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Different acquisition data approaches have been used to fetch the fluorescence spectra. However, the comparison between them is rare. Also, the extendability of a sensor array, which can work with heavy metal ions and other types of analytes, is scarce. In this study, we used first- and second-order fluorescent data generated by 6-Aza-2-thiothymine-gold nanocluster (ATT-AuNCs) as a single probe along with machine learning to distinguish between a group of heavy metal ions. Moreover, the dimensionality reduction was carried out for the different acquisition data approaches. In our case, the accuracy of different machine learning algorithms using first-order data outperforms the second-order data before and after the dimensionality reduction. For proving the extendibility of this approach, four anions were used as an example. As expected, the same finding has been found. Furthermore, random forest (RF) showed more stable and accurate results than other models. Also, linear discriminant analysis (LDA) gave acceptable accuracy in the analysis of the high-dimensionality data. Accordingly, using LDA in high-dimensionality data (the first- and second-order data) analysis was highlighted for discrimination between the selected heavy metal ions in different concentrations and in different molar ratios, as well as in real samples. Also, the same method was applied for the anion's discrimination, and LDA gave an excellent separation ability. Moreover, LDA was able to differentiate between all the selected analytes with excellent separation ability. Additionally, the quantitative detection was considered using a wide concentration range of Cd

To compare direct costs of index and revision operations of thoracic posterior spinal instrumented fusion (TPSIF) and thoracic anterior spinal tethering (TAST) for adolescent idiopathic thoracic scoliosis in children.Children (ages 11-18 years) who underwent TPSIF and TAST (2/2013-9/2019) were reviewed. Follow-up 2 years and cervical instrumentation and/or instrumentation of a lumbar level at L3 or below were exclusion criteria. Patient demographics, radiographic curve magnitude, index operations and postoperative data, as well as indications for revisions/readmissions were collected. Direct costs were identified and compared for index and revision operations during follow-up.One hundred and four patients were included (TPSIF: 78; TAST: 25). TAST procedures were performed in children significantly younger and for smaller curve magnitudes. They had significantly fewer levels instrumented, shorter operating room (OR) times, and less estimated blood loss (EBL). After operation, a significantly higher percentage of TAST were admitted to ICU. Hospital length of stay (LOS) was similar between groups. Index operations' average direct costs were significantly higher for TAST than TPSIF ($52,947 v. $46,641; p = 0.02). Major cost drivers for both groups were implants, OR services, post-anesthesia care unit (PACU), and room/board. Revisions following TAST were more frequent than for TPSIF (36 v. 11.5%). Majority of TPSIF revisions were for junctional deformity. Curve progression and overcorrection were most common reason for TAST revisions. Average direct costs for revisions/readmissions were similar between groups (TPSIF: $28,485 v. TAST: $27,590; p = 0.46).Index operations' average direct costs were statistically similar between TPSIF and TAST for adolescent idiopathic scoliosis. Major cost drivers were implants, OR services, PACU, and room/board. TAST index operations' direct costs and associated direct costs for implants and room/board were significantly higher, while their anesthesia and OR services were significantly lower than TPSIF. TAST revisions were for overcorrection and curve progression, while TPSIF revisions were most commonly for junctional deformity. Overall average direct costs for revisions were similar despite revision rates being higher for TAST.III.

10 pags.- 4 Figs. Under Licence CC BY 4.0, Global warming delays the autumn date of foliar senescence (DFS) in recent decades, with positive implications for growing season length and therefore global carbon storage. However, warming-associated drought, leading to water limitation, may conversely stimulate earlier DFS. Using ground observations since 1940s and 34 years of satellite greenness data (1982‒2015) over the Northern Hemisphere (>30° N), we show the increased impact of drought on DFS. Earlier DFS is linked to decreased precipitation under warming and weaker drought resistance associated with various plant functional traits. For example, isohydric plants with strict regulation of water status may drop leaves fast during droughts. We derive an improved set of phenology models based on this influence and project earlier DFS by the end of the century, particularly at high latitudes (>50° N). Our results limit uncertainties in the later end of plant growth with warming, aiding estimation of carbon uptake of terrestrial ecosystems., This work was funded by the Strategic Priority Research Programme of the Chinese Academy of Sciences (XDA19040103), the National Natural Science Foundation of China (42125101) and the CAS Interdisciplinary Innovation Team (JCTD-2020-05). J.P. and P.C. were funded by European Research Council Synergy grant ERC-SyG-2013-610028 IMBALANCE-P. J.P. was also financially supported by the Fundación Ramon Areces grant ELEMENTAL-CLIMATE, the Spanish Government grant 2013-610028 and the Catalan Government grant SGR 2017-1005.

Background The purpose of the study was to compare the efficacy of two novel obesity indices, lipid accumulation product (LAP) and visceral adiposity index (VAI), with traditional obesity indices in predicting early-onset type 2 diabetes (T2DM). Methods In this cross-sectional study, a total of 744 participants, including 605 patients newly diagnosed with T2DM and 139 non-diabetic control subjects, were enrolled from a tertiary care hospital in Tianjin, China. Participants with T2DM were divided into two groups based on their age at diagnosis, namely early-onset T2DM (age less than 40 years, n = 154) and late-onset T2DM (age 40 years or older, n = 451). The predictive power of each obesity index was evaluated using receiver operating characteristic (ROC) curve analysis. Furthermore, binary logistic regression analysis was conducted to examine the independent relationship between LAP and VAI with early-onset T2DM risk. The relationship between novel obesity indices and the age of T2DM onset was also evaluated through correlation and multiple linear regression analysis. Results In males, LAP had the highest predictive power for early-onset T2DM with an area under the ROC curve (AUC) of 0.742 (95% CI 0.684–0.799, P Conclusions In young Chinese individuals, LAP and VAI are recommended over traditional obesity indices for improved prediction of early-onset T2DM risk.

Purpose While posterior spinal instrumentation and fusion (PSIF) for severe adolescent idiopathic scoliosis (AIS) is the gold standard, anterior vertebral body tethering (AVBT) is becoming an alternative for select cases. Several studies have compared technical outcomes for these two procedures, but no studies have compared post-operative pain and recovery. Methods In this prospective cohort, we evaluated patients who underwent AVBT or PSIF for AIS for a period of 6 weeks after operation. Pre-operative curve data were obtained from the medical record. Post-operative pain and recovery were evaluated with pain scores, pain confidence scores, PROMIS scores for pain behavior, interference, and mobility, and functional milestones of opiate use, independence in activities of daily living (ADLs), and sleeping. Results The cohort included 9 patients who underwent AVBT and 22 who underwent PSIF, with a mean age of 13.7 years, 90% girls, and 77.4% white. The AVBT patients were younger (p = 0.03) and had fewer instrumented levels (p = 0.03). Results were significant for decreased pain scores at 2 and 6 weeks after operation (p = 0.004, and 0.030), decreased PROMIS pain behavior at all time points (p = 0.024, 0.049, and 0.001), decreased pain interference at 2 and 6 weeks post-operative (p = 0.012 and 0.009), increased PROMIS mobility scores at all time points (p = 0.036, 0.038, and 0.018), and faster time to functional milestones of weaning opiates, independence in ADLs, and sleep (p = 0.024, 0.049, and 0.001). Conclusion In this prospective cohort study, the early recovery period following AVBT for AIS is characterized by less pain, increased mobility, and faster recovery of functional milestones, compared with PSIF. Level of evidence IV.

The accuracy of preoperative patient-reported weight was never evaluated in patients undergoing lower extremity procedures. The purpose of this study was to: (1) compare the disparity between patient-reported and measured weights in patients undergoing lower extremity total joint arthroplasty (LE-TJA) and arthroscopy; and (2) investigate the association between patient-specific factors (patient age, BMI, zip code, and psychiatric comorbidities) and the accuracy of patient-reported weight. Preoperative self-reported weights were retrospectively compared to measured weights in 400 LE-TJA and 85 control arthroscopy patients. The difference between reported and measured weights was calculated. Additionally, the percent of accurate reporting within 0.5, 1, and 5 kg ranges of the measured weight was calculated. Outcomes were compared between surgical modalities as well as between patient-specific factors. There was low disparity (p = 0.838) between patient-reported and measured weights among LE-TJA (mean difference 0.18 ± 3.63 kg; p = 0.446) and that of arthroscopy (0.27 ± 4.08 kg; p = 0.129) patients. Additionally, LE-TJA patients were equally likely to report weights accurately within 0.5 kg of the measured weight (74% vs. 71.76%; p = 0.908). LE-TJA and arthroscopy patients had similar reporting accuracy within 1 and 5 kg of the measured weights (p > 0.05). Preoperative patient-reported weights demonstrated acceptable accuracy in both LE-TJA and lower extremity arthroscopic orthopaedic patient populations making it a potentially reliable parameter of preoperative assessment.

Long noncoding RNAs (lncRNAs) have been reported to exert important roles in tumors, including clear cell renal cell carcinoma (ccRCC). PVT1 is an important oncogenic lncRNA which has critical effects on onset and development of various cancers, however, the underlying mechanism of PVT1 functioning in ccRCC remains largely unknown. VHL deficiency-induced HIF2α accumulation is one of the major factors for ccRCC. Here, we identified the potential molecular mechanism of PVT1 in promoting ccRCC development by stabilizing HIF2α. PVT1 was significantly upregulated in ccRCC tissues and high PVT1 expression was associated with poor prognosis of ccRCC patients. Both gain-of-function and loss-of function experiments revealed that PVT1 enhanced ccRCC cells proliferation, migration, and invasion and induced tumor angiogenesis in vitro and in vivo. Mechanistically, PVT1 interacted with HIF2α protein and enhanced its stability by protecting it from ubiquitination-dependent degradation, thereby exerting its biological significance. Meanwhile, HIF2α bound to the enhancer of PVT1 to transactivate its expression. Furthermore, HIF2α specific inhibitor could repress PVT1 expression and its oncogenic functions. Therefore, our study demonstrates that the PVT1/ HIF2α positive feedback loop involves in tumorigenesis and progression of ccRCC, which may be exploited for anticancer therapy.

Many methods are used to locate preoperative small pulmonary nodules. However, deficiencies of complications and success rates exist. We introduce a novel magnetic gel for small pulmonary nodules localization in rabbit model, and furtherly evaluate its safety and feasibility. Rabbits were used as the experimental objects. A magnetic gel was used as a tracer magnet, mixed as sodium alginate-Fe3O4 magnetic fluid and calcium gluconate solution. In short-term localization, a coaxial double-cavity puncture needle was applied to inject the gel into the lung after thoracotomy, and a pursuit magnet made of Nd-Fe-B permanent magnetic materials was used to attract the gel representing location of the nodule. In long-term localization, the gel was injected under X-ray guidance. Imaging changes to the lung were observed under X-ray daily. Thoracotomy was performed to excise tissue containing the gel, and hematoxylin–eosin staining was used to observe the tissue on postoperative days 1, 3, 5, and 7. Observe tissues morphology of heart, liver, spleen, and kidney in the same way. The gel was formed after injection and drew lung tissue to form a protrusion from the lung surface under the applied magnetic field. No complication was observed. The shape and position of the gel had not changed when viewed under X-ray. Pathological analysis showed the gel had a clear boundary without diffusion of magnetic fluid. All tissues retained good histologic morphology and no magnetic fluid was observed. Our study preliminarily suggested that the technique using sodium alginate-Fe3O4 magnetic gel to locate small pulmonary nodules with guidance of X-ray, and to search for them under an applied magnetic field during the operation is safe and feasible.

Background Studies have given some pieces of evidence for the effect of total knee arthroplasty (TKA) on knee proprioception of patients with knee osteoarthritis (KOA), but their results were conflicting. This review was performed to provide an updated evidence-based meta-analysis investigating the influence of TKA on knee proprioception. Methods The electronic databases including PubMed, Google Scholar, and the Cochrane Library were accessed from their inception to March 2020. Two reviewers identified the studies that met the selection criteria for this review. Information on study type, participants, follow-up time, and outcome measures was extracted. Methodological quality was independently assessed by two reviewers using the Cochrane Handbook 5.1.0. Eleven studies with 475 participants were included in the meta-analysis. Results The I2 index assessed the heterogeneity between studies. The results showed that the pooled standard mean difference of mean angle of error was − 0.58° (95% CI − 1 to – 0.16; P = 0.007; I2 = 69%), and the joint position sense of KOA patients was better after TKA surgery than that before surgery. Pooled standard mean difference of displacement of center of pressure (COP) was − 0.39 (95% CI − 0.72 to − 0.06; P = 0.02; I2 = 51%), and KOA patients had better static balance after TKA surgery than before surgery. Conclusions To conclude, no standardized comprehensive evaluation protocol presently exists though different assessment tools are available to measure proprioception. Contrasting results were found in the literature since some studies found that TKA improves proprioception in KOA patients, while others found no difference in proprioception. These differences are seen whether the proprioception was assessed by joint position sense (JPS), or it was indirectly assessed by static balance. However, the lack of sufficient data on the threshold to detect passive movement (TTDPM) and dynamic balance made it difficult to draw a conclusion about whether or not the sense of motion improved after surgery. The method for measuring and evaluating knee joint force sense is worth paying attention, which will make progress with knee proprioception on TKA patients.

Sensitive and rapid detection of pathogenic bacteria plays an important role in avoiding food poisoning. However, the practical application value of conventional assays for detection of foodborne bacteria, are limited by major drawbacks; these include the laboriousness of pure culture preparation, complexity of DNA extraction for polymerase chain reaction, and low sensitivity of enzyme-linked immunosorbent assay. Herein, we designed a non-complex strategy for the sensitive, quantitative, and rapid detection of Salmonella typhimurium with high specificity, using an anti-Salmonella typhimurium IgG-AuNC-based immunofluorescent-aggregation assay. Salmonella typhimurium was agglutinated with fluorescent anti-Salmonella typhimurium IgG-AuNC on a glass slide, and observed using a fluorescence microscope with photoexcitation and photoemission at 560 nm and 620 nm, respectively. Under optimized reaction conditions, the AuNC-based immunofluorescent-aggregation assay had a determination range between 7.0 × 10

We introduce a variant of the timber grid shell, the timber Voronoi shell, whose surface is reticulated by Voronoi tessellation and whose edges are made of discrete dimensional timber. This work explores form-finding methods of the Voronoi shell as a compressive funicular shell. Two closed-form solutions to shape initialization are proposed. We develop methods for minimizing the deviation from coplanarity between timber members and adjacent surface normal in order to facilitate manufacturing. A well-defined fabrication process is important for making the physical structure consistent with the structural model. A 6-axis robot with a motor spindle is employed to prefabricate the timber so the in situ manual assembly becomes easier. A parametric model describes the joint details. We formulate the robotic toolpath as a closed-form function of the resultant mesh from form finding. Thus, a general-purpose programming language can directly implement the mesh optimization and manufacturing processes without CAD or CAM software. The physical implementations, including an exhibition pavilion, validated the approach.

Endothelial cells are important components of peripheral nerve stumps that contribute to Schwann cell migration and peripheral nerve regeneration. Let-7d modulates the phenotype of Schwann cells and affected peripheral nerve regeneration. However, the regulatory roles of let-7d on endothelial cells remain undetermined. In this study, by transfecting cultured human umbilical vein endothelial cells (HUVECs) with let-7d mimic or let-7d inhibitor, we investigated the biological effects of let-7d on endothelial cells. EdU proliferation assay showed that upregulated let-7d decreased the proliferation rates of HUVECs while downregulated let-7d increased the proliferation rates of HUVECs. Transwell-based migration assay and wound-healing assay demonstrated that let-7d inhibited the migration ability of HUVECs. Matrigel assay suggested that let-7d decreased the numbers of formed meshes and suppressed the tubulogenesis of HUVECs. RNA sequencing, bioinformatic analysis, gene expression validation, and luciferase assay suggested that let-7d directly targeted interferon-induced protein 44 like (IFI44L) gene and negatively regulated the expression of IFI44L. Taken together, our study illuminated the inhibitory roles of let-7d on the proliferation, migration, and tubulogenesis of endothelial cells, identified the target gene of let-7d, and deepened the understanding of the biological effects of let-7d on key elements of peripheral nerve regeneration.

Our scanning tunneling microscopy (STM) study observes, for the first time, twin domain boundary (TDB) formations on the surface of WTe2 single crystal, which is glued by solidifying indium to Si substrate. In these TDB regions, a large inhomogeneous strain field, especially a critical shear strain of about 7%, is observed by geometric phase analysis. This observation does not obey the old believe that a small mechanical stress is sufficient to drive thermally-induced TDB formations in two-dimensional materials. To resolve the contradiction, we perform density functional theory calculations combined with elasticity theory analysis, which show that TDBs on WTe2 are entirely displacement-induced, for which a critical strain is necessary to overcome the onset barrier.

This review aims to (1) assess the breadth of pediatric orthopaedic research in low- and middle-income countries (LMICs) and (2) determine the impact of academic collaboration (an LMIC and a non-LMIC investigator) in published LMIC research. Pediatric orthopaedic clinical studies conducted in LMICs from 2004 to 2014 were extracted from Embase, Cochrane, and Pubmed databases. Of 22,714 searched studies, 129 met inclusion criteria. 85% generated low-quality evidence (level IV or lower). 21% were collaborative, and these were more likely than non-collaborative papers to generate level III evidence or higher (25% vs 13%, p = 0.141). Pediatric orthopaedic research produced by LMICs rarely achieves level I–III evidence, but collaborative studies are associated with higher levels of evidence. Level of evidence: N/A.

Coronavirus disease 2019 (COVID-19) is a novel harmful respiratory disease that has rapidly spread worldwide. At the end of 2019, COVID-19 emerged as a previously unknown respiratory disease in Wuhan, Hubei Province, China. The world health organization (WHO) declared the coronavirus outbreak a pandemic in the second week of March 2020. Simultaneous deep learning detection and classification of COVID-19 based on the full resolution of digital X-ray images is the key to efficiently assisting patients by enabling physicians to reach a fast and accurate diagnosis decision. In this paper, a simultaneous deep learning computer-aided diagnosis (CAD) system based on the YOLO predictor is proposed that can detect and diagnose COVID-19, differentiating it from eight other respiratory diseases: atelectasis, infiltration, pneumothorax, masses, effusion, pneumonia, cardiomegaly, and nodules. The proposed CAD system was assessed via five-fold tests for the multi-class prediction problem using two different databases of chest X-ray images: COVID-19 and ChestX-ray8. The proposed CAD system was trained with an annotated training set of 50,490 chest X-ray images. The regions on the entire X-ray images with lesions suspected of being due to COVID-19 were simultaneously detected and classified end-to-end via the proposed CAD predictor, achieving overall detection and classification accuracies of 96.31% and 97.40%, respectively. Most test images from patients with confirmed COVID-19 and other respiratory diseases were correctly predicted, achieving average intersection over union (IoU) greater than 90%. Applying deep learning regularizers of data balancing and augmentation improved the COVID-19 diagnostic performance by 6.64% and 12.17% in terms of the overall accuracy and the F1-score, respectively. It is feasible to achieve a diagnosis based on individual chest X-ray images with the proposed CAD system within 0.0093 s. Thus, the CAD system presented in this paper can make a prediction at the rate of 108 frames/s (FPS), which is close to real-time. The proposed deep learning CAD system can reliably differentiate COVID-19 from other respiratory diseases. The proposed deep learning model seems to be a reliable tool that can be used to practically assist health care systems, patients, and physicians.