Search

Machine learning (ML) models are increasingly trained with distributed workers possessing heterogeneous resources. In such scenarios, model training efficiency may be negatively affected by \emph{stragglers}---workers that run much slower than others. Efficient model training requires eliminating such stragglers, yet for modern ML workloads, existing load balancing strategies are inefficient and even infeasible. In this paper, we propose a novel strategy, called \emph{semi-dynamic load balancing}, to eliminate stragglers of distributed ML workloads. The key insight is that ML workers shall be load-balanced at \emph{iteration boundaries}, being non-intrusive to intra-iteration execution. Based on it we further develop LB-BSP, an integrated worker coordination mechanism that adapts workers' load to their instantaneous processing capabilities---by right-sizing the sample batches at the synchronization barriers. We have designed distinct load tuning algorithms for ML in CPU clusters, in GPU clusters as well as in federated learning setups, based on their respective characteristics. LB-BSP has been implemented as a Python module for ML frameworks like TensorFlow and PyTorch. Our EC2 deployment confirms that LB-BSP is practical, effective and light-weight, and is able to accelerating distributed training by up to $54\%$ .

Modern transportation is associated with considerable challenges related to safety, mobility, the environment and space limitations. Vehicular networks are widely considered to be a promising approach for improving satisfaction and convenience in transportation. However, with the exploding popularity among vehicle users and the growing diverse demands of different services, ensuring the efficient use of resources and meeting the emerging needs remain challenging. In this paper, we focus on resource allocation in vehicular cloud computing (VCC) and fill the gaps in the previous research by optimizing resource allocation from both the provider's and users' perspectives. We model this problem as a multi-objective optimization with constraints that aims to maximize the acceptance rate and minimize the provider's cloud cost. To solve such an NP-hard problem, we improve the nondominated sorting genetic algorithm II (NSGA-II) by modifying the initial population according to the matching factor, dynamic crossover probability and mutation probability to promote excellent individuals and increase population diversity. The simulation results show that our proposed method achieves enhanced performance compared to the previous methods.

OBJECTIVE Free tissue transfer is widely used for head and neck reconstruction. In certain circumstances, vein grafting is required to elongate free flap pedicles to connect them to appropriate recipient vessels. Because of controversy regarding the use of interposition vein grafts in free tissue reconstruction, this paper reports vein graft indications, techniques, safety, and outcomes for head and neck microvascular surgery. METHODS Twenty-six patients (23 men and 3 women) who underwent interposition vein grafting concurrent with free tissue transfer were included in this study. The most common reason for head and neck reconstruction with vein graft was tumor recurrence, followed by flap salvage. The interposition vein grafts were applied in two manners as temporary arteriovenous (A-V) loop and conduit to extend the length of the free flap for venous drainage. RESULTS The most common reconstructions were anterolateral thigh flaps (15 cases), followed by vastus lateralis myocutaneous (3 cases) and radial forearm (2 cases) flaps. The common recipient vessels were superior thyroid artery, superficial temporal artery and external jugular vein. The free flap loss rate was 7.7% with vein grafts and 4.9 without vein grafts (p = 0.380). The free flap complication rate was 50.0% and 16.8% in patients with and without vein grafts, respectively (p

Protein aggregation causes alpha-synuclein (α-syn) to change from its original physiological role to a pathological state, which is a potential pathogenic mechanism in Parkinson’s disease (PD). Chi...

Muscle strength after detraining is still higher than the level before training, which is an important issue for middle-aged and older adults. The purpose of the present study was to examine the effects of detraining duration (DD), resistance training duration (RTD), and intensity on the maintenance of resistance training (RT) benefits after detraining in middle-aged and older adults. A systematic search yielded 15 randomized control trails (n = 383) eligible for inclusion. The results showed that RTD ≥ 24 weeks and DD ≥ RTD, the RT benefits were still significantly maintained even with medium and low intensity (standardized mean difference = 1.16, 95% confidence interval, CI [0.38, 1.94], p = .004). When RTD p = .0002; DD 8–16 weeks: standardized mean difference = 1.35, 95% CI [0.66, 2.04], p = .0001). However, when DD > RTD, the RT benefits were not maintained even with high intensity. In summary, when RTD was less than 24 weeks, RTD > DD was an important factor in maintaining muscle strength.

In recent years, vehicular named data networking (VNDN) has quickly ascended to the spotlight and gained enormous popularity, which has emerged as a candidate to support various applications of vehicular communications. VNDN has the potential improve the data dissemination efficiency by mitigating the performance degradation from Internet Protocol (IP) addressing, unstable connectivity and diversified service requirements. With the number of connected vehicles increasing rapidly, the traffic burden of the base station (BS) also grows. As an effective edge computing paradigm, in-vehicle caching can significantly relieve the pressure of the BS. However, the design of a fair caching strategy is still challenging due to the selfish nature of individuals. In this paper, to address the above issues, a popularity-incentive caching scheme (PICS) is proposed in VNDN, where the BS will reward vehicles who execute cache offloading and content sharing with others. To balance the conflict of interest between the BS and vehicles, a Stackelberg game is modeled with rational utilities envisioned. Next, we propose the solution of this game model and evaluate the influence of different weight parameters. Finally, simulation results validate the effectiveness of PICS.

Androgen deprivation therapy (ADT) includes bilateral orchiectomy or long-acting gonadotropin-releasing hormone (GnRH) agonists/antagonists. It remains controversial with respect to ADT associated cardiovascular outcomes. Hereby, we compared the risk of major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with prostate cancer receiving either surgical castration or GnRH therapies.Using the Taiwan Cancer Registry and Taiwan's National Health Insurance Research Database, we identified 8,413 patients receiving GnRH therapies compared with 694 receiving surgical castration from 2008 to 2017. The median followup duration was 3 years.The crude incidences of 3-year mortality and MACCEs were 19.90% vs 26.51% and 8.23% vs 8.65% in patients receiving GnRH therapies or surgical castration, respectively. After adjusting for age, cancer stage and comorbidities, despite no significant differences in MACCEs between groups there was a slight increase in the incidence of acute myocardial infarction (AMI) in patients receiving surgical castration compared with those receiving GnRH therapies. The mortality adjusted hazard ratios of MACCEs and AMI among patients receiving surgical castration were 1.11- and 1.8-fold higher than those receiving GnRH therapies. Notably, in subgroup analysis regarding cancer stage, patients with cancer stage IV showed the most significantly increasing risk of AMI in those receiving surgical castration compared with GnRH therapies.Collectively, we indicated an increased risk of AMI in patients with prostate cancer, especially in patients receiving surgical castration rather than those receiving GnRH therapies. Our findings highlight concerns regarding the cardiac safety of surgical castration compared with GnRH therapies.

Introduction Increased fiber intake has been associated with decreased breast cancer risk, while increased animal protein intake with increased risk. The objective of this study is to examine the relationship of dietary fiber and protein intake to estrogen and sex hormone–binding globulin (SHBG) concentrations at puberty onset. Methods These analyses were conducted using the Cincinnati puberty cohort of the Breast Cancer and the Environment Research Program, with girls followed every 6 months from ages 6 and 7. The analyses included serum measurements at 6-month intervals for estrogen and SHBG concentrations, from 18 months prior to breast stage 2 (onset of puberty). Dietary intake was documented via 24-hour dietary recalls every 3 months. Dietary factors of interest included total energy intake; total and animal protein; total, soluble, and insoluble fiber; and lignan and flavanol intake. Results This study included 260 participants who generated 871 serum specimens and 3,000 days of diet intake. In longitudinal models, estradiol was associated inversely with insoluble fiber intake; estrone positively with animal protein intake; SHBG with greater insoluble fiber and lower total protein intake; and ratio of estrone to SHBG, a measure of bioavailable estrogen, positively with animal protein. Conclusions Greater protein intake, especially animal protein, led to greater estrogen concentrations and lower SHBG; greater animal protein and greater caloric intake led to increased bioavailable estrogen. This relationship may have served an evolutionary advantage in the past for greater fertility with adequate high-quality protein; in contemporary women, a modest decrease in animal protein may be beneficial in reducing breast cancer risk.

The prevalence of obesity is a major cause of many chronic metabolic disorders, including type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and cancer. Insulin resistance is often associated with metabolic unhealthy obesity (MUO). Therapeutic approaches aiming to improve insulin sensitivity are believed to be central for the prevention and treatment of MUO. However, current antiobesity drugs are reported as multitargeted and their insulin-sensitizing effects remain unclear. In this review, we discuss current understanding of the mechanisms of insulin resistance from the aspects of endocrine disturbance, inflammation, oxidative, and endoplasmic reticulum stress (ERS). We then summarize the antiobesity drugs, focusing on their effects on insulin sensitivity. Finally, we discuss strategies for obesity treatment.

Objective: D-dimer is correlated to the poor prognosis of non-small-cell lung cancer. The study aimed to investigate the association between plasma D-dimer and concomitant mutations in non-small-cell lung cancer. Methods: A total of 517 non-small-cell lung cancer patients were recruited and tested for ALK, BRAF, EGFR, HER2/ERBB2, KRAS, MET, PIK3CA, RET and ROS1 mutation by next-generation sequencing. Multiple gene mutation information, clinical baseline data and laboratory test data were analyzed statistically. Results: All patients were divided into three groups: wild-type group, single-gene mutation group and concomitant mutation group. The analysis of D-dimer, uric acid, gender, family history, smoking history, histology and distant metastasis all showed significant differences in the three groups (p

Female carriers with X-linked chronic granulomatous disease (XL-CGD) who have

Plants and associated microorganisms are essential sources of natural products against human cancer diseases, partly exemplified by plant-derived anticancer drugs such as Taxol (paclitaxel). Natural products provide diverse mechanisms of action and can be used directly or as prodrugs for further anticancer optimization. Despite the success, major bottlenecks can delay anticancer lead discovery and implementation. Recent advances in sequencing and omics-related technology have provided a mine of information for developing new therapeutics from natural products. Artificial intelligence (AI), including machine learning (ML), has offered powerful techniques for extensive data analysis and prediction-making in anticancer leads discovery. This review presents an overview of current AI-guided solutions to discover anticancer lead compounds, focusing on natural products from plants and associated microorganisms.

Considering the high mobility and uneven distribution of vehicles, an efficient routing protocol should avoid that the sent packets are forwarded within road segments with ultra-low density or serious data congestion in vehicular networks. To this end, in this paper, we propose a Traffic aware and Link Quality sensitive Routing Protocol (TLRP) for urban Internet of Vehicles (IoV). First, we design a novel routing metric, i.e., Link Transmission Quality (LTQ), to account for the impact of the number, quality and relative positions of communication links along a routing path on the network performance. Then, to adapt to the dynamic characteristics of IoV, a road weight evaluation scheme is presented to assess each road segment using the real-time traffic and link information quantified by the LTQ. Next, the path with the lowest aggregated weight is selected as the routing candidate. Extensive simulations demonstrate that our proposed protocol achieves significant performance improvements compared to the state-of-the-art protocol MM-GPSR, the typical junction-based scheme E-GyTAR, and the classic connectivity-based routing iCAR, in terms of packet delivery ratio and average transmission delay.

Simultaneous and proportional control (SPC) using surface electromyography (sEMG) signals has become a prevailing solution for the intuitive control of prosthesis and human–robot interaction. However, only time and frequency domain features are generally involved in conventional SPC algorithms, ignoring the globally spatial information across channels. In this article, we presented an instantaneous sEMG-image-based model for continuous estimation on multiple degrees of freedom wrist torques. Specifically, a convolutional neural network was used to extract features from sEMG-images, and then to estimate wrist torques. The results demonstrated that the sEMG-image-based model outperformed three conventional regression methods and a deep-learning-based method with superior performance on estimation accuracy and smoothness. Furthermore, we found a strong linear correlation between the first two principal components of extracted features and the recorded wrist torques, validating the effectiveness of the proposed approach. The outcomes open up a new perspective for SPC and potentially enhance the performance of myoelectric control in practical application.

Rationale: The initial hypertrophy response to cardiac pressure overload is considered compensatory, but with sustained stress, it eventually leads to heart failure. Recently, a role for recruited macrophages in determining the transition from compensated to decompensated hypertrophy has been established. However, whether cardiac resident immune cells influence the early phase of hypertrophy development has not been established. Objective: To assess the role of cardiac immune cells in the early hypertrophy response to cardiac pressure overload induced by transverse aortic constriction (TAC). Methods and Results: We performed cytometry by time-of-flight to determine the identity and abundance of immune cells in the heart at 1 and 4 weeks after TAC. We observed a substantial increase in cardiac macrophages 1 week after TAC. We then conducted Cite-Seq single-cell RNA sequencing of cardiac immune cells isolated from 4 sham and 6 TAC hearts. We identified 12 clusters of monocytes and macrophages, categorized as either resident or recruited macrophages, that showed remarkable changes in their abundance between sham and TAC conditions. To determine the role of cardiac resident macrophages early in the response to a hypertrophic stimulus, we used a blocking antibody against macrophage colony-stimulating factor 1 receptor (CD115). As blocking CD115 initially depletes all macrophages, we allowed the replenishment of recruited macrophages by monocytes before performing TAC. This preferential depletion of resident macrophages resulted in enhanced fibrosis and a blunted angiogenesis response to TAC. Macrophage depletion in CCR2 (C-C chemokine receptor type 2) knockout mice showed that aggravated fibrosis was primarily caused by the recruitment of monocyte-derived macrophages. Finally, 6 weeks after TAC these early events lead to depressed cardiac function and enhanced fibrosis, despite complete restoration of cardiac immune cells. Conclusions: Cardiac resident macrophages are a heterogeneous population of immune cells with key roles in stimulating angiogenesis and inhibiting fibrosis in response to cardiac pressure overload.

In order to overcome the problems of poor timeliness and low accuracy of mining existing in traditional methods, this paper designs a bit-object based maximum frequent pattern mining method for intensive cloud computing data. After judging the support number according to the bit object of the maximum frequent pattern, the intensive cloud computing data is accurately collected according to the difference between the load value of cloud data and the true value of load, so as to improve the accuracy of subsequent mining results, and then the maximum frequent pattern of data is accurately mined by combining the bit object. Experimental results show that the maximum time to generate mining results is only 4.6 s, the maximum bit error rate of output results is only 7%, and the maximum memory occupancy is only 3.90%. The above results show that this method is more suitable for practical excavation.

Background/purpose Herpes simplex virus type 1 (HSV-1) is the pathogenic agent of human diseases, including gingivostomatitis and herpes labialis. The anti-viral activities of the tea polyphenol, epigallocatechin-3-gallate (EGCG), have been demonstrated. This study examined the combined effects of EGCG and the antiviral drug, acyclovir (ACV), on infection of HSV-1 in oral epithelial cells. Methods Cell viability was examined using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide. Viral yields were determined using the plaque assay. Viral proteins were detected using Western blotting analysis or confocal laser scanning microscopy. Viral DNA was detected using the real-time polymerase chain reaction. Results Cytotoxic effects of HSV-1 on the viability of oral epithelial cells were evidently reduced in the presence of EGCG (25 μg/ml) or/and ACV (50 μg/ml). Viral yields were also significantly reduced by treatment of cells with EGCG or/and ACV. Expression of viral immediate early protein, infected cell protein 0 (ICP0), was greatly inhibited when cells were treated with EGCG. Combined effects of EGCG and ACV were more evident for the expression of viral thymidine kinase, ICP5 and glycoprotein D. EGCG, but not ACV, significantly reduced the levels of viral particles and viral DNA during viral entry phase. However, at 20 h post infection, the intracellular viral DNA was evidently reduced in HSV-1 infected cells treated with EGCG and ACV. Moreover, the stimulatory effects of HSV-1 on phosphorylation of c-Jun N-terminal kinase could be reduced by ACV. Conclusion The results demonstrated the additive effects of EGCG and ACV on HSV-1 infection in oral epithelial cells.

PURPOSE Thirty-day unplanned readmission is one of the key components in measuring quality in patient care. Risk of readmission in oncology patients may be associated with a wide variety of specific factors including laboratory results and diagnoses, and it is hard to include all such features using traditional approaches such as one-hot encoding in predictive models. METHODS We used clinical embeddings to represent complex medical concepts in lower dimensional spaces. For predictive modeling, we used gradient-boosted trees and adopted the shapley additive explanation framework to offer consistent individualized predictions. We used retrospective inpatient data between 2013 and 2018 with temporal split for training and testing. RESULTS Our best performing model predicting readmission at discharge using clinical embeddings showed a testing area under receiver operating characteristic curve of 0.78 (95% CI, 0.77 to 0.80). Use of clinical embeddings led to up to 23.1% gain in area under precision-recall curve and 6% in area under receiver operating characteristic curve. Hematology models had more performance gain over surgery and medical oncology. Our study was the first to develop (1) explainable predictive models for the hematology population and (2) dynamic models to keep track of readmission risk throughout the duration of patient visit. CONCLUSION To our knowledge, our study was the first to develop (1) explainable predictive models for the hematology population and (2) dynamic models to keep track of readmission risk throughout the duration of patient visit.

BACKGROUND Sedation with propofol injections is associated with a risk of addiction, but remimazolam benzenesulfonate is a comparable anesthetic with a short elimination half-life and independence from cell P450 enzyme metabolism. Compared to remimazolam, remimazolam benzenesulfonate has a faster effect, is more quickly metabolized, produces inactive metabolites and has weak drug interactions. Thus, remimazolam benzenesulfonate has good effectiveness and safety for diagnostic and operational sedation. AIM To investigate the clinical value of remimazolam benzenesulfonate in cardiac surgery patients under general anesthesia. METHODS A total of 80 patients who underwent surgery in the Department of Cardiothoracic Surgery from August 2020 to April 2021 were included in the study. Using a random number table, patients were divided into two anesthesia induction groups of 40 patients each: remimazolam (0.3 mg/kg remimazolam benzenesulfonate) and propofol (1.5 mg/kg propofol). Hemodynamic parameters, inflammatory stress response indices, respiratory function indices, perioperative indices and adverse reactions in the two groups were monitored over time for comparison. RESULTS At pre-anesthesia induction, the remimazolam and propofol groups did not differ regarding heart rate, mean arterial pressure, cardiac index or volume per wave index. After endotracheal intubation and when the sternum was cut off, mean arterial pressure and volume per wave index were significantly higher in the remimazolam group than in the propofol group (P < 0.05). After endotracheal intubation, the oxygenation index and the respiratory index did not differ between the groups. After endotracheal intubation and when the sternum was cut off, the oxygenation index values were significantly higher in the remimazolam group than in the propofol group (P < 0.05). Serum interleukin-6 and tumor necrosis factor-α levels 12 h after surgery were significantly higher than before surgery in both groups (P < 0.05). The observation indices were re-examined 2 h after surgery, and the epinephrine, cortisol and blood glucose levels were significantly higher in the remimazolam group than in the propofol group (P < 0.05). The recovery and extubation times were significantly lower in the remimazolam group than in the propofol group (P < 0.05); there were significantly fewer adverse reactions in the remimazolam group (10.00%) than in the propofol group (30.00%; P < 0.05). CONCLUSION Compared with propofol, remimazolam benzenesulfonate benefited cardiac surgery patients under general anesthesia by reducing hemodynamic fluctuations. Remimazolam benzenesulfonate influenced the surgical stress response and respiratory function, thereby reducing anesthesia-related adverse reactions.

Summary Background The conduct and reporting of pilot studies is important to assess the feasibility of future randomized controlled trials (RCT). The Consolidated Standards of Reporting Trials (CONSORT) statement extension to pilot/feasibility studies addresses the reporting quality of the pilot studies (Summary Table 1). The aims of this systematic review are (1) to assess the reporting quality of pilot studies in pediatric urology and (2) to explore the factors that are associated with the reporting quality of these studies. Methods A comprehensive search was conducted through MEDLINE® and EMBASE® to identify pilot RCTs from 2005 to 2018. Two reviewers independently performed title and abstract screening and full text review, with discrepancies resolved by consensus. CONSORT extension reported items were summarized and overall proportion of reported items for each article was estimated. A linear regression model was conducted to determine factors associated with higher reporting quality. Publication year, biostatistician/epidemiologist support, sample size justification and journal impact factor were collected. Results Of the 1463 titles duplicates were removed and 1347 were screened, 36 studies were included. Overall, 36 pilot studies reported about 8–9 of 17 items [51% (95% CI: 46 – 56%)]. The most reported items were contact details for the corresponding author (97%), title identification of study as randomised pilot or feasibility trial (95%), eligibility criteria and setting (81%), both interventions (78%), and specific objectives of the pilot trial (75%). Less fulfilled items were blinding (11%), registration of the trial (11%), randomization details (28%), detailing recruitment status in the pilot study (19%), trial design (31%), and source of funding for pilot trial (34%). Interpretation of the results of pilot trial and their implications for the future definitive trial was reported by 34% of the studies. Factors associated with higher reporting quality were the presence of biostatistician or epidemiologist (P = 0.004), and if the sample size for the pilot study was justified (P = 0.002). Discussion Overall reporting quality of pilot studies in pediatric urology literature from 2005-2018 was suboptimal. The quality of pilot RCTs included in the present review were lower than that observed in the orthopedic literature, however, it appears to be consistent with the trends regarding OQS in chronic kidney disease and allopathic medicine. While we endeavoured to maintain utmost rigidity of this systematic review, there are inherent limitations. The CONSORT 2010 extension for pilot RCTs was published in 2016. Clinical trials can take several years, many pilot studies published pre-2016 would not have had the guidance of the extension during designing phases. Not all pilot RCTs are published, so this could potentially reduce the generalizability of the findings from this review. Only studies in English, published in full peer-reviewed journals were included, and this review only addressed the reporting quality of pilot studies in pediatric urology. Conclusion This review demonstrated that reporting quality of pilot studies in pediatric urology is currently suboptimal. Including biostatistician and/or epidemiologist, can ameliorate the quality of future pilot studies. Implementing CONSORT 2010 extension by journals as a prerequisite for submission of pilot or feasibility trials is recommended to improve the robustness and transparency of future pilot studies.

Learning from a few examples (one/few-shot learning) on the fly is a key challenge for on-device machine intelligence. We present the first chip-level demonstration of one-shot learning with Stanford Associative memory for Programmable, Integrated Edge iNtelligence via life-long learning and Search (SAPIENS), a resistive random access memory (RRAM)-based non-volatile associative memory (AM) chip that serves as the backend for memory-augmented neural networks (MANNs). The 64-kb fully integrated RRAM-CMOS AM chip performs long-term feature embedding and retrieval, demonstrated on a 32-way one-shot learning task on the Omniglot dataset. Using only one example per class for 32 unseen classes during on-chip learning, SAPIENS achieves 79% measured inference accuracy on Omniglot, comparable to edge software model accuracy using five-level quantization (82%). It achieves an energy efficiency of 118 GOPS/W at 200 MHz for in-memory L1 distance computation and prediction. Multi-bank measurements on the same chip show that increasing the capacity from three banks (24 kb) to eight banks (64 kb) improves the chip accuracy from 73.5% to 79%, while minimizing the accuracy excursion due to bank-to-bank variability.

Background Patients with lung cancer are at high risk for active tuberculosis (TB) but fragile status and drug-drug interaction might lead TB treatment interrupted. However, the occurrence and the predictors of TB treatment incompletion remain unclear among lung cancer patients. Methods We recruited patients with lung cancer with new-onset TB from Taiwan Cancer Registry and Taiwanese National Health Insurance databases from 2007 to 2015. TB treatment incompletion was identified as the primary outcome and we analysed the associated risk factors. Results A total of 1,155 lung cancer patients were identified with new-onset TB and were classified as treatment incompletion (n=706, 61.13%) and treatment completion (n=449) groups. Gender and age did not differ in both groups. Under multivariable logistic regression, advanced clinical cancer (stage III and IV), and no use of first-line TB drugs were independent factors for treatment incompletion. Old age did not play a role for the treatment incompletion. For the patients survived > 1 year, the independent factors for the incompletion included no first-line TB drugs except pyrazinamide and absence of hypertension. Cancer stage became borderline significance. Conclusions High TB treatment incompletion around 65.7% occurred in lung cancer patients. Advanced lung cancer stage and not using of first-line anti-TB drugs but not old age were associated with TB treatment incompletion of lung cancer patients. Hypertension in the patients survived > 1 year might be favourable for TB treatment completion. We need to titrate the TB treatment carefully in lung cancer patients especially with the risk factors to avoid treatment incompletion.

One of the major roadblocks for filamentary type resistive random access memory is variations in both the write voltage and the read resistance. The variation is inevitable because of the stochastic nature of oxygen ion movement inside the metal oxide. In this letter, we show that by inserting a thin SnO 2 layer within the HfO 2 switching layer, these variations can be significantly reduced. The TiN/HfO 2 /SnO 2 /HfO 2 /Pt material stack achieves ~ 10 times smaller standard deviation for the high resistance state( $>100\text{k}\Omega $ ) cycle to cycle distribution compared with the control group without the SnO 2 layer. The tight high resistance state distribution retained after 10 7 pulse cycling. Incremental RESET pulse measurement indicates that the thin SnO 2 acts as an oxygen stopping layer and thus explains the origin of reduced variability. The concept of an oxygen stopping layer is promising for reducing variability for resistive memory.

This study sought to explore the effects of COVID-19 exposure, pandemic-related appraisals and coping strategies on psychological symptoms among the front-line healthcare workers based on the transactional theory of stress and coping. A cross-sectional study was conducted in a Wuhan hospital designated for inpatients with COVID-19, assessing COVID-19 exposure (whether or not exposed to confirmed patients at workplace), psychological symptoms, appraisals, and coping strategies in 311 participants. Results revealed that the pandemic markedly affected healthcare workers' mental well-being through appraisal and coping, with 38.9% reporting high levels of psychological symptoms. Primary appraisal related closely with COVID-19 exposure, especially in female, while secondary appraisal was associated with problem-focused coping. Both problem-focused and emotion-focused coping had a protective effect against psychological symptoms, but also showed gender differences in its relations with other variables. These findings could potentially benefit to enrich relevant theories, and to develop psychological programs for future epidemics.

Background Patients with non-small cell lung cancer (NSCLC) are diagnosed in advanced stages and with a poor 5-year survival rate. There is a critical need to identify novel biomarkers to improve the therapy and overall prognosis of this disease. Methods Differentially expressed genes (DEGs) were identified from three profiles of GSE101586, GSE101684 and GSE112214 using Venn diagrams. hsa_circ_0043256 were validated using quantitative real-time polymerase chain reaction (RT-qPCR). The circular RNA-microRNA-messenger RNA (circRNA-miRNA-mRNA) regulatory network was constructed with Cytoscape 3.7.0. Hub genes were identified with protein interaction (PPI) and validated with the Gene Expression Profiling Interactive Analysis (GEPIA), Human Protein Atlas (HPA) databases, and immunohistochemistry. Survival analyses were also performed using a Kaplan-Meier (KM) plotter. The effects of hsa_circ_0043256 on cell proliferation and cell cycles were evaluated by EdU staining and flow cytometry, respectively. Results hsa_circ_0043256, hsa_circ_0029426 and hsa_circ_0049271 were obtained. Following RT-qPCR validation, hsa_circ_0043256 was selected for further analysis. In addition, functional experiment results indicated that hsa_circ_0043256 could inhibit cell proliferation and cell-cycle progression of NSCLC cells in vitro. Prediction by three online databases and combining with DEGs identified from The Cancer Genome Atlas (TCGA), a network containing one circRNAs, three miRNAs, and 209 mRNAs was developed. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis indicated DEGs might be associated with lung cancer onset and progression. A PPI network based on the 209 genes was established, and five hub genes (BIRC5, SHCBP1, CCNA2, SKA3, and GINS1) were determined. Following verification of five hub genes using GEPIA database, HPA database, and immunohistochemistry. High expression of all five hub genes led to poor overall survival. Conclusion Our study constructed a circRNA-miRNA-mRNA network of hsa_circ_0043256. hsa_circ_0043256 may be a potential therapeutic target for lung cancer.

To evaluate the midterm outcomes of penetrating keratoplasty (PK) following allogeneic cultivated limbal epithelial transplantation (CLET) for bilateral total limbal stem cell deficiency (LSCD)，ten patients (10 eyes) with bilateral LSCD were enrolled in this prospective noncomparative case series study. Each participant received a PK approximately 6 months after a CLET. Topical tacrolimus, topical and systemic steroids, and oral ciclosporin were given postoperatively. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), ocular surface grading scores (OSS), corneal graft epithelial rehabilitation, persistent epithelial defect (PED), immunological rejection, and graft survival rate were assessed. The time interval between PK and allogeneic CLET was 6.90 ± 1.29 (6-10) months. BCVA developed from 2.46±0.32 LogMAR preoperatively to 0.77±0.55 LogMAR post-PK (P

Background Several guidelines have suggested alternative glycemic markers for hemoglobin A1c among older adults with limited life expectancy or multiple coexisting chronic illnesses. We evaluated associations between fructosamine, albumin-corrected fructosamine (AlbF), fasting plasma glucose (FPG), and mortality in the diabetic and nondiabetic subpopulations, and compared which marker better predicts mortality among participants aged 80 and older. Methods Included were 2 238 subjects from the Healthy Ageing and Biomarkers Cohort Study (2012–2018) and 207 participants had diabetes at baseline. Multivariable Cox proportional hazards regression models investigated the associations of fructosamine, AlbF, FPG, and all-cause, cardiovascular disease (CVD), and non-CVD mortality in the diabetic and nondiabetic subpopulations. Restricted cubic splines explored potential nonlinear relations. C-statistic, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) evaluated the additive value of different glycemic markers to predict mortality. Results Overall, 1 191 deaths were documented during 6 793 person-years of follow-up. In the linear model, per unit increases of fructosamine, AlbF, and FPG were associated with a higher risk of mortality in nondiabetic participants, with hazard ratios of 1.02 (1.00, 1.05), 1.27 (1.14, 1.42), and 1.04 (0.98, 1.11) for all-cause mortality, and 1.04 (1.00, 1.07), 1.38 (1.19, 1.59), and 1.10 (1.01, 1.19) for non-CVD mortality, respectively. Comparisons indicated that AlbF better predicts all-cause and non-CVD mortality in nondiabetic participants with significant improvement in IDI and NRI. Conclusions Higher concentrations of fructosamine, AlbF, and FPG were associated with a higher risk of all-cause or non-CVD mortality among the very elderly where AlbF may constitute an alternative prospective glycemic predictor of mortality.

Malaria microscopy, microscopic examination of stained blood slides to detect parasite Plasmodium, is considered to be a gold-standard for detecting life-threatening disease malaria. Detecting the plasmodium parasite requires a skilled examiner and may take up to 10 to 15 minutes to completely go through the whole slide. Due to a lack of skilled medical professionals in the underdeveloped or resource deficient regions, many cases go misdiagnosed; resulting in unavoidable complications and/or undue medication. We propose to complement the medical professionals by creating a deep learning-based method to automatically detect (localize) the plasmodium parasites in the photograph of stained film. To handle the unbalanced nature of the dataset, we adopt a two-stage approach. Where the first stage is trained to detect blood cells and classify them into just healthy or infected. The second stage is trained to classify each detected cell further into the life-cycle stage. To facilitate the research in machine learning-based malaria microscopy, we introduce a new large scale microscopic image malaria dataset. Thirty-eight thousand cells are tagged from the 345 microscopic images of different Giemsa-stained slides of blood samples. Extensive experimentation is performed using different CNN backbones including VGG, DenseNet, and ResNet on this dataset. Our experiments and analysis reveal that the two-stage approach works better than the one-stage approach for malaria detection. To ensure the usability of our approach, we have also developed a mobile app that will be used by local hospitals for investigation and educational purposes. The dataset, its annotations, and implementation codes will be released upon publication of the paper.

Chiroptical nanomaterials have generated significant levels of interest for generating strong circularly polarized luminescence (CPL) signals. We used the Langmuir-Schaeffer technique to generate the continuous and compact assembly of CdSe/CdS chiral film. We assembled achiral CdSe/CdS nanorods by controlling the number of layers and angles between different layers. This allowed us to tailor chiroptical properties to achieve high CPL signals. The chiral film was symmetrical and had the highest circular dichroism (CD) response and CPL signals with ten layers (RH (right-handed)-/LH (left-handed)-5 + 5 layers) and a 45° inter-angle. Specifically, RH-5+5 of the chiral film exhibited 1431 mdeg of CD activity and strong CPL signals with a dissymmetry factor (glum) of 0.0997. The helical stacked crystal plates with linear birefringence resulted in strong circular birefringence, as determined by the Reusch model. Electromagnetic simulations indicated that such remarkable optical activity was attributed to the birefringence and dichroism of the well-aligned CdSe/CdS nanorod layers in the chiral films. Under right/left circular polarized (RCP/LCP) light excitation, the well aligned semiconductor nanorods exhibited differences in the coupling efficiencies to RCP and LCP light. Our CdSe/CdS chiral films, which exhibit ultra-strong CPL activity, will provide a novel strategy for the fabrication of chiroptical devices.

To assess associations between infants with macrosomia and placental expression levels of lipid activated/transport-related factors and umbilical cord blood lipid concentrations in healthy pregnancy. We conducted a case-control study of 38 macrosomic neonates (MS group) and 39 normal-birth-weight newborns (NC group) in a healthy pregnancy. Cord blood lipid levels were measured by automatic biochemical analyzer, mRNA and protein expression levels of placental lipid activated/transport-related factors were determined by real-time polymerase chain reaction and western blot, respectively. Compared with NC group, cord blood total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), and non-esterified fatty acid (NEFA) concentrations were decreased in the MS group. The mRNA and protein expression levels of placental peroxisome proliferator-activated receptors (PPARα, PPARγ), plasma membrane fatty acid-binding protein (FABPpm), and fatty acid translocase (FAT/CD36) were significantly higher in the MS group than the NC group. And there was a weak positive correlation between the expression of PPARγ, FABP4, and FABP3 mRNA in the placenta and the HDLC (rs = 0.439; P = 0.005), NEFA (rs = 0.342; P = 0.041), and TG (rs = 0.349; P = 0.034) levels in the cord blood in the MS group, respectively. After multivariate adjustment, the logistic regression analysis showed that high placental PPARα (adjusted odds ratio [AOR] = 3.022; 95% confidence interval [CI] 1.032-8.853) and FAT/CD36 (AOR=2.989; 95%CI 1.029-8.679) and low LDLC concentration in the cord blood (AOR=0.246; 95%CI 0.080-0.759) increased the risk of macrosomia. The increased PPARα and FAT/CD36 expression levels may influence the occurrence of fetal macrosomia through regulating placental lipid transport.

Two-stage exchange arthroplasty is a feasible treatment for chronic PJI (periprosthetic joint infection) of total hip arthroplasty (THA). However, there are large numbers of patients who are unable to ultimately receive reimplantation after resection arthroplasty owing to uncontrolled infection and multiple comorbidities. The purpose of the current study was to identify patient-related risk factors and reasons for being unable to undergo revision THA. Individuals undergoing resection arthroplasty for chronic PJI treatment from 2013 to 2020 at our institution were retrospectively reviewed. A variety of patient comorbidities, laboratory data, isolated pathogens, and follow-up status were collected for analysis. A total of 84 patients (46 men and 38 women) with a 2.7 ± 2.1-year follow-up were analyzed. Thirty-eight (45.2%) patients eventually underwent revision THA, while the other 46 (54.8%) did not receive reimplantation during follow-up. The patients without receiving reimplantation had higher Charlson comorbidity index (CCI) score (3.1 ± 2.9 versus 1.2 ± 1.5; p = 0.001). Lower cumulative incidence of receiving reimplantation was observed in patients with chronic kidney disease (log-rank test, p = 0.019), anemia (p = 0.011), presence of initial fever (p = 0.030), and oxacillin-resistant strain infection (p = 0.030). The most common reasons for not receiving reimplantation were uncontrolled infection, unstable medical conditions, and death. The patients without reimplantation had a relatively higher mortality rate (log-rank test, p = 0.002). Chronic hip PJI with poor medical conditions or oxacillin-resistant strain infection decreased the chance of undergoing revision surgery. These patients had unfavourable outcomes and a higher mortality rate after resection arthroplasty.

Colorectal cancer has the second highest incidence of malignant tumors and is the fourth leading cause of cancer deaths in China. Early diagnosis and treatment of colorectal cancer will lead to an improvement in the 5-year survival rate, which will reduce medical costs. The current diagnostic methods for early colorectal cancer include excreta, blood, endoscopy, and computer-aided endoscopy. In this paper, research on image analysis and prediction of colorectal cancer lesions based on deep learning is reviewed with the goal of providing a reference for the early diagnosis of colorectal cancer lesions by combining computer technology, 3D modeling, 5G remote technology, endoscopic robot technology, and surgical navigation technology. The findings will supplement the research and provide insights to improve the cure rate and reduce the mortality of colorectal cancer.

Acute lung injury (ALI) is a sudden onset systemic inflammatory response. ALI causes severe morbidity and death and currently no effective pharmacological therapies exist. Natural products represent an excellent resource for discovering new drugs. Screening anti-inflammatory compounds from the natural product bank may offer viable candidates for molecular-based therapies for ALI. In this study, 165 natural compounds were screened for anti-inflammatory activity in lipopolysaccharide (LPS)-challenged macrophages. Among the screened compounds, flavokawain B (FKB) significantly reduced LPS-induced pro-inflammatory IL-6 secretion in macrophages. FKB also reduced the formation of LPS/TLR4/MD2 complex by competitively binding to MD2, suppressing downstream MAPK and NF-κB signaling activation. Finally, FKB treatment of mice reduced LPS-induced lung injury, systemic and local inflammatory cytokine production, and macrophage infiltration in lungs. These protective activities manifested as increased survival in the ALI model, and reduced mortality upon bacterial infection. In summary, we demonstrate that the natural product FKB protects against LPS-induced lung injury and sepsis by interacting with MD2 and inhibiting inflammatory responses. FKB may potentially serve as a therapeutic option for the treatment of ALI.

Background Whether hepatitis B virus (HBV) infection poses risk to patients with nasopharyngeal carcinoma (NPC) in the intensity-modulated radiotherapy (IMRT) era remains unclear. Methods 953 patients with non-metastatic, newly diagnosed NPC who received detection of serologic hepatitis B surface antigen (HBsAg) and treated with IMRT were retrospectively reviewed. 171 patients had HBV infection (HBsAg seropositive). Propensity score matching method (PSM) and stabilized inverse probability of treatment weighting (IPTW) were used to address confounding. The survival rates were evaluated by Kaplan-Meier analysis and the survival curves were compared by Log-rank test. Prognostic factors were explored by multivariate analysis. Results No significant survival differences were observed between HBsAg-negative group and HBsAg-positive group [5-year overall survival (OS), 87.7% vs. 83.9%, P=0.181; locoregional recurrence-free survival (LRFS), 83.5% vs. 78.3%, P=0.109; distant metastasis-free survival (DMFS), 80.2% vs. 77.9%, P=0.446; progression-free survival (PFS), 77.4% vs. 71.4%, P=0.153], consistent with the results of PSM and IPTW analysis. Further analyses revealed that HBV infection was an independent prognostic factor for poor OS [multivariate analysis; hazard ratio (HR), 3.74; 95% confidence interval (CI), 1.45–9.68; P=0.006], LRFS (HR, 2.86; 95% CI, 1.37–5.95); P=0.005] in patients with stage N1, DMFS (HR, 2.65; 95% CI, 1.15–6.09; P=0.022) and PFS (HR, 2.63; 95% CI, 1.34–5.14; P=0.005). Among HBsAg-positive patients, liver protection improved OS (90.3% vs. 77.2%; P=0.022). Conclusions HBV infection is an independent risk factor for patients with stage N1 NPC in the IMRT era. Hepatic protection may benefit the survival of HBsAg-positive patients.

Flavonoid glycoside scutellarin (SCU) has been widely applied in the treatment of cerebral ischemic diseases in China. In this article, we conducted research on the working mechanisms of SCU in hypoxia reoxygenation (HR) injury of isolated cerebral basilar artery (BA) and erebral ischemia reperfusion (CIR) injury in rat models. In isolated rat BA rings, HR causes endothelial dysfunction (ED) and acetylcholine (ACh) induces endothelium-dependent vasodilation. The myography result showed that SCU (100 µM) was able to significantly improve the endothelium-dependent vasodilation induced by Ach. However, SCU did not affect the ACh-induced relaxation in normal BA. Further studies suggested that SCU (10–1000 µM) dose-dependently induced relaxation in isolated BA rings which were significantly blocked by the cGMP dependent protein kinase (PKG) inhibitor Rp-8-Br-cGMPs (PKGI-rp, 4 µM). Pre-incubation with SCU (500 µM) reversed the impairment of endothelium-dependent vasodilation induced by HR, but the reversing effect was blocked if PKGI-rp (4 µM) was added. The brain slice staining test in rats’ model of middle cerebral artery occlusion (MCAO) induced CIR proved that the administration of SCU (45, 90 mg/kg, iv) significantly reduced the area of cerebral infarction. The Western blot assay result showed that SCU (45 mg/kg, iv) increased brain PKG activity and PKG protein level after CIR surgery. In conclusion, our findings suggested that SCU possesses the ability of protecting brain cells against CIR injury through vascular endothelium protection and PKG signal. Graphic Abstract

A Trunk Line Based Geographic Routing(TLBGR) protocol in Vehicular Ad-hoc Networks (VANETs) is proposed in this paper to solve the problem of data acquisition in the traditional trunk coordinated control system. Because of the characteristics of short communication time and high packet loss among vehicles, the vehicles entering the trunk lines can not transmit their information to the trunk coordinated control system stably. To resolve this problem, the proposed protocol uses the trunk lines’ traffic flow and the surrounding road network to provide a real-time data transmission routing scheme. It takes into account the data congestion problem caused by the large traffic flow of the main roads, which leads to the corresponding increase of the information flow of the section and the package loss, and the link partition problem caused by the insufficient traffic flow, which makes the vehicles have to carry and relay information thus increasing the transmission delay. The proposed TLBGR protocol can be divided into two stages: the next-intersection selection, and the next-hop selection in the chosen path between the current and next intersections. Simulation results show that, compared with other IoT routing protocols including Greedy Perimeter Stateless Routing (GPSR), Ad-hoc On Demand Vector (AODV), and Q-AODV, the TLBGR protocol has better performance in aspects of end-to-end delay, delivery rate, and routing cost under the scenario of urban traffic trunk lines. The TLBGR protocol can effectively avoid data congestion and local optimum problems, increase the delivery rate of data packets, and is therefore suitable for the routing requirements in this application scenario.

This study aimed to investigate alterations of brain functional network connectivity (FNC) in lung cancer patients after chemotherapy and explore links between these FNC differences and cognitive impairment. Twenty-two lung cancer patients receiving chemotherapy and 26 healthy controls (HCs) underwent resting-state functional MRI (rs-fMRI) and neuropsychological testing. Group independent component analysis (GICA) was applied to rs-fMRI data to extract whole-brain resting state networks (RSNs). Static and dynamic FNC (dFNC) were constructed to reveal RSNs connectivity alterations between lung cancer patients and HCs group, and the correlations between the group differences in RSNs and cognitive performance were analyzed. Our findings revealed that chemotherapeutics can produce widespread connectivity abnormalities in RSNs, mainly focused on default mode network (DMN) and executive control network. Furthermore, the dFNC analysis help identify network configurations of each state and capture more chemotherapy-induced disorders of interactions between and within RSNs, which mainly includes sensorimotor network, attentional network and auditory network. In addition, after chemotherapy, the lung cancer patients spend shorter mean dwell time (MDT) in state 2. The decreased dFNC between DMN [independent component 5 (IC5)] and DMN (IC6) in the lung cancer patients after chemotherapy in state 4 was negatively correlated with Montreal Cognitive Assessment (MoCA) scores (r=-0.447, p=0.042). The dFNC analysis enrich our understanding of the neural mechanisms underlying the chemobrain, and suggested that the temporal dynamics of FNC could be a potential effective method to detect cognitive changes in lung cancer patients receiving chemotherapy.

Rationale:Timely inhibition of inflammation and initiation of resolution are important to repair injured tissues. MST1/2 (mammalian STE20-like protein kinase 1/2) acts as a regulator of macrophage-associated immune responses to bacterial infections. However, the role of MST1/2 in regulating macrophage phenotype and function in myocardial infarction (MI) remains unclear.Objective:To determine the function and underlying mechanism of macrophage MST1/2 in cardiac repair post-MI.Methods and Results:UsingLysMCre-mediatedMst1/2-deficient mice, we found that MST1 deficiency exacerbated cardiac dysfunction after MI. Single-cell RNA sequencing assay indicated that the effect was attributed to a shift of macrophage subtypes from those expressingCxcl2andCd163towardCcl2andCcl4expression. Mass spectrometry identified LTB4 (leukotriene B4) as the lipid mediator that was upregulated in the absence of MST1. We found that MST1 phosphorylated 5-LOX (5-lipoxygenase) at its T218 residue, disrupting the interaction between 5-LOX and 5-LOX-activating protein, resulting in a reduction of LTB4 production. In contrast, a 5-LOXT218Avariant showed no response to MST1. Moreover, treatment of peritoneal macrophages with LTB4 or medium conditioned byMst1-deficient macrophages resulted in highCcl2andCcl4expression and lowCxcl2andCd163expression, except when the cells were co-treated with the BLT1 (LTB4 receptor 1) antagonist CP105696. Furthermore, CP105696 ameliorated cardiac dysfunction inLysMCre-mediatedMst1/2-deficient mice and enhanced cardiac repair in wild-type mice treated with XMU-MP-1 (4-((5,10-dimethyl-6-oxo-6,10-dihydro-5H-pyrimido[5,4-b]thieno[3,2-e][1,4]diazepin-2-yl)amino)benzenesulfonamide) after MI.Conclusions:Taken together, our results demonstrate that inhibition of MST1/2 impaired post-MI repair through activating macrophage 5-LOX–LTB4–BLT1 axis.

As a key use case of Industry 4.0 and the Smart City, the Internet of Vehicles (IoV) provides an efficient way for city managers to regulate the traffic flow, improve the commuting performance, reduce the transportation facility cost, alleviate the traffic jam, and so on. In fact, the significant development of Internet of Vehicles has boosted the emergence of a variety of Industry 4.0 applications, e.g., smart logistics, intelligent transforation, and autonomous driving. The prerequisite of deploying these applications is the design of efficient data dissemination schemes by which the interactive information could be effectively exchanged. However, in Internet of Vehicles, an efficient data scheme should adapt to the high node movement and frequent network changing. To achieve the objective, the ability to predict short-term traffic is crucial for making optimal policy in advance. In this article, we propose a novel data dissemination scheme by exploring short-term traffic prediction for Industry 4.0 applications enabled in Internet of Vehicles. First, we present a three-tier network architecture with the aim to simply network management and reduce communication overheads. To capture dynamic network changing, a deep learning network is employed by the controller in this architecture to predict short-term traffic with the availability of enormous traffic data. Based on the traffic prediction, each road segment can be assigned a weight through the built two-dimensional delay model, enabling the controller to make routing decisions in advance. With the global weight information, the controller leverages the ant colony optimization algorithm to find the optimal routing path with minimum delay. Extensive simulations are carried out to demonstrate the accuracy of the traffic prediction model and the superiority of the proposed data dissemination scheme for Industry 4.0 applications.