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ACE2 has long been known as an injury protective protein, which can protect against a variety of organ damage such as the heart, liver, kidney, and lung. Especially in cardiovascular diseases, as a negative regulator of RAAS, ACE2 is an extremely important protective factor that mainly plays a role by converting Ang II to Ang-(1-7). Nevertheless, with the recent outbreak of COVID-19, it is exposed that another identity of ACE2 is the entry receptor for SARS-CoV-2, which previously serves as the entry receptor for SARS. With the in-depth clinical research, it is found that the severity and susceptibility of COVID-19 are related to cardiovascular diseases, and SARS-CoV-2 binding to ACE2 receptor is also potentially associated with heart injury symptoms. Therefore, in this article, we mainly summarize the relationship between ACE2, COVID-19, and cardiovascular diseases/heart injury.

Background After a stroke, 80% of the chronic patients have difficulties to use their paretic upper limb (UL) in activities of daily life (ADL) even after rehabilitation. Virtual reality therapy (VRT) and anodal transcranial direct current stimulation (tDCS) are two innovative methods that have shown independently to positively impact functional recovery of the paretic UL when combined with conventional therapy. The objective of the project will be to evaluate the impact of adding anodal high-definition (HD)-tDCS during an intensive 3-week UL VRT and conventional therapy program on paretic UL function in chronic stroke. Methods The ReArm project is a quadruple-blinded, randomized, sham-controlled, bi-centre, two-arm parallel, and interventional study design. Fifty-eight chronic (> 3 months) stroke patients will be recruited from the Montpellier and Nimes University Hospitals. Patients will follow a standard 3-week in-patient rehabilitation program, which includes 13 days of VRT (Armeo Spring, 1 × 30 min session/day) and conventional therapy (3 × 30 min sessions/day). Twenty-nine patients will receive real stimulation (4x1 anodal HD-tDCS montage, 2 mA, 20 min) to the ipsilesional primary motor cortex during the VRT session and the other 29 patients will receive active sham stimulation (2 mA, 30 s). All outcome measures will be assessed at baseline, at the end of rehabilitation and again 3 months later. The primary outcome measure will be the wolf motor function test. Secondary outcomes will include measures of UL function (Box and Block Test), impairment (Fugl Meyer Upper Extremity), compensation (Proximal Arm Non-Use), ADL (Actimetry, Barthel Index). Other/exploratory outcomes will include pain, fatigue, effort and performance, kinematics, and motor cortical region activation during functional motor tasks. Discussion This will be the first trial to determine the impact of adding HD-tDCS during UL VRT and conventional therapy in chronic stroke patients. We hypothesize that improvements in UL function will be greater and longer-lasting with real stimulation than in those receiving sham. Trial registration The ReArm project was approved by The French Research Ethics Committee, (Comité de Protection des Personnes-CPP SUD-EST II, N°ID-RCB: 2019-A00506-51, http://www.cppsudest2.fr/). The ReArm project was registered on ClinicalTrials.gov (NCT04291573, 2nd March 2020.

BACKGROUND Syphilis is a chronic, classic sexually transmitted disease caused by Treponema pallidum, which can invade almost all organs of the body and produce various symptoms and signs. Although there are some cases of colorectal bleeding caused by syphilis, small intestinal bleeding caused by syphilis is still rare. CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years. Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions. During the same admission, multiple intestinal ulcers were found by capsule endoscopy, and syphilis was also diagnosed. With a history of atrial fibrillation and chronic pancreatitis, he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease. After anti-syphilis treatment, the melena and abdominal pain disappeared and his hemoglobin gradually increased. It is considered that gastrointestinal bleeding, chronic pancreatitis, atrial fibrillation, and heart valvular disease may have been caused by syphilis. CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding. In addition, treatment of the disease requires both sexual partners to be treated. Finally, although syphilis is easy to treat, it is more important to consider that bleeding could be caused by syphilis.

Bank loans can convey information about the borrowing firms that have proper corporate governance systems. Using a sample of bank loan announcements in China, we find that the market reaction is positive after the split share structure reform in 2005, which aligns the interests of large shareholders and minority shareholders, government and public investors, and alleviates their tunneling incentives. We also find that this effect is more pronounced for private firms as the reform mainly enhances corporate governance for private firms. The signaling role of bank loans is less pronounced for firms with less severe information asymmetry after the reform, e.g. higher shareholdings of mutual funds and higher proportion of independent directors. Related party transactions decrease when they obtain bank loans after the reform, which reflects the alleviation of tunneling after the reform.

Cancer cachexia is characterized by weight loss, anorexia, asthenia, and anemia among cancer patients and can lead to their decreased physical function, poor quality of life, and reduced survival. Progestins have been reported to have beneficial effects on appetite improvement in patients with cancer; however, serious complications have been reported as a result of their use. Traditional Chinese medicine (TCM) is a complementary and alternative system of medicine that may be effective in treating cancer cachexia. This review aims to identify existing evidence on the efficacy and safety of traditional Chinese herbs and common TCM technologies in treating cancer cachexia. We searched six databases - the Cochrane Library, PubMed, EMBASE, CINAHL, China National Knowledge Infrastructure, and Wan Fang Database, using medical subject headings and free text. The search was performed in January 2021, and the reference lists of relevant articles were also searched. A total of 4685 citations were identified, and 20 studies were included. The results showed that traditional Chinese herbs can improve appetite, weight, biomarkers, the Karnofsky performance status, cachexia-related symptoms, and quality of life in patients with cancer cachexia. Some traditional Chinese herbs may have superiority in curative effects and safety, compared with progestins. Interestingly, acupuncture can improve appetite, nausea, constipation, and quality of life among patients with cancer cachexia but cannot increase body weight. However, high-quality evidence regarding the effect of TCM technologies in treating cancer cachexia is limited. It would be beneficial to explore the use of moxibustion and other TCM technologies in future studies.

A design approach is presented based on insights into power division among modes for a dual‐band filtering power divider using a single multimode resonator. The relationship between the energy of the input port under different modes and the corresponding external quality factor (Qe) is analysed. Then, the power distribution among the in‐band modes and between output ports can be all expressed by Qe. Therefore, the synthesis of a coupling matrix to achieve independent power distribution in the two bands is simplified. For further verification, a quad‐mode dielectric resonator with independently controllable modes is designed. Based on this, dual‐band filtering power dividers with equal and unequal power split ratios (1:1 in the lower band and 2:1 in the higher band) are simulated and implemented. The simulation and measurement agree, proving the correctness of the approach.

Background IgA nephropathy(IgAN)) is the common pathological type of glomerular diseases. The role of gut microbiota in mediating “gut-IgA nephropathy” has not received sufficient attention in the previous studies. The purpose of this study was to investigate the changes of fecal short-chain fatty acids(SCFAs), a metabolite of the intestinal microbiota, in patients with IgAN and its correlation with intestinal flora and clinical indicators, and to further investigate the role of the gut-renal axis in IgAN. Methods There were 29 patients with IgAN and 29 normal control subjects recruited from January 2018 to May 2018. The fresh feces were collected. The fecal SCFAs were measured by gas chromatography/mass spectrometry and gut microbiota was analysed by16S rDNA sequences, followed by estimation of α- and β-diversity. Correlation analysis was performed using the spearman’s correlation test between SCFAs and gut microbiota. Results The levels of acetic acid, propionic acid, butyric acid, isobutyric acid and caproic acid in the IgAN patients were significantly reduced compared with control group(P P = 0.010) and isobutyric acid(r=-0.298, P = 0.022) were negatively correlated with urea acid; butyric acid(r=-0.316, P = 0.016) was negatively correlated with urea nitrogen; caproic acid(r=-0.415,P = 0.025) showed negative correlation with 24-h urine protein level.Exemplified by the results of α-diversity and β-diversity, the intestinal flora of IgAN patients was significantly different from that of the control group. Acetic acid was positively associated with c_Clostridia(r = 0.357, P = 0.008), o_Clostridiales(r = 0.357, P = 0.008) and g_Eubacterium_coprostanoligenes_group(r = 0.283, P = 0.036). Butyric acid was positively associated with g_Alistipes (r = 0.278, P = 0.040). The relative abundance of those were significantly decreased in IgAN group compared to control group. Conclusions The levels of fecal SCFAs in the IgAN patients were reduced, and correlated with clinical parameters and gut microbiota, which may be involved in the pathogenesis of IgAN, and this finding may provide a new therapeutic approach.

Highly ordered silicon nanostructures were fabricated using the nanosphere mask and reactive ion etching method. A self-assembled SiO2 nanospheres monolayer obtained by spin-coating method was used...

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Background and aim The promotion of peripherally inserted central catheter (PICC) maintenance in primary hospitals can benefit discharged patients with PICCs living in remote areas a lot. Yet, no primary hospitals had introduced PICC maintenance technology in Hunan province, China. The present study aimed to evaluate nurses' attitudes and knowledge of PICC maintenance in primary hospitals in Hunan province, China. Materials and methods From November 2018 to January 2019, a total of 560 nurses from 28 community hospitals and 28 township hospitals in 14 cities across Hunan were recruited in the present study. All nurses were registered nurses engaged in clinical work related to intravenous infusion, and their attitudes and knowledge of PICC maintenance were measured by a self-designed questionnaire that was based on literature review and expert consultation. Results The response rate was 93.6% (560 of 598). Almost all participants could realize the importance and necessity of PICC maintenance. More than 90% of the participants expressed interest in PICC maintenance and showed strong demands for relevant training. However, the nurses' correct response rate of most knowledge items was at a low level (7.14-57.68%), with only three items exhibiting the correct response rate of 90% or higher. The factors influencing the nurses' PICC maintenance knowledge included their nursing experience, professional title, work setting, and department. Conclusion Although nurses in primary hospitals had a positive attitude toward PICC maintenance, their knowledge level was unsatisfactory, which might be a barrier to the promotion of PICC maintenance technology in primary hospitals in Hunan province, China. Multiple parties should get involved and take measures to improve the nurses' PICC maintenance knowledge, including the government, nursing associations, large-scale hospitals, and primary hospitals themselves. Besides, new training models and dynamic assessment methods should be explored to improve training effectiveness in the future.

Submarine pipeline was widely used to transport oil and gas in offshore petroleum exploitation. In practice, deep-water pipeline experiences several times of maintenance every year. This periodic o...

Objective: Endoscopic resection of colorectal polyps is widely established as the optimal method to manage precancerous lesions. But the optimal technique for removal of the polyps is uncertain. Th...

BackgroundDifferential diagnosis of patients with suspected infections is particularly difficult, but necessary for prompt diagnosis and rational use of antibiotics. A substantial proportion of these patients have non-infectious diseases that include malignant tumors. This study aimed to explore the clinical value of metagenomic next-generation sequencing (mNGS) for tumor detection in patients with suspected infections.MethodsA multicenter, prospective case study involving patients diagnosed with suspected infections was conducted in four hospitals in Shanghai, China between July 2019 and January 2020. Based upon mNGS technologies and chromosomal copy number variation (CNV) analysis on abundant human genome, a new procedure named Onco-mNGS was established to simultaneously detect pathogens and malignant tumors in all of the collected samples from patients.ResultsOf 140 patients screened by Onco-mNGS testing, 115 patients were diagnosed with infections; 17 had obvious abnormal CNV signals indicating malignant tumors that were confirmed clinically. The positive percent agreement and negative percent agreement of mNGS testing compared to clinical diagnosis was 53.0% (61/115) and 60% (15/25), vs. 20.9% (24/115) and 96.0% (24/25), respectively, for conventional microbiological testing (both P <0.01). Klebsiella pneumoniae (14.8%, 9/61) was the most common pathogen detected by mNGS, followed by Escherichia coli (11.5%, 7/61) and viruses (11.5%, 7/61). The chromosomal abnormalities of the 17 cases included genome-wide variations and local variations of a certain chromosome. Five of 17 patients had a final confirmed with malignant tumors, including three lung adenocarcinomas and two hematological tumors; one patient was highly suspected to have lymphoma; and 11 patients had a prior history of malignant tumor.ConclusionThis preliminary study demonstrates the feasibility and clinical value of using Onco-mNGS to simultaneously search for potential pathogens and malignant tumors in patients with suspected infections.

Objective: This study aims to comprehensively analyze the influence of spontaneous tumor rupture on the prognosis of hepatocellular carcinoma patients following hepatic resection.Methods: We systematically searched four online electronic databases, including PubMed, Embase, Web of Science, and Cochrane Library, for eligible studies published from inception to March 2021. The main endpoints were overall survival (OS) and disease-free survival (DFS).Results: This meta-analysis included 21 observational articles with 57,241 cases. The results revealed that spontaneous tumor rupture was associated with worse OS (hazard ratio (HR), 1.65; 95% confidence interval (CI), 1.33–2.05) and DFS (HR, 1.42; 95% CI, 1.12–1.80) in resectable hepatocellular carcinoma patients. This phenomenon was observed in most subgroups, which were classified by recorded survival time, age, country, alpha-fetoprotein (AFP) concentration, liver cirrhosis, and microvascular invasion. However, in subgroups of macrovascular invasion positive, spontaneous tumor rupture was not a risk factor for OS (HR, 1.55; 95% CI, 0.99–2.42) and DFS (HR, 1.23; 95% CI, 0.91–1.65) in hepatocellular carcinoma patients after hepatectomy. For macrovascular invasion negative, compared with non-ruptured hepatocellular carcinoma patients, ruptured hepatocellular carcinoma patients exhibited worse prognosis for OS (HR, 1.55; 95% CI, 0.99–2.42) and DFS (HR, 1.23; 95% CI, 0.91–1.65) following hepatectomy.Conclusions: Spontaneous tumor rupture was a prognostic risk factor for hepatocellular carcinoma patients after hepatic resection. However, in macrovascular invasion patients, spontaneous tumor rupture was not a prognostic risk factor.

International audience; Among the common image structures, line feature is the extensively used geometric structure for various image processing applications, including the analysis of biomedical image with blood vessels highlighting, graph-shape structures, cracks detection, satellite images or remote sensing data. Multi-scale processing of line feature is essentially required for the extraction of more relevant information or line structures of heterogeneous widths. In this paper, a multi-scale filtering-based line detection approach using second-order semi-Gaussian anisotropic kernel is proposed. Meanwhile, a strategy is introduced to calculate the strength of the observed line feature across the different scales. The proposed technique is evaluated on real images by using their tied hand-labeled images. Finally, the experimental results and comparison of images containing different line feature widths with state-of-the-art techniques have sufficiently supported the effectiveness of our technique.

Background Early detection/prediction of flare‐ups in asthma, commonly triggered by viruses, would enable timely treatment. Previous studies on exhaled breath analysis by electronic nose (eNose) technology could discriminate between stable and unstable episodes of asthma, using single/few time‐points. To investigate its monitoring properties during these episodes, we examined day‐to‐day fluctuations in exhaled breath profiles, before and after a rhinovirus‐16 (RV16) challenge, in healthy and asthmatic adults. Methods In this proof‐of‐concept study, 12 atopic asthmatic and 12 non‐atopic healthy adults were prospectively followed thrice weekly, 60 days before, and 30 days after a RV16 challenge. Exhaled breath profiles were detected using an eNose, consisting of 7 different sensors. Per sensor, individual means were calculated using pre‐challenge visits. Absolute deviations (|%|) from this baseline were derived for all visits. Within‐group comparisons were tested with Mann‐Whitney U tests and receiver operating characteristic (ROC) analysis. Finally, Spearman's correlations between the total change in eNose deviations and fractional exhaled nitric oxide (FeNO), cold‐like symptoms, and pro‐inflammatory cytokines were examined. Results Both groups had significantly increased eNose fluctuations post‐challenge, which in asthma started 1 day post‐challenge, before the onset of symptoms. Discrimination between pre‐ and post‐challenge reached an area under the ROC curve of 0.82 (95% CI = 0.65–0.99) in healthy and 0.97 (95% CI = 0.91–1.00) in asthmatic adults. The total change in eNose deviations moderately correlated with IL‐8 and TNFα (ρ ≈ .50–0.60) in asthmatics. Conclusion Electronic nose fluctuations rapidly increase after a RV16 challenge, with distinct differences between healthy and asthmatic adults, suggesting that this technology could be useful in monitoring virus‐driven unstable episodes in asthma., Electronic nose sensor fluctuations increased after a RV‐16 challenge in asthmatic and healthy adults, more evidently in asthma. In asthma, the increase in eNose fluctuations occurred before the onset of cold‐like symptoms. The magnitude of the change in eNose fluctuations was not correlated with FeNO and cold‐like symptoms, but moderately correlated with pre‐ and post‐challenge cytokine levels in asthma.

International audience; Ridges (resp., valley) are the useful geometric features due to their wide varieties of applications, mainly in image analysis problems such as object detection, image segmentation, scene understanding, etc. Many characterizations have contributed to formalize the ridge notion. The signification of each characterization rely however on its actual application. The objective analysis of ridge characterized as thin and complex image structure is thus essentially important, for choosing which parameter’s values correspond to the suitable configuration to obtain accurate results and optimal performance. In this article an extensive analysis followed by a supervised and objective comparison of different filtering-based ridge detection techniques is led. Furthermore, the optimal parameter configuration of each filtering techniques aimed for image salient feature analysis tool have been objectively investigated, where each chosen filter’s parameters corresponds to the width of the desired ridge or valley. At last, the comparative evaluations and analysis results are reported on both synthetic images, distorted with various types of noises and real images.

Our study aimed to scrutinize the incidence and risk factors of femoral inserted central catheter (FICC)-related thrombosis in patients with superior vena cava syndrome (SVCS) undergoing chemotherapy.A retrospective analysis of patients with SVCS undergoing chemotherapy who received FICC catheterization at the Xiangya Hospital, Central South University, Changsha City, Hunan Province between May 2012 and February 2019 was performed. Both asymptomatic thrombosis and symptomatic thrombosis were diagnosed by color doppler ultrasound (CDUS). Univariate and multivariate logistic regression analyses were performed to identify patient-, insertion-, and catheter-related factors.Eight hundred and seventy-four patients with SVCS undergoing chemotherapy, with a total of 157,180 catheter days were enrolled in our study. FICC-related thrombosis was detected in 144 patients, and yielding an overall incidence of 16.47% or 0.92 events per 1000 catheter days. Of these, 19(2.17%) patients had symptomatic thrombosis. The mean time interval between FICC insertion and thrombosis onset was (10.40 ± 6.32) days and the mean catheter indwelling time was (179.84 ± 46.15) days. The history of deep venous thrombosis, treatment with vascular endothelial growth factor (VEGF) inhibitor (bevacizumab), puncture site (mid-thigh, groin), tip position and catheter size showed association with FICC-related thrombosis. Treatment with VEGF inhibitor [odds ratio (OR) = 2.779; 95%confidence interval (CI): 1.860-4.153; P 0.001] and puncture site at the groin (OR = 10.843; 95%CI: 6.575-17.881; P 0.001) were identified as independent risk factors of FICC-related thrombosis.Treatment with VEGF inhibitor and puncture site at the groin during FICC catheterization were considered as high-risk factors in FICC-related thrombosis.

Aim To detect how BRCA-associated protein 1 (BAP1) regulates cell migration in uveal melanoma (UM) cells. Methods Wound healing and transwell assays were performed to detect UM cell migration abilities. Protein chip, immunoprecipitations and surface plasmon resonance analyses were applied to identify BAP1 protein partners. Western blot and calpain activity assays were used to test the expression and function of calpastatin (CAST). Results CAST protein was confirmed as a new BAP1 protein partner, and loss of BAP1 reduced the expression and function of CAST in UM cells. The overexpression of CAST rescued the cell migration phenotype caused by BAP1 loss. Conclusion BAP1 interacts with CAST in UM cells, and CAST and its subsequent calpain pathway may mediate BAP1-related cell migration regulation.

BackgroundThis is a study aimed at exploring the relationship between pretreatment overweight/obesity, adipose tissue distribution, and long-term prognosis of gastric cancer.MethodsA total of 607 gastric cancer patients were involved in the retrospective cohort study. Overweight/obese patients were defined as body mass index (BMI) greater than 25 kg/m2, and adipose tissue distribution parameters, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT ratio were measured at the level of the third lumbar vertebra using computerized tomography images within 15 days before the surgery. Multiple Cox regression models were applied to evaluate the association between overweight/obesity and disease-specific survival (DSS) of gastric cancer, and covariates including age, gender, T stage, N stage, and chemotherapy were adjusted. Furthermore, multiple Cox regression models were performed to evaluate the association between adipose tissue distribution parameters and DSS of gastric cancer; except for covariates mentioned above, overweight/obesity was adjusted additionally.ResultsOverweight/obesity was a predictive factor (HR = 0.61, 95% CI: 0.37–0.99) for the prognosis of gastric cancer. After additionally adjusting for overweight/obesity, high SAT percentage was an independent protective factor (HR = 0.59, 95% CI: 0.36–0.96), while high VAT percentage (HR = 1.68, 95% CI: 1.06–2.68) and high VAT/SAT ratio (HR = 1.99, 95% CI: 1.19–3.34) were independent risk factors for DSS of gastric cancer. Compared with other patients (overweight/obesity with low VAT/SAT ratio group, non-overweight/obesity or high VAT/SAT ratio group), patients in the non-overweight/obesity with high VAT/SAT ratio group had a worse prognosis (HR = 1.89, 95% CI: 1.28–2.77).ConclusionThese results suggest that overweight/obesity is a predictive factor for the prognosis of gastric cancer. The VAT/SAT ratio could be used as a promising prognostic factor for gastric cancer. Therefore, in preoperative evaluation of gastric cancer patients, attention should be paid not only to BMI but also to adipose tissue distribution.

Background The effect of dairy products intake on breast cancer (BC) is highly controversial. This study aims to investigate the relationship between dairy intake and BC incidence. Methods A search was carried out in PubMed, EBSCO, Web of Science, and Cochrane Library databases before January 2021. The primary objective was the risk of BC and intake of dairy products were exposure variables. Results The meta-analysis comprised 36 articles with 1,019,232 participants. Total dairy products have a protective effect on female population (hazard ratio (HR) =0.95, 95% confidence interval (CI) =0.91–0.99, p = 0.019), especially for estrogen receptor-positive (ER+) (HR = 0.79, p = 0.002) and progesterone receptor-positive (PR+) BC (HR = 0.75, p = 0.027). For ER+/PR+ BC, there is a trend of protection, but it has not reached statistical significance (HR = 0.92, p = 0.075). Fermented dairy products can reduce BC risk in postmenopausal population (HR = 0.96, 95%CI = 0.93–0.99, p = 0.021), but have no protective effect on premenopausal population (HR = 0.98, 95%CI = 0.94–1.03, p = 0.52). Non-fermented dairy products have no significant effect on BC occurrence (p > 0.05). High-fat dairy products are harmful to women, without statistical difference (HR = 1.06, 95%CI = 1.00–1.13, p = 0.066). On the contrary, low-fat dairy products can protect the premenopausal population (HR = 0.94, 95%CI = 0.89–1.00, p = 0.048). Conclusion The intake of dairy products can overall reduce BC risk in the female population, but different dairy products have varying effects on different BC subtypes and menopausal status.

BackgroundPrevious studies have shown that the all-cause mortality and non-colorectal cancer mortality of patients with fecal occult blood test (FOBT) positivity are significantly increased, implying that FOBT results may have more prognostic value.MethodsRetrospective analysis was performed for gastric cancer (GC) patients who underwent R0 gastrectomy from July 2007 to July 2014 at our hospital. Propensity score matching (PSM) was used to reduce confounding bias and a computerized technique for the nearest available score matching without replacement was applied. The cumulative survival rate was calculated using the Kaplan-Meier method and a log-rank test. Cox proportional hazards regression and logistic regression was used to determine the independent prognostic factors associated with survival and postoperative complications, respectively. The expression level of tumor-associated macrophages (TAMs) and proinflammatory cytokines (TNF-α, IL-6) were evaluated by immunohistochemical (IHC).ResultsA total of 3,003 patients were included and 246 patients (8.2%) were in preoperative FOBT positive status. There was no significant difference in demographic data between preoperative FOBT positive and negative group after a 1:4 PSM. The overall postoperative complications, major complications, and anastomotic leakage were significantly higher in the preoperative FOBT-positive group than in the preoperative FOBT-negative group. Moreover, preoperative FOBT-positivity was an independent risk factor for 5-year overall survival (OS) (HR: 1.32, p = 0.005). For stage II/III patients, the postoperative adjuvant chemotherapy (PAC) benefit was found in preoperative FOBT-negative group (5-year OS: 49.9 vs. 36.8%, p = 0.001), whereas the PAC benefit was lost in preoperative FOBT-positive groups (5-year OS: 40.8 vs. 37.7% p = 0.896). Finally, IHC found that preoperative FOBT-positivity in patients was significantly associated with higher TAMs infiltration and higher expression of IL-6 and TNF-α in tumor tissues than in the preoperative FOBT-negative group.ConclusionAs a simple and low-cost method, preoperative FOBT results can predict both complications and survival after R0 gastrectomy for GC. More importantly, stage II/III GC patients with FOBT-positive seem not benefit from PAC alone. Further exploration is warranted.

This paper mainly studies the deformation and stress of the concrete plat under the uniform load considering the thickness of the compression layer of layered ground. Firstly, the load characteristics and the ground strategy are discussed in detail to clarify the boundary condition. Then the deformation of the ground in each layer is calculated by GEO-Cal program and the final settlement and uneven deformation is also predicted using consolidation theory. Ground stress and settlement is also calculated by FEM to verify the previous calculation.

International audience; Ridges and valleys are the principle geometric features for their diverse applications, especially in image analysis problems such as segmentation, object detection, etc. Numerous characterizations have contributed to formalize the ridge and valley theory. The significance of each characterization rely however on its practical usefulness in a particular application. The objective comparison and evaluation of ridgeness/valleyness characterized as thin and complex image structure is thus crucially important, for choosing, which parameter’s values correspond to the optimal configuration to obtain accurate results and best performance. This paper presents a supervised and objective comparison of different filtering-based ridge detectors. Moreover, the optimal parameter configuration of each filtering techniques have been objectively investigated.

Background: Cross-sectional and longitudinal studies capture different aspects of physiological signals. Objective: To investigate whether single snapshots of exhaled breathprints from eNose can discriminate asthmatics from healthy controls and capture differences in breath profiles triggered by a viral challenge. Methods: The study followed-up 12 asthmatic and 12 healthy controls thrice weekly for 2 months before and 1 month after a rhinovirus challenge. The eNose ability to classify asthmatics from controls at each visit and between pre and post-viral states, was estimated by area under receiver operating characteristic curves (AUCs-ROC) for eNose sensors. The influence of the viral challenge on longitudinal variations of eNose signals was estimated by a mixed effects model (MEM). Results: The eNose was able to provide 100% discrimination between asthmatics and controls at each study visit, irrespective of the viral-challenge (Fig A). However, more changes in VOCs were found in asthmatics than in controls as indicated from the MEM. Discrimination of pre and post-viral phases was highest at visits 1, 3 and 7 in asthmatics vs only visit 7 in controls (Fig B & C). Conclusion: Cross-sectional study designs may uncover biomarkers distinguishing disease from health, but longitudinal designs are essential to detect influences by external triggers. In both cases, eNose may serve as a non-invasive asthma monitoring tool.

Multiple-Input Multiple-Output (MIMO) is a key technology due to its high spectral efficiency and data rate in communication systems. Due to the high complexity of linear Minimum Mean Square Error (MMSE) detection, Gauss-Seidel iterative method is applied to MIMO detection as an approximate method of MMSE and achieves the effect of MMSE detection. In this paper, we propose a learnable Gauss-Seidel detector based on model-driven Deep Learning (DL) for MIMO systems. The proposed detector is designed by unfolding the Gauss-Seidel detection method. In the proposed detector, we add some parameters α, s and δ that can be learned to improve the detection performance. Simulation results show that the proposed detector has better detection performance than traditional Gauss-Seidel detector.

Objective: The correlation of the angiotensin-converting enzyme ( ACE) insertion/deletion (I/D) polymorphism with pediatric asthma risk was assessed in this meta-analysis. Methods: PubMed, Web of Science, Embase and CNKI databases were systematically searched for relevant literature, followed by application of odds ratios (OR) along with 95% confidence interval (CI) for determining the strength of relationship. Results: Seven articles with 802 cases and 632 controls fulfilled the inclusion criteria. As a result, the ACE I/D polymorphism was related to elevated pediatric asthma risk (D vs I: OR = 1.87, 95% CI = 1.59–2.20; dominant model: OR =1.53, 95% CI = 1.28–1.81; recessive model: OR =1.54, 95% CI = 1.28–1.85; DD vs II: OR =2.95, 95% CI = 2.19–3.98; DI vs II: OR = 0.96, 95% CI = 0.78–1.19). Subgroup analysis stratified by race revealed significant interrelation in Asians. Conclusion: This meta-analysis demonstrated that the ACE I/D polymorphism might be related to the risk of pediatric asthma.

BACKGROUND: Growing evidence supports an individualised approach rather than radical surgery for conjunctival melanoma (CM). This study aimed to compare the long-term outcome between individualised and conventional exenteration techniques. METHODS: Our study retrospectively recruited advanced CM (clinical T3 stage) patients treated with individualised (13 cases) or conventional (18 cases) exenteration from June 2014 to April 2019. The individualised approach preserved at least three quadrants of the orbit, and the conventional procedures removed at least one third of the orbital tissues. The medical records were collected and analyzed during April 2020, including demographics, tumour characteristics, surgical details, postoperative rehabilitation and tumour-related prognosis. RESULTS: The tumour basal diameter was statistically (P = 0.011) larger in the conventional group (23.3 ± 7.6 mm) than in the individualised group (15.4 ± 6.3 mm). More tissues were preserved in the individualised group, resulting in a shorter duration of wound healing (2.1 ± 0.6 vs. 3.6 ± 2.0 weeks, P = 0.018) and less incidence of hollow appearance (15% vs. 72%, P = 0.003) than the conventional group. After follow-up for 39.3 ± 17.3 months, a comparison of survival curves showed no significant differences (P = 0.638) between the two groups. The 1- and 2-year overall survival rates were estimated as 100% and 80.0% in the individualised group, and 93.8% and 72.5% in the conventional group, respectively. Low or mixed pigmentation was identified as the risk factor for tumour-related mortality based on multivariate regression analysis. CONCLUSIONS: The individualised approach to exenteration offers improved aesthetic results while still maximises the curable chance for advanced CM.

With the increase of the scale and complexity of mechanical equipment, traditional intelligent fault diagnosis (IFD) based on shallow machine learning methods is unable to meet the demand of coupling faults. In the past decades, the vigorous development of deep learning (DL) brings new opportunities for IFD, especially the representation learning based on Autoencoder (AE) theory has been widely applied. To provide a more comprehensive reference, the theoretical foundations of multi-type AEs and the training method of stacked autoencoder (SAE) are briefly introduced. Then the application advances of AE are reviewed from optimization and combination aspects, which are aiming at improving the representation learning ability. To provide ways for the application of AE-based methods, two typical study cases for ideal and complex engineering systems are illustrated respectively. Finally, the challenges and prospects of AE-based representation learning are reported from four aspects, which give a guidance for the future research direction.

Purpose: Early application of protease inhibitors through the intestinal lumen could increase survival following experimental shock by blocking the pancreatic digestive enzymes. Hence, it was hypothesized that two-route injection (intraintestinal + intravenous) of ulinastatin (UTI), a broad-spectrum protease inhibitor, could better alleviate intestinal injury than single-route injection (either intravenous or intraintestinal). Methods: A sepsis model induced by lipopolysaccharide on rats was established. The rats were randomly divided into five groups: sham, sepsis, UTI intravenous injection (Uiv), UTI intraintestinal injection (Uii), and UTI intraintestinal + intravenous injection (Uii + Uiv) groups. The mucosal barrier function, enzyme-blocking effect, levels of systemic inflammatory cytokines, and 5-day survival rate were compared among groups. The small intestinal villus height (VH), crypt depth (CD), and two components of mucosal barrier (E-cadherin and mucin-2) were measured to evaluate the mucosal barrier function. The levels of trypsin and neutrophil elastase (NE) in the intestine, serum, and vital organs were measured to determine the enzyme-blocking effect. Results: Compared with the single-route injection group (Uiv or Uii), the two-route injection (Uii + Uiv) group displayed: (1) significantly higher levels of VH, VH/CD, E-cadherin, and mucin-2; (2) decreased trypsin and NE levels in intestine, plasma, and vital organs; (3) reduced systemic inflammatory cytokine levels; and (4) improved survival of septic rats. Conclusion: Two-route UTI injection was superior to single-route injection in terms of alleviating intestinal injury, which might be explained by extensive blockade of proteases through different ways. Keywords: Sepsis, Ulinastatin, Intestines, Trypsin, Elastase

Acute respiratory tract infections (ARI) in infancy have been implicated in the development of chronic respiratory disease, but the complex interplay between viruses, bacteria and host is not completely understood. We aimed to prospectively determine whether nasal microbiota changes occur between the onset of the first symptomatic ARI in the first year of life and 3 weeks later, and to explore possible associations with the duration of respiratory symptoms, as well as with host, environmental and viral factors. Nasal microbiota of 167 infants were determined at both time-points by 16S ribosomal RNA-encoding gene PCR amplification and subsequent pyrosequencing. Infants were clustered based on their nasal microbiota using hierarchical clustering methods at both time-points. We identified five dominant infant clusters with distinct microbiota at the onset of ARI but only three clusters after 3 weeks. In these three clusters, symptom persistence was overrepresented in the Streptococcaceae-dominated cluster and underrepresented in the cluster dominated by “Others” (p, Nasal microbiota in infants is associated with symptom persistence after acute symptomatic respiratory infections. http://ow.ly/3Mhh30mC1wJ

Purpose: This study aimed to investigate the effects and complications of different types of peripherally inserted central catheters through femoral vein catheterization in patients with lung cancer undergoing chemotherapy. Methods: A retrospective analysis of 158 patients with lung cancer undergoing implantation of a venous access through femoral vein catheterization was performed. The patients were divided into two groups by convenience sampling: the single-lumen silicone Groshong peripherally inserted central catheters with valved tip were used in patients in group A, the single-lumen power-injectable polyurethane peripherally inserted central catheters with no valve were used in patients in group B. The gravity flow rate and indwelling time of the catheter and incidences of total obstruction, transient obstruction, irreversible obstruction, catheter-related thrombosis, catheter breakage, and accidental dislodgment were compared between the two groups. Results: The catheter indwelling time and incidences of irreversible obstruction, catheter-related thrombosis, and accidental dislodgment in the two groups were not statistically significantly different ( p > 0.05). The catheter gravity flow rate and incidences of total obstruction, transient obstruction, and catheter breakage were statistically significantly different between the two groups ( p Conclusion: Single-lumen power-injectable peripherally inserted central catheters with no valve had a high gravity flow rate, were strong and not prone to rupture, tolerant to high-pressure injection, and were more suitable for femorally inserted central venous catheterization in patients with lung cancer undergoing chemotherapy.

Transition metal dichalcogenides (TMDCs) are considered to be the most promising next-generation materials for electronics and optoelectronics due to their excellent properties. In this work, well-performing CuS films were prepared by e-beam evaporation of Cu films as precursor layers. Ag/n-Si/Al2O3/CuS/ITO heterojunction photodetector with high responsivity (0.41 A·W−1), detectivity (1.739 × 1011 Jones) and fast response speed (17 μs) at zero bias were prepared by optimising sulphuration temperature and using silicon wafers with inverted pyramid light-trapping structures as substrates. Besides, the photodetector exhibited excellent light absorption ability, with an EQE of 51.91% at 980 nm. All these results demonstrated that excellent photodetector materials can be obtained by using metal films as precursor layers, which provides novel ideas and methods for the synthesis of TMDCs materials.

Micro and nano light-trapping structures are widely applied to improve the performance of optoelectronic devices. In this work, inverted-pyramid light trapping texture on industrial-sized p-type silicon was prepared by a rapid and repeatable one-step room-temperature Cu-MACE process. On this basis, various TMOs (transition metal oxide)-Si heterojunction photodetectors (PDs) are fabricated by a low-temperature process. After careful comparison, a ZnO/Al2O3/p-Si/Al2O3/CuO heterojunction is selected as the ideal device structure, and the corresponding work mechanism is proposed. Finally, by optimizing the Al2O3 tunneling layers’ thickness, a high-performance NIR PD working at 980 nm and −5 V bias stands out. The bifacial carrier selective transportation PD exhibits a considerable detectivity (5.56 × 1011 Jones) and a high responsivity (7.10 A/W). Our work will expand the application of inverted-pyramid textured silicon and will pave a road for mass fabrication of TMOs-Si heterojunction PD.

Spherical cameras are widely used due to their full 360$^\circ$ fields of view. However, a common but severe problem is that anything carrying the camera is always included in the view, occluding visual information. In this letter, we propose a novel method to remove such occlusions in videos taken from a freely moving spherical camera. Our method can recover the occluded background accurately in distorted spherical videos by inpainting the color and motion information of pixels. The missing color and motion information inside the occluded region is iteratively recovered in a coarse-to-fine optimization. Spatial and temporal coherence of color and motion information is enforced, considering spherical image geometry. Initially, feature-point matching is used to remove the effect of camera rotation in order to deal with large pixel displacements. Following this, the iterative optimization process is bootstrapped using a reliable estimate of motion information obtained by interpolating it from surrounding regions. We demonstrate its effectiveness by successfully completing videos and recovering occluded regions recorded in various practical situations and by quantifying it against other state-of-the-art methods.

The fault diagnosis of motorized spindle contributes to the improvement of the reliability of computer numerical control machine tools. Presently, numerous mechanical fault diagnosis technologies suffer from the drawbacks of mode mixing, non-adaptive analysis, and low efficiency. Therefore, adopting an effective signal processing method for fault diagnosis of motorized spindle is essential. A method based on modified empirical wavelet transform (EWT) and kernel principal component analysis (Kernel PCA) is proposed. A new method, which determines the proper number of the Fourier spectrum segments, is applied when using EWT. To improve computational efficiency, Kernel PCA is adopted to reduce dimension. The support vector machine optimized by genetic algorithm is introduced to accomplish fault identification. The performance of the proposed method is validated through single and compound fault experiments. Results show that the recognition rate using the proposed method reached 98.8095 % and 98.4375 % in terms of single and compound fault diagnoses, respectively. Moreover, compared with empirical mode decomposition (EMD), ensemble empirical mode decomposition (EEMD), local mean decomposition (LMD) and EWT, the proposed method can save much computing time. The proposed method can be generalized to other mechanical fault diagnoses as well.

Background. Delirium is a primary adverse event in ventilated patients who receive long-term monosedative treatment. Sequential sedation may reduce these adverse effects. This study evaluated risk factors for delirium in sequential sedation patients. Methods. A total of 141 patients who underwent sequential sedation were enrolled. Delirium was diagnosed using Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scale. Univariate and multivariate Cox proportional hazards regressions were used to predict risk factors. Results. Older age (≥51) (RR = 2.432, 95% CL 1.316–4.494, p=0.005), higher SOFA score (≥14) (RR = 2.022, 95% CL 1.076–3.798, p=0.029), regular smoking (RR = 2.366, 95% CL 1.277–4.382, p=0.006), and higher maintenance dose of midazolam (RR = 1.052, 95% CL 1.000–1.107, p=0.049) and fentanyl (RR = 1.045, 95% CL 1.019–1.072, p=0.001) when patients met sequential criteria, were independent risk factors of delirium. Sequential sedation with dexmedetomidine (RR = 0.448, 95% CL 0.209–0.963, p=0.040) was associated with a lower risk of delirium. Conclusions. Older age, higher SOFA score, regular smoking, and higher maintenance dose of midazolam and fentanyl when patients met sequential criteria were independent risk factors of delirium in sequential sedation patients. Sequential sedation with dexmedetomidine reduced risk of delirium.

Asthma is a dynamic disease, in which lung mechanical and inflammatory processes interact in a complex manner, often resulting in exaggerated physiological, in particular, inflammatory responses to exogenous triggers. We hypothesize that this may be explained by respiratory disease-related systems instability and loss of adaptability to changing environmental conditions, manifested in highly fluctuating biomarkers and symptoms. Using time series of inflammatory (eosinophils, neutrophils, FeNO), clinical and lung function biomarkers (PEF, FVC,FEV1), we estimated this loss of adaptive capacity (AC) during an experimental rhinovirus infection in 24 healthy and asthmatic human volunteers. Loss of AC was estimated by comparing similarities between pre- and post-challenge time series. Unlike healthy participants, the asthmatic’s post-viral-challenge state resembled more other rhinovirus-infected asthmatics than their own pre-viral-challenge state (hypergeometric-test: p=0.029). This reveals loss of AC and supports the concept that in asthma, biological processes underlying inflammatory and physiological responses are unstable, contributing to loss of control.

Efficient classification of short videos is of a great challenge in industry due to their large amounts and diverse semantics. In this paper, we present a real-time multi-label classification system to attain it. Specifically, a frame-level preprocessing strategy is first proposed to efficiently decode the videos for useful information. Then an image-based model is developed to achieve the final video-level classification. For the multi-label classification case, three modules are proposed to enhance the model’s classification capability, relieve the label-imbalance issue and exploit the label correlation respectively. Our system achieves an accuracy of 86% on both private test sets of the challenge "Short Video Real-time Classification" in AI Challenger 2018, and on its open validation set it achieves an accuracy of 89.2% with a speed of 28ms per video on a workstation with an Intel Xeon CPU E5-2650 and a NVIDIA GPU TITAN Xp.

Asthma is a dynamic disease, in which lung mechanical and inflammatory processes often interact in a complex, unpredictable manner. We hypothesize that this may be explained by respiratory disease-related systems instability and loss of adaptability to changing environmental conditions, resulting in highly fluctuating biomarkers and symptoms. Using time series of inflammatory (eosinophils, neutrophils, FeNO), clinical and lung function biomarkers (PEF, FVC, and FEV1), we estimated this loss of adaptive capacity (AC) during an experimental perturbation with a rhinovirus in 24 healthy and asthmatic volunteers. Loss of AC was estimated by comparing similarities between pre- and post-challenge time series. Unlike healthy participants, the asthmatic’s post-viral-challenge state resembled significantly more other rhinovirus-infected asthmatics than their own pre-viral-challenge state (hypergeometric-test: p=0.029). This reveals loss of AC, and supports the novel concept that not only single physiological mechanisms, but interacting dynamic disease properties are altered in asthma and contribute to a more vulnerable phenotype.

A broadly tunable grating-coupled external cavity laser system in the green region is demonstrated by employing a commercially available broad-area green laser diode. A simple Littrow-type external cavity configuration was adopted, and two gratings with different diffraction efficiencies were used as the light feedback elements. When a grating with the first-order diffraction efficiency of 50% and the zeroth-order diffraction efficiency of 31% was used, a tuning bandwidth of 11.0 nm with an output power near 400 mW was achieved. When a grating with the first-order diffraction efficiency of 10% and the zeroth-order diffraction efficiency of 78% was used, a tuning bandwidth of 5.0 nm with an output power near 750 mW was achieved. Meanwhile, the spectral linewidth was narrowed significantly down to 0.08-0.18 nm from the free-running linewidth of 2.81 nm due to the external mode selection effect. Such high-power broadly tunable green EC lasers are important for second harmonic generation.

The aim of this study was to predict Ki-67 labeling index (LI) preoperatively by three-dimensional (3D) CT image parameters for pathologic assessment of GGO nodules. Diameter, total volume (TV), the maximum CT number (MAX), average CT number (AVG) and standard deviation of CT number within the whole GGO nodule (STD) were measured by 3D CT workstation. By detection of immunohistochemistry and Image Software Pro Plus 6.0, different Ki-67 LI were measured and statistically analyzed among preinvasive adenocarcinoma (PIA), minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC). Receiver operating characteristic (ROC) curve, Spearman correlation analysis and multiple linear regression analysis with cross-validation were performed to further research a quantitative correlation between Ki-67 labeling index and radiological parameters. Diameter, TV, MAX, AVG and STD increased along with PIA, MIA and IAC significantly and consecutively. In the multiple linear regression model by a stepwise way, we obtained an equation: prediction of Ki-67 LI=0.022*STD+0.001* TV+2.137 (R=0.595, R’s square=0.354, p

The most effective and potential approach to improve the performance of heterojunction photodetectors is to obtain favorable interfacial passivation by adding an insertion layer. In this paper, MoO x /Al2O3/n-Si heterojunction photodetectors with excellent photocurrents, responsivity and detectivity were fabricated, in which alumina acts as a tunneling passivation layer. By optimizing the post-annealing treatment temperature of the MoO x and the thickness of the ultra-thin Al2O3, the photodetector achieved a ratio of photocurrent to dark current of 3.1 × 105, a photoresponsivity of 7.11 A W−1 (@980 nm) and a detective of 9.85 × 1012 Jones at −5 V bias. Besides, a self-driven response of 0.17 A W−1 and a high photocurrent/dark current ratio of 2.07 × 104 were obtained. The result demonstrated that optimizing the interface of heterojunctions is a promising way to obtain a heterojunction photodetector with high-performance.

From the perspective of engineering field, this paper introduces the application of sensors in engineering field, and then forecasts the application trend of sensors in engineering field by introducing the status quo of sensors in engineering field, especially in the field of comprehensive treatment of water environment.

To achieve the goal of automated rolling bearing fault diagnosis, a variational mode decomposition (VMD) based diagnosis scheme was proposed. VMD was firstly used to decompose the vibration signals into a series of band-limited intrinsic mode functions (BLIMFs). Subsequently, the multiscale fractal dimension (MSFD) and multiscale energy (MSEN) of each BLIMF were calculated and combined together as features of the original vibration signals. In an attempt to accelerate the classification speed, one-way analysis of variance (ANOVA) test was adopted to extract significant features from the redundant features. Finally, those significant features were fed into the optimized support vector machine (SVM), which was optimized by the genetic algorithm (GA), for classification. Experimental results on the international public Case Western Reserve University bearing data indicate the effectiveness of the proposed method with a classification accuracy of 99.75 % for seven classes. Moreover, our approach also shows good anti-noise performance in different signal-to-noise ratios (SNRs).

Many efforts have been undertaken towards the synthesis of vertically stacked two-dimensional (2D) crystals due to their unique electronic and optical properties. Here, we present direct molecular beam epitaxy (MBE) growth of a MoS2/graphene heterostructure by a strict epitaxial mechanism. By combining Raman, photoluminescence, transmission electron microscopy characterizations and first-principles calculations, we find that there exists a strain effect and strong interlayer coupling between MoS2 and graphene resulting from the intrinsic crystal lattice mismatch, which could generate potential metallic behavior of the heterostructure. The direct epitaxial technique applied here enables us to investigate the growth mechanisms and interlaminar interaction of 2D heterostructures without sample handling and transfer, and offers a new approach to synthesize multilayer electronic and photonic devices.

This paper summarizes the research status of intelligent monitoring and early warning technology in China from the aspects of IOT, big data, cloud computing and artificial intelligence. According to the practical application of engineering intelligent monitoring technology, this paper points out that there are some problems in intelligent monitoring and early warning, such as poor reliability of front-end information collection of monitoring equipment, insufficient integration of cloud platform integration application, and immature application of artificial intelligence technology in monitoring. Finally, the development trend of intelligent monitoring and early warning technology is prospected.

ObjectivesThe present study aimed to assess the level of knowledge on peripherally inserted central catheter (PICC) maintenance among nurses in China and to analyse the related factors influencing this variable.DesignA cross-sectional survey.SettingNinety-one hospitals at three different levels in Hunan Province, China: county hospitals, municipal hospitals and provincial hospitals.ParticipantsA total of 4110 registered nurses engaged in clinical work related to intravenous infusion.Primary and secondary outcome measuresNurses’ knowledge of PICC maintenance was measured by the score of an anonymous, self-reported questionnaire.ResultsThe mean score of PICC maintenance among 4110 nurses was 72.86±14.86. 83.5% of the participants exhibited a score of 60 or above, and 34.1% of them exhibited a good grade with a score of 80 or above. The difference in the correct rate among different dimensions was statistically significant (H=17.721, pConclusionsIn conclusion, the knowledge of PICC maintenance was at a medium level among nurses in Hunan province, China. Multiple steps should be taken to improve the nurses’ PICC maintenance knowledge, including disseminating PICC maintenance knowledge in multiple ways, such as courses, lectures, seminars and new media. Particular attention should be given to populations who responded poorly in this survey, and targeted education for nurses should be distributed based on their performance on specific dimensions, such as the replacement of dressing and needle-free connectors. In addition, the quality of the nurses’ practical performance could be measured in the future.