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Objective: Accurate preoperative prediction of sinonasal inverted papilloma (SNIP) malignant transformation is essential and challenging. In this study, 3.0T magnetic resonance was used for qualitative, quantitative, and multi-parametric analysis to evaluate the predictive value of magnetic resonance imaging (MRI) in malignant transformation. Methods: The data of patients with SNIP (n=83) or SNIP-transformed squamous cell carcinoma (SNIP-SCC) (n=21) were analysed retrospectively. Univariate analysis and multivariate logistic regression were used to establish models to predict the risk factors for the malignant transformation of SNIP. Receiver operating characteristic (ROC) curves were used to evaluate the ability of independent risk factors and related combination models to predict malignant transformation of SNIP. Result: Convoluted cerebriform pattern (CCP) mutation, apparent diffusion coefficient ratio (ADCr), and wash-in index (WII) 2 and 3 were independent risk factors for predicting malignant transformation of SNIP, with area under the ROC curve (AUC) values of 0.845, 0.862, 0.727, and 0.704, respectively. The AUC of the quantitative parameter model combined with ADCr and WII 2 and 3 was 0.910 for diagnosing malignant transformation. The AUC of the comprehensive model comprising all independent risk factors was 0.937, with a sensitivity, specificity, and accuracy of 90.48%, 90.36%, and 92.31%, respectively. Conclusion: Compared with assessing independent risk factors of CCP mutation, ADCr and WII, and the quantitative parameter model, the comprehensive model could improve the differential diagnosis ability of SNIP and SNIP-SCC, which provides an important imaging basis for the possible accurate preoperative evaluation of malignant transformation of SNIP.

BACKGROUND: Neer type II/bilateral distal clavicular fracture is an extremely rare injury combination, with few cases having been reported. CASE PRESENTATION: This paper reports a case of polytrauma in a 16-year-old female following a road traffic accident. The radiographs revealed distal fractures of the bilateral clavicles (Neer type II), and an open reduction and internal fixation procedure was performed. Initially, the distal fracture of the right clavicle was fixed with a six-hole hook plate before the fracture of the left clavicle was fixed using a pre-contoured lateral locking plate following reduction. At the two-year follow-up, the patient had an excellent constant score in terms of the bilateral shoulder joints. CONCLUSION: It is important to achieve stability and to aim for excellence in terms of full shoulder function in this rare combination injury.

Background: The consistent definition of sarcopenic obesity (SO) is limited, its association with mild cognitive impairment (MCI) has not been clarified. Objective: This study aimed to evaluate the prevalence and agreement of SO using different definitions and the association between SO and MCI. Methods: SO was diagnosed by the co-existence of sarcopenia defined by the Asia Working Group for Sarcopenia (AWGS) and obesity by body mass index (BMI), visceral fat area (VFA), waist circumference (WC), or body fat percentage (BF%). Cohen’s kappa was used to assess the agreement between the different definitions. The association between SO and MCI was assessed using multivariable logistic regression. Results: Among 2,451 participants, the prevalence of SO ranged from 1.7% to 8.0% under different definitions. SO defined by AWGS and BMI (AWGS+BMI) showed fair agreements with the other three criteria (κ ranged from 0.334 to 0.359). The other criteria showed good agreements with each other. The κ statistics were 0.882 for AWGS+VFA and AWGS+BF%, 0.852 for AWGS+VFA and AWGS+WC, and 0.804 for AWGS+BF% and AWGS+WC, respectively. When using different diagnoses of SO, compared with the health group, the adjusted ORs of MCI for SO were 1.96 (95% CI: 1.29-2.99, SO: AWGS+WC), 1.75 (95% CI: 1.14-2.68, SO: AWGS+VFA), 1.37 (95% CI: 1.03-1.82, SO: AWGS+BF%), and 1.45 (95% CI: 0.67-3.12, SO: AWGS+BMI), respectively. Conclusion: Using different obesity indicators combined with AWGS to diagnose SO, BMI had lower prevalence and agreement compared with other three indicators. SO was associated with MCI under different methods (WC, VFA, or BF%).

The pre-bored grouted planted (PGP) pile is a new type of composite pile, and the core PHC pile is surrounded by cemented soil layer. The frictional capacity of core PHC pile – cemented soil interface has a significant effect on the bearing capacity of PGP pile. A series of square pile (pipe pile) – soil interface shear tests were carried out in this study to study the frictional capacity of smooth square pile (pipe pile) – cemented soil interface. The shear test results show that the peak skin friction of square pile (pipe pile) – cemented soil interface both increased with the cemented soil strength; the peak skin friction of square pile – cemented soil interface was smaller than the peak skin friction of pipe pile – cemented soil interface of identical pile (equivalent) diameter, owing to the occurrence of stress concentration at the corners of square pile; the peak skin friction of square pile (pipe pile) – cemented soil interface both decreased with the pile (equivalent) diameter; the occurrence of cracks in the cemented soil caused the brittle failure of both square pile (pipe pile) – cemented soil interface.

In clinical practice, we noticed that triple negative breast cancer (TNBC) patients had higher shear-wave elasticity (SWE) stiffness than non-TNBC patients and a higher α-SMA expression was found in TNBC tissues than the non-TNBC tissues. Moreover, SWE stiffness also shows a clear correlation to neoadjuvant response efficiency. To elaborate this phenomenon, TNBC cell membrane-modified polylactide acid-glycolic acid (PLGA) nanoparticle was fabricated to specifically deliver artesunate to regulate SWE stiffness through inhibiting CAFs functional status. As tested in MDA-MB-231 and E0771 orthotopic tumor models, CAFs functional status inhibited by 231M-ARS@PLGA nanoparticles (231M-AP NPs) had reduced the SWE stiffness as well as attenuated hypoxia of tumor as tumor soil loosening agent which amplified the antitumor effects of paclitaxel and PD1 inhibitor. Single-cell sequencing indicated that the two main CAFs (extracellular matrix and wound healing CAFs) that produces extracellular matrix could influence the tumor SWE stiffness as well as the antitumor effect of drugs. Further, biomimetic nanoparticles inhibited CAFs function could attenuate tumor hypoxia by increasing proportion of inflammatory blood vessels and oxygen transport capacity. Therefore, our finding is fundamental for understanding the role of CAFs on affecting SWE stiffness and drugs antitumor effects, which can be further implied in the potential clinical theranostic predicting in neoadjuvant therapy efficacy through non-invasive analyzing of SWE imaging.

Density peaks clustering (DPC) is as an efficient algorithm due for the cluster centers can be found quickly. However, this approach has some disadvantages. Firstly, it is sensitive to the cutoff distance; secondly, the neighborhood information of the data is not considered when calculating the local density; thirdly, during allocation, one assignment error may cause more errors. Considering these problems, this study proposes a domain density peak clustering algorithm based on natural neighbor (NDDC). At first, natural neighbor is introduced innovatively to obtain the neighborhood of each point. Then, based on the natural neighbors, several new methods are proposed to calculate corresponding metrics of the points to identify the centers. At last, this study proposes a new two-step assignment strategy to reduce the probability of data misclassification. A series of experiments are conducted that the NDDC offers higher accuracy and robustness than other methods.

The DArk Matter Particle Explorer (DAMPE) is well suitable for searching for monochromatic and sharp $\gamma$-ray structures in the GeV$-$TeV range thanks to its unprecedented high energy resolution. In this work, we search for $\gamma$-ray line structures using five years of DAMPE data. To improve the sensitivity, we develop two types of dedicated data sets (including the BgoOnly data which is the first time to be used in the data analysis for the calorimeter-based gamma-ray observatories) and adopt the signal-to-noise ratio optimized regions of interest (ROIs) for different DM density profiles. No line signals or candidates are found between 10 and 300 GeV in the Galaxy. The constraints on the velocity-averaged cross section for $\chi\chi \to \gamma\gamma$ and the decay lifetime for $\chi \to \gamma\nu$, both at 95% confidence level, have been calculated and the systematic uncertainties have been taken into account. Comparing to the previous Fermi-LAT results, though DAMPE has an acceptance smaller by a factor of $\sim 10$, similar constraints on the DM parameters are achieved and below 100 GeV the lower limits on the decay lifetime are even stronger by a factor of a few. Our results demonstrate the potential of high-energy-resolution observations on dark matter detection., Comment: 14 pages, 8 figures. Update the content to keep up with the published version

Oxide ions in transition metal oxide cathodes can store charge at high voltage offering a route towards higher energy density batteries. However, upon charging these cathodes, the oxidized oxide ions condense to form molecular O2 trapped in the material. Consequently, the discharge voltage is much lower than charge, leading to undesirable voltage hysteresis. Here we capture the nature of the electron holes on O2− before O2 formation by exploiting the suppressed transition metal rearrangement in ribbon-ordered Na0.6[Li0.2Mn0.8]O2. We show that the electron holes formed are delocalized across the oxide ions coordinated to two Mn (O–Mn2) arranged in ribbons in the transition metal layers. Furthermore, we track these delocalized hole states as they gradually localize in the structure in the form of trapped molecular O2 over a period of days. Establishing the nature of hole states on oxide ions is important if truly reversible high-voltage O-redox cathodes are to be realized.

Funding Information: This work was financially supported in part by the University of Oulu (projects: Entity, ROAR, and Memristors and neuromorphic sensors from vertically aligned layered materials). We acknowledge funding from the EU Erasmus + programme (project: TACMEE), and the Academy of Finland (Center of Excellence Program in Life-inspired Hybrid Materials (LIBER), and projects: 311058, 325185, and 330214). We thank the personnel of the Centre for Material Analysis at the University of Oulu for providing us with technical assistance. We also thank CSC Finland for the generous grants of computer time. Publisher Copyright: © 2023 The Authors. Published by American Chemical Society. Cost-effective and high-performance H2S sensors are required for human health and environmental monitoring. 2D transition-metal carbides and nitrides (MXenes) are appealing candidates for gas sensing due to good conductivity and abundant surface functional groups but have been studied primarily for detecting NH3 and VOCs, with generally positive responses that are not highly selective to the target gases. Here, we report on a negative response of pristine Ti3C2Tx thin films for H2S gas sensing (in contrast to the other tested gases) and further optimization of the sensor performance using a composite of Ti3C2Tx flakes and conjugated polymers (poly[3,6-diamino-10-methylacridinium chloride-co-3,6-diaminoacridine-squaraine], PDS-Cl) with polar charged nitrogen. The composite, preserving the high selectivity of pristine Ti3C2Tx, exhibits an H2S sensing response of 2% at 5 ppm (a thirtyfold sensing enhancement) and a low limit of detection of 500 ppb. In addition, our density functional theory calculations indicate that the mixture of MXene surface functional groups needs to be taken into account to describe the sensing mechanism and the selectivity of the sensor in agreement with the experimental results. Thus, this report extends the application range of MXene-based composites to H2S sensors and deepens the understanding of their gas sensing mechanisms.

A series of dihydroquinolinones have been synthesized via synergistic catalysis combining photolysis and Lewis base catalysis utilizing in situ generated ketenes and ortho-amino MBH carbonates.

Fluorinated saccharide-derived hard carbon is prepared as a cathode material of lithium primary batteries, and the effect of the polymerization degree of the starting saccharide is investigated.

The electron-rich Ru sites are isolated in body-centered cubic RuGa intermetallic compounds, which reduces the energy barrier of the rate-limiting step in the HER process, thus promoting the high-current-density HER activity.

Supertyphoons (STs) and strong convection gales (SCGs) are extremely hazardous weather events over land. Knowledge of their processes is crucial for various applications, such as intensity forecasts of gales and the design of high-rise construction and infrastructure. Here, an observational analysis of two strong SCGs and two STs is presented based on data from the Shenzhen meteorological gradient tower, the tallest in Asia. Differences in the intrinsic physical characteristics measured at each event can be associated with different disaster-causing mechanisms. Wind speeds during STs are comparatively much larger but feature slower variations, while those of SCGs are more abrupt. Unlike that observed during STs, the vertical distribution of wind speeds during SCGs obeys a power law or exponential distribution only within 1-h maximum wind speed windows. In comparison with a Gaussian distribution, a generalized extreme value distribution can better characterize the statistical characteristics of the gusts of both STs and SCGs events. Deviations from Kolmogorov’s −5/3 power law were observed in the energy spectra of both phenomena at upper levels, albeit with differences. Different from what is seen in the ST energy spectrum distribution, a clear process of energy increase and decrease could be seen in SCGs during gale evolution. Nonetheless, both SCGs and STs exhibited a high downward transfer of turbulent momentum flux at a 320 m height, which could be attributed to the pulsation of the gusts rather than to the large-scale base flow. Significance Statement Strong gales induced by typhoons and severe convection have potential serious impacts on human society. The current study compares and analyzes the characteristics of the gales induced by the two different weather systems using the data observed by a 356-m-tall tower in South China. This paper also shows the relationship between gusts of the near-surface wind and the turbulent momentum fluxes, thus suggesting a possible mechanism leading to destructive forces in surface winds. In terms of social value, this study would contribute to increase the awareness of gales (the instantaneous wind speed over 17 m s−1) and improve the prediction and prevention of different types of gales, as well as the wind-resistant design of high-rise buildings.

(R-/S-Br-MBA)3MnBr5 shows reversible conversion of CPL emission in wavelength and direction during heating and cooling.

Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) was first described by Nasr et al. in 2004 with a subsequent study composed of a larger patient cohort a few years later [1,2]. Although more commonly occurring in older adults, PGNMID has since been reported in a wide range of age groups including children [3-5]. PGNMID is categorized as a monoclonal gammopathy of renal significance (MGRS), and is additionally included in the recently expanded concept of monoclonal gammopathy of clinical significance (MGCS), which encompasses disorders of any organ system related to underlying plasma cell or B-cell clones [6]; however, most patients with PGNMID do not show evidence of a circulating monoclonal protein or clonal plasma cell proliferation, and monoclonal gammopathy has not been reported in any pediatric patients with the disease. Herein we briefly discuss the clinical and histopathologic features of PGNMID, as well as advances in our understanding of the pathogenesis and clinical course of the disease.

This study was aimed at exploring the function of Exosomes isolated from bone marrow-derived mesenchymal stem cells (BMSC-Exos) in corneal wound healing and at revealing the underlying mechanisms involving the p44/42 mitogen-activated protein kinase (MAPK) pathway.The isolated BMSC-Exos were identified by transmission electron microscopy, Western blot, and nanoparticle tracking analysis. After coculture with BMSC-Exos, the proliferation and migration of human corneal epithelial cells (HCEs) were evaluated. The protein expression of p-MEK/MEK and p44/42 MAPK was detected by Western blot. A mouse model of alkali-burned cornea was established via NaOH exposure. After injection with BMSC-Exos, the pathological changes and expression of α-SMA (a fibrosis marker) and CD31 (a vascularization marker) in corneal tissues were detected.BMSC-Exos enhanced the proliferation and migration of HCEs in a dose-dependent manner. The p44/42 MAPK pathway was activated by the treatment of BMSC-Exos, and its blocking using U0126 partially abrogated the effects of BMSC-Exos on promoting the proliferation and migration of HCEs. In vivo, the injection of BMSC-Exos facilitated the remission of the pathological changes (inflammation) and weakened the upregulation of α-SMA (fibrosis) and CD31 (vascularization) in corneal tissues of mice with alkali-burn injury.BMSC-Exos promoted the proliferation and migration of HCEs via activating the p44/42 MAPK pathway in vitro and also inhibited alkali burn-induced inflammation, fibrosis, and vascularization in corneal tissues in vivo. BMSC-Exos may be promising resources for promoting corneal wound healing.

Recent learning-based intrinsic image decomposition methods have achieved remarkable progress. However, they usually require massive ground truth intrinsic images for supervised learning, which limits their applicability on real-world images since obtaining ground truth intrinsic decomposition for natural images is very challenging. In this paper, we present an unsupervised framework that is able to learn the decomposition effectively from a single natural image by training solely with the image itself. Our approach is built upon the observations that the reflectance of a natural image typically has high internal self-similarity of patches, and a convolutional generation network tends to boost the self-similarity of an image when trained for image reconstruction. Based on the observations, an unsupervised intrinsic decomposition network (UIDNet) consisting of two fully convolutional encoder-decoder sub-networks, i.e., reflectance prediction network (RPN) and shading prediction network (SPN), is devised to decompose an image into reflectance and shading by promoting the internal self-similarity of the reflectance component, in a way that jointly trains RPN and SPN to reproduce the given image. A novel loss function is also designed to make effective the training for intrinsic decomposition. Experimental results on three benchmark real-world datasets demonstrate the superiority of the proposed method.

Xiao Liu,1,&ast; Kun-He Lin,1,&ast; Yue-Hua Li,2 Jun-Nan Jiang,3 Zheng-Dong Zhong,1 Ying-Bei Xiong,1 Jin Zhou,1 Li Xiang1,4 1School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Wuhan Center for Tuberculosis Control and Prevention, Wuhan Pulmonary Hospital, Wuhan, People’s Republic of China; 3School of Public Administration, Zhongnan University of Economics and Law, Wuhan, People’s Republic of China; 4HUST Base of National Institute of Healthcare Security, Huazhong University of Science and Technology, Wuhan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Li Xiang, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Email xllyf@hust.edu.cnBackground: Drug-resistant tuberculosis (DR-TB) is an increasingly serious global issue. DR-TB has a lower success rate and more severe interruption of treatment than ordinary tuberculosis. Incomplete treatment not only reduces recovery rate in DR-TB patients but also increases the spread of DR-TB. Optimizing medical security policies for DR-TB can reduce the economic burden of patients and can thereby improve treatment success rate.Methods: Patients with DR-TB who were registered in Wuhan Center for Tuberculosis Control and Prevention from January 2016 to December 2019 were selected as research subjects. General descriptive statistical analysis methods were used in analyzing patients’ treatment outcomes and medical security compensation rate. The binary logistic regression was used in analyzing the impacts of medical security level on treatment outcomes of DR-TB.Results: A total of 409 DR-TB patients were included in the study, and the refusal rate was 12.47%. The treatment success rate was only 37.09% for patients who started treatment and had treatment outcomes. The total out-of-pocket expenses (OOPs) per capita for DR-TB patients were 13,005.61 Chinese yuan. The outpatient effective compensation ratio (ECR) of DR-TB patients was only 51.04%. The outpatient ECR of DR-TB with subsidies of public health projects (SPHPs) were nearly 80% higher than those without SPHP. high outpatient ECR helped optimize treatment outcomes (P < 0.001, OR = 1.038). The inpatient ECR had no effect on patients’ treatment outcomes (P = 0.158, OR = 0.986).Conclusion: Many DR-TB patients did not receive complete treatment. The key breakthrough point in improving DR-TB treatment outcomes is to optimize the outpatient medical insurance compensation policy. Including the costs of DR-TB in expenses for severe diseases in outpatient care is recommended, and financial investment should be appropriately increased to ensure the high coverage ratio of subsidies for public health projects.Keywords: drug-resistant tuberculosis, medical security, treatment outcomes