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A dilemma faced by classification is that the data is not collected at the same frequency in some applications. We investigate the mixed frequency data in a new way and recognize them as a special style of multi-view data, in which each view data is collected at a different sampling frequency. This paper proposes a discriminative dictionary pair learning method constrained by ordinal locality for mixed frequency data classification (shorted by DPLOL-MF). This method integrates synthesis dictionary and analysis dictionary into a dictionary pair, which not only improves computational cost caused by the ${\ell_0}$ or ${\ell_1}$ -norm constraint, but also can deal with the sampling frequency inconsistency. The DPLOL-MF utilizes a synthesis dictionary to learn class-specified reconstruction information and employs an analysis dictionary to generate coding coefficients by analyzing samples. Particularly, the ordinal locality preserving term is leveraged to constrain the atoms of dictionaries pair to further facilitate the learned dictionary pair to be more discriminative. Besides, we design a specific classification scheme for the inconsistent sample size of mixed frequency data. This paper illustrates a novel idea to solve the classification task of mixed frequency data and the experimental results demonstrate the effectiveness of the proposed method.

OBJECTIVE Stereotactic radiosurgery (SRS) treats severe, medically refractory essential tremor and tremor-dominant Parkinson disease. However, the optimal target for SRS treatment within the thalamic ventral intermediate nucleus (VIM) is not clearly defined. This work evaluates the precision of the physician-selected VIM target, and determines the optimal SRS target within the VIM by correlation between early responders and nonresponders. METHODS Early responders and nonresponders were assessed retrospectively by Elements Basal Ganglia Atlas autocontouring of the VIM on the pre–SRS-treatment 1-mm slice thickness T1-weighted MRI and correlating the center of the post–SRS-treatment lesion. Using pre- and posttreatment diffusion tensor imaging, the fiber tracking package in the Elements software generated tremor-related tracts from autosegmented motor cortex, thalamus, red nucleus, and dentate nucleus. Autocontouring of the VIM was successful for all patients. RESULTS Among 23 patients, physician-directed SRS targets had a medial–lateral target range from +2.5 mm to −2.0 mm from the VIM center. Relative to the VIM center, the SRS isocenter target was 0.7–0.9 mm lateral for 6 early responders and 0.9–1.1 mm medial for 4 nonresponders (p = 0.019), and without differences in the other dimensions: 0.2 mm posterior and 0.6 mm superior. Dose–volume histogram analyses for the VIM had no significant differences between responders and nonresponders between 20 Gy and 140 Gy, mean or maximum dose, and dose to small volumes. Tractography data was obtained for 4 patients. CONCLUSIONS For tremor control in early responders, the Elements Basal Ganglia Atlas autocontour for the VIM provides the optimal SRS target location that is 0.7–0.9 mm lateral to the VIM center.

Cutaneous infection by Balamuthia mandrillaris is a rare condition that is sometimes complicated by life-threatening CNS involvement. It often evades timely diagnosis due to its rarity and non-specific clinical manifestations. Patients can be either immunocompetent or immunocompromised. It is probably transmitted via inhalation or inoculation through broken skin, and then spreads to the brain and other organs through haematogenous spread. It is important for clinicians to be aware of this disease because rapid diagnosis and subsequent therapy has, in some cases, been associated with survival. In this Grand Round, we report the case of a 7-year-old boy who presented with large, chronic plaques on his face. Several biopsies showed non-specific granulomatous inflammation. The patient deteriorated rapidly and died within 1 month of displaying abnormal symptoms in the CNS. Immunohistochemical staining of skin tissue identified B mandrillaris as the infectious agent. The diagnosis was confirmed with PCR, which detected B mandrillaris DNA in formalin-fixed skin tissue sections. B mandrillaris infection should be considered in the differential diagnosis of patients with chronic granulomatous lesions. We also reviewed the epidemiology, B mandrillaris in nature and in the laboratory, clinical manifestations, histopathology, diagnosis, and treatment of infection.

Background: The development of cancer drugs is among the most focused “bench to bedside activities” to improve human health. Because of the amount of data publicly available to cancer research, drug development for cancers has significantly benefited from big data and Artificial Intelligence (AI). In the meantime, challenges, like curating the data of low quality, remain to be resolved. Objective: This review focused on the recent advancements in and challenges of AI in developing cancer drugs. Method: We discussed target validation, drug repositioning, de novo design, and compounds' synthetic strategies. Results and Conclusion: AI can be applied to all stages during drug development, and some excellent reviews detailing the applications of AI in specific stages are available.

Background B-cell acute lymphoblastic leukemia (B-ALL) is the most common malignancy of childhood. Even though significant progresses have been made in the treatment of B-ALL, some pediatric B-ALL have still poor prognosis. The identification of tumor autoantibodies may have utility in early cancer diagnosis and immunotherapy. In this study, we used serological proteome analysis (SERPA) to screen serum autoantibodies of pediatric B-ALL, aiming to contribute to the early detection of B-ALL in children. Methods The total proteins from three pooled B-ALL cell lines (NALM-6, REH and BALL-1 cells) were separated using two-dimensional gel electrophoresis (2-DE), which was followed by Western blot by mixed serum samples from children with B-ALL (n=20) or healthy controls (n=20). We analyzed the images of 2-D gel and Western blot by PDQuest software, and then identified the spots of immune responses in B-ALL samples compared with those in control samples. The proteins from spots were identified using mass spectrometry (MS). The autoantibodies against alpha-enolase (α-enolase) and voltage-dependent anion-selective channel protein 1 (VDAC1) were further validated in sera from another 30 children with B-ALL and 25 normal individuals by the use of enzyme-linked immunosorbent assay (ELISA). The protein expression levels of the candidate antigens α-enolase and VDAC1 in B-ALL were thoroughly studied by immunohistochemical analysis. Results Utilizing the SERPA approach, α-enolase and VDAC1 were identified as candidate autoantigens in children with B-ALL. The frequencies of autoantibodies against α-enolase and VDAC1 in children with B-ALL were 27% and 23% by using ELISA analysis, respectively, which were significantly higher than those in normal controls (4% and 0, p Conclusions This study incidated that α-enolase and VDAC1 may be the autoantigens associated with B-ALL. Therefore, α-enolase and VDAC1 autoantibodies may be the potential serological markers for children with B-ALL.

In this paper, we establish the structure model of multilayer Graphene (MLG)/Mg2Si/Si heterojunction photodetector (PD) based on the Technology CAD (TCAD). We further investigate the effect of Graphene layers on the photoelectric properties of MLG/Mg2Si/Si heterojunction PD. The simulation results indicate that compared with Mg2Si/Si PD, the photoelectric properties of MLG/Mg2Si/Si heterojunction PD are enhanced. The responsivity is increased from 0.51 A/W to 0.84 A/W, the external quantum efficiency (EQE) increased from 70.68% to 107.29%, and the noise equivalent power (NEP) reduced from 7.071011 WHz1/2 to 1.591011 WHz1/2. It is further shown that detectivity (D*) is increased from 1.41010 Jones to 6.31010 Jones, and the on/off ratio is increased from 141.45 to 629. After adding Graphene layers, the maximum improvement rates of the responsivity, EQE, NEP, D*, and on/off ratio of heterojunction PDs improved by 65%, 52%, 77.5%, 350%, and 345%, respectively. Moreover, it is seen that the energy band of MLG/Mg2Si/Si heterojunction PDs is shifted to the valence band, the reverse breakdown voltage and dark current are decreased. A strong electric field is formed at the interface between MLG and Mg2Si, which is beneficial to the separation of photogenic carriers.

Clinicians’ information needs are frequent and, all too often, unresolved. Online information resources are available to address many of these needs, but they are underutilized for a variety of reasons. The information needs that arise while clinicians use clinical information systems are particularly disposed to resolution with such resources. Many researchers have investigated approaches to integrating these systems with each other. One method that has been investigated and shows promise to being widely disseminated is called “infobuttons”. We describe work to develop infobutton managers that provide a flexible, generic method for integrating infobuttons with clinical systems. These infobutton managers have been successfully integrated with several different clinical information systems in an institution-independent manner. We also describe a standard developed by Health Level Seven International (HL7) to enable a standards-based approach to implementing infobuttons. Finally, we discuss ongoing research related to this kind of clinical decision support capability, including question and answering systems, as well as potential future directions.

Neutrophilic asthma (NA) is a severe type of steroid resistant asthma, and so far the immune mechanisms underlying NA are not clear. In this article, we performed a comprehensive assessment of Th-cell subsets and cytokines in severe NA patients. A total of 13 healthy individuals and 31 severe asthma patients were enrolled in this study. Refractory asthma patients were defined as those with eosinophilic asthma (EA, accounted for 32% of asthmatic patients) or NA (68%) according to sputum neutrophil/eosinophil counts or blood eosinophils. Th-cell subsets in peripheral blood mononuclear cells (PBMCs) were analyzed by flow cytometry, and cytokines were detected by cytometric bead array (CBA). The results showed significant differences were observed in Th-cell phenotypes, where the number of Th1 cells were reduced and the numbers of Th2 cells were increased in NA and EA groups, respectively, when compared with healthy controls. Th17 cells were not strongly associated with severe neutrophilic asthma. The frequencies of mucosal-associated invariant T (MAIT) cells were strikingly reduced in severe asthma patients, especially in the NA group. This NA group also showed increased levels of IL-17A, IL-17F, TNF-α, and IL-6 in serum and increased levels of IL-17A, IL-17F, IFN-γ, TNF-α, IL-1β, IL-5, IL-6, and IL-8 in sputum. In addition, sputum IL-6 was positively correlated with TNF-α, IFN-γ, IL-17A, and IL-8. Our results uncovered a controversial role for Th17 cells, which were reduced in severe asthma patients. Severe neutrophilic asthma was associated with a striking deficiency of MAIT cells and high pro-inflammatory cytokine levels.

BACKGROUND Despite being the most common intraocular malignancy among adults, choroidal melanoma is a rare cancer type, even more so when accompanied by lung cancer. We report a patient with synchronous choroid melanoma and lung cancer treated with carbon ion radiotherapy (CIRT). CASE SUMMARY A 41-year-old woman was transferred to our center with a diagnosis of choroidal melanoma in her right eye. During the examination, we found a right lung tumor that was histologically diagnosed as lung cancer. The patient was treated with CIRT for both malignant neoplasms. The CIRT dose was 70 photon equivalent doses (GyE) in five fractions for the right eye choroidal melanoma and 72 GyE in 16 fractions for the right lung cancer. At 3 mo after CIRT, the choroidal melanoma completely disappeared, as did the right lung cancer 7 mo after; the patient was in complete remission. CONCLUSION CIRT may be an effective treatment for double primary lung cancer and choroid melanoma.

Continual learning has attracted much attention in recent years, and many continual learning methods based on deep neural networks have been proposed. However, several important problems about these methods may lead to high decision cost and affect the practical application of continual learning networks. First, continual learning networks treat all categories equally, although the unbalance of misclassification cost happens in real-world cases. Second, there is a trade-off between learning new knowledge and keep old knowledge, which leads to the forgetting of old knowledge (i.e., the catastrophic forgetting). Third, even if low confidence of a sample, the continual learning methods based on the neural network will still give a clear classification result. We propose a sequential three-way decision model for continual learning to address these problems, named Incremental Sequential Three-Way Decision model (ISTWD). Introducing cost-sensitive sequential three-way decision to continual learning network, ISTWD reduces the decision cost of continual learning, which may alleviate the potentially high cost caused by the accuracy loss in continual learning. Besides, ISTWD includes a checkpoint procedure to judge whether the process of continual learning should stop. Experimental results on CIFAR-100 and Tiny-ImageNet verify the effectiveness of our method.

Skin-mountable capacitive-type strain sensors with great linearity and low hysteresis provide inspiration for the interactions between human and machine. For practicality, high sensing performance, large stretchability, and self-healing are demanded but limited by stretchable electrode and dielectric and interfacial compatibility. Here, we demonstrate an extremely stretchable and self-healing conductor via both hard and soft tactics that combine conductive nanowire assemblies with double dynamic network based on π-π attractions and Ag-S coordination bonds. The obtained conductor outperforms the reported stretchable conductors by delivering an elongation of 3250%, resistance change of 223% at 2000% strain, high durability, and multiresponsive self-healability. Especially, this conductor accommodates large strain of 1500% at extremely knotted and twisted deformations. By sandwiching hydrogel conductors with a newly developed dielectric, ultrahigh stretchability and omni-healability are simultaneously achieved for the first time for a capacitive strain sensor inspired by metal-thiolate coordination chemistry, showing great potentials in wearable electronics and soft robotics.

Many patients with ocular myasthenia gravis (OMG) progress to generalized disease within the first 2 years of the onset of ocular symptoms. Several retrospective studies have identified risk factors associated with generalization, however these studies included patients on immunosuppression therapy or those undergoing thymectomy, which may reduce the generalization risk. In this study we explored the risk factors for generalization in non-immunosuppressed and non-thymectomized patients with OMG. Data from patients with OMG treated at seven tertiary hospitals in China were retrospectively reviewed. Clinical characteristics, including sex, age at onset, symptoms at onset, comorbid autoimmune diseases, neostigmine test response, repetitive nerve stimulation (RNS) findings, presence of serum anti-acetylcholine receptor antibody (AChR-Ab), and thymic status based on radiological and pathological studies, were collected. The main outcome measure was disease generalization. The follow-up period was defined as the date of ocular symptom onset to the date of confirmation of generalization or immunotherapy initiation, or last follow-up (defined as 60 months). The Cox proportional hazards model was used to assess the risk factors for generalization. Overall, 572 patients (269 women) were eligible for inclusion in the analysis, of whom 144 developed generalization. The mean (standard deviation) onset age was 45.5 (19.8) years, and the median (interquartile range) follow-up period was 14.5 (7.0–47.3) months. Multivariable Cox regression analysis demonstrated that both early-onset (adjusted hazard ratio [aHR] 5.34; 95% confidence interval [CI] 1.64–17.36; p = 0.005) and late-onset (aHR 7.18; 95% CI 2.22–23.27; p = 0.001) in adulthood, abnormal RNS findings (aHR 3.01; 95% CI 1.97–4.61; p

Novice lecturer professional development is regarded as a continuous process that begins during pre-service lecturer training and continues throughout the academic career. It is focused on enabling and empowering lecturers by improving their professional confidence, teaching skills, and classroom management. The purpose of this paper is to explore the professional development practices of novice lecturers and to comprehend their situation and feelings about these practices at a public university in China. Using a qualitative case study, five novice lecturers were selected to participate in this study. Relevant programs and activities on professional development are analyzed. Semi-structured interviews were conducted to explore the perceptions of novice lecturers. Another data collection method was documentation. The findings indicate that the professional development practices of novice lecturers in this selected university were done by organizing lecturer teaching competitions, teaching ability training, establishing the mentorship system, information technology application ability training. Novice lecturers are generally satisfied with the implementation of these programs and activities and hope that the university could provide more opportunities to help them grow quickly. https://doi.org/10.26803/ijlter.20.10.7

Lung cancer is the most common cancer and the leading cause of cancer-related death worldwide. The optimal management of computed tomography (CT)-indeterminate pulmonary nodules is important. To optimize individualized follow-up strategies, we developed a radiomics nomogram for predicting 2-year growth in case of indeterminate small pulmonary nodules. A total of 215 histopathology-confirmed small pulmonary nodules (21 benign and 194 malignant) in 205 patients with ultra-high-resolution CT (U-HRCT) were divided into growth and nongrowth nodules and were randomly allocated to the primary (n = 151) or validation (n = 64) group. The least absolute shrinkage and selection operator (LASSO) method was used for radiomics feature selection and radiomics signature determination. Multivariable logistic regression analysis was used to develop a radiomics nomogram that integrated the radiomics signature with significant clinical parameters (sex and nodule type). The area under the curve (AUC) was applied to assess the predictive performance of the radiomics nomogram. The net benefit of the radiomics nomogram was assessed using a clinical decision curve. The radiomics signature and nomogram yielded AUCs of 0.892 (95% confidence interval [CI]: 0.843–0.940) and 0.911 (95% CI: 0.867–0.955), respectively, in the primary group and 0.826 (95% CI: 0.727–0.926) and 0.843 (95% CI: 0.749–0.937), respectively, in the validation group. The clinical usefulness of the nomogram was demonstrated by decision curve analysis. A radiomics nomogram was developed by integrating the radiomics signature with clinical parameters and was easily used for the individualized prediction of two-year growth in case of CT-indeterminate small pulmonary nodules. • A radiomics nomogram was developed for predicting the two-year growth of CT-indeterminate small pulmonary nodules. • The nomogram integrated a CT-based radiomics signature with clinical parameters and was valuable in developing an individualized follow-up strategy for patients with indeterminate small pulmonary nodules.

Background: Posture Instability (PI) is known to be a severe complication in Parkinson’s Disease (PD), and its mechanism remains poorly understood. Our study aims to explore the changes of brain network in PI of PD, and further investigate the role of peripheral inflammation on activities of different brain regions in PD with PI. Methods: 167 individuals were recruited, including 36 PD cases with PI and 131 ones without PI. We carefully assessed the status of motor and cognitive function, measured serum inflammatory factors, and detected the dopaminergic pathways and the metabolism of different brain regions by Positron Emission Tomography (PET). Data analysis was conducted by variance, univariate analysis, chi-square analysis, logistic regression, and partial correlation. Result: No difference was found for age or onset age between the two groups (P>0.05). Female patients were susceptible to posture impairment and had a 2.14-fold risk for PI compared with male patients in PD (P Conclusion: Female patients were susceptible to posture instability and had a 2.14-fold risk for PI of PD. Patients with PI had more severe impairments of motor and cognitive function for a longer duration than those without PI. PI was associated with a dopamine drop of the nigrostriatal system and lower activities of the limbic cortex in PD. Peripheral inflammation may be involved in degeneration of the cerebral cortex in PD combined with PI.

PurposeA global shift in ethical/sustainable purchase drivers highlights Generation Z (persons aged 15–24) as an important market for producers and marketers. Although much research has touched on fair trade consumption, very little has focused on Gen Z's consumption patterns. This study provides insights into and implications of younger consumers' motivations in ethical/sustainable consumption.Design/methodology/approachThis research examines Gen Z's purchase intention towards fair trade coffee with the theory of reasoned action framework. Data were collected with a convenience sample, and analyses were conducted using structural equation modelling.FindingsThe research found a significant influence of knowledge of fair trade towards product interest. Furthermore, general attitudes towards fair trade had a significant influence on product interest, product likeability and convenience. Lastly, product interest and subjective norms significantly influenced Gen Z's purchase intentions towards fair trade coffee.Originality/valueFindings suggest that Gen Z's shift in ethical/sustainable consumption revolves around their subjective norms or peer influence circles and contributes to the notions of self-branding, identify claims and social currency. Younger generations are digital natives, and social media has created a looking glass into their actions. This digital expansion has created more opportunities for individuals to monitor the actions of others and release information in real-time. Therefore, ethical/sustainable consumption by Gen Z can be used as a communication tool among their peers to project personal values and ideological shifts and to influence others close to them.

OBJECTIVE The convoluted element of PM2.5 may cause various biological reactions. Nowadays, few studies have indicated the long-term health effects of PM2.5 on HCC. Therefore, this meta-analysis first aims to obtain more precise estimates of the effects of PM2.5 exposure on HCC to assess the strength of the evidence. METHODS A combination of computer and manual retrieval was used to search in Medline through PubMed, EMBASE and Web of Science. Review Manager 5.3 software was used to examine the heterogeneity among the studies. RESULTS Finally, 8 qualified articles meet the inclusion criteria. The results were I2 = 0%, P > 0.1 indicating that there was no heterogeneity. The results showed that the concentration of PM2.5 increased by 10 μg/m3 was significantly correlated with liver cancer, and HR was 1.22 (95% CI 1.14-1.30, P

The purpose of this study was to investigate whether or not angiotensin II type 1 receptor blocker irbesartan (ARB) with a partial agonist of PPAR-γ could protect against chronic nocturnal intermittent hypoxia (CIH)–induced cardiac Fas/FasL-mediated to mitochondria-mediated apoptosis. Sprague–Dawley rats were in a normoxic control group (CON-G), or rats were in a chronic nocturnal intermittent hypoxia group (HP-G, from 3 to 7% oxygen versus 21% oxygen per forty seconds cycle, nocturnally 8 h per day for 1 month), or rats were in a chronic nocturnal intermittent hypoxia group pretreated with ARB (50 mg/kg/day, S.C.) (ARB-HP-G). Echocardiography, H&E staining, TUNEL staining, and Western blotting were measured in the left ventricle. Hypoxia-induced SIRT1 degradation, Fas receptors, FADD, active caspase-8 and caspase-3 (Fas/FasL apoptotic pathway) and Bax, tBid, active caspase-9 and -3 (mitochondrial apoptotic pathway) and TUNEL-positive apoptosis were reduced in ARB-HP-G when compared with HP-G. IGF-I, IGF1 receptor, p-PI3k, p-Akt, Bcl2, and Bcl-XL (IGF1/PI3K/AKT pro-survival pathway) were increased in ARB-HP-G compared to HP-G. Our findings suggest that the ARB may prevent cardiac Fas/FasL to mitochondrial apoptotic pathways and enhance cardiac IGF1/PI3K/AKT pro-survival pathway in the sleep apnea model associated with JNK de-activation and SIRT1 upregulation. ARB prevents chronic sleep apnea–enhanced cardiac apoptosis via enhancing survival pathways.

Autoimamune disease is an inappropriate response to one's tissues due to a break in immune tolerance and exposure to self-antigens. It often leads to structural and functional damage to organs as well as systemic disorders. To date, there are no effective interventions to prevent the progression of autoimmune diseases. Hence, there is an urgent need for new treatment targets. TRPM7 is an enzyme-coupled, transient receptor ion channel of the subfamily M that plays a vital role in pathologic and physiologic conditions. While TRPM7 is constitutively activated under certain conditions, it can regulate cell migration, polarization, proliferation, and cytokine secretion. However, a growing body of evidence highlights the critical role of TRPM7 in autoimmune diseases, including rheumatoid arthritis, multiple sclerosis, and diabetes. Herein we present; a) a review of the channel kinase properties of TRPM7 and its pharmacological properties, b) discuss the role of TRPM7 in immune cells (neutrophils, macrophages, lymphocytes, and mast cells) and its upstream immunoreactive substances, and c) highlight TRPM7 as a potential therapeutic target for autoimmune diseases.

Background Laparoscopic hepatectomy (LH) for treating hepatocellular carcinoma (HCC) is a complex procedure. Compared to open hepatectomy (OH), LH offers certain advantages such as faster recovery, smaller incisions, and shorter hospital stay, but bleeding during LH remains a significant concern. Currently, the impacts of blood loss on the short- and long-term outcomes of patients undergoing LH are poorly understood. This retrospective study analyzes the impacts of blood loss on the prognosis of LH in HCC patients. Methods Between 2001 and 2019, 192 patients underwent LH for HCC at a single high-volume center. These patients were divided into two groups according to intraoperative blood loss (IBL) (Group A: ≤250 mL; Group B: >250 mL). The patient characteristics assessed included age, gender, cirrhosis, hepatitis B virus (HBV) infection, Child-Pugh class, number of tumors, tumor size, vascular invasion, and diabetes mellitus. The perioperative and postoperative factors compared included operative time, blood loss, type of resection, blood transfusion, general complications, surgical complications, hospital mortality, and postoperative hospital stay. Results Factors associated with IBL in our multivariate analysis included the type of resection (P1,000 mL had a worse median OS (24 months) and median RFS (6 months), while patients with IBL 250–1,000 mL had a median OS of 36 months and RFS of 12 months, and patients with IBL ≤250 mL had a median OS of 36 months and RFS of 24 months. Conclusions We found that the extent of IBL during LH was related to tumor size, operative time, and surgery type. Increased IBL during LH was also an independent prognostic factor for tumor recurrence. Furthermore, a dose-response relationship between increased IBL and decreased RFS and OS was evident.

BACKGROUND Neurofibromatosis type 1 (NF1) is an inherited autosomal dominant disorder affecting many parts of the body with cafe au lait spots, skeletal deformity, and scoliosis. A familial case of NF1 with scoliosis and a painless mass had not yet been reported. CASE SUMMARY We describe the case of a 15-year-old male patient with a painless lump on the left side of his neck for 10 years and scoliosis. His right shoulder was about 5 cm lower than the left, the left side of his face was deformed, and the left submandibular skin was relaxed. The folding and drooping were obvious and movement was poor. Computed tomography revealed the involvement of the neck, upper chest wall, and surrounding left shoulder, accompanied by bone changes and scoliosis. Histological evaluation showed subepidermal pale blue mucoid degeneration, fibrous fusiform cells in the dermis in a fascicular, woven arrangement. His mother had the same medical history. The diagnosis was neurofibromatosis of the left neck. Various parts of the tumor tissue were serially resected during several visits. Eight months after surgery, there was a slight tendency to regrow. CONCLUSION This case of slow-progressing NF1 highlights the importance of early diagnosis and treatment to reduce its impact on the patient's growth and development.

The purpose of the study was to investigate the branding strategies implemented by the Beijing Aimer Lingerie Company Ltd. that support its success. A case study method was used which included on-site visits and in-depth interviews with Aimer executives, mid-level managers, and frontline employees. Additionally, a review of the company’s website and internal documents, as well as an extensive external search of relevant news reports, social media contents, industry information, and academic literature contributed to the data source. The study adopted a deductive content analysis strategy by integrating Balmer and Gray’s (2003) C2ITE framework and the luxury fashion brand dimensions, and used triangulation as a validation strategy. The most important element of Aimer’s success is strategic planning and continuous brand development. In every step of Aimer’s business development, the executive team strategically planned its next step and had a clear vision for the future. Aimer executed well for each dimension of the analytical framework (Cultural, Marketing Communication, Tangible Branding, Intangible Branding, and Commitment) except one: brand signature (Cultural dimension). The findings provide valuable implications for other Chinese apparel manufacturers striving to establish their own brands, as well as global companies that compete in the Chinese marketplace.

Purpose The purpose of this paper is to gain an understanding of baby boomers’ physiological and psychological needs through clothing consumption. Design/methodology/approach A qualitative research approach was employed for this study. Data were collected from two generational segments: early baby boomers (1946–1954), and late baby boomers (1955–1964). In total, 13 informants aged from 53 to 71 years were participated in this study. Content analysis and interpretive approach were used for data analysis. Findings According to the findings, there are several reasons why the baby boomers shopped for clothing, including a way of stress relief or retail therapy, wardrobe update, replacement of worn-out garments, attractiveness of clothing styles and convenience. Style, fit, comfort and colour were the four most important product evaluative cues. Other than product cues, age appropriateness is an important factor for clothing consumption. Many informants were disappointed with their current body type, shopping experience and the industry offers. Practical implications Age-appropriate clothing can give wearers greater self-assurance/-gratification. If fashion designers create their products based on the baby boomers’ cognitive age, it would probably increase their customers’ acceptance and satisfaction. Originality/value The rapid growth of the aging population is a global phenomenon. Therefore, investigating the needs and challenges of the baby boomer generation is both timely and imperative. This study intended to offer new knowledge on the issues of baby boomers’ unmet needs, and provide insights and implications to fashion practitioners.

BACKGROUND Awake craniotomy has been widely used for tumor resection, epilepsy surgery, deep brain stimulation, and carotid endarterectomy. The report on awake artery malformation clipping is rare, especially for anesthesia management. CASE SUMMARY A 62-year-old female diagnosed with malformation of anterior cerebral artery at the right side. We clipped the artery malformation with intraoperative neuromonitoring (IONM) in awake craniotomy. Spontaneous respiration was maintained throughout the procedure by nasopharyngeal airway during the surgery successfully. CONCLUSION The technique of monitoring anesthesia care can be performed successfully for the patient with IONM.

The problem of initialization of active learning is considered in this paper. Especially, this paper studies the problem in an imbalanced data scenario, which is called as class-imbalance active learning cold-start. The novel method is two-stage clustering-based active learning cold-start (ALCS). In the first stage, to separate the instances of minority class from that of majority class, a multi-center clustering is constructed based on a new inter-cluster tightness measure, thus the data is grouped into multiple clusters. Then, in the second stage, the initial training instances are selected from each cluster based on an adaptive candidate representative instances determination mechanism and a clusters-cyclic instance query mechanism. The comprehensive experiments demonstrate the effectiveness of the proposed method from the aspects of class coverage, classification performance, and impact on active learning.

Background Diagnostic criteria for sarcopenia have not been established in Chinese. This study established criteria based on the L3‐skeletal muscle index (L3‐SMI) and assessed its value for outcomes predicting in cirrhotic Chinese patients. Methods Totally 911 subjects who underwent a CT scan at two centres were enrolled in Cohort 1 (394 male and 417 female subjects, aged 20–80 years). The data of those subjects younger than 60 years (365 male and 296 female subjects) were used to determine the reference intervals of the L3‐SMI and its influencing factors. Cohort 2 consisted of 480 patients (286 male and 184 female patients) from three centres, and their data were used to investigate the prevalence of sarcopenia and evaluate the value of L3‐SMI for predicting the prognosis and complications of cirrhosis. Results Age and sex had the greatest effects on the L3‐SMI (P 14 (RR = 4.310, 95% CI 2.091–8.882, P

BACKGROUND Radical cystectomy is considered the first choice for the treatment of muscle-invasive bladder cancer. However, for some patients who have lost the indications for surgery, external beam radiotherapy is a non-invasive and effective treatment. CASE SUMMARY A 76-year-old patient with bladder cancer who had serious comorbidities and could not tolerate surgery or chemotherapy came to the Wuwei Heavy Ion Center. He received carbon ion radiotherapy (CIRT) with a whole-bladder dose of 44 GyE and tumor boost of 20 GyE. When he finished CIRT, his bladder cancer-related hematuria completely disappeared, and computed tomography examination showed that the tumor had obviously decreased in size. At the 3-mo follow-up, the tumor disappeared, and there were no acute or late adverse events. CIRT was well tolerated in this patient. CONCLUSION CIRT may allow for avoiding resection and was well tolerated with curative outcomes.

Background Ultra-high-resolution computed tomography (U-HRCT) has improved image quality for displaying the detailed characteristics of disease states and lung anatomy. The purpose of this study was to retrospectively examine whether U-HRCT target scanning in the lateral or oblique body position (protocol G scan) could predict histological invasiveness of pulmonary adenocarcinoma manifesting as pure ground-glass nodules (pGGNs). Methods From January 2015 to December 2016, 260 patients with 306 pathologically confirmed pGGNs who underwent preoperative protocol G scans were retrospectively reviewed and analyzed. The U-HRCT findings of preinvasive lesions [atypical adenomatous hyperplasias (AAH) and adenocarcinomas in situ (AIS)] and invasive pulmonary adenocarcinomas [minimally invasive adenocarcinomas (MIA) and invasive adenocarcinomas (IAC)] were manually compared and analyzed using orthogonal multiplanar reformation (MPR) images. The logistic regression model was established to determine variables that could predict the invasiveness of pGGNs. Receiver operating characteristic (ROC) curve analysis was performed to evaluate their diagnostic performance. Results There were 213 preinvasive lesions (59 AAHs and 154 AISs) and 93 invasive pulmonary adenocarcinomas (53 MIAs and 40 IACs). Compared with the preinvasive lesions, invasive adenocarcinomas exhibited a larger diameter (13.5 vs. 9.3 mm, P=0.000), higher mean attenuation (-571 vs. -613 HU, P=0.002), higher representative attenuation (-475 vs. -547 HU, P=0.000), lower relative attenuation (-339 vs. -292 HU, P=0.000) and greater frequencies of heterogeneity (P=0.001), air bronchogram (P=0.000), bubble lucency (P=0.000), and pleural indentation (P=0.000). Multiple logistic analysis revealed that larger diameter [odds ratio (OR), 1.328; 95% CI: 1.208-1.461; P=0.000] and higher representative attenuation (OR, 1.005; 95% CI: 1.003-1.007; P=0.000) were significant predictive factors of invasive pulmonary adenocarcinomas from preinvasive lesions. The optimal cut-off value of the maximum diameter for invasive pulmonary adenocarcinomas was larger than 10 mm (sensitivity, 66.7%; specificity, 72.8%). Conclusions The imaging features based on protocol G scanning can effectively help predict the histological invasiveness of pGGNs. The maximum diameter and representative attenuation are important parameters for predicting invasiveness.

It is a common fact that data (features, characteristics or variables) are collected at different sampling frequencies in some fields such as economic and industry. The existing methods usually either ignore the difference from the different sampling frequencies or hardly take notice of the inherent temporal characteristics in mixed frequency data. The authors propose an innovative dual attention‐based neural network for mixed frequency data (MID‐DualAtt), in order to utilize the inherent temporal characteristics and select the input characteristics reasonably without losing information. According to the authors’ knowledge, this is the first study to use the attention mechanism to process mixed frequency data. The MID‐DualAtt model uses the frequency alignment method to transform the high‐‐frequency variables into observation vectors at low frequency, and more critical input characteristics are selected for the current prediction index by attention mechanism. The temporal characteristics are explored by the encoder‐decoder with attention based on long‐ short‐term memory networks (LSTM). The proposed MID‐DualAtt has been tested in practical application, and the experimental results show that it has better prediction ability than the compared models.

Lightweight shielding materials that can protect devices against undesirable multispectral electromagnetic waves are critical in electronic, medical, military, and aerospace applications. However, the existing shielding materials are heavyweight and work only in a narrow frequency-range. In this work, we developed metal–metal oxide Ag-WO3 decorated polymeric nanofiber hybrid membranes with versatile multispectral electromagnetic shielding abilities for practical applications. The Ag-WO3 hybrid provides multiple functions, such as excellent metallic conductivity provided by silver, high photoelectric effect and low thermal conductivity arising from the high atomic number in WO3, and strong infrared energy absorbing capability caused by a designed Schottky barrier interface between Ag and WO3. Additionally, the nanofibrous hybrid membrane structure provides high surface area, good air permeability, and robust mechanical strength and durability. These highly conductive, lightweight, ultrathin, and flexible membranes exhibit efficient microwave electromagnetic interference shielding of 92.3 dB at a thickness of ~42 μm in 8–26.5 GHz frequency range, 0.75–0.5 emissivity for near- to far-field infrared bands, and 32.03% attenuation for X-rays of 30 keV at 0.24 mm thickness, indicating their potential for shielding against large-scale multispectral electromagnetic waves from low-frequency microwaves to high-frequency X-rays. Shielding materials are crucial in protecting devices against electromagnetic radiation but are often heavyweight and operate in narrow frequency ranges. Here, highly conductive, lightweight, ultrathin, and flexible membranes based on Ag-WO3-coated polymeric nanofibers provide multispectral shielding from microwaves to X-rays.

Excessive accumulation of trace elements (TEs) in farmland soil-crop systems is a severe threat to food safety impeding the sustainable development of the ecological environment. This study examine...

Purpose. Transcutaneous electrical acupoint stimulation (TEAS) is widely used. However, no study evaluated TEAS on systemic inflammatory response syndrome (SIRS) of patients after percutaneous nephrolithotomy (PCNL). The study was to evaluate TEAS on SIRS of patients after PCNL. Methods. 67 patients were enrolled and divided into group TEAS and group sham TEAS. Data were collected from 60 participants finally. In the study, TEAS or sham TEAS on bilateral Shenshu (BL23), Yinlingquan (SP9), Hegu (LI4), and Neiguan (PC6) was performed continuously throughout the procedure. The primary outcome included the incidence of systemic inflammatory response syndrome (SIRS) within 48 h after surgery. The secondary outcomes included the serum levels of inflammatory cytokines, hemodynamics changes, complications, and hospital stay after surgery. The serum levels of tumor necrosis factor- (TNF-) α and interleukin- (IL-) 6, mean arterial pressure (MAP), and heart rate (HR) at 30 min before anesthesia (T0), the time after surgery (T1), 24 h postoperation (T2), and 48 h postoperation (T3) were recorded. The consumption of analgesic during surgery was also recorded, as well as the complications and duration of hospital stay after PCNL. Results. The incidence of SIRS in group TEAS was lower than group sham TEAS (30% vs. 6.67%, p = 0.023 ). Compared with the sham TEAS group, both levels of TNF-α and IL-6 at T1, T2, and T3 were lower in the TEAS group ( p < 0.05 ). The levels of MAP and HR in sham TEAS at T1, T2, and T3 were markedly higher than that in the TEAS group ( p < 0.05 ). The total consumption of propofol and remifentanil during surgery in group TEAS was lower than that in the sham TEAS group. The incidence of hypotension, hypertension, emergence agitation, and postoperative nausea and vomiting (PONV) was also lower in group TEAS after PCNL ( p < 0.05 ). Conclusions. TEAS could effectively reduce the incidence of SIRS and inflammatory cytokines for patients who underwent PCNL. In addition, TEAS helped to maintain the hemodynamic stability and cut down the consumption of analgesics during PCNL, reducing the complications after PCNL.

BACKGROUND Although the bystander effect and abscopal effect are familiar in medicine, they are relatively rare in clinical practice. Herein, we report the case of a patient who demonstrated an obvious bystander effect and abscopal effect response following carbon-ion irradiation for recurrent thymic carcinoma. CASE SUMMARY A 44-year-old female presented with shortness of breath. Eleven years prior, she was diagnosed with athymic tumor located in the anterosuperior mediastinum. She underwent extensive tumor resection, and the postoperative pathologic diagnosis was thymic carcinoma. She was administered 50 Gy/25 Fx of postoperative radiation. In 2019, she was diagnosed with a recurrence of thymic carcinoma, with multiple recurrent nodules and masses in the left thoracic chest and peritoneal cavity, the largest of which was in the diaphragm pleura proximal to the pericardium, with a size of 6.7 cm × 5.3 cm × 4.8 cm. She received carbon-ion radiotherapy. After carbon-ion radiotherapy treatment, the treated masses and the untreated masses were observed to have noticeably shrunk on the day of carbon-ion radiotherapy completion and on follow-up imaging. We followed the CARE Guidelines for consensus-based clinical case reporting guideline development and completed the CARE Checklist of information to report this case. CONCLUSION This report is the first of obvious abscopal and bystander effects following carbon-ion irradiation in a human patient, and further research is needed to better elucidate the mechanisms of bystander and abscopal effects.

BACKGROUND Little is known about the postoperative sleep quality of infective endocarditis patients during hospitalization and after discharge. AIM To investigate the sleep characteristics of infective endocarditis patients and to identify potential risk factors for disturbed sleep quality after surgery. METHODS The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale were used to assess patient sleep quality. Logistic regression was used to explore the potential risk factors. RESULTS The study population (n = 139) had an average age of 43.40 ± 14.56 years, and 67.6% were men (n = 94). Disturbed sleep quality was observed in 86 patients (61.9%) during hospitalization and remained in 46 patients (33.1%) at 6 mo after surgery. However, both PSQI and Epworth Sleepiness Scale scores showed significant improvements at 6 mo (P < 0.001 and P = 0.001, respectively). Multivariable logistic regression analysis showed that the potential risk factors were age (odds ratio = 1.125, 95% confidence interval: 1.068-1.186) and PSQI assessed during hospitalization (odds ratio = 1.759, 95% confidence interval: 1.436-2.155). The same analysis in patients with PSQI ≥ 8 during hospitalization suggested that not using sleep medication (odds ratio = 15.893, 95% confidence interval: 2.385-105.889) may be another risk factor. CONCLUSION The incidence of disturbed sleep after infective endocarditis surgery is high. However, the situation improves significantly over time. Age and early postoperative high PSQI score are risk factors for disturbed sleep quality at 6 mo after surgery.

Objectives Sternal incisions can generate persistent and intense post-sternotomy pain. Propofol has been shown to improve postoperative analgesia, but the preventive effect on persistent pain after cardiac surgery is unknown. The hypothesis of the present study was that intraoperative propofol-based anesthesia compared with volatile anesthesia could reduce the risk of chronic pain after cardiac surgery. Design A single-center, two-arm, patient-and-evaluator-blinded, randomized controlled trial. Setting A single major urban teaching and university hospital. Patients Five-hundred adult patients undergoing cardiac surgery via sternotomy randomly were assigned. With six withdrawals from the study and five from surgery, 244 in the total intravenous anesthesia group and 245 in the volatile group were included in the modified intention-to-treat analysis. Interventions Patients randomly were assigned to receive either propofol-based total intravenous anesthesia or volatile anesthesia during surgery. Measurements and Main Results The primary outcomes were the incidence of pain at three, six, and 12 months after surgery defined as pain score >0 on the numeric rating scale. The secondary outcomes included acute pain, opioid use during the first 72 hours after surgery, and quality of life. The use of propofol did not significantly affect chronic pain at three months (55.4% v 52.9%, difference 2.5%, 95% confidence interval [CI] –6.6 to 11.6; p = 0.656), six months (35.5% v 37.5%, difference –2.0%, 95% CI –10.9 to 6.9; p = 0.657), or 12 months (18.2% v 20.7%, difference –2.5%, 95% CI –9.8 to 4.8; p = 0.495) compared with volatile anesthetics. Furthermore, there were no differences in acute pain score; morphine-equivalent consumption during the first 72 hours; and quality of life at three, six, and 12 months after surgery. Conclusions Intraoperative administration of propofol did not reduce persistent pain after cardiac surgery compared with volatile anesthetics.

PURPOSE: Insufficient characterization of the optimal multidisciplinary team and lack of understanding of barriers to quality care are unmet needs in the management of stage III or IV non–small-cell lung cancer (NSCLC). A national survey was conducted to inform the design and execution of process improvement plans and address identified barriers. METHODS: A steering committee of multidisciplinary specialists and representation from patient advocacy collaborated for a comprehensive, double-blind, web-based survey (January-April 2019) to obtain insights on care delivery for patients with advanced NSCLC in a diverse set of US community cancer programs. RESULTS: Overall, 639 responses (160 unique cancer programs across 44 US states) were included; 41% (n = 261) of respondents indicated an absence of a thoracic multidisciplinary clinic in their cancer program. Engagement in shared decision making was significantly associated with the presence of navigation and radiation oncology disciplines ( P ≤ .04); 19.2% and 33.3% of respondents belonged to cancer programs with no lung cancer screening and no protocol for biomarker testing, respectively. The frequency of tumor board meetings negatively correlated with time to complete disease staging ( P = .03); the average time to first therapeutic intervention in newly diagnosed patients was 4 weeks. The most challenging barriers to quality care included insufficient quantity of biopsy material for biomarker testing, lack of primary care provider referrals, and diagnostic costs. CONCLUSION: Improving the quality of advanced NSCLC care, including optimization of a multidisciplinary team framework, may surmount barriers to care coordination, diagnosis and staging, and treatment planning, consequently improving adherence to evolving standards of care.

Gastric cancer is one of the most common cancers, which ranks third among the leading causes of cancer death. Biopsy of gastric mucosa is a standard procedure in gastric cancer screening test. However, manual pathological inspection is labor-intensive and time-consuming. Besides, it is challenging for an automated algorithm to locate the small lesion regions in the gigapixel whole-slide image and make the decision correctly. To tackle these issues, we collected large-scale whole-slide image dataset with detailed lesion region annotation and designed a whole-slide image analyzing framework consisting of 3 networks which could not only determine the screening result but also present the suspicious areas to the pathologist for reference. Experiments demonstrated that our proposed framework achieves sensitivity of 97.05 % and specificity of 92.72 % in screening task and Dice coefficient of 0.8331 in segmentation task. Furthermore, we tested our best model in real-world scenario on 10 , 315 whole-slide images collected from 4 medical centers.

In recent years, immune checkpoint inhibitors (ICIs) have become a standard treatment for patients with advanced lung cancers. With the widespread use of immunotherapy in clinical practice, immune-related adverse events (irAEs) have become increasingly common. This case report details a 72-year-old man with small-cell lung cancer (SCLC) who developed pneumonitis, appendicitis, and biliary obstruction during treatment with toripalimab. The patient was initially diagnosed with limited-stage SCLC in January 2019 and completed 5 sequential cycles of etoposide/cisplatin (EP) and radiotherapy (60 Gy/30 F). The overall response was complete response (CR) after first line treatment. He developed radiation pneumonitis after completion of radiotherapy, which responded well to symptomatic treatment. Due to newly diagnosed bone metastasis, he was administered toripalimab intravenously every 3 weeks and 12 mg anlotinib orally once a day from January 2020. By the third cycle, the patient presented with electrocardiographic abnormalities, gingival swelling and pain, and hoarseness, and consequently, the anlotinib was suspended. After 4 cycles, he developed suppurative appendicitis, which was managed successfully with anti-inflammatory agents. He then presented with shortness of breath on exertion and after a comprehensive examination, he was diagnosed with ICI-related-pneumonitis. After 6 weeks of treatment with methylprednisolone, the shortness of breath was mostly relieved and treatment continued. In June 2020, the patient developed severe vomiting. Computed tomography (CT) indicated biliary obstruction, and at endoscopic retrograde cholangiopancreatography (ERCP) there was edema of the major papilla of the duodenum. The patient's symptoms were relieved after treatment with gastric acid suppression and antiemetics. Re-examination by magnetic resonance imaging (MRI) showed that the biliary obstruction had been resolved. Although the disease progressed after immunotherapy, no tumor tissue related to the biliary obstruction was detected, and this was therefore classified as an irAE.

Background: The hypothermic circulatory arrest (HCA) is an indispensable step in the surgical treatment of an acute type A aortic dissection (ATAAD), which could greatly affect the postoperative outcome. We modified the HCA technique and validated the feasibility and superiority of the new approach relative to the conventional method. Methods and results: Eighty-eight patients with ATAAD were enrolled in this study between May 2016 and April 2018. Of those, 36 patients in the Conventional treatment group had circulatory arrest at 25°C for about 16-28 minutes, while 52 patients in the Modification group underwent a circulatory arrest at 28°C for only 1-3 minutes. The preoperative clinical data and postoperative clinical outcomes were compared between the two groups. No intraoperative mortality occurred in any of the cases. No significant differences were observed in the aortic cross-clamp times during the cardiopulmonary bypass (CPB) between the two groups. In the Modification group, several indicators, such as mechanical ventilation time, postoperative 48-h drainage volume, blood transfusion volume, the ICU-stay time and postoperative hospital stay, were reduced significantly as compared with those in the Conventional group. Whereas three postoperative deaths in the hospital occurred in the Conventional treatment group, all the patients in the Modification group were cured. There is no difference in the incidence of postoperative complications between the two groups. The patients had a 100% follow up with a mean of 17 ± 6 months. Conclusions: A moderate hypothermia with a short circulatory arrest is a safe and effective HCA approach that provides satisfactory early and near-midterm results in the patients who received ATAAD treatment.

BACKGROUND At present, the value of lipid indicators in evaluating the prognosis of colorectal cancer is still relatively limited. AIM To evaluate the value of a novel parameter for colorectal cancer (CRC) prognosis scoring based on preoperative serum lipid levels. METHODS Four key serum lipid factors, namely, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB), were detected. Two representative ratios, HDL-C-LDL-C ratio (HLR) and ApoA1-ApoB ratio (ABR) were calculated. The relationship of these parameters with the prognosis of CRC patients including progression-free survival (PFS) and overall survival (OS) was analyzed by Kaplan-Meier plot and Cox proportional hazards regression. A novel lipoprotein cholesterol-apolipoprotein (LA) score based on HLR and ABR was established and its value in prognosis evaluation for CRC patients was explored. RESULTS Multivariate Cox proportional hazards regression analysis of PFS and OS showed that HDL-C, ApoA1, HLR, and ABR were positively associated with the prognosis of CRC patients. LA score was independently associated with a good prognosis in resectable CRC patients. Data processing of a dummy variable showed that the prognosis of patients with higher LA scores is better than that with lower LA scores. CONCLUSION The newly established LA score might serve as a better predictor of the prognosis of resectable CRC patients.

The coronavirus disease 2019 (COVID-19) epidemic is a major public health emergency characterized by fast spread, a wide range of infections, and enormous control difficulty. Since the end of December 2019, Wuhan has become the first core infection area of China's COVID-19 outbreak. Since March 2020, the domestic worst-hit areas have moved to the Heilongjiang Province due to the increased number of imported COVID-19 cases. Herein, we reported the major COVID-19 outbreak, which caused a rebound of the epidemic in Harbin, China. After the rebound, different levels of causes for the recurrence of COVID-19, including city-level, hospital-level, and medical staff-level cause, were investigated. Meanwhile, corresponding countermeasures to prevent the recurrence of the epidemic were also carried out on the city level, hospital level, and medical staff level, which eventually showed the effect of infection control function in a pandemic. In this study, we described the complete transmission chain, analyzed the causes of the outbreak, and proposed corresponding countermeasures from our practical clinical experience, which can be used as a valuable reference for COVID-19 control.

Clinical studies have shown that dapagliflozin can reduce cardiovascular outcome in patients with type 2 diabetes mellitus (T2DM), but the exact mechanism is unclear. In this study, we used the molecular docking and network pharmacology methods to explore the potential mechanism of dapagliflozin on T2DM complicated with cardiovascular diseases (CVD). Dapagliflozin's potential targets were predicted via the Swiss Target Prediction platform. The pathogenic targets of T2DM and CVD were screened by the Online Mendelian Inheritance in Man (OMIM) and Gene Cards databases. The common targets of dapagliflozin, T2DM and CVD were used to establish a protein‐protein interaction (PPI) network; the potential protein functional modules in the PPI network were found out by MCODE. Metascape tool was used for Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway enrichment analysis. A potential protein functional module with the best score was obtained from the PPI network and 9 targets in the protein functional module all showed good binding properties when docking with dapagliflozin. The results of KEGG pathway enrichment analysis showed that the underlying mechanism mainly involved AGE‐RAGE signalling pathway in diabetic complications, TNF signalling pathway and MAPK signalling pathway. Significantly, the MAPK signalling pathway was considered as the key pathway. In conclusion, we speculated that dapagliflozin played a therapeutic role in T2DM complicated with CVD mainly through MAPK signalling pathway. This study preliminarily reveals the possible mechanism of dapagliflozin in the treatment of T2DM complicated with CVD and provides a theoretical basis for future clinical research.

Background Selective amygdalohippocampectomy (SelAH) is designed to treat medically refractory mesial temporal lobe epilepsy with reduced morbidity compared to standard anterior temporal lobectomy. At our institution, we perform SelAH via a transcortical approach via small corticectomy in the middle temporal gyrus. Objective To discuss the surgical anatomy and nuances of SelAH, share our institutional experience, and perform a review of literature. Methods Institutional experience was recorded by collecting demographic and outcome data from 1999 to 2017 under an Institutional Review Board protocol in a prospective manner using a REDCap database. Results A total of 211 SelAH procedures were performed at our institution between 1999 and 2017. Of these patients, 54% (113/211) were females. The average age at surgery was 39.4 yr. Two-year Engel outcome data were available for 168 patients, of which 73% (123/168) had Engel I outcomes. Engel II outcomes were reported in 16.6% (28/168), III in 4.7% (8/168), and IV in 5.3% (9/168). Our review of literature showed that this is comparable to the seizure freedom rates reported by other groups. We then reviewed our surgical methodology based on operative reports and created illustrations of the surgical anatomy of temporal lobe approach. These illustrations were compared with postoperative magnetic resonance imaging to provide a better 3D understanding of the complex architecture of mesial temporal structures. Conclusion SelAH is a minimally invasive, safe, and effective approach for the treatment of medically refractory epilepsy with good surgical outcomes and low morbidity. We feel that mastering the complex anatomy of this approach helps achieve successful outcomes.

The vortex electromagnetic wave has attracted considerable attentions due to its theoretically infinite and orthogonal orbital angular momentum (OAM) mode characteristics. However, it is very diffi...

Objective To explore the clinical efficacy of collateral-pricking and blood-letting cupping combined with surrounding needling technique electroacupuncture in the treatment of post-herpetic neuralgia (PHN). Methods Seventy-two patients with post-herpetic neuralgia were randomized into observation group and control group. Of the 72 cases, 12 cases fell off, so finally 30 cases in each group. The observation group was treated with collateral-pricking and blood-letting cupping combined with surrounding needling technique electroacupuncture, while the control group was treated simply with pregabalin capsules for 20 consecutive days. On the basis of the western medication pregabalin capsules, the same as that of the control group, collateral-pricking and blood-letting cupping combined with electroacupuncture in a surrounding needling technique, was adopted for the observation group, once every two days, ten days as one course of treatment, a total of two courses. The immediate visual analogue scale (VAS) before and after treatment were observed in the two groups, and their clinical effects were compared. Results The VAS scores of PHN patients in the two groups after treatment were lower than those before treatment (both P Conclusion The clinical effect of collateral-pricking and blood-letting cupping combined with electroacupuncture is relatively satisfactory in the treatment of post-herpetic neuralgia.

BACKGROUND: Infantile hemangioma (IHA) is the most common tumor in infancy. We aimed to explore the effect of propranolol on the expression of microRNA (miR)-424 in IHA tissues and XPTS-1 cells, as well as its molecular mechanism of inhibiting XPTS-1 cell activity. METHODS: Tumor tissues and peritumoral tissue were collected from 13 IHA patients in Lishui Municipal Central Hospital. The level of miR-424 were detected using real-time quantitative reverse transcription polymerase chain reaction (RT-PCR). Cell counting kit-8 (CCK-8) was used to measure XPTS-1 cell viability. Flow cytometry and transwell were used to detect the apoptosis level and invasion ability of XPTS-1 cells. Western blot was used to measure the protein level of vascular endothelial growth factor-A (VEGFA). The luciferase reporter gene assay detected the targeting relationship between miR-424 and VEGFA. RESULTS: Compared with normal tissues and human umbilical vein endothelial cells, the expression level of miR-424 in IHA tissues and XPTS-1 cells was significantly reduced (P

OBJECTIVES The objective of this study was to develop and validate a model, based on the blood biochemical (BBC) indexes, to predict the recurrence of acute pancreatitis patients. METHODS We retrospectively enrolled 923 acute pancreatitis patients (586 in the primary cohort and 337 in the validation cohort) from January 2014 to December 2016. Aiming for an extreme imbalance between recurrent acute pancreatitis (RAP) and non-RAP patients (about 1:4), we designed BBC index selection using least absolute shrinkage and selection operator regression, along with an ensemble-learning strategy to obtain a BBC signature. Multivariable logistic regression was used to build the RAP predictive model. RESULTS The BBC signature, consisting of 35 selected BBC indexes, was significantly higher in patients with RAP (P < 0.001). The area under the curve of the receiver operating characteristic curve of BBC signature model was 0.6534 in the primary cohort and 0.7173 in the validation cohort. The RAP predictive nomogram incorporating the BBC signature, age, hypertension, and diabetes showed better discrimination, with an area under the curve of 0.6538 in the primary cohort and 0.7212 in the validation cohort. CONCLUSIONS Our study developed a RAP predictive nomogram with good performance, which could be conveniently and efficiently used to optimize individualized prediction of RAP.

Background:. The neoadjuvant chemotherapy is increasingly used in advanced gastric cancer, but the effects on safety and survival are still controversial. The objective of this meta-analysis was to compare the overall survival and short-term surgical outcomes between neoadjuvant chemotherapy followed by surgery (NACS) and surgery alone (SA) for locally advanced gastric cancer. Methods:. Databases (PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar) were explored for relative studies from January 2000 to January 2021. The quality of randomized controlled trials and cohort studies was evaluated using the modified Jadad scoring system and the Newcastle-Ottawa scale, respectively. The Review Manager software (version 5.3) was used to perform this meta-analysis. The overall survival was evaluated as the primary outcome, while perioperative indicators and post-operative complications were evaluated as the secondary outcomes. Results:. Twenty studies, including 1420 NACS cases and 1942 SA cases, were enrolled. The results showed that there were no significant differences in overall survival (P = 0.240), harvested lymph nodes (P = 0.200), total complications (P = 0.080), and 30-day post-operative mortality (P = 0.490) between the NACS and SA groups. However, the NACS group was associated with a longer operation time (P