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Background and objective: Robot-assisted radical prostatectomy (RARP) is widely used because of the many advantages of a robotic approach. The da Vinci Si robot is one of the most commonly used surgical robot systems, but it may be associated with higher costs owing to the use of consumable surgical supplies. Our aim was to conduct a preliminary investigation of the capability of the MP1000 system for RARP. Methods: In this prospective, multicentre, single-blinded study, we randomly assigned 42 patients scheduled to undergo RARP between April and September 2021 to a da Vinci Si group (control) or an MP1000 group (intervention). Patients underwent RARP performed using the assigned robotic system and were followed up at 3-mo intervals. The primary outcome was the rate of conversion to open/laparoscopic surgery. Secondary outcomes were installation and operation times, intraoperative blood loss, postoperative surgical margin status, hospital stay, incontinence, complications, safety indicators, and surgeon ergonomics. Key findings and limitations: All procedures were successfully completed without conversion to open/laparascopic surgery or major complications. Secondary outcomes, including oncological and ergonomic indicators, did not differ significantly between the groups over the study period. One patient in the control group experienced dysuria (Clavien-Dindo grade 3). No patients had incontinence at 3 mo. A limitation of the study is the small sample size. Conclusions and clinical implications: RARP with the MP1000 system is feasible, safe, and effective in the management of localised prostate cancer. Patient summary: We assessed the effectiveness and safety of the new MP1000 robot system for robot-assisted removal of the prostate in comparison to the da Vinci Si robot. We found no difference in effectiveness or safety among 42 patients with prostate cancer who were assigned randomly to one of the two systems. We conclude that the MP1000 is a suitable robot for this surgery.

The millimeter-sized glass (SiO2) shells play key roles in inertial confinement fusion (ICF) experiments, especially for the so-called ''direct-drive'' configuration. The preparation of large diameter/thickness ratio glass shells and the exploration of transformation mechanisms for silicon-doped glow discharge polymer (Si-GDP) to SiO2 still face challenges. Here, we prepared large diameter/thickness ratio glass shells with the diameter of ∼1200 μm and shell thickness of ∼5 μm by increasing the Si contents in Si-GDP precursors. The influence of Si contents in Si-GDP shells on the compositions, morphologies and geometrical properties of glass shells were carefully investigated. The formability and uniformity of micro morphologies of the glass shells will improve with the increase of Si contents in precursors. The chemical composition of the prepared glass shells is SiO2 with some carbides adsorbed on their surfaces and the compositions present negligible relationship with the Si contents. The sphericity, thickness uniformity and surface quality will increase with the increase of Si contents in precursors. Besides, the oxidation mechanisms for Si-GDP to SiO2 were explored by the combination of an in situ high temperature infrared spectroscopy and a simultaneous thermal analyzer.

Abstract Objectives Histological transformation to small cell lung cancer (SCLC) has been identified as a mechanism of TKIs resistance in EGFR-mutant non-small cell lung cancer (NSCLC). We aim to explore the prevalence of transformation in EGFR-wildtype NSCLC and the mechanism of SCLC transformation, which are rarely understood. Methods We reviewed 1474 NSCLC patients to investigate the NSCLC-to-SCLC transformed cases and the basic clinical characteristics, driver gene status and disease course of them. To explore the potential functional genes in SCLC transformation, we obtained pre- and post-transformation specimens and subjected them to a multigene NGS panel involving 416 cancer-related genes. To validate the putative gene function, we established knocked-out models by CRISPR-Cas 9 in HCC827 and A549-TP53-/- cells and investigated the effects on tumor growth, drug sensitivity and neuroendocrine phenotype in vitro and in vivo. We also detected the expression level of protein and mRNA to explore the molecular mechanism involved. Results We firstly reported an incidence rate of 9.73% (11/113) of SCLC transformation in EGFR-wildtype NSCLC and demonstrated that SCLC transformation is irrespective of EGFR mutation status (P = 0.16). We sequenced 8 paired tumors and identified a series of mutant genes specially in transformed SCLC such as SMAD4, RICTOR and RET. We firstly demonstrated that SMAD4 deficiency can accelerate SCLC transition by inducing neuroendocrine phenotype regardless of RB1 status in TP53-deficient NSCLC cells. Further mechanical experiments identified the SMAD4 can regulate ASCL1 transcription competitively with Myc in NSCLC cells and Myc inhibitor acts as a potential subsequent treatment agent. Conclusions Transformation to SCLC is irrespective of EFGR status and can be accelerated by SMAD4 in non-small cell lung cancer. Myc inhibitor acts as a potential therapeutic drug for SMAD4-mediated resistant lung cancer. Video Abstract

Objective: Penile vascular anomalies (PVAs) or hemangioma can arouse patient concern about aesthetics and cause symptoms like bleeding and sexual dysfunction. However, its low incidence and the deficiency of large-volume studies hinder urologists from making informed decisions. This study aimed to investigate the clinical features and treatment experience of PVAs at the Seventh Medical Center of PLA General Hospital, Beijing, China. Furthermore, by systematically analysis of studies on PVAs in Chinese people, we aimed to provide novel insights on the management of this condition. Methods: We retrospectively investigated clinical features and pathology of surgery-treated PVAs at our center. Moreover, by systemically reviewing the literature from PubMed and the three largest medical databases (China National Knowledge Infrastructure, Wan Fang, and Chinese Medical Journal Database) in China, we analyzed the clinical features and various therapies of PVAs in Chinese people. Results: Between March 1, 2018 and March 1, 2023, a total of 356 cases with vascular anomalies were treated with surgery at out center. Only seven (2.0%) cases had lesions involving the perineum and external genitalia. All the seven cases were pathologically benign and demonstrated no recurrence over a follow-up period of 1–52 months (median 14 months). A total of 410 cases from 44 studies were selected in the cumulative analysis. Most patients (92.4%) diagnosed with PVAs were asymptomatic, and 68.8% of the patients were treated with sclerotherapy. As to the pathology, 57.1% were venous malformation. Conclusion: The most common PVA is venous malformation and the majority of patients are asymptomatic. Sclerotherapy and laser have emerged as viable options for treating small lesions. Surgery still has its role in treating large lesions and obtaining pathology. Although PVAs often relapse or demand multiple treatments, the prognosis is favorable.

Glow discharge polymer (GDP) capsules are often used as the ablation layer in laser inertial confinement fusion (ICF) research, because of its excellent properties in low X-ray opacity, high tensile strength, and high thermal conductivity. The isolated surface defects and distribution of oxygen content on the surface of GDP capsules can lead to the increase of hydrodynamic instability and the decrease of compression efficiency. In this work, by using media spheres and silica nanoparticles, a tumble polishing device for GDP capsule polishing is built to improve the surface morphology. The effects of polishing parameters on the surface roughness and oxygen content of GDP were investigated. The test results show that tumble polishing can effectively remove convex defects, only 24 identified defects with a height below 231 nm were found after 144 h polishing, reduce the surface roughness (∼10 nm) and improve the surface quality of GDP capsules. Moreover, the oxygen content distribution on the surface of GDP is uniform after tumble polishing. And the depth analysis results show that the tumble polishing has no obvious effect on the change of oxygen content in GDP shell under the surface layer.

Abstract. Amoxicillin is widely used by the Chinese population and available in pharmacies without prescription. We performed a retrospective study on patients with fever who took amoxicillin before going to the fever clinic of the Second Affiliated Hospital of Nanchang University from March 1, 2020 to March 31, 2021. Among the total of 9093 patients attending the fever clinic, 446 patients had a history of taking amoxicillin, from which 100 cases were randomly selected to evaluate the therapeutic effects of non-prescribed amoxicillin by changes in clinical symptoms, counts of white blood cells, neutrophils, and lymphocytes, and levels of C-reactive protein (CRP). The control group consisted of 100 randomly selected patients for who it was verified that they did not take antibiotics before attending the fever clinic. Our study showed that there were no significant differences between the group of patients taking amoxicillin and the control group in terms of symptom improvement, white blood cell, neutrophil or lymphocyte counts, or the levels of CRP. Therefore, our study indicated that although non-prescribed amoxicillin is widely used among patients with fever, it does not provide significant beneficial therapeutic effects. There is still a long way to go to standardize the application of antibiotics and popularize knowledge on proper antibiotics use among the population.

C15H16N5O5Cl, monoclinic, P21/n (no. 14), a = 7.37210(10) Å, b = 13.30639(19) Å, c = 17.1682(2) Å, β = 97.2301(12)°, Z = 4, V = 1670.74(4) Å3, Rgt(F) = 0.0357, wRref(F2) = 0.1023, T = 173(1) K.

Abstract Background Ischemic heart diseases are still a threat to human health. Human pluripotent stem cell-based transplantation exhibits great promise in cardiovascular disease therapy, including heart ischemia. The purpose of this study was to compare the efficacy of human embryonic stem cell-derived cardiomyocyte (ESC-CM) therapy in two heart ischemia models, namely, permanent ischemia (PI) and myocardial ischemia reperfusion (IR). Methods Human embryonic stem cell-derived cardiomyocytes were differentiated from engineered human embryonic stem cells (ESC-Rep) carrying green fluorescent protein (GFP), herpes simplex virus-1 thymidine kinase (HSVtk), and firefly luciferase (Fluc). Two different heart ischemia models were generated by the ligation of the left anterior descending artery (LAD), and ESC-Rep-derived cardiomyocytes (ESC-Rep-CMs) were transplanted into the mouse hearts. Cardiac function was analyzed to evaluate the outcomes of ESC-Rep-CM transplantation. Bioluminescence signal analysis was performed to assess the cell engraftment. Finally, the inflammation response was analyzed by real-time PCR and ELISA. Results Cardiac function was significantly improved in the PI group with ESC-Rep-CM injection compared to the PBS-injected control, as indicated by increased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS), as well as reduced fibrotic area. However, minimal improvement by ESC-Rep-CM injection was detected in the IR mouse model. We observed similar engraftment efficiency between PI and IR groups after ESC-Rep-CM injection. However, the restricted inflammation was observed after the injection of ESC-Rep-CMs in the PI group, but not in the IR group. Transplantation of ESC-Rep-CMs can partially preserve the heart function via regulating the inflammation response in the PI model, while little improvement of cardiac function in the IR model may be due to the less dynamic inflammation response by the mild heart damage. Conclusions Our findings identified the anti-inflammatory effect of ESC-CMs as a possible therapeutic mechanism to improve cardiac function in the ischemic heart.

Targeting reliability assessment problems with a small sample size and large amount of zero-failure data which appear in the life assessment tests of aero-engine compressor disks, a reliability assessment method and simulation test method were developed by fusing numerical simulation and zero-failure data based on the life reliability assessment method for zero-failure data. The developed method was verified by numerical examples, and further applied in the reliability analysis of compressor disks by combining the test and simulation results. The results indicated that fusing the test data with the simulation data increased the amount of information, improved the life prediction accuracy, and increased the lower confidence limit of the reliable life by 6.02% compared with the case where the test data alone were used.

Nickel-based single-crystal superalloys are widely used in aeroengine hot-end components, owing to their unique crystal structure and outstanding high-temperature mechanical properties. In the present study, round rod specimens of different sizes were subjected to high temperature creep tests at 980 °C/300 MPa of a second-generation nickel-based single crystal superalloy. The effect of size on the creep behavior of nickel-based single-crystal superalloys was studied with reference to the creep curves and microstructure morphologies. Creep interruption tests of 3-mm micro-round rod specimens were performed for 30, 60, and 90 h until creep fracture occurred. It was found that for nickel-based single crystal superalloys, the smaller the diameter of the specimen, the longer its creep life. Furthermore, the creep fracture morphology showed obvious creep cavitation in the fracture region. The law of organization evolution was used to analyze the rafting phenomena during the creep process. A typical “N”-type drifting strip structure was found during the creep process. Meanwhile, the width of the γ-phase channel increases continuously with creep, and the rate of change of the width of the matrix phase was fastest at the earliest stage of creep, slowing significantly during the middle and late stages of creep with the completion and appearance the rafting phenomenon.

Background/Aims: Renal reperfusion injury occurs after the blood flow to the ischemic kidney is re-established under various clinical conditions, such as organ transplantation, renal artery stenosis, embolic disease, and the repair of descending aortic. The current study aims to explore the effects of src homology 2 domain-containing protein tyrosine phosphatase 2 (SHP-2) on the release of inflammatory cytokines and the apoptosis of renal tubular epithelial cells by regulating the TLR4/NF-κB signaling pathway in rats with renal ischemia-reperfusion (I/R) injury. Methods: A total of 60 normal clean Sprague Dawley (SD) (WT) rats were used in this study. The levels of creatinine (Cr) and blood urea nitrogen (BUN) were determined using an automatic biochemical analyzer. The apoptosis in renal tissue was detected by TUNEL assay. The renal tubular epithelial cells of rats were cultured, infected and treated with different lentivirus vectors. The serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), IL-1β and SHP27 were measured. Reverse transcription quantitative polymerases chain reaction and Western blot analysis were performed to measure the expression of relevant genes and proteins. Furthermore, the effect of SHP-2 on the proliferation, cell cycle and apoptosis of renal tubular epithelial cells was also investigated. Results: In the serum of rats with renal I/R injury and prolonged reperfusion time, the contents of Cr and BUN were increased, the positive expression of SHP-2 was higher, the level of apoptosis was promoted, IL-6, TNF-α, IL-1β and SHP27 expression in the serum was increased, the expression of SHP2, TLR4, NF-κB, IL-6, TNF-α and Bax was up-regulated, and the expression of Bcl-2 was down-regulated. Lentivirus-mediated silencing of SHP-2 promoted the proliferation of renal tubular epithelial cells, inhibited their apoptosis, and reduced the expression of inflammatory factors in these cells by functionally suppressing the TLR4/NF-κB signaling pathway. Conclusion: The results indicated that lentivirus-mediated silencing of SHP-2 inhibited the release of inflammatory cytokines and the apoptosis of renal tubular epithelial cells, and promoted the proliferation of these cells by inhibiting the TLR4/NF-κB signaling pathway in rats with renal I/R injury.

Abstract Background The prevalence of adverse food reactions in patients with chronic inhalant diseases has seldom been studied in China. This study is to investigate the prevalence of adverse food reactions and the symptoms caused in respiratory patients. Methods Respiratory patients in allergy clinics were asked to complete a questionnaire. Patients’ information such as age, gender, family history of allergy, and adverse reactions to a list of 48 foods and the symptoms caused, was recorded. Multivariate analyses were performed to determine the prevalence of adverse food reactions and their associated symptoms. Results 459 subjects, with an average age of 32 years old, completed the questionnaire; 45.3% were male. Among the 459 subjects, 38.1% (175/459) had an adverse reaction to food: 13.6% had an adverse food reaction to crab, 12.4% had an adverse food reaction to shrimp; and 9.9% had an adverse reaction to shellfish. Peach and nectarine were also shown to be common causative foods with 6.8% of the study group showing an adverse reaction to peach and 5.2% to nectarine. Seafood mainly caused skin symptoms and fruits gave rise to more throat, oral, and gastrointestinal problems. Conclusion The prevalence of adverse food reactions is high for patients with respiratory diseases. This indicates that adverse food reactions should be considered in the treatment and management of patients with chronic inhalant diseases.

C22H27N3O, monoclinic, P21/c (no. 14), a = 18.4984(4) Å, b = 11.4221(3) Å, c = 9.79600(19) Å, β = 90.9652(19)°, V = 2069.51(8) Å3, Z = 4, Rgt(F) = 0.0605, wRref(F2) = 0.1773, T = 293(2) K.

C35H35N7O, triclinic, P1̄ (no. 2), a = 10.2870(3) Å, b = 11.9918(4) Å, c = 13.8995(5) Å, α = 109.210(3)°, β = 96.833(3)°, γ = 107.594(3)°, Z = 2, V = 1497.32(9) Å3, Rgt(F) = 0.0401, wRref(F2) = 0.1091, T = 110(1) K.

C33H34N5O3Br, triclinic, P1̄ (no. 2), a = 9.1179(2) Å, b = 9.3291(3) Å, c = 18.4706(6) Å, α = 91.187(3)°, β = 95.764(2)°, γ = 102.256(2)°, Z = 2, V = 1526.15(8) Å3, Rgt(F) = 0.0357, wRref(F2) = 0.0954, T = 105.7(5) K.

C22H16N6O, monoclinic, P21/c (no. 14), a = 13.2081(5) Å, b = 23.3620(11) Å, c = 12.2769(5) Å, β = 102.345(4)°, V = 3700.7(3) Å3, Z = 8, Rgt(F) = 0.0648, wRref(F2) = 0.1730, T = 293(2) K.

C34H34N5O2Br, orthorhombic Pca21 (no. 29), a = 21.3626(13) Å, b = 11.8358(8) Å, c = 12.0998(9) Å, Z = 4, V = 3059.38(4) Å3, Rgt(F) = 0.0507, wRref(F2) = 0.1401, T = 173 K.

The existing iOS platform is lacking ofsystematic assessment methods of privacy leak detection.To solve this problem,a multi-dimensional iOSprivacy disclosure evaluation model was presented.This model combined static analysis,dynamic analysis and network data analysis method to extract the features of the application’s pri-vacy disclosure behavior and evaluate it form multiple dimensions way.The model on 30 different types of apps from the iOS App Store and found out that more than 50% of all investigated apps aretracking users’ locations were evaluated,almost 40% of all send data to a server without the user’s consent.The model makes up for the limitations of single static analysis or dynamic analysis methods,solves the quantization problem of privacy disclosure effectively.

Cold stress is one of the most important abiotic stresses in rice. C2H2 zinc finger proteins play important roles in response to abiotic stresses in plants. In the present study, we isolated and functionally characterized a new C2H2 zinc finger protein transcription factor OsCTZFP8 in rice. OsCTZFP8 encodes a C2H2 zinc finger protein, which contains a typical zinc finger motif, as well as a potential nuclear localization signal (NLS) and a leucine-rich region (L-box). Expression of OsCTZFP8 was differentially induced by several abiotic stresses and was strongly induced by cold stress. Subcellular localization assay and yeast one-hybrid analysis revealed that OsCTZFP8 was a nuclear protein and has transactivation activity. To characterize the function of OsCTZFP8 in rice, the full-length cDNA of OsCTZFP8 was isolated and transgenic rice with overexpression of OsCTZFP8 driven by the maize ubiquitin promoter was generated using Agrobacterium-mediated transformation. Among 46 independent transgenic lines, 6 single-copy homozygous overexpressing lines were selected by Southern blot analysis and Basta resistance segregation assay in both T1 and T2 generations. Transgenic rice overexpressing OsCTZFP8 exhibited cold tolerant phenotypes with significantly higher pollen fertilities and seed setting rates than nontransgenic control plants. In addition, yield per plant of OsCTZFP8-expressing lines was significantly (p

C11H10N4O2, monoclinic P21/c (no. 14), a = 6.6161(7) Å, b = 24.064(2) Å, c = 7.1768(9) Å, β = 115.463(15)°, Z = 4, V = 1031.6(2) Å3, Rgt(F) = 0.0412, wRref(F2) = 0.0953, T = 173(2) K.

Staphylococcus aureus causes a broad range of life-threatening diseases in humans. The pathogenicity of this micro-organism is largely dependent upon its virulence factors. One of the most extensively studied virulence factors is the extracellular protein α-toxin. In this study, we show that allicin, an organosulfur compound, was active against S. aureus with MICs ranged from 32 to 64 μg/mL. Haemolysis, Western blot and real-time RT-PCR assays were used to evaluate the effects of allicin on S. aureus α-toxin production and on the levels of gene expression, respectively. The results of our study indicated that sub-inhibitory concentrations of allicin decreased the production of α-toxin in both methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) in a dose-dependent manner. Furthermore, the transcriptional levels of agr (accessory gene regulator) in S. aureus were inhibited by allicin. Therefore, allicin may be useful in the treatment of α-toxin-producing S. aureus infections.

This work addresses the issues associated with implant surface modification. We propose a method to form the oxide film on implant surfaces by dry turning to generate heat and injecting oxygen-rich gas at the turning-tool flank. The morphology, roughness, composition, and thickness of the oxide films in an oxygen-rich atmosphere were characterized using scanning electron microscopy, optical profiling, and Auger electron spectroscopy. Electrochemical methods were used to study the corrosion resistance of the modified surfaces. The corrosion resistance trends, analyzed relative to the oxide film thickness, indicate that the oxide film thickness is the major factor affecting the corrosion resistance of titanium alloys in a simulated body fluid (SBF). Turning in an oxygen-rich atmosphere can form a thick oxide film on the implant surface. The thickness of surface oxide films processed at an oxygen concentration of 80% was improved to 4.6 times that of films processed at an oxygen concentration of 21%; the free corrosion potential shifted positively by 0.357 V, which significantly improved the corrosion resistance of titanium alloys in the SBF. Therefore, the proposed method may (partially) replace the subsequent surface oxidation. This method is significant for biomedical development because it shortens the process flow, improves the efficiency, and lowers the cost.

In specific industrial applications like very thin-walled aeronautical structures or turbine blades, workpiece vibration is strongly dominant in comparison with spindle-tool set vibration. A method for predicting the dynamic stable lobe diagram (DSLD) of thin-walled component peripheral milling process is proposed, which takes into account the variations of dynamic characteristics of workpiece with the tool position. A specific DSLD is elaborated by scanning the dynamic properties of workpiece along the machined direction throughout the machining process. And, based on the results of stability prediction for thin-walled component milling, influences of chatter on machining distortion (including cutting distortion and secular distortion) are investigated through specifying cutting conditions. Then these results are compared and verified by milling experiments.

BackgroundHepatitis E is caused by two viral genotype groups: human types and zoonotic types. Current understanding of the epidemiology of the zoonotic hepatitis E disease is founded largely on hospital-based studies.MethodsThe epidemiology of hepatitis E was investigated in a community-based surveillance study conducted over one year in a rural city in eastern China with a registered population of 400,162.ResultsThe seroprevalence of hepatitis E in the cohort was 38%. The incidence of hepatitis E was 2.8/10,000 person-years. Totally 93.5% of the infections were attributed to genotype 4 and the rest, to genotype 1. Hepatitis E accounted for 28.4% (102/359) of the acute hepatitis cases and 68.9% (102/148) of the acute viral hepatitis cases in this area of China. The disease occurred sporadically with a higher prevalence during the cold season and in men, with the male-to-female ratio of 3∶1. Additionally, the incidence of hepatitis E increased with age. Hepatitis B virus carriers have an increased risk of contracting hepatitis E than the general population (OR = 2.5, 95%CI 1.5-4.2). Pre-existing immunity to hepatitis E lowered the risk (relative risk = 0.34, 95% CI 0.21-0.55) and reduced the severity of the disease.ConclusionsHepatitis E in the rural population of China is essentially that of a zoonosis due to the genotype 4 virus, the epidemiology of which is similar to that due to the other zoonotic genotype 3 virus.

This article deals with the interaction between wave effects in mounts and resonances of foundations inflexible vibration isolation systems. A new model is proposed that is represented as a rigid mass supported by two linear unidirectional isolators on a flexible foundation beam, whose closed-form solutions for transmissibility and response ratio are then obtained, with which the influence of wave effects coupled with the flexibility of the foundation on the effectiveness of isolation is discussed. The wave effects on flexible isolation systems are analyzed under various parametric conditions and compared with those in rigid systems. In addition, several special cases are presented to show the transition between various limiting cases. Some approaches to control wave effects are also proposed.

Laboratory diagnosis of acute infection of hepatitis E virus (HEV) is commonly based on the detection of HEV RNA, IgM and/or rising IgG levels. However, the profile of these markers when the patients present have not been well determined. To clarify the extent of misdiagnosed sporadic hepatitis E in the initial laboratory detection, serial sera of 271 sporadic acute hepatitis cases were collected, detected and the dynamics of each acute marker during the illness course were analyzed. 91 confirmed cases of hepatitis E were identified based on the presentation of HEV RNA, IgM or at least 4 fold rising of IgG levels. 21 (23.1%) hepatitis E cases were false negative for the viral RNA and 40 (44.0%) for rising IgG, because occurrence of these markers were confined to acute phase of infection and viremia had already subsided and antibody level peaked when these patients presented. IgM was detected in 82 (90.1%) cases. It is the most prevalent of the three markers, because the antibody persisted until early convalescence. Nine cases negative for IgM were positive for rising IgG and one was also positive for the viral RNA; all of these nine cases showed high avid IgG in their acute phase sera, which indicated re-infection. In summary, it is not practicable to determine the true occurrence of sporadic hepatitis E. Nevertheless, it could be closely approximated by approach using a combination of all three acute markers.

BackgroundPatients are increasingly able to access their laboratory test results via patient portals. However, merely providing access does not guarantee comprehension. Patients could experience confusion when reviewing their test results. ObjectiveThe aim of this study is to examine the challenges and needs of patients when comprehending laboratory test results. MethodsWe conducted a web-based survey with 203 participants and a set of semistructured interviews with 13 participants. We assessed patients’ perceived challenges and needs (both informational and technological needs) when they attempted to comprehend test results, factors associated with patients’ perceptions, and strategies for improving the design of patient portals to communicate laboratory test results more effectively. Descriptive and correlation analysis and thematic analysis were used to analyze the survey and interview data, respectively. ResultsPatients face a variety of challenges and confusion when reviewing laboratory test results. To better comprehend laboratory results, patients need different types of information, which are grouped into 2 categories—generic information (eg, reference range) and personalized or contextual information (eg, treatment options, prognosis, what to do or ask next). We also found that several intrinsic factors (eg, laboratory result normality, health literacy, and technology proficiency) significantly impact people’s perceptions of using portals to view and interpret laboratory results. The desired enhancements of patient portals include providing timely explanations and educational resources (eg, a health encyclopedia), increasing usability and accessibility, and incorporating artificial intelligence–based technology to provide personalized recommendations. ConclusionsPatients face significant challenges in interpreting the meaning of laboratory test results. Designers and developers of patient portals should employ user-centered approaches to improve the design of patient portals to present information in a more meaningful way.

BackgroundThe language gap between health consumers and health professionals has been long recognized as the main hindrance to effective health information comprehension. Although providing health information access in consumer health language (CHL) is widely accepted as the solution to the problem, health consumers are found to have varying health language preferences and proficiencies. To simplify health documents for heterogeneous consumer groups, it is important to quantify how CHLs are different in terms of complexity among various consumer groups. ObjectiveThis study aimed to propose an informatics framework (consumer health language complexity [CHELC]) to assess the complexity differences of CHL using syntax-level, text-level, term-level, and semantic-level complexity metrics. Specifically, we identified 8 language complexity metrics validated in previous literature and combined them into a 4-faceted framework. Through a rank-based algorithm, we developed unifying scores (CHELC scores [CHELCS]) to quantify syntax-level, text-level, term-level, semantic-level, and overall CHL complexity. We applied CHELCS to compare posts of each individual on online health forums designed for (1) the general public, (2) deaf and hearing-impaired people, and (3) people with autism spectrum disorder (ASD). MethodsWe examined posts with more than 4 sentences of each user from 3 health forums to understand CHL complexity differences among these groups: 12,560 posts from 3756 users in Yahoo! Answers, 25,545 posts from 1623 users in AllDeaf, and 26,484 posts from 2751 users in Wrong Planet. We calculated CHELCS for each user and compared the scores of 3 user groups (ie, deaf and hearing-impaired people, people with ASD, and the public) through 2-sample Kolmogorov-Smirnov tests and analysis of covariance tests. ResultsThe results suggest that users in the public forum used more complex CHL, particularly more diverse semantics and more complex health terms compared with users in the ASD and deaf and hearing-impaired user forums. However, between the latter 2 groups, people with ASD used more complex words, and deaf and hearing-impaired users used more complex syntax. ConclusionsOur results show that the users in 3 online forums had significantly different CHL complexities in different facets. The proposed framework and detailed measurements help to quantify these CHL complexity differences comprehensively. The results emphasize the importance of tailoring health-related content for different consumer groups with varying CHL complexities.

Objective: Bacillus Calmette-Guérin (BCG) instillation is the standard adjuvant treatment for intermediate- and high-risk non-muscle-invasive bladder cancer after transurethral resection. Nevertheless, its toxicity often causes bladder complications. On follow-up cystoscopy, post-BCG bladder lesions can be pathologically benign, urothelial carcinoma recurrence, or other types of bladder malignancy. Only a small number of case reports have been published on post-BCG bladder lesions. Their clinical features, natural course, and management remain unknown. Methods: We retrospectively studied cystoscopic videos and medical records of BCG-treated bladder cancer patients at our center. During a long-term follow-up, we took biopsies on tumor-like lesions and described their changes. In addition, we summarized previous studies on post-BCG bladder lesions by systematic literature searching and review. Results: We described a series of three cases with post-BCG bladder lesions mimicking tumor recurrence from a total of 38 cases with follow-up data for more than 5 years. Those lesions could last, grow, or disappear spontaneously, and remain pathological benign for years. In systematic review, we identified and analyzed a total of 15 cases with post-BCG bladder lesions with detailed clinical information. Eleven of the 15 were benign and have a good prognosis with nephrogenic adenoma being the most common pathological type. Conclusion: Based on previous studies and our experience, benign lesions after BCG instillation cannot distinguish with cancer recurrence by cystoscopy alone, even under narrow band imaging mode. Nonetheless, given most of them have a good prognosis, random biopsy or transurethral resection might be spared in the patients with long-term negative biopsy and urine cytology.

Abstract Background Human brucellosis has become one of the major public health problems in China, and increases atypical manifestations, such as fever of unknown origin (FUO), and misdiagnosis rates has complicated the diagnosis of brucellosis. To date, no relevant study on the relationship between brucellosis and FUO has been conducted. Methods We retrospectively reviewed the medical charts of 35 patients with confirmed human brucellosis and prospectively recorded their outcomes by telephone interview. The patients were admitted to the Second Affiliated Hospital of Nanchang University between January 01, 2013 and October 31, 2019. Patient data were collected from hospital medical records. Results The percentage of males was significantly higher than that of female in FUO (78.95% vs. 21.05%, P

Abstract Background Esophageal cancer is a common malignant tumor of digestive tract with esophageal squamous cell carcinoma (ESCC) being the main histological subtype. This study aimed to identify potential hub gene associated with the pathophysiology of ESCC through bioinformatics analysis and experiment validation. Methods Three microarray datasets were obtained from the Gene Expression Omnibus (GEO) database. The overlapping differentially expressed genes (DEGs) were analyzed by GEO2R tool. Gene Ontology (GO) and Kyoto Encyclopedia of Genes (KEGG) pathway analyses were performed to predict the potential functions of DEGs. Nine hub genes were identified using protein–protein interaction (PPI) network and Cytoscape software. We selected RAD51-associated protein 1 (RAD51AP1) for further research because of its poor prognosis and it has not been sufficiently studied in ESCC. The effects of RAD51AP1 on proliferation, apoptosis, migration and invasion of ESCC cells were determined by in vitro functional assays. Results RAD51AP1 expression was significantly upregulated in ESCC tissues compared with normal tissues by using The Cancer Genome Atlas (TCGA) database. High expression of RAD51AP1 was associated with worse survival in ESCC patients. RAD51AP1 expression was positively associated with the enrichment of Th2 cells and T helper cells. Furthermore, CCK-8 and colony formation assays showed knockdown of RAD51AP1 inhibited the proliferation of ESCC cells. Flow cytometry analysis indicated knockdown of RAD51AP1 induced cell cycle arrest and apoptosis in ESCC cells. Transwell assay revealed knockdown of RAD51AP1 suppressed the migration and invasion of ESCC cells. Conclusions Finally, our results demonstrated that RAD51AP1 silencing significantly inhibited cell proliferation and invasion in ESCC, thereby highlighting its potential as a novel target for ESCC treatment.

ABSTRACT The intracellular protozoan parasite Babesia gibsoni infects canine erythrocytes and causes babesiosis. The hazards to animal health have increased due to the rise of B. gibsoni infections and medication resistance. However, the lack of high-quality full-genome sequencing sets has expanded the obstacles to the development of pathogeneses, drugs, and vaccines. In this study, the whole genome of B. gibsoni was sequenced, assembled, and annotated. The genomic size of B. gibsoni was 7.94 Mbp in total. Four chromosomes with the size of 0.69 Mb, 2.10 Mb, 2.77 Mb, and 2.38 Mb, respectively, 1 apicoplast (28.4 Kb), and 1 mitochondrion (5.9 Kb) were confirmed. KEGG analysis revealed 2,641 putative proteins enriched on 316 pathways, and GO analysis showed 7,571 annotations of the nuclear genome in total. Synteny analysis showed a high correlation between B. gibsoni and B. bovis. A new divergent point of B. gibsoni occurred around 297.7 million years ago, which was earlier than that of B. bovis, B. ovata, and B. bigemina. Orthology analysis revealed 22 and 32 unique genes compared to several Babesia spp. and apicomplexan species. The metabolic pathways of B.gibsoni were characterized, pointing to a minimal size of the genome. A species-specific secretory protein SA1 and 19 homologous genes were identified. Selected specific proteins, including apetala 2 (AP2) factor, invasion-related proteins BgAMA-1 and BgRON2, and rhoptry function proteins BgWH_04g00700 were predicted, visualized, and modeled. Overall, whole-genome sequencing provided molecular-level support for the diagnosis, prevention, clinical treatment, and further research of B. gibsoni. IMPORTANCE The whole genome of B. gibsoni was first sequenced, annotated, and disclosed. The key part of genome composition, four chromosomes, was comparatively analyzed for the first time. A full-scale phylogeny evolution analysis based on the whole-genome-wide data of B. gibsoni was performed, and a new divergent point on the evolutionary path was revealed. In previous reports, molecular studies were often limited by incomplete genomic data, especially in key areas like life cycle regulation, metabolism, and host-pathogen interaction. With the whole-genome sequencing of B. gibsoni, we provide useful genetic data to encourage the exploration of new terrain and make it feasible to resolve the theoretical and practical problems of babesiosis.

Abstract In this paper, we present a non-convex ℓ 2/ℓ q (0

This article attempts to characterize some important aspects of ‘New Korean Confucianism,’ by focusing on the life and thoughts of two major thinkers of 20th century Korea, namely Pak Chonghong (1903–1976) and Yi Sang-ŭn (1905–1976). While there are volumes of studies on ‘New Confucianism’, the focus remains mostly on Chinese academics; however, just like Song–Ming, Neo-Confucianism spread throughout East Asian countries, where a unique and distinct Neo-Confucian model emerged with its own arguments and debates. The New Confucianism that appeared at the turn of the 20th century in an attempt to embrace Western cultural power within a Confucian value system has also been extended and widely adopted in Korea and has transformed itself according to its socio-political environment. Pak and Yi, who lived during and after the Japanese colonial period, struggled to grasp a sense of autonomy as the unique Korean tradition and spirit was about to be swept away by a flood of foreign ideas and social turmoil. Although the two thinkers differed in their approaches—Pak studied Western philosophy and Yi Chinese New Confucianism—they devoted their life to uncovering and systematizing the distinctive structure of Korean traditional philosophy and thereby laid the cornerstone of New Korean Confucianism.

ObjectiveTo evaluate the clinical performance and utility for risk stratification of DH3 HPV assay in women (≥30 years) with NILM cytology.MethodsA prospective cohort was established in Central China between November 8 to December 14, 2016 which consisted of 2180 women aging 30-64 years with NILM cytology. At baseline, all women were screened using DH3 HPV assay. HPV 16/18 positive women would be assigned to colposcopy and biopsied if necessary. Then, hr-HPV positive women without CIN2+ lesions would be followed up by cytology every 12 months for two years. In the 3rd year of follow up, all women that were not biopsy proven CIN2+ would be called back and screened by cytology again. In follow-up period, women with ASC-US and above were referred to colposcopy and biopsied if clinically indicated. CIN2+ was the primary endpoint in analysis. The clinical performance and utility for risk stratification of DH3 HPV assay were assessed by SPSS 22.0 and SAS 9.4.ResultsOf 2180 qualified women, the prevalence of hr-HPV was 8.5% (185/2180), 45(2.1%) were HPV 16/18 positive. The clinical performance for HPV16/18 was 91.7% for sensitivity, 98.4% for specificity, respectively against CIN2+ detection at baseline. In four years of study, the corresponding rates of HPV 16/18 were 51.5% and 98.7%, respectively. The cumulative absolute risk for the development of CIN2+ was as high as 37.8% for HPV 16/18 positive women, followed by hr-HPV positive (14.6%), other hr-HPV positive (11.0%) and HPV negative (0.3%) in three years. The relative risk was 125.6 and 3.4 for HPV 16/18 positive group when compared with HPV negative and other hr-HPV positive group, respectively.ConclusionsDH3 HPV assay demonstrated excellent clinical performance against CIN2+ detection in cervical cancer screening and utility of risk stratification by genotyping to promote scientific management of women with NILM cytology.

BackgroundUrachal cancer is a rare neoplasm in the urological system. To our knowledge, no published study has explored to establish a model for predicting the prognosis of urachal cancer. The present study aims to develop and validate nomograms for predicting the prognosis of urachal cancer based on clinicopathological parameters.MethodsBased on the data from the Surveillance, Epidemiology, and End Results database, 445 patients diagnosed with urachal cancer between 1975 and 2018 were identified as training and internal validation cohort; 84 patients diagnosed as urachal cancer from 2001 to 2020 in two medical centers were collected as external validation cohort. Nomograms were developed using a multivariate Cox proportional hazards regression analysis in the training cohort, and their performance was evaluated in terms of its discriminative ability, calibration, and clinical usefulness by statistical analysis.ResultsThree nomograms based on tumor–node–metastasis (TNM), Sheldon and Mayo staging system were developed for predicting cancer-specific survival (CSS) of urachal cancer; these nomograms all showed similar calibration and discrimination ability. Further internal (c-index 0.78) and external (c-index 0.81) validation suggested that Sheldon model had superior discrimination and calibration ability in predicting CSS than the other two models. Moreover, we found that the Sheldon model was able to successfully classify patients into different risk of mortality both in internal and external validation cohorts. Decision curve analysis proved that the nomogram was clinically useful and applicable.ConclusionsThe nomogram model with Sheldon staging system was recommended for predicting the prognosis of urachal cancer. The proposed nomograms have promising clinical applicability to help clinicians on individualized patient counseling, decision-making, and clinical trial designing.

In order to analyze the influence of bearing preload on the dynamic characteristics of high-speed and heavy-load planetary gear transmission system， a dynamics model of high-speed heavy-load planetary gear transmission is established. Considered bearing preload factors， the preload of planetary pin bearing influence is analyzed for system support stiffness， natural frequency， internal and external Engagement vice dynamic meshing force. The results show that the planetary pin bearing preload can effectively increase the support stiffness of the planetary pin； the natural frequency of the system decreases with the preload and then increases， and increases with the increase of the clearance；the peak value of the dynamic meshing force of the internal and external meshing pairs of the planetary gear increases with the preload and then decreases， and increases with the increase of the clearance. The research results can provide support for optimizing the bearing preload of high-speed and heavy-load planetary gear transmission.

Deuterated polymer microspheres can be used as a neutron source in conjunction with lasers because thermonuclear fusion neutrons can be produced efficiently by collisions of the resulting energetic deuterium ions. A new type of solid deuterated polymer microsphere with a carbon hydrogen–carbon deuterium (CH-CD) multilayer has been designed for preparing the target for inertial confinement fusion (ICF) experiments. To fabricate these solid CH-CD multilayer microspheres, CH beads are first fabricated by a microfluidic technique, and the CD coating layer is prepared by a plasma polymerization method. Both polystyrene (PS) and poly(α-methylstyrene) (PAMS) are used as the material sources for the CH beads. The effects of the PS and PAMS materials on the quality of the solid CH beads and the resulting CH-CD multilayer polymer microspheres are investigated. The solid PS beads have better sphericity and a smoother surface, but large vacuoles are observed in solid PS-CD multilayer microspheres owing to the presence of residual fluorobenzene in the beads and a glass transition temperature of the solid PS beads that is lower than the temperature of plasma polymerization. Therefore, solid PAMS beads are more suitable as a mandrel for fabricating solid CH-CD multilayer polymer microspheres. Solid CH-CD multilayer microspheres with specified size have been successfully prepared by controlling the droplet size and the CD deposition rate and deposition time. Compared with the design value, the diameter deviation of the inner CH beads and the thickness deviation of the CD layer can be controlled within 20 µm and 2 µm, respectively. Thus, an approach has been developed to fabricate solid CH-CD multilayer microspheres that meet the physical design requirements for ICF.

BackgroundConventional clinical detection methods such as CT, urine cytology, and ureteroscopy display low sensitivity and/or are invasive in the diagnosis of upper tract urinary carcinoma (UTUC), a factor precluding their use. Previous studies on urine biopsy have not shown satisfactory sensitivity and specificity in the application of both gene mutation or gene methylation panels. Therefore, these unfavorable factors call for an urgent need for a sensitive and non-invasive method for the diagnosis of UTUC.MethodsIn this study, a total of 161 hematuria patients were enrolled with (n = 69) or without (n = 92) UTUC. High-throughput sequencing of 17 genes and methylation analysis for ONECUT2 CpG sites were combined as a liquid biopsy test panel. Further, a logistic regression prediction model that contained several significant features was used to evaluate the risk of UTUC in these patients.ResultsIn total, 86 UTUC− and 64 UTUC+ case samples were enrolled for the analysis. A logistic regression analysis of significant features including age, the mutation status of TERT promoter, and ONECUT2 methylation level resulted in an optimal model with a sensitivity of 94.0%, a specificity of 93.1%, the positive predictive value of 92.2% and a negative predictive value of 94.7%. Notably, the area under the curve (AUC) was 0.957 in the training dataset while internal validation produced an AUC of 0.962. It is worth noting that during follow-up, a patient diagnosed with ureteral inflammation at the time of diagnosis exhibiting both positive mutation and methylation test results was diagnosed with ureteral carcinoma 17 months after his enrollment.ConclusionThis work utilized the epigenetic biomarker ONECUT2 for the first time in the detection of UTUC and discovered its superior performance. To improve its sensitivity, we combined the biomarker with high-throughput sequencing of 17 genes test. It was found that the selected logistic regression model diagnosed with ureteral cancer can evaluate upper tract urinary carcinoma risk of patients with hematuria and outperform other existing panels in providing clinical recommendations for the diagnosis of UTUC. Moreover, its high negative predictive value is conducive to rule to exclude patients without UTUC.

Background: Two kinds of regimens (2-1-1 and 1-1-1-1-1) can be selected after Zagreb regimen(2-1-1)of PVRV was officially approved in Beijing in January 2015. Up to now, the subjects for most studies about the comparison between Zagreb and Essen regimen are under 50 y old, rarely at and above. Aging of the immune system may result in decreasing efficacy of vaccination, especially for adults aged above 65–70 y. This study compared the safety and immunogenicity of the Zagreb and Essen regimen in Chinese adults aged 50 and above with the goal to provide a supplemental data for this age group. Methods: A total of 114 cases were divided into 2 groups randomly, received PVRV under the Zagreb and Essen regimens respectively. Serum samples were collected at D0, D7, D14, D42, D180 and D365 to determine the rabies serum neutralizing antibody by rapid fluorescent focus inhibition test (RFFIT). Safety analyses were made by comparing the AEs in day-3, day-7, and day-(7 + 21) in Zagreb or day-(7 + 28) in Essen by gender and age cohorts. Results: 617 blood samples were obtained. Two groups showed similar immunogenicity, the neutralizing antibody titer of all subjects at D14 and D42 showed >0.5 IU/ml. Under the same regimen, Subjects ≥65 y had lower GMC than those who