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We aimed to describe the weight-for-age Z-score growth trajectory (WAZ-GT) of infants with complex congenital heart disease (cCHD) after neonatal cardiac surgery in the first 4 months of life and assess potential risk factors.We utilized data from a previously reported trial of the REACH telehealth home monitoring (NCT01941667) program which evaluated 178 infants with cCHD from 2012 to 2017. Over the first 4 months of life, weekly infant weights were converted to WAZ. WAZ-GT classes were identified using latent class growth modeling. Multinomial logistic regression models were used to examine the associations between potential risk factors and WAZ-GT classes.Four distinct classes of WAZ-GT were identified: maintaining WAZ0, 14%; stable around WAZ = 0, 35%; partially recovered, 28%; never recovered, 23%. Compared with reference group "stable around WAZ=0," we identified clinical and sociodemographic determinants of class membership for the three remaining groups. "Maintaining WAZ0" had greater odds of having biventricular physiology, borderline appetite, and a parent with at least a college education. "Partially recovered" had greater odds of hospital length of stay14 days and being a single child in the household. "Never recovered" had greater odds hospital length of stay14 and30 days, tube feeding at discharge, and low appetite.This study described distinct classes of WAZ-GT for infants with cCHD early in infancy and identified associated determinants.Findings from this study can be used in the identification of infants at risk of poor WAZ-GT and in the design of interventions to target growth in this vulnerable patient population.

People’s lives are undergoing tremendous changes with the development of the times. Compared with the past, people’s pursuit of spiritual and cultural life also makes our education field usher in a huge development to adapt to the changes in the context of the times. But, at the same time, the development of labor education is gradually being downplayed by people, resulting in a series of problems such as people preferring comfort and not working. Aiming at this common problem, this paper will use the ant colony algorithm and particle swarm optimization algorithm in the computer intelligent algorithm to optimize the way of labor education. It includes the principle and basic process of the ant colony algorithm, the establishment of the mathematical model of the original ant colony algorithm, and the improved algorithm of the ant colony algorithm. The research results of the optimization method of labor education showed the following: when the number of ant colonies reaches 51, the number of iterations of the algorithm will be the least, and the corresponding shortest path is also the best solution; when the combination of pheromone intensity and volatility factor is 3, the optimal solution can be quickly found, and the algorithm inflection point of MMAS is 44.82. From the research results, it can be seen that the computer intelligent algorithm has a good choice for the optimization of labor education and can achieve a major breakthrough in the traditional model of labor education.

Water pollution threatens the safety of human production and life. To quickly respond to water pollution, it is important for water management staff to predict water quality changes in advance. Drawing on the temporality of water quality data, the leaky integrator echo state network (ESN) was introduced to construct the water quality prediction models for dissolved oxygen (DO), permanganate index (CODMn), and total phosphorus (TP), respectively. First, the missing values were filled by the linear trend method of adjacent points, and the outliers were detected and corrected by the Z-score method and the linear trend method. Second, the singular spectrum analysis (SSA) was performed to denoise the original monitoring data, such that the predicted data catch up with the real data, and the model accuracy is not affected by the hidden noise in the data. Third, the correlation between water quality indices was measured by the maximum information coefficient (MIC), and the strongly correlated indices were imported to the prediction model. Finally, according to these strong correlation indicators, the water quality prediction models based on multiple features were constructed, respectively, using the offline and online learning algorithms of the ESN. The hyperparameters of the models were optimized through the sequential model-based optimization (SMBO). Experimental results show that the proposed water quality prediction models, namely, SSA-MIC-SMBO-Offline ESN and SSA-MIC-SMBO-Online ESN, predicted DO, CODMn, and TP accurately, providing suitable tools for practical applications.

Background The Bazhen decoction is one of the most extensively used Traditional Chinese medicine (TCM) prescriptions for anti-aging. However, due to the complicity of the components, the pharmacological mechanism of Bazhen decoction is still limited.Methods We applied RNA sequencing and transcriptome analysis to get the full view of the signaling pathways regulated by Bazhen decoction in the wild type cell background. By using the progeroid cells derived from Werner syndrome mice, we applied Western blot, Immunofluorescence, flow cytometry and telomere FISH to verify the transcriptome data.Results The transcriptome profile revealed that Bazhen decoction might systematically regulate multiple anti-aging pathways, including stem cell regulation, protein homeostasis, cardiovascular function, neuronal function, anti-inflammation, anti-DNA damage induced stress, DNA helicase activity and telomere lengthening. We found that multiple DNA helicases and telomere regulating proteins were up-regulated by Bazhen decoction, which promoted the resolving of G-quadruplex (G4) structure, and facilitated DNA replication and telomere elongation. These improvements also endowed the cellular resistance to DNA damages induced by replication stress. Together these data suggest that Bazhen decoction facilitate G4 resolving and telomere maintenance, which might contribute to the longevity sustaining properties revealed by transcriptome profile.Conclusions Our data revealed a new strategy for recovering the pharmacological signature pathways for TCM, which could help the clinical precision medicine of TCM. By applying transcriptome in TCM-treated normal cell, we tried out a systematic analysis for dissecting the molecular mechanism of complicated TCM prescription in the normal genetic background.

The tumor microenvironment induces immunosuppression via recruiting and expanding suppressive immune cells such as regulatory T cells (Treg) to promote cancer progression. In this study, we documented that tumor-infiltrating CD73+ γδTregs were the predominant Tregs in human breast cancer and exerted more potent immunosuppressive activity than CD4+ or CD8+ Tregs. We further demonstrated that cancer-associated fibroblast (CAF)–derived IL6, rather than TGFβ1, induced CD73+ γδTreg differentiation from paired normal breast tissues via the IL6/STAT3 pathway to produce more adenosine and become potent immunosuppressive T cells. CD73+ γδTregs could in turn promote IL6 secretion by CAFs through adenosine/A2BR/p38MAPK signaling, thereby forming an IL6–adenosine positive feedback loop. CD73+ γδTreg infiltration also impaired the tumoricidal functions of CD8+ T cells and significantly correlated with worse prognosis of patients. The data indicate that the IL6–adenosine loop between CD73+ γδTregs and CAFs is important to promote immunosuppression and tumor progression in human breast cancer, which may be critical for tumor immunotherapy.

Supplemental Figures 1-12 and Supplementary Tables 1-3

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Purpose: Cytokine BAFF is a potent molecule for the activation and survival of B cells, and it also plays an important role in T-cell function. Genetic polymorphism (rs9514828C>T) in BAFF has been associated with elevated BAFF transcription. We sought to determine whether rs9514828 is associated with T-cell lymphoma (TCL) survival.Experimental Design:BAFF rs9514828 genotypes and survival of TCL were analyzed in the discovery group including 150 patients, and the results were replicated in an independent validation group of 120 patients. Kaplan–Meier analysis was conducted to compare survival among different genotypes. Cox proportional hazard models were used to identify independent significant variables. Luciferase reporter gene assays were conducted to examine the function of rs9514828 variant.Results: We found that BAFF rs9514828 polymorphism was significantly associated with TCL survival. In pooled analysis of two independent groups, the favorable rs9514828 TC and TT genotypes had significantly better five-year survival rates compared with the CC genotype (47% and 53% vs. 22%, P = 2.27 × 10−5 for log-rank test). Multivariate Cox regression analysis showed that rs9514828 was an independent prognostic factor, with HRs for patient death being 0.48 [95% confidence interval (CI), 0.32–0.71] for the CT and 0.47 (95% CI, 0.23–0.93) for the TT genotypes. Reporter gene assays indicated that the rs9514828T allele had significantly higher promoter activity than the rs9514828C counterpart.Conclusion: These findings suggest that functional polymorphism in BAFF might be a genetic determinant for the survival of patients with TCL. Clin Cancer Res; 18(8); 2250–6. ©2012 AACR.

Supplementary Figures 1-2, Tables 1-6 from Genetic Variants on Chromosome 15q25 Associated with Lung Cancer Risk in Chinese Populations

Due to the low activity and poor selectivity of current artificial nitrogen fixation catalysts, there is an urgent need to develop efficient and environmentally friendly Electrochemical ammonia synthesis (EAS) electrocatalysts. Electrochemical ammonia synthesis is considered an environmentally friendly and sustainable method for artificial nitrogen fixation. Herein, Fe2O3 nanoparticles assembled on MoSe2 (Fe2O3/MoSe2) were first developed and regarded as an efficient electrocatalytic nitrogen fixation catalyst with high electroactive. The Fe2O3/MoSe2 composites exhibited excellent NRR activity with an NH3 yield of 55.52 µg∙h− 1∙mg− 1 at -0.5 V and Faradaic efficiency of 9.6% at -0.6 V vs. RHE. Notably, the Fe2O3/MoSe2 composites exhibited excellent stability and durability in recycling tests. Density functional theory (DFT) calculations revealed that the interfacial charge transport from Fe2O3 to MoSe2 could significantly enhance the Electrochemical nitrogen reduction reaction (NRR) activity of Fe2O3/MoSe2 by promoting the conductivity of Fe2O3/MoSe2 and reducing the free energy barrier for the rate-determining of *N2 to *N2H formation step. This work provides a promising avenue for the green synthesis of NH3.

RGB salient object detection (SOD) has made great progress. However, the performance of this single-modal salient object detection will be significantly decreased when encountering some challenging scenes, such as low light or darkness. To deal with the above challenges, thermal infrared (T) image is introduced into the salient object detection. This fused modal is called RGB-T salient object detection. To achieve deep mining of the unique characteristics of single modal and the full integration of cross-modality information, a novel Cross-Guided Fusion Network (CGFNet) for RGB-T salient object detection is proposed. Specifically, a Cross-Scale Alternate Guiding Fusion (CSAGF) module is proposed to mine the high-level semantic information and provide global context support. Subsequently, we design a Guidance Fusion Module (GFM) to achieve sufficient cross-modality fusion by using single modal as the main guidance and the other modal as auxiliary. Finally, the Cross-Guided Fusion Module (CGFM) is presented and serves as the main decoding block. And each decoding block is consists of two parts with two modalities information of each being the main guidance, i.e., cross-shared Cross-Level Enhancement (CLE) and Global Auxiliary Enhancement (GAE). The main difference between the two parts is that the GFM using different modalities as the main guide. The comprehensive experimental results prove that our method achieves better performance than the state-of-the-art salient detection methods. The source code has released at: https://github.com/wangjie 0825/CGFNet.git.

GOAL: The objective of this retrospective, observational study is to assess the mediating effect of medical complexity on the relationship between social vulnerability and four acute care resource use outcomes, specifically numbers of hospitalizations, emergency department (ED) visits, observation stays, and total visits. Such information may help management better anticipate the effects of interventions targeted to the socially vulnerable in their patient population and others. METHODS: Electronic health record data from 147,496 adults served by 27 primary care practices in one large health system from 2015 to 2017 were used. Descriptive statistics were used to characterize patients and the primary care practices included in the study. Causal mediation analyses using a modified Baron and Kenny approach were performed. PRINCIPAL FINDINGS: Causal mediation analyses demonstrated that increased social vulnerability was associated with increased medical complexity (IRR=1.57), and increased number of hospitalizations (IRR=1.63), ED visits (IRR=2.14), observation stays (IRR=1.94), and total visits (IRR=2.04). Effects remained significant, though attenuated, after adjusting for medical complexity (mediator), demographics, and medications (hospitalizations IRR=1.44; ED visits IRR=2.02; observation stays IRR=1.74; and total visits IRR=1.86). Between 8% (ED visits) and 26% (hospitalizations) of variation in outcomes was explained by social vulnerability, given medical complexity. PRACTICAL APPLICATIONS: These findings reinforce the need to modify interventions for medically complex adults to address social needs and, consequently, reduce use of costly health services. Health systems seeking to reduce the use of costly care can use these results to estimate savings in the treatment of patients with high social vulnerability—both before they get chronic conditions and afterwards as they seek care.

Background: The World Health Organization acknowledges quality of life (QOL) as subjectively perceived overall well-being by the individual and recognizes it as an essential construct for overall health and wellness. The purpose of this study was to examine the association of infant, environmental, and parental factors with the QOL of mothers of infants at four months post-hospital discharge from cardiac surgery. Methods: Secondary analysis of prospectively collected data from the REACH randomized clinical trial of telehealth home monitoring. The sample included mothers (n = 148) of infants with congenital heart disease who provided data at four months post-discharge. Ten imputations were generated using fully conditional specification methods to address missing data and were combined. All analyses were performed on the imputed data. Mothers’ QOL was the main outcome of the analysis, as measured by the Ulm Quality of Life Inventory for Parents. Predictors on QOL were identified based on the World Health Organization QOL framework which recognizes the multidimensional domains influencing QOL that include personal factors, environmental factors, and physical factors related to disease and functioning. Results: The treatment and control groups did not differ on any study variable, thus data were collapsed and analyzed together. Final multivariable model found that the combination of dyadic adjustment, social support, parenting stress, and post-traumatic stress symptoms explained approximately three-quarters of the variance in QOL scores. Conclusions: QOL for mothers of infants with congenital heart disease is largely influenced by psychosocial factors. Future research targeted toward improving maternal QOL should include psychosocial interventions that address social networks and stress.

RGB and thermal infrared (RGBT) image saliency detection is a relatively new direction in the field of computer vision. Combining the advantages of RGB images and T images can significantly improve detection performance. Currently, there are only a few methods to work on RGBT saliency detection, and the number of image samples cannot meet the training requirements for deep learning, so it remains valuable to propose an effective unsupervised method. In this paper, we present an unsupervised RGBT saliency detection method based on multi-graph fusion and learning. Firstly, RGB images and T images are adaptively fused based on boundary information to produce more accurate superpixels. Next, a multi-graph fusion model is proposed to selectively learn useful information from multi-modal images. Finally, we implement the theory of finding good neighbors in the graph affinity and propose different algorithms for two stages of saliency ranking. Experimental results on three RGBT datasets show that the proposed method is effective compared with the state-of-the-art algorithms.

Slipping-stretching landslides have long been recognized as a common type of landslide case, but such reactions have rarely been reported. There was a slipping-stretching landslide reaction at Liangtianao, Guangxi Province, China, and the geological background and deformation characteristics of the case were identified by detailed geological survey and long-term monitoring. A FEM model of the case was built using GEO5 to analyze the mechanism of reaction and deformation. The results are as follows. 1) The Liangtianao landslide is a bedding rock ancient landslide, which remained in a creeping state after the landslide occurred in geological history. 2) The new sliding surface in the Liangtianao landslide is basically consistent with the weak interlayers formed by ancient landslides, and the fault-type is a slipping-stretching type with the following deformation process: strain at leading edge by road excavation→ leading edge instability→ middle part shear and creep→ back edge tensile. 3) Micro-geomorphology, rock mass bedding, and weak interlayers are internal causes of the Liangtianao landslide reaction, while excavation unloading and rainfall are the external causes. The inclinometer indicates that the Liangtianao landslide is still highly sensitive to rainfall after the landslide reaction, which may trigger a secondary landslide reaction. 4) The numerical analysis results indicate that the maintenance of a passive state in the anti-sliding section is highly beneficial to maintaining basic stability after the landslide reaction; unloading only 1/20 of the sliding section makes the landslide stable in the long term.

Purpose The SingHealth-Duke-GlaxoSmithKline COPD and Asthma Real-world Evidence (SDG-CARE) collaboration was formed to accelerate the use of Singaporean real-world evidence in research and clinical care. A centerpiece of the collaboration was to develop a near real-time database from clinical and operational data sources to inform healthcare decision making and research studies on asthma and chronic obstructive pulmonary disease (COPD). Methods Our multidisciplinary team, including clinicians, epidemiologists, data scientists, medical informaticians and IT engineers, adopted the hybrid waterfall-agile project management methodology to develop the SingHealth COPD and Asthma Data Mart (SCDM). The SCDM was developed within the organizational data warehouse. It pulls and maps data from various information systems using extract, transform and load (ETL) pipelines. Robust user testing and data verification was also performed to ensure that the business requirements were met and that the ETL pipelines were valid. Results The SCDM includes 199 data elements relevant to asthma and COPD. Data verification was performed and found the SCDM to be reliable. As of December 31, 2019, the SCDM contained 36,407 unique patients with asthma and COPD across the spectrum from primary to tertiary care in our healthcare system. The database updates weekly to add new data of existing patients and to include new patients who fulfil the inclusion criteria. Conclusions The SCDM was systematically developed and tested to support the use RWD for clinical and health services research in asthma and COPD. This can serve as a platform to provide research and operational insights to improve the care delivered to our patients.

Landslides are frequent in the Nanpeng River fault zone in southwest Yunnan. Based on a Zhen Qing Expressway survey, the geological conditions and characteristics of landslides in this area were studied. The conclusions are as follows: 1) the geological background was the internal cause of local highly steep slopes and broken rock masses. The main landslide types in study area are fault-type and accumulation landslides. 2) The formation of fault-type landslides is related to endogenous causes, such as tectonic movements, but they are less easily triggered than accumulation landslides. Accumulation landslides are related to broken rock masses and are sensitive to external factors such as rainfall and artificial unloading. 3) The coordinated control of permanent support engineering, local deformation control, and overall support reinforcement should be considered as preventive measures.

Cobaltite spinel oxides (CuCo2O4), which show electrocatalytic activity for oxygen evolution reaction (OER), are readily synthesized using a facile hydrothermal method, with a stationary ratio, uniform flower-like mesopores morphology, and high crystallinity. We have carried out first-principles calculations on the mechanism of the reaction pathway and the Gibbs free energy diagram of CuCo2O4 structures using density functional theory (DFT) and purely confirmed by experimental results. This catalyst performed an outstanding OER performance with an overpotential 230 mV at 10 mA∙cm− 2 in 1 M KOH, which was close to IrO2 with an overpotential 190 mV at 10 mA∙cm− 2. This work provides a facile method for electrocatalytic oxygen production with enhanced conductivity and enhanced OER by replacing cobalt with copper.

The COVID-19 pandemic continues to disrupt every society as SARs-CoV-2 variants surge among the populations. Health care providers are exhausted, becoming ill themselves, and in some instances have died. Indeed, hospitals are struggling to find staff to care for critically ill patients most in need. Previous work has reported on the unending work-related conditions that hospital staff are laboring under and their subsequent mental and physical health strains. Health care providers need support, but it is not clear where that support is to come from. While much research has reported on the COVID-19-related fears of nurses and physicians, fewer studies have focused on supportive features of the hospital work environment and how it may provide relief to front-line health care providers.This purpose of this study was to explore an often-overlooked resource within hospital systems across the United States-clinical ethicists-and examine their many roles during COVID-19 and the types of ethical issues they addressed with nurses, physicians, administrators, and others.This was a primary analysis of semi-structured, qualitative interviews with 23 clinical ethicists across the United States. The interviews were conducted from November 2020-April 2021 and were audiotaped, transcribed verbatim, and de-identified; both inductive and deductive analyses were used to identify qualitative themes.Five major themes were identified: ethical issues that were increasingly more complex, moral distress that was "endemic," shifting ethical paradigms from the focus on the individual to the population, fostering a supportive environment, and organizational ethics: variation in the value, roles, and policy input of clinical ethicists.Our findings report on the integral and expanded role of clinical ethicists at an unprecedented time in our nation, and how they stepped forward to support front-line clinicians in hospitals across the country.

The electron beam dump for Dalian Advanced Light Source (DALS) is designed to absorb 15 kW of electron beam power at beam energy up to 120 MeV. The DALS accelerator produces an electron beam with very small beam size of up to 100 μA average current. The resulting beam power, up to 15 kW at 120 MeV, and the very high beam power density, pose challenging problems for beam dump design. High power dump with water cooled has been developed for DALS. In the dump, most of the beam power is finally absorbed in water and taken out from the dump. The core of the high power electron beam dump is designed to be constructed from an aluminum alloy using a cylindrical geometry with fins arranged around to promote the heat transfer. The cooling water is forced by a cooling pump, to cool the core of the dump through the cooling channels. The beam is stopped in the dump involving a high production of neutron and gamma radiation and activation of its surface. A shield has been designed to attenuate both the radiation produced during accelerator operation and the residual radiation. Design details for the dump, including radiation shielding calculations, thermal analysis are presented.

The improvement of reproductive capacity of poultry is important for the poultry industry. The existing studies on reproductive capacity mainly focus on the testis tissue, but few reports on regulationary effect of brain neuroendocrime on reproductive capacity have been available. The hypothalamus–pituitarium–gonad (HPG) axis is an important pathway regulating spermatogenesis and sexual behavior. This study analyzed the gene expression in the hypothalamus and pituitary tissues of male ducks in high-semen-quality group (DH), low-semen-quality group (DL), and non-response group (DN) by RNA-sequencing. A total of 1980 differentially expressed genes (DEGs) were identified, and significantly less DEGs were found in pituitary gland than in hypothalamus. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses showed that these DEGs were mainly enriched in nerve-related and synapse-related biological processes, mitochondrial inner membrane formation pathway, and ribosome structure pathway. Notably, the neuroactive ligand–receptor interaction pathway significantly enriched in all three comparisons (DH vs. DL, DH vs. DN, and DL vs. DN) was related to different reproductive performance such as semen quality and sexual response. Furthermore, six genes, including POMC, CPLX2, HAPLN2, EGR4, TOX3, and MSH4, were identified as candidate genes regulating reproductive capacity. Our findings provide new insights into the regulation mechanisms underlying the reproductive performance of male poultry, and offer a valuable reference for duck breeding programs aimed at promoting reproductive capacity.

Saliency detection methods which center on RGB images are sensitive to surrounding environments. Fusing complementary RGB and thermal infrared (RGB-T) images is an effective way to promote the final saliency performance. However, there are relatively few datasets and algorithms for RGB-T saliency detection, which is the prominent problem in this research field. Therefore, an unsupervised method that does not require a large amount of labeled data is proposed for RGB-T image saliency detection in this paper. At first, we construct the graph model in which the superpixels are treated as graph nodes. Instead of utilizing the Euclidean distance to construct initial affinity matrix, a novel node classification distance is designed to explore the local relationship and graph geometrical structure of nodes. Additionally, the advantageous constraint is proposed to increase the sparsity of the image, which not only makes the initial affinity matrix sparse and accurate but also enhances the foreground or background consistency during the graph learning. Furthermore, an adaptive ranking algorithm fusing classification distance and sparse constraint is used to unify the graph affinity learning and the computation of saliency values, which helps to generate more accurate saliency results. Experiments on two public RGB-T datasets demonstrate that the applied method performs desirably against the state-of-the-art algorithms.

Extramammary Paget’s disease is a rare skin malignancy, and its diagnosis requires invasive biopsy and histopathological examination. Surgery is the standard treatment for extramammary Paget’s disease patients; however, as incision boundaries and the depth of tumor cell infiltration are often unclear, the postoperative recurrence rate is high. We present a case in which we used photodynamic diagnosis in combination with reflectance confocal microscopy before surgery to detect an extramammary Paget’s disease lesion that was located 3 cm away from the classical lesion. This secondary lesion exhibited a subclinical presentation, and it was eventually confirmed as an extramammary Paget’s disease lesion by pathological examination. During detection using our technique, we delineated the boundaries of the extramammary Paget’s disease lesion as a guide for surgical excision. The findings of our case demonstrate that photodynamic diagnosis combined with reflectance confocal microscopy can be used for the noninvasive diagnosis of subclinical extramammary Paget’s disease and may be used to guide strategies for planning treatment and preventing relapse.

Objectives: This study examines healthcare resource use (hospitalizations, emergency department [ED] visits, and home health episodes) among adults 65 and older diagnosed with hearing, vision, or dual sensory loss (SL) seen in the primary care setting of an academic health system. Methods: Multivariable logistic regression models were used to examine the relationship between SL (identified using ICD-10 codes) and healthcare resource use for 45,000 primary care patients. Results: The sample included 5.5% ( N = 2479) with hearing loss, 10.4% ( N = 4697) with vision loss, and 1.0% with dual SL ( N = 469). Hearing loss increased the likelihood of having an ED visit (OR = 1.22, CI: 1.07–1.39), and home health services (OR = 1.27, CI: 1.07–1.51) compared to older adults without any SL. Vision loss reduced the likelihood of having a hospitalization (OR = .81, CI: .73–.91). Discussion: Findings support research into the drivers of healthcare use among older adults with sensory loss.

We aimed to investigate the mechanisms of Brahma related gene 1 (BRG1) in promoting vascular calcification in chronic kidney disease (CKD). The expression of BRG1 was examined in high phosphorus stimulated rat aortic smooth muscle cells (RASMCs) and calcified artery tissues from rat models and hemodialysis patients. Autophagosome formation was measured in high phosphorus stimulated RASMCs with and without BRG1 knock-down. We also detected the coexistence of BGR1 and exosomes, and measured the circulatory levels of BRG1 in the hemodialysis patients. BRG1 promoted the osteogenic transdifferentiation of RASMCs. Silencing BRG1 prevented autophagy from being induced by high phosphorus stimulation in RASMCs. Increased expression of BRG1 was observed in calcified blood vessels. Serum BRG1 level increased in the hemodialysis patients. BRG1 was involved in the development of high phosphorus induced osteogenic phenotype in vitro and in vivo, and its underlying mechanism might be facilitating autophagy.

The crisis of water scarcity has become one of the most urgent issues to be settled. It is still a challenge to develop a highly efficient water purification technology. In this work, highly efficient capacitive removal of metal ions from wastewater was demonstrated by using Ti–C redox interfaces created by an atomic layer deposition (ALD) strategy. It has been illustrated that the TiO2 nanolayer was formed by reaction on the surface of porous carbon (PC) by using an ALD strategy, which could effectively build the Ti–C redox interfaces; and thus, the TiO2 nanolayer on PC was beneficial for facilitating ion diffusion/transmission and adsorption/insertion. Impressively, this process showed a deionization capacity of 38.54 mg g−1 in a 500 mg L−1 NaCl solution at 1.2 V. In addition, this process had excellent capacitive removal efficiency to treat complicated water containing multiple metal ions (K+, Mg2+, Ca2+, Ni2+, Co2+, Cu2+, Pb2+, Cd2+, Cr2+, Fe3+ and Al3+). This work has important practical implication for highly efficient removal of metal ions from wastewater.

Anxiety is common and distressing in people living with cognitive impairment. High caregiver mastery, a positive view of one’s ability to provide care, is known to be protective against anxiety in people whom they are caring for. However, the longitudinal relationship between caregiver mastery and anxiety is unknown. Our objective was to examine whether improvement in caregiver mastery was related to decrease in anxiety in people living with cognitive impairment. This was a secondary data analyses using Healthy Patterns Clinical Trial (NCT03682185), an RCT of a home-based activity intervention designed to improve circadian rhythm disorders in people living with cognitive impairment. A total of 158 participants with cognitive impairment who provided data at both pretest (T1) and posttest (T2) were analyzed. Measures included Caregiver Mastery Scale and Neuropsychiatric Inventory. We used linear regression analyses to examine the relationship between changes in caregiver mastery and changes in anxiety. The sample was primarily female (66.7%), Black (63.1%), with mean age 73.3±8.4. The mean change of anxiety frequency (T2-T1) was -0.2±1.0; anxiety frequency decreased over time. The mean change of caregiver mastery (T2-T1) was 0.4± 3.0; caregiver mastery improved over time. After controlling for age, cognition, changes in sleep impairments, changes in depression, and intervention group assignment, improvement of caregiver mastery over time (B=-0.087, SE=0.035, t=-2.51, p=0.013) was related to decreased anxiety frequency over time (R2= 0.112, F=2.31, p= 0.039). Interventions to improve caregiver mastery may alleviate anxiety symptoms in people living with cognitive impairment. Additional research and practice implications will be discussed.

The tumor microenvironment induces immunosuppression via recruiting and expanding suppressive immune cells such as regulatory T cells (Treg) to promote cancer progression. In this study, we documented that tumor-infiltrating CD73+ γδTregs were the predominant Tregs in human breast cancer and exerted more potent immunosuppressive activity than CD4+ or CD8+ Tregs. We further demonstrated that cancer-associated fibroblast (CAF)–derived IL6, rather than TGFβ1, induced CD73+ γδTreg differentiation from paired normal breast tissues via the IL6/STAT3 pathway to produce more adenosine and become potent immunosuppressive T cells. CD73+ γδTregs could in turn promote IL6 secretion by CAFs through adenosine/A2BR/p38MAPK signaling, thereby forming an IL6–adenosine positive feedback loop. CD73+ γδTreg infiltration also impaired the tumoricidal functions of CD8+ T cells and significantly correlated with worse prognosis of patients. The data indicate that the IL6–adenosine loop between CD73+ γδTregs and CAFs is important to promote immunosuppression and tumor progression in human breast cancer, which may be critical for tumor immunotherapy.

The efficacy of cellular immunotherapy plus chemotherapy in treatment of gastric cancer (GC) remains inconsistent even controversial. Hence, we performed a meta-analysis to better comprehend the clinical value of cellular immunotherapy plus chemotherapy for GC patients. We searched PubMed, Embase and EBSCO databases to identify the studies evaluating the association of cellular immunotherapy plus chemotherapy and overall survival (OS) and/or disease-free survival (DFS) in patients with GC, and then combined relevant data into hazard ratios (HRs) for OS, DFS and clinicopathological features such as TNM stage, etc. with STATA 12.0. Eleven studies with 1244 patients were included in this meta-analysis. We found that cellular immunotherapy plus chemotherapy remarkably improved overall survival (OS) and diseases-free survival (DFS) as compared to the chemotherapy for GC patients. In subgroup analyses, pooled data showed that the combined therapy was significantly associated with better 3-year and 5-year survival rate, but not with 1-year survival rate of patients; the application of cellular immunotherapy based on either CIK or DC-CIK cells could enhance survival as well as NK, γδT and CIK cells-based immunotherapy. More importantly, the addition of cellular immunotherapy considerably improved OS and DFS only in patients with stage III rather than stage II. In addition, we also discovered that the combined therapy did not cause intolerable side effects to patients. Cellular immunotherapy plus chemotherapy ameliorates survival in GC, especially in patients with stage III, implicating that it is a valuable therapeutic strategy for these patients.

Background: Early palliative care consultation (“PCC”) to discuss goals-of-care benefits seriously ill patients. Risk factor profiles associated with the timing of conversations in hospitals, where late conversations most likely occur, are needed. Objective: To identify risk factor patient profiles associated with PCC timing before death. Methods: Secondary analysis of an observational study was conducted at an urban, academic medical center. Patients aged 18 years and older admitted to the medical center, who had PCC, and died July 1, 2014 to October 31, 2016, were included. Patients admitted for childbirth or rehabilitationand patients whose date of death was unknown were excluded. Classification and Regression Tree modeling was employed using demographic and clinical variables. Results: Of 1141 patients, 54% had PCC “close to death” (0-14 days before death); 26% had PCC 15 to 60 days before death; 21% had PCC >60 days before death (median 13 days before death). Variables associated with receiving PCC close to death included being Hispanic or “Other” race/ethnicity intensive care patients with extreme illness severity (85%), with age 75 increasing this probability (98%). Intensive care patients with extreme illness severity were also likely to receive PCC close to death (64%) as were 50% of intensive care patients with less than extreme illness severity. Conclusions: A majority of patients received PCC close to death. A complex set of variable interactions were associated with PCC timing. A systematic process for engaging patients with PCC earlier in the care continuum, and in intensive care regardless of illness severity, is needed.

Saliency detection is a significant research topic in the field of image processing and computer vision. Currently, most saliency detection methods are applied to RGB images, so that they may encounter adverse scenarios characterized by complex background, inclement weather, and low illumination. Fusing complementary advantages of RGB and thermal infrared (RGB-T) images can effectively boost saliency detection performance. Therefore, we propose a novel RGB-T saliency detection method in this letter. To this end, we first regard superpixels as graph nodes and calculate the affinity matrix for each feature. Then, we propose a low-rank tensor learning model for the graph affinity, which can suppress redundant information and improve the relevance of similar image regions. Finally, a novel ranking algorithm is proposed to jointly obtain the optimal affinity matrix and saliency values under a unified structure. Test results on two RGB-T datasets illustrate the proposed method performs well when against the state-of-the-art algorithms.