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Two quantitative PCR (qPCR)–based methods, for clonal immunoglobulin or T-cell receptor gene (Ig/TCR) rearrangements and for fusion transcripts, are widely used for the measurement of minimal residual disease (MRD) in patients with B-precursor acute lymphoblastic leukemia (ALL). MRD of bone marrow samples from 165 patients carrying the three major fusion transcripts, including 74 BCR-ABL1, 54 ETV6-RUNX1, and 37 TCF3-PBX1, was analyzed by using the two qPCR-based methods. The correlation coefficient of both methods was good for TCF3-PBX1 (R2 = 0.8088) and BCR-ABL1 (R2 = 0.8094) ALL and moderate for ETV6-RUNX1 (R2 = 0.5972). The concordance was perfect for TCF3-PBX1 ALL (97.2%), substantially concordant for ETV6-RUNX1 ALL (87.1%), and only moderate for BCR-ABL1 ALL (70.6%). The discordant MRD, positive for only one method with a difference greater than one log, was found in 4 of 93 samples (4.3%) with ETV6-RUNX1, 31 of 245 samples (12.7%) with BCR-ABL1, and none of TCF3-PBX1 ALL. None of the eight non-transplanted patients with BCR-ABL1-MRD (+)/Ig/TCR-MRD (–) with a median follow-up time of 73.5 months had hematologic relapses. Our study showed an excellent MRD concordance between the two qPCR-based methods in TCF3-PBX1 ALL, whereas qPCR for Ig/TCR is more reliable in BCR-ABL1 ALL.

Background Maxacalcitol was approved in Taiwan in 2018 as the first active vitamin D3 injection for secondary hyperparathyroidism (SHPT) in patients on maintenance hemodialysis. However, no data from any clinical study with maxacalcitol in Taiwanese patients is available. Objectives This analysis aimed to evaluate the profiles of parathyroid hormone (PTH) and calcium (Ca) concentrations in Taiwanese SHPT patients on hemodialysis and maxacalcitol. Methods We developed population pharmacokinetic (PK) and pharmacodynamic (PD) models using a modeling and simulation approach. The data for these analyses were obtained from two studies: a clinical pharmacology study in Japanese patients and an ethnic comparison study in healthy Japanese and -Taiwanese volunteers. We then conducted a simulation study with a PK-PD model comprising the PK and PD models developed here. Results Serum maxacalcitol concentration profile was modeled using a two-compartment model that took into consideration the distribution of concentrations below the lower limit of quantification. An ethnic difference in clearance was included in the PK model as a covariate. A PD model that used a PTH/Ca feedback loop best described the observed data. There were no significant differences in Ca or PTH concentrations between Taiwanese and Japanese based on the simulation results from our PK-PD model, even though maxacalcitol exposure was approximately 40% higher in Taiwanese than in Japanese. Conclusions On the basis of these population PK and PD analyses and the clinical study conducted in Japan, there is no clinically relevant difference between Taiwanese and Japanese in terms of serum Ca or PTH levels.

Emerging wearable electronics, wireless communication, and tissue engineering require the development of conductive fiber-shaped electrodes and biointerfaces. Ti3C2Tx MXene nanosheets serve as promising building block units for the construction of highly conductive fibers with integrated functionalities, yet a facile and scalable fabrication scheme is highly required. Herein, a cation-induced assembly process is developed for the scalable fabrication of conductive fibers with MXene sheaths and alginate cores (abbreviated as MXene@A). The fabrication scheme of MXene@A fibers includes the fast extrusion of alginate fibers followed by electrostatic assembly of MXene nanosheets, enabling high-speed fiber production. When multiple fabrication parameters are optimized, the MXene@A fibers exhibit a superior electrical conductivity of 1083 S cm-1, which can be integrated as Joule heaters into textiles for wearable thermal management. By triggering reversible de/hydration of alginate cores upon heating, the MXene@A fibers can be repeatedly contracted and generate large contraction stress that is >40 times higher than the ones of mammalian skeletal muscle. Furthermore, the MXene@A springs demonstrate large contraction strains up to 65.5% and are then fabricated into a reconfigurable dipole antenna to wirelessly monitor the surrounding heat sources. In the end, with the biocompatibility of MXene nanosheets, the MXene@A fibers enable the guidance of neural stem/progenitor cells differentiation and the promotion of neurite outgrowth. With a cation-induced assembly process, our multifunctional MXene@A fibers exhibit high scalability for future manufacturing and hold the prospect to inspire other applications.

Background Hepatoblastoma (HB) is the most common childhood primary hepatic malignancy. The overall survival rate in patients with HB has reached more than 80% over the past decades. The poor prognostic and high-risk HB have been defined, but the treatment and cure of refractory or relapsed HB is still an arduous task. Methods The complete records of HB in patients under the age of 18 at the MacKay Memorial Hospital between 1990 and 2019 were examined. Results The treatment results for 11 patients with refractory or relapsed HB are presented. The multi-modality treatment records were reviewed and the clinical characteristics associated with poor outcome included multifocal lesions, low α-fetoprotein, great vessel invasion and metastases. Delayed liver tumor surgery was carried out in eight cases. The median duration of follow-up for the 11 patients was 48.6 months (range 1.9 to 316.8 months). The 5-year and 10-year overall survival rate were 62.3% ± 15% (SE) and 49.9% ± 16.4% (SE), respectively. Most treatment-related toxicities were tolerable. The major concern during long term follow-up was irreversible high-frequency hearing loss. Conclusion Patients with refractory/relapsed HB are still a thorny issue and more research is needed to improve the outcome.

Cheng-Kun Wu,1 Chien-Ning Hsu,2,3 Wei-Ru Cho,1 Shih-Cheng Yang,1 An-Che Liu,4 Wei-Chen Tai,1 Chen-Hsiang Lee,5 Yao-Hsu Yang,6– 8 Seng-Kee Chuah,1 Chih-Ming Liang1 1Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 2Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; 3School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 5Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 6Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; 7Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan; 8School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, TaiwanCorrespondence: Chih-Ming LiangDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Dabi Road, Kaohsiung, 833, TaiwanTel +886-7-731-7123, ext. 8301Fax +886-7-732-2402Email gimy54861439@gmail.comBackground and Aim: Endoscopic sphincterotomy (ES) abolished the barrier between the hepatobiliary system and duodenum and might be at risk of pyogenic liver abscess (PLA). We aimed to identify the association factors of PLA in patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) procedures for treatment of choledocholithiasis.Methods: This study was based on the Chung Gung Research Database (CGRD) between January 1, 2001 and December 31, 2018. Those who had an International Classification of Diseases, Ninth and Tenth Revision (ICD9 and ICD10) codes of choledocholithiasis and received ERCP were enrolled. After strict exclusions, 11,697 patients were further divided into the endoscopic sphincterotomy (ES) group (n=7,111) and other ERCP group (n=4,586) for analysis.Results: Patients receiving ES had significantly higher rates of PLA than those of the other ERCP group (5-year cumulative incidence 2.4% versus 1.7%; 10-year cumulative incidence 3.9% versus 3.2%, log-rank p=0.0177). Aging, male gender, surgery for hepato-pancreato-biliary system and hepatobiliary malignancy were significant association factors of PLA. On multivariate analysis, the ES increased the risk of PLA (adjusted hazard ratio [aHR]=1.49; 95% CI=1.12– 1.98; p=0.0058) but decreased the risks for acute pancreatitis (aHR=0.72; 95% CI=0.60– 0.85; p=0.0002) and cholangitis (aHR= 0.91; 95% CI=0.84– 0.99; p=0.0259). There was no significant difference about recurrent choledocholithiasis between groups.Conclusion: This study demonstrated a significant risk of PLA after patients receiving ES compared with the other ERCP group. We should also carefully monitor the association factors of PLA after ERCP treatment of choledocholithiasis including aging, male gender, surgery for the hepato-pancreato-biliary system and hepatobiliary malignancy.Keywords: pyogenic liver abscess, endoscopic sphincterotomy, choledocholithiasis, endoscopic retrograde cholangiopancreatography

SARS-CoV-2 infection, which is responsible for the current COVID-19 pandemic, can cause life-threatening pneumonia, respiratory failure and even death. Characterizing SARS-CoV-2 pathogenesis in primary human target cells and tissues is crucial for developing vaccines and therapeutics. However, given the limited access to clinical samples from COVID-19 patients, there is a pressing need for in vitro/in vivo models to investigate authentic SARS-CoV-2 infection in primary human lung cells or tissues with mature structures. The present study was designed to evaluate a humanized mouse model carrying human lung xenografts for SARS-CoV-2 infection in vivo. Methods: Human fetal lung tissue surgically grafted under the dorsal skin of SCID mice were assessed for growth and development after 8 weeks. Following SARS-CoV-2 inoculation into the differentiated lung xenografts, viral replication, cell-type tropism and histopathology of SARS-CoV-2 infection, and local cytokine/chemokine expression were determined over a 6-day period. The effect of IFN-α treatment against SARS-CoV-2 infection was tested in the lung xenografts. Results: Human lung xenografts expanded and developed mature structures closely resembling normal human lung. SARS-CoV-2 replicated and spread efficiently in the lung xenografts with the epithelial cells as the main target, caused severe lung damage, and induced a robust pro-inflammatory response. IFN-α treatment effectively inhibited SARS-CoV-2 replication in the lung xenografts. Conclusions: These data support the human lung xenograft mouse model as a useful and biological relevant tool that should facilitate studies on the pathogenesis of SARS-CoV-2 lung infection and the evaluation of potential antiviral therapies.

Background Gallstones are uncommon in infants and children and Asian children are thought to have very low risk. Diagnoses have increased in recent years with the widespread use of ultrasonography (USG). This study aimed to review our experience with risk factors, complications, and treatment of pediatric gallstones in low-incidence populations. Methods We retrospectively reviewed patients younger than 18 years old diagnosed with gallstones using USG between November 2006 and December 2012 in a tertiary referral hospital in Taiwan. Demographic information including age and sex, follow-up period, USG findings, predisposing factors, complications, treatment approaches and outcomes were recorded. Results Ninety-eight children with gallstones diagnosed with USG were enrolled and reviewed in our study. Females comprised 55% of patients, with no specific gender tendency. No risk factor could be identified in 30.8% of patients. The most common risk factors were cephalosporin (CS) use, presence of a choledochal cyst (CC), and spherocytosis. CS use was not associated with a higher dissolution rate. The presence of type IVa CC implied a high rate of gallstone recurrence after Roux-en-Y hepaticojejunostomy. Complications were seen in 22.4% of patients, but only two needed emergency stone removal. Expectant management was performed in 61% of patients and 62.5% of them achieved spontaneous resolution; the stone dissolution rate was not lower than in the group treated with ursodeoxycholic acid (UDCA). Stone size was significantly decreased after UDCA use if resolution did not occur. Conclusions Pediatric gallstones showed high resolution rate, and the clinical course was largely benign. CS use was the most common risk factor and did not predict a higher dissolution rate. Type IVa CC was also an important risk factor associated with a high recurrence rate. Conservative treatment and oral UDCA may be reasonable strategies in most patients, unless complications are present.

The surface modification of a layer substrate has received attention for many biomedical applications (e.g., tissue engineering and biosensing). Under an in situ control, we proposed a strategy for surface modification of hard and brittle ceramics with ultrafast laser pulses for cell culture. A type of ultrafast laser based on the picosecond pulse technique was employed to ablate the surface of a pristine aluminum oxide (Al2O3) substrate. The surface of the formed reproducible micro-nanostructures indicated the fish-scale structures, which was analyzed under different laser ablation conditions. Subsequently, the SV40 T-antigen human embryonic kidney 293 (HEK293T) cells were cultured on the laser-ablated Al2O3 substrates. These microstructures and nanostructures can enhance cell proliferation response. The surface effect played a crucial role, by which the surface roughness (Ra) and contact angle (CA) of water droplets on the ablated Al2O3 substrate increased with the increasing laser fluence. The formed fish-scale structures were formed by the parameters of laser ablation where the structural characteristics of the Al2O3 substrate can be remained in the ultrafast laser process. The presented process provides a simple support for developing ablated structures on the Al2O3 substrate for cell culture.

For the intelligence of metamaterials, the -sensing mechanism and programmable reaction units are two important components for self-recognition and -determination. However, their realization still face great challenges. Here, we propose a smart sensing metasurface to achieve self-defined functions in the framework of digital coding metamaterials. A sensing unit that can simultaneously process the sensing channel and realize phase-programmable capability is designed by integrating radio frequency (RF) power detector and PIN diodes. Four sensing units distributed on the metasurface aperture can detect the microwave incidences in the x- and y-polarizations, while the other elements can modulate the reflected phase patterns under the control of a field programmable gate array (FPGA). To validate the performance, three schemes containing six coding patterns are presented and simulated, after which two of them are measured, showing good agreements with designs. We envision that this work may motivate studies on smart metamaterials with high-level recognition and manipulation.

Highlights • It is difficult to visualize extra-hepatic biliary anatomy clearly because of long-presence of ICG in liver when administered intravenously. • Intracholecystic ICG injection illuminates extra-hepatic biliary tree preferentially thus reducing background hepatic noise. • Surgeons can experience more satisfaction with the use of fluorescent cholangiography during laparoscopic cholecystectomy when the intracystic route of ICG administration is utilized., Introduction The utility of intracystic administration of indocyanine green for near-infrared fluorescent cholangiography in acute calculous cholecystitis initially treated with percutaneous transhepatic gallbladder drainage (PTGBD) was described in this report. Presentation of case Two cases who underwent near-infrared fluorescent cholangiography guided interval laparoscopic cholecystectomy two weeks post-PTGBD were studied retrospectively. Both patients were diagnosed with moderate acute calculous cholecystitis based on diagnostic criteria of the Tokyo guidelines. Two routes of indocyanine green administration were utilized during surgery, first through direct intracystic administration through PTGBD tube (5 ml of 12.5 mg ICG) to achieve critical view of safety and then intravenous administration (1 ml of 2.5 mg ICG) to visualize cystic artery. Discussion Both patients had critical view of safety visualized clearly with ICG with the operation time of 84 and 125 min in cases 1 and 2, respectively without any intra or postoperative complications. Conclusion In comparison with intravenous ICG administration, trans-PTGBD ICG route can provide better signal-to-noise ratio by avoiding hepatic fluorescence and thus increasing the bile duct to liver contrast. However, ICG may enter the lymphatic system through necrotic and inflammatory gallbladder mucosa, of which lymph spillage during gallbladder dissection can obscure the fluorescent view.

Comparison of treatment strategies in de novo pediatric acute lymphoblastic leukemia (ALL) requires standardized measures of efficacy. Key parameters that define disease-related events, including complete remission (CR), treatment failure (TF; not achieving CR), and relapse (loss of CR) require an updated consensus incorporating modern diagnostics. We collected the definitions of CR, TF, and relapse from recent and current pediatric clinical trials for the treatment of ALL, including the key components of response evaluation (timing, anatomic sites, detection methods, and thresholds) and found significant heterogeneity, most notably in the definition of TF. Representatives of the major international ALL clinical trial groups convened to establish consensus definitions. CR should be defined at a time point no earlier than at the end of induction and should include the reduction of blasts below a specific threshold in bone marrow and extramedullary sites, incorporating minimal residual disease (MRD) techniques for marrow evaluations. TF should be defined as failure to achieve CR by a prespecified time point in therapy. Relapse can only be defined in patients who have achieved CR and must include a specific threshold of leukemic cells in the bone marrow confirmed by MRD, the detection of central nervous system leukemia, or documentation of extramedullary disease. Definitions of TF and relapse should harmonize with eligibility criteria for clinical trials in relapsed/refractory ALL. These consensus definitions will enhance the ability to compare outcomes across pediatric ALL trials and facilitate development of future international collaborative trials.

Full list of authors: Kim, Minbin; Ripa, Jakub; Park, Il H.; Bogomolov, Vitaly; Brandt, Søren; Budtz-Jørgensen, Carl; Castro-Tirado, Alberto J.; Chang, Sheng-Hsiung; Chang, Yenyun; Chen, Chia Ray; Chen, C. -W.; Chen, Pisin; Connell, Paul; Eyles, Chris; Gaikov, Georgii; Hong, Gihan; Huang, Jian Jung; Huang, Ming-Huey Alfred; Jeong, Soomin; Kim, Jieun; Lee, Jik; Lim, Heuijin; Lin, Chih-Yang; Liu, Tsung-Che; Nam, Jiwoo; Panasyuk, Mikhail; Petrov, Vasily; Reglero, Victor; Rodrigo, Juana M.; Svertilov, Sergey; Vedenkin, Nikolay; Wang, Ming Zu; Yashin, Ivan.--This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., We developed an X-ray detector using 36 arrays, each consisting of a 64-pixellated yttrium oxyorthosilicate (YSO) scintillation crystal and a 64-channel multi-anode photomultiplier tube. The Xray detector was designed to detect X-rays with energies lower than 10 keV, primarily with the aim of localizing gamma-ray bursts (GRBs). YSO crystals have no intrinsic background, which is advantageous for increasing low-energy sensitivity. The fabricated detector was integrated into UBAT, the payload of the Ultra-Fast Flash Observatory (UFFO)/Lomonosov for GRB observation. The UFFO was successfully operated in space in a low-Earth orbit. In this paper, we present the responses of the X-ray detector of the UBAT engineering model identical to the flight model, using241 Am and55 Fe radioactive sources and an Amptek X-ray tube. We found that the X-ray detector can measure energies lower than 5 keV. As such, we expect YSO crystals to be good candidates for the X-ray detector materials for future GRB missions. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland., This study was supported by grants from the Korean National Research Foundation (NRF-2017K1A4A3015188, NRF-2021R1A2B5B03002645, and NRF-2019H1D3A2A02060090). The Russian work was partially supported by ROSCOSMOS grants and by RFFI grant No. 13-02-12175 and No.15-35-21038 and support from the Development Program of Lomonosov Moscow State University is acknowledged. AJCT acknowledges support from the Spanish MINECO Projects AYA 2009-14000-C03-01/ESP and AYA2015-1718-R (including EU/FEDER funds). The authors thank Taiwan’s National Science Council Vanguard Program (100-2119-M-002-025) and Ministry of Science and Technology (MOST) for the funding (104-2811-M-002-160). MBK acknowledges the support from NRF-2015-GPF., With funding from the Spanish government through the Severo Ochoa Centre of Excellence accreditation SEV-2017-0709.

Limited data are available on antimicrobials exposure and microbiology evolution in pediatric acute myeloid leukemia (AML) patients underwent antimicrobials prophylaxis. To assess the effectiveness of antimicrobials prophylaxis, antibiotic susceptibilities of bacteria, and exposure of antimicrobials during intensive chemotherapy for AML patients, 90 consecutive de novo AML patients aged 0–18 years between January 1, 1997 and March 31, 2018 were enrolled. Vancomycin, ciprofloxacin and voriconazole prophylaxis was administered from January 1, 2010. During the preprophylaxis period, January 1997 to December 2009, 62 patients experienced a total of 87 episodes of bloodstream infection (BSI) and 17 episodes of invasive fungal infection (IFI) among 502 courses of chemotherapy. In contrast, 16 episodes of BSI occurred and no IFIs were reported to occur in 28 patients who received 247 courses of chemotherapy in the prophylaxis period. Patients who received antimicrobial prophylaxis had a significant reduction of BSI, IFI, and febrile neutropenia in comparison with patients without prophylaxis. Exposure to amikacin, carbapenem, amphotericin B was reduced in the prophylaxis period. Imipenem susceptibility of Enterobacter cloacae as well as vancomycin susceptibility of Enterococcus species were reduced in the prophylaxis period. At the time of the last follow up, patients with prophylaxis had a better subsequent 5-year overall survival rate than those without prophylaxis. Prophylactic antimicrobials administration in children with AML who undergo chemotherapy can significantly reduce the rates of life-threatening infection, exposure to antimicrobials, and might result in a better outcome.

Objective Determine long term (11 year) trends in gabapentin and pregabalin prescribing among workers' compensation claimants at various opioid dose combinations (low, medium, high, and very high) in Louisiana. Method A longitudinal study of 18,737 claimants who filled any prescriptions between 2008 and 2018. Results The proportion of claimants prescribed opioids alone at all dose levels decreased dramatically. The proportion claimants prescribed the combination of low dose opioids and low dose gabapentinoids increased (7.7% to10.9%). Prescribing higher daily doses of gabapentinoids was associated with higher daily doses of opioids. Gabapentinoid prescribing was associated with continued prescribing of medium and high dose opioids as claims matured. Conclusions Overall opioid prescribing decreased over time, while prescribing low dose opioids with gabapentinoids, increased.

Recently, programmable metasurfaces have aroused great attention for various applications such as beam manipulation, wireless communication, and holograms by modulating the spatial phase or amplitude. However, programmable amplitude‐coding modulations have rarely been investigated due to the difficulty in realizing dynamic control of amplitude. Herein, a real‐time programmable amplitude‐coding metasurface with multifrequency modulation is proposed by integrating PIN diodes and chip attenuators to the metaelement. The element is encoded as “11,” “10,” and “00,” corresponding to the ON/OFF states of two diodes. By switching the two states of the PIN diode, the metaelement exhibits distinctly reflected amplitude responses in three frequencies (2.98, 4.11, and 5.73 GHz). For the whole metasurface, the magnitude of the reflected beam can be modulated with some specific coding patterns. To verify the performance, six coding patterns with 10 × 10 metaelements are designed, and four of them are measured. Experimental results are fundamentally consistent with theoretical designs and simulations. Further a wireless communication demonstration is designed and implemented to perform direct modulation of digital signals without using mixers required in the conventional wireless communication systems. It is envisioned that this work will find applications in new architecture encrypted communication and imaging systems.

The NASA supported High-Altitude Calibration (HiCal)-2 instrument flew as a companion balloon to the ANITA-4 experiment in December 2016. Based on a HV discharge pulser producing radio-frequency (RF) calibration pulses, HiCal-2 comprised two payloads, which flew for a combined 18 days, covering 1.5 revolutions of the Antarctic continent. ANITA-4 captured over 10,000 pulses from HiCal, both direct and reflected from the surface, at distances varying from 100-800 km, providing a large dataset for surface reflectivity measurements. Herein we present details on the design, construction and performance of HiCal-2., Comment: Published in NIM-A, final version

Studies of childhood anaplastic large cell lymphoma (ALCL) are less reported from East Asian countries. Clinical features and outcome of 90 children with ALCL in Taiwan were analyzed. The median age at diagnosis was 11.7 years. The most common presentation was lymph node involvement (86.7%). Advanced diseases accounted for 70% of patients at diagnosis. Most patients (93.1%) had positive staining for anaplastic lymphoma kinase. The five-year overall survival and event-free survival (EFS) rates were 79.7% and 73.3%, respectively. Bone marrow involvement, advanced stage, and thoracopulmonary ALCL were adverse prognostic factors for EFS (

Improvement in outcomes of children with acute myeloid leukemia (AML) is attributed to several refinements in clinical management. We evaluated treatment outcomes of Taiwanese pediatric AML patients in the past 20 years. Overall, 860 de novo AML patients aged 0–18 years and registered in the Childhood Cancer Foundation of R.O.C during January 1996–December 2019 were included. Survival analysis was performed to identify factors that improved treatment outcomes. Regardless of treatment modalities used, patients during 2008–2019 had better 5-year event-free survival (EFS) and overall survival (OS) rates than patients during 1996–2007. For patients received the TPOG-AML-97A treatment, only 5-year OS rates were significantly different between patients diagnosed before and after 2008. Patients with RUNX1–RUNX1T1 had similar relapse-free survival rates, but 5-year OS rates were better during 2008–2019. However, the survival of patients who received hematopoietic stem-cell transplantations (HSCT) did not differ significantly before and after 2008. For patients without relapse, the 5-year OS improved during 2008–2019. Non-relapse mortality decreased annually, and cumulative relapse rates were similar. In conclusion, 5-year EFS and OS rates improved during 2008–2019, though intensities of chemotherapy treatments were similar before and after 2008. Non-relapse mortality decreased gradually. Further treatment strategies including more intensive chemotherapy, novel agents’ use, identification of high-risk patients using genotyping and minimal residual disease, early intervention of HSCT, and antibiotic prophylaxis can be considered for future clinical protocol designs in Taiwan.

The image quality of reflective optical systems is influenced strongly when the position of each mirror changed compared to the theoretical design state. Since multiple degrees of freedom in reflective optical system and the interaction between each mirror coupled, which makes it difficult to separate the misalignment of each mirror accurately. By now, vector wave-front aberration theory has been used to computer-aided alignment of two-mirror and three-mirror optical systems widely, however, due to actual engineering demands, optical systems with more than three mirrors have been designed, which greatly increases the difficulty of installation and alignment. At present, there are still few researches on this aspect. Based on vector wave aberration theory, the aberration shift vector of each element in four-mirror optical systems with off-axis field is derived by using paraxial ray trace equation of the optical axis ray and the principle ray, then the misalignment model of the four-mirror optical systems with shifted field is established in detail. The model can accurately calculate the misalignment of optical elements, which greatly promotes the high-precision alignment of complex reflective optical systems. And the perturbed off-axis four-mirror telescope can be perfectly aligned in terms of the vector aberration theory. This greatly facilitates the optical design technology of complex reflective optical systems in some way.

Reflective optical systems have many advantages such as no chromatic aberration, wide detection band range, suitable for large aperture, light weight and compact structure. More and more two-mirror and three-mirror optical systems have been applied widely, which greatly promotes the development of space optical detection technology. With the continuous development of optical design, in order to increase the field of view, eliminate stray light and compact systems structure, some off-axis four mirror optical systems have been designed. Based on the vector wave-front aberration theory of reflective optical systems, a design method of off-axis four-mirror optical system is proposed in this paper. This method is more intuitive in aberration optimization and can greatly improve the design efficiency of optical system. At last, by using of the optical design software CODE V, a four-mirror optical system with the off-axis field of view is designed.

5-year overall survival rates have surpassed 90% for childhood acute lymphocytic leukaemia, but survivors are at risk for permanent health sequelae. Although event-free survival appropriately represents the outcome for cancers with poor overall survival, this metric is inadequate when cure rates are high but challenged by serious, persistent complications. Accordingly, a group of experts in paediatric haematology-oncology, representative of 17 international acute lymphocytic leukaemia study groups, launched an initiative to construct a measure, designated severe toxicity-free survival (STFS), to quantify the occurrence of physician-prioritised toxicities to be integrated with standard cancer outcome reporting. Five generic inclusion criteria (not present before cancer diagnosis, symptomatic, objectifiable, of unacceptable severity, permanent, or requiring unacceptable treatments) were used to assess 855 health conditions, which resulted in inclusion of 21 severe toxicities. Consensus definitions were reached through a modified Delphi process supplemented by two additional plenary meetings. The 21 severe toxicities include severe adverse health conditions that substantially affect activities of daily living and are refractory to therapy (eg, refractory seizures), are without therapeutic options (eg, blindness), or require substantially invasive treatment (eg, cardiac transplantation). Incorporation of STFS assessment into clinical trials has the potential to improve and diversify treatment strategies, focusing not only on traditional outcome events and overall survival but also the frequencies of the most severe toxicities. The two major aims of this Review were to: prioritise and define unacceptable long-term toxicity for patients with childhood acute lymphocytic leukaemia, and define how these toxicities should be combined into a composite quantity to be integrated with other reported outcomes. Although STFS quantifies the clinically unacceptable health tradeoff for cure using childhood acute lymphocytic leukaemia as a model disease, the prioritised severe toxicities are based on generic considerations of relevance to any other cancer diagnosis and age group.

Publisher Copyright: © 2021 Lippincott Williams and Wilkins. All rights reserved. Asparaginase-associated pancreatitis (AAP) frequently affects children treated for acute lymphoblastic leukemia (ALL) causing severe acute and persisting complications. Known risk factors such as asparaginase dosing, older age and single nucleotide polymorphisms (SNPs) have insufficient odds ratios to allow personalized asparaginase therapy. In this study, we explored machine learning strategies for prediction of individual AAP risk. We integrated information on age, sex, and SNPs based on Illumina Omni2.5exome-8 arrays of patients with childhood ALL (N=1564, 244 with AAP aged 1.0 to 17.9 y) from 10 international ALL consortia into machine learning models including regression, random forest, AdaBoost and artificial neural networks. A model with only age and sex had area under the receiver operating characteristic curve (ROC-AUC) of 0.62. Inclusion of 6 pancreatitis candidate gene SNPs or 4 validated pancreatitis SNPs boosted ROC-AUC somewhat (0.67) while 30 SNPs, identified through our AAP genome-wide association study cohort, boosted performance (0.80). Most predictive features included rs10273639 (PRSS1-PRSS2), rs10436957 (CTRC), rs13228878 (PRSS1/PRSS2), rs1505495 (GALNTL6), rs4655107 (EPHB2) and age (1 to 7 y). Second AAP following asparaginase re-exposure was predicted with ROC-AUC: 0.65. The machine learning models assist individual-level risk assessment of AAP for future prevention trials, and may legitimize asparaginase re-exposure when AAP risk is predicted to be low.

In order to use a depth camera to simplify the acquisition process of integral imaging, this paper proposes a depth map restoration algorithm combining pixel filling and improved joint bilateral filtering(DIJBF). The depth image collected by the depth camera has the problems of background noise and holes in the foreground and background of the object. Firstly, the background filling method or the neighborhood value filling method is adopted to complete the preliminary restoration of the large edge void area according to the situation, and then combined with the improved joint bilateral filtering algorithm that adds the depth image depth value similarity factor to optimize the secondary restoration of the preliminary restoration depth map. After the depth image is restored and optimized, the contour of the three-dimensional object is clear and the edge is smooth. Combined with the color image, a high-quality elemental image array can be subsequently generated for the integral imaging display system.

Objective To characterize changes in opioid, gabapentin, and pregabalin utilization patterns and cost trends between 2008 and 2018 in a Louisiana workers' compensation claims population and explore the role of gabapentinoids as alternative analgesics during the opioid epidemic. Method Filled prescriptions for gabapentinoids and opioids were studied for 11 years in a cohort of 18,737 claimants. Results The proportion of claimants prescribed gabapentin increased 2-fold (8.9% to 18.9%) and average drug cost per claimant decreased 22% ($612 to $480). The proportion of claimants prescribed pregabalin decreased approximately 80% (11.7% to 2.5%) and average drug cost per claim increased 224% ($911 to $2,952). Proportion of claimants prescribed opioids decreased 20% (80% to 64.2%) and average drug cost per claim decreased 46% ($691 to $371). Conclusions Utilization increased substantially for gabapentin and decreased for pregabalin and opioids.

Epidemiological studies of the COVID-19 patients have suggested the male bias in outcomes of lung illness. To experimentally demonstrate the epidemiological results, we performed animal studies to infect male and female Syrian hamsters with SARS-CoV-2. Remarkably, high viral titer in nasal washings was detectable in male hamsters who presented symptoms of weight loss, weakness, piloerection, hunched back and abdominal respiration, as well as severe pneumonia, pulmonary edema, consolidation, and fibrosis. In contrast with the males, the female hamsters showed much lower shedding viral titers, moderate symptoms, and relatively mild lung pathogenesis. The obvious differences in the susceptibility to SARS-CoV-2 and severity of lung pathogenesis between male and female hamsters provided experimental evidence that SARS-CoV-2 infection and the severity of COVID-19 are associated with gender.

BACKGROUND In childhood cancer survivors, low bone mineral density (BMD) is a bone-related consequence. Efficacy of denosumab, an effective therapy for adult patients with osteoporosis, remains unclear in children. This study aimed to investigate denosumab therapy efficacy for low BMD in childhood cancer survivors. PROCEDURE Between January 2014 and January 2018, we monitored lumbar BMD of children with cancer using dual-energy X-ray absorptiometry after completing chemotherapy with a 6-month interval. For patients with low BMD, defined as height-adjusted Z-scores of BMD

Artificial intelligence is facilitating human life in many aspects. Previous artificial intelligence has been mainly focused on computer algorithms (e.g. deep-learning and extreme-learning) and integrated circuits. Recently, all-optical diffractive deep neural networks (D2NN) were realized by using passive structures, which can perform complicated functions designed by computer-based neural networks at the light speed. However, once a passive D2NN architecture is fabricated, its function will be fixed. Here, we propose a programmable artificial intelligence machine (PAIM) that can execute various intellectual tasks by realizing hierarchical connections of brain neurons via a multi-layer digital-coding metasurface array. Integrated with two amplifier chips in each meta-atom, its transmission coefficient covers a dynamic range of 35 dB (from -40 dB to -5 dB), which is the basis to construct the reprogrammable physical layers of D2NN, in which the digital meta-atoms make the artificial neurons alive. We experimentally show that PAIM can handle various deep-learning tasks for wave sensing, including image classifications, mobile communication coder-decoder, and real-time multi-beam focusing. In particular, we propose a reinforcement learning algorithm for on-site learning and discrete optimization algorithm for digital coding, making PAIM have autonomous intelligence ability and perform self-learning tasks without the support of extra computer.

Background Patients with childhood cancer are at increased risk for the development of second cancers. Methods A national multicenter survey of second cancers conducted by the Taiwan Pediatric Oncology Group retrieved retrospective data from the database at the Children Cancer Foundation in Taiwan beginning in 1995. The characteristics of second cancers and associations of patient demographic and clinical characteristics with time to death due to a second cancer were analyzed. Results We examined the records of 8782 patients with a primary cancer diagnosed between January 1, 1995 and December 31, 2013, and a total of 99 patients with a second cancer were identified. The most common type of second cancer was acute myeloid leukemia (n = 35), followed by acute lymphoblastic leukemia (n = 15), central nervous system (CNS) tumors (n = 15), and sarcomas (n = 10). Secondary hematological malignancies occurred earlier than other secondary cancers. The frequencies of second CNS tumors and second bone cancers and sarcomas were notably increased when prior radiation doses increased from zero, low dose to high dose. The overall 5-year survival of patients with a second cancer was poor (33.7%). Multivariate survival analysis revealed that the year of primary diagnosis ≤2002, secondary hematological malignancies, and age at second cancer diagnosis ≤9.3 years or >26.8 years increased the risk of death following second cancer. Conclusion Children who develop a second cancer have an unfavorable outcome. Early detection and improved treatment for second cancers are needed.

Acupuncture is a key component of Traditional Chinese Medicine in which needles are inserted into specific areas in the body to stimulate certain physiological reactions of the body. Clinical research shows that acupuncture is beneficial in treating a variety of illnesses, such as erectile dysfunction. Therefore, we investigated the effect of electroacupuncture (EA) stimulation of both low- and high frequencies at Guanyuan (CV4) and Zhongji (CV3) acupoints on male copulatory behavior in sexually experienced male rats. The animals were randomly divided into four groups: control, sham EA, EA, and only acupuncture. The administered low and high EA were 2 Hz and 80 Hz, respectively, for which the respective intensities were 1.5 mA (30 min/day for 5 days) and 1.5 mA (30 min once). The only acupuncture-administered group received acupunctures at CV4 and CV3 without electrical stimulation. Following the acupuncture treatments, copulatory behavior test was conducted. Eventually, animals were sacrificed and blood samples were collected for testing the serum hormonal profile including luteinizing hormone (LH), testosterone (T), and serotonin (5-HT). Results showed that low-frequency EA-treated rats exhibited increasing intromissions and ejaculation latency compared to control, sham EA, and acupuncture groups, while high-frequency EA-treated rats displayed lower intromissions and ejaculation frequency when compared with those in controls. Furthermore, serum levels of 5-HT and LH in low-frequency EA-treated rats were higher than all the other groups. These results indicate that compared to high-frequency EA, the low-frequency EA might be efficacious in the treatment of premature ejaculation, thereby improving sexual behavior.

Background: Enterovirus D68 (EV-D68) infections poses a serious public health threat, which caused outbreaks of severe respiratory illness and has been closely associated with "polio-like" central nervous system disease. The patterns of immune responses to EV-D68 have not been fully understood. This study was performed to investigate the level of neutralizing antibody against EV-D68 among the healthy population in Xiamen City.Methods: A total of 515 serum samples from healthy people were selected by stratified random sampling in Xiamen City in 2016, and the titer of neutralizing antibody against EV-D68 was detected by an efficient micro-neutralization assay.Results: The overall seroprevalence of neutralizing antibody against EV-D68 was 81.9%, and the overall geometric mean titers (GMT) was 248.0. The positive rates were 42.2%, 49.3%, 71.9%, 94.2% and 98.5%, respectively, in groups of Conclusions: EV-D68 infection was prevalent in Xiamen City. Children are the high-risk groups for EV-D68-related illnesses, especially those aged ≤ 3 years. It is necessary to establish preventive measures and strengthened the surveillance on EV-D68 to prevent disease outbreaks.

BACKGROUND/AIM Epithelial-mesenchymal transition (EMT) via Sonic Hedgehog (Shh) signaling may be one of the mechanisms of progression of castration-resistant prostate cancer (CRPC). In this study, we investigated the possible therapeutic effect of vismodegib, a new Shh inhibitor, in a mouse CRPC model. MATERIALS AND METHODS We determined cell proliferation, apoptosis and the expression of EMT-related genes for three prostate cancer cell lines; androgen-dependent LNCaP and independent C4-2B and PC-3 in the presence of vismodegib in vitro. Fifty mg/kg of vismodegib were orally administered into mice bearing C4-2B and PC-3 tumors, respectively every other week for 3 weeks. RESULTS Vismodegib significantly inhibited cell proliferation and induced cell apoptosis in all cell lines in vitro (p

BACKGROUND B-mode-ultrasound-guided percutaneous cholecystostomy (PC) may be performed by a transhepatic or transperitoneal approach, called percutaneous transhepatic gallbladder drainage (PHGD) and percutaneous transperitoneal gallbladder drainage (PPGD), respectively. We compared the impact of PC related to the route of catheter placement on subsequent laparoscopic cholecystectomy (LC). AIM To compare the impact of PC related to the route of catheter placement on subsequent LC. METHODS We retrospectively studied 103 patients with acute calculous cholecystitis who underwent scheduled LC after PC between January 2010 and January 2019. Group I included 58 patients who underwent scheduled LC after PHGD. Group II included 45 patients who underwent scheduled LC after PPGD. Clinical outcomes were analyzed according to each group. RESULTS Baseline demographic characteristics did not differ significantly between both groups (P > 0.05). Both PHGD and PPGD were able to quickly resolve cholecystitis sepsis. Group I showed significantly higher efficacy than group II in terms of lower pain score during puncture (3.1 vs 4.5; P = 0.001) and at 12 h follow-up (1.5 vs 2.2; P = 0.001), lower rate of fever within 24 h after PC (13.8% vs 42.2%; P = 0.001), shorted operation duration (118.3 vs 139.6 min; P = 0.001), lower amount of intraoperative bleeding (72.1 vs 109.4 mL; P = 0.001) and shorter length of hospital stay (14.3 d vs 18.0 d; P = 0.001). However, group II had significantly lower rate of local bleeding at the PC site (2.2% vs 20.7%; P = 0.005) and lower rate of severe adhesion (33.5% vs 55.2%; P = 0.048). No significant differences were noted between both groups regarding the conversion rate to laparotomy, rate of subtotal cholecystectomy, complications and pathology. CONCLUSION B-mode-ultrasound-guided PHGD is superior to PPGD followed by LC for treatment of acute calculous cholecystitis, with shorter operating time, minimal amount of intraoperative bleeding and short length of hospital stay.

Erectile dysfunction (ED) is an inability to attain or maintain adequate penile erection for successful vaginal intercourse, leading to sexual and relationship dissatisfaction. To combat ED, various surgical and non-surgical approaches have been developed in the past to restore erectile functions. These therapeutic interventions exhibit significant impact in providing relief to patients; however, due to their associated adverse effects and lack of long-term efficacy, newer modalities such as regenerative therapeutics have gained attention due to their safe and prolonged efficacy. Stem cells and platelet-derived biomaterials contained in platelet-rich plasma (PRP) are thriving as some of the major therapeutic regenerative agents. In recent years, various preclinical and clinical studies have evaluated the individual, as well as combined of stem cells and PRP to restore erectile function. Being rich in growth factors, chemokines, and angiogenic factors, both stem cells and PRP play a crucial role in regenerating nerve cells, myelination of axons, homing and migration of progenitor cells, and anti-fibrosis and anti-apoptosis of damaged cavernous nerve in corporal tissues. Further, platelet-derived biomaterials have been proven to be a biological supplement for enhancing the proliferative and differentiation potential of stem cells towards neurogenic fate. Therefore, this article comprehensively analyzes the progresses of these regenerative therapies for ED.

High-precision wind power prediction is important for the planning, economics, and security maintenance of a power grid. Meteorological features and seasonal information are strongly related to wind power prediction. This paper proposes a hybrid method for ultrashort-term wind power prediction considering meteorological features (wind direction, wind speed, temperature, atmospheric pressure, and humidity) and seasonal information. The wind power data are decomposed into stationary subsequences using the ensemble empirical mode decomposition (EEMD). The principal component analysis (PCA) is used to reduce the redundant meteorological features and the algorithm complexity. With the stationary subsequences and extracted meteorological features data as inputs, the long short-term memory (LSTM) network is used to complete the wind power prediction. Finally, the seasonal autoregressive integrated moving average (SARIMA) is innovatively used to fit seasonal features (quarterly and monthly) of wind power and reconstruct the prediction results of LSTM. The proposed method is used to predict 15-minute wind power. In this study, three datasets were collected from a windfarm in Laizhou to validate the prediction performance of the proposed method. The experimental results showed that the prediction accuracy was significantly improved when meteorological features were considered and further improved with seasonal correction.

Regeneration of existing buildings and abandoned areas is a governmental and European key objective. This research focuses on Poveglia: an abandoned island in the Venetian lagoon, Italy. The underpinning idea concerns the upgrade of Poveglia to a zero energy Cognitive University Campus, connected to other educational institutions in the lagoon. The vision aims at reusing abandoned islands combining architecture, learning environments and digital networks, to demonstrate the potential of new technologies for the transformation of abandoned areas. The case study demonstrates the effectiveness of employing improved and revised systems and tools, developed in eLUX lab at the University of Brescia, for the regeneration of the island. The inclusion of the island in a smart campus network results in triggering positive synergies both enhancing energy efficiency and the learning environment. A further development concerns the setup of strategies for historical preservation, energy efficiency and renewable energy production.

Background Neuroblastoma is a common childhood cancer with poor prognosis. This is a retrospective review of the outcomes in children with low-stage neuroblastoma in Taiwan. Methods We reviewed the charts of all children with International Neuroblastoma Staging System (INSS) stages 1 and 2 diagnosed at the Mackay Memorial Hospital between November 1994–December 2013. The patients' demographic data, age of diagnosis, treatment, and survival rates were analyzed. Results A total of 75 children with all stages of neuroblastoma were identified, of which 23 children in the low stage were enrolled. There were 12 (16.0%) patients in stage 1, and 11 (14.6%) patients in stage 2. The mean age of diagnosis for stage 1 and stage 2 was 5.4 months and 10.2 months, respectively. A total of 18 (78.3%) patients received initial complete surgical excision, and 5 patients received initial biopsy. The site of the tumor was the adrenal gland in 19 (82.6%) patients. Total or near-total resection was possible in 18 (78.3%) patients; all children with stage 1 were treated by complete surgical resection. Seven patients (63.6%) in stage 2 received chemotherapy. Children in both stages 1 and 2 had the same 5-year overall survival of 100%. The event-free survival rate for patients in stage 1 and stage 2 was 91.7% and 81.8%, respectively. Conclusion This retrospective study confirmed that children with stage 1 and 2 neuroblastoma had good outcomes. Specifically, children with stage 1 disease are best treated by surgery alone, but selected patients in stage 2 need additional chemotherapy.

Background: Surgical site infection(SSI) and anastomotic leakage are major causes of morbidity after colorectal resections. Mechanical bowel preparation (MBP) combined with oral antibiotics (OAs) was considered to reduce SSI and anastomotic leakage. Purpose: This study analyzed the influence of oral antibiotic use together with MBP on SSI, anastomotic leakage rate and length of hospital stays in patients with elective colorectal surgery. Materials and Methods: From January 2013 to December 2015, 321 patients who underwent elective colorectal resections with complete bowel preparation were included in the study. All patients received MBP. Patients in group A did not receive OAs, whereas patients in group B received OAs. Exclusion criteria were emergent operation, colonoscopy, colostomy or closure of colostomy and received preoperative chemoradiotherapy. The outcome measured was SSI, anastomotic leakage and prophylactic colostomy. Results: Of 321 patients, group A (n =122) and group B (n =199), both groups had similar age, gender, localization and stage of the disease, underlying disease, prophylactic stomy and operation time. Patients receiving OAs with MBP didn't demonstrated a lower rate of SSI and lower leakage rate after multivariate logistic analysis. Conclusions: OAs with MBP prior to elective colorectal resection was no better than MBP only on reducing SSI and anastomotic leakage rates. And OAs will increase patients uncomfortable and GI function side effect. Therefore, MBP alone might be enough colon prepare and higher compliance for the patients.

Objective: The objective of this study was to evaluate augmented reality-assisted single-incision laparoscopic adrenalectomy (AR-SILA) and compare with pure SILA. Materials and Methods: Between January 2009 and March 2012, a total of 19 patients had received SILA. Eight cases were AR-SILA and the others were pure SILA. Results: Eight AR-SILA procedures and 11 SILA were successfully completed. There was no significant difference between the two groups in terms of age, body mass index, and tumor size. Operative times were shorter in the AR-SILA group (102.5 ± 12.8 vs. 150.9 ± 46.3, P = 0.005). The mean blood loss in the AR-SILA group was slightly less than that in the SILA group (60.0 ± 25.6 vs. 109.1 ± 80.1, P = 0.129). There was neither postoperative mortality nor morbidity at the time of discharge and during follow-up. Conclusion: AR-SILA provides important intraoperative information for surgeons to recognize where the pathological lesions and vessels are located beyond the surgeon's direct vision. It made SILA safer and easier.

The Payload for Ultrahigh Energy Observations (PUEO) long-duration balloon experiment is designed to have world-leading sensitivity to ultrahigh-energy neutrinos at energies above 1 EeV. Probing this energy region is essential for understanding the extreme-energy universe at all distance scales. PUEO leverages experience from and supersedes the successful Antarctic Impulsive Transient Antenna (ANITA) program, with an improved design that drastically improves sensitivity by more than an order of magnitude at energies below 30 EeV. PUEO will either make the first significant detection of or set the best limits on ultrahigh-energy neutrino fluxes., Comment: 40 pages, 17 figures. Version accepted to JINST

There have been numerous recent advances in wound care management. Nevertheless, the assessment of hemostatic dressing is essential to enable surgeons and other physicians and healthcare professionals to make the correct decisions regarding the disposition of severe hemorrhage. Here, we investigated the relative efficacies of chitosan-based and conventional gauze dressings in a rat model of femoral artery hemorrhage and in patients with surgical wounds. Dressing effectiveness was evaluated based on hemostatic profiles, biocompatibility, antimicrobial activity, and blood factor responses in coagulation. Relative to standard gauze dressing, the chitosan fiber (CF) dressing treatment significantly shortened the time to hemostasis in injured rats. Moreover, the CF dressing significantly prolonged partial thromboplastin time, enhanced blood absorption, and reduced antithrombin production without altering the prothrombin ratio. Unlike regular gauze bandages, the CF dressing demonstrated remarkable antibacterial activity. The results of this study indicate the effectiveness of chitosan as a hemostatic dressing and elucidate its underlying mechanism. It is possible that chitosan surgical dressings could serve as first-line intervention in hospital emergency care for uncontrolled hemorrhage.

There is an increasing need to remotely monitor people in daily life using radio-frequency probe signals. However, conventional systems can hardly be deployed in real-world settings since they typically require objects to either deliberately cooperate or carry a wireless active device or identification tag. To accomplish complicated successive tasks using a single device in real time, we propose the simultaneous use of a smart metasurface imager and recognizer, empowered by a network of artificial neural networks (ANNs) for adaptively controlling data flow. Here, three ANNs are employed in an integrated hierarchy, transforming measured microwave data into images of the whole human body, classifying specifically designated spots (hand and chest) within the whole image, and recognizing human hand signs instantly at a Wi-Fi frequency of 2.4 GHz. Instantaneous in situ full-scene imaging and adaptive recognition of hand signs and vital signs of multiple non-cooperative people were experimentally demonstrated. We also show that the proposed intelligent metasurface system works well even when it is passively excited by stray Wi-Fi signals that ubiquitously exist in our daily lives. The reported strategy could open up a new avenue for future smart cities, smart homes, human-device interaction interfaces, health monitoring, and safety screening free of visual privacy issues., Machine learning: Metasurfaces gain the power of recognition Combining radio-frequency imaging with artificial intelligence could make it easier for computers to interact with individuals using non-verbal cues, such as sign language. Lianlin Li from Peking University in Beijing, China and Tie Jun Cui from Southeast University in Nanjing, China, and co-workers fabricated a meter-scale flat panel containing ‘meta-atoms’, tiny electronic devices that manipulate the phases of light waves, arranged in a grid-like pattern. By emitting microwave signals or manipulating stray Wi-Fi signals and detecting echoes bounced back, the metasurface can collect high-resolution imaging data on multiple non-cooperative subjects, even those behind solid walls. The teams fed the microwave data to a series of artificial intelligence algorithms that first identify human shapes, modify signal distributions to better focus on specific body parts, and recognize people's hand signs and vital signs . Experiments showed this setup could continuously monitor hand signals and breathing, even using stray Wi-Fi signals that ubiquitously exist in the daily lives.

Background Intranasal influenza vaccines may provide protective efficacy by inducing both systemic antibodies and local secretory IgA. Live attenuated intranasal vaccines are not feasible for high-risk groups. A previously constructed inactivated vaccine with adjuvant revealed an association with neurological events in some studies. In this phase II trial, we aimed to evaluate the safety and immunogenicity of an intranasal influenza vaccine with a novel adjuvant, heat-labile enterotoxin (LT)-derived from E. coli (LTh(αK)). Methods This study is a multicenter, randomized controlled, double-blind, phase II trial of an intranasal influenza vaccine containing 22.5 μg of the hemagglutinin (HA) antigen of three influenza strains in combination with 2 different LTh(αK) adjuvant doses (group 1: 30 μg; group 2: 45 μg) in subjects 20–70 years old. The control vaccine was 22.5 μg of influenza HA antigen alone (group 3). The vaccine was intranasally administered on days 1 and 8. Serum anti-HA antibody and nasal secretory IgA were measured, and adverse events (AEs) were recorded prevaccination and 29 (±2) days postvaccination. Results Of 354 participants randomized in the study, 340 received two vaccine doses. AEs were mostly mild, and there was no discontinuation related to the vaccine. Only a higher frequency of diarrhea after the first dose was noted among group 2 (11.5%) than among group 3 (2.8%), and there was no significant difference after the second dose. The three groups had comparable serum anti-HA antibody immunogenicity. However, the adjuvanted vaccines induced greater mucosal IgA antibody production than the control vaccine. In a subgroup analysis, group 1 participants achieved adequate immunogenicity among both 20- to 60- and 61- to 70-year-old participants. Conclusion The intranasal influenza vaccine adjuvanted with LTh(αK) is generally safe and could provide systemic and local antibody responses. Adjuvanted vaccines were significantly more immunogenic than the nonadjuvanted control vaccine in mucosal immunity. ClinicalTrials.gov Identifier: NCT03784885.

In the background of the increase in wind power installed capacity in power systems, high-precision ultra-short-term wind power prediction is an important basis for ensuring reliable operation of the system. In order to make full use of the effective information in historical data to further improve the prediction accuracy of wind power generation, a prediction method combining empirical mode decomposition(EMD) and deep long-term memory(DLSTM) is proposed, constructing a multi-scale combined prediction model(EMD-DLSTM). In the process of model construction, firstly, the EMD method is used to decompose the wind power sequence into intrinsic mode function(IMF)of different scales and a trend term to weaken the volatility of the wind power sequence and obtain more regular components. Then, the DLSTM network is used to model the decomposed wind power sequence and its features, and then weight the predicted values of each component to obtain the true predicted wind power. The empirical analysis of a wind farm data in Laizhou shows that the EMD-DLSTM method proposed in the paper has better prediction ability than the existing forecasting methods.

Rapid thermal cycling (RTC) in an on-chip device can perform DNA amplification in vitro through precise thermal control at each step of the polymerase chain reaction (PCR). This study reports a straightforward fabrication technique for patterning an on-chip graphene-based device with hole arrays, in which the mechanism of surface structures can achieve stable and uniform thermal control for the amplification of DNA fragments. A thin-film based PCR device was fabricated using picosecond laser (PS-laser) ablation of the multilayer graphene (MLG). Under the optimal fluence of 4.72 J/cm2 with a pulse overlap of 66%, the MLG can be patterned with arrays of 250 μm2 hole surface structures. A 354-bp DNA fragment of VP1, an effective marker for diagnosing the BK virus, was amplified on an on-chip device in less than 60 min. A thin-film electrode with the aforementioned MLG as the heater was demonstrated to significantly enhance temperature stability for each stage of the thermal cycle. The temperature control of the heater was performed by means of a developed programmable PCR apparatus. Our results demonstrated that the proposed integration of a graphene-based device and a laser-pulse ablation process to form a thin-film PCR device has cost benefits in a small-volume reagent and holds great promise for practical medical use of DNA amplification., Highlights • A straightforward fabrication technique of graphene-based device with the hole arrays in 250 μm × 250 μm area for DNA amplification was proposed. • Rapid thermal cycling in the thin-film based device was fabricated by picosecond laser ablation. • The hydrophilic surface structures on on-chip PCR device can achieve stable and uniform thermal control for the amplification of DNA fragments. • The detection limit of BKV from the 354-bp DNA fragment of VP1 by the way of amplification was 5 × 10-6 pg/μL.