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Objective. The purpose of this review was to evaluate the effects of sling exercise on pain intensity, disability, and health-related quality of life in adults with neck pain. Methods. The Cochrane Central Register of Controlled Trials, EMBASE, Physiotherapy Evidence Database (PEDro), and 6 other databases were searched from inception to July 2020. The reference lists of relevant articles to identify additional trials were also screened. Randomized controlled trials were included if they investigated the effects of sling suspension therapy in patients with neck pain, including mechanical neck disorders, cervicogenic headache, and neck disorders with radicular findings. Studies were required to be published in English or Chinese. The methodological quality and levels of evidence of studies were assessed using the PEDro scale and the Grading of Recommendations Assessment, Development and Evaluation approach, respectively. The random-effects model was used to perform meta-analyses. Results. Eleven randomized controlled trials were included (n = 595). The mean total PEDro score was 4.64 (SD =1.21) of 10, which indicated a fair methodological quality. The intervention groups showed significant improvements in pain intensity (SMD = -1.23; 95% CI = -1.8 8 t o -0.58) immediately postintervention compared with the control groups. No significant effects were found for disability, cervical range of motion, and health-related quality of life. However, sensitivity analyses revealed significant short-term improvements in pain intensity, disability, and cervical range of motion and sustained effects on disability at intermediate-term follow-up. Conclusion. Sling exercise appears to be beneficial for improvements in pain intensity (moderate- to low-level evidence) among patients with neck pain. However, no definitive conclusion could be made regarding the effect of sling exercise for neck pain due to methodological limitations and high heterogeneity in the included studies. Impact. This review provides overall moderate- to very low-level evidence for health care professionals who may consider including sling exercise in the intervention program for patients with neck pain. Keywords: Disability, Exercise Therapy, Neck Pain, Systematic Review, Sling Exercise, Introduction Neck pain is a prevalent condition and has a 1-year prevalence of 30% to 50% and a lifetime prevalence of 14.2% to 71% (.1-3) People with neck pain demonstrate [...]

A high head-hand efficiency and low-SAR mobile phone antenna is proposed in this article. The impact of the antenna’s current distribution on its efficiency and spatial-average specific absorption rate (SAR) is analyzed, revealing that unidirectional and uniform current distributions on the antenna can achieve a dual benefit of high head-hand efficiency and low-SAR values. Based on this idea, a double loop antenna consisted of a $1\lambda $ outer loop with differential feed and a $0.5\lambda $ inner loop with coupled feed is designed, which can implement unidirectional and uniform current distribution in a wide frequency band. The measured −6 dB impedance bandwidth of the proposed antenna can cover 1710–2690 MHz. Its measured average head-hand efficiency from 1710 to 2690 MHz is −5.3 dB (29.5%). Its simulated normalized peak head and body SAR values are lower than 1.0 W/kg.

Chromatin accessibility remodeling driven by pioneer factors is critical for the development of early embryos. Current studies have illustrated several pioneer factors as being important for agricultural animals, but what are the pioneer factors and how the pioneer factors remodel the chromatin accessibility in porcine early embryos is not clear. By employing low-input DNase-seq (liDNase-seq), we profiled the landscapes of chromatin accessibility in porcine early embryos and uncovered a unique chromatin accessibility reprogramming pattern during porcine preimplantation development. Our data revealed that KLF4 played critical roles in remodeling chromatin accessibility in porcine early embryos. Knocking down of KLF4led to the reduction of chromatin accessibility in early embryos, whereas KLF4overexpression promoted the chromatin openness in porcine blastocysts. Furthermore, KLF4 deficiency resulted in mitochondrial dysfunction and developmental failure of porcine embryos. In addition, we found that overexpression of KLF4in blastocysts promoted lipid droplet accumulation, whereas knockdown of KLF4disrupted this process. Taken together, our study revealed the chromatin accessibility dynamics and identified KLF4 as a key regulator in chromatin accessibility and cellular metabolism during porcine preimplantation embryo development.

The decorative and fireproof performance degradation of the grouting fireproof glass exposed to UV irradiation limits its application in the fire protection of buildings. To solve this issue, a transparent polyacrylamide/polyvinyl alcohol (PAM/PVA) interpenetrating network hydrogel was designed to prepare grouting fireproof glass with enhanced theheat insulation and anti-aging properties. The results show that the light transmittance of PAM/PVA interpenetrating network hydrogel decreases with the increased content of PVA, and a proper content of PVA in the PAM/PVA interpenetrating network is beneficial to maintain high optical transparency in the resulting hydrogel. Heat insulation test shows that the PAM/PVA interpenetrating network improves the water-locking ability of the resulting hydrogels, and the fireproof glass containing 3 wt% PVA shows the lowest backside temperature of 92.6 °C at 3600 s, which is 51.9% lower than that of fireproof glass with PAM only. Thermogravimetric (TG) and differential scanning calorimetry (DSC) analysis show that the PAM/PVA interpenetrating network hydrogel improves the thermal stability and charring ability of hydrogel, and the hydrogel containing 3 wt% PVA exhibits the best charring effect among the samples, showing the highest residual yield of 39.2 % at 800 °C. The analyses of decomposition products and char residues show that the PAM/PVA interpenetrating network hydrogel can extend the heat absorption process of water evaporation and improve the gas flame retardant efficiency. Accelerated aging test shows that the presence of PVA greatly slows down the blistering and yellowing phenomenon of fireproof glass, thus endowing the fireproof glass with the super durability of fire resistance. Especially, the backside temperature at 3600 s and light transmittance of the sample containing 2 wt% PVA after 168 h aging test only changed 19.2 °C and 1.9 %, respectively, compared to the those of unaged sample.

Background: Understanding similarities and differences between groups with intersecting social identities provides key information in research and practice to promote well-being. Building on the intersectionality literature indicating significant gender and racial/ethnic differences in depressive symptoms, the present study used quantile regression to systematically present the diversity in the development of depressive symptoms for individuals with intersecting gender, race/ethnicity, and levels of symptoms. Methods: Information from the National Longitudinal Survey of Youth 79: Child and Young Adult study was employed. A detailed picture of depressive symptom trajectories from low to high quantiles was illustrated by depicting 13 quantile-specific trajectories using follow-up data from ages 15 to 40 in six gender-race/ethnicity groups: both genders of Black, Hispanic, and non-Black, non-Hispanic individuals. Results: From low to high quantiles, Black and non-Black, non-Hispanic individuals showed mostly curved, and Hispanic individuals showed mostly flat trajectories. Across the six gender-race/ethnicity groups, the trajectories below 0.50 quantiles were similar in levels and shapes from mid-adolescence to young adulthood. The differences between the six gender-race/ethnicity groups widened, indicated by outspreading trajectories, especially at quantiles above 0.50. Furthermore, non-Black, non-Hispanic males and females showed especially fast-increasing patterns at quantiles above 0.75. Among those without or with only a high school degree, Black females and non-Black, non-Hispanic females tended to report similar levels of depressive symptoms higher than other groups at high quantiles. These unique longitudinal trajectory profiles cannot be captured by the mean trajectories. Conclusions: The intersectionality of gender, race/ethnicity, and quantile of symptoms on the development of depressive symptoms was identified. Further studying the mechanism explaining this diversity can help reduce mental health disparities.

ABSTRACTMacroautophagy/autophagy is a cellular and energy homeostatic mechanism that contributes to maintain the number of primordial follicles, germ cell survival, and anti-ovarian aging. However, it remains unknown whether autophagy in granulosa cells affects oocyte maturation. Here, we show a clear tendency of reduced autophagy level in human granulosa cells from women of advanced maternal age, implying a potential negative correlation between autophagy levels and oocyte quality. We therefore established a co-culture system and show that either pharmacological inhibition or genetic ablation of autophagy in granulosa cells negatively affect oocyte quality and fertilization ability. Moreover, our metabolomics analysis indicates that the adverse impact of autophagy impairment on oocyte quality is mediated by downregulated citrate levels, while exogenous supplementation of citrate can significantly restore the oocyte maturation. Mechanistically, we found that ACLY (ATP citrate lyase), which is a crucial enzyme catalyzing the cleavage of citrate, was preferentially associated with K63-linked ubiquitin chains and recognized by the autophagy receptor protein SQSTM1/p62 for selective autophagic degradation. In human follicles, the autophagy level in granulosa cells was downregulated with maternal aging, accompanied by decreased citrate in the follicular fluid, implying a potential correlation between citrate metabolism and oocyte quality. We also show that elevated citrate levels in porcine follicular fluid promote oocyte maturation. Collectively, our data reveal that autophagy in granulosa cells is a beneficial mechanism to maintain a certain degree of citrate by selectively targeting ACLY during oocyte maturation.Abbreviations:3-MA: 3-methyladenine; ACLY: ATP citrate lyase; AMA: advanced maternal age; CG: cortical granule; CHX: cycloheximide; CQ: chloroquine; CS: citrate synthase; COCs: cumulus-oocyte-complexes; GCM: granulosa cell monolayer; GV: germinal vesicle; MII: metaphase II stage of meiosis; PB1: first polar body; ROS: reactive oxygen species; shRNA: small hairpin RNA; SQSTM1/p62: sequestosome 1; TCA: tricarboxylic acid; TOMM20/TOM20: translocase of outer mitochondrial membrane 20; UBA: ubiquitin-associated domain; Ub: ubiquitin; WT: wild-type

ABSTRACTMacroautophagy/autophagy is a conserved cellular mechanism to degrade unneeded cytoplasmic proteins and organelles to recycle their components, and it is critical for embryonic stem cell (ESC) self-renewal and somatic cell reprogramming. Whereas autophagy is essential for early development of embryos, no information exists regarding its functions during the transition from naive-to-primed pluripotency. Here, by using an in vitrotransition model of ESCs to epiblast-like cells (EpiLCs), we find that dynamic changes in ATG7-dependent autophagy are critical for the naive-to-primed transition, and are also necessary for germline specification. RNA-seq and ATAC-seq profiling reveal that NANOG acts as a barrier to prevent pluripotency transition, and autophagy-dependent NANOG degradation is important for dismantling the naive pluripotency expression program through decommissioning of naive-associated active enhancers. Mechanistically, we found that autophagy receptor protein SQSTM1/p62 translocated into the nucleus during the pluripotency transition period and is preferentially associated with K63 ubiquitinated NANOG for selective protein degradation. In vivo, loss of autophagy by ATG7 depletion disrupts peri-implantation development and causes increased chromatin association of NANOG, which affects neuronal differentiation by competitively binding to OTX2-specific neuroectodermal development-associated regions. Taken together, our findings reveal that autophagy-dependent degradation of NANOG plays a critical role in regulating exit from the naive state and marks distinct cell fate allocation during lineage specification.Abbreviations:3-MA: 3-methyladenine; EpiLC: epiblast-like cell; ESC: embryonic stem cell; PGC: primordial germ cell

This paper considers the output feedback sliding-mode control for an uncertain linear system with unstable zeros. Based on a frequency shaping design, a dynamic-gain observer is used for state estimation of an uncertain system. This paper confirms that (1) state estimation is globally stable in a practical sense, (2) the resultant error can be arbitrarily small with respect to the system uncertainties, and (3) the proposed sliding-mode control can drive the uncertain system state into an arbitrarily small residual set around the origin, such that the size of residual set is controlled by the filter design. Moreover, the proposed control design is inherently robust to measurement noise; the effect of measurement noise can effectively be attenuated without any additional work. [ABSTRACT FROM AUTHOR]

•Influence of ambient wind on discrete flame spread process is investigated.•Heat transfer model for discrete flame spread under ambient wind is established.•A calculation model of discrete flame spread rate is derived.•Relationship between dimensionless flame length and dimensionless heat release rate is determined.•Prediction correlation for mass loss rate is proposed, matching well with the experiments.

Emerging evidence highlights the regulatory role of paired-like (PRD-like) homeobox transcription factors (TFs) in embryonic genome activation (EGA). However, the majority of PRD-like genes are lost in rodents, thus prompting an investigation into PRD-like TFs in other mammals. Here, we showed that PRD-like TFs were transiently expressed during EGA in human, monkey, and porcine fertilized embryos, yet they exhibited inadequate expression in their cloned embryos. This study, using pig as the research model, identified LEUTX as a key PRD-like activator of porcine EGA through genomic profiling and found that LEUTXoverexpression restored EGA failure and improved preimplantation development and cloning efficiency in porcine cloned embryos. Mechanistically, LEUTX opened EGA-related genomic regions and established histone acetylation via recruiting acetyltransferases p300 and KAT2A. These findings reveal the regulatory mechanism of LEUTX to govern EGA in pigs, which may provide valuable insights into the study of early embryo development for other non-rodent mammals.

The Qinling Mountain Range (QMR) spans a large region in China and is an important area of hominin activities. Many Paleolithic sites are found in Bahe, South Luohe, and Hanjiang river valleys in the northern, eastern, and southern part of the range, respectively. The Danjiang River valley acts as a channel connecting these valleys and stretches from the north to the south of the QMR. The previous dating of the Paleolithic sites in the Danjiang valley mainly relied on geomorphologic comparison, stratigraphic correlation, fossil characteristics, and Paleolithic artifacts, indicating a lack of absolute data. In this study, we conducted a detailed geochronological investigation of the entire valley, and selected an ideal site—the Miaokou profile. Based on the identification of the loess-paleosol sequences, optically stimulated luminescence, and magnetostratigraphy, the Paleolithic artifacts of the Miaokou site located within the S5 and S6 layers of the profile belong to ∼0.6–0.7 Ma. This suggests that the Paleolithic site is an old site in the Danjiang River valley, and this period also witnessed a rapid increase in the number of hominin sites during the Middle Pleistocene. Combining our results with previous reports across the QMR, we propose that the Danjiang River valley might have been a corridor for hominin migration, and is worthy of further investigation.

Histone modifications are critical epigenetic indicators of chromatin state associated with gene expression. Although the reprogramming patterns of H3K4me3 and H3K27me3 have been elucidated in mouse and human preimplantation embryos, the relationship between these marks and zygotic genome activation (ZGA) remains poorly understood. By ultra-low-input native chromatin immunoprecipitation and sequencing, we profiled global H3K4me3 and H3K27me3 in porcine oocytes and in vitro fertilized (IVF) embryos. We observed sharp H3K4me3 peaks in promoters of ZGA genes in oocytes, and these peaks became broader after fertilization and reshaped into sharp peaks again during ZGA. By simultaneous depletion of H3K4me3 demethylase KDM5B and KDM5C, we determined that broad H3K4me3 domain maintenance impaired ZGA gene expression, suggesting its function to prevent premature ZGA entry. In contrast, broad H3K27me3 domains underwent global removal upon fertilization, followed by a re-establishment for H3K4me3/H3K27me3 bivalency in morulae. We also found that bivalent marks were deposited at promoters of ZGA genes, and inhibiting this deposition was correlated with the activation of ZGA genes. It suggests that promoter bivalency contributes to ZGA exit in porcine embryos. Moreover, we demonstrated that aberrant reprogramming of H3K4me3 and H3K27me3 triggered ZGA dysregulation in somatic cell nuclear transfer (SCNT) embryos, whereas H3K27me3-mediated imprinting did not exist in porcine IVF and SCNT embryos. Our findings highlight two previously unknown epigenetic reprogramming modes coordinated with ZGA in porcine preimplantation embryos. Finally, the similarities observed between porcine and human histone modification dynamics suggest that the porcine embryo may also be a useful model for human embryo research.

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Purpose: To use Doppler ultrasound velocimetry to detect and compare the postoperative flow characteristics of the bypassing grafts in patients following minimally invasive direct coronary artery bypass surgery (MIDCAB). Materials [...]

The Asian summer monsoon (ASM) is a vast climate system, whose variability is critical to the livelihoods of billions of people across the Asian continent. During the past half-century, much progress has been made in understanding variations on a wide range of timescales, yet several significant issues remain unresolved. Of note are two long-standing problems concerning orbital-scale variations of the ASM. (1) Chinese loess magnetic susceptibility records show a persistent glacial-interglacial dominated ~100 kyr (thousand years) periodicity, while the cave oxygen-isotope (δ18O) records reveal periodicity in an almost pure precession band (~20 kyr periodicity)—the “Chinese 100 kyr problem”. (2) ASM records from the Arabian Sea and other oceans surrounding the Asian continent show a significant lag of 8–10 kyr to Northern Hemisphere summer insolation (NHSI), whereas the Asian cave δ18O records follow NHSI without a significant lag—a discrepancy termed the “sea-land precession-phase paradox”. How can we reconcile these differences? Recent and more refined model simulations now provide spatial patterns of rainfall and wind across the precession cycle, revealing distinct regional divergences in the ASM domain, which can well explain a large portion of the disparities between the loess, marine, and cave proxy records. Overall, we also find that the loess, marine, and cave records are indeed complementary rather than incompatible, with each record preferentially describing a certain aspect of ASM dynamics. Our study provides new insight into the understanding of different hydroclimatic proxies and largely reconciles the “Chinese 100 kyr problem“ and “sea-land precession-phase paradox”.

Four alternating copolymers of carbazole (Cz) and triphenylamine (TPA) with thienylene-vinylene (TV) conjugated side chain containing different acceptor end groups of aldehyde (PCzTPA−TVCHO), monocyano (PCzTPA−TVCN) dicyano (PCzTPA−TVDCN), and 1,3-diethyl-2-thiobarbituric acid (PCzTPA−TVDT), have been designed and synthesized. The structures and properties of the main chain donor-side chain acceptor D−A copolymers were fully characterized. Through changing the acceptor group attached to the TV conjugated side chain on TPA, the electronic properties and energy levels of the copolymers were effectively tuned. The effect of substituent on the electronic structures of the copolymers was also studied by molecular simulation. These results indicate that it is a simple and effective approach to tune the bandgap in a conjugated polymer by attaching an acceptor end group on the conjugated side chains. PCzTPA−TVCN, PCzTPA−TVDCN, and PCzTPA−TVDTwere used as donor in polymer solar cells; the device based on PCzTPA−TVDT/PC70BM demonstrates a power conversion efficiency of 2.76% with Vocof 0.87 V under the illumination of AM1.5G, 100 mW/cm2.

The rising prevalence of obesity in Saudi Arabia is a major contributor to the nation’s high levels of cardiometabolic diseases such as type 2 diabetes. To assess the impact of obesity on the diabetic metabolic phenotype presented in young Saudi Arabian adults, participants (n= 289, aged 18–40 years) were recruited and stratified into four groups: healthy weight (BMI 18.5–24.99 kg/m2) with (n= 57) and without diabetes (n= 58) or overweight/obese (BMI > 24.99 kg/m2) with (n= 102) and without diabetes (n= 72). Distinct plasma metabolic phenotypes associated with high BMI and diabetes were identified using nuclear magnetic resonance spectroscopy and ultraperformance liquid chromatography mass spectrometry. Increased plasma glucose and dysregulated lipoproteins were characteristics of obesity in individuals with and without diabetes, but the obesity-associated lipoprotein phenotype was partially masked in individuals with diabetes. Although there was little difference between diabetics and nondiabetics in the global plasma LDL cholesterol and phospholipid concentration, the distribution of lipoprotein particles was altered in diabetics with a shift toward denser and more atherogenic LDL5 and LDL6 particles, which was amplified in the presence of obesity. Further investigation is warranted in larger Middle Eastern populations to explore the dysregulation of metabolism driven by interactions between obesity and diabetes in young adults.

Objective We aimed to investigate the association between the 5A/6A promoter polymorphism in the matrix metalloproteinase 3 (MMP3) gene and in-stent restenosis (ISR) in a regional Chinese population.Methods A total of 818 patients who underwent primary implantation of drug-eluting stents were enrolled and received a 6-month follow-up angiography and DNA genotyping of the 5A/6A polymorphism.Results ISR was found in 36.9% of all patients (302 ISR vs. 516 no ISR). The genotype proportion of 6A6A was significantly increased in ISRs (74.2% ISR vs. 66.8% no ISR), whereas the allele frequency of 5A was significantly decreased in ISR patients (25.8%) compared with controls who did not undergo ISR (33.1%).Conclusions Our data indicate that the MMP36A6A genotype is a genetic susceptibility factor for ISR after coronary stent placement, but the 5A allele can lower the risk for patients within 6 months after stenting. Therefore, genotyping 5A/6A in the MMP3promoter is suggested for patients who undergo coronary stent implantation.

Cerebral arteriovenous malformation during pregnancy is rare but lethal disease that usually present with new-onset seizures and headaches mimicking eclampsia. We report a rare case of cerebral arteriovenous malformation with abrupt seizures in the third trimester.

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Gonadotropin-Releasing Hormone Agonist (GnRH-a) and levonorgestrel releasing intrauterine system (LNG-IUS) are conventional conservative treatments for adenomyosis, and high-intensity focused ultrasound (HIFU) is a novel ablation technique. This study aimed to investigate the effectiveness of HIFU combined with GnRH-a or LNG-IUS for adenomyosis patients.

Timely recognition of the characteristic electrocardiographic pattern of de Winter syndrome is important for providing immediate reperfusion therapy for acute anterior myocardial infarction. In this case, an electrocardiogram showed 1- to 3-mm upsloping ST-segment depression at the J point in leads V1 to V6, with loss of R wave progression in leads V1 to V4. Urgent angiography showed occlusion of the proximal left anterior descending coronary artery and 70% stenosis in the ostial first diagonal branch (Medina type 1.1.1.). For this bifurcation lesion, we successfully performed a modified jailed-balloon technique to protect the side branch during percutaneous coronary intervention stenting. Thereafter, thrombolysis in myocardial infarction 3 flow was restored in both branches. This modified jailed-balloon technique is safe and effective in stent placement for de Winter syndrome without any loss of side branches.

ABSTRACTMicroRNAs (miRNAs) have been proved to be involved in many biological processes during tumorigenesis and progression, including cell proliferation and cell cycle progression. However, the potential role of miR-26b-5p in tongue squamous cell carcinoma (TSCC) remains unclear. In the present study, we demonstrated that miR-26b-5p was decreased in TSCC tissues in both TCGA-TSCC subset and eight paired samples from TSCC patients, while Proline Rich 11 (PRR11) was obviously increased. Transfection of miR-26b-5p mimics inhibited CALL7 cell proliferation by arresting the cells at the S/G2 transition. Meanwhile, miR-26b-5p inhibitor had the opposite biological functions. The results of luciferase activity and RNA-pulldown assays indicated that miR-26b-5p directly targeted the PRR11 3ʹ -untranslated region in CAL27 cells. Furthermore, the effects of miR-26b-5p on cell cycle regulation were reversed after treatment with siRNA against PRR11. In summary, our findings indicate that miR-26b-5p induce cell cycle arrest in TSCC by targeting PRR11. Hence, targeting miR-26b-5p could be a promising therapeutic strategy for the treatment of TSCC.

Cesarean section scar defect isthmocele, the pouchlike defect in the anterior uterine wall of the prior cesarean site. No previous report of malignant neoplasm in the isthmocele have been published. We reported a case of High-grade endometrial stromal sarcoma in isthmocele.

From the compression test of steel fiber recycled mortar porous brick masonry, it was researched the effects of different amounts of steel fiber and recycled fine aggregate on compressive strength, failure morphology, elastic modulus, stress-strain law and Poisson's ratio performance. The test value is compared with the calculation formula of ordinary mortar porous brick given in GB 50003-2011.The test showed that the steel fiber recycled mortar porous brick masonry had better compressive strength and deformability.

Introduction: A successful arteriovenous fistula is essential for effective haemodialysis. We aim to validate the existing failure to maturation equation and to propose a new clinical scoring system by evaluating arteriovenous fistula success predictors.Methods: Data of end-stage renal disease patients initiated on haemodialysis from January 2010 to December 2012 were retrospectively obtained from medical records with follow-up until 1 January 2014. Application of the failure to maturation equation was evaluated. A nomogram was developed using arteriovenous fistula success predictors and was calibrated with a bootstrapping technique.Results: A total of 694 patients were included with mean duration of follow-up of 2.3 years. Arteriovenous fistula maturation was achieved by 542 patients (78%). Comparing our cohort with the failure to maturation cohort, there were statistically significant differences in mean age, ethnicity and presence of diabetes mellitus. The failure to maturation equation failed to predict arteriovenous fistula outcomes with area under the curve performance of 0.519 on a receiver operating characteristic curve. Multivariate logistic regression showed that Malay patients (odds ratio = 0.628; 95% confidence interval = 0.403–0.978; p< 0.05) and patients requiring preoperative vein mapping (odds ratio = 0.601; 95% confidence interval = 0.410–0.883; p< 0.01) had a lower chance of arteriovenous fistula success, whereas male gender (odds ratio = 1.526; 95% confidence interval = 1.040–2.241; p< 0.05) and presence of postoperative good thrill (odds ratio = 3.137; 95% confidence interval = 2.127–4.625; p< 0.0001) had a higher chance of arteriovenous fistula success. The derived nomogram predicted arteriovenous fistula success (odds ratio = 1.030; 95% confidence interval = 1.022–1.038; p< 0.0001) with the area under the curve of 0.695 on a receiver operating characteristic curve and an adequacy index of 99.86% (p< 0.0001).Conclusion: The failure to maturation equation was not validated in our cohort. The clinical utility of our proposed arteriovenous fistula scoring system requires external validation in larger studies.

To investigate whether partial laryngectomy is a risk factor for obstructive sleep apnea (OSA) and the effect of different partial laryngectomy methods on OSA. A prospective study was carried out involving 40 patients who underwent supracricoid partial laryngectomy (SCPL) (24) or vertical partial laryngectomy (VPL) (16) for carcinoma of the larynx. Apnea-hypopnea index (AHI) and oxygen saturation determined by polysomnography (PSG), Epworth sleepiness scale (ESS) score, and body mass index (BMI) were evaluated in patients before surgery, on the day of tracheal tube removal and three months later. In patients who developed apnea, laryngoscopy, Muller’s test, computer tomography (CT) and dynamic sleep magnetic resonance imaging (MRI) were performed to assess the location of airway stenosis and collapse. The AHI (P<0.001) increased and the lowest oxygen saturation (P<0.001), ESS score (P<0.001) and BMI (P=0.017) decreased after extubation compared with before surgery. Three months after extubation, the same changes were found in AHI (P<0.001) and the lowest oxygen saturation (P<0.001), but the ESS score (P<0.001) increased compared with that preoperatively. The AHI in the SCPL group was significantly higher than that in the VPL group post-operatively (P=0.010), while the miniSpO2 in the SCPL group was lower than that of the VPL group (P=0.022). Laryngoscopy showed that the patients with partial excision of the larynx had a narrowed retropalatal and retrolingual space post-operatively. Muller's test showed the collapse of the retropalatal and retrolingual space, and the CT scan showed that the tongue root was positioned lower in the SCPL group. Compared with the retropalatal and retrolingual space in the expiratory phase according to dynamic sleep MRI, the space in the inspiratory phase was clearly decreased. Laryngeal function preservation surgery for laryngeal cancer results in the occurrence of OSA by altering the anatomical structure of the larynx and pharynx. OSA was more severe in patients undergoing SCPL than in patients undergoing VPL. The effect of partial laryngectomy on OSA may be related to the surgical method used.

Due to the unique geographical location and sensitive response to global climate changes, the Antarctic region plays an important role in paleoclimate researches, and attracts great attentions from various scholars. One 324 cm long sediment core (ANT29-P7-09) was obtained from Prydz Bay, Antarctica, during the 29th Chinese National Antarctic Research Expedition. Based on sediment particle size, TOC, δ13C analyses and magnetism data, the authors show that the dominant magnetic minerals are ferrimagnetic pseudo single domain (PSD)-multi domain (MD) magnetite. Variations in the paleoenvironmental records allow us to define 4 zones in the core. These zones outline the climatic variations in the region since the late Early Pleistocene, including a warm period, a transitional period, and a cold period. The magnetic particle assemblage varies with glacial-interglacial cycles. Abrupt changes in particle size, TOC content, and geomagnetism occur at 102–90 cm deep in the core, indicating a sudden warming in the Antarctic region, signaling the onset of the Holocene. The authors identified 3 additional climatic signals in the middle part of the core (232–162 cm) that show unexpected cooling events during the warm period in Prydz Bay, Antarctica.

Objective To evaluate the efficiency and incremental value of chromosomal microarray analysis as compared with standard karyotyping for the identification of genomic abnormalities in fetal DNA.Methods This retrospective study enrolled female patients with ultrasonographically diagnosed fetal ventriculomegaly. The prevalence, associated anomalies and clinical outcomes of ventriculomegaly were evaluated based on data from a single maternal and child health hospital in southwest China.Results A total of 943 cases of ventriculomegaly were analysed in this study, which were diagnosed at a mean ± SD gestational age of 23.8 ± 8.2 weeks. Non-isolated ventriculomegaly cases had a significantly higher maternal age than isolated cases (29.6 ± 5.5 versus 27.9 ± 4.2 years, respectively) and were also associated with a larger proportion of bilateral (56.1% versus 46.7%, respectively) and severe (12.8% versus 3.7%, respectively) ventriculomegaly. There were 97 cases detected by both karyotyping and microarray analysis. All apparent chromosome abnormalities identified upon karyotyping were detected with the use of microarray analysis. Microarray analysis also reported genetic abnormalities in 20 additional cases not detected by karyotyping. Of these additional 20 cases, 9.3% of pregnancies reported standard genetic variants for clinically relevant information, whereas 11.3% reported uncertain genetic abnormalities.Conclusion Chromosomal microarray analysis is an efficient tool, significantly increasing the diagnostic power for prenatal diagnosis.

Objective Metabolic syndrome (MS) is a common clinical condition associated with cardiovascular disease in patients undergoing peritoneal dialysis (PD); however, its prognostic implication among patients receiving PD remains controversial.Methods In a prospective study from January 2013 and June 2016, we enrolled 190 patients undergoing PD and followed them for 46.4 ± 30.7 months. We assessed the associations of clinical characteristics and measurements with diabetes mellitus (DM) status, MS, and prognostic outcomes among the included patients.Results We found that DM was associated with shortened duration of dialysis and poor survival. The prevalence of MS was 58.9% among all patients. We found significant differences in age, body weight, body mass index, triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, leukocytes, platelets, neutrophil percentage, and pre-albumin between patients with and without MS. We found a negative correlation trend between serum intact parathyroid hormone and MS among our patients. The arteriosclerosis index was significantly elevated in the MS group compared with the non-MS group. Serum calcium concentration and frequency of hospital admissions were significantly associated with mortality and technique failure.Conclusions MS was positively associated with cardiovascular disease. DM, and hypocalcemia. Frequent hospital admissions can predict poor prognosis in patients undergoing PD.

Poly(di(pyridin‐2‐yl)methyl acrylate) (PDPyMA), which was obtained by the free radical polymerization of designed coordinative monomer of di(pyridin‐2‐yl)methyl acrylate, is able to coordinate with various metal ions to form heterogeneous catalysts for diverse catalytic reactions. The Pd and Cu complexes supported by PDPyMA were developed for the heterogeneous Suzuki‐Miyaura reaction and Friedel‐Crafts alkylation, respectively. The PDPyMA‐based catalysts showed no significant decline of reactivity after five times recycling. However, the hydrolysis of the PDPyMA backbone under alkaline conditions limited the catalytic efficiency of this heterogeneous catalyst so that the coordinative monomer was redesigned as 1,1‐di(pyridine‐2‐yl)‐2‐(4‐vinylphenyl)ethan‐1‐ol and then 2,2′‐(1‐methoxy‐2‐(4‐vinylphenyl)ethane‐1,1‐diyl)dipyridine (MVPhDPy). With copolymerization of N‐isopropyl acrylamide (NIPAM), the efficiency of polymer‐based heterogeneous catalysts could be further raised, demonstrated by the increased turn over number in the Suzuki‐Miyaura reaction, which approached 5,260 by using the catalyst formed from poly(MVPhDPy‐co‐NIPAM) and Pd(OAc)2. poly(MVPhDPy‐co‐NIPAM) copolymer, therefore, could be a versatile platform to support different metal ions for various heterogeneous catalytic reactions. The coordinative copolymers and metal ions were used to form the heterogeneous catalyst that could approach a high conversion in the mediation of Suzuki‐Miyaura reaction with no detectable metal leaching after the recycling, indicating that this polymeric backbone could carry other metal ions for the catalysis of different reactions.

It is assumed that the potential intensity of tropical cyclones (TC) will increase with rising global temperature. The western North Pacific is one of the three principal TC centers, but TC records from the region are scarce and sometimes controversial. Here we present grain‐size distributions and element contents of sediment cores from the East China Sea, in the western North Pacific. We interpret changes in the mean grain size of the coarse fraction as a proxy for TC intensity, and we infer a linkage of TC intensity to temperature changes over the last two millennia. Supported by model simulations, our results show that TC intensity increased (decreased) during relatively warm (cool) periods, confirming the control of temperature on TC intensity on a multicentennial scale. Our results suggest that long‐term TC intensity in the western North Pacific may increase with continued global warming. It is assumed that the potential intensity of tropical cyclones (TC) will increase with rising global temperature. However, the long‐term observational trend of TC intensity, and thus its relationship with temperature changes, is debated. Here we present a 2,000‐year TC reconstruction using physical and geochemical proxies from sediments of the East China Sea in the western North Pacific. Our results suggest that TC intensity increased (decreased) during relatively warm (cool) periods on a multicentennial scale. Our finding provides improved insinto the relationship between TC intensity and changes in global temperature. The coarse fraction of Chinese coastal sediments is used as a proxy for TC intensityA 2,000‐year record of TC intensity in the western North Pacific is reconstructedTC intensity increased during relatively warm periods on a multicentennial scale

The feasibility of vaginoscopic hysteroscopy combined with office endometrial biopsy after ultrasonography for management of post-menopausal vaginal bleeding (PMB).

Residual thermal stress in the system is a serious problem that affects the application of tritium permeation barrier coatings in fusion reactors. The stress not only determines the adhesion between coating and substrate, but also changes the properties of the material. In this study, finite element analysis was used to investigate the relationship between the residual thermal stress and the mechanical properties of Al2O3tritium penetration barrier systems. Moreover, the residual thermal stress influenced by factors such as different substrates, temperature, and substrate roughness was also analyzed. The calculation showed that the hardness and elastic modulus increased with increasing compressive stress. However, the hardness and elastic modulus decreased with increasing tensile stress. The systems composed of Al2O3coatings and different substrates exhibited different trends in mechanical properties. As the temperature increased, the hardness and the elastic modulus increased in an Al2O3/316L stainless steel system; the trend was opposite in an Al2O3/Si system. Apart from this, the roughness of the substrate surface in the system could magnify the change in hardness and elastic modulus of the coating. Results showed that all these factors led to variation in the mechanical properties of Al2O3tritium permeation barrier systems. Thus, the detailed reasons for the changes in mechanical properties of these materials need to be analyzed.

The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw (3DPS) and minimally invasive reconstruction plate (MIRP) in treating sacroiliac complex injury and the surgical procedures of 3DPS were introduced. A retrospective analysis was performed on 49 patients with sacroiliac complex injury from March 2013 to May 2017. Twenty-one cases were treated by 3DPS, and 28 cases by MIRP. Intraoperative indexes as operative time, blood loss, incision length, length of hospital stay and postoperative complications were respectively documented. Quality of reduction was postoperatively evaluated by Matta radiological criteria, and clinical effect was assessed by Majeed scoring criteria at the last follow-up. Operative time and hospital stay were significantly shortened, and blood loss, and incision length were significantly reduced in 3DPS group as compared with those in MIRP group (P<0.05). No statistically significant difference was found between 3DPS group and MIRP group in the assessment of reduction and function (P>0.05). It was concluded that both 3DPS and MIRP can effectively treat the sacroiliac complex injury, and 3DPS can provide an accurate, safe and minimally invasive fixation with shorter operative time and hospital stay.

Early invasive growth along specific anatomical structures, especially the white matter tract, is regarded as one of the main causes of poor therapeutic outcome of people with gliomas. We show that some glioma stem cells (GSCs) are preferentially located along white matter tracts, which exhibit a demyelinated phenotype, at the invasive frontier of glioma tissues. These GSCs are CD133+Notch1+, whereas the nerve fibers express the Notch ligand Jagged1. The Notch-induced transcription factor Sox9 promotes the transcription of SOX2and the methylation level of the NOTCH1promoter is attenuated by the upregulation of SOX2to reinforce NOTCH1expression in GSCs. This positive-feedback loop in a cohort of glioma subjects is correlated with a poor prognosis. Inhibition of Notch signaling attenuates the white-matter-tract tropism of GSCs. These findings provide evidence indicating that the NOTCH1-SOX2positive-feedback loop controls GSC invasion along white matter tracts.

ABSTRACTSURVIVIN is an essential chromosomal passenger complex (CPC) subunit and participates in cell division. In this study, we used porcine oocyte as a model to investigate the roles of Survivinduring porcine oocyte maturation. Survivinwas highly expressed in germinal vesicle (GV) and germinal vesicle breakdown (GVBD) stages oocytes, mainly localized in the GV at GV stage and on the chromosomes after GVBD. We have used RNA interference to specifically deplete Survivinin oocytes during invitro maturation (IVM). Immunofluorescence assay showed that Survivin-depleted oocytes failed to produce polar body in meiosisⅠ (failed to complete cytokinesis), and they were arrested in metaphaseⅠwith misaligned chromosomes. The homologous chromosomes in Survivin-depleted oocytes could not be separated normally. Moreover, both the phosphorylation levels of Aurora B and the mRNA level of Mad2L1 related to spindle assembly checkpoint (SAC) was decreased in Survivin-depleted oocytes, which thus inhibited the degradation of Cyclin B1(CCNB1) to complete meiosis. Taken together, we conclude that Survivinis an important mediator of centromere and midbody docking of Aurora-B as well as its activity and regulates SAC and MPF activity during meiosis in porcine oocytes.

Introduction: Hemodialysis is the main modality of renal replacement therapy in Singapore. However, a majority of the patients in Singapore are initiated on hemodialysis via a catheter. This study examines the complication rates and factors predicting catheter-related bloodstream infections and mortality rates in patients who were initiated on hemodialysis at our institution.Methods: This is a single-center retrospective analysis of incident hemodialysis patients who were initiated on renal replacement therapy between 1 January 2010 and 31 December 2012. Catheter-related bloodstream infection risk factors, organisms, and associated mortality were analyzed.Results: The catheter-related bloodstream infection and exit site infection incidence rates were 0.75 and 0.50 per 1000 catheter days, respectively. The mean duration to first catheter-related bloodstream infection episode was 182.47 ± 144.04 catheter days. Prolonged catheter duration was found to be a risk factor for catheter-related bloodstream infection. Compared to patients initiated on dialysis via arteriovenous fistula, initiation of dialysis via catheter is strongly associated with increased mortality (6.0% vs 14.5%; p= 0.02). In particular, the presence of diabetes mellitus and development of catheter-related bloodstream infection was associated with increased mortality (p= 0.04 and 0.05, respectively). In addition, patients who began hemodialysis before being seen by a nephrologist were associated with decreased mortality (3.4% vs 13.0%; p= 0.03).Conclusion: In conclusion, prolonged duration of catheter insertion is found to be a risk factor for catheter-related bloodstream infection in hemodialysis patients, and its development is associated with increased mortality. Early referral to a nephrologist and creation of arteriovenous fistula in pre-end-stage renal disease patients are pivotal in improving the outcomes of patients.

Many studies use ultrasound for diaphragmatic excursion (DE) evaluation. The calculation of DE value requires recording the diaphragm movement, freezing the ultrasound image, recalling video and measuring target distance which is time consuming. We aimed at using an ultrasound image tracking algorithm (UITA) to trace diaphragm movement and reveal DE values in real time. We tested UITA with 40 young volunteers under four respiration conditions: standing with quiet breathing (SQB), supine with quiet breathing (SuQB), standing with deep breathing (SDB), and supine with deep breathing (SuDB). The value of DE during SQB, SuQB, SDB, and SuDB was 24.5 ± 10.2, 31.9 ± 10.5, 68.9 ± 15.9, and 98.1 ± 27.4 mm, respectively. We found displacement of diaphragm can be translated to waveforms like spirometry graphs with real-time DE value. DE decreased about 30% in the standing position than in the supine position. Quiet breathing or deep breathing had similar effect on the percent decrease of DE. Further studies are needed to validate this tracking algorithm as a clinical tool in patients with the diaphragm dysfunction.

Autophagy is an essential cellular mechanism that degrades cytoplasmic proteins and organelles to recycle their components. Here we showed that autophagy was essential for the glycolysis switch and energy homeostasis in mouse granulosa cells under hypoxic condition. Our data indicated that hypoxia inducible factor-1α (HIF-1α) could be largely increased in developing follicles and this remarkable upregulation of HIF-1α triggered cell autophagy and glucose uptake. We found that blocking autophagy by Atg7knockdown and 3-methyladenine (3-MA) treatment affected the glucose metabolism, with increased glycolytic enzyme activity and decreased ATP production. We also found enhanced lactate level, which was harmful to granulosa cells and could induce cell apoptosis. Thus, our findings highlight a protective role of HIF-1α-dependent autophagy for the granulosa cell glycolysis switch in both energy supply and cell survival.HIF-1α-induced autophagy is essential for glycolysis metabolism in mouse granulosa cells.

•The heat transfer in the wellbore and formation are both unsteady.•CO2physical properties in our model are vary with temperature and pressure.•The heat generated by fluid friction losses is absorbed by the tubing and CO2according to the contact coefficient.

Understanding factors that regulate zygotic genome activation (ZGA) is critical for determining how cells are reprogrammed to become totipotent or pluripotent. There is limited information regarding how this process occurs physiologically in early mammalian embryos. Here, we identify a mediator complex subunit, MED13, as translated during mouse oocyte maturation and transcribed early from the zygotic genome. Knockdown and conditional knockout approaches demonstrate that MED13 is essential for ZGA in the mouse, in part by regulating expression of the embryo-specific chromatin remodeling complex, esBAF. The role of MED13 in ZGA is mediated in part by interactions with E2F transcription factors. In addition to MED13, its paralog, MED13L, is required for successful preimplantation embryo development. MED13L partially compensates for loss of MED13 function in preimplantation knockout embryos, but postimplantation development is not rescued by MED13L. Our data demonstrate an essential role for MED13 in supporting chromatin reprogramming and directed transcription of essential genes during ZGA.MED13 is required for activating transcription of essential genes during the maternal to zygotic transition in the mouse.

Maternal obesity can impair embryo development and offspring health, yet the mechanisms responsible remain poorly understood. In a high-fat diet (HFD)-based female mouse model of obesity, we identified a marked reduction of Stella (also known as DPPA3 or PGC7) protein in oocytes. Starting with this clue, we found that the establishment of pronuclear epigenetic asymmetry in zygotes from obese mice was severely disrupted, inducing the accumulation of maternal 5-hydroxymethylcytosine modifications and DNA lesions. Furthermore, methylome-wide sequencing analysis detected global hypomethylation across the zygote genome in HFD-fed mice, with a specific enrichment in transposon elements and unique regions. Notably, overexpression of Stella in the oocytes of HFD-fed mice not only restored the epigenetic remodeling in zygotes but also partly ameliorated the maternal-obesity-associated developmental defects in early embryos and fetal growth. Thus, Stella insufficiency in oocytes may represent a critical mechanism that mediates the phenotypic effects of maternal obesity in embryos and offspring.

AbstractIn this article, the authors illustrate some of the multiple applications of the seminal idea planted by McLuhan that technologies are extensions of human faculties or abilities. The intention of the article is not to break new ground but rather to demonstrate that this McLuhanist idea remains relevant and vital in the contemporary era.

ABSTRACTCheckpoint 1 (Chk1), as an important member of DNA replication checkpoint and DNA damage response, has an important role during the G2/M stage of mitosis. In this study, we used porcine oocyte as a model to investigate the function of Chk1during porcine oocyte maturation. Chk1was expressed from germinal vesicle (GV) to metaphase II (MII) stages, mainly localized in the cytoplasm at GV stage and moved to the spindle after germinal vesicle breakdown (GVBD). Chk1depletion not only induced oocytes to be arrested at MI stage with abnormal chromosomes arrangement, but also inhibited the degradation of Cyclin B1 and decreased the expression of Mitotic Arrest Deficient 2-Like 1 (Mad2L1), one of spindle assembly checkpoint (SAC) proteins, and cadherin 1 (Cdh1), one of coactivation for anaphase-promoting complex/cyclosome (APC/C). Moreover, Chk1overexpression delayed GVBD. These results demonstrated that Chk1facilitated the timely degradation of Cyclin B1 at anaphase I (AI) and maintained the expression of Mad2L1 and Cdh1, which ensured that all chromosomes were accurately located in a line, and then oocytes passed metaphase I (MI) and AI and exited from the first meiotic division successfully. In addition, we proved that Chk1 had not function on GVBD of porcine oocytes, which suggested that maturation of porcine oocytes did not need the DNA damage checkpoint, which was different from the mouse oocyte maturation.

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Introduction Cervical squamous cell carcinoma (CESC) is the most common gynecological malignancy worldwide. Although the cancer susceptibility 18 (CASC18)gene was involved in the regulation of cancer biology, its specific role in CESC is not well characterized.Methods CASC18-related axis was predicted by bioinformatic analyses, and the competing endogenous RNA (ceRNA) interaction was further validated using quantitative real-time PCR, western blotting, RNA pulldown, and luciferase reporter assays. Transwell and wound healing assays were performed to verify the effect of CASC18on SiHa and HeLa cell motility.Results We found that CASC18was upregulated in CESC tissues. Moreover, interference with CASC18attenuated NUAK1-mediated epithelial-mesenchymal transition (EMT) and thus suppressed cancer cell motility. Furthermore, the effects of CASC18knockdown on CESC cells were partly rescued by transfection with the miR-5586-5p inhibitor. Additionally, our findings indicated that CASC18acts as a ceRNA to enhance NUAK1expression by sponging miR-5586-5p.Conclusion Our study showed a novel CASC18/miR-5586-5p/NUAK1ceRNA axis that could regulate cell invasion and migration by modulating EMT in CESC. These findings suggest that CASC18may potentially serve as a novel therapeutic target in CESC treatment.

LiNi0.5Mn1.5O4(LNMO) spinel cathode is a potential cathode material for high-power, low-cost lithium-ion batteries (LIBs) due to its low raw material cost, high operating voltage and efficient lithium-ion transport channel. However, LNMO suffers from structural stability due to the two-phase-transformation during charge/discharge process, leading to poor cycling performance. To address the issues, we have constructed a homogeneous aggregated LNMO cathode with a multifaceted primary particle, namely the LNMO with single-crystal secondary particles (SSP LNMO). Ex situ and in situ characterizations including the synchrotron X-ray diffraction, the neutron diffraction and full pouch cell validated that the SSP LNMO exhibit a single solid-solution reactions with a restrained lattice evolution during the delithiation/ lithiation process. This is in contrast to the normal LNMO cathode, which demonstrates a significant two-phase transition from spinel Li1-xNi0.5Mn1.5O4to rock-salt MnO2at high voltage. Therefore, the SSP LNMO has greatly improved cycle life compared to the normal LNMO cathode. Overall, this study demonstrates the possibility of constructing LNMO based on primary-grain morphology modulation to improve the intrinsic stability of LIBs.

AbstractThe authors of this article have conducted a comparison study to investigate the construction characteristics of both single-well and two-well systems; two model experiments were conducted using large-size moulded rock salt specimens. An experimental platform was designed to simulate the process of leaching and a theoretical equation of calculating and predicting the cavern volume was derived. The experimental results illustrate that the variation trend of brine instantaneous concentration for single-well and two-well systems is identical, and an equilibrium state appears at last. Moreover, the equilibrium is reached early, after 5–8 pumping cycles. The construction rate in the two-well system is faster than the single-well system, and this phenomenon is observed mainly in the early periods (1–3 pumping cycles). Besides, the cavern shapes for the two construction methods are also found to be distinctive. The cavern of the single-well system has a circular cross section and an axisymmetric profile while that of the two-well system has an ovular cross section and a non-axisymmetric profile.