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Tactile devices provide an intuitive way for texture display, which allows users to perceive the detailed surface properties of virtual or remote objects. For existing tactile devices that create actual topographical transformations, it remains challenging to render surface textures with high spatial resolution due to the limitation of the size of actuators. To address this challenge, a magnetically responsive soft actuator with a diameter of 1 mm is proposed. Integrating the high-density soft actuator array and a soft membrane bracket, we develop a magnetically responsive soft tactile device (named MRS-Tex) for texture display. When a magnetic field is applied, the magnetic units will sink to form pits, and the soft membrane bracket resists the finger pressure so that users can perceive the rendered surface texture. Thanks to the proposed sunken solution, MRS-Tex is capable of rendering surface textures with millimeter-level resolution while providing the sufficient upward holding force. Moreover, we conduct quantitative experiments and two user studies to evaluate the performance of MRS-Tex. Experimental results show that MRS-Tex can generate pits with a depth of more than 0.20 mm, which is sufficient for rendering perceivable surface textures.

In thermodynamics, it is essential to distinguish between state functions and process functions. The reason is that the simple compressible thermodynamic system is a bivariate-process system, and the change of internal energy, a state function, corresponds to two process functions, heat and work. Among the state functions in thermodynamics, entropy is a special one because it has to be defined through a process function, exchanged heat δ Q , and a unique factor of integration, 1/T. In heat transfer, it is shown that Fourier's law and the differential equation of heat conduction are both relations of state quantities alone, and process quantities appear when an integration with respect to time is applied. Moreover, an incompressible heat conduction medium element without conversion between heat and work is a univariate-process system governed by a single variable, temperature. In this case, the change of the thermal energy (“heat content”) stored in the system, a state quantity as a function of T alone, corresponds to only one process quantity, the transferred heat. Therefore, on the one hand, it is unnecessary to strictly distinguish between state quantities and process quantities in heat transfer, and on the other hand, there is no need to use a factor of integration to prove entransy a state quantity in heat transfer. Thermodynamics and heat transfer are two parallel sub-disciplines in thermal science. It is incorrect to deny entransy as a state quantity in heat transfer by the uniqueness of the factor of integration for entropy in thermodynamics, and entransy has significant physical meaning in the analysis and optimization of heat transfer processes.

Purpose The aim of this study was to assess the effect of high-quality nursing based on the concept of childlike interest in children with cleft lip and palate following operation on healing time, degree of pain, psychological state, quality of life, and the occurrence of complications. Methods A series of 62 children with cleft lip and palate was treated in our hospital from January 2019 to March 2021. The patients were randomly divided into observation group (31 cases, given high-quality nursing based on childlike interest) and control group (31 cases, given routine nursing intervention). The healing time and hospital stay of the two groups were recorded. The degree of pain, psychological state and quality of life of the two groups before and after intervention were compared, and the occurrence of complications was closely monitored. Results Compared with the control group, the healing time and hospital stay of the study group were significantly shorter after the intervention (P 0.05), while after intervention the SDS and SAS scores of the two groups were lower than those before treatment. Compared with the control group, the SDS and SAS scores of the study group were remarkably lower (P 0.05), while after the intervention, the scores of quality of life in the two groups were associated with lower outcomes. Compared with the control group, the scores of quality of life in the study group were significant lower (P Conclusions High quality nursing based on childlike interest exerted beneficial outcomes in terms of shortening the healing time and hospital stay, reducing the degree of pain and complications, as well as improving the psychological state and quality of life of children harboring cleft lip and palate. Additionally, its high safety feature contributes to the wide application for clinical practice.

Research on mobile robots began in the late 1960s. Mobile robots are a typical autonomous intelligent system and a hot spot in the high-tech field. They are the intersection of multiple technical disciplines such as computer artificial intelligence, robotics, control theory and electronic technology. The product not only has potentially very attractive application value and commercial value, but the research on it is also a challenge to intelligent technology. The development of mobile robots provides excellent research for various intelligent technologies and solutions. This dissertation aims to study the research of multi-sensor information fusion and intelligent optimization methods and the methods of applying them to mobile robot related technologies, and in-depth study of the construction of mobile robot maps from the perspective of multi-sensor information fusion. And, in order to achieve this function, combined with autonomous exploration and other related theories and algorithms, combined with the Robot Operating System (ROS). This paper proposes the area equalization method, equalization method, fuzzy neural network and other methods to promote the realization of related technologies. At the same time, this paper conducts simulation research based on the SLAM comprehensive experiment of the JNPF-4WD square mobile robot. On this basis, the high precision and high reliability of robot positioning are further realized. The experimental results in this paper show that the maximum error of the X-axis and Y-axis, FastSLAM algorithm is smaller than EKF algorithm, and the improved FASTSALM algorithm error is further reduced compared with the original FastSLAM algorithm, the value is less than 0.1.

AIM To assess the performance of the apparent diffusion coefficient (ADC) and relative ADC (rADC) to differentiate benign from malignant breast lesions using the plateau pattern of the time–intensity curve (Type II TIC), including the impact of lesions-enhancement subtypes and menopausal status of patients. MATERIALS AND METHODS Between September 2016 and December 2019, 408 patients with 169 benign and 239 malignant lesions with Type II TIC underwent magnetic resonance imaging (MRI), including diffusion-weighted imaging, with b-values of 50 and 800 s/mm2. ADC and rADC values were calculated by placing regions of interest (ROIs) on the lesion, the parenchyma of the normal breast, and the pectoralis major muscle. A receiver operating characteristic (ROC) curve was generated to compare the diagnostic performance of each parameter in distinguishing between benign and malignant breast lesions. Further classification was undertaken to study the discriminatory performance of each parameter in the different lesions enhancement subtypes (mass-like enhancement [MLE] and non-MLE [NMLE]) and menopausal status of patients (pre-menopausal and post-menopausal). RESULTS There was a significant difference in the ADC and rADC values between benign and malignant lesions. The sensitivities of lesion ADC, gland rADC, and muscle rADC were 79.29%, 77.51%, and 79.29%, respectively, with specificities of 94.56%, 82.01%, and 94.98%, respectively. The area under the ROC curve (AUC) of muscle rADC was the highest (AUC=0.92), especially in the MLE subtype (AUC=0.96), and was not affected by the menopausal status. CONCLUSION Muscle rADC and lesion ADC assessment improved the diagnostic performance of breast MRI in distinguishing between benign and malignant breast lesions with Type II TIC, especially muscle rADC in the MLE subtype.

To systematically investigate the effect of imaging features at different DCE-MRI phases to optimise a radiomics model based on DCE-MRI for the prediction of tumour-infiltrating lymphocyte (TIL) levels in breast cancer. This study retrospectively collected 133 patients with pathologically proven breast cancer, including 73 patients with low TIL levels and 60 patients with high TIL levels. The volumes of breast cancer lesions were manually delineated on T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and each phase of DCE-MRI, followed by 6250 quantitative feature extractions. The least absolute shrinkage and selection operator (LASSO) method was used to select predictive feature sets for the classifiers. Four models were developed for predicting TILs: (1) single enhanced phase radiomics models; (2) fusion enhanced multi-phase radiomics models; (3) fusion multi-sequence radiomics models; and (4) a combined radiomics-based clinical model. Image features extracted from the delayed phase MRI, especially DCE_Phase 6 (DCE_P6), demonstrated dominant predictive performances over features from other phases. The fusion multi-sequence radiomics model and combined radiomics-based clinical model achieved the highest predictive performances with areas under the curve (AUCs) of 0.934 and 0.950, respectively; however, the differences were not statistically significant. The DCE-MRI radiomics model, especially image features extracted from the delayed phases, can help improve the performance in predicting TILs. The radiomics nomogram is effective in predicting TILs in breast cancer. • Radiomics features extracted from DCE-MRI, especially delayed phase images, help predict TIL levels in breast cancer. • We developed a nomogram based on MRI to predict TILs in breast cancer that achieved the highest AUC of 0.950.

Background Although an association between the cytochrome P4502D6 (CYP2D6) *10 (100C>T) polymorphism and hepatocellular carcinoma (HCC) is known, the mechanism remains unclear. Here we aimed to explore mechanisms of CYP2D6*10 (100C>T) polymorphism conferring to HCC, and screen markers for HCC. Methods Label-free global proteome profiling with 34 normal livers and peritumor tissue from 61 HCC patients was performed, and angiopoietin-like protein-6 (ANGPTL6) was evaluated in 2 liver samples validation cohorts and 2 blood specimens validation cohorts. Results We found a significantly decreased frequency of TT in HCC patients which reduced HCC susceptibility by 69.2% and was accompanied by lowered enzymatic activity for CYP2D6. Proteomic analysis revealed 1342 differentially expressed proteins (DEPs) that were associated with HCC and 88 DEPs were identified as 100 TT-related proteins, likely underlying the susceptibility to HCC. Twenty-two upregulated DEPs and 66 downregulated DEPs were mainly related to lipid metabolism and the extracellular matrix, respectively. High ANGPTL6 was associated with a higher risk to HCC and worse prognosis. ANGPTL6 was both an independent risk factor and an independent prognostic factor for HCC and exhibited strong potential for predicting HCC occurrence, with comparable AUC values and higher sensitivity compared with alpha-fetoprotein. Conclusions The TT genotype-associated decreased risk of HCC appears to be related to lowered CYP2D6 activity and altered protein expression in the tumor microenvironment, and ANGPTL6 is a promising new diagnostic and prognostic biomarker for HCC. Our findings reveal new mechanistic insights for polymorphisms related to HCC risk and provide avenues for screening for HCC.

Background Atrial fibrillation (AF) and stable coronary artery disease (SCAD) frequently coexist. Hypothesis To investigate the prognosis of catheter ablation versus drug therapy in patients with AF and SCAD. Methods In total, 25 512 patients with AF in the Chinese AF Registry between 2011 and 2019 were screened for SCAD. 815 patients with AF and SCAD underwent catheter ablation therapy were matched with patients by drug therapy in a 1:1 ratio. Primary end point was composite of thromboembolism, coronary events, major bleeding, and all‐cause death. The secondary endpoints were each component of the primary endpoint and AF recurrence. Results Over a median follow‐up of 45 ± 23 months, the patients in the catheter ablation group had a higher AF recurrence‐free rate (53.50% vs. 18.41%, p

BACKGROUND: We previously found that atorvastatin (ATV) enhanced mesenchymal stem cells (MSCs) migration, by a yet unknown mechanism. CXC chemokine receptor 4 (CXCR4) is critical to cell migration and regulated by microRNA-146a (miR-146a). Therefore, this study aimed to assess whether ATV ameliorates MSCs migration through miR-146a/CXCR4 signaling. METHODS: Expression of CXCR4 was evaluated by flow cytometry. Expression of miR-146a was examined by reverse transcription-quantitative polymerase chain reaction. A transwell system was used to assess the migration ability of MSCs. Recruitment of systematically delivered MSCs to the infarcted heart was evaluated in Sprague–Dawley rats with acute myocardial infarction (AMI). Mimics of miR-146a were used in vitro, and miR-146a overexpression lentivirus was used in vivo, to assess the role of miR-146a in the migration ability of MSCs. RESULTS: The results showed that ATV pretreatment in vitro upregulated CXCR4 and induced MSCs migration. In addition, flow cytometry demonstrated that miR-146a mimics suppressed CXCR4, and ATV pretreatment no longer ameliorated MSCs migration because of decreased CXCR4. In the AMI model, miR-146a-overexpressing MSCs increased infarct size and fibrosis. CONCLUSION: The miR-146a/CXCR4 signaling pathway contributes to MSCs migration and homing induced by ATV pretreatment. miR-146a may be a novel therapeutic target for stimulating MSCs migration to the ischemic tissue for improved repair.

Objectives. To evaluate the value of the whole volume apparent diffusion coefficient (ADC) histogram in distinguishing between benign and malignant breast lesions and differentiating different molecular subtypes of breast cancers and to assess the correlation between ADC histogram parameters and Ki-67 expression in breast cancers. Methods. The institutional review board approved this retrospective study. Between September 2016 and February 2019, 189 patients with 84 benign lesions and 105 breast cancers underwent magnetic resonance imaging (MRI). Volumetric ADC histograms were created by placing regions of interest (ROIs) on the whole lesion. The relationships between the ADC parameters and Ki-67 were analysed using Spearman’s correlation analysis. Results. Of the 189 breast lesions included, there were significant differences in patient age ( P < 0.001 ) and lesion size ( P = 0.006 ) between the benign and malignant lesions. The results also demonstrated significant differences in all ADC histogram parameters between benign and malignant lesions (all P < 0.001 ). The median and mean ADC histogram parameters performed better than the other ADC histogram parameters (AUCs were 0.943 and 0.930, respectively). The receiver operating characteristic (ROC) analysis revealed that the 10th percentile ADC value and entropy could determine the human epidermal growth factor receptor 2 (HER-2) status (both P = 0.001 ) and estrogen receptor (ER)/progesterone receptor (PR) status ( P = 0.020 and P = 0.041 , respectively). Among all breast cancer lesions, 35 tumours in the low-proliferation group ( Ki − 67 < 14 % ) and 70 tumours in the high-proliferation group ( Ki − 67 ≥ 14 ) were analysed with ROC curves and correlation analyses. The ROC analysis revealed that entropy and skewness could determine the Ki-67 status ( P = 0.007 and P < 0.001 , respectively), and there were weak correlations between ADC entropy ( r = 0.383 ) and skewness ( r = 0.209 ) and the Ki-67 index. Conclusion. The volumetric ADC histogram could serve as an imaging marker to determine breast lesion characteristics and may be a supplemental method in predicting tumour proliferation in breast cancer.

This paper proposes a meaningful ciphertext encryption algorithm of good practicability and strong robustness. The plaintext undergoes pre‐encryption of bit scrambling and secondary encryption of discrete wavelet transform (DWT) to obtain meaningful ciphertext. In the pre‐encryption stage, only the higher three bit pages that are not all 0 or 1 are scrambled. The embedding method in the secondary encryption process is to add the hundreds and tens’ digit and ones’ digit of the middle ciphertext to the scrambled detail information obtained by DWT of the cover image. The information entropy of the intermediate ciphertext obtained by this method can reach 7.997, the correlation coefficient between the ciphertext and the cover image can reach 0.99, and the decrypted image of the ciphertext under high‐intensity pollution can still be identified. It shows that the pre‐encryption can conceal the plaintext information well, and the secondary encryption can eliminate the ciphertext texture characteristics while retaining the good robustness. Finally, the improved three one‐dimensional chaos are used to generate random sequences, and the plaintext hash value is associated with the chaotic key. The improved chaos greatly improves the randomness of the sequence and broadens the range of parameters. The hash value SHA‐256 of the plaintext is added to make the key stream adaptively change with the plaintext, which greatly improves the sensitivity of the plaintext and the ability to resist selected plaintext and ciphertext attacks. Experiments have also verified that the encryption algorithm can encrypt images of different types and shapes and has strong practicability, good bit scrambling effect, and high sensitivity to scrambling.

The wearable and self-powered sensors with multiple functions are urgently needed for energy saving devices, economical convenience, and artificial human skins. It is a meaningful idea to convert excess heat sources into power supplies for wearable sensors. In this report, we have fabricated a series of free-standing self-powered temperature-strain dual sensors based on poly(3,4-ethylenedioxythiophene) polystyrenesulfonate (PEDOT:PSS)/carbon nanocoils (CNCs)-poly(vinyl) alcohol composite films by a simple drop casting method. The Seebeck coefficients of the composite films were measured to be 19 μV/K. The sensor, with the addition of CNCs, showed a superior sensing performance to that without CNCs. PEDOT:PSS is used to provide a thermoelectric power to detect temperature changes and strain deformations. The minimum detect limit for the temperature difference was 0.3 K. Under a constant temperature gradient of 30 K, strains from 1 to 10% were detected without any external power supply. The films can be easily made into an array to detect the temperature of the fingers and motions of the wrist by attaching it to the human wrist directly. For the first time, due to the independent action of the thermoelectric material and strain sensing material, the thermoelectric voltage which is generated by a constant temperature difference is maintained under different strains. This kind of free-standing self-powered multifunctional sensors has great application prospects in the fields of healthcare and artificial intelligence in the future.

Background To evaluate the impact of family history of atrial fibrillation (FAF) on postablation atrial tachyarrhythmia (AT) recurrence. Methods All the 8198 patients undergoing initial AF ablation registered in the Chinese Atrial Fibrillation Registry study were analyzed. FAF was defined as having first-degree relatives diagnosed as AF at age 65 years or younger, and before the time the case in this study was diagnosed. Cox proportional hazards models were used to evaluate the impact of FAF on postablation AT recurrence. Age, sex, body mass index, AF type, history of congestive heart failure, hypertension, diabetes mellitus, prior stroke/transient ischemic attack/systemic embolism, vascular diseases, use of contact force-sensing catheter, and completion of high school were adjusted. The definition of AT recurrence was any documented AF, atrial flutter, or AT lasting more than or equal to 30 s after 3 months blanking period. Results After a mean follow-up of 26.2 ± 19.6 months, 318 out of the 645 patients (49.3%) with FAF and 3339 out of the 7553 patients (44.2%) without FAF experienced AT recurrence, corresponding to annual recurrence rates of 22.8% and 20.2%, respectively. Patients with FAF had a significant higher risk of AT recurrence (adjusted hazard ratio 1.129, 95% confidence interval 1.005-1.267) in multivariable analysis. Moreover, FAF had a significant higher impact on AT recurrence in the subgroup of patients diagnosed with AF at age 50 years or younger (p for interaction = .036). Conclusion FAF is a risk factor for postablation AT recurrence. This is especially true in those with AF diagnosed at 50 years or younger.

To explore the novel magnetic resonance imaging techniques, IVIM-DWI and IDEAL-IQ in detecting bone marrow fat and microcirculation in steroid-induced osteonecrosis of the femoral head (SIONFH). In this prospective study, 49 patients (80 hips) with SIONFH taking glucocorticoids and 24 healthy volunteers (48 hips) were recruited and assessed by T1WI, T2WI/fs, IDEAL-IQ and IVIM-DWI. The affected hips, contralateral asymptomatic hips and normal hips, as well as normal, penumbra and necrotic areas in the affected hips, were classified and evaluated. Imaging results were compared with histologic bone sections obtained from SIONFH patients undergoing surgery. The fat fraction (FF) and perfusion fraction (f) differences between groups were analyzed using analysis of variance, the LSD t-test, Pearson correlation analysis and ROC curve analysis. Our results demonstrate that IDEAL-IQ (FF) and IVIM-DWI (f) enable the classification of SIONFH at different ARCO stages. The FF was positively associated with the progression of the disease (r = 0.72), in contrast to f (r = −0.17). The FF and f were significantly different among the necrotic, penumbra and normal areas, and they were negatively correlated with each other (r = −0.37). The diagnostic sensitivity and specificity of IDEAL-IQ were 96.9% and 86.7%, and those of IVIM-DWI were 72.34% and 58.33%, respectively. The FF in contralateral asymptomatic hips was significantly higher than in normal hips, but no difference was found for f. IDEAL-IQ, and not IVIM-DWI, was identified to successfully detect bone marrow fat, which is beneficial to the diagnosis of the severity of SIONFH.

Cirrhosis is the primary driver of hepatocellular carcinoma (HCC). Blocking the deterioration of cirrhosis into HCC would be of benefit for long–term survival. We applied a series of bioinformatic ...

Wen-Jie Tang,1,* Yun-Shi Liang,2,* Jing Yan,3 Yue Hu,4 Mei-Li Sun,5 Guo-Shun Liu,1 Xiao-Huan Pan,6 Xin-Hua Wei,1 Xin-Qing Jiang,1 Yuan Guo1 1Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, People’s Republic of China; 2Department of Pathology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, People’s Republic of China; 3Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, People’s Republic of China; 4Department of Ultrasound, Sun Yat-Sen Memorial Hospital Sun Yat-Sen University, Guangzhou 510120, People’s Republic of China; 5Department of Radiology, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People’s Republic of China; 6Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuan Guo; Xin-Qing JiangDepartment of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, No. 1 Panfu Road, Guangzhou, Guangdong 510180, People’s Republic of ChinaTel +86 136-3249-8569; +86 181-0281-2838Fax +86-20-81048873Email eyguoyuan@scut.edu.cn; eyjiangxq@scut.edu.cnBackground: Encapsulated papillary carcinoma (EPC) of the breast is a rare entity. EPC can be underappreciated on percutaneous biopsy, which may require additional procedures if invasion is not recognized preoperatively. We aimed to investigate the magnetic resonance imaging (MRI) phenotypes correlated with preoperative pathological risk stratification for clinical guidance.Materials and Methods: The preoperative MRI scans of 30 patients diagnosed with 36 EPCs in multiple centers between August 2015 and February 2020 were reviewed by two breast radiologists. According to the WHO classification published in 2019, EPCs were classified into two pathological subtypes: encapsulated papillary carcinoma and encapsulated papillary carcinoma with invasion. Clinicopathological analysis of the two subtypes and MR feature analysis were performed.Results: Evaluation of the MRI phenotypes and pathological subtype information revealed that not circumscribed (P=0.04) was more common in EPCs with invasion than in EPCs. There was a significant difference in the age of patients (P=0.05), and the risk increased with age. The maximum diameter of the tumor increased with tumor risk, but there was no significant difference (P=0.36). Nearly half of the EPC with invasion patients showed hyperintensity on T1WI (P=0.19). A total of 63.6% of the EPC with invasion group showed non-mass enhancement surrounding (P=0.85). In addition, 29 patients (96.7%) had no axillary lymph node metastasis, and only one patient with EPC with invasion had axillary lymph node metastasis. Further pathological information analysis of EPCs showed that higher Ki-67 levels were more common in patients with EPCs with invasion (P=0.04). A total of 29 patients (96.7%) had the luminal phenotype, and one patient with EPC with invasion had the Her-2-positive phenotype.Conclusion: The margin, age and Ki-67 level were the key features for EPC risk stratification. In addition, these MRI signs, including a larger tumor, non-mass enhancement surrounding and axillary lymph node metastasis, may be suggestive of a high-risk stratification. Therefore, MRI phenotypes may provide additional information for the risk stratification of EPCs.Keywords: carcinoma, papillary, breast neoplasms, magnetic resonance imaging, pathology

Background The association between physical activity (PA) and atrial tachyarrhythmia (AT) recurrence after ablation for atrial fibrillation (AF) remains unclear. Methods We consecutively enrolled 496 patients treated with AF ablation therapy in Beijing Anzhen Hospital. After excluding six patients with valvular heart disease, seven patients with congenital heart disease, 33 patients lost to follow-up, and 14 patients who did not provide PA level during follow-ups, 436 patients had their PA level assessed by the International Physical Activity Questionnaire-Short Form before ablation and each time of follow-up. The association between PA level (measured at the time closest to AT recurrence, or the end of 12-month follow-up if no AT recurrence), as well as active PA during follow-up, and postablation AT recurrence was tested by multivariate logistic regression. Results Of the enrolled patients, 134 (30.7%) patients experienced AT recurrence in the first 12 months postablation. Compared to patients with low PA, patients with moderate or high PA had a lower risk of AT recurrence (odds ratio [OR] = .44; 95% confidence interval [CI], .25-.80; P = .01 for patients with moderate PA; and OR = .43 [95% CI, .21-.85], P = .02 for patients with high PA). Compared to patients without active PA, patients with active PA had a lower risk of AT recurrence (OR = .44 [95% CI, .27-.70], P Conclusions Moderate and high PA are associated with a lower risk of AT recurrence after AF ablation. Active PA during follow-up is also associated with a significantly lower risk of AT recurrence in the postablation AF population.

Cardiovascular disease (CVD) is one of the most serious health disorders with increasing prevalence and high morbidity and mortality. Although diagnosis and treatment of CVD have achieved huge breakthrough in recent years, it still needs additional enhancements, which result in the demand for new techniques. Artificial intelligence (AI) is an emerging science field that has been widely used to guide diseases diagnosis, evaluation and treatment. AI techniques are promising in CVD to explore novel pathogenic genes phenotype, guide optimal individualized therapeutic strategy, improve the management and quality of discharged patients, predict disease prognosis, and as adjuvant therapy tool. Thus, we summarize the latest application of AI techniques in clinical diagnosis, evaluation and treatment of CVD, aiming to provide novel beneficial evidence of AI and promote its application in CVD.

This study aimed to verify the reliability of ablation index (AI) for ablation lesion estimating with different settings for radiofrequency (RF) parameters: power, impedance, contact angles, irrigation rate, temperature of irrigation saline, and irrigation solution. RF ablations (N = 66) were performed on ex vivo porcine left ventricle submerged in 37 °C saline. The aforementioned ablation parameters were changed to measure whether the size of the ablation lesion was consistent at a fixed AI value of 500. The maximum lesion diameter (r = - 0.631, P = 0.028), depth (r = - 0.896, P 0.001), and volume (r = - 0.745, P 0.005) were significantly reduced with an increase of the impedance. The lesion depth (P 0.05) and the lesion volume (P 0.05) were significantly larger with glucose irrigation than saline irrigation. In conclusion, at a fixed AI value, impedance and irrigation solution have impact on the ablation lesions, which could affect the accuracy of AI formula to estimate ablation lesion size. Graphical abstract.

Wind energy is a promising source of renewable energy and is projected to shift to offshore areas increasingly. Monopile foundation is one of the most commonly used foundations for offshore wind applications with the priority in load bearing capability and initial cost. This study describes an innovative monopile foundation, which institutes a creative strategy over the traditional large diameter monopile foundation to achieve higher axially load bearing capacity. This is achieved by adding a restriction plate inside the pile to intensify the soil plug effect. This design is based on the soil plug mechanism, and the arching effects and plug resistance mobilizations are considered. In this study, an extensive amount of geotechnical centrifuge experiments was conducted to analyze the bearing behaviors of the innovative monopile with restriction plates. The pile with 1-hole restriction plate and the pile with 4-hole restriction plate are considered to discuss effects of the plate shape. Twelve models with different diameters and restriction plate types are investigated. The traditional open-ended and close-ended piles are included for comparisons. The static tests are conducted in saturated silica sand first to determine the ultimate bearing capacity of the innovative pile, after which the cyclic tests are performed. The innovative pile is proved to provide a larger bearing capacity than the pipe pile. An analytical method is proposed to estimate the capacity of the innovative pile. The study aims to develop the design code for innovative piles and provide design reference to large-scale offshore wind turbine projects.

An objective and accurate evaluation of liver grafts is required to improve the prognosis of liver transplant recipients and to increase the number of available liver grafts.To compare outcomes using FibroScan with that of pathology in liver grafts from brain-dead donors (DBD).Liver grafts from 52 DBD were examined using ultrasound (US), FibroScan before liver transplantation (LT). Blood tested before LT and a biopsy was performed pre- or intra-operation to determine pathology. The diagnostic accuracy of the FibroScan results was compared with the pathology results, which is the gold standard for evaluating liver grafts. The donors enrolled were grouped by the stage of liver fibrosis (F0-F4) and steatosis (S0-S3), based on Kleiner's scoring system of nonalcoholic fatty liver disease, respectively.The liver stiffness (LS) value in group F1 was significantly increased compared with group F0 (8.74±1.32kPa and 5.93±1.64kPa, respectively, P0.01). The LS value had a significant positive correlation with the liver graft fibrosis stage (r=0.73, P0.01). The area under receiver operating characteristic curves (AUROC) for F1 stage fibrosis was 0.93 (P0.01). Significant differences in the controlled attenuation parameter (CAP) were found among groups S0, S1, and S2 (173.30±38.36dB/m, 230.29±23.27dB/m, 250.00±57.01dB/m, respectively; F=12.41, P0.01). The CAP was associated with the liver graft steatosis stage (r=0.64, P0.01). The AUROC for S1 and S2 stage steatosis in liver grafts was 0.89 (P=0.002) and 0.83 (P=0.007), respectively.Transient elastography quantifies fibrosis and steatosis in liver grafts from 52 DBD with a high diagnostic accuracy and provides further imaging evidence for use in assessing liver grafts.

Background Histological grade (HG) is an important prognostic factor for hepatocellular carcinoma. With the development of precision medicine, diagnosis with a sequencing technology has become increasingly accepted. It is vital to discuss their similarities and differences to bridge or improve the traditional HG diagnosis with the novel sequencing technique. Methods A total of 658 tumor samples were collected from 602 Chinese hepatocellular carcinoma patients and sequenced for a panel of pan-cancer genes. Nucleotide usage bias, genomic variation-related scores, driver genes, and biological processes were compared among different HGs. These results were further verified using a cohort dataset from the Western population. Results Genomic variation subtypes, such as C>G substitution, maximum somatic allele frequency (MSAF), and TP53, and biological processes including “angiogenesis” and “regulation of homotypic cell-cell adhesion” were found to be significantly associated with HG in both Chinese and Western populations. Conclusions The association identified between genomic variation and HG could aid our understanding of HG as an important clinical measure, and potentially be used to predict HG for hepatocellular carcinoma.

Aim and Objective: Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a common chronic kidney disease that leads to End-Stage Renal Disease (ESRD). The key target of this therapy is to prevent the progression of kidney failure. Tolvaptan could slow kidney cyst growth and are proven highly effective. The aims of this analysis are to perform a systematic review, estimate and evaluate the efficacy and safety of tolvaptan in ADPKD patients. Materials and Methods: Randomized controlled trials of tolvaptan in ADPKD were identified in PubMed, Ovid, Web of Science and the Cochrane Library electronic database. The changes observed in kidney function, treatment efficiency and the incidence of adverse events between the tolvaptan and placebo groups were compared. Data were analyzed by the RevMan software. Results: Eight trials, including 7 double-blinded randomised controlled trials and 1 quasi RCT involving 1,536 patients were extracted. Significant differences in the annual rate of change in the total kidney volume TKV at any stages of CKD (MD = -3.32, 95%CI =-4.57,-2.07, I2 =70%) and the glomerular filtration rate (MD = 1.4, 95%CI = 0.83,1.97, I2 =0%) were observed between the tolvaptan group and the placebo group. Subgroup analysis of patients in different CKD stages also showed the same conclusion. There was an increase in the urine osmolality, and 24-hour urine volume in patients receiving tolvaptan. Tolvaptan reduced the rate of serious hypertension and kidney pain events in ADPKD patients. At higher doses, it increased the rate of adverse events (liver injuries, thirst, pollakiuria, and nocturia). There was no significant risk of bias in the included studies. Conclusions: Tolvaptan has a beneficial effect on ADPKD, but is associated with an increase in adverse events at high doses when compared with the placebo. Further RCTs on tolvaptan may be required to support this conclusion.

Under big data, the integrated system of case-based reasoning and Bayesian network has exhibited great advantage in implementing the intelligence of engineering application in many domains. To further improve the performance of the hybrid system, this article proposes Probability Change Measurement of Solution Parameters (PCMSP)–Half-Division-Cross (HDC) method, which includes two algorithms, namely PCMSP and HDC algorithm. PCMSP algorithm can select principal problem features according to their effects upon all solution features measured by calculating the weighted relative probability (RP) change of all solution features caused by each problem feature. PCMSP algorithm can perfectly work under big data no matter how complex the data types are and how huge the data size is. HDC algorithm is used to assign the computation task of big data to enhance the efficiency of the integrated system. HDC algorithm assigns big data by grouping all the problem parameters into many small sub-groups and then distributing the data which covers the same sub-group of problem parameters to a slave node. HDC algorithm can guarantee enough efficiency of the integrated system under big data no matter how large the number of problem parameters is. Finally, lots of experiments are executed to validate the proposed method.

Background Right free-wall (RFW) accessory pathway (AP) with branched atrial insertions is a rare, underrecognized AP that may be associated with initial ablation failure. Objective The purpose of this study was to investigate the clinical and electrophysiological characteristics of this AP. Methods From January 2011 to March 2018, 10 patients identified with branched RFW-AP were enrolled in this study, and 30 consecutive patients with conventional RFW-APs served as control group. Right atrium (RA) was activation-mapped and 3-dimensionally reconstructed during AP-mediated orthodromic tachycardia or right ventricular pacing. Atrial insertions were defined as the earliest breakout sites, and their relationship with the tricuspid annulus (TA) were described and analyzed. Results An average of 3 separate atrial insertions on the atrial side were documented among these 10 cases (5 female and 5 male; mean age 38.0 ± 13.9 years). All atrial insertions were away from the TA. The nearest atrial insertions averaged 15.9 ± 3.4 mm away from the TA, and the farthest atrial insertions were 22.6 ± 5.7 mm away from the TA. Anterograde and retrograde AP conduction remained unaffected after ablation of the first earliest breakout site but were eliminated by ablating all insertions after an average of 2.5 (range 2–2.5) remaps, 3 sites of ablation (range 2.5–4.5), 21 (range 15.5–37.8) radiofrequency applications, and 659.5 (range 464.3–1144.3) seconds of radiofrequency ablation duration. After 12-month follow-up, no patients reported AP conduction recovery or recurrent tachycardia. Conclusion RFW-AP with branched atrial insertions is an atypical AP variant and featured by >1 distinct atrial insertions on atrial side. Stepwise ablation rather than single focal ablation is required to eliminate all retrograde conduction.

Background Although whole-lesion apparent diffusion coefficient (ADC) histogram has been increasingly used for breast lesions, it has not been routinely used in clinical practice as an emergent promising imaging tool. Purpose To evaluate the performance of whole-lesion ADC histogram analysis metrics for differentiating benign and malignant breast lesions. Material and Methods A systematic PubMed/EMBASE/Cochrane electronic database search was performed for original diagnostic studies from 1 January 1970 to 2 January 2019. Summary estimates of diagnostic accuracy were generated and meta-regression was performed to explore sources of heterogeneity according to study and magnetic resonance imaging characteristics. Results Five original articles involving 493 patients were included in the meta-analysis. The pooled sensitivity and specificity of whole-lesion ADC histogram analysis were 0.85 (95% confidence interval [CI] = 0.81–0.89) and 0.79 (95% CI = 0.72–0.84) for distinguishing benign and malignant breast lesions, respectively. The area under the curve (AUC) was 0.9178. No publication bias was detected ( P = 0.51). In subgroup analysis, the summary sensitivity and specificity of 50th percentile ADC value were 0.81 (95% CI = 0.71–0.88) and 0.86 (95% CI = 0.74–0.94), respectively. Meta-regression analysis indicated no covariates were sources of heterogeneity ( P > 0.05). Conclusion Whole-lesion ADC histogram analysis demonstrated good diagnostic performance for differentiating between benign and malignant breast lesions, with 50th percentile ADC value showing higher diagnostic accuracy than other histogram parameters. Given the limited number of studies included in the analysis, the findings from our meta-analysis will need further confirmation in future research.

Background: Cytogenetically normal acute myeloid leukemia (CN-AML) is a large proportion of AMLs with diverse prognostic outcomes. Identifying membrane protein genes as prognostic factors to stratify CN-AML patients will be critical to improve their outcomes. Purpose: This study aims to identify prognostic factors to stratify CN-AML patients to choose better treatments and improve their outcomes. Methods: CN-AML data were from TCGA cohort (n = 79) and four GEO datasets. We identified independent prognostic genes by Cox regression and Kaplan-Meier methods, and constructed linear regression model using LASSO algorithm. The prediction error curve was calculated using R package "pec". Results: Based on independent prognostic membrane genes, we constructed a regression model for CN-AML prognosis prediction: score = (0.0492 * CD52) - (0.0018 * CD96) + (0.0131 * EMP1) + (0.2058 * TSPAN2) + (0.0234 * STAB1) - (0.3658 * MBTPS1), which was named as MPG6 (6-Membrane Protein Gene) score. Tested in multiple CN-AML datasets, consistent results showed that CN-AML patients with high MPG6 score had poor survival, higher WBC count and shorter EFS. Comparing with other reported scoring models, the benchmark result of MPG6 achieved better association with survival in multiple cohorts. Moreover, by combining with other clinical indicators in CN-AML, MPG6 could improve the performance of survival prediction and serve as a robust prognostic factor. Conclusions: We identified the MPG6 score as a stable indicator with great potential for clinical application in risk stratification and outcome prediction in CN-AML.

This paper proposes a color image encryption algorithm based on a cloud model Fibonacci chaotic system, as well as a matrix convolution operation that can protect image content effectively and safely. The algorithm combines the cloud model with the generalized Fibonacci, creating a new complex chaotic system that realizes the dynamic random variation of chaotic sequences. The chaotic sequence is used to scramble the pixel coordinates of the mosaic images of the R, G, and B components of the color image. Then, the chaotic sequence value is used as a matrix convolution cloud algorithm that alternately updates the input value of the matrix convolution operation and the pixel value to obtain the permutation transformation of the original pixel value. Finally, the pixel values of the replacement and cloud model Fibonacci chaotic sequence and the pixel values of the front (rear) adjacent pixel points are subjected to a two-way exclusive XOR operation. Realizing the change of the arbitrary pixel value causes a chain transformation of the pixel values of all of the pixel points, and sequentially generates an encrypted image. Experiments show that the histogram of the encrypted image is smoother and adjacent pixels of the image have low correlation. In addition, this algorithm can resist attack experiments such as differential attack, select plaintext attack and noise attack and provides high encryption security, high anti-interference, and strong robustness. The dynamic chaotic system is used to realize the color image encryption of the dynamic key, and the encryption algorithm has higher security and the validity of the algorithm.

Aiming at the problem that the existing bit scrambling encryption algorithm is not sensitive to the bit scrambling between 8 bits of one pixel, and the anti-noise and anti-selective plaintext attack ability is weak, a 3D cyclic shift bit scrambling image encryption algorithm is proposed in this paper. Discarding the scrambling mode of 8 bits of one pixel and the bits of all pixels, the pixel values are converted into binary arrays and then converted into 3D matrices in this paper. And the higher bit-planes and the lower bit-planes, which contain the plaintext information of different weights, are scrambled by cyclic shifting respectively. Therefore the sensitivity of the bit scrambling, the anti-noise attack ability of the algorithm and the randomness of intermediate ciphertext are improved. Moreover the randomness and the anti-noise ability can be adjusted by changing the number of higher bit-planes according to different encryption requirements. A new type of Logistic-Fibonacci (L-F) cascade chaos is constructed to generate random sequences, which solves the problem of blank windows in the uneven distribution of Logistic chaos. The initial value and the control parameters are increased, the sequence randomness is improved, and the fastness of low-dimensional chaos is preserved. By strongly correlating the key with SHA-256 of the plaintext, the key stream can change adaptively with the plaintext, which greatly improves the sensitivity of the plaintext and the ability of resisting the selective plaintext and ciphertext attack. The experiments show that the algorithm can encrypt all kinds of images with high efficiency, and can resist common attacks. It is a secure and reliable image encryption algorithm.

Ternary organic solar cells (OSCs) have demonstrated great potential in promoting the power conversion efficiency (PCE) of single-junction OSCs. Generally, the introduction of a third component with redshifted absorption spectra can broaden the absorption spectra and thereby potentially enhances short-circuit current density (JSC), but reduces open circuit voltage (VOC). Herein, a small-molecule acceptor (SMA) named N7IT with a high LUMO energy level and a redshifted absorption spectrum, is employed as the third component in the PM6:IT-4F-based binary host. Unlike previous results, the introduction of N71T enhances both the VOC and the JSC relative to the PM6:IT-4F host binary system. The champion ternary device (PM6 : IT-4F : N7IT = 1 : 0.7 : 0.3) demonstrates an outstanding PCE of 15.02%, significantly higher than its binary counterparts. This strategy is further validated in PM6:Y6 blends, where the addition of SY3 featuring near-infrared absorption and high LUMO effectively boosts the PCE from 16.49% to 17.07%. Our result proves the effectiveness of an appropriate third component and demonstrates the potential of red-absorbing, high-LUMO SMAs in further promoting the efficiency of single-junction binary OSCs.

In this paper, we investigate a low complexity technique for simultaneous wireless information and power transfer (SWIPT) in the context of cellular networks, where the multiple-antenna user equipments (UEs) employ maximum ratio combining technique. In particular, our proposed technique allocates a subset of antennas for information decoding (ID), only when their post-combiner signal-to-interference ratio exceeds a certain threshold, while the remaining antennas are allocated for energy harvesting (EH). In contrast to conventional approaches, where an uncorrelated or a fully correlated interference is considered, we develop a realistic mathematical framework that accurately captures the interference correlation effects on the performance of the proposed technique. By using stochastic geometry tools, we derive analytical expressions for both the ID and EH success probability, as well as the joint ID and EH success probability. Our results demonstrate the impact of spatial interference correlation on both the ID and the EH success probability, and we establish the optimal threshold for the proposed antenna switching scheme, that maximizes the joint ID and EH success probability., © 2021 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.

BackgroundPrimary neuroendocrine tumors of the gallbladder (GB-NETs) are rare, accounting for 2% of all gallbladder cancers. Among GB-NETs, mixed neuroendocrine non-neuroendocrine neoplasms of the gallbladder (GB-MiNENs) are sporadic.Case PresentationA 56-year-old woman admitted to our hospital due to right upper abdominal pain of 3 days duration. She underwent positron emission tomography/computed tomography, which showed multiple metastatic tumors and was unsuitable for operation. Initially, the patient was diagnosed with gallbladder adenocarcinoma. She underwent PD-1 inhibitor or combined with chemotherapy considering the PD-L1 high positive score. In the latter, the patient has the opportunity of surgery, and the new diagnosis was MiNENs. She achieved long-term disease control and has been alive from the first diagnosis.ConclusionThis case might support the strategy that PD-1 inhibitor could provide a feasible treatment option for MiNENs of gallbladder patients with the positive expression of PD-L1 in the future.

BackgroundCognitive impairment in the late stage of traumatic brain injury (TBI) is associated with the NOD-, LRR and pyrin domain-containing protein 3 (NLRP3) inflammasome, which plays an important role in neuroinflammation. Although classical inflammatory pathways have been well-documented in the late stage of TBI (4–8 weeks post-injury), the mechanism by which the NLRP3 inflammasome impairs cognition is still unclear.MethodsMice lacking the gene encoding for NLRP3 (NLRP3-knockout mice) and their wild-type littermates were used in a controlled cortical impact model of TBI. Levels of NLRP3 inflammasome and inflammatory factors such as IL-1β and HMGB1 were detected in post-injury hippocampal tissue, as well as long-term potentiation. Behaviors were assessed by T-maze test, novel object recognition, and nesting tests. Glycyrrhizin was used to antagonize HMGB1. Calcium imaging were performed on primary neuronal cultures.ResultsBy using the NLRP3-knockout TBI model, we found that the continuous activation of the NLRP3 inflammasome and high mobility group box 1 (HMGB1) release were closely related to cognitive impairment. We also found that inhibition of HMGB1 improved LTP reduction and cognitive function by increasing the phosphorylation level of the NMDAR1 subunit at serine 896 while reducing NLRP3 inflammasome activation.ConclusionNLRP3 inflammasome damages memory in the late stage of TBI primarily through HMGB1 upregulation and provides an explanation for the long-term progression of cognitive dysfunction.

Most relapsed chronic myeloid leukemia (CML) patients after tyrosine kinase inhibitor (TKI) discontinuation are in a chronic phase and could achieve remission through restarting the TKI treatment. Here we reported a case of sudden lymphoid blast crisis after 67 months of TKI discontinuation and depicted the patient by DNA and RNA sequencing to investigate intrinsic molecular features. The mutations of TGFBR2 and PCNT and the dysregulations of TGF-β and other pathways might accelerate the B cell transformation, which may serve as a blast crisis risk indicator of CML. Single-cell transcriptome data revealed that several clusters of immature B cells and late pro-B cells presented clone evolution during the treatment. After failing multiple lines of TKIs, conditioning chemotherapies and chimeric antigen receptor T cells (CAR-T) targeting CD19 and CD22 were performed to achieve remission. In conclusion, we report the first case of a CML patient with sudden lymphoid blast crisis after a long treatment-free remission and additional gene abnormalities other than BCR-ABL1 might participate in the progression, which need to be closely monitored, and CAR-T could be a solution to the chemoresistant progression.

BACKGROUND The aim was to probe the association of pleural effusion with lung infection in patients with liver transplantation and to provide a theoretical foundation for preventing, diagnosing, and remedying pulmonary complications after liver transplantation. METHODS Our team harvested clinical data of patients undergoing orthotopic allogeneic liver transplantation complicated with pleural effusion after surgery in our institution from May 2018 to July 2019. Based on whether puncture drainage was needed, patients were allocated to either control group or observation group. The differences in pleural effusion depth, lung function, lung infection, serum inflammatory factor levels and 6-month survival before and after surgery were compared. Finally, ROC curves were constructed for dissecting the correlation of pleural effusion with lung infection. RESULTS On day 3 after surgery, (1) pleural effusion depth of the observation group was 5.70 ± 1.20 cm, which was saliently greater than that of control group (p < 0.05); (2) in comparison to control group, lung function indexes FVC, FEV1.0, MVV, and PaO2 of observation group declined (all p < 0.05); (3) sputum culture evinced that the lung infection rates of the control group and observation group were 17.24% and 71.70%, respectively, and the observation group harbored brilliantly higher infection rate (p < 0.05); (4) in comparison to the control group, IL-6, IL-8, and TNF-α in observation group were increased (p < 0.05); (5) AUC of pleural effusion depth and lung infection was 0.849, 0.805, and 0.853, respectively on days 1, 2, and 3 after surgery. CONCLUSIONS A positive correlation existed between pleural effusion and lung infection after liver transplantation. When patients have persistent pleural effusion, the incidence of lung infection should be prevented and reduced.

Tau hyperphosphorylation is a characteristic alteration present in a range of neurological conditions, such as traumatic brain injury (TBI) and neurodegenerative diseases. Treatments targeting high-mobility group box protein 1 (HMGB1) induce neuroprotective effects in these neuropathologic conditions. However, little is known about the interactions between hyperphosphorylated tau and HMGB1 in neuroinflammation. We established a model of TBI with controlled cortical impacts (CCIs) and a tau hyperphosphorylation model by injecting the virus encoding human P301S tau in mice, and immunofluorescence, western blotting analysis, and behavioral tests were performed to clarify the interaction between phosphorylated tau (p-tau) and HMGB1 levels. We demonstrated that p-tau and HMGB1 were elevated in the spatial memory-related brain regions in mice with TBI and tau-overexpression. Animals with tau-overexpression also had significantly increased nucleotide-binding oligomerization domain-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome activation, which manifested as increases in apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), activating caspase-1 and interleukin 1 beta (IL-1β) levels. In addition, NLRP3–/– mice and the HMGB1 inhibitor, glycyrrhizin, were used to explore therapeutic strategies for diseases with p-tau overexpression. Compared with wild-type (WT) mice with tau-overexpression, downregulation of p-tau and HMGB1 was observed in NLRP3–/– mice, indicating that HMGB1 alterations were NLRP3-dependent. Moreover, treatment with glycyrrhizin at a late stage markedly reduced p-tau levels and improved performance in the Y- and T-mazes and the ability of tau-overexpressing mice to build nests, which revealed improvements in spatial memory and advanced hippocampal function. The findings identified that p-tau has a triggering role in the modulation of neuroinflammation and spatial memory in an NLRP3-dependent manner, and suggest that treatment with HMGB1 inhibitors may be a better therapeutic strategy for tauopathies.

Epidemiological studies have indicated that obesity is an independent risk factor for colitis and that a high-fat diet (HFD) increases the deterioration of colitis-related indicators in mice. Melatonin has multiple anti-inflammatory effects, including inhibiting tumor growth and regulating immune defense. However, the mechanism of its activity in ameliorating obesity-promoted colitis is still unclear. This study explored the possibility that melatonin has beneficial functions in HFD-induced dextran sodium sulfate (DSS)-induced colitis in mice. Here, we revealed that HFD-promoted obesity accelerated DSS-induced colitis, while melatonin intervention improved colitis. Melatonin significantly alleviated inflammation by increasing anti-inflammatory cytokine release and reducing the levels of proinflammatory cytokines in HFD- and DSS-treated mice. Furthermore, melatonin expressed antioxidant activities and reversed intestinal barrier integrity, resulting in improved colitis in DSS-treated obese mice. We also found that melatonin could reduce the ability of inflammatory cells to utilize fatty acids and decrease the growth-promoting effect of lipids by inhibiting autophagy. Taken together, our study indicates that the inhibitory effect of melatonin on autophagy weakens the lipid-mediated prosurvival advantage, which suggests that melatonin-targeted autophagy may provide an opportunity to prevent colitis in obese individuals.

BACKGROUND: Ulcerative colitis, as a kind of inflammatory bowel disease (IBD) is characterized by abdominal pain. This study aimed to investigate the effect of icariin (ICA) on the intestinal microflora of colitis mice. METHODS: Fifteen female C57BL/6 mice were randomly divided into the Control group, dextran sodium sulfate (DSS)-induced colitis (DSS) group, and ICA treatment (DSS+ICA) group. The severity of inflammation in DSS-induced colitis mice was evaluated using disease activity scoring (considering weight-loss percentage, stool-shape change, and stool-bleeding scoring). Pathological changes of mice intestinal tract were evaluated using hematoxylin–eosin (HE) staining. Serum levels of TNF-α and IL-6 were detected with enzyme-linked immunosorbent assay. Expressions of p65 and p-p65 (p-p65/p65 ratio) were analyzed using Western blot assay. 16S rDNA sequencing was used to analyze the abundance and composition of intestinal microflora. RESULTS: Compared with DSS group, ICA significantly improved disease activity (P < .05) and reduced inflammatory damage of colon tissues (P < .05) in DSS-induced colitis mice. Compared with the DSS group, mice in the ICA group demonstrated significant weight and colon length (P < .05). ICA significantly inhibited expressions of IL-6 and TNF-α compared to the DSS group (P < .05). p-p65/p65 ratio in the DSS+ICA group was remarkably enhanced compared to the DSS group (P < .05). ICA significantly reduced the proportion and activity of Bacteroides, Helicobacteraceae, Turicibacter, and significantly increased that of beneficial microflora (Lactobacillus, Lachnospiraceae, Akkermansia), so as improved damages of colon tissues. CONCLUSION: ICA can improve intestinal flora abundance and composition of DSS-induced colitis mice, and inhibit tissue damage and inflammatory response through modulating the p-p65/p65 expression. Keywords: Icariin, ulcerative colitis, intestinal microflora, dextran sulfate sodium, inflammation

One of the safety concerns with the delivery of therapeutic ultrasound is overheating of the transducer-skin interface due to poor or improper coupling. The objective of this research was to define a model that could be used to calculate the heating in the skin as a result of a novel, wearable long-duration ultrasound device. This model was used to determine that the maximum heating in the skin remained below the minimum threshold necessary to cause thermal injury over multiple hours of use. In addition to this model data, a human clinical study used wire thermocouples on the skin surface to measure heating characteristics during treatment with the sustained ultrasound system. Parametric analysis of the model determined that the maximum temperature increase is at the surface of the skin ranged from 40-41.8° C when perfusion was taken into account. The clinical data agreed well with the model predictions. The average steady state temperature observed across all 44 subjects was 40°C. The maximum temperature observed was less than 44° C, which is clinically safe for over 5 hours of human skin contact. The resultant clinical temperature data paired well with the model data suggesting the model can be used for future transducer and ultrasound system design simulation. As a result, the device was validated for thermal safety for typical users and use conditions.

BACKGROUND Whether ablation therapy reduces the risk of death and embolic events in elderly patients with atrial fibrillation (AF) remains unclear. MATERIAL AND METHODS AF patients ≥65 years old receiving either catheter ablation or non-ablation therapy at 2 tertiary and 2 non-tertiary hospitals in Beijing from November 2009 to December 2012 were enrolled. Patients were followed up every 6 months for information on treatment and clinical event occurrence. A propensity score matching algorithm produced comparable 2 groups of patients treated with ablation or non-ablation. Rates of a composite of all-cause death, non-fatal stroke, and peripheral embolism were the primary outcomes. Each composite component and major bleeding were the secondary outcomes. RESULTS There were 596 ablated patients and 1144 patients with non-ablation therapy enrolled. Propensity score algorithm matched 347 comparable pairs of patients. Patient characteristics variables were well balanced. During 523.5 and 497.5 patient-years follow-up, respectively, ablation therapy was associated with a significant lower risk of experiencing the primary composite outcome (hazard ratio [HR]=0.40; 95% confidence interval [CI]: 0.19-0.85), all-cause death (HR=0.13 95% CI: 0.04-0.43), and major bleeding (HR=0.23; 95% CI: 0.12-0.67), without apparent heterogeneity by age, sex, and AF type, and for risk score subgroups. CONCLUSIONS In this propensity-matched elderly sample, ablation therapy was associated with lower risk of composite outcome consisting of all-cause death, non-fatal stroke, and peripheral embolism, and therefore might be an alternative to conservative therapy.

Objective To investigate the feasibility and safety of wire-guided pericardial access without contrast. Methods From January 2014 to February 2019, patients who received epicardial mapping and ablation of ventricular tachycardia in the Beijing Anzhen Hospital were entered into the current study. They were divided into contrast-guided access group or wire-guided access group according to the pericardial puncture technique used. The baseline variables, procedure parameters, complications were collected and compared. Results During the study period, a consecutive of 73 patients received epicardial access. The initial 32 patients received contrast-guided puncture with success achieved in 30 patients, the remaining 41 patients underwent wire-guided puncture with success achieved in 40 patients (30/32 and 40/41, P = .581). Fluoroscopy time (4.45 ± 0.52 and 4.38 ± 0.46 minutes, P = .891) and access time (5.14 ± 0.58 and 5.34 ± 0.50 minutes, P = .657) were comparable between the two groups. Inadvertent right ventricular puncture occurred more commonly in the contrast-guided group (5/32 and 1/41, P = .038). Though more pericardial effusions (2/32 and 1/41, P = .575), tamponade (2/32 and 1/41, P = .575), and surgical repair (1/32 and 0/41, P = .432) occurred in the contrast-guided group, they reached no statistical difference. Conclusion Wire-guided pericardial puncture exhibits better safety and similar success rates to contrast-guided technique with a trend towards less complications.

Automatic generation of artistic glyph images is a challenging task that attracts many research interests. Previous methods either are specifically designed for shape synthesis or focus on texture transfer. In this paper, we propose a novel model, AGIS-Net, to transfer both shape and texture styles in one-stage with only a few stylized samples. To achieve this goal, we first disentangle the representations for content and style by using two encoders, ensuring the multi-content and multi-style generation. Then we utilize two collaboratively working decoders to generate the glyph shape image and its texture image simultaneously. In addition, we introduce a local texture refinement loss to further improve the quality of the synthesized textures. In this manner, our one-stage model is much more efficient and effective than other multi-stage stacked methods. We also propose a large-scale dataset with Chinese glyph images in various shape and texture styles, rendered from 35 professional-designed artistic fonts with 7,326 characters and 2,460 synthetic artistic fonts with 639 characters, to validate the effectiveness and extendability of our method. Extensive experiments on both English and Chinese artistic glyph image datasets demonstrate the superiority of our model in generating high-quality stylized glyph images against other state-of-the-art methods., Accepted by SIGGRAPH Asia 2019, code and datasets: https://hologerry.github.io/AGIS-Net/

Background The use of alpha‐fetoprotein (AFP) testing for the surveillance, diagnosis, and prognosis of hepatocellular carcinoma (HCC) remains controversial. Here, we compared AFP testing rates, elevated AFP rates, factors associated with elevated AFP levels, and prognostic factors associated with overall survival (OS) in HCC patients from different ethnic groups. Methods Patients with HCC were identified from the Surveillance, Epidemiology, and End Results registries. Race was categorized as white, black, and others. AFP testing rates and elevated AFP rates were analyzed. Multivariable logistic regression and Cox regression analyses were used to identify independent factors associated with elevated AFP levels and prognosis, respectively. All statistical tests were two sided. Results A proportion of 79.2% of total HCC patients had AFP testing reports; 77.3% of white, 79.7% of black, and 81.2% of other races underwent AFP testing. Compared with white and other races, black HCC patients had a higher rate of elevated AFP levels among all patients and the early‐stage HCC patient cohort. Elevated AFP level was a significant prognostic factor for all HCC patients in different race groups. Factors associated with elevated AFP level and prognostic factors associated with OS varied significantly by race. Conclusions AFP testing, elevated AFP rates, predictors of elevated AFP level, and prognostic factors associated with OS differed significantly according to race after adjusting for AFP levels among the three groups. AFP testing for the surveillance, diagnosis, and prognosis of HCC patients is strongly recommended, although racial disparities need to be considered., We hypothesized that the racial disparities of the elevated AFP in HCC patients may be an important issue regarding to the difference of using AFP for HCC surveillance and diagnosis between Asian and the United States HCC patients. Our results showed that elevated AFP rates were high in all three race groups, and the highest rate of AFP tests performed and elevated was the black race group, which was reported to be the least likely to present with an elevated AFP at diagnosis. Our present findings suggest that AFP testing could still be considered for the diagnosis, and prognosis of HCC patients with more attention to the black race.

Background Data on management of maternal arrhythmia among Chinese were limited. Radiofrequency catheter ablation (RFCA) proved to be a reliable treatment choice for sustained tachyarrhythmia but it has rarely been performed during pregnancy due to radiation exposure. Objective To investigate the incidence of idiopathic sustained maternal arrhythmia and the feasibility of RFCA in the pregnant patients without fluoroscopy. Methods From January of 2015 to December of 2018, the medical records on pregnancy-related admissions in Beijing Anzhen Hospital (Beijing, China) were retrospectively analyzed. Patients who had sustained tachyarrhythmia episodes without structural heart disease were identified. Catheter ablation was performed in those with drug resistant and severely frequent tachyarrhythmia under the guidance of electroanatomical mapping system and intracardiac echocardiography catheter (ICE), if appropriate. Results During the study period, 12 584 consecutive pregnant women were admitted for pregnancy-related reasons, 156 (1.2%) of them were identified as sustained maternal tachyarrhythmia. Twenty-eight patients (age 21-37 years) received catheter ablation because the arrhythmias were drug resistant and severely frequent. The RFCA was successfully performed in all patients with zero fluoroscopy after 72.4 ± 24.7 min. Transseptal puncture was performed in 11 patients under the guidance of ICE. In a median of 37 (interquartile range [IQR]: 34-39) weeks' pregnancy, 28 healthy fetuses were delivered. No cardiac-related adverse event occurred during delivery. During later follow-up, all patients were free of arrhythmia, and all the infants were well developed. Conclusion Sustained maternal tachyarrhythmia is not uncommon in the clinical practice. To those with drug resistant and severely frequent arrhythmia, RFCA with zero fluoroscopy could be safely performed with acceptable efficacy.

Grandparents caring for grandchildren has become a common experience in China. However, the health implications of grandparenting, especially for health self-management, remain unclear. A cross-sectional study was conducted to investigate the effects of grandparenting on health self-management in older adults in China. Information on socioeconomic characteristics, grandparenting, and health self-management was collected through interviewer-administered questionnaires. Age less than 50, male gender, higher education level, being a local resident, having a chronic illness, and supporting themselves financially were all factors that were significantly positively associated with health self-management (P < .05) in grandparents. Grandparenting characteristics, including caring for grandchildren at night, a caregiving burden of more than 50%, poorly behaved grandchildren, caring for grandchildren more than 6 hours per day, and caring for grandchildren less than 1 year in age were significantly negatively associated with health self-management in grandparents (P < .05). Multiple regression analyses indicated that grandparent age, receiving financial support from children, being a local resident, education level, grandchild behavior and age, and being an urban resident were all statistically significant factors associated with health self-management in grandparents involved in grandparenting. Taken together, these results suggested that financial condition and caregiving burden might be the major factors affecting health self-management in grandparents involved in grandparenting.

Sprengel’s deformity is a rare congenital anomaly that can present in children, leading to cosmetic and functional impairment. This study investigated clinical results of this deformity among cases managed using a modified Green procedure. From February 2008 to September 2015 a total of 34 patients with Sprengel’s deformity were treated with a modified Green procedure. The mean age of patients at the time of surgery was 4.8 years (range 2–12 years) and the average follow-up time was 6.1 years (range 4–10 years). The shoulder abduction, Cavendish classification, Rigault classification, scapular elevation, and postoperative complications were evaluated. The mean shoulder abduction was 102.3° (range 70–140°) preoperatively and 142.6° (range 120–170°) postoperatively. The scapular elevation was 4.2 cm (range 2–6.5 cm) preoperatively and 1.35 cm (range 0–2 cm) postoperatively. Improvement by at least one Cavendish and/or Rigault grade was attained in all cases postoperatively. The differences in preoperative and postoperative shoulder abduction, scapular elevation, Cavendish grade and Rigault grade were statistically significant (p

The Ig superfamily member V-domain Ig-containing suppressor of T-cell activation (VISTA) is a negative regulator with broad-spectrum activities and has reported that blockade of VISTA or combination with other negative checkpoint receptors sufficiently break tumor tolerance. However, it remains unclear whether VISTA could induce allogeneic T-cell hyporesponsiveness and inhibit allograft rejection. Here we found VISTA treatment significantly inhibited lymphocyte proliferation and activation in allogeneic MLR assay through impairing SYK-VAV pathway. Interestingly, though neither VISTA protein nor VISTA-Fc fusion protein administration exerted satisfactory immunosuppressive effect on allograft survival due to their short half-life in circulation, this problem was solved by conjugating VISTA protein on liposome by biotin-streptavidin system, which markedly prolonged its circulating half-life to 60 h. With islet transplant model, administration of VISTA-conjugated liposome could markedly prolong allograft survival by inhibition of SYK-VAV pathway, thus maintained the normal blood glucose level of recipients during treatment period. The results indicate VISTA is a promising therapeutic target to treat allograft rejection of islet transplantation.

Background Diffusion-weighted imaging (DWI) in MRI plays an increasingly important role in diagnostic applications and developing imaging biomarkers. Automated whole-breast segmentation is an important yet challenging step for quantitative breast imaging analysis. While methods have been developed on dynamic contrast-enhanced (DCE) MRI, automatic whole-breast segmentation in breast DWI MRI is still underdeveloped. Purpose To develop a deep/transfer learning-based segmentation approach for DWI MRI scans and conduct an extensive study assessment on four imaging datasets from both internal and external sources. Study type Retrospective. Subjects In all, 98 patients (144 MRI scans; 11,035 slices) of four different breast MRI datasets from two different institutions. Field strength/sequences 1.5T scanners with DCE sequence (Dataset 1 and Dataset 2) and DWI sequence. A 3.0T scanner with one external DWI sequence. Assessment Deep learning models (UNet and SegNet) and transfer learning were used as segmentation approaches. The main DCE Dataset (4,251 2D slices from 39 patients) was used for pre-training and internal validation, and an unseen DCE Dataset (431 2D slices from 20 patients) was used as an independent test dataset for evaluating the pre-trained DCE models. The main DWI Dataset (6,343 2D slices from 75 MRI scans of 29 patients) was used for transfer learning and internal validation, and an unseen DWI Dataset (10 2D slices from 10 patients) was used for independent evaluation to the fine-tuned models for DWI segmentation. Manual segmentations by three radiologists (>10-year experience) were used to establish the ground truth for assessment. The segmentation performance was measured using the Dice Coefficient (DC) for the agreement between manual expert radiologist's segmentation and algorithm-generated segmentation. Statistical tests The mean value and standard deviation of the DCs were calculated to compare segmentation results from different deep learning models. Results For the segmentation on the DCE MRI, the average DC of the UNet was 0.92 (cross-validation on the main DCE dataset) and 0.87 (external evaluation on the unseen DCE dataset), both higher than the performance of the SegNet. When segmenting the DWI images by the fine-tuned models, the average DC of the UNet was 0.85 (cross-validation on the main DWI dataset) and 0.72 (external evaluation on the unseen DWI dataset), both outperforming the SegNet on the same datasets. Data conclusion The internal and independent tests show that the deep/transfer learning models can achieve promising segmentation effects validated on DWI data from different institutions and scanner types. Our proposed approach may provide an automated toolkit to help computer-aided quantitative analyses of breast DWI images. Level of evidence 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:635-643.