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With the rapid development of 5G, Mobile Edge Computing (MEC) paradigm has emerged to enable various devices or servers at the network edge to contribute their computing capacity for reducing communication delay. A fundamental problem is to preserve satisfactory quality-of-service (QoS) for mobile users in light of densely dispersed wireless communication environment and capacity-constrained MEC nodes. Such user-perceived QoS, typically in terms of the end-to-end delay, is highly vulnerable to both access network bottleneck and communication delay. Previous works primarily focused on optimizing the communication delay through dynamic service placement, while ignoring the critical effect of access network selection on the access delay. This paper studies the problem of jointly optimizing the access network selection and service placement for MEC, with the objective of improving QoS in a cost-efficient manner by judiciously balancing the access delay, communication delay, and service switching cost. We propose an efficient online framework to decompose this long-term time-varying optimization problem into a series of one-shot subproblems. To address the NP-hardness of the one-shot problem, we design a computationally-efficient two-phase algorithm, which achieves a near-optimal solution. Both theoretical analysis on the optimality gap and trace-driven simulations are conducted to validate the efficacy of our proposed solution.

We propose a complete hardware-based architecture of multilayer neural networks (MNNs), including electronic synapses, neurons, and periphery circuitry to implement supervised learning (SL) algorithm of extended remote supervised method (ReSuMe). In this system, complementary (a pair of n- and p-type) memtransistors (C-MTs) are used as an electrical synapse. By applying the learning rule of spike-timing-dependent plasticity (STDP) to the memtransistor connecting presynaptic neuron to the output one whereas the contrary anti-STDP rule to the other memtransistor connecting presynaptic neuron to the teacher one, extended ReSuMe with multiple layers is realized without the usage of those complicated supervising modules in previous approaches. In this way, both the C-MT-based chip area and power consumption of the learning circuit for weight updating operation are drastically decreased comparing with the conventional single memtransistor (S-MT)-based designs. Two typical benchmarks, the linearly nonseparable benchmark XOR problem and Mixed National Institute of Standards and Technology database (MNIST) recognition have been successfully tackled using the proposed MNN system while impact of the nonideal factors of realistic devices has been evaluated.

The rapid growth of the Internet of Things (IoTs) has resulted in an explosive increase in data, and thus has raised new challenges for data processing units. Edge computing, which settles signal processing and computing tasks at the edge of networks rather than uploading data to the cloud, can reduce the amount of data for transmission and is a promising solution to address the challenges. One of the potential candidates for edge computing is a memristor, an emerging nonvolatile memory device that has the capability of in-memory computing. In this article, from the perspective of edge computing, we review recent progress on memristor-based signal processing methods, especially on the aspects of signal preprocessing and feature extraction. Then, we describe memristor-based signal classification and regression, and end-to-end signal processing. In all these applications, memristors serve as critical accelerators to greatly improve the overall system performance, such as power efficiency and processing speed. Finally, we discuss existing challenges and future outlooks for memristor-based signal processing systems.

Mathematical morphology operations are widely used in image processing such as defect analysis in semiconductor manufacturing and medical image analysis. These data-intensive applications have high requirements during hardware implementation that are challenging for conventional hardware platforms such as central processing units (CPUs) and graphics processing units (GPUs). Computation-in-memory (CIM) provides a possible solution for highly efficient morphology operations. In this study, we demonstrate the application of morphology operation with a novel memristor-based auto-detection architecture and demonstrate non-neuromorphic computation on a multi-array-based memristor system. Pixel-by-pixel logic computations with low parallelism are converted to parallel operations using memristors. Moreover, hardware-implemented computer-integrated manufacturing was used to experimentally demonstrate typical defect detection tasks in integrated circuit (IC) manufacturing and medical image analysis. In addition, we developed a new implementation scheme employing a four-layer network to realize small-object detection with high parallelism. The system benchmark based on the hardware measurement results showed significant improvement in the energy efficiency by approximately 358 times and 32 times more than when a CPU and GPU were employed, respectively, exhibiting the advantage of the proposed memristor-based morphology operation.

Automatic seizure detection technology is of great significance to reduce workloads of neurologists for epilepsy diagnosis and treatments. Imbalanced classification is a challenge in seizure detection from long-term continuous EEG recordings, as the durations of the seizure events are much shorter than the non-seizure periods. An imbalanced deep learning model is proposed in this paper to improve the performance of seizure detection. To modify imbalanced EEG data distribution, a generative adversarial network (GAN) that is a strong candidate for data enhancement is built to produce the seizure-period EEG data used for forming a more balanced training set. Next, a pyramidal one-dimensional convolutional neural network (1DCNN) is designed to deal with 1D EEG signals and trained on the augmented training set that consists of both original and generated EEG data. Compared to the conventional 2DCNNs, the deep architecture of the 1DCNN reduces the training parameters so as to greatly increase the training speed. The proposed method is evaluated on three publicly available EEG databases. After data augmentation by the GAN, the designed 1DCNN shows much better classification for seizure detection, achieving competitive results over the three EEG databases, which demonstrates the generalizability of this method across different databases. Comparison with other published methods indicates its enhanced detection performance for imbalanced EEG data.

Objective To develop and validate a nomogram for predicting the risk of venous thromboembolism in critically ill patients with primary intracerebral hemorrhage. Methods Patients ≥18 years old with primary intracerebral hemorrhage were screened within 24 hours of onset from January 2019 to April 2021. Univariate and multivariate logistic regression analyses were performed to screen out independent predictors that were significantly associated with venous thromboembolism. A nomogram was constructed based on the results of a multivariate regression analysis. Discrimination and calibration were used to evaluate performance of the nomogram. A decision curve analysis was used to assess its clinical utility. Results This study enrolled 369 patients. The nomogram included 3 predictors from the regression analysis: D-dimer, National Institutes of Health Stroke Scale score, and Glasgow Coma Scale score on admission. The area under the receiver operating characteristic curve was 0.794, indicating good discrimination of the nomogram. The nomogram demonstrated calibration curves with slight deviation from the ideal predictions. Decision curve analysis showed that the prediction nomogram was clinically useful. Conclusions This nomogram comprising D-dimer, National Institutes of Health Stroke Scale score and Glasgow Coma Scale score on admission can accurately predict the risk of venous thromboembolism in critically ill patients with intracerebral hemorrhage.

Patients treated with immune checkpoint inhibitors (ICIs) often experience unique immune-related adverse events (irAEs), and the previous studies demonstrated an association between irAEs and better outcomes in patients with ICI treatment for advanced non-small cell lung cancer (NSCLC). However, the correlation between the occurrence of mild and severe irAEs and prognosis remains unclear. Additionally, little is known regarding the association between the timing of mild and severe irAEs and clinical outcomes. We retrospectively conducted a multicenter study of advanced NSCLC patients treated with ICI monotherapy. Of the 222 patients, 79 patients (35.6%) experienced at least one irAE, and most were of grade 1 or 2 (mild) (26.6%). The most common irAEs were pneumonitis (n = 21, 9.5%) and skin-related adverse reactions (n = 19, 8.6%). The median progression-free survival of all patients treated with ICIs was 3.2 months. Patients experiencing irAEs had a better prognosis than those without such events (6.5 vs. 2.6 months, p = 0.004), and mild irAEs were associated with the best prognosis. The difference in overall survival between mild and severe irAEs was significant (34.3 vs. 17.3 months, p = 0.021). We further analyzed differences between patients with irAEs occurring at 3 or 6 weeks, and found that the earlier the occurrence of mild irAEs, the better the prognosis; however, the opposite was true for severe irAEs. In summary, patients with early occurring mild irAEs showed better clinical outcomes, whereas those with early severe irAEs tended to show poorer clinical outcomes.

Memory devices for low-temperature electronics have great application potential in emerging fields like quantum computing, deep-space exploration etc. However, the practical non-volatile memory device for cryogenic use still remains as a challenge today. We propose a delicately designed resistive memory device with bi-layer structure. The resistive switching layer is covered by a thermal enhancement capping layer which confines the Joule heat for better switching performance and also serves as an oxygen vacancy reservoir. This structure gives the device the multilevel resistive switching capability within a large temperature range from 8 K to 300 K. The endurance more than $10^{{6}}$ cycles at 8 K is demonstrated. Combined with kinetic Monte-Carlo simulation, the role of the thermal enhancement capping layer is analyzed.

Huntington's disease (HD) is an autosomal dominant neurodegenerative disease involving motor, cognitive and psychiatric disturbances. HD patients with psychosis symptoms usually have bad prognosis. It is of great significance to explore the clinical, imaging and biological characteristics of HD patients with psychosis. A total of 118 Han Chinese patients with HD confirmed by Huntingtin genetic testing were recruited during 2013–2020. They were assessed by Unified Huntington's Disease Rating Scale (UHDRS) and followed up in an average of 34 months by telephone or clinical visits. Psychosis was determined by the presence of delusions or hallucinations using UHDRS-Problem Behavior Assessment. Data of magnetic resonance imaging (n = 28) and serum neurofilament light chain (NfL, n = 28) were collected in some patients. Among 118 patients (mean age 46.0 years, SD 12.0; female 53.5%), the frequency of psychosis was 14.4% (n = 17) in the cross-sectional analysis and 17.8% (n = 21) in the longitudinal observation. Probands with psychosis were predominantly female (82.3%). They exhibited worse motor, cognitive, behavioral and functional performances compared with patients without psychosis. Furthermore, the lateral ventricle volume was larger in patients with psychosis compared with patients without psychosis (p = 0.0013) while there was no difference in NfL levels between two groups. NfL levels of patients with psychosis were negatively correlated with caudate volumes (r = −0.54, p = 0.044) and white matter volumes (r = −0.57, p = 0.035). In summary, HD patients with psychosis had distinct clinical, imaging and biological features. These features might help clinicians to identify psychosis in HD patients early and provide protective interventions before adverse outcomes occur.

The detection sensitivity and lift-off impaction of the eddy current sensing are the challenges in the field of electromagnetic nondestructive testing. Higher detection sensitivity, larger lift-off capability, and deeper defect detectability remain challenges. This paper presents a double-layer differential planar coil with the discussion of the most sensitive coupling gap. The upper layer contains two symmetrical excitation coils as it can generate symmetrical and opposite magnetic fields. The rectangular structure makes the induced current uniform and symmetrical. The lower layer constructs a differential receiving coil, which can reduce the interference caused by the lift-off impaction as well as the external magnetic field. Different types of surface defects of metallic materials were used for validation. Experimental results show that properly increasing the distance between the excitation and detection layers can effectively improve its sensitivity. Simulation and experimental results confirm that the performance of high sensitivity can be maintained under large lift-off affection.

This work aimed to investigate the effect of blood flow pulsation in patients with pulsatile tinnitus (PT). Nine blood flow patterns with different pulsations were designed on the basis of the blood flow data of a patient with PT (control group; cases with blood flow pulsation indexes that had decreased by 20%, 40%, 60%, and 80%; and cases with blood flow pulsation indexes that had increased by 20%, 40%, 60%, and 80%). The transient-state multiphysics coupling method was used to clarify the biomechanical and acoustic changes that had occurred under different blood flow pulsations. Results showed that blood flow impacted directly the vessel wall in the sigmoid sinus wall dehiscence (SSWD) area. The impact velocity of the blood flow slowed with the decrement in blood flow pulsation index but increased with the increase in blood flow pulsation index. With the reduction in blood flow pulsation index, the average pressure of the SSWD area decreased by 1.84, 3.93, 6.23, and 8.31 Pa; the average displacement of the vessel wall in the SSWD area decreased by 0.11, 0.23, 0.36, and 0.48 µm; and the average sound pressure level at the tympanum decreased by 2.2, 4.16, 7.14, and 12.97 dB. By contrast, with the increase in blood flow pulsation index, the average pressure increased by 2.46, 4.21, 6.28, and 8.56; the average displacement increased by 0.14, 0.2, 0.36, and 0.49 µm; and the average sound pressure level increased by 1.32, 2.87, 4.15, and 5.19 dB. Statistical analysis revealed that the pathological induction of PT had a strong quadratic correlation with the pulsation of blood flow. The degree of PT could be attenuated by reducing blood flow pulsation. Such an approach would aid clinical treatment. The conclusion obtained in this work would present a theoretical basis for the treatment of patients with PT.

Objective to observe the clinical effect of electroacupuncture on postpartum urinary retention (PPUR) through a randomized controlled study. Methods seventy-two PPUR puerperae who met the inclusion criteria were divided into the observation group (electroacupuncture at Ciliao (次髎BL32) and Zhōngliao (中髎BL33) group) and the control group (sham acupuncture group) according to the random number table method, with 36 cases in each. Urine catheters were retained. After 3 days of treatment, the therapeutic effect of PPUR was compared between the two groups. Results in the observation group, the first urination time was significantly earlier than that in the control group, the first urination volume was significantly more than that in the control group, the bladder residual urine volume was significantly less than that in the control group, and the urinary infection was significantly less than that in the control group, the differences were statistically significant (all P Conclusion the therapeutic value of electroacupuncture at BL32 and BL33 for primiparae with PPUR is significantly obvious. This therapy is worthy of clinical promotion.

Meal ingestion elicits a variety of neuronal, physiological and hormonal responses that differ in healthy, obese or diabetic individuals. The mixed meal tolerance test (MMTT) is a well-established method to evaluate pancreatic β-cell reserve and glucose homeostasis in both preclinical and clinical research in response to calorically defined meal. Nonhuman primates (NHPs) are highly valuable for diabetic research as they can naturally develop type 2 diabetes mellitus (T2DM) in a way similar to the onset and progression of human T2DM. The purpose of this study was to investigate the reproducibility and effects of a MMTT containing acetaminophen on plasma glucose, insulin, C-peptide, incretin hormones, lipids, acetaminophen appearance (a surrogate marker for gastric emptying) in 16 conscious obese cynomolgus monkeys (Macaca fascicularis). Plasma insulin, C-peptide, TG, aGLP-1, tGIP, PYY and acetaminophen significantly increased after meal/acetaminophen administration. A subsequent study in 6 animals showed that the changes of plasma glucose, insulin, C-peptide, lipids and acetaminophen were reproducible. There were no significant differences in responses to the MMTT among the obese NHPs with (n = 11) or without (n = 5) hyperglycemia. Our results demonstrate that mixed meal administration induces significant secretion of several incretins which are critical for maintaining glucose homeostasis. In addition, the responses to the MMTTs are reproducible in NHPs, which is important when the MMTT is used for evaluating post-meal glucose homeostasis in research.

To investigate the relationship between retinal vascular parameters and cystatin C in patients with type 2 diabetes in northwestern China. This was a cross-sectional study of 1689 patients with type 2 diabetes. A validated fully automated computer program was used to extract retinal vascular parameters from the entire vascular tree. Multiple logistic regression analyses were conducted to investigate the relationship between these vascular measurements and cystatin C. For retinal vascular geometrical measurements, smaller arteriolar fractal dimension was related to high cystatin C after adjusting for multiple variables (odds ratio [OR] 0.149, 95% CI 0.042–0.532). For retinal vascular caliber measurements, narrower central and middle arteriolar calibers were related to high cystatin C after adjusting for multiple variables (central: OR 0.922, 95% CI 0.886–0.960; middle: OR 0.940, 95% CI 0.901–0.981). Wider central, middle and peripheral venular calibers were associated with high cystatin C after adjusting for multiple variables (central: OR 1.058, 95% CI 1.003–1.117; middle: OR 1.094, 95% CI 1.040–1.150; peripheral: OR 1.075, 95% CI 1.023–1.130). Multiple retinal vascular geometrical and caliber measurements are associated with cystatin C in type 2 diabetic patients. Further studies are needed to explore whether these retinal vascular changes can predict the incidence and progress of diabetic nephropathy.

Background & aims Nonalcoholic fatty liver disease (NAFLD) is associated with elevation of many cytokines particularly IL-6; however, the role of IL-6 in NAFLD remains obscure. The aim of this study was to examine how myeloid-specific IL-6 signaling affects NAFLD via the regulation of anti-fibrotic microRNA-223 in myeloid cells. Approach & results Patients with NAFLD or nonalcoholic steatohepatitis (NASH) and healthy controls were recruited, and serum IL-6 and soluble IL-6 receptor α (sIL-6Rα) were measured. Compared to controls, serum IL-6 and sIL-6Rα levels were elevated in NAFLD/NASH patients. IL-6 levels correlated positively with the number of circulating leukocytes and monocytes. The role of IL-6 in NAFLD was investigated in Il6 knockout (KO) and Il6 receptor A (Il6ra) conditional KO mice after high-fat diet (HFD) feeding. HFD-fed Il6 KO mice had worse liver injury and fibrosis, but less inflammation compared to WT mice. Hepatocyte-specific Il6ra KO mice had more steatosis and liver injury, whereas myeloid-specific Il6ra KO mice had lower number of hepatic infiltrating macrophages and neutrophils with increased cell death of these cells but greater liver fibrosis than WT mice. Mechanistically, the increased liver fibrosis in HFD-fed myeloid-specific Il6ra KO mice was due to the reduction of anti-fibrotic miR-223 and subsequent upregulation of the miR-223 target gene transcriptional activator with PDZ-binding motif (TAZ), a well-known factor to promote NASH-fibrosis. In vitro, IL-6 treatment upregulated exosome biogenesis-related genes and subsequently promoted macrophages to release miR-223-enriched exosomes that were able to reduce pro-fibrotic TAZ expression in hepatocytes via exosomal transfer. Finally, serum IL-6 and miR-223 levels were elevated and correlated with each other in NAFLD patients. Conclusions Myeloid-specific IL-6 signaling inhibits liver fibrosis via exosomal transfer of anti-fibrotic miR-223 into hepatocytes, providing novel therapeutic targets for NAFLD therapy.

Repeated food scandals in China have prompted growing consumer consciousness on food safety and health. Organic food, considered to be of higher quality, is being increasingly demanded by Chinese consumers. This study examines preferences for organic labels to provide insight on the sustainable development of the Oolong tea industry. Research was conducted using the choice experiment (CE) method in Fujian and Guangdong Provinces. The results demonstrate that place of origin, organic label, and brand attributes are all significant factors affecting the purchase of Oolong. Also, people demonstrated significantly positive attitudes toward organic labels and preferred Oolong tea from Fujian Province to those from Guangdong Province and Taiwan. Increasing trust can enhance consumer preference and willingness to pay (WTP) for organic labels. Contrary to previous studies, people have a higher WTP for Chinese organic labels than Japanese and American ones. This is probably because respondents are more familiar with domestic Oolong tea and trust more in Chinese organic certification. This provides an opportunity for domestic producers to tailor their organic food labels and better satisfy consumer demands. These findings suggest that the Chinese government should take more responsibility for reducing food-related fraud and thus improve consumer trust regarding organic food.

Eddy current testing (ET) and eddy current thermography (ECT) are both important nondestructive testing methods that have been widely used in the field of conductive materials evaluation. Conventional ECT systems have often employed to test static specimens even though they are inefficient when the specimen is large. In addition, the requirement of high-power excitation sources tends to result in bulky detection systems. To mitigate these problems, in this article, a moving detection mode of multiphysics structured ET and ECT is proposed in which a novel L-shape ferrite magnetic yoke circumambulated with array coils is designed. The theoretical derivation model of the proposed method is developed which is shown to improve the detection efficiency without compromising the excitation current by ECT. The specimens can be speedily evaluated by scanning at a speed of 50–250 mm/s while reducing the power of the excitation current due to the supplement of ET. The unique design of the excitation-receiving structure has also enhanced the detectability of omnidirectional cracks. Moreover, it does not block the normal direction visual capture of the specimens. Both numerical simulations and experimental studies on different defects have been carried out and the obtained results have shown the reliability and detection efficiency of the proposed system.

Hydroliquefaction behavior of preasphaltenes, derived from direct coal liquefaction, was carried out in a 30 mL autoclave with FeS + S catalyst and tetralin at initial hydrogen of 5.0 MPa, residence time of 0–60 min and reaction temperature of 380–440°C in order to optimize the conditions of direct coal liquefaction and improve oil yield. The products distribution and kinetic parameters of preasphaltenes catalytic hydroliquefaction were investigated. A new kinetic model was established to simulate the preasphalteneshydroliquefaction catalyzed by FeS + S catalyst using lump kinetic model. It was found that preasphaltenes were hydroliquefaction into asphaltenes and char directly, and then asphaltenes were hydrocracked into oil + gas products. Regressive reactions of preasphaltenes to char and asphaltenes to preasphaltenes occurred at higher temperatures. Higher temperature and longer time were favorable for increasing the conversion of preasphaltenes and the oil + gas yield. The hydroliquefaction of preasphaltenes under 440°C and 60 min reached 79.45% with 34.7% of oil + gas yield. The hydroliquefaction conversions calculated from the model agreed well with the experimental data, and the activation energies ranged within 50–245 kJ/mol.

Objective To evaluate the clinical effect of electroacupuncture treatment for chloasma in young and middle-aged women. Methods Sixty young and middle-aged female patients with chloasma were divided into treatment group (n = 30) and control group (n = 30) according to random number table. In the treatment group, the electroacupuncture was applied to the facial acupoints and “Vagus” in the cavity of concha in the ear. The selection of facial acupoints was relating to the running course of facial nerve trunk: Yifēng (翳风 TE17), Shangguān (上关 GB3)—Sīzhukōng (丝竹空 TE 23) (Temporal branch), Xiaguān (下关 ST7)—Sibai (四白 ST2) (Zygomatic branch), Qiānzheng (牵正 Extra) —Quanliao (颧髎 SI18) (Zygomatic branch), Jiāchē (颊车 ST6) —Jiāchengjiāng (夹承浆Extra) (Buccal branch), Hegǔ (合谷LI 4). Electro-stimulation was adopted at “Vagus” in the cavity of concha in the ear (two distribution points of the vagus in the cavity of concha of each ear). The control group received conventional acupuncture (surrounding method of needling at the Ashi points in the facial lesion area and 15 acupoints which were selected in the highest frequency in the conventional acupuncture treatment). After 8 weeks of treatment, the clinical effects were compared.The total score of facial skin lesion, score of skin lesion color, score of lesion area, and effective rate of treatment for chloasma were used to evaluate the clinical effect of the two groups before and after treatment. Results After treatment, the effective rate of the treatment group was 95.00%, that of the control group was 67.50%. The effect of the treatment group was better than that of the control group, and the difference was statistically significant (χ2 = 9.928, P = 0.002). Before treatment, there was no difference in the area score, color score, and total score of skin lesions between the two groups (P>0.05). After treatment, the area score, color score, and total score of skin lesions in the treatment group were (1.05±0.64), (1.05±0.64), and (2.10±0.98) points respectively, while those in the control group were (1.38±0.63), (1.28±0.75), and (2.65±1.19) points respectively.The area score, color score, and total score of skin lesions in the treatment group were lower than those in the control group, with statistically significant differences (all P Conclusion electroacupuncture is more effective than conventional acupuncture in treating chloasma in young and middle-aged women.

Background and aims 17-Beta hydroxysteroid dehydrogenase 13 (HSD17B13) is genetically associated with human nonalcoholic fatty liver disease (NAFLD). Inactivating mutations in HSD17B13 protect humans from NAFLD-associated and alcohol-associated liver injury, fibrosis, cirrhosis, and hepatocellular carcinoma, leading to clinical trials of anti-HSD17B13 therapeutic agents in humans. We aimed to study the in vivo function of HSD17B13 using a mouse model. Approach and results Single-cell RNA-sequencing and quantitative RT-PCR data revealed that hepatocytes are the main HSD17B13-expressing cells in mice and humans. We compared Hsd17b13 whole-body knockout (KO) mice and wild-type (WT) littermate controls fed regular chow (RC), a high-fat diet (HFD), a Western diet (WD), or the National Institute on Alcohol Abuse and Alcoholism model of alcohol exposure. HFD and WD induced significant weight gain, hepatic steatosis, and inflammation. However, there was no difference between genotypes with regard to body weight, liver weight, hepatic triglycerides (TG), histological inflammatory scores, expression of inflammation-related and fibrosis-related genes, and hepatic retinoid levels. Compared to WT, KO mice on the HFD had hepatic enrichment of most cholesterol esters, monoglycerides, and certain sphingolipid species. Extended feeding with the WD for 10 months led to extensive liver injury, fibrosis, and hepatocellular carcinoma, with no difference between genotypes. Under alcohol exposure, KO and WT mice showed similar hepatic TG and liver enzyme levels. Interestingly, chow-fed KO mice showed significantly higher body and liver weights compared to WT mice, while KO mice on obesogenic diets had a shift toward larger lipid droplets. Conclusions Extensive evaluation of Hsd17b13 deficiency in mice under several fatty liver-inducing dietary conditions did not reproduce the protective role of HSD17B13 loss-of-function mutants in human NAFLD. Moreover, mouse Hsd17b13 deficiency induces weight gain under RC. It is crucial to understand interspecies differences prior to leveraging HSD17B13 therapies.

OBJECTIVE This study intends to discuss the individualized selection of surgical scheme of hydrocephalus complicated with skull defect. METHODS A total of 141 patients with hydrocephalus complicated with skull defect in our hospital from January 2012 to December 2018 were the main subjects of this study. Among these 141 patients, 78 patients underwent shunt and skull repair surgery in our hospital. In the present study, according to the classification of bone window tension, and combined with factors that affect the operation, different surgical schemes were selected, namely, repair surgery in the first phase and shunt surgery in the second phase, or simultaneous surgery, or shunt surgery in the first phase and repair surgery in the second phase. RESULTS The results of the present study show that an individualized surgical scheme can allow for the operation of hydrocephalus complicated with skull defect, without increasing the risk of complications, such as shunt infection, epidural hematoma, etc. CONCLUSIONS The surgical scheme for hydrocephalus complicated with skull defect differs in clinic.

Presurgical discrimination of blood blister-like aneurysms (BBAs) can assist neurosurgeons in clinical decision-making. The aim of this study was to investigate the characteristics of BBAs and construct a useful tool to distinguish BBAs. This study reviewed patients with small/median, hemispherical, and wide-necked aneurysms of the internal carotid artery in our institution. BBAs were identified via their intraoperative findings. A hemodynamic analysis was performed using a patient-specific model. The independent risk factors of BBAs were investigated using a logistic analysis. A scoring system was then established to discriminate BBAs, in which its predicting value was analyzed using receiver operating characteristic (ROC) analysis. A total of 67 aneurysms comprising 21 BBAs were enrolled. Comparing features between BBAs and non-BBAs, statistical significances were found in the aspect ratio (AR), height-to-width ratio, aneurysm angle (AA), wall shear stress gradient (WSSG), and normalized wall shear stress average. A multivariate logistic analysis identified AR (OR = 0.29, p = 0.021), WSSG (OR = 1.54, p = 0.017) and AA (OR = 2.49, p = 0.039) as independent risk factors for BBAs. A scoring system was constructed using these parameters, effectively distinguishing BBAs (AUC = 0.931, p < 0.01). Our multidimensional scoring system may effectively assist in the discrimination of BBAs from wide-necked non-BBAs.

Low stability of photoanodes in electrolytes, especially in alkaline electrolytes, greatly limits their practical applications. Therefore, it is highly meaningful to develop a strategy to stabilize photoanodes under strongly alkaline conditions. Herein, a metal-free poly(p-phenylene pyromellitimide) film is coated onto a BiVO4 photoanode as a bifunctional catalyst layer and protective layer by in situ thermal polymerization. Structural characterization shows that the polymer film can effectively protect the BiVO4 semiconductor. Photoelectrochemical studies verify that the polymer film can improve the efficiency of the surface-reaching hole reaction and promote the separation of surface carriers. Thus, the polymer-coated photoanode shows a superior photoelectrochemical activity, which is 2.5 times higher than that of the pristine photoanode. Meanwhile, the polymer-coated photoanode also exhibits excellent stability in neutral and alkaline electrolytes. The photocurrent remains above 70% even after a six-hour reaction in a strongly alkaline electrolyte. This work provides a simple solution to stabilize semiconductor photoanodes under alkaline conditions for efficient photoelectrochemical applications.

BackgroundTartary buckwheat (Fagopyrum tataricum) is a nutritionally balanced and flavonoid-rich crop plant that has been in cultivation for 4000 years and is now grown globally. Despite its nutraceutical and agricultural value, the characterization of its genetics and its domestication history is limited.ResultsHere, we report a comprehensive database of Tartary buckwheat genomic variation based on whole-genome resequencing of 510 germplasms. Our analysis suggests that two independent domestication events occurred in southwestern and northern China, resulting in diverse characteristics of modern Tartary buckwheat varieties. Genome-wide association studies for important agricultural traits identify several candidate genes, includingFtUFGT3andFtAP2YT1that significantly correlate with flavonoid accumulation and grain weight, respectively.ConclusionsWe describe the domestication history of Tartary buckwheat and provide a detailed resource of genomic variation to allow for genomic-assisted breeding in the improvement of elite cultivars.

Digital PCR has shown great potential for quantitative nucleic acid testing (NAT), but most existing platforms are dependent on large auxiliary equipment (e.g., vacuum pump, amplification instrument, fluorescence microscope) to achieve target dispersion, amplification, signal capture and result analysis. Such complex, expensive and bulky NAT platforms have limited their applications in resource-limited areas, especially for point-of-care testing (POCT). In this work, we designed a digital isothermal NAT platform based on a pump-free open droplet array microfluidic chip. A pump-free microfluidic chip was developed based on an open microdroplet array in the form of thousands of independent microdroplets for spontaneous sample dispersion, without the need for external power. Combined with a handheld fluorescent signal reader based on a smartphone, this digital NAT platform can accurately quantify as low as 1 copy per μL of λDNA. Therefore, our integrated NAT platform, as a potable, robust and low-cost tool for highly accurate NA quantitative analysis, holds great potential for POCT applications.

In recent years, two-dimensional (2D) lead-free double perovskites have been attracting much attention because of their unique performance in photovoltaic solar cells and photocatalysis. Nonetheless, how thickness affects the photoelectric properties of lead-free double perovskite remains unclear. In this work, by means of density functional theory (DFT) with a spin orbit coupling (SOC) effect, we have investigated the electronic and optical properties systemically, including band structures, carrier mobility, optical absorption spectra, exciton-binding energies, band edges alignment and molecule adsorption performance of Cs2AgBiBr6 with different thicknesses. The calculated results revealed the thickness-induced band gap and optical performance for Cs2AgBiBr6. It shows a low band gap and outstanding optical absorption of visible and ultraviolet light. When the thickness is reduced to a monolayer, Cs2AgBiBr6 moves from an indirect band gap to a direct band gap. Moreover, the carrier mobility of Cs2AgBiBr6 is excellent and the exciton-binding energy increases with the decreased thickness. Importantly, an analysis of molecule adsorption and band edge alignment indicates that Cs2AgBiBr6 is prone to H2O adsorption and H2 desorption theoretically, which is conducive to the photocatalytic water splitting for hydrogen generation and other photovatalytic reactions. Our work suggests that Cs2AgBiBr6 is a potential candidate as a solar cell or a photocatalyst, and we provide theoretical explorations into reducing the layers of lead-free double perovskite materials to 2D atomic thickness for a better photocatalytic application, which can serve as guidelines for the design of excellent photocatalysts.

Most of the photocathode semiconductors that can be used for hydrogen production are difficult to prepare or get corroded in the electrolyte of an aqueous solution. Hence it is a huge challenge to develop stable photoelectrochemical (PEC) hydrogen evolution systems. Perovskite-type LaFeO3, as a new p-type semiconductor, is used in the PEC hydrogen evolution reaction and shows excellent stability. We synthesized a high-purity LaFeO3 nanorod array on an FTO substrate and its bandgap is 2.14 eV. Moreover, the carrier migration efficiency of a LaFeO3 photocathode is improved by doping with Li ions, and the doping effect also causes a red-shift of the optical maximum absorption edge. As a result, the photocurrent density of the Li-doped LaFeO3 photocathode is increased from −30 μA cm−2 (LaFeO3) to −50 μA cm−2 at 0.4 V (vs. RHE). Herein, the Li-doped LaFeO3 show great potential as a PEC photocathode for achieving an efficient, stable and inexpensive PEC hydrogen evolution reaction.

A new nerve matrix membrane derived from decellularized porcine nerves has been shown to retain the major extracellular matrix components, and to be effective in preventing adhesion between the nerve anastomosis sites and the surrounding tissues in a rat sciatic nerve transection model, thereby enhancing regeneration of the nerve. The effectiveness of the membrane may be attributed to its various bioactive components. In this prospective, randomized, single-blind, parallel-controlled multicenter clinical trial, we compared the safety and efficacy of the new nerve matrix membrane with a previously approved bovine tendon-derived type I collagen nerve wrapping. A total of 120 patients with peripheral nerve injury were recruited from Beijing Jishuitan Hospital, The First Bethune Hospital of Jilin University, and Yantai Yuhuangding Hospital, China. The patients were randomly assigned to undergo end-to-end and tension-free neurorrhaphy with nerve matrix membrane (n = 60, 52 male, 8 female, mean age 41.34 years, experimental group) or tendon-derived collagen nerve wrapping (n = 60, 42 male, 18 female, mean age 40.17 years, control group). Patients were followed-up at 14 ± 5, 30 ± 7, 90 ± 10 and 180 ± 20 days after the operation. Safety evaluation included analyses of local and systemic reactions, related laboratory tests, and adverse reactions. Efficacy evaluation included a static 2-point discrimination test, a moving 2-point discrimination test, and a Semmes-Weinstein monofilament examination. Sensory nerve function was evaluated with the British Medical Research Council Scale and Semmes-Weinstein monofilament examination. The ratio (percentage) of patients with excellent to good results in sensory nerve recovery 180 ± 20 days after the treatment was used as the primary effectiveness index. The percentages of patients with excellent to good results in the experimental and control groups were 98.00% and 94.44%, respectively, with no significant difference between the two groups. There were no significant differences in the results of routine blood tests, liver and renal function tests, coagulation function tests, or immunoglobulin tests at 14 and 180 days postoperatively between the two groups. These findings suggest that the novel nerve matrix membrane is similar in efficacy to the commercially-available bovine-derived collagen membrane in the repair of peripheral nerve injury, and it may therefore serve as an alternative in the clinical setting. The clinical trial was approved by the Institutional Ethics Committee of Beijing Jishuitan Hospital, China (approval No. 20160902) on October 8, 2016, the Institutional Ethics Committee of the First Bethune Hospital of Jilin University, China (approval No. 160518-088) on December 14, 2016, and the Institutional Ethics Committee of Yantai Yuhuangding Hospital, China (approval No. 2016-10-01) on December 9, 2016. The clinical trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2000033324) on May 28, 2020.

In this paper, a novel joint loss Generative Adversarial Networks (GAN) framework is proposed for thermography nondestructive testing named Defect-Detection Network (DeftectNet). A new joint loss function that incorporates both the modified GAN loss and penalty loss is proposed. The strategy enables the training process to be more stable and to significantly improve the detection rate. The obtained result shows that the proposed joint loss can better capture the salient features in order to improve the detection accuracy. In order to verify the effectiveness and robustness of the proposed method, experimental studies have been carried out for inner debond defects on both regular and irregular shaped carbon fiber reinforced polymer/plastic (CFRP) specimens. A comparison experiment has been undertaken to study the proposed method with other current state-of-the-art deep semantic segmentation algorithms. The promising results have been obtained where the performance of the proposed method can achieve end-to-end detection of defects.

Soft and wearable electronics have transformed healthcare monitoring, leading to the public awareness of physical fitness and unprecedented prosperity of personalized health management by unlocking insightful healthcare information to end-users in real-time and at anywhere. Thus, it has been greatly encouraging people to leave the locker room to sweat, and monitor their health for a continual period at exactly the same time. However, longstanding limitations on temperature stability, hydrated stability, and mechanical stability have limited the application of these electronic devices. Luckily, a new generation of technologies is coming online that is bringing soft electronics to mainstream applications. This review highlights innovations in materials and structure design that have begun to enable the function of soft electronic devices in conditions of varying temperature, humidity, and mechanical deformations, even in extreme conditions, and discusses ongoing challenges and opportunities for further developing soft and wearable electronics for health monitoring in varying environment.

Power dissipation is a fundamental issue for future chip-based electronics. As promising channel materials, two-dimensional semiconductors show excellent capabilities of scaling dimensions and reducing off-state currents. However, field-effect transistors based on two-dimensional materials are still confronted with the fundamental thermionic limitation of the subthreshold swing of 60 mV decade−1 at room temperature. Here, we present an atomic threshold-switching field-effect transistor constructed by integrating a metal filamentary threshold switch with a two-dimensional MoS2 channel, and obtain abrupt steepness in the turn-on characteristics and 4.5 mV decade−1 subthreshold swing (over five decades). This is achieved by using the negative differential resistance effect from the threshold switch to induce an internal voltage amplification across the MoS2 channel. Notably, in such devices, the simultaneous achievement of efficient electrostatics, very small sub-thermionic subthreshold swings, and ultralow leakage currents, would be highly desirable for next-generation energy-efficient integrated circuits and ultralow-power applications., Here, the authors demonstrate an atomic threshold-switching field-effect transistor constructed by integrating a metal filamentary switch with a two-dimensional MoS2 channel, and obtain abrupt steepness in the turn-on characteristics and 4.5 mV/dec subthreshold swing over five decades.

Purpose: To compare the benefits and risks of extra 6 months of warfarin therapy with those of rivaroxaban treatment in patients with initial unprovoked pulmonary embolism (PE) episode who completed 3- or 6-month of therapy on heparin/vitamin K antagonist standard regime.Methods: This prospective observational study included 212 patients with follow-up from July 2013 to July 2018. The primary endpoint was symptomatic recurrent venous thromboembolism (VT), composite of non-fatal symptomatic PE or deep vein thrombosis or fatal VT, and major bleeding (non-fatal/fatal) up to 6 months. Secondary endpoints were death not related to PE or major bleeding.Results: During the 6-month therapy period, the primary endpoint was seen in 3 out of 106 patients (2.83 %) in warfarin category, and in rivaroxaban category, for a hazard ratio (HR) of 1.22 [95 % confidence interval (CI) = 0.09 - 11.18; p = 0.813]. With warfarin therapy, 2 patients (1.89 %) had recurrent VT, while 3 patients (2.83 %) had VT with rivaroxaban. Major bleeding was observed in 2 patients (1.89 %) on warfarin, and in one patient (0.94 %) on rivaroxaban. During the entire 18-month period, the primary endpoint was seen in 15 patients (14.15 %) treated with warfarin, and in 18 patients (16.98 %) treated with rivaroxaban (HR 0.84; 95 % CI = 0.47 - 1.84; p = 0.431). Major bleeding was observed in 5 patients (4.72 %) under warfarin (one fatal), relative to 3 patients (2.83 %) under rivaroxaban (R 1.67; 95 % CI = 0.62 - 5.95; p = 0.09).Conclusion: Rivaroxaban showed higher efficacy than warfarin in recurrent VT prevention, with lower risk of major bleeding. However, the extended therapeutic benefit was not maintained post-therapy. Keywords: Pulmonary embolism, Rivaroxaban, Warfarin, Heparin, Vitamin K, Hazard ratio

Chronic liver injury with any etiology can progress to fibrosis and the end-stage diseases cirrhosis and hepatocellular carcinoma. The progression of liver disease is controlled by a variety of factors, including liver injury, inflammatory cells, inflammatory mediators, cytokines, and the gut microbiome. In the current review, we discuss recent data on a large number of cytokines that play important roles in regulating liver injury, inflammation, fibrosis, and regeneration, with a focus on interferons and T helper (Th) 1, Th2, Th9, Th17, interleukin (IL)-1 family, IL-6 family, and IL-20 family cytokines. Hepatocytes can also produce certain cytokines (such as IL-7, IL-11, and IL-33), and the functions of these cytokines in the liver are briefly summarized. Several cytokines have great therapeutic potential, and some are currently being tested as therapeutic targets in clinical trials for the treatment of liver diseases, which are also described.

Objective We aimed to compare the imaging features of gestational trophoblastic neoplasias (GTNs) and benign pregnancy-related uterine diseases on contrast-enhanced ultrasound (CEUS) to explore the clinical value of CEUS in differentiating these two types of uterine lesions. Materials and methods In this prospective study, patients with GTNs before and after chemotherapy and benign pregnancy-related uterine lesions received conventional US and CEUS. The imaging features and parameters of CEUS of the lesions were assessed. Results A total of 73 patients were enrolled in this study, including 48 with GTNs and 25 with benign lesions. The enhancement pattern of newly diagnosed GTNs was mainly diffuse enhancement (70.8%), with a non-enhanced area of less than 1/3 of the entire lesion. For the benign group, the enhancement pattern was mainly ring-shaped enhancement (72.0%), and the non-enhanced area was more than 1/2 (68.0%), significantly different from that of GTNs (P = 0.000 and 0.002, respectively). Forty-one lesions demonstrated unclear boundaries on greyscale US but clearly displayed on CEUS. In both the benign and malignant groups, the measurements of lesion size on CEUS were larger than those on greyscale US (P = 0.000). The measurement differences (ΔD: D2-D1) of the malignant cases were higher than those of the benign cases (P = 0.001). Conclusion GTNs and benign pregnancy-related uterine diseases have different imaging characteristics on CEUS. The boundary and involved range of the lesion can be clearly demonstrated on CEUS. CEUS possesses clinical value in diagnosing and evaluating GTNs and benign pregnancy-related diseases.

Nondestructive testing for natural microcracks is a critical challenge in assessing the surface and subsurface integrity of material. This paper proposes a shuttle-shaped sensing model with wide open inspection based on eddy current pulsed thermography (ECPT) system for natural microcrack detection on the specimens with complex geometry. To decrease the noise interference caused by uneven heating, the proposed model induces a unidirectional and uniform electromagnetic field in the region of interest. It significantly enhances thermal contrast and signal-to-noise ratio between non-defective and defective areas as well as improving the detectability and adaptability to different subjects. Besides, the direction of the infrared camera with respect to the specimen is set parallel to the specimen, which benefits the collection of the thermal signal. Experiments for several conductive cracks are implemented to verify the detectability of the proposed model.

Background Chemotherapy is the major choice for advanced non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor exon 20 insertion (EGFR ex20ins). The efficacy of pemetrexed-based with other chemotherapy regimens and EGFR ex20ins subtypes in this population has not been well studied. Methods We screened patients with EGFR ex20ins by next-generation sequencing (NGS) from a large cohort. The clinicopathologic and medical information were collected in advanced NSCLC patients with EGFR ex20ins. We also compared the clinical outcomes among patients with different subtypes of EGFR ex20ins. Results We retrospectively collected 119 stage IIIB/IV NSCLC patients with EGFR ex20ins from 9142 NSCLC patients across China from June 2013 to December 2018. The subtypes of EGFR ex20ins included A767_V769dupASV (33/119, 27.73%), S768_D770dupSVD (19/119, 15.97%), N771_H773dupNPH (11/119, 9.24%), A763_Y764insFQEA (2/119, 1.68%) and others (54/119, 45.38%). A total of 64.7% (77/119) of patients received pemetrexed-based first-line chemotherapy and 13.45% (16/119) of patients received pemetrexed-based second-line chemotherapy. Pemetrexed-based chemo-treated patients had longer median progression-free survival (PFS) than patients without pemetrexed-based chemo-treated (5.5 vs. 3.0 months, P=0.0026). Survival data was available for 66 patients and the median overall survival (OS) was 24.7 months. Pemetrexed-based chemo-treated patients had longer OS tendency than patients without pemetrexed-based chemo-treated (25.0 vs. 19.6 months, P=0.0769). Patients harboring A767_V769dupASV had better OS than other subtypes of EGFR ex20ins but without statistical significance (P=0.0676). Multivariate analysis revealed that histological type of NSCLC and bone-metastasis before treatment were independent prognostic factors for OS in all patients after adjusting all characteristic and treatment factors (P Conclusions To the best of our knowledge, it is the largest cohort study of advanced NSCLC patients with EGFR ex20ins across China. Pemetrexed-based treatment could have better control of disease than non-pemetrexed-based chemotherapies in this population. Furthermore, more effective agents are expected for patients harboring EGFR ex20ins.

Background & Aims Nonalcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease, characterized by steatosis and hallmark liver neutrophil infiltration. NASH also is associated with adipose tissue inflammation, but the role of adipose tissue inflammation in NASH pathogenesis remains obscure. The aim of this study was to investigate the interplay between neutrophil recruitment in adipose tissue and the progression of NASH. Methods A mouse model of NASH was obtained by high-fat diet (HFD) feeding plus adenovirus-Cxcl1 overexpression (HFD+AdCxcl1). Genetic deletion of E-selectin (Sele) and treatment with an S100A9 inhibitor (Paquinimod) were investigated using this model. Results By analyzing transcriptomic data sets of adipose tissue from NASH patients, we found that E-selectin, a key adhesion molecule for neutrophils, is the highest up-regulated gene among neutrophil recruitment-related factors in adipose tissue of NASH patients compared with those in patients with simple steatosis. A marked up-regulation of Sele in adipose tissue also was observed in HFD+AdCxcl1 mice. The HFD+AdCxcl1-induced NASH phenotype was ameliorated in Sele knockout mice and was accompanied by reduced lipolysis and inflammation in adipose tissue, which resulted in decreased serum free fatty acids and proinflammatory adipokines. S100A8/A9, a major proinflammatory protein secreted by neutrophils, was highly increased in adipose tissue of HFD+AdCxcl1 mice. This increase was blunted in the Sele knockout mice. Therapeutically, treatment with the S100A9 inhibitor Paquinimod reduced lipolysis, inflammation, and adipokine production, ameliorating the NASH phenotype in mice. Conclusions E-selectin plays an important role in inducing neutrophil recruitment in adipose tissue, which subsequently promotes inflammation and lipolysis via the production of S100A8/A9, thereby exacerbating the steatosis-to-NASH progression. Targeting adipose tissue inflammation therefore may represent a potential novel therapy for treatment of NASH., Graphical abstract

Aim The aim of this study was to evaluate amino acids as glucagon receptor (GCGR)-specific biomarkers in rodents and cynomolgus monkeys in the presence of agonism of both glucagon-like peptide-1 receptor (GLP1R) and GCGR with a variety of dual agonist compounds. Materials and methods Primary hepatocytes, rodents (normal, diet-induced obese and GLP1R knockout) and cynomolgus monkeys were treated with insulin (hepatocytes only), glucagon (hepatocytes and cynomolgus monkeys), the GLP1R agonist, dulaglutide, or a variety of dual agonists with varying GCGR potencies. Results A long-acting dual agonist, Compound 2, significantly decreased amino acids in both wild-type and GLP1R knockout mice in the absence of changes in food intake, body weight, glucose or insulin, and increased expression of hepatic amino acid transporters. Dulaglutide, or a variant of Compound 2 lacking GCGR agonism, had no effect on amino acids. A third variant with ~31-fold less GCGR potency than Compound 2 significantly decreased amino acids, albeit to a significantly lesser extent than Compound 2. Dulaglutide (with saline infusion) had no effect on amino acids, but an infusion of glucagon dose-dependently decreased amino acids on the background of GLP1R engagement (dulaglutide) in cynomolgus monkeys, as did Compound 2. Conclusions These results show that amino acids are sensitive and translatable GCGR-specific biomarkers.

The growing resistance of insects to chemical pesticides is reducing the effectiveness of conventional methods for pest control and thus, the development of novel insecticidal agents is imperative. Scorpion toxins specific for insect voltage-gated sodium channels (Navs) have been considered as one of the most promising insecticide alternatives due to their host specificity, rapidly evoked toxicity, biodegradability, and the lack of resistance. However, they have not been developed for uses in agriculture and public health, mainly because of a limited understanding of their molecular and evolutionary basis controlling their phylogenetic selectivity. Here, we show that the traditionally defined insect-selective scorpion toxin LqhIT2 specifically captures a prey Nav through a conserved trapping apparatus comprising a three-residue-formed cavity and a structurally adjacent leucine. The former serves as a detector to recognize and bind a highly exposed channel residue conserved in insects and spiders, two major prey items for scorpions; and the latter subsequently seizes the "moving" voltage sensor via hydrophobic interactions to reduce activation energy for channel opening, demonstrating its action in an enzyme-like manner. Based on the established toxin-channel interaction model in combination with toxicity assay, we enlarged the toxic spectrum of LqhIT2 to spiders and certain other arthropods. Furthermore, we found that genetic background-dependent cavity shapes determine the species selectivity of LqhIT2-related toxins. We expect that the discovery of the trapping apparatus will improve our understanding of the evolution and design principle of Nav-targeted toxins from a diversity of arthropod predators and accelerate their uses in pest control. ispartof: MOLECULAR BIOLOGY AND EVOLUTION vol:37 issue:11 pages:3149-3164 ispartof: location:United States status: published

Introduction Subdural effusion is a common complication that occurs after decompressive craniectomy. According to the endoscopy results, the formation mechanism of subdural effusion after decompressive craniectomy was discussed. Aim The morphological structure of subdural effusion in skull defects was observed with endoscopy, and endoscopic-assisted surgery was performed for subdural effusion. Material and methods From January 2018 to March 2020, 19 cases of skull repair and treatment of subdural effusion were performed. The external wall of the capsule was kept intact during the operation, subdural effusion and surgical procedure of the subdural effusion under an endoscope could be observed, and the results of endoscopic observation were described and recorded. A hemostasis gauze was placed between the two layers of the subdural effusion cavity. Another 13 cases of skull defects with subdural effusion treated without endoscopy during the same time period were enrolled in the study as the control group. The postoperative disappearance of effusion and the incidence of postoperative complications were compared between the two groups. Results Analysis with an endoscope revealed that all cases of subdural effusion in skull defects presented capsules. The main structures included the outer wall, boundary, inner wall, and fistula. The outer wall was made up of new tissue that had formed after removing the bone flap under the skin flap by artificial peeling under the condition of keeping the whole cavity. The inner wall consisted of thickened arachnoid, dura, and artificial dura. It presented with neovascularization networks, which showed a tendency to form new membrane structures through mutual adhesion and fusion. The inner and outer wall of the skull had fused to form the boundary of the cavity. Cerebrospinal fluid fistulas were detected in 31.6% of the internal walls. Subdural effusion was effectively treated in both the experimental group and the control group. Compared with the control group, complications in the experimental group were significantly reduced. Conclusions The effusion cavity can be divided into three types based on its structural characteristics: fistula type, membrane type, and closed type. In this study, the formation mechanism of skull defects combined with subdural effusion was explored. This represents a new method for treating subdural effusion in which hemostasis gauze is placed between the two layers of the effusion cavity and cerebrospinal fluid fistula under an endoscope, which can effectively reduce the incidence of postoperative complications.

Background Balloon dilatation with stent implantation has been proved to be an effective option for left iliac vein compression syndrome (LIVCS), but thrombosis may still occur after the operation. Currently, warfarin is used for anticoagulant therapy, but long-term monitoring is required, while rivaroxaban does not need laboratory monitoring, which can simplify treatment. Therefore, this study aimed to compare the efficacy and safety of rivaroxaban and warfarin in anticoagulation. Methods This study is a multicenter, randomized controlled trial. We will recruit 224 patients with thrombotic LIVCS from 9 hospitals. Moreover, these patients will be randomized to either the experimental group (rivaroxaban) or the control group (warfarin plus nadroparin). The primary outcome is stent occlusion rate. Secondary outcomes are quality of life scale survey results, all-cause mortality, anticoagulation-related mortality, and the proportion of participants with stent displacement/fracture, thrombosis, hemorrhage, and other vascular events. Discussion This study will provide reliable, evidence-based clinical evidence for the efficacy and safety of rivaroxaban antithrombotic therapy after stent implantation. Trial registration ClinicalTrials.gov NCT04067505. Registered on August 26, 2019.

Alcoholic hepatitis (AH) is a clinical syndrome characterized by jaundice and progressive inflammatory liver injury in patients with a history of prolonged periods of excess alcohol consumption and recent heavy alcohol abuse. Severe AH is a life-threatening form of alcohol-associated liver disease with a high short-term mortality rate around 30–50% at one month from the initial presentation. A large number of pro-inflammatory mediators, metabolic pathways, transcriptional factors and epigenetic factors have been suggested to be associated with the development and progression of AH. Several factors may contribute to liver failure and mortality in patients with severe AH including hepatocyte death, inflammation, and impaired liver regeneration. Although the pathogeneses of AH have been extensively investigated and many therapeutic targets have been identified over the last five decades, no new drugs for AH have been successfully developed. In this review, we discuss interleukin-22 (IL-22) biology and its roles of anti-apoptosis, anti-fibrosis, anti-oxidation, anti-bacterial infection and regenerative stimulation in protecting against liver injury in many preclinical models including several recently developed models such as chronic-plus-binge ethanol feeding, acute-on-chronic liver failure (ACLF), C-X-C motif chemokine ligand 1 (CXCL1) plus high-fat diet (HFD) (HFD(+Cxcl1))-induced nonalcoholic steatohepatitis (NASH). Finally, clinical trials of IL-22 for the treatment of AH are also discussed, which showed some promising benefits for AH patients.

Advanced fibrosis and portal hypertension influence short-term mortality. Lipocalin 2 (LCN2) regulates infection response and increases in liver injury. We explored the role of intrahepatic LCN2 in human alcoholic hepatitis (AH) with advanced fibrosis and portal hypertension and in experimental mouse fibrosis. We found hepatic LCN2 expression and serum LCN2 level markedly increased and correlated with disease severity and portal hypertension in patients with AH. In control human livers, LCN2 expressed exclusively in mononuclear cells, while its expression was markedly induced in AH livers, not only in mononuclear cells but also notably in hepatocytes. Lcn2−/− mice were protected from liver fibrosis caused by either ethanol or CCl4 exposure. Microarray analysis revealed downregulation of matrisome, cell cycle and immune related gene sets in Lcn2−/− mice exposed to CCl4, along with decrease in Timp1 and Edn1 expression. Hepatic expression of COL1A1, TIMP1 and key EDN1 system components were elevated in AH patients and correlated with hepatic LCN2 expression. In vitro, recombinant LCN2 induced COL1A1 expression. Overexpression of LCN2 increased HIF1A that in turn mediated EDN1 upregulation. LCN2 contributes to liver fibrosis and portal hypertension in AH and could represent a new therapeutic target.

Electromagnetic Acoustic Transducer (EMAT) has become one of the fastest-growing solutions for pipeline weld inspection over the past decade due to its non-contact advantage. One primary problem of EMAT is that it has relatively lower energy transition efficiency compared to widely used piezoelectric transducers, coupled with the effect of lift-off and the non-uniformity issue of welding material, the Signal-to-Noise Ratio (SNR) can be significantly restricted. This brings great difficulty in interpreting the EMAT signal measured from pipeline girth welds. To overcome this challenge, this paper presents a deep learning-based ultrasonic pattern recognition method to identify the pipeline girth weld cracking automatically. The proposed method utilizes a deep Convolution Neural Network (CNN) integrated with a pre-trained Support Vector Machine (SVM) classifier to extract the high-level features from the time-frequency representation of A-scan signals measured by bulk-wave EMAT and classify these signals into defective or non-defective groups. To validate the proposed method, a set of experiments is carried out to classify A-scan signals measured from the girth welds of an ex-service type 813-X70 gas pipeline. A comparative investigation is also undertaken to demonstrate the superiority of the proposed method against the conventional ultrasonic pattern recognition methods for evaluation.

Diagnosis of breast invasive micropapillary carcinoma (IMPC) before surgery is of great value for determining the optimal treatment strategy. The aim of the present study was to investigate the magnetic resonance imaging (MRI) and pathological features of IMPC. MRI features of IMPC were characterized in relation to the patients' clinicopathological features. Clinical manifestations, mammography results and/or MRI findings of patients with IMPC were retrospectively analyzed. Parameters included morphology, plain T2-weighted imaging (T2WI) signal intensity, the apparent diffusion coefficient (ADC), the internal enhancement mode, early enhancement rates and time-intensity curve (TIC) types during dynamic enhanced scanning. A total of 10 lesions were detected by MRI in eight patients, with one case having three lesions with the mean diameter of 34.44 mm. In plain T2WI scanning, the lesions appeared inhomogeneous with a moderate or high signal intensity. When the b value was 800 sec/mm2, the average ADC value was 0.823±0.12×10−3 mm2/sec. A total of four cases exhibited mass-like enhancement, including an oval rim in one case (three lesions), irregular inhomogeneous enhancement in two cases and irregular uniform enhancement in one case. The margins were clear in one case (three lesions), irregular in two cases and spiculate in one case. Among the four cases with non-mass enhancement, the distribution was focal in two cases, linear in one case and regional in one case, and the internal enhancement mode was cluster-like in one case, heterogeneous in one case and uniform in two cases. The average early enhancement rate was 116.96±45.26%. TICs of type III were observed in all cases. In conclusion, MRI of IMPC demonstrated typical features of malignant tumors and lymphatic vessel infiltration, suggesting that MRI may exhibit guiding significance for the diagnosis and treatment planning of IMPC.

A memristor1 has been proposed as an artificial synapse for emerging neuromorphic computing applications2,3. To train a neural network in memristor arrays, changes in weight values in the form of device conductance should be distinct and uniform3. An electrochemical metallization (ECM) memory4,5, typically based on silicon (Si), has demonstrated a good analogue switching capability6,7 owing to the high mobility of metal ions in the Si switching medium8. However, the large stochasticity of the ion movement results in switching variability. Here we demonstrate a Si memristor with alloyed conduction channels that shows a stable and controllable device operation, which enables the large-scale implementation of crossbar arrays. The conduction channel is formed by conventional silver (Ag) as a primary mobile metal alloyed with silicidable copper (Cu) that stabilizes switching. In an optimal alloying ratio, Cu effectively regulates the Ag movement, which contributes to a substantial improvement in the spatial/temporal switching uniformity, a stable data retention over a large conductance range and a substantially enhanced programmed symmetry in analogue conductance states. This alloyed memristor allows the fabrication of large-scale crossbar arrays that feature a high device yield and accurate analogue programming capability. Thus, our discovery of an alloyed memristor is a key step paving the way beyond von Neumann computing.

Organ-on-a-chip has emerged as a new technique for constructing normal or diseased models in vitro , attracting rapidly increasing attention from researchers and clinics. Similar to other traditional methods, the main advantages of organ-on-a-chip are its high portability, high throughput and ability to replicate microenvironment cells. Thus organ-on-a-chip holds great potential in disease pathogenesis study, drug screening, etc. In this paper, we reviewed the history of organ-on-a-chip and discussed the main constitutions and materials of organs-on-chips. Through evaluating the existing organs-on-chips, we proposed that a highly integrated organ-on-a-chip should include four elements, microfluidic chip, cells or microtissues, microenvironment building implementing parts, and microsensors. The manufacturing methods were summarized for each item. Besides, the latest developments in organ-on-a-chip and clinical technology problems have been added. In the end, this paper addressed organ-on-a-chip’s future directions.

Aims/Introduction There are substantial differences in genes, diet, culture and environment between the northern and southern Chinese populations, which might influence treatment strategy and screening policy. We studied the differences in type 2 diabetes and diabetic complications between northern and southern China. Materials and Methods We carried out a cross‐sectional survey using data from the China Cardiometabolic Registries on blood pressure, blood lipids and blood glucose in 25,398 Chinese type 2 diabetes patients. Macrovascular, microvascular and other complications were collected by self‐report or medical records, and then divided into the northern and southern groups by the boundary of the Yangtze River. Results Northern patients were younger, and had heavier weight, greater body mass index and waist circumference, higher blood pressure, higher total cholesterol, higher low‐density lipoprotein cholesterol, and higher hemoglobin A1C. The prevalence of cardiovascular, cerebrovascular and macrovascular complications were 1.76‐fold, 1.24‐fold and 1.47‐fold more in northern than that in southern Chinese patients. In addition, the prevalence of diabetic nephropathy, retinopathy, neuropathy and microvascular complications in northern Chinese patients also increased. When stratified by age, the difference in both cardiovascular disease and ischemic stroke morbidity became significant, even in the 35–44 years age group. Conclusions More macrovascular and microvascular complications were found in northern compared with southern patients, and the largest difference also appeared in the younger age groups, Northern patients were diagnosed with type 2 diabetes at an earlier age. More macrovascular and microvascular complications were found in the northern compared with the southern Chinese patients, and the largest difference also appeared in the younger age groups

Background Subacute thyroiditis (SAT) is the most common cause of thyroid pain. Several clinical guidelines recommend that patients who fail to respond to full doses of non-steroidal anti-inflammatory drugs (NSAIDs) should be treated instead with oral corticosteroid therapy. However, albeit strong recommendations, the treatment protocol is based on low-quality evidence and high-quality clinical trials are lacking with respect to the optimal initiation dosage and usage of corticosteroid. We aimed to evaluate whether 15 mg/day of prednisolone (PSL) as the initial dosage could provide non-inferiority effectiveness but with lower risk and more safety compared with 30 mg/day of PSL as the initial dosage. Methods/design This is a multicenter, open-label, randomized, parallel trial that will be conducted at five academic hospitals in China. A total of 90 adult patients diagnosed with SAT who present moderate to severe pain or fail to respond to full doses of NSAIDs will be randomly assigned with a 1:1 ratio to the low initial PSL dosage group (15 mg daily) and standard initial PSL dosage group (30 mg daily). The primary endpoint is the time period (days) required for PSL treatment (including PSL treatment for recurrence). Discussion Our randomized controlled trial will try to determine the optimal protocol in the treatment of SAT by providing high-quality evidence. Trials registration Chinese Clinical Trial Register, ChiCTR1900023884. Registered on 15 June 2019.