with trifocal IOLs and FSAK (p = 0.036, 0.010, and 0.030, respectively), whereas the latter had greater uncorrected intermediate VA at every visit and greater VA in the intermediate range of defocus curve (at −1.50 and − 2.00 D) than the eyes with bifocal TIOLs. The postoperative RA of the eyes with trifocal IOL and FSAK was significantly higher than that of the bifocal TIOL-implanted eyes at the 3- and 6-month follow-ups.DiscussionBoth FSAK and TIOL implantation effectively reduce pre-existing moderate astigmatism in patients with cataract. The eyes with bifocal TIOLs had more stable long-term astigmatism correction, whereas those with trifocal IOLs and FSAK had better intermediate VA. Therefore, a mix-and-match implantation of trifocal IOL with FSAK and contralateral bifocal TIOL could achieve effective astigmatism correction and provide an overall optimal VA.

Abstract Background Investigation of the prevalence of climatic droplet keratopathy (CDK) in Tacheng, Xinjiang, China. Methods A total of 1030 participants, in their 40s or older, from the Kazakh ethnic group in Tacheng, were randomly sampled by stratification method. Ophthalmic examinations and surveys were carried out on these participants. Factors associated with CDK were analyzed with logistic regression models. Results CDK was found in 66 (6.4%; 95% confidence interval [CI]: 4.9–7.9%) Kazakh individuals. After multiple regression model analysis, it demonstrated that age (

Abstract Background To investigate the distribution of corneal astigmatism, aberration, and biometric parameters in Chinese congenital cataract (CC) /developmental cataract patients before cataract surgery. Methods We evaluated eyes of CC /developmental cataract patients scheduled for cataract surgery from January 2016 to September 2019. Astigmatism, aberrations, and biometric parameters were measured with the Pentacam Scheimpflug imaging device (Pentacam HR, Oculus). Cataract was diagnosed and classified by slit-lamp examination after full mydriasis. Results We evaluated 538 eyes in 356 patients. The mean values of anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), and total corneal astigmatism (TCA) were determined as 1.98 ± 1.06 D (range 0.0‒4.8 D), 0.49 ± 0.26 D (range 0.0‒1.9 D), and 2.09 ± 1.19 D (range 0.2‒8.8 D), respectively. ACA and TCA ≥ 1.25 D was present in 379 eyes (70.3%) and 392 eyes (72.8%), respectively. PCA between 0.25 D and 0.75 D was found in 380 eyes (70.6%). There was a statistically significant positive linear correlation between lower-order aberrations root mean square values (LOA RMS) and corneal astigmatism (CA). Furthermore, in terms of distribution of central cornea thickness, anterior chamber depth, ACA, PCA, and TCA in different types of cataracts, ACA was highest in patients with zonular cataracts. Finally, we found anterior corneal measurements may overestimate WTR astigmatism, underestimate ATR astigmatism, and underestimate oblique astigmatism, respectively. Conclusions Most CC /developmental cataract patients had moderate to high astigmatism and ACA accounted for the largest proportion in the zonular group. This can provide a basis for planning of CC/developmental cataract surgery by ophthalmologists in clinical practice.

Background/Aims. To investigate the long-term efficacy and rotational stability of toric intraocular lenses (IOLs) implanted for the correction of moderate-to-high corneal astigmatism. Methods. A total of 57 cataract patients (57 eyes) with regular corneal astigmatism (≥2.57 D) were enrolled in this retrospective cohort study. Phacoemulsification with toric IOL implantation was performed for all patients. The uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were recorded before and one year after surgery, and statistical analysis of preoperative corneal astigmatism, postoperative residual astigmatism, aberrations, IOL rotation, and related factors was performed to evaluate the efficacy, safety, and stability of toric IOLs in correcting moderate-to-high corneal astigmatism. Results. One year after surgery, visual acuity was significantly improved compared with that before surgery (preoperative log MAR 0.87 ± 0.34 vs. postoperative log MAR 0.31 ± 0.26, p

Abstract While operational stability has evolved to be the primary issue for the practical applications of perovskite solar cells (PSCs), the understanding of the origins of device degradation is still limited. Hysteresis is known as a unique and significant feature of PSCs. The hysteresis behavior of the current density-voltage (J–V) curves, governed by the interaction between the evolving ion-induced electric field and the carrier transport/recombination, offers rich and important information about the physical properties of the device. Herein, we propose to establish hysteresis as a diagnostic key to unveil and remedy degradation issues with device physics. With a custom-made ion-incorporated drift-diffusion simulator, we comprehensively investigate the relations between characteristic J–V hysteresis features and critical device issues such as bulk and surface defects, and low mobility of each layer in the PSCs. Ultimately, we derive a fundamental understanding and unveil the origins of the device degradation during the continuous operation of PSCs. This work therefore offers a new way to address and optimize PSC operational stability.

Abstract The wide‐angle electromagnetic scattering problems can be rapidly solved by using the method of moments in conjunction with compressive sensing theory. The method mainly has two computational parts: measurement and recovery. To further enhance the performance, an improved orthogonal matching pursuit algorithm with a randomised atom selection process is proposed, significantly reducing the computational complexity of the recovery part. Additionally, a restart mechanism is designed to eliminate possible errors that might occur during the random process, ensuring the accuracy of recovery results. Numerical experiments with objects of different shapes validate the effectiveness and efficiency of the proposed scheme.

Animal models of COVID-19 facilitate the development of vaccines and antivirals against SARS-CoV-2. The efficacy of antivirals or vaccines may differ in different animal models with varied degrees of disease. Here, we introduce a mouse model expressing human angiotensin-converting enzyme 2 (ACE2). In this model, ACE2 with the human cytokeratin 18 promoter was knocked into the Hipp11 locus of C57BL/6J mouse by CRISPR – Cas9 (K18-hACE2 KI). Upon intranasal inoculation with high (3 × 105 PFU) or low (2.5 × 102 PFU) dose of SARS-CoV-2 wildtype (WT), Delta, Omicron BA.1, or Omicron BA.2 variants, all mice showed obvious infection symptoms, including weight loss, high viral loads in the lung, and interstitial pneumonia. 100% lethality was observed in K18-hACE2 KI mice infected by variants with a delay of endpoint for Delta and BA.1, and a significantly attenuated pathogenicity was observed for BA.2. The pneumonia of infected mice was accompanied by the infiltration of neutrophils and pulmonary fibrosis in the lung. Compared with K18-hACE2 Tg mice and HFH4-hACE2 Tg mice, K18-hACE2 KI mice are more susceptible to SARS-CoV-2. In the antivirals test, REGN10933 and Remdesivir had limited antiviral efficacies in K18-hACE2 KI mice upon the challenge of SARS-CoV-2 infections, while Nirmatrelvir, monoclonal antibody 4G4, and mRNA vaccines potently protected the mice from death. Our results suggest that the K18-hACE2 KI mouse model is lethal and stable for SARS-CoV-2 infection, and is practicable and stringent to antiviral development.

Abstract The non-ionizing and penetrative characteristics of terahertz (THz) radiation have recently led to its adoption across a variety of applications. To effectively utilize THz radiation, modulators with precise control are imperative. While most recent THz modulators manipulate the amplitude, frequency, or phase of incident THz radiation, considerably less progress has been made toward THz polarization modulation. Conventional methods for polarization control suffer from high driving voltages, restricted modulation depth, and narrow band capabilities, which hinder device performance and broader applications. Consequently, an ideal THz modulator that offers high modulation depth along with ease of processing and operation is required. In this paper, we propose and realize a THz metamaterial comprised of microelectromechanical systems (MEMS) actuated by the phase-transition material vanadium dioxide (VO2). Simulation and experimental results of the three-dimensional metamaterials show that by leveraging the unique phase-transition attributes of VO2, our THz polarization modulator offers notable advancements over existing designs, including broad operation spectrum, high modulation depth, ease of fabrication, ease of operation condition, and continuous modulation capabilities. These enhanced features make the system a viable candidate for a range of THz applications, including telecommunications, imaging, and radar systems. Graphical Abstract

Abstract Developing a mucosal vaccine against SARS-CoV-2 is critical for combatting the epidemic. Here, we investigated long-term immune responses and protection against SARS-CoV-2 for the intranasal vaccination of a triple receptor-binding domain (RBD) scaffold protein (3R-NC) adjuvanted with a flagellin protein (KFD) (3R-NC + KFDi.n). In mice, the vaccination elicited RBD-specific broad-neutralizing antibody responses in both serum and mucosal sites sustained at high level over a year. This long-lasting humoral immunity was correlated with the presence of long-lived RBD-specific IgG- and IgA-producing plasma cells, alongside the Th17 and Tfh17-biased T-cell responses driven by the KFD adjuvant. Based upon these preclinical findings, an open labeled clinical trial was conducted in individuals who had been primed with the inactivated SARS-CoV-2 (IAV) vaccine. With a favorable safety profile, the 3R-NC + KFDi.n boost elicited enduring broad-neutralizing IgG in plasma and IgA in salivary secretions. To meet the challenge of frequently emerged variants, we further designed an updated triple-RBD scaffold protein with mutated RBD combinations, which can induce adaptable antibody responses to neutralize the newly emerging variants, including JN.1. Our findings highlight the potential of the KFD-adjuvanted triple-RBD scaffold protein is a promising prototype for the development of a mucosal vaccine against SARS-CoV-2 infection.

Abstract Introduction If a large amount of urate crystals is deposited in a joint cavity for an extended period of time, bone erosion will occur and gradually cause skeletal muscle necrosis and joint deformity. The aim of this study was to describe the clinical characteristics and factors associated with bone erosion in gout patients with tophi. Methods A total of 210 gout patients with tophi were enrolled and divided into a bone erosion group (n = 135) and a non-bone erosion group (n = 75). Digital radiography (DR) was performed to detect bone erosion in the elbow, wrist, knee, ankle joints, interphalangeal and metatarsophalangeal joints. The clinical characteristics were recorded and compared between the two groups. Multivariate logistic regression analysis was conducted to explore the factors associated with bone erosion. Results Compared with the non-bone erosion group, the bone erosion group had an older age, longer disease duration of gout and tophi, higher level of serum creatinine (sCr), higher proportion of drinking history and ulceration, and a lower glomerular filtration rate (GFR). Univariate logistic regression analysis results showed that sex, age, body mass index (BMI), gout duration, tophi duration, GFR, white blood cell (WBC) count, sCr level, smoking history, drinking history, and presence of ulceration were associated with bone destruction. Multivariable logistic regression analysis results indicated that tophi duration, drinking history, ulceration and sCr were positively and independently related to bone erosion. Conclusions Tophi patients with bone erosion presented different clinical characteristics. Tophi duration, drinking history, ulceration and sCr were associated with bone erosion in gout patients with tophi.

3D printing technology is applied to the processing and manufacturing of antennas because it can improve the freedom of antenna design and fabricate antennas that are difficult to achieve with conventional processes. In this paper, a compact bamboo dragonfly-liked circularly polarized antenna is designed using 3D printing technology. The antenna consists of two pairs of orthogonally distributed S-shaped radiation arms. Two ring-delay lines connect two pairs of S-shaped arms to introduce two 90° phase delays to achieve circular polarization. A $50~\Omega $ coaxial cable connected the radiation arms to feed the antenna. Simulation results show that a bandwidth of 2.33-2.65 GHz with S $11\lt -10$ dB and a bandwidth of 2.33-2.46 GHz with axial ratio (AR) ize of 41 mm $\times 41$ mm $\times 5.5$ mm ( $0.33\lambda _{0} \times 0.33\lambda _{0} \times 0.044\lambda _{0}$ , $f_{0} =2.4$ GHz) was fabricated to verify the design. The measured working bandwidth is 2.3-2.6 GHz with S $11\lt -10$ dB. The measured realized gain and radiation efficiency are 1.36 dBic and 80.35% at 2.4 GHz, respectively. This proposed antenna with a lightweight of 1.7 g can maintain a stable landing from the air, which can be deployed from air vehicles and to build an outdoor sensor network.

A wideband differentially fed circularly polarized (CP) antenna featuring a slotted patch design with a large beamwidth is presented. The final design of the differentially fed CP antenna, aimed at achieving high gain and a wide axial ratio (AR) bandwidth, involves coupling a differential bending dipole antenna to the slotted patch in the same plane. The presented differentially fed CP antenna demonstrates characteristics of a large AR beamwidth, as verified by simulation and experiment. The measured AR beamwidths of 132.3° in the xoz plane (phi = 0°) and 116.2° in the yoz plane (phi = 90°) are realized at 5.5 GHz. The measured result exhibits broadband performance with a −10-dB impedance bandwidth of 78.8% (3.81–8.76 GHz), a 3-dB AR bandwidth of 36.7% (4.78–6.93 GHz), and a maximum gain of 10.2 dBic.

A theoretical model for the calculation of thermal elastohydrodynamic lubrication performance of the flow distribution pair of piston pumps is established, which is composed of the oil film pressure governing equation and energy equation, and solved by means of numerical solution and simulation. We carry out quantitative analysis of the influence of various parameters on the thermal elastohydrodynamic lubrication characteristics of the flow distribution pair. The results indicate that both the oil film thickness and the cylinder tilt angle of the flow distribution pair vary in a periodic manner. The increase in the rotational speed of the cylinder block will increase the film thickness of the oil film and reduce the fluctuation, and the inclination angle of the cylinder block and its fluctuation amplitude will decrease. An increase in working pressure will lead to a decrease in the average oil film thickness, an increase in fluctuations, and an elevation in both the tilt angle of the cylinder block and its fluctuation amplitude. The increase in the rotational speed of the cylinder block and the increase in the working pressure will lead to the increase in the viscous friction dissipation of the flow distribution pair, the increase in the oil film temperature and the increase in the leakage. The reduction in the sealing belt will lead to the reduction in oil film friction torque and leakage.

Abstract A low sidelobe 77 GHz centre‐fed microstrip patch array antenna is proposed for automotive radar application. The proposed antenna comprises eight linear antenna arrays, each of which is centre‐fed by a coplanar waveguide with ground transmission line at the back of the microstrip patches. Each linear antenna array contains 10 patch antenna units, which are connected through a T‐type power divider network to achieve a −30 dB Taylor weighted distribution. The simulation results show that the designed phased array antenna has a good one‐dimensional phased scanning ability of ±45° with active voltage standing wave ratio less than 2 at 75–79 GHz, along with −20 dB low sidelobe symmetrical radiation patterns in the H plane. An antenna sample fed by a WR12 waveguide is fabricated and measured to verify its performance. The measured VSWR is less than 2 at 73.6–85 GHz. This design provides a new idea for millimetre wave automotive radar antenna design.

Abstract Coronavirus disease 2019 (COVID-19) was first reported three years ago, when a group of individuals were infected with the original SARS-CoV-2 strain, based on which vaccines were developed. Here, we develop six human monoclonal antibodies (mAbs) from two elite convalescents in Wuhan and show that these mAbs recognize diverse epitopes on the receptor binding domain (RBD) and can inhibit the infection of SARS-CoV-2 original strain and variants of concern (VOCs) to varying degrees, including Omicron strains XBB and XBB.1.5. Of these mAbs, the two most broadly and potently neutralizing mAbs (7B3 and 14B1) exhibit prophylactic activity against SARS-CoV-2 WT infection and therapeutic effects against SARS-CoV-2 Delta variant challenge in K18-hACE2 KI mice. Furthermore, post-exposure treatment with 7B3 protects mice from lethal Omicron variants infection. Cryo-EM analysis of the spike trimer complexed with 14B1 or 7B3 reveals that these two mAbs bind partially overlapped epitopes onto the RBD of the spike, and sterically disrupt the binding of human angiotensin-converting enzyme 2 (hACE2) to RBD. Our results suggest that mAbs with broadly neutralizing activity against different SARS-CoV-2 variants are present in COVID-19 convalescents infected by the ancestral SARS-CoV-2 strain, indicating that people can benefit from former infections or vaccines despite the extensive immune escape of SARS-CoV-2.

Transmissive metasurfaces are essentially conducive to stealth, absorbers, and communications. However, most of the current schemes only allow microwave to transmit and generally adopt multilayer structures or thick dielectric substrates to improve the electromagnetic performance, restricting optical transmission and conformal application. In addition, most metasurfaces still require metal wires and external power suppliers for programmability. Here, we propose and design an intelligent transmissive microwave metasurface with optical sensing and transparency, which provides both microwave and optical channels without redundant optical devices and power suppliers, and the 2 transmission channels are associated with each other. The metasurface is realized by validly integrating photosensitive materials into microwave meta-structures. As a demonstration, we fabricate an ultrathin optically transparent transmissive metasurface based on polyethylene terephthalate substrate and photoresistors, whose thickness is only 0.125 mm. We further construct cross-wavelength transmission links based on the metasurface sample and experimentally validate that the microwave transmissions vary with light intensities under full-polarization and large-angle incidences, and this metasurface possesses high optical transparency. The intelligent transmissive microwave metasurface with optical sensing and transparency has potential applications in optical–microwave hybrid transmission devices and stealth technology.

Abstract Advanced mRNA vaccines play vital roles against SARS-CoV-2. However, most current mRNA delivery platforms need to be stored at −20 °C or −70 °C due to their poor stability, which severely restricts their availability. Herein, we develop a lyophilization technique to prepare SARS-CoV-2 mRNA-lipid nanoparticle vaccines with long-term thermostability. The physiochemical properties and bioactivities of lyophilized vaccines showed no change at 25 °C over 6 months, and the lyophilized SARS-CoV-2 mRNA vaccines could elicit potent humoral and cellular immunity whether in mice, rabbits, or rhesus macaques. Furthermore, in the human trial, administration of lyophilized Omicron mRNA vaccine as a booster shot also engendered strong immunity without severe adverse events, where the titers of neutralizing antibodies against Omicron BA.1/BA.2/BA.4 were increased by at least 253-fold after a booster shot following two doses of the commercial inactivated vaccine, CoronaVac. This lyophilization platform overcomes the instability of mRNA vaccines without affecting their bioactivity and significantly improves their accessibility, particularly in remote regions.

Abstract Programmable metamaterials and metasurfaces have gained great interest due to real‐time electromagnetic control and digital information processing capabilities. Different from traditional electrically‐controlled programmable metasurfaces, recently, light‐controlled programmable metasurfaces have been presented, on which the microwaves can be manipulated and modulated wirelessly in the space domain or time domain by incident light. More importantly, such the metasurface platform offers an efficient interface to link directly light and microwave signals, showing huge potential to develop wave‐based optoelectronic hybrid devices and relevant applications. Here, we review some of these recent developments, focusing particularly on the mechanisms of light‐controlled programmable metasurfaces and their fascinating functions from remote microwave control to hybrid signal processing. We survey related implementation methods based on the hybrid integrations of microwave digital metasurfaces and different photoresponsive components including photodiodes, photoresistors, infrared modules, and light sensors, as well as discuss their unique advantages. In the summary, the perspective on the challenges and future directions of light‐controlled programmable metasurfaces are presented.

Abstract Background Robotic surgery has been widely used in the radical treatment of colonic cancer. However, it is unclear what advantages the robotic approach offers over other approaches in left colectomy. This study aims to explore the advantage of robotic surgery in left colectomy by comparing open, laparoscopic, and robotic surgery. Methods A retrospective analysis was performed on the clinical data of patients with radical left colectomy for colon cancer who were admitted to the Department of General Surgery, The First Affiliated Hospital of Nanchang University, from November 2012 to November 2017. Two hundred eleven patients included were divided into the open surgery group (OS, n=49), laparoscopic surgery group (LS, n=92), and robotic surgery group (RS, n=70) according to surgical techniques. The clinicopathologic data were collected for clinical outcome assessment. Finally, the clinical value of RS in radical left colectomy was further evaluated by propensity score matching (PSM) analysis. Results Three groups were similar in demographics and clinical characteristics. Compared with OS, LS and RS groups had better intraoperative and perioperative clinical outcomes. Moreover, the RS group exhibited the minimum operative times, length of stay (LOS), and evaluated blood loss. LS and RS also exhibited less perioperative and postoperative long-term complications. Three groups showed similar postoperative pathological outcomes. The overall survival and disease-free survival were also similar among the three groups (all P > 0.05). Cox regression analysis showed surgical approach was not a prognostic factor for overall survival (P = 0.671) and disease-free survival (P = 0.776). PSM analysis of RS and LS by clinical characteristics showed RS showed shorter operation time (P < 0.001) and LOS for patients without complications (P = 0.005). However, no significant differences were found in perioperative and long-term postoperative complications, pathological outcomes, overall survival, and disease-free survival. Conclusions Among three techniques for radical left colectomy, LS and RS had significant advantages over OS in short-term clinical outcomes, and no significant differences were found in overall, disease-free survival, local recurrence, and distant metastasis incidence. Moreover, RS shows better perioperative clinical outcomes but without compromising survival compared with LS.

Due to the complex imaging mechanism of SAR images and the lack of multi-angle and multi-parameter real scene SAR target data, the generalization performance of existing deep-learning-based synthetic aperture radar (SAR) image target detection methods are extremely limited. In this paper, we propose an unsupervised domain-adaptive SAR ship detection method based on cross-domain feature interaction and data contribution balance. First, we designed a new cross-domain image generation module called CycleGAN-SCA to narrow the gap between the source domain and the target domain. Second, to alleviate the influence of complex backgrounds on ship detection, a new backbone using a self-attention mechanism to tap the potential of feature representation was designed. Furthermore, aiming at the problems of low resolution, few features and easy information loss of small ships, a new lightweight feature fusion and feature enhancement neck was designed. Finally, to balance the influence of different quality samples on the model, a simple and efficient E12IoU Loss was constructed. Experimental results based on a self-built large-scale optical-SAR cross-domain target detection dataset show that compared with existing cross-domain methods, our method achieved optimal performance, with the mAP reaching 68.54%. Furthermore, our method achieved a 6.27% improvement compared to the baseline, even with only 5% of the target domain labeled data.

As a 2-D full-wave numerical algorithm in the time domain, the compact Finite Difference Time Domain (FDTD) is an efficient algorithm for eigenvalue analysis of optical waveguide system. However, the numerical dispersion accuracy and stability of fast algorithm need to be improved while simulating at high frequency. A novel high-order symplectic compact FDTD scheme is developed and validated for optical waveguide modal analysis. The stability condition and the numerical dispersion of schemes with fourth-order accuracy in temporal and spatial using the symplectic integrator and compact scheme are analyzed. By comparisons with other time-domain schemes, their stable and accurate performance is qualitatively verified. The proposed high-order SC-FDTD method can be used for efficiently simulating electrically large and longitudinally invariant optical devices since the reduction of simulation dimensionality and the novel high-order symplectic algorithm can greatly reduce the memory cost and the numerical dispersive errors.

Random phase screen method was used to simulate the light intensity and phase distribution of the synthesized double vortex beams transmitted in atmospheric turbulence given the light intensity characteristics and phase characteristics of double Laguerre–Gaussian beams (DLGB) generated by coaxial superposition. Results show that the scintillation coefficient decreases initially, and then increases with the topological charge difference of the double vortex beam, and the topological charge difference is related to the number of split spots. When the number of split spots is small, the intensity distribution is concentrated, exhibiting a good penetrating effect on atmospheric turbulence.

Abstract Background Robotic surgery has been taken as a new modality to surpass the technical limitations of conventional surgery. Here we aim to compare the oncologic outcomes of patients with rectal cancer receiving robotic vs. laparoscopic surgery. Methods Data from patients diagnosed with rectal cancer between March 2011 and December 2018 were obtained for outcome assessment at the First Affiliated Hospital of Nanchang University. All patients were separated into two groups: a robot group (patients receiving robotic surgery, n = 314) and a laparoscopy group (patients receiving laparoscopic surgery, n = 220). The primary endpoint was survival outcomes. The secondary endpoints were the general conditions of the operation, postoperative complications and pathological characteristics. Results The 5-year overall survival (OS) and disease-free survival (DFS) at years 1, 3 and 5 were 96.6%, 88.7%, and 87.7% vs. 96.7%, 88.1%, and 78.4%, and 98.6%, 80.2-, and 73.5% vs. 96.2-, 87.2-, and 81.1% in the robot and laparoscopy groups, respectively (P > 0.05). In the multivariable-adjusted analysis, robotic surgery was not an independent prognostic factor for OS and DFS (P = 0.925 and 0.451, respectively). With respect to the general conditions of the operation, patients in the robot group had significantly shorter operation times (163.5 ± 40.9 vs. 190.5 ± 51.9 min), shorter times to 1st gas passing [2(1) vs. 3(1)d] and shorter hospital stay days [7(2) vs. 8(3)d] compared to those in the laparoscopy group (P 0.05, respectively). Conclusions This monocentre retrospective comparative cohort study revealed short-term advantages of robot-assisted rectal cancer resection but similar survival compared to conventional laparoscopy.

Synthetic aperture radar (SAR) can provide high-resolution and large-scale maritime monitoring, which is beneficial to ship detection. However, ship-detection performance is significantly affected by the complexity of environments, such as uneven scattering of ship targets, the existence of speckle noise, ship side lobes, etc. In this paper, we present a novel anomaly-based detection method for ships using feature learning for superpixel (SP) processing cells. First, the multi-feature extraction of the SP cell is carried out, and to improve the discriminating ability for ship targets and clutter, we use the boundary feature described by the Haar-like descriptor, the saliency texture feature described by the non-uniform local binary pattern (LBP), and the intensity attention contrast feature to construct a three-dimensional (3D) feature space. Besides the feature extraction, the target classifier or determination is another key step in ship-detection processing, and therefore, the improved clutter-only feature-learning (COFL) strategy with false-alarm control is designed. In detection performance analyses, the public datasets HRSID and LS-SSDD-v1.0 are used to verify the method’s effectiveness. Many experimental results show that the proposed method can significantly improve the detection performance of ship targets, and has a high detection rate and low false-alarm rate in complex background and multi-target marine environments.

Abstract Objective Robotic and laparoscopic surgery for rectal cancer has been applied in the clinic for decades; nevertheless, which surgical approach has a lower rate of postoperative complications is still inconclusive. Therefore, the aim of this meta-analysis was to compare the postoperative complications within 30 days between robotic and laparoscopic rectal cancer surgery based on randomized controlled trials. Methods Randomized controlled trials (until May 2020) that compared robotic and laparoscopic rectal cancer surgery were searched through PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and China Biology Medicine disc (CBMdisc). Data regarding sample size, clinical and demographic characteristics, and postoperative complications within 30 days, including overall postoperative complications, severe postoperative complications (Clavien-Dindo score ≥ III), anastomotic leakage, surgical site infection, bleeding, ileus, urinary complications, respiratory complications, conversion to open surgery, unscheduled reoperation, perioperative mortality, and pathological outcomes, were extracted. The results were analyzed using RevMan v5.3. Results Seven randomized controlled trials that included 507 robotic and 516 laparoscopic rectal cancer surgery cases were included. Meta-analysis showed that the overall postoperative complications within 30 days [Z = 1.1, OR = 1.18, 95% CI (0.88–1.57), P = 0.27], severe postoperative complications [Z = 0.22, OR = 1.12, 95% CI (0.41–3.07), P = 0.83], anastomotic leakage [Z = 0.96, OR = 1.27, 95% CI (0.78–2.08), P = 0.34], surgical site infection [Z = 0.18, OR = 1.05, 95% CI (0.61–1.79), P = 0.86], bleeding [Z = 0.19, OR = 0.89, 95% CI (0.27–2.97), P = 0.85], ileus [Z = 1.47, OR = 0.66, 95% CI (0.38–1.15), P = 0.14], urinary complications [Z = 0.66, OR = 1.22, 95% CI (0.67–2.22), P = 0.51], respiratory complications [Z = 0.84, OR = 0.64, 95% CI (0.22–1.82), P = 0.40], conversion to open surgery [Z = 1.73, OR = 0.61, 95% CI (0.35–1.07), P = 0.08], unscheduled reoperation [Z = 0.14, OR = 0.91, 95% CI (0.26–3.20), P = 0.89], perioperative mortality [Z = 0.28, OR = 0.79, 95% CI (0.15–4.12), P = 0.78], and pathological outcomes were similar between robotic and laparoscopic rectal surgery. Conclusion Robotic surgery for rectal cancer was comparable to laparoscopic surgery with respect to postoperative complications within 30 days.

BackgroundMacrophage activation syndrome (MAS) is a severe complication of autoimmune diseases with high mortality. We report the effectiveness of baricitinib as an option for the maintenance therapy in MAS secondary to nodular panniculitis.Case summaryA 24-year-old female came to our hospital with repeated fever and a skin nodule on right tibial tuberosity. Results were notable for raised serum ferritin (SF), triglycerides (TG), elevated liver function enzymes, interleukin-6 (IL-6), interferon-γ (IFN-γ), soluble interleukin-2 receptor (sIL-2R) and decreased activity of NK cells. The pathological biopsy of the subcutaneous nodules indicated nodular panniculitis. Hemophagocytic cells were found in bone marrow aspiration. She was diagnosed as MAS secondary to nodular panniculitis. With the treatment of methylprednisolone (MP) and immunoglobulin, her symptoms and laboratory data gradually improved. Nevertheless, her disease relapsed when the MP dose was tapered. Regarding the usage of JAK inhibitors in MAS, we used baricitinib (JAK1/2 inhibitor) to treat MAS and her symptom and abnormal laboratory findings returned to normal. During follow-up, though the MP dose was tapered, she was stable without a MAS recurrence.ConclusionThe case report suggested baricitinib is an option for MAS in the maintenance therapy phase and is potentially beneficial to prevent recurrence.

High-resolution remote sensing image scene classification has attracted widespread attention as a basic earth observation task. Remote sensing scene classification aims to assign specific semantic labels to remote sensing scene images to serve specified applications. Convolutional neural networks are widely used for remote sensing image classification due to their powerful feature extraction capabilities. However, the existing methods have not overcome the difficulties of large-scene remote sensing images of large intraclass diversity and high interclass similarity, resulting in low performance. Therefore, we propose a new remote sensing scene classification method that combines lightweight channel attention and multiscale feature fusion discrimination, called LmNet. First, ResNeXt is used as the backbone; second, a new lightweight channel attention mechanism is constructed to quickly and adaptively learn the salient features of important channels. Furthermore, we designed a multiscale feature fusion discrimination framework, which fully integrates shallow edge feature information and deep semantic information to enhance feature representation capabilities and uses multiscale features for joint discrimination. Finally, a cross-entropy loss function based on label smoothing is built to reduce the influence of interclass similarity on feature representation. In particular, our lightweight channel attention and multiscale feature fusion mechanism can be flexibly embedded in any advanced backbone as a functional module. The experimental results on three large-scale remote sensing scene classification datasets show that compared with the existing advanced methods, our proposed high-efficiency end-to-end scene classification method has reached state-of-the-art. Moreover, our method has a weaker dependence on labeled data and provided better generalization performance.

All-dielectric metasurfaces offer unconventional optical functional behaviors for manipulating light, due to the strong localization of light with negligible dissipative loss. Here, we propose a compact design for a light emission cavity consist of an all-dielectric grating reflector and an all-dielectric symmetry-breaking metasurface supporting “dark” mode. The “dark” mode of the asymmetric metasurface structure results in high quality factor, and the broadband perfect reflector leads to directional emission. We present a theoretical study of the spectral characterization of the emission cavity, and the emission property of the nanocavity embedded with gain medium is investigated by a Maxwell-Bloch Langevin approach. Strong luminescence enhancement with directive light emission and reduced lasing threshold are observed. Our observations offer enormous potential in controlling light emission and provides an essential step for developing efficiency and directionality LEDs, and ultra-compact lasers.

The perovskite light-emitting diodes (PeLEDs) have attracted considerable research interests in recent years due to their decent and tunable optoelectronic characteristics. Here, we unveil the properties of the emission source (e.g., location, polarization, etc.) and the influences of the incorporated nanopatterns on the light emission of PeLEDs by using the finite difference time domain (FDTD) method. The results indicated that the PeLEDs with nanopatterns not only show substantial improvement of light extraction intensity but also reveal a remarkable directivity. Moreover, the emission angle of the directional PeLEDs can be continuously engineered over 65o by judicious selection of the nanopatterns. This work is of great importance for engineering highly directional and efficient luminescence devices.

All-dielectric metasurfaces have been widely used in nanophotonics because of their properties, such as negligible Ohmic loss, stable properties, and flexible fabrication techniques. We propose an all-dielectric metasurface consisting of subwavelength particles, which supports a “trapped” mode after the introduction of adequate symmetry-breaking in the silicon meta-atoms. Coating the metasurface with monolayer graphene enables the adsorption of nucleic acids such as DNA and RNA. We compare the resonant states in the transmission spectrum and find that the proposed metasurface is ultra-sensitive to the surrounding environment and exhibits excellent biosensing performance. Our conclusions indicate that all-dielectric metasurfaces can be a promising platform to realize ultra-sensitive bio-sensors.

Quasi-bound states in the continuum (quasi-BIC) are a particular resonant state, which can be regulated by the degree of symmetry breaking in nanostructures. Here, we propose a fourfold rotationally symmetric (C4v) metasurface supporting the dual quasi-BIC modes. The Fano characteristics have observed in the near-infrared region. The resonant peaks of the dual quasi-BIC modes can be adjusted flexibly and independently with a simple breaking of the structural symmetry. More importantly, the dual quasi-BIC modes demonstrate the extraordinary capability in controlling the optical activity. This work will offer us more freedom for controlling the resonance and optical activity by the quasi-BIC modes, which is promising to engineer the optical device in displaying and optics communications.

In this work, we theoretically investigate the linear and nonlinear optical absorption properties of open triangulene spin chains and cyclic triangulene spin chains in relation to their lengths and shapes. The physical mechanism of local excitation within the triangular alkene unit and the weak charge transfer between the units are discussed. The uniformly distributed electrostatic potential allows the system to have a small permanent dipole moment that blocks the electronic transition in the light excitation such that the electronic transition can only be carried out between adjacent carbon atoms. The one-photon absorption (OPA) spectra and two-photon absorption (TPA) spectra are red-shifted with the addition of triangulene units compared to N = 3TSCs (triangulene spin chains, TSCs). Here, TPA is mainly caused by the first step of the transition. The length of the spin chain has a significant adjustment effect on the photon cross-section. TSCs of different lengths and shapes can control chirality by adjusting the distribution of the electric dipole moment and transition magnetic dipole moment. These analyses reveal the photophysical properties of triangulene and provide a theoretical basis for studying the photophysical properties of triangulene and its derivatives.

Target detection in synthetic aperture radar (SAR) images has a wide range of applications in military and civilian fields. However, for engineering applications involving edge deployment, it is difficult to find a suitable balance of accuracy and speed for anchor-based SAR image target detection algorithms. Thus, an anchor-free detection algorithm for SAR ship targets with deep saliency representation, called SRDet, is proposed in this paper to improve SAR ship detection performance against complex backgrounds. First, we design a data enhancement method considering semantic relationships. Second, the state-of-the-art anchor-free target detection framework CenterNet2 is used as a benchmark, and a new feature-enhancing lightweight backbone, called LWBackbone, is designed to reduce the number of model parameters while effectively extracting the salient features of SAR targets. Additionally, a new mixed-domain attention mechanism, called CNAM, is proposed to effectively suppress interference from complex land backgrounds and highlight the target area. Finally, we construct a receptive-field-enhanced detection head module, called RFEHead, to improve the multiscale perception performance of the detection head. Experimental results based on three large-scale SAR target detection datasets, SSDD, HRSID and SAR-ship-dataset, show that our algorithm achieves a better balance between ship target detection accuracy and speed and exhibits excellent generalization performance.

Duodenal cavernous haemangiomas are rare, benign disorders, and massive gastrointestinal (GI) bleeding is a rare clinical condition. The present case report describes a 50-year-old male patient who presented with severe, ongoing haematochezia. A peripheral blood smear at the time of admission showed significant anaemia, and haemoglobin level was 52 g/l (normal range, 120–175 g/l). Albumin level was also low at 28 g/l (normal range, 40–55 g/l). Standard computed tomography (CT) showed mural thickening and relative lumen stenosis in the ascending (fourth) portion of the duodenum. Contrast-enhanced CT using hypotonic solution revealed the lesions to be hypervascular haemangiomas. Laparotomy and segmental duodenum resection were performed, and the first jejunal limb was anastomosed using a side-to-end technique. Histopathological examination confirmed the diagnosis of cavernous haemangioma. The patient showed marked improvement during follow-up. The present case findings emphasize that duodenal haemangioma is possible without a history of chronic anaemia, and should remain a consideration in differential diagnosis for patients presenting with massive GI bleeding. CT is useful for preoperative diagnosis of massive bleeding, and surgery with segmental resection is usually curative.

ABSTRACTQuantitative real time PCR (RT-PCR) is widely used as the gold standard for clinical detection of SARS-CoV-2. However, due to the low viral load specimens and the limitations of RT-PCR, significant numbers of false negative reports are inevitable, which results in failure to timely diagnose, cut off transmission, and assess discharge criteria. To improve this situation, an optimized droplet digital PCR (ddPCR) was used for detection of SARS-CoV-2, which showed that the limit of detection of ddPCR is significantly lower than that of RT-PCR. We further explored the feasibility of ddPCR to detect SARS-CoV-2 RNA from 77 patients, and compared with RT-PCR in terms of the diagnostic accuracy based on the results of follow-up survey. 26 patients of COVID-19 with negative RT-PCR reports were reported as positive by ddPCR. The sensitivity, specificity, PPV, NPV, negative likelihood ratio (NLR) and accuracy were improved from 40% (95% CI: 27–55%), 100% (95% CI: 54–100%), 100%, 16% (95% CI: 13–19%), 0.6 (95% CI: 0.48–0.75) and 47% (95% CI: 33–60%) for RT-PCR to 94% (95% CI: 83–99%), 100% (95% CI: 48–100%), 100%, 63% (95% CI: 36–83%), 0.06 (95% CI: 0.02–0.18), and 95% (95% CI: 84–99%) for ddPCR, respectively. Moreover, 6/14 (42.9%) convalescents were detected as positive by ddPCR at 5–12 days post discharge. Overall, ddPCR shows superiority for clinical diagnosis of SARS-CoV-2 to reduce the false negative reports, which could be a powerful complement to the RT-PCR.