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BACKGROUND Direct oral anticoagulants (DOACs) combined with antiplatelet therapy for acute coronary syndrome (ACS) may reduce ischemic events, but there is no consensus on bleeding risk. Moreover, the effect of DOACs on stable coronary artery disease (CAD) needs to be elucidated. We conducted a meta-analysis to summarize the efficacy and safety of DOACs combined with antiplatelet therapy in the treatment of stable CAD and ACS. METHODS We searched PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials, then performed a systematic review of all 17 randomized controlled trials. RESULTS For patients with stable CAD, DOACs combined with antiplatelet therapy significantly reduced the rate of major adverse cardiovascular events (MACE) (risk ratio; 95% confidence interval: 0.88; 0.81-0.95) and ischemic stroke (0.62; 0.50-0.77), with a relatively low risk of major bleeding (1.72; 1.42-2.07). For patients with ACS, the combination of DOACs reduced the risk of MACE (0.91; 0.85-0.97), myocardial infarction (MI) (0.90; 0.83-0.98), and ischemic stroke (0.75; 0.58-0.97), accompanied by increased non-fatal bleeding events and intracranial hemorrhage (3.42; 1.76-6.65). Results were similar when restricting the analysis to phase III studies except for the rate of stroke in patients with ACS. CONCLUSIONS Combination therapy reduced the incidence of MI in ACS patients, but the risk of bleeding from intracranial hemorrhaging outweighs the benefit of MACE driven by MI. That is due to combination therapy having no positive impact on mortality; thus, the benefit-risk balance may be more favorable in patients with stable CAD.

Purpose A high-precision rotated elliptical beam profiling method based on pixel ion chamber is proposed in this paper. This method aims to improve the accuracy by modeling the transverse profile of rotated beam as an ellipse with additional correlation coefficient and eliminating the fitting error due to the volume averaging effect of pixel ion chamber. Methods In pencil beam scanning (PBS) proton therapy systems, the transverse beam profile model is generally represented as a standard Gaussian distribution. Considering the elliptical spots, two-dimensional (2D) joint Gaussian distribution characterized with the correlation coefficient ρ is adopted in this study. Gaussian-type particle distribution with white noise was generated and processed in MATLAB to simulate the secondary particle collection in the pixel ion chamber. The simulated pixel ion chamber is a commercially available ion chamber which consists of 12 × 12 small square pixels (3.75 × 3.75 mm2 ) with a 0.05 mm interval. The simulated signals were preprocessed by filtering with the noise threshold and extracting the maximum simply connected domain (MSCD) of the signal. Then, five geometric parameters that identify the transverse beam profiles were fitted under different signal-to-noise ratio (SNR) conditions: the center of the beam (x0 , y0 ), the spot size (σmajor , σminor ), and the rotation angle θ formed between the major axes of elliptical spot and the x axes of the ion chamber. First, the simulated signals were preprocessed by filtering with the noise threshold and extracting the MSCD of the signal. Second, a rectification curve of systematic error in fitted spot size versus the prescribed spot size was used to predict the systematic error due to the volume averaging effect. Finally, the effects of fitting errors on therapeutic dose were evaluated in terms of gamma index and relative dose difference. Results When the SNR is not less than 20 dB, the relative fitting error of spot size and the absolute fitting error of angle θ are less than 1% and 6.1°, respectively. The fitting error of beam center increases with spot size and will not exceed 0.22 mm when spot size reaches up to 12 mm. At a SNR equal to 20 dB, neither cold nor hot spots were presented in dose distribution calculated with the fitted spot parameters. Conclusion The improved Gaussian fitting algorithm performs well when SNR is not less than 20 dB. This method can effectively distinguish the nominal beam and rotated elliptical beam. An ideal systematic error curve can be predicted and used to correct the fitted spot size, thus eliminating the systematic error due to the volume averaging effect of the pixel ion chamber. The fitting error of spot size cannot be fully corrected, but it is negligible and shows little effect on the overall therapeutic dose.

Potential earthquake-induced damage to overlapped tunnels probably occurs during the operation and maintenance of mountain tunnel engineering, especially in the seismically active zone. This study investigated the dynamic response and the failure characteristics of the parallel overlapped tunnel under seismic loadings by employing shaking table tests. The failure mode of the parallel overlapped tunnels was analyzed through macroscopic test phenomena. The dynamic responses of the surrounding rock and tunnel lining were evaluated by acceleration and dynamic strain, respectively. In particular, wavelet packets were used to investigate the spectrum characteristics of the tunnel structure in depth. The failure process of the model can be divided into three stages. The upper-span and the under-crossing tunnels showed different failure characteristics. Additionally, the lining damage on the outer surface of the tunnel mainly occurred on the right side arch waist and the left side wall, whereas the lining damage on the inner surface of the tunnel mainly appeared on the crown and invert. Wavelet packet energy results showed that the energy characteristic distributions of the upper-span and the under-crossing tunnels were not consistent. Specifically, the energy eigenvalues of the crown of the upper-span tunnel and the invert of the under-crossing tunnel were the largest, which should be considered to be the weak parts in the seismic design.

Aims Computer-assisted auscultation has become available to assist clinicians with physical examinations to detect congenital heart disease (CHD). However, its accuracy and effectiveness remain to be evaluated. This study seeks to evaluate the accuracy of auscultations of abnormal heart sounds of an artificial intelligence-assisted auscultation (AI-AA) platform we create. Methods and results Initially, 1397 patients with CHD were enrolled in the study. The samples of their heart sounds were recorded and uploaded to the platform using a digital stethoscope. By the platform, both remote auscultation by a team of experienced cardiologists from Shanghai Children’s Medical Center and automatic auscultation of the heart sound samples were conducted. Samples of 35 patients were deemed unsuitable for the analysis; therefore, the remaining samples from 1362 patients (mean age—2.4 ± 3.1 years and 46% female) were analysed. Sensitivity, specificity, and accuracy were calculated for remote auscultation compared to experts’ face-to-face auscultation and for artificial intelligence automatic auscultation compared to experts’ face-to-face auscultation. Kappa coefficients were measured. Compared to face-to-face auscultation, remote auscultation detected abnormal heart sound with 98% sensitivity, 91% specificity, 97% accuracy, and kappa coefficient 0.87. AI-AA demonstrated 97% sensitivity, 89% specificity, 96% accuracy, and kappa coefficient 0.84. Conclusions The remote auscultations and automatic auscultations, using the AI-AA platform, reported high auscultation accuracy in detecting abnormal heart sound and showed excellent concordance to experts’ face-to-face auscultation. Hence, the platform may provide a feasible way to screen and detect CHD.

Pressure sensors have attracted much attention for their potential applications in health monitoring, wearable devices, electronic skins, smart robots, etc. With the rapid development of the Internet of Things, considering the large number and small scale of sensors, power consumption has become a key factor in large-scale applications. A new generation of self-powered pressure sensors based on a triboelectric nanogenerator has been developed in terms of its incomparable advantages in power consumption and potential performance. Based on the coupling effects of triboelectrification and electrostatic induction, it enables obtaining information on the mechanical input, e.g., magnitude and frequency, by analyzing the electrical output signals. Intensive efforts have been devoted to improving the sensing performance of triboelectric pressure sensors to meet the demands of practicality. In this review, the key advancements in materials, structures and applications of self-powered triboelectric pressure sensors are systematically reviewed. Then, the theoretical basis, impact mechanism and approaches to optimize the pressure sensing performance have been comprehensively analyzed. Finally, the future perspectives of self-powered triboelectric pressure sensors have also been discussed.

Texture analysis is an emerging field that allows mathematical detection of changes in MRI signals that are not visible among image pixels. Alzheimer's disease, a progressive neurodegenerative disease, is the most common cause of dementia. Recently, multiple texture analysis studies in patients with Alzheimer's disease have been performed. This review summarizes the main contributors to Alzheimer's disease-associated cognitive decline, presents a brief overview of texture analysis, followed by review of various MR imaging texture analysis applications in Alzheimer's disease. We also discuss the current challenges for widespread clinical utilization. MR texture analysis could potentially be applied to develop neuroimaging biomarkers for use in Alzheimer's disease clinical trials and diagnosis.

Purpose: To seek optimal keV settings for imaging carpal tunnel in adults by dual-energy computed tomography (DECT) monoenergetic technique; to describe anatomic characteristics of carpal tunnel and to observe correlation between carpal bony and soft tissue structures. Methods: DECT images of 20 wrists (11 left and 9 right wrists; 14 men, mean age 26.93 ± 1.38 years, range 23 to 28, and 6 women, mean age 24.17 ± 0.98 years, range 23 to 26) were evaluated. Monoenergetic images were reconstructed at 42, 62, 82, 102, 122, and 142 keV. Image quality was assessed along a 5-point Likert scale, and the highest-quality images were chosen for quantitative analysis. Two musculoskeletal radiologists performed both analyses independently. Results: The optimal energy spectrum with the best contrast-to-noise ratio (CNR) for monoenergetic images were at 62 keV (19 wrists, 95%) and 61 keV (1 wrist, 5%). There was substantial interobserver agreement between the readers in the 5-point Likert scale analysis of image quality (? = 0.793). Bland-Altman plots also indicated good agreement between observers in quantitative analysis. Intra-category 1 and 2 correlation was mostly discovered at hamate hook level and middle level of pisiform (P < 0.05), while bony and soft tissue structures partly reached correlation (P < 0.05). Conclusion: The optimal energy spectrum for monoenergetic DECT imaging of carpal tunnel structures was 62 keV. DECT monoenergetic imaging could predict changes in soft tissue structures and demonstrate carpal tunnel anatomic structures. Keywords: DECT, monoenergetic, keV, carpal tunnel, Continuous...

Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of sudden cardiac death worldwide. Researchers have found significant pathophysiological differences between females and males and clinically significant sex differences related to medical services. However, conflicting results exist and there is no uniform agreement regarding sex differences in survival and prognosis after OHCA. Therefore, we investigated the relationship between the prognosis of OHCA and sex factors. Methods We comprehensively searched the PubMed, Embase, and Cochrane databases and obtained a total of 1042 articles, from which 33 studies were selected for inclusion. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Results The meta-analysis included 1,268,664 patients. Compared with males, females were older (69.7 years vs. 65.4 years, p p Conclusions Our results indicate that the overall discharge survival rate of females is lower than that of males, and females face a poor prognosis of the nervous system. This is likely related to the pathophysiological characteristics of females, more conservative treatment measures compared with males, and different post-resuscitation care. However, these findings should be interpreted with caution due to the presence of several confounding factors.

To suppress the ongoing COVID-19 pandemic, the Chinese government has implemented nonpharmaceutical interventions (NPIs). Because COVID-19 and influenza have similar means of transmission, NPIs targeting COVID-19 may also affect influenza transmission. In this study, the extent to which NPIs targeting COVID-19 have affected seasonal influenza transmission was explored. Indicators of seasonal influenza activity in the epidemiological year 2019–2020 were compared with those in 2017–2018 and 2018–2019. The incidence rate of seasonal influenza reduced by 64% in 2019–2020 (P < .001). These findings suggest that NPIs aimed at controlling COVID-19 significantly reduced seasonal influenza transmission in China.

A new proton therapy facility is under construction in Huazhong University of Science and Technology. Scanning magnets play an important role in this device. They can form an arbitrary two-dimensional radiation shape conformal with the tumor. In the pencil beam scanning system, the magnetic fields are excited by time-varying currents and the maximum repetition is up to 50 Hz. Therefore, the temperature rises of two magnets caused by eddy currents should be considered. In this paper, the coupling analysis of Multiphysics was carried out by COMSOL electromagnetic thermal module to optimize the magnetic pole structure of the scanning magnet. The tapered air gap of the downstream magnet X was designed to match the deflection envelope of the proton beam after the upstream magnet Y. The pole of the magnet SMX was optimized to meet the requirement of the local and integral fields. The module of natural convection and surface heat radiation were used to replace the empirical heat transfer coefficient in the thermal analysis so that the simulation agrees better with reality. The results show that the accuracy of the heat transfer coefficient should be further validated by comparison with the simulation that is more realistic.

Cardiac hypertrophy is a significant risk factor for cardiovascular disease, including heart failure, arrhythmia, and sudden death. Cardiac hypertrophy involves both embryonic gene expression and transcriptional reprogramming, which are tightly regulated by epigenetic mechanisms. An increasing number of studies have demonstrated that epigenetics plays an influential role in the occurrence and development of cardiac hypertrophy. Here, we summarize the latest research progress on epigenetics in cardiac hypertrophy involving DNA methylation, histone modification, and non-coding RNA, to help understand the mechanism of epigenetics in cardiac hypertrophy. The expression of both embryonic and functional genes can be precisely regulated by epigenetic mechanisms during cardiac hypertrophy, providing a substantial number of therapeutic targets. Thus, epigenetic treatment is expected to become a novel therapeutic strategy for cardiac hypertrophy. According to the research performed to date, epigenetic mechanisms associated with cardiac hypertrophy remain far from completely understood. Therefore, epigenetic mechanisms require further exploration to improve the prevention, diagnosis, and treatment of cardiac hypertrophy.

Recent studies have demonstrated sex-specific differences in etiology, course and brain dysfunction that are associated with cigarette smoking. However, little is known about sex-specific differences in subcortical structure and function. In this study, structural and resting-state functional magnetic resonance imaging (fMRI) data were collected from 60 cigarette smokers (25 females) and 67 nonsmokers (28 females). The structural MRI was applied to identify deficits in sex-specific subcortical volume. Using resting-state fMRI, sex-related alterations in resting-state functional connectivity (rsFC) were investigated in subcortical nuclei with volume deficits as seed regions. Compared to nonsmokers, male but not female smokers demonstrated a significantly smaller volume in the left caudate, while female but not male smokers showed a smaller volume in the right amygdala. Resting-state FC analysis revealed that male but not female smokers had increased rsFC between the left caudate and the left prefrontal cortex but decreased rsFC within the bilateral caudate and between the right amygdala and right orbitofrontal cortex (OFC). Furthermore, the right amygdala volume was negatively correlated with the impulsivity score in female but not male smokers. The rsFC of the right amygdala-OFC circuit was negatively associated with the craving score in male but not female smokers. These findings indicate that cigarette smoking may have differential effects on the caudate and amygdala volumes as well as rsFC between men and women, contributing to our knowledge of sex-specific effects of nicotine addiction. Such sex-specific differences in subcortical structure and function may provide a methodological framework for the development of sex-specific relapse prevention therapies.

Background An efficient surface cleaning strategy would first target cleaning to surfaces that make large contributions to the risk of infections. Methods In this study, we used data from the literature about methicillin-resistant Staphylococcus aureus (MRSA) and developed an ordinary differential equations based mathematical model to quantify the impact of contact heterogeneity on MRSA transmission in a hypothetical 6-bed intensive care unit (ICU). The susceptible patients are divided into two types, these who are cared by the same nurse as the MRSA infected patient (Type 1) and these who are not (Type 2). Results The results showed that the mean MRSA concentration on three kinds of susceptible patient nearby surfaces was significantly linearly associated with the hand-touch frequency (p Conclusions This study provided a framework to study the pathogen concentration dynamics on environmental surfaces and quantitatively showed the importance of cleaning patient nearby HTSs on controlling the nosocomial infection transmission via contact route.

Long-term therapy with levodopa (L-DOPA) in patients with Parkinson’s disease (PD) often triggers motor complications termed as L-DOPA-induced dyskinesia (LID). However, few studies have explored the pathogenesis of LID from the perspective of neuroanatomy. This study aimed to investigate macroscopic structural changes in a rat model of LID and the underlying histological mechanisms. First, we established the hemiparkinsonism rat model through stereotaxic injection of 6-hydroxydopamine (6-OHDA) into the right medial forebrain bundle, followed by administration of saline (PD) or L-DOPA to induce LID. Magnetic resonance imaging (MRI) and behavioral evaluations were performed at different time points. Histological analysis was conducted to assess the correlations between MRI signal changes and cellular contributors. Voxel-based morphometry (VBM) analysis revealed progressive bilateral volume reduction in the cortical and subcortical areas in PD rats compared with the sham rats. These changes were partially reversed by chronic L-DOPA administration; moreover, there was a significant volume increase mainly in the dorsolateral striatum, substantia nigra, and piriform cortex of the lesioned side compared with that of PD rats. At the striatal cellular level, glial fibrillary acidic protein-positive (GFAP+) astrocytes were significantly increased in the lesioned dorsolateral striatum of PD rats compared with the intact side and the sham group. Prolonged L-DOPA treatment further increased GFAP levels. Neither 6-OHDA damage nor L-DOPA treatment influenced the striatal expression of vascular endothelial growth factor (VEGF). Additionally, there was a considerable increase in synapse-associated proteins (SYP, PSD95, and SAP97) in the lesioned striatum of LID rats relative to the PD rats. Golgi-Cox staining analysis of the dendritic spine morphology revealed an increased density of dendritic spines after chronic L-DOPA treatment. Taken together, our findings suggest that striatal volume changes in LID rats involve astrocyte activation, enrichment of synaptic ultrastructure and signaling proteins in the ipsilateral striatum. Meanwhile, the data highlight the enormous potential of structural MRI, especially VBM analysis, in determining the morphological phenotype of rodent models of LID.

The components in traditional human–machine interaction (HMI) systems are relatively independent, distributed and low-integrated, and the wearing experience is poor when the system adopts wearable electronics for intelligent control. The continuous and stable operation of every part always poses challenges for energy supply. In this work, a triboelectric technology-based all-in-one self-powered HMI system for wireless remote telemetry and the control of intelligent cars is proposed. The dual-network crosslinking hydrogel was synthesized and wrapped with functional layers to fabricate a stretchable fibrous triboelectric nanogenerator (SF-TENG) and a supercapacitor (SF-SC), respectively. A self-charging power unit containing woven SF-TENGs, SF-SCs, and a power management circuit was exploited to harvest mechanical energy from the human body and provided power for the whole system. A smart glove designed with five SF-TENGs on the dorsum of five fingers acts as a gesture sensor to generate signal permutations. The signals were processed by the microcontroller and then wirelessly transmitted to the intelligent car for remote telemetry and control. This work is of paramount potential for the application of various terminal devices in self-powered HMI systems with high integration for wearable electronics.

Patients with type 2 diabetes mellitus (T2DM) often have cognitive impairment and structural brain abnormalities. The magnetic resonance imaging (MRI)-based brain atrophy and lesion index can be used to evaluate common brain changes and their correlation with cognitive function, and can therefore also be used to reflect whole-brain structural changes related to T2DM. A total of 136 participants (64 men and 72 women, aged 55–86 years) were recruited for our study between January 2014 and December 2016. All participants underwent MRI and Mini-Mental State Examination assessment (including 42 healthy control, 38 T2DM without cognitive impairment, 26 with cognitive impairment but without T2DM, and 30 T2DM with cognitive impairment participants). The total and sub-category brain atrophy and lesion index scores in patients with T2DM with cognitive impairment were higher than those in healthy controls. Differences in the brain atrophy and lesion index of gray matter lesions and subcortical dilated perivascular spaces were found between non-T2DM patients with cognitive impairment and patients with T2DM and cognitive impairment. After adjusting for age, the brain atrophy and lesion index retained its capacity to identify patients with T2DM with cognitive impairment. These findings suggest that the brain atrophy and lesion index, based on T1-weighted and T2-weighted imaging, is of clinical value for identifying patients with T2DM and cognitive impairment. Gray matter lesions and subcortical dilated perivascular spaces may be potential diagnostic markers of T2DM that is complicated by cognitive impairment. This study was approved by the Medical Ethics Committee of University of South China (approval No. USC20131109003) on November 9, 2013, and was retrospectively registered with the Chinese Clinical Trial Registry (registration No. ChiCTR1900024150) on June 27, 2019.

Background: Skin cutaneous melanoma (SKCM) is considered one of the most aggressive and lethal cancers of the skin. G-protein coupled receptor 143 (GPR143), which has been reported to cause congenital nystagmus, belongs to the superfamily of G protein-coupled receptors. Methods and Results: We analyzed the expression of GPR143 and survival of SKCM patients in SKCM via Gene Expression Profiling Interactive Analysis (GEPIA). Then, logistic regression and multivariate cox analysis was used to analyze the influence of GPR143 expression on clinicopathological elements and survival. We explored the immune response of 22 TIICs in SKCM via CIBERSORT and used TIMER to assess the correlation of GPR143 expression and immune infiltration level. Finally, we used gene set enrichment analysis (GSEA) to assess the TCGA dataset. The outcomes suggest that GPR143 expression in tumor samples is remarkedly higher than in normal samples and high GPR143 expression is associated with poorer prognosis. The result of multivariate analysis indicated that increased GPR143 expression is an independent prognostic factor for prognosis. We found GPR143 expression level has prominent negative correlations with infiltrating levels of B cell, CD8+ T cells, etc. GSEA indicated that pigment metabolic process, pigment biosynthetic process and other pathways were identified as differentially enriched pathways in Gene Ontology (GO). Oxidative phosphorylation, Parkinson’s disease and other pathways were showed significantly differential enrichment in GPR143 high expression phenotype in Kyoto Encyclopedia of Genes and Genomes (KEGG).Conclusions: In conclusion, GPR143 may be a novel prognostic biomarker and associated with immune infiltrates in SKCM.

Tellurite glasses of TeO2 BaF2−REF3 (RE = La, Gd, and Y) co-doped with Er3+/Yb3+ were prepared and investigated comparatively for optical fiber temperature sensors. For this purpose, their thermal and optical properties were examined in detail. The J-O theory was adopted to estimate the transition properties based on absorption spectra. The dominant green emissions were observed in both of the downshifting and upconversion luminescence. The optical temperature sensing abilities based on the FIR of Er3+ green emissions were studied under both of the UV (380 nm) and NIR (980 nm) excitations. Results show that these three tellurite glasses, especially for the TBG glass, should be very qualified for the design of optical fiber temperature sensors under different excitation modes.

This meta-analysis tested whether (a) internet overuse was linked to subjective well-being, life satisfaction, positive emotion, or negative emotion and (b) whether participants’ geographical region, age, or gender moderated these links. Meta-analysis of 70 primary studies with 68,964 participants showed that students with internet overuse had more negative emotions, less subjective well-being, less life satisfaction, and less positive emotions. Geographic region, age, and gender moderated these links. The link between negative emotions and internet overuse was stronger in studies of participants in Central China and Western China than those of participants in Eastern China. In addition, internet overuse’s links to subjective well-being and positive emotions were stronger in studies of younger students than in studies of university students. Lastly, internet overuse’s negative links with subjective well-being, life satisfaction, and positive emotion were stronger in samples with more females than with more males.

Fluoxetine (Flx), a selective serotonin reuptake inhibitor, is extensively used to treat mood and anxiety disorders. Previous animal studies have shown that early-life exposure to Flx results in long-lasting behavioral alterations and neuroplasticity in the hippocampus and cortex, which may persist into adulthood. It remains unclear whether repeated Flx treatment in normal adult animals can induce lasting neuroplasticity and behavioral alterations persisting long beyond the treatment period. In this study, young adult rats (about 9 weeks old) were treated with Flx (10 mg/kg body weight, twice daily) for 15 consecutive days, and the effects of Flx on medial prefrontal cortex (mPFC) neuroplasticity and mPFC-related behaviors were assessed 20 days after the last injection. It was observed that the mPFC of Flx-treated rats had significant increases in the number of 5-bromodeoxyuridine-positive (BrdU+) cells, dendritic complexity/spine density in layer II/III pyramidal neurons, and brain-derived neurotrophic factor (BDNF)/tropomyosin receptor kinase B (TrkB) expression levels, as well as a significant decrease in the number of parvalbumin-positive (PV+) interneurons. The Flx-treated rats exhibited higher motivation to explore new environments, evidenced by a significantly increased number of entries into the novel arm in the Y-maze test. However, they did not show any significant changes in the anhedonia and anxiety levels measured by sucrose preference and elevated plus maze tests respectively. In conclusion, repeated Flx treatment, with the paradigm used, induces long-lasting neuroplastic changes in the mPFC of normal adult rats; such changes and related behavioral manifestations may persist up to 20 days after the last dose.

Constructing electronic systems without an external power source is urgently required toward self-powered photodetection. In this work, we proposed a self-driven photodetection system with a MoS2 nanosheets photodetector as light intensity sensor, a vertical contact-separate mode triboelectric nanogenerator (CS-TENG) as power source, and several LEDs as alarm. The MoS2 based planar photodetector was fabricated by conventional photolithography technique and lift-off process. It is highly sensitive for visible light illumination with high current on-off ratio and excellent reproducibility characteristics under light on-off switching. When conjuncting these functional devices, the induced output voltage of the CS-TENG is tuned by the load resistance of the photodetector, which is responded to the light intensity. The mechanism can be ascribed to the impedance matching effect between specific output characteristics of TENG and working status of photodetector. By adding a Zener diode acts as a voltage regulator, the self-driven renders the voltage and current varying from 1.58 to 20.60 V and 0.06–4.78 μA in a range of light intensity from 0 to 3.19 W/m2, respectively. Finally, it is demonstrated that the output of CS-TENG varies with the variable working states of the MoS2 photodetector and then accurately reflects on the lighted number of LEDs.

ZnTe crystal is a promising electro-optical crystal materials applied for THz generation and detection. However, there is still a big challenge to obtain large sized high quality ZnTe crystals. In this work, large sized ZnTe bulk crystals with Φ30 mm × 150 mm were grown by the traveling solvent melting zone (TSMZ) method. With the characterization of the optical and electrical properties of as-grown ZnTe crystals, the band gap (2.22 eV), high IR transmittance (around 60%), high resistivity (3.5 × 103 Ω·cm), low density (1.3 × 105 cm−2) and small sizes (3 μm - 5 μm) of Te inclusions in ZnTe crystals, low etch pit densities (1.5 × 105 cm−2), high peak intensity to FWHM ratio (2.5 × 104) of the LO peak in the Raman spectra were obtained. Furthermore, the THz transmission spectra was measured and the maximum transmittance is more than 40% at the range of 0.3 - 3 THz. Based on these results, high quality and large aspect ratio ZnTe bulk crystals can be obtained by the TSMZ technique. Our work has greatly facilitated the application of ZnTe crystals in THz device.

Brain tissue survival and functional recovery after ischemic stroke greatly depend on cerebral vessel perfusion and functional collateral circulation in the ischemic area. Semaphorin 3E (Sema3E), one of the class 3 secreted semaphorins, has been demonstrated to be a critical regulator in embryonic and postnatal vascular formation via binding to its receptor PlexinD1. However, whether Sema3E/PlexinD1 signaling is involved in poststroke neovascularization remains unknown. To determine the contribution of Sema3E/PlexinD1 signaling to poststroke recovery, aged rats (18 months) were subjected to a transient middle cerebral artery occlusion. We found that depletion of Sema3E/PlexinD1 signaling with lentivirus-mediated PlexinD1-specific-shRNA improves tissue survival and functional outcome. Sema3E/PlexinD1 inhibition not only increases cortical perfusion but also ameliorates blood-brain barrier damage, as determined by positron emission tomography and magnetic resonance imaging. Mechanistically, we demonstrated that Sema3E suppresses endothelial cell proliferation and angiogenic capacity. More importantly, Sema3E/PlexinD1 signaling inhibits recruitment of pericytes by decreasing production of platelet derived growth factor-BB in endothelial cells. Overall, our study revealed that inhibition of Sema3E/PlexinD1 signaling in the ischemic penumbra, which increases both endothelial angiogenic capacity and recruitment of pericytes, contributed to functional neovascularization and blood-brain barrier integrity in the aged rats. Our findings imply that Sema3E/PlexinD1 signaling is a novel therapeutic target for improving brain tissue survival and functional recovery after ischemic stroke.

BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach. It has been reported that pepsinogen (PG) can reflect the morphology and function of the gastric mucosa, and it is therefore used as a marker for the early diagnosis of atrophic gastritis. AIM To evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination. METHODS Medical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018. For each study subject, serum PG levels and presence of Helicobacter pylori (H. pylori) infection were investigated. Pathology was evaluated using the Operative Link for Gastritis Assessment (OLGA) classification and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) systems. All statistical analyses were carried out using SPSS statistical software. RESULTS A total of 2256 subjects were enrolled and 1922 cases were finally included in the study. Based on the OLGA grading system, the levels of PGI were slightly decreased, while those of PGII were slightly increased. The PGI/PGII ratio (PGR) was reduced with increasing atrophy. The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system. Compared with the OLGA-0 group, a statistically significant difference was observed in the mean age of OLGA-I, III, and IV groups (P < 0.05). In the H. pylori-positive subjects, the PGR levels were notably lower in the OLGA-I, II, and III groups compared with the OLGA-0 group (P < 0.05). H. pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H. pylori-negative patients in different OLGA groups (P < 0.05). CONCLUSION Serum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.

Taking the technical and tactical performance of the world’s top female table tennis player Liu Shiwen as the research object, this study detects Liu Shiwen’s offensive performance characteristics from the perspective of the duration of preparing for the 2020 Tokyo Olympic Games. Using professional high-speed camera system software to analyze her offensive movement structure, combined with table tennis technical and tactical analysis software, this study detects and analyzes Liu Shiwen’s offensive performance in a series of contests against the world’s top female table tennis players. By integrating the offensive technical and tactical effect data, this study comprehensively describes the offensive application process in the actual combat of the team so as to improve the availability of data analysis. Different from the traditional method of video observation combined with artificial statistics, this study analyzes the techniques and tactics adopted by Liu Shiwen when she was playing against left-handed and right-handed players, as well as the advantages and disadvantages of these techniques and tactics. In doing so, the study aims to provides detailed detection information of technical and tactical performance for coaches and players, make a dynamic study of the offensive characteristics of the world’s top female table tennis players, and provide technical support for the preparation of Chinese female table tennis players for the 2020 Tokyo Olympic Games.

This paper presents the seismic dynamic response and spectrum characteristics of an orthogonal overlapped tunnel by shaking table tests. First, a prototype of the engineering and shaking table test device, which was used to design details of the experiment, was developed. Then, the sensors used in the test were selected, and the measurement points were arranged. Subsequently, the Wenchuan seismic wave with horizontal direction in different peak ground accelerations was inputted into the model, followed by a short analysis of the seismic response of the overlapped tunnel in the shaking table test as well as the distribution of the peak acceleration. Throughout the studies, the model exhibited obvious deformation stages during the seismic wave loading process, which can be divided into elastic, plastic, plastic enhancement, and failure stage. In particular, the time- and frequency-domain characteristics of the key parts of the tunnel were discussed in detail by using the continuous wavelet transform (CWT) based on the Morlet wavelet as the basis function. We found that the acceleration response was more intense within 25–60 s after the seismic wave was inputted. Furthermore, owing to “the superposition effect,” the seismic response at the crown of the under-crossing tunnel was stronger than that at the invert of the upper-span tunnel. The low and medium frequencies in the transformation of small scales (5–20) significantly affected the overlapped tunnel. These results elucidate the seismic dynamic response of the overlapped tunnel and provide guidance for the design of stabilizing structures for reinforcing tunnels against earthquakes.

The electronic structure of GaSe/silicane (GaSe/SiH) van der Waals (vdW) heterostructure in response to a vertical electric field and strain was studied via first-principle calculations. The heterostructure had indirect band gap characteristics in the range [−1.0, −0.4] V/Å and direct band gap features in the range [−0.3, 0.2] V/Å. Furthermore, a type-II to type-I band alignment transition appeared at −0.7 and −0.3 V/Å. Additionally, the GaSe/SiH vdW heterostructure had a type-II band alignment under strain, but an indirect to direct band gap semiconductor transition occurred at −3%. These results indicated that the GaSe/SiH vdW heterostructure may have applications in novel nanoelectronic and optoelectronic devices.

Converging lines of evidence indicates that smoking and internet gaming disorder (IGD) affect spontaneous brain activity, respectively. However, little is known about whether these two factors work together on the human brain. In this study, we investigated the interaction between smoking and IGD on local spontaneous brain activity using amplitude of low-frequency fluctuation (ALFF) based on resting-state fMRI (rs-fMRI). Forty-six cigarette smokers, 38 IGD individuals, 34 participants with both IGD and cigarette smoking (IGD-Smoking), and 60 healthy individuals involved in the study. Voxel-wise analysis of covariance of ALFF revealed that there were significant interactions between IGD by smoking in the right medial pre-frontal cortex (MPFC)/ventral striatum, bilateral cerebellar, and visual-related regions as well as the left temporal gyrus. In the right MPFC/ventral striatum and left temporal gyrus, ALFF in smoking group was significantly higher than healthy group while there were no significant ALFF differences between IGD-Smoking group and IGD group. While in the bilateral cerebellar and visual-related regions, ALFF in the smoking group was significantly lower than healthy group while ALFF in IGD-Smoking group did not show significant difference with IGD group. In addition, in the smoking group, ALFF of the right MPFC/ventral striatum was associated positively with anxiety and depression scores while the ALFF value in the smoking group had a trend toward negative correlation with SDS scores in the bilateral cerebellar and visual-related regions. The ALFF value in the smoking group was associated positively with anxiety score in the left temporal gyrus. These findings indicate that smoking and IGD interacted with each other in the human brain. Our results, in terms of spontaneous brain activity, may imply the fact that IGD people are more tended to get smoking. Moreover, it is possible to predict that smokers may be more easily to get internet addiction than healthy people.

Highlights • Infection risk of household contacts is 10 times higher than other contacts. • Risk of household transmission in adults is about 3-times higher than that in children. • SARS-CoV-2 is much more transmissible than SARS-CoV and Middle East Respiratory Syndrome Coronavirus in households, which challenges the home isolation of COVID-19 patients.

Background Coronavirus disease 2019 (COVID-19) continues to threaten human life worldwide. We explored how human behaviors have been influenced by the COVID-19 pandemic in Hong Kong, and how the transmission of other respiratory diseases (eg, influenza) has been influenced by human behavior. Methods We focused on the spread of COVID-19 and influenza infections based on the reported COVID-19 cases and influenza surveillance data and investigated the changes in human behavior due to COVID-19 based on mass transit railway data and the data from a telephone survey. We did the simulation based on a susceptible-exposed-infected-recovered (SEIR) model to assess the risk reduction of influenza transmission caused by the changes in human behavior. Results During the COVID-19 pandemic, the number of passengers fell by 52.0% compared with the same period in 2019. Residents spent 32.2% more time at home. Each person, on average, came into close contact with 17.6 and 7.1 people per day during the normal and pandemic periods, respectively. Students, workers, and older people reduced their daily number of close contacts by 83.0%, 48.1%, and 40.3%, respectively. The close contact rates in residences, workplaces, places of study, restaurants, shopping centers, markets, and public transport decreased by 8.3%, 30.8%, 66.0%, 38.5%, 48.6%, 41.0%, and 36.1%, respectively. Based on the simulation, these changes in human behavior reduced the effective reproduction number of influenza by 63.1%. Conclusions Human behaviors were significantly influenced by the COVID-19 pandemic in Hong Kong. Close contact control contributed more than 47% to the reduction in infection risk of COVID-19.

Self-powered sensors, as the essential information notes in low power consumption of Internet of healthcare, exhibit a great potential to monitor the state of human health in real time. In this work, a bamboo-inspired self-powered triboelectric sensor (BSTS) using 3D-printing and freeze-drying fabrication processes is presented. The designed triboelectric layer with hollow and bamboo-joint microstructures has a low equivalent stiffness coefficient and a great deformation limit, contributing significantly to the high sensitivity and wide detection range of BSTS. An electromechanical model was proposed to better understand the influence mechanism of inner structures in the dielectric layer on the sensing performance. The sensitivity of the BSTS can reach 3.627 kPa-1 in the pressure range of 0-8 kPa and still keep 1.264 kPa-1 in the range of 8-80 kPa. Moreover, the BSTS is able to detect tiny pressure as low as 5 Pa and possesses ultra-fast response time of 40 ms. A touch-controlled lighting system and a sitting posture monitoring system based on the BSTS for healthcare application are demonstrated. This strategy paves a way to fabricate the self-powered triboelectric pressure sensor with high sensitivity in all working ranges.

Background Nonpharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19) are vital to reducing transmission risks. However, the relative efficiency of social distancing against COVID-19 remains controversial, since social distancing and isolation/quarantine were implemented almost at the same time in China. Methods In this study, surveillance data of COVID-19 and seasonal influenza in 2018–2020 were used to quantify the relative efficiency of NPIs against COVID-19 in China, since isolation/quarantine was not used for the influenza epidemics. Given that the relative age-dependent susceptibility to influenza and COVID-19 may vary, an age-structured susceptible/infected/recovered model was built to explore the efficiency of social distancing against COVID-19 under different population susceptibility scenarios. Results The mean effective reproductive number, Rt, of COVID-19 before NPIs was 2.12 (95% confidence interval [CI], 2.02–2.21). By 11 March 2020, the overall reduction in Rt of COVID-19 was 66.1% (95% CI, 60.1–71.2%). In the epidemiological year 2019–20, influenza transmissibility was reduced by 34.6% (95% CI, 31.3–38.2%) compared with transmissibility in epidemiological year 2018–19. Under the observed contact pattern changes in China, social distancing had similar efficiency against COVID-19 in 3 different scenarios. By assuming the same efficiency of social distancing against seasonal influenza and COVID-19 transmission, isolation/quarantine and social distancing could lead to 48.1% (95% CI, 35.4–58.1%) and 34.6% (95% CI, 31.3–38.2%) reductions of the transmissibility of COVID-19, respectively. Conclusions Though isolation/quarantine is more effective than social distancing, given that the typical basic reproductive number of COVID-19 is 2–3, isolation/quarantine alone could not contain the COVID-19 pandemic effectively in China.

By March 31, 2020, COVID-19 had spread to more than 200 countries. Over 750,000 confirmed cases were reported, leading to more than 36,000 deaths. In this study, we analysed the efficiency of various intervention strategies to prevent infection by the virus, SARS-CoV-2, using an agent-based SEIIR model, in the fully urbanised city of Shenzhen, Guangdong Province, China. Shortening the duration from symptom onset to hospital admission, quarantining recent arrivals from Hubei Province, and letting symptomatic individuals stay at home were found to be the three most important interventions to reduce the risk of infection in Shenzhen. The ideal time window for a mandatory quarantine of arrivals from Hubei Province was between 10 January and January 17, 2020, while the ideal time window for local intervention strategies was between 15 and 22 January. The risk of infection could have been reduced by 50% if all symptomatic individuals had immediately gone to hospital for isolation, and by 35% if a 14-day quarantine for arrivals from Hubei Province had been introduced one week earlier. Intervention strategies implemented in Shenzhen were effective, and the spread of infection would be controlled even if the initial basic reproduction number had doubled. Our results may be useful for other cities when choosing their intervention strategies to prevent outbreaks of COVID-19., Highlights • Shortening the delay to hospital is the most effective intervention in Shenzhen. • 10 to 17 January is the best time for a mandatory quarantine of Hubei's arrivals. • 15 to 22 January is the best time for local intervention strategy in Shenzhen. • Work/school closure and mask wearing are effective interventions in other countries. • Airport screening is not very effective.

The portable UV photodetector is used to timely remind humans of overexposure to UV radiation. However, the traditional UV photodetector cannot meet the practical demands, and the power supply problem hinders its further development. In this work, we demonstrated a flexible, transparent, and self-powered UV photodetector by coupling of triboelectric and photoelectric effects. The device integrates a flexible ZnO nanoparticle (NP) UV photodetector, a transparent- and flexible-film-based TENG (TFF-TENG), commercial chip resistors, and LEDs on the PET thin film. The TFF-TENG could harvest mechanical energy from finger tapping and sliding motion and power the ZnO NP UV photodetector to realize self-powered detection. The voltage of the constant resistors connected with the UV photodetector in series changes from 0.5 to 19 V under the UV light with power intensities increasing from 0.46 to 21.8 mW/cm2, and the voltage variation is reflected by the number of LEDs directly. The excellent flexibility and transparency of the device could extend its application scenarios; for example, such a portable device could be applied to real-time monitoring of the UV radiation to remind humans of intense UV light.

We propose an injection-locked VCSEL on silicon photonics through a grating coupler to enhance the injection directionality. The measured coupling efficiency of the coupler is -2.5 dB at 1546.8 nm under 10o incidence.

This study investigates on the molecular and mechanical markers of intestinal fibrosis in Crohn’s Disease using endoscopic photoacoustic imaging. The quantitative imaging results in vivo are validated by histology and microelastometry.

Objective: The objective was to evaluate the application of transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model in the left atrial appendage occlusion. Methods: A total of 53 patients with persistent atrial fibrillation hospitalized from January 2015 to February 2019 were selected. Transesophageal echocardiography and cardiac computed tomography angiography were performed simultaneously before operation, and three-dimensional reconstruction of the left atrial appendage model was performed based on the cardiac computed tomography angiography findings. The morphology and size of the left atrial appendage were displayed by the left atrial appendage angiography during the operation. Results: Cardiac computed tomography angiography revealed filling defects in the left atrial appendage in four patients, whereas transesophageal echocardiography revealed thrombosis in two patients of the four patients. According to the cardiac computed tomography angiography results, the morphology of the left atrial appendage was classified into chicken wing–like, cauliflower-like, wind vane–like, and cactus-like. The diameters and depths of the left atrial appendage measured by cardiac computed tomography angiography and three-dimensional reconstruction model were found to be the greatest, and the orifice sizes and depths of the left atrial appendage measured by the left atrial appendage angiography were the smallest. Conclusion: Transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model can evaluate the morphology and size of the left atrial appendage. The cardiac computed tomography angiography and three-dimensional reconstruction model could demonstrate the internal structure of the left atrial appendage more clearly.

We performed a meta-analysis of 79 studies to explore the relationship between positive and negative indicators of parenting style and Internet addiction among 44,650 mainland Chinese teenagers. Results showed that positive indicators of parenting style had a significant negative correlation with teenagers' Internet addiction and that the correlation was moderated by region and school level. Negative indicators of parenting style were significantly and positively correlated with teenagers' Internet addiction and the correlation was also moderated by region and school level. Theoretical and practical implications of the findings are discussed.

Although many studies show that social support and Internet addiction are negatively correlated, others show a positive correlation. To address this controversy, we investigate the relation between social support and Internet addiction in mainland China with a meta-analysis of 76 articles comprising 47,899 teenagers and young adults. The results show a medium-sized negative correlation between social support and Internet addiction. Furthermore, this medium-sized link differed across measures of Internet addiction, gender, and geography. This negative correlation was smaller when measuring Internet addiction with the Internet Addiction Test (IAT) than when using other measures. In samples with more males, the negative correlation between social support and Internet addiction was larger. The size of the negative correlation coefficient was largest in Eastern China, smaller in Central China, and smallest in Western China.

Credibility assessment of a simulation model is a hard problem as subjectivity is always involved. Linguistic expressions are much more straightforward and friendlier for a subject matter expert (SME) to represent qualitative judgments. Therefore, an assessment method based on hesitant cloud linguistic term sets (HCLTSs) is proposed in this paper. SMEs use context-free grammars and linguistic expressions to express their opinions. Then, these linguistic expressions are transformed into HCLTSs. Finally, aggregation results are calculated by synthetic cloud algorithm and weighted average cloud algorithm. An example under multiple-criteria group decision making is presented to illustrate the proposed method for credibility assessment.

Predicting battery remaining useful life (RUL) is used for early warning of battery aging failure and providing instructions of battery maintenance and recycling. The existing RUL prediction focus too much on decreasing the dependence of aging tests, neglecting the value of test data. In this regard, a battery RUL prediction method driven by multi-source data is proposed for EVs to make full use of the aging test data from other cells. Six lithium-ion batteries were used to verify the effectiveness of the method. The results show that the prediction error is less than only 1 cycle in the case of capacity ‘diving’. In conclusion, the proposed method effectively improves the performance of RUL prediction by using multi-source data, and provides a solution for battery management in the era of big data.

NTRU is a fast public key cryptosystem remaining unbroken. However, there is no known worst-to-average reduction for the original NTRU cryptosystem. Several provably secure NTRU modifications such as NAEP, pNE and NTRUCCA were proposed in the literature at the cost of inefficiency in encryption/decryption and enlarged ciphertext expansion. NAEP completes the IND-CCA security of the original NTRU under the average-case NTRU one-wayness intractability assumption. Both pNE and NTRUCCA obtain provable security goals under worst-case lattice assumptions. In this paper, a general framework for NTRU is considered, and a new PKC called D-NTRU is proposed. It is shown that the D-NTRU cryptosystem reduces the ciphertext expansion of the NTRU algorithm, and the encryption and decryption algorithms of D-NTRU perform even asymptotically faster than the NTRU algorithm only at the cost of slightly enlarged secret and public keys. The security of D-NTRU is proven in the standard model and under the average-case NTRU one-wayness assumption. The proof of the IND-CPA security of D-NTRU is completed by introducing another NTRU variant called C-NTRU as a bridge, defining some problems, and then proving the equivalence of these problems. So the proposed D-NTRU algorithm is more advantageous than the original NTRU algorithm, and much more efficient than all the provably secure variants of NTRU.

Inorganic perovskite CsPbBr3 nanocrystals (NCs) are emerging, highly attractive light emitters with high color purity and good thermal stability for light-emitting diodes (LEDs). Their high photo/electroluminescence efficiencies are very important for fabricating efficient LEDs. Here, we propose a novel strategy to enhance the photo/electroluminescence efficiency of CsPbBr3 NCs through doping of heterovalent Ce3+ ions via a facile hot-injection method. The Ce3+ cation was chosen as the dopant for CsPbBr3 NCs by virtue of its similar ion radius and formation of higher energy level of conduction band with bromine in comparison with the Pb2+ cation to maintain the integrity of perovskite structure without introducing additional trap states. It was found that by increasing the doping amount of Ce3+ in CsPbBr3 NCs to 2.88% (atomic percentage of Ce compared to Pb) the photoluminescence quantum yield (PLQY) of CsPbBr3 NCs reached up to 89%, a factor of 2 increase in comparison with the native, undoped ones. The ...

Identifying the exact transmission route(s) of infectious diseases in indoor environments is a crucial step in developing effective intervention strategies. In this study, we proposed a comparative analysis approach and built a model to simulate outbreaks of 3 different in-flight infections in a similar cabin environment, that is, influenza A H1N1, severe acute respiratory syndrome (SARS) coronavirus (CoV), and norovirus. The simulation results seemed to suggest that the close contact route was probably the most significant route (contributes 70%, 95% confidence interval [CI]: 67%-72%) in the in-flight transmission of influenza A H1N1 transmission; as a result, passengers within 2 rows of the index case had a significantly higher infection risk than others in the outbreak (relative risk [RR]: 13.4, 95% CI: 1.5-121.2, P = .019). For SARS CoV, the airborne, close contact, and fomite routes contributed 21% (95% CI: 19%-23%), 29% (95% CI: 27%-31%), and 50% (95% CI: 48%-53%), respectively. For norovirus, the simulation results suggested that the fomite route played the dominant role (contributes 85%, 95% CI: 83%-87%) in most cases; as a result, passengers in aisle seats had a significantly higher infection risk than others (RR: 9.5, 95% CI: 1.2-77.4, P = .022). This work highlighted a method for using observed outbreak data to analyze the roles of different infection transmission routes.

The inflammatory process in stroke is the major contributor to blood-brain barrier (BBB) breakdown. Previous studies indicated that semaphorin 4D (Sema4D), an axon guidance molecule, initiated inflammatory microglial activation and disrupted endothelial function in the CNS. However, whether Sema4D disrupts BBB integrity after stroke remains unclear. To study the effect of Sema4D on BBB disruption in stroke, rats were subjected to transient middle cerebral artery occlusion and targeted injection of lentivirus-mediated clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 gene disruption of PlexinB1. We found that Sema4D synchronously increased with BBB permeability and accumulated in the perivascular area after stroke. Suppressing Sema4D/PlexinB1 signaling in the periinfarct cortex significantly decreased BBB permeability as detected by MRI and fibrin deposition, and thereby improved stroke outcome. In vitro, we confirmed that Sema4D disrupted BBB integrity and endothelial tight junctions. Moreover, we found that Sema4D induced pericytes to acquire a CD11b-positive phenotype and express proinflammatory cytokines. In addition, Sema4D inhibited AUF1-induced proinflammatory mRNA decay effect. Taken together, our data provides evidence that Sema4D disrupts BBB integrity and promotes an inflammatory response by binding to PlexinB1 in pericytes after transient middle cerebral artery occlusion. Our study indicates that Sema4D may be a novel therapeutic target for treatment in the acute phase of stroke.-Zhou, Y.-F., Li, Y.-N., Jin, H.-J., Wu, J.-H., He, Q.-W., Wang, X.-X., Lei, H., Hu, B. Sema4D/PlexinB1 inhibition ameliorates blood-brain barrier damage and improves outcome after stroke in rats.

Objective: The aim of this study was to evaluate the safety and efficiency of enucleation (EU) for proximal pancreatic non-invasive neoplasms. Methods: Patients with solitary non-invasive neoplasms in the proximal pancreas from January 1998 to April 2014 at the Second Affiliated Hospital of Zhejiang University, Hangzhou, China were included. Different operations and outcomes were analyzed. Results: A total of 123 patients were enrolled. Forty patients (32.5%) underwent EU including 18 patients who had tumors close to the main pancreatic duct (MPD). Sixty-one patients (49.6%) had pancreaticoduodenectomy (PD) performed and 22 (17.9%) underwent central pancreatectomy (CP). Pathological outcomes included neuroendocrine tumors, cystic lesions, and solid pseudopapillary tumors. Operation time, intra-operative blood loss, and duration of hospital stay were significantly reduced in the EU group. PD was associated with the greatest complication rate (55.7%), followed by EU (50%) and CP (40.9%), though the pancreatic fistula rate after EU was the highest (50%), especially in patients with tumors larger than 3 cm and tumors close to the MPD. EU had advantages in the preservation of pancreatic parenchyma and endocrine and exocrine function. Conclusions: EU can be carried out safely and effectively for tumors in the proximal pancreas with improved outcomes compared with standard resections, even if the tumor is larger than 3 cm and close to the MPD.