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An intelligent cleaning vehicle improves the efficiency of road cleaning to a great extent. In this case, road garbage recognition is fundamental and crucial. Usually, the pebbles are too small, and the sand has an inconspicuous boundary and unfixed shape on the roads. These issues make the stones and sand too hard to be detected by a garbage recognition system. Hence, we designed a novel semantic segmentation network that acquires the areas and categories of road garbage. We designed a Deep Supervision and High Fusion (DSHF) block to improve the road garbage segmentation accuracy. The designed block with a backbone network of HFCN and UNet++ is comparable with a model that only has either a deep supervision block or a high fusion block. According to the collected road garbage segmentation dataset comprising four categories (stones, leaves, sand and bottles), the model we designed has improved the metric value of MPA by 3% over the state-of-art methods and achieved the highest MIoU (Mean Intersection over Union) with the value of 77.92%. The results of our experiments show that the semantic segmentation of road garbage is feasible and that the proposed DSHF block is practical for improving the segmentation effect of road garbage.

Visual quality of images captured by mobile devices is often inferior to that of images captured by a Digital Single Lens Reflex (DSLR) camera. This paper presents a novel generative adversarial network-based mobile image enhancement method, referred to as MIEGAN. It consists of a novel multi-module cascade generative network and a novel adaptive multi-scale discriminative network. The multi-module cascade generative network is built upon a two-stream encoder, a feature transformer, and a decoder. In the two-stream encoder, a luminance-regularizing stream is proposed to help the network focus on low-light areas. In the feature transformation module, two networks effectively capture both global and local information of an image. To further assist the generative network to generate the high visual quality images, a multi-scale discriminator is used instead of a regular single discriminator to distinguish whether an image is fake or real globally and locally. To balance the global and local discriminators, an adaptive weight allocation is proposed. In addition, a contrast loss is proposed, and a new mixed loss function is developed to improve the visual quality of the enhanced images. Extensive experiments on the popular DSLR photo enhancement dataset and MIT-FiveK dataset have verified the effectiveness of the proposed MIEGAN.

CD1d-restricted natural killer T (NKT) cells are innate-like T lymphocytes with protective or pathogenic roles in the development of influenza pneumonia. Here, we show that lung-infiltrated and activated NKT cells are the major cellular source of LIGHT/TNFSF14, which determines the severity of pulmonary pneumonia by highly deteriorative influenza A virus (IAV) infection. Compared to wild-type mice, LIGHT−/− mice exhibit much lower morbidity and mortality to IAV, due to alleviated lung damage and reduced apoptosis of alveolar macrophages (AMs). LIGHT preferentially promotes cell death of lymphotoxin β receptors positive (LTβR+) AMs but not herpesvirus entry mediator positive (HVEM+) AMs. Therefore, these results suggest that NKT-derived LIGHT augments cell death of the tissue protective AMs in exacerbating lung pathology and susceptibility to fatal influenza infection. Suppression of LIGHT signaling might be a viable option in the treatment of influenza-associated acute respiratory distress syndrome.

Disseminated infection caused by Nocardia farcinica with primary nephrotic syndrome is exceedingly rare. A 66-year-old female visited the outpatient department due to fever and fatigue who had been diagnosed as membranous nephropathy and with a long-term prednisone and immunosuppressive therapy. After lung biopsy for many times, culture from space-occupying lesion of the right lung and species identification by mass spectrometry-based methods (MALDI-TOF) revealed Nocardia farcinica. By imaging examination, space-occupying lesions from the lungs, brain, abdominal cavity and kidney were found. After 2 weeks of meropenem intravenous and up to 6 months of trimethoprim-sulfamethoxazole (TMP-SMX) therapy, our patient has remained relapse-free at that time of writing. Disseminated infection caused by Nocardia farcinica is usually subacute with complex clinical manifestations. In addition, it can be easily confused with diseases such as tumor and mycobacterial infection, and lead to fatal consequences. Therefore, we hope that we can remind clinicians considering by discussing common features of disseminated Nocardia farcinica infection.

Terahertz (THz) vortex beams carrying orbital angular momentum (OAM) with high purity and tunable topological charge (TC) will undoubtedly bring extraordinary capacities for advanced imaging or communication systems. We propose a convenient and efficient method to generate a tunable and broadband vortex beam that is excited by superradiant Smith Purcell radiation (SSPR) on a helical grating. This scheme fully explores the advantages of natural broadband evanescent wave carried by the electron beam and the Bloch’s theorem regulated helical periodic systems. An explicit relation is established between the index of the spatial harmonic wave on the grating and the topological charge of the vortex beam. The electron energy in the SSPR can be customized to ignite the specific spatial harmonics and manipulate the OAM beam, accordingly. The separated radiation region also promises the high purity of the OAM spectrum. The harmonic excitation reduces the communality between the wavelength and the device size and alleviates the difficulty of device fabrication in the THz band. The proposed vortex scheme can not only be handily scaled to microwave and mid‑infrared regions, but also bring possibilities to applications based on compact tunable vortex beam sources.

Background:. Existing clinical prediction models for in vitro fertilization are based on the fresh oocyte cycle, and there is no prediction model to evaluate the probability of successful thawing of cryopreserved mature oocytes. This research aims to identify and study the characteristics of pre-oocyte-retrieval patients that can affect the pregnancy outcomes of emergency oocyte freeze-thaw cycles. Methods:. Data were collected from the Reproductive Center, Peking University Third Hospital of China. Multivariable logistic regression model was used to derive the nomogram. Nomogram model performance was assessed by examining the discrimination and calibration in the development and validation cohorts. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test and calibration plots. Results:. The predictors in the model of “no transferable embryo cycles” are female age (odds ratio [OR] = 1.099, 95% confidence interval [CI] = 1.003–1.205, P = 0.0440), duration of infertility (OR = 1.140, 95% CI = 1.018–1.276, P = 0.0240), basal follicle-stimulating hormone (FSH) level (OR = 1.205, 95% CI = 1.051–1.382, P = 0.0084), basal estradiol (E2) level (OR = 1.006, 95% CI = 1.001–1.010, P = 0.0120), and sperm from microdissection testicular sperm extraction (MESA) (OR = 7.741, 95% CI = 2.905–20.632, P 10 mm on the day of hCG administration.

AIM: To evaluate the effects, advantages, disadvantages, and indications of infrabrow skin excision to correct upper eyelid dermatochalasis in middle-aged and elderly Chinese women. METHODS: Sixty eyelids in 30 patients were subjected to this surgical procedure from January to June 2018. All patients had upper eyelid dermatochalasis, and the functions of their levator palpebrae were all normal. The primary indications of the procedure were upper lid dermatochalasis with lateral hooding. All 30 patients underwent infrabrow skin excision at Shanxi Eye Hospital. The degree of skin relaxation before and after surgery was evaluated in all patients, and surgical outcomes and postoperative complications were also assessed. RESULTS: All patients were female, ranging from 40 to 64 (mean: 53.20±7.10) years old. Skin relaxation of the upper eyelid was improved in all 30 patients. One month after the operation, 52 lids (86.7%) showed good results and 8 lids (13.33%) showed fair results. The objective Strasser system was applied to evaluate surgical results at 1 and 6 months. All patients had scores between 0 and 1 point, indicating good results. Preoperative unsatisfactory position and shape of the eyebrows were improved, and crow's feet and frontal lines were reduced. All patients were satisfied with the results. No complications related to wound dehiscence, lagophthalmos, or hypertrophic scars were observed. CONCLUSION: Infrabrow skin excision is a simple, useful operation to reconstruct the upper eyelids in selected patients of Chinese ancestry. This procedure not only retains the advantages of classic blepharoplasty, but also alleviates many eyebrow problems at the same time, and maintains the original shape of the eyelid, minimizes scarring, and produces a smoother, more youthful appearance.

Objective Recurrent cervical cancer is hard to treat when occurring in a previous radiated area and unresectable or distant metastasis. We present three such cases who achieved complete remission (CR) after chemoradiotherapy and pembrolizumab. Case Report Case 1 was diagnosed with cervical adenocarcinoma, stage IVB. She obtained CR after concurrent chemoradiotherapy (CCRT) and post-CCRT adjuvant chemotherapy and bevacizumab. Recurrence at previous irradiated sacral bone was controlled with pembrolizumab and CCRT using proton therapy (PT). Case 2 was diagnosed with stage IVB squamous cell carcinoma. First recurrence occurred at inguinal lymph node (LN). Secondary recurrence occurred at paraaortic LN ten years later. PT with chemotherapy and pembrolizumab achieved CR. Case 3 had a small cell carcinoma (stage IVB) with bone metastasis. She had CR to CCRT with etoposide-cisplatin. Liver metastasis was salvaged with CCRT and pembrolizumab. Conclusion CCRT with pembrolizumab is potentially curative for recurrent cervical cancer conventionally amenable for palliation.

Road garbage recognition and cleanliness assessment are very important for intelligent cleaning of vehicles. However, widely used garbage detection methods cannot provide accurate information to assess cleanliness. Also, only a few contributions are available in the road cleanliness assessment, and they too mainly depend on the category and quantity of garbage. In this paper, deep supervision UNet++ (DUNet++) is proposed to solve the problem of road garbage classification and segmentation, which can directly impact the output of the category of garbage and the occupied ground area. A new, simple and accurate method is established to assess road cleanliness by combining the results of garbage segmentation. Compared with the cleanliness index (CI), the road cleanliness index based on semantic segmentation (CISS) not only considers the road area occupied by different types or categories of the garbage but also considers the difficulty of cleaning them. A road garbage segmentation dataset, which consists of four categories (stones, leaves, sand, and bottles), is collected to train the designed garbage segmentation model, and it has achieved considerable garbage segmentation improvement with an MIoU (Mean Intersection over Union) of $76.73\pm 0.11$ . Especially when compared with the state-of-the-art methods, the model we designed has greatly improved the accuracy of garbage segmentation. Experimental results have shown that our road garbage segmentation and cleanliness assessment methods are relatively simple, and can provide accurate road cleanliness information for cleaning vehicles.

A three-port plasmonic array is proposed to achieve a dual-field superfocusing using the forward-propagation method based on spatial Fourier transform. The algorithm of fast Fourier transform is used to facilitate the design process. Both the electric and magnetic fields can be superfocused on the focal plane of z = 0.1 λ ( λ is the free-space wavelength) based on an effect of radiationless electromagnetic interference. The full widths of the half-maximum of both two fields are 0.060 λ and 0.072 λ , respectively. Besides, the metrics of the dual-field superfocusing are 1.67 and 1.39. The proposed theory can simplify the design process of superfocusing, and the plasmonic array with brief three ports can sufficiently facilitate the construction of the desired source. This letter can be beneficial for the development of beam steering, sophisticated holography, super-resolution imaging, and other applications of near- or far-field devices.

Drawing upon the New Industrial City (NIC) projects by China Fortune Land Development (CFLD), a Shanghai stock-listed top 10 real estate enterprise, this article accounts for the emergence of busin...

Recent advances in spoof surface plasmon (SSP) have offered enormous opportunities for engineering electromagnetic waves at the subwavelength scale. However, the fundamental limitation of the extremely finite space channels on exciting SSP challenges their practical applications. Here, to the best of our knowledge, a new method that can realize high-efficiency infinite-channel SSP excitation based on hyperbolic plasmonic metasurfaces is proposed. Free-space propagating waves impinging from arbitrary directions can be coupled to SSP owing to the theoretical perfect wave vector match between the modulated incident waves and the hyperbolic plasmonic metasurfaces. A proof-of-method metacoupler working at 8 GHz is designed and fabricated with the novel functionality numerically and experimentally verified by the consistent guide wavelength with theory. Further experimental investigation reveals a total coupling efficiency exceeding 50% for the impinging waves with incidence angles ranging from −44° to 44°. The proposed methodology provides a new route to design multichannel antennas and detectors.

Assessing the downstaging effects of neoadjuvant chemotherapy (NACT) in patients with locally advanced nasopharyngeal carcinoma (LANPC) and predicting response to treatment remain challenging. The present study aimed to evaluate the long-term prognosis of downstaging after NACT in patients with LANPC and to investigate the prognostic value of post-NACT tumor downstaging on treatment outcomes in the era of concurrent chemoradiotherapy (CCRT). This retrospective study included 226 patients with stage III (n = 188) and IVA (n = 38) NPC admitted to Haikou People’s Hospital between 1 October 2009 and 1 October 2012. The patients were grouped as downstaging or no after NACT. Overall survival (OS), locoregional failure-free survival (LFFS), and distant failure-free survival (DFFS) were analyzed. Among 226 patients, 196 (86.7%) were in the downstaging group and 30 (13.3%) were in the non-downstaging group. The longest follow-up was 76 months, and the median was 45 months. The 3-year OS rates of the downstaging group and non-downstaging group were 91.0% (95% CI 0.89–0.93) and 69.5% (95% CI 0.66–0.72) (P = 0.005). The 5-year OS rates were 81.6% (95% CI 0.78–0.86) and 53.3% (95% CI 0.49–0.61) (P = 0.001). N downstaging (3-year OS, HR 0.491, 95% CI 0.221–0.881, P = 0.022; 5-year OS, HR = 0.597, 95% CI 0.378–0.878, P = 0.021) was independently associated with OS. In the treatment of LANPC, the patients with downstaging after NACT have a better prognosis than those without downstaging. This study suggests that NACT can improve the prognosis for patients with LANPC if there is downstaging.

Background This study sought to explore the clinical effects of vancomycin-loaded calcium phosphate cement (CPC) in the treatment of chronic osteomyelitis. Methods Ninety-eight patients with chronic osteomyelitis, who were treated at our Department from December 1st, 2014 to December 1st, 2015, were randomly allocated into the research group or the control group. Each group comprised 49 patients. Patients in the research group (Group A) received a 1-stage treatment of vancomycin-loaded CPC after debridement, while those in the control group (Group B) received an irrigation and drainage device that administered irrigated antibiotics. The treatment effects, recurrence rates, and safety outcomes of the two groups were observed. Results Patients in the two groups were followed up with for a period of 12 months. The control group without recurrence in one case. There was some systemic adverse postoperative effects and safety issues. The X-ray film showed that CPC filling is good and part of the degradation of osteogenesis. Some patients in the research group the CPC particles were absorbed, the bone defect area was healed, after One-year postoperatively. Further, the cure rate was high. Conclusions One-stage vancomycin-loaded CPC implantation osteomyelitis lesions fill the die cavity, enable patients to continue to fight infection, induce bone defect osteogenesis, reduce the recurrence of chronic osteomyelitis, and are an effective method for treating chronic osteomyelitis. Trial registration Chinese Clinical Trial Registry website (ChiCTR2100044724).

In order to improve the data-embedding capacity of modification-free steganography algorithm, scholars have done a lot of research work to meet practical demands. By researching the user's behavioral habits of several social platforms, a semi-structured modification-free steganography algorithm is introduced in the paper. By constructing the mapping relationship between small icons and binary numbers, the idea of image stitching is utilized, and small icons are stitched together according to the behavioral habits of people's social platforms to implement the graphical representation of secret messages. The convolutional neural network (CNN) has been used to train the small icon recognition and classification data set in the algorithm. In order to improve the robustness of the algorithm, the icons processed by various attack methods are introduced as interference samples in the training set. The experimental results show that the algorithm has good anti-attack ability, and the hiding capacity can be improved, which can be used in the covert communication.

Unsupervised domain adaptation (UDA) has achieved great success in handling cross-domain machine learning applications. It typically benefits the model training of unlabeled target domain by leveraging knowledge from labeled source domain. For this purpose, the minimization of the marginal distribution divergence and conditional distribution divergence between the source and the target domain is widely adopted in existing work. Nevertheless, for the sake of privacy preservation, the source domain is usually not provided with training data but trained predictor (e.g., classifier). This incurs the above studies infeasible because the marginal and conditional distributions of the source domain are incalculable. To this end, this article proposes a source-free UDA which jointly models domain adaptation and sample transport learning, namely Sample Transport Domain Adaptation (STDA). Specifically, STDA constructs the pseudo source domain according to the aggregated decision boundaries of multiple source classifiers made on the target domain. Then, it refines the pseudo source domain by augmenting it through transporting those target samples with high confidence, and consequently generates labels for the target domain. We train the STDA model by performing domain adaptation with sample transport between the above steps in alternating manner, and eventually achieve knowledge adaptation to the target domain and attain confident labels for it. Finally, evaluation results have validated effectiveness and superiority of the proposed method.

Background In current clinical practice, the most commonly used fusion cage materials are titanium (Ti) alloys. However, titanium alloys are non-degradable and may cause stress shielding. ZK60 is a bio-absorbable implant that can effectively avoid long-term complications, such as stress shielding effects, implant displacement, and foreign body reactions. In this study, we aimed at investigating the biomechanical behavior of the cervical spine after implanting different interbody fusion cages. Methods The finite element (FE) models of anterior cervical disc removal and bone graft fusion (ACDF) with a ZK60 cage and a Ti cage were constructed, respectively. Simulations were performed to evaluate their properties of flexion, extension, lateral bending, and axial rotation of the cervical spine. Moreover, a side-by-side comparison was conducted on the range of motion (ROM), the deformation of cages, the stress in the cages, bone grafts, and cage-end plate interface. Simultaneously, according to the biomechanical analysis results, the microporous structure of the ZK60 cage was improved by the lattice topology optimization technology and validation using static structure. Results The ROMs in the current study were comparable with the results reported in the literature. There was no significant difference in the deformation of the two cages under various conditions. Moreover, the maximum stress occurred at the rear of the cage in all cases. The cage’s and endplate-cage interface’s stress of the ZK60 group was reduced compared with the Ti cage, while the bone graft stress in the ZK60 fusion cage was significantly greater than that in the Ti fusion cage (average 27.70%). We further optimized the cage by filling it with lattice structures, the volume was decreased by 40%, and validation showed more significant biomechanical properties than ZK60 and Ti cages. Conclusion The application of the ZK60 cage can significantly increase the stress stimulation to the bone graft by reducing the stress shielding effect between the two instrumented bodies. We also observed that the stress of the endplate-cage interface decreased as the reduction of the cage’s stiffness, indicating that subsidence is less likely to occur in the cage with lower stiffness. Moreover, we successfully designed a porous cage based on the biomechanical load by lattice optimization.

Oral submucous fibrosis (OSMF) is a kind of chronic, insidious disease, and it is categorized into potentially malignant disorders (PMD), which poses a global and regional problem to public health. It is considered to be a multifactorial disease, such as due to areca nut chewing, trace element disorders, and genetic susceptibility. However, there is still no unanimous conclusion on its pathogenesis, diagnosis, and treatment strategies. Hence, this article provides a comprehensive review and prospect of OSMF research, providing scholars and clinicians with a better perspective and new ideas for the research and treatment of OSMF.

BACKGROUND: The outbreak of COVID-19 poses a major and urgent threat to global public health. CT findings associated with COVID-19 pneumonia from initial diagnosis until patient recovery. This study aimed to retrospectively analyze abnormal lung changes following initial computed tomography (CT) among patients with coronavirus disease 2019 (COVID-19) in Yunnan, and to evaluate the effectiveness of a chest CT-based model for the diagnosis of COVID-19. METHODS: One hundred and nine patients with COVID-19 pneumonia confirmed with the positive new coronavirus nucleic acid antibody who exhibited abnormal findings on initial CT were retrospectively analyzed. Thereafter, changes in the number, distribution, shape, and density of the lesions were observed. Further, the epidemiological, clinical, and CT imaging findings (+/-) were correlated. Following univariate and multivariate logistic regression analysis, receiver operating characteristic (ROC) curves were generated for significant factors, and models were established to evaluate the diagnostic ability of CT for COVID-19. RESULTS: Our results showed significant differences between patients with COVID-19 in epidemiological history (first, second, and third generation), clinical type (moderate, severe, and critical), and abnormal CT imaging characteristics (+/-) (P

Objective By observing the 3D anatomy of normal adult cervical facet joints, using the picture archiving and communication system to measure its 3D parameters and discussing its clinical significance, the aim of this study was to provide a reliable morphological basis for the design and manufacture of lower cervical facet joint interface distractors. Methods We selected 200 patients who underwent cervical spine 3D spiral computed tomography (CT) examination in the imaging department of our hospital from September 2019 to May 2020 and whose spiral CT images showed no cervical spinal canal stenosis, cervical disc herniation, obvious bone hyperplasia, or infection. The anterior and posterior diameters of the facet joints on both sides of the cervical spine, the space between the joints, and the left and right diameters were measured on the sagittal, cross-sectional and coronal planes after reconstruction with 3D spiral CT. Results The anterior and posterior diameters of the facet joints of the cervical spine, the space between the joints, and the left and right diameters all increased from top to bottom along the cervical spine. The 3D parameters of the C2-3~C6-7 segments were significantly different between the male and female groups. Conclusion The anteroposterior diameter, joint space interval, and left and right diameter of cervical facet joints are different in each segment and between the sexes. The lower cervical facet joint interface fusion device designed according to the measurement results can fully meet the needs of most patients.

BACKGROUND: The volar locking plate technique with an L-shaped incision of the PQ muscle through the classic volar Henry approach is a popular method for treating distal radius fractures. Recently we revised and improved this traditional technique by performing mini-invasive surgery. OBJECTIVE: The purpose of this study was to evaluate the clinical effects after fixation of distal radius fracture with volar locking palmar plates while preserving the pronator quadratus through minimally invasive approach. METHODS: From May 2014 to March 2017, 58 patients (38 males and 21 females) with an age range of 22–72 years (mean age 44.6 years) and with distal radius fractures underwent open reduction and internal fixation with volar locking palmar plates. The patients were classified as 23A-2 through 23C-2 according to the Orthopedic Trauma Association fracture classification system. All surgeries were completed by one trained team. The group that received volar locking palmar plates of distal radius performed with the traditional method through Henry approach involved 33 patients (21 males and 12 females) and the group that received PQ through minimally invasive approach group involved 25 patients (16 males and 9 females). We compared the two groups for wrist pain, forearm range of motion, grip strength, preoperative complications and wrist functional recovery score. RESULTS: The minimum follow-up for the whole cohort was one year. The differences between the two groups were significant in terms of wrist pain, forearm range of motion, grip strength and wrist function at 1, 2, 6 weeks postoperatively, but insignificant at 3 and 12 months postoperatively. In the minimally invasive group a case of limited extension of the forefinger 3 months postoperatively was found. No significant differences were found for preoperative complications and radiographs postoperatively. CONCLUSION: Fixation with volar locking palmar plates through minimally invasive approach is a satisfactory and optional method in the treatment of distal radius fractures. This technique yields better early wrist function, shortens rehabilitation time and gets high psychological satisfaction.

Background/Purpose We sought to compare the diagnostic performances of 68Ga-PSMA-11 PET/CT and prostate/whole-abdomen multiparametric magnetic resonance imaging (PWAmpMRI) in Taiwanese patients with biochemically recurrent prostate cancer following robot-assisted radical prostatectomy. Methods Between June 2017 and December 2018, we prospectively enrolled 34 patients. Upon review of all available clinical and imaging data, a best valuable comparator (BVC) was defined on an individual basis in the light of a consensus reached by a multidisciplinary tumor board. Diagnostic positivity was investigated in relation to the different lesion types. Results On a patient-based analysis, 68Ga-PSMA-11 PET/CT and PWAmpMRI showed a moderate agreement (kappa coefficient = 0.62). 68Ga-PSMA-11 PET/CT identified local recurrences, regional, and non-regional lymph node metastases, and bone metastases in 15, 10, 1, and 5 patients, respectively. Conversely, PWAmpMRI detected these lesions in 26, 8, 1, and 4 patients, respectively. When the BVC was used as reference standard, the positive diagnostic rates for local recurrences, regional lymph node metastases, non-regional lymph node metastases, and bone metastases were 57.7%, 90.9%, 100%, and 100%, respectively for 68Ga-PSMA-11 PET/CT, and 100%, 72.7%, 100%, and 80% for PWAmpMRI, respectively. The use of both PWAmpMRI and 68Ga-PSMA-11 PET/CT showed a complete diagnostic yield for detecting both local recurrence and systemic failure when PSA levels reached 0.5 ng/mL. Conclusion Due to urine radioactivity, 68Ga-PSMA-11 PET/CT performs less than PWAmpMRI on local recurrences. However, it can have a complementary diagnostic role in the detection of lymph node metastases and in identifying non-axial bone metastases beyond the PWAmpMRI scanning field.

Menstruation occurs in few species and involves a cyclic process of proliferation, breakdown and regeneration under the control of ovarian hormones. Knowledge of normal endometrial physiology, as it pertains to the regulation of menstruation, is essential to understand disorders of menstruation. Accumulating evidence indicates that autophagy in the endometrium, under the regulation of ovarian hormones, can result in the infiltration of immune cells, which plays an indispensable role in the endometrium shedding, tissue repair and prevention of infections during menstruation. In addition, abnormal autophagy levels, together with resulting dysregulated immune system function, are associated with the pathogenesis and progression of endometriosis. Considering its potential value of autophagy as a target for the treatment of menstrual-related and endometrium-related disorders, we review the activity and function of autophagy during menstrual cycles. The role of the estrogen/progesterone-autophagy-immunity axis in endometriosis are also discussed.

Interest in the low-cost production of clean hydrogen is growing. Anion exchange membrane water electrolyzers (AEMWEs) are considered one of the most promising sustainable hydrogen production technologies because of their ability to split water using platinum group metal-free catalysts, less expensive anode flow fields, and bipolar plates. Critical to the realization of AEMWEs is understanding the durability-limiting factors that restrict the long-term use of these devices. This article presents both durability-limiting factors and mitigation strategies for AEMWEs under three operation modes, i.e., pure water-fed (no liquid electrolyte), concentrated KOH-fed, and 1 wt% K2CO3-fed operating at a differential pressure of 100 psi. We examine extended-term behaviors of AEMWEs at the single-cell level and connect their behavior with the electrochemical, chemical, and mechanical instability of single-cell components. Finally, we discuss the pros and cons of AEMWEs under these operation modes and provide direction for long-lasting AEMWEs with highly efficient hydrogen production capabilities.

This letter presents a dual-polarized wideband plate array antenna in D-band for future fixed high-capacity wireless communication. To achieve the high polarization isolation and wideband operation at the same time, a two-stage multimode cavity is introduced, consisting of a polarization isolation cavity and a cascaded dividing cavity. They are combined to optimize and improve the bandwidth of the dual-polarized antenna array. The TE210 and TE120 degenerate modes are selected to resonate in the cavity. They can be used to generate two orthogonal linear polarization modes with the extremely low cross polarization after cascading four integrated horns with a proper placement. To validate the design, an 8 × 8 element array is fabricated by the diffusion bonding of laminated thin copper plates technology. The gain is more than 24.5 dBi from 130 to 149 GHz. The isolation between two channels is higher than 50 dB and the cross polarization level is below −45 dB over the whole band.

Objectives: To investigate whether PET–CT or PET–MRI is more appropriate for imaging prostate cancer, in terms of primary tumor detection, local staging and recurrence, as well as lymph nodes and distant metastases. Methods: A systematic literature search was conducted on Embase, PubMed/MEDLINE, and the Cochrane Library database. Studies evaluating the diagnostic performance of PET–CT vs PET–MRI in prostate cancer patients were emphasized. Results: We reviewed 57 original research articles during the period 2016–2021: 14 articles regarding the radiotracer PSMA; 18 articles regarding the primary tumor detection, local tumor staging, managing local recurrence; 17 articles for managing lymph node metastases; and eight articles for managing bone and other distant metastases. PSMA PET could be complementary to mpMRI for primary prostate cancer localization and is particularly valuable for PI-RADS three lesions. PET–MRI is better than PET–CT in local tumor staging due to its specific benefit in predicting extracapsular extension in MRI-occult prostate cancer patients. PET–MRI is likely superior as compared with PET–CT in detecting local recurrence, and has slightly higher detection rates than PET–CT in lymph node recurrence. PET–CT and PET–MRI seem to have equivalent performance in detecting distant bony or visceral metastases. Conclusion: In conclusion, PET–MRI is suitable for local and regional disease, either primary staging or restaging, whereas PET–CT is valuable for managing distant bony or visceral metastasis. Advances in knowledge: We reviewed the emerging applications of PET–MRI and PET–CT in clinical aspects. Readers will gain an objective overview on the strength and shortfalls of PET–MRI or PET–CT in the management of prostate cancer.

Background Supraventricular tachycardia (SVT) with coronary sinus (CS) ostial atresia (CSA) or coronary sinus stenosis (CSS) causes difficulty in electrophysiological procedures, but its characteristics are poorly understood. Objective Study the anatomical and clinical features of SVT patients with CSA/CSS. Methods Of 6128 patients with SVT undergoing electrophysiological procedures, consecutive patients with CSA/CSS were enrolled, and the baseline characteristics, imaging materials, intraoperative data, and follow-up outcomes were analyzed. Results Thirteen patients, seven with CSA and six with CSS, underwent the electrophysiological procedure. Decapolar catheters were placed into the proximal CS in three cases, while the rest were placed at the free wall of the right atrium. Fourteen arrhythmias were confirmed: four atrioventricular nodal reentrant tachycardias, five left-sided accessory pathways, three paroxysmal atrial fibrillations, and two atrial flutters (AFLs). In addition to three patients who underwent only an electrophysiological study, the acute ablation success rate was 100% in 10 cases, with no procedure-related complications. After a median follow-up period of 59.6 months, only one case of atypical AFL recurred. For those cases (seven CSA and two CSS) with a total of 10 anomalous types of CS drainage, three types were classified: from the CS to the persistent left superior vena cava (n = 3), from an unroofed CS (n = 3), and from the CS to the small cardiac vein (n = 3) or Thebesian vein (n = 1). Conclusion Patients with CSA/CSS may develop different kinds of SVT. Electrophysiological procedures for such patients are feasible and effective. An individualized mapping strategy based on the three types of CS drainage will be helpful.

BACKGROUND The global pandemic of coronavirus disease 2019 pneumonia poses a particular challenge to the emergency surgical treatment of elderly patients with high-risk acute abdominal diseases. Elderly patients are a high-risk group for surgical treatment. If the incarceration of gallstones cannot be relieved, emergency surgery is unavoidable. CASE SUMMARY We report an 89-year-old male patient with acute gangrenous cholecystitis and septic shock induced by incarcerated cholecystolithiasis. He had several coexisting, high-risk underlying diseases, had a history of radical gastrectomy for gastric cancer, and was taking aspirin before the operation. Nevertheless, he underwent emergency laparoscopic cholecystectomy, with maintenance of postoperative heart and lung function, successfully recovered, and was discharged on day 8 after the operation. CONCLUSION Emergency surgery for elderly patients with acute abdominal disease is safe and feasible during the coronavirus disease 2019 pandemic, the key is to abide strictly by the hospital’s epidemic prevention regulations, fully implement the epidemic prevention procedure for emergency surgery, fully prepare before the operation, accurately perform the operation, and carefully manage the patient postoperatively.

The n-type ultrathin fully depleted silicon-on-insulator (FDSOI) metal–oxide–semiconductor field-effect transistors (MOSFETs), with a Hf0.5Zr0.5O2 high dielectric permittivity (high-k) dielectric as gate insulator, were fabricated. The total ionizing dose effects were investigated, and an X-ray radiation dose up to 1500 krad(Si) was applied for both long- and short-channel devices. The short-channel devices (0.025–0.100 μm) exhibited less irradiation sensitivity compared with the long-channel devices (0.35–16 μm), leading to a 71% reduction in the irradiation-induced drain current growth and a 26% decrease in the shift of the threshold voltage. It was experimentally demonstrated that the OFF mode is the worst case among the three working conditions (OFF, ON and All0) for short-channel devices. Also, the determined effective electron mobility was enhanced by 38% after X-ray irradiation, attributed to the different compensations for charges triggered by radiation between the high-k dielectric and buried oxide. By extracting the carrier mobility, gate length modulation, and source/drain (S/D) parasitic resistance, the degradation mechanism on X-ray irradiation was revealed. Finally, the split capacitance–voltage measurements were used to validate the analysis.

ECG classification is important to the diagnosis of cardiovascular disease. This paper develops a robust and accurate algorithm for automatic detection of heart arrhythmias from ECG signals recorded with one lead. A novel model based on the convolutional neural network is proposed to extract low-level and high-level features of short term ECG. In addition, Information-Theoretic Metric Learning is utilized as a final classification model to boost the discrimination abilities of the network trained features. The experimental results over the MIT-BIH arrhythmia database show that the model achieves a comparable performance with most of the state-of-the-art methods and Information-Theoretic Metric Learning further improves the performance. Besides the good accuracy achieved, the proposed method balances different criteria.

Background Many healthcare workers were infected by coronavirus disease 2019 (COVID-19) early in the epidemic posing a big challenge for epidemic control. Hence, this study aims to explore perceived infection routes, influencing factors, psychosocial changes, and management procedures for COVID-19 infected healthcare workers. Methods This is a cross-sectional, single hospital-based study. We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29, 2020. All participants completed a validated questionnaire. Electronic consent was obtained from all participants. Perceived causes of infection, infection prevention, control knowledge and behaviour, psychological changes, symptoms and treatment were measured. Results Finally, 103 professional staff with COVID-19 finished the questionnaire and was included (response rate: 98.1%). Of them, 87 cases (84.5%) thought they were infected in working environment in hospital, one (1.0%) thought their infection was due to the laboratory environment, and 5 (4.9%) thought they were infected in daily life or community environment. Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively. Forty-three (41.8%) thought their infection was related to protective equipment, utilization of common equipment (masks and gloves). The top three first symptoms displayed before diagnosis were fever (41.8%), lethargy (33.0%) and muscle aches (30.1%). After diagnosis, 88.3% staff experienced psychological stress or emotional changes during their isolation period, only 11.7% had almost no emotional changes. Arbidol (Umifenovir; an anti-influza drug; 69.2%) was the drug most commonly used to target infection in mild and moderate symptoms. Conclusion The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases. Positive psychological intervention is necessary.

We are entering the era of big data. In this epoch, people are required to develop big data thinking gradually. It is a new kind of thinking that is different from people's previous natural thinking. It has the characteristics of data integration, statistic probability, focus on related relationships and intelligence. From the perspective of Chinese traditional philosophy, big data thinking is highly compatible with many elements of Chinese traditional philosophy, such as benevolence, harmony as well as difference and the unity of theory and practice based on empathy. This article discusses and believes that there is an interrelation between big data thinking and Chinese traditional philosophy. The latter has certain reference and guiding significance for the development of big data thinking in the era of big data.

A 1 bit single-polarization broadband space-time-coding digital metasurface element with a zero cross polarization is proposed. This element consists of a modified patch, an electronic switch, a dc-bias network, a ground plane, and two-layer dielectrics. The upper patch with edge loading and centered square hole is fully optimized to achieve broadband and stable phase difference between two states. By electronically controlling the diode, the element achieves a 1 bit phase shift with a relative bandwidth of 20% within 180° ± 30° from 7.71 to 9.43 GHz. Moreover, a negligible cross polarization is obtained due to the uniaxial symmetry of the structure, and the amplitude loss is less than 0.8 dB for two states. The experimental results measured in a rectangular waveguide are well matched with the simulations, further demonstrating validity of the proposed element.

Terahertz biosensing provides a suitable method to identify biomolecules due to their rich spectral fingerprint in this electromagnetic region. However, owing to the limitations of terahertz sources and detectors, the signal is weak and requires to be enhanced by particular technologies. In this paper, we propose a terahertz plasmonic biosensor based on Goos-Hanchen effect in graphene. Sample sensing can be realized by measuring the Goos-Hanchen shift of the reflected light. Numerical simulations show that the sensitivity of this biosensor can reach a high value up to $2.5\times 10^4\mu$ m/RIU. This graphene plasmonic configuration combined with Goos-Hanchen effect provides a novel high-sensitivity approach for future terahertz biosensing applications.

Background/purpose: Ovarian clear cell carcinoma (OCCC) with recurrence/progression after treatment has dismal prognosis. We aimed to investigate the management and outcomes of such patients. Methods: OCCC patients who were treated between 2000 and 2013 with cancer recurrence or progression after primary treatment were analyzed. Univariate and multivariate analyses were used to identify the independent predictors of survival after recurrence (SAR) and cancer-specific survival (CSS). Results: A total of 64 patients experienced treatment failure (49 recurred after remission and 15 progressed without remission). The 5-year CSS rates of recurrent/progressive OCCC patients were 22.9% (progression group: median CSS 5.9 months [range, 0.8–25.2] vs recurrence group: 43.6 months [range, 7.1–217.8]; p 12 months (HR: 0.22–0.40, p = 0.001 and p = 0.023), CA125

We investigate optical property of polarization-maintaining fiber taper (PMFT) for tunable multi-wavelength laser generation in a fiber ring cavity. A panda-type polarization fiber is fused and tapered into a fiber taper with a diameter of about 2.5 μm. Optical and thermal properties of the PMFT are investigated theoretically and experimentally. As combined with a polarization dependent isolator, tunable multi-wavelength fiber laser operation is achieved by controlling of polarization-dependent loss in the fiber ring cavity. The laser wavelength number can be switched from 1 to 4. The 3 dB bandwidths of laser spectra are less than 0.05 nm for all wavelength numbers, with a maximum OSNR of about 54 dB. For single-wavelength laser operation near 1561.66 nm, the measured wavelength and power fluctuations are

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named “2019 novel coronavirus (2019-nCoV)” by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

As a vital sign, Electrocardiogram (ECG) has highly discriminative characteristics in the field of biometrics. This paper aims to propose a novel robust ECG biometric method based on graph regularized non-negative matrix factorization (GNMF) and sparse representation. First, after ECG signal pre-processing and heartbeat segmentation, GNMF is used to reduce the dimensions of each heartbeat. In GNMF, an affinity graph is constructed to encode the geometrical information and label information in order to obtain more discriminative features. Second, in order to seek highly discriminability of ECG, the sparse representation is utilized to perform final feature extraction. We evaluate the method on two public datasets: ECG-ID and MIT-BIH Arrhythmia (MITDB). When fusing three heartbeats as a test sample, the accuracy achieves 98.03% and 100% on the ECG-ID dataset and the MITDB dataset, respectively. Experimental results show that the proposed method is robust for within-session and across-session of the ECG signal.

The new vision-based object sorting system is a fundamental module in the construction and demolition waste recycling industry, where image deblurring is vital as the system often fails due to the heavily blurred images caused by the vibration of the conveyor belt that carries solid wastes. This paper proposes a novel blind deblurring approach in which a novel penalty function is formulated as the regularization term in the total energy function. This regularization term is based on sparse prior and solved as part of a mathematical optimization problem, which is operated on the dark channel of the input image. The method not only reserves the structure information of the image but also avoids over-smoothing in the final restoration. On synthetic and natural blurred images, the method outperforms other popular methods. Even with less iterations, the convergence rate and quality of the results are superior. We apply this approach for solid waste image restoration and achieve remarkable results with high validity and reliability.

Background: A variety of supraventricular arrhythmias (SVAs) may occur in patients with hypertrophic cardiomyopathy (HCM). The characteristics and long-term ablation outcomes of different types of SVAs in HCM have not been comprehensively investigated.Methods: We retrospectively enrolled 101 consecutive patients with HCM who were referred to the electrophysiology and arrhythmia service from May 2010 to October 2020. The clinical features and ablation outcomes were analyzed.Results: Seventy-eight patients had SVAs, which comprised 50 (64.1%) cases of atrial fibrillation (AF), 16 (20.5%) of atrial flutter (AFL), 15 (19.2%) of atrioventricular reentrant tachycardia (AVRT), 11 (14.1%) of atrial arrhythmia (AT), and 3 (3.8%) of atrioventricular nodal reentrant tachycardia (AVNRT). Thirty-four patients underwent catheter ablation and were followed up for a median (interquartile range) of 58.5 (82.9) months. There was no recurrence in patients with non-AF SVAs. In patients with AF, the 1- and 7-year AF-free survival rates were 87.5 and 49.5%, respectively. A receiver operator characteristic analysis showed that a greater left ventricular end-diastolic dimension (LVEDD) was associated with a higher recurrence of AF, with an optimum cutoff value of 47 mm (c-statistic = 0.91, p = 0.011, sensitivity = 1.00, specificity = 0.82). In Kaplan–Meier analysis, patients with a LVEDD ≥ 47 mm had worse AF-free survival than those with a LVEDD p = 0.014).Conclusions: In this unique population of HCM, AF was the most common SVA, followed in order by AFL, AVRT, AT, and AVNRT. The long-term catheter ablation outcome for non-AF SVAs in HCM is satisfactory. A greater LVEDD predicts AF recurrence after catheter ablation in patients with HCM.

Background Better protection can be provided during neurosurgery due to the establishment of somatosensory-evoked potential (SEP) and motor-evoked potential (MEP) monitoring technologies. However, some studies have showed that inhaled halogenated anesthetics have a significant impact on neurophysiological monitoring. Methods A total of 40 consecutive patients undergoing neurosurgery were randomly assigned to two groups receiving inhaled anesthetics, either desflurane or sevoflurane. Multiples levels (concentrations of 0.3, 0.6 and 0.9) of anesthetics were administered at minimum alveolar concentration (MAC), and then the latencies and amplitudes of SEPs and MEPs were recorded. Results SEP and MEP signals were well preserved in patients who underwent neurosurgery under general anesthesia supplemented with desflurane or sevoflurane at concentrations of 0.3, 0.6 and 0.9 MAC. In each desflurane or sevoflurane group, the amplitudes of SEPs and MEPs decreased and the latencies of SEPs were prolonged significantly as the MAC increased (P P P Conclusions SEPs and MEPs were inhibited in a dose-dependent manner by both desflurane and sevoflurane. At the same MAC concentration, desflurane appeared to have a stronger inhibitory effect than sevoflurane. All patients studied had normal neurological examination findings, hence, these results may not be applicable to patients with preexisting deficits. Trial registration The study registered on the Chinese Clinical Trial Registry (www.chictr.org.cn), Clinical Trials identifier ChiCTR2100045504 (18/04/2021).

Purpose: To investigate the factors influencing refracture after percutaneous kyphoplasty and to develop and validate a prognostic model.Method: We retrospectively collected clinical data in 392 patients with osteoporotic vertebral compression fractures who underwent percutaneous kyphoplasty at the Affiliated Hospital of Xuzhou Medical University from 1 January 2018 to 1 January 2020.Predictors significantly associated with refracture after PKP were selected based on last absolute shrinkage and selection operator regression. Then a prognostic model were developed and internal validated using enhanced Bootstrap validation.Results: Among the 392 patients who included in this study, there were 19 refracture after percutaneous kyphoplasty(4.8%). Four factors were selected by least absolute shrinkage and selection operator regression for significant association with refracture after percutaneous kyphoplasty, including body mass index, bone mineral density, unilateral puncture, and bone cement leakage. After enhance Bootstrap validation, the bias-corrected curve of the model fitted well with the apparent curve, with the area under ROC curve of 0.931 and 95% CI of (0.789,0.936).Conclusion: The prognostic model developed based on four clinical profiles: body mass index, bone mineral density, unilateral puncture, and bone cement leakage can be used to identify those at most risk of refracture after percutaneous kyphoplasty.

In this work, we propose an angle-independent beam splitter based on spoof surface plasmon. Arbitrary incident waves can be divided in half, and scatter towards two specific and independent directions. The proposed beam splitter consists of the upper periodic metal cylinder and the metal grating below. The former is placed to modulate the incident wave and the spoof surface plasmon with the specified wave vector, and the latter is used to support the excited spoof surface plasmon. To verify the proposed functionalities, we design three beam splitters with different splitter angles and calculate their field distributions under the illumination of the same Gaussian beam. The ideal numerical results agree well with the theory.

Spoof surface plasmons (SSPs) can manipulate electromagnetic waves with subwavelength prints, which offers possibilities for many applications. To generate the SSPs propagating on a two-dimensional (2D) scale, the all-dielectric or dielectric-metal metasurfaces are generally exploited. However, the power capacity of the all-dielectric or dielectric-metal metasurfaces is relatively low. In this work, a 2D groove metal array is utilized to generate the SSPs. The dimension of the grooves is changed to possess the SSPs propagating on it. Based on this principle, a 2D half-Maxwell-fisheye lens is proposed utilizing the groove metal array, on which a spot on one side of the lens can diverge to a plane wave on the exit facet in the simulation. The all-metal half-Maxwell-fisheye lens is capable to be employed for high-power application scenarios.

Based on the effect of radiationless electromagnetic interference (REI), a dual-foci superfocusing is achieved using a plasmonic array with a physically realizable extreme size of 0.195λ, where λ is the free-space wavelength). The full widths at half maximum (FWHM) of both electric and magnetic fields are 0.061λ and 0.052λ at a distance of 0.1λ.

MVI has significant clinical value for treatment selection and prognosis evaluation in hepatocellular carcinoma (HCC). We aimed to construct a model based on MVI-Related Genes (MVIRGs) for risk assessment and prognosis prediction in patients with HCC. This study utilized various statistical analysis methods for prognostic model construction and validation in the Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) cohorts, respectively. In addition, immunohistochemistry and qRT-PCR were used to analyze and identify the value of the model in our cohort. After the analyses, 153 differentially expressed MVIRGs were identified, and three key genes were selected to construct a prognostic model. The high-risk group showed significantly lower overall survival (OS), and this trend was observed in all subgroups: different age groups, genders, stages, and grades. Risk score was a risk factor independent of age, gender, stage, and grade. Moreover, the ICGC cohort validated the prognostic value of the model corresponding to the TCGA. In our cohort, qRT-PCR and immunohistochemistry showed that all three genes had higher expression levels in HCC samples than in normal controls. High expression levels of genes and high-risk scores showed significantly lower recurrence-free survival (RFS) and OS, especially in MVI-positive HCC samples. Therefore, the prognostic model constructed by three MVIRGs can reliably predict the RFS and OS of patients with HCC and is valuable for guiding clinical treatment selection and prognostic assessment of HCC.

Chronic spinal cord injury (CSCI) results from progressive compression of the spinal cord over time. A variety of factors cause CSCI, and its exact pathogenesis is unknown. Cyclin-dependent kinase 1 (CDK1) is closely related to the apoptosis pathway, but no CSCI-related studies on CDK1 have been conducted. In this study, the role of CDK1 in CSCI was explored in a rat model. The CSCI model was established by screw compression using the cervical anterior approach for twelve weeks. The neurological function of the rats was evaluated using the neurological severity scores (NSS) and motor evoked potentials (MEPs). Pathological changes in spinal cord tissue were observed by hematoxylin-eosin (HE) staining, and Nissl staining was performed to assess the survival of motor neurons in the anterior horn of the spinal cord. Changes in autophagy and apoptosis in anterior horn of spinal cord tissue were detected using transmission electron microscopy and the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay, respectively. The expression levels of glial fibrillary acidic protein (GFAP), ionized calcium-binding adaptor (IBA) and choline acetyltransferase (CHAT) in the anterior horn were determined using immunohistochemistry assays to investigate astrocytes, microglia and motor neurons, respectively, in the anterior horn. Western blot assays were used to detect the expression levels of CDK1, Bcl-2, Bax, Caspase 3, LC3 and Beclin1. Changes in the expression of CDK1, LC3 and Beclin1 were also observed using immunohistochemistry. The results indicated that CSCI resulted in neuronal injury and a decrease in the NSS. In the CSCI model group, anterior horn astrocytes and microglia were activated, and motor neurons were decreased. Neuronal apoptosis was promoted, and the number of autophagic vacuoles was elevated. Rats treated with the CDK1 shRNA-expressing lentivirus exhibited better NSS, more surviving motor neurons, and fewer apoptotic neurons than the model rats. The occurrence of autophagy and the expression of proapoptotic and autophagy-related proteins were lower in the CDK1 shRNA group than the model group. In conclusion, CDK1 downregulation suppressed the activation of anterior horn astrocytes and microglia, promoted motor neuron repair, and inhibited neurons apoptosis and autophagy to promote the recovery of motor function after spinal cord injury.

Hypervirulent fowl adenovirus serotype 4 (hvFAdV-4) has emerged as a major pathogen of hepatitis-hydropericardium syndrome (HHS) with increased mortality in chickens, resulting in economic losses to the Chinese poultry industry since June 2015. Here, we isolated a hypervirulent FAdV-4 (hvFAdV-4) strain (designated GD616) from 25-day-old meat-type chickens with severe HHS in Guangdong Province China in June 2017. The whole genome of the strain GD616 shares high homology with those in the recently-reported hvFAdV-4 isolates in China, with natural deletions of ORF19 and ORF27. A comparative analysis of Hexon and Fiber-2 proteins revealed that 2 unique amino acid residues at positions 378 and 453 of the Fiber-2 protein might be associated with virulence due to their occurrences in all the hvFAdV-4 isolates only. To systemically evaluate the effect of age on the susceptibility of chickens to hvFAdV-4, we used this hvFAdV-4 strain to intramuscularly inoculate 7- to 180-day-old specific-pathogen-free chickens for the evaluation of pathogenicity. These results showed that the pathogenicity of the hvFAdV-4 strain GD616 to chickens exhibited age-relatedness, with younger than 59-day-old chickens showing 100% morbidity and mortality, while 180-day-old chickens still exhibited a hydropericardium syndrome-like clinicopathology with 60% morbidity and 20% mortality. These findings enrich the current available knowledge regarding the pathogenicity of the hypervirulent FAdV-4 virus in chickens with a wide range of ages, which assists with the selection of suitable-aged chickens for the evaluation of hvFAdV-4 vaccines.