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In this work, we demonstrate a novel In0.52Al0.48As based top-illuminated avalanche photodiode (APD), designed to circumvent the problem of serious bandwidth degradation under high gain (>100) and high power operation and significantly enhance the dynamic range in the established frequency modulated continuous wave (FMCW) lidar system. In our APD design, the carriers transiting through the dual multiplication (M-)layers are subjected to a stepped-up electric field profile, so they can be energized by the first step and propagate to the second step to trigger the avalanche processes. Such a cascade avalanche process leads to an ultra-high gain bandwidth product (460 GHz) with a 1 A/W responsivity at unit gain. Compared to the high-performance and commercial p-i-n PD and photo-receiver (PD + trans-impedance amplifier (TIA)) installed in the same lidar test bed, our demonstrated APD receiver (without TIA) has a larger S/N ratio under high operation gain (33 A/W) with less optical local-oscillator (LO) power required (0.25 vs. 0.5 mW), while exhibiting a wider dynamic range in each pixel. These advantages in turn lead to the construction of a better quality of 3-D lidar image by using the demonstrated APD.

Optoelectronic synaptic elements are emerging functional devices for the vigorous development of advanced neuromorphic computing technology in the post-Moore era. However, optoelectronic devices based on transition metal dichalcogenides (TMDs) are limited to their poor mobilities and weak light-matter interactions, which still hardly exhibit superior device performances in the application of artificial synapses. Here, we demonstrate the successful fabrication of Au nanoparticle-coupled MoS2 heterostructures via chemical vapor deposition (CVD), where the light absorption of MoS2 is greatly enhanced and engineered by plasmonic effects. Hot electrons are excited from Au nanoparticles, and then injected into MoS2 semiconductors under the light illumination. The plasmonically-engineered photo-gating effect at the metal-semiconductor junction is demonstrated to create optoelectronic devices with excellent synaptic behaviors, especially in ultra-sensitive excitatory postsynaptic current (EPSC, 9.6 × 10−3 nA@3.4 nW·cm−2), ultralow energy consumption (34.7 pJ), long-state retention time (> 1,000 s), and tunable synaptic plasticity transitions. The material system of Au-nanoparticles coupled TMDs presents unique advantages for building artificial synapses, which may lead the future development of neuromorphic electronics in optical information sensing and learning.

With the polarization-selective metamaterial absorber (PSMA), a unique approach for reducing the in-band radar cross section (RCS) while preserving the radiation performance of a tightly coupled dipole array (TCDA) is proposed. The proposed PSMA structure is comprised of resistive films, dielectric layers, and polarization gates. In detail, the resistive films are loaded on the surface of a TCDA, and the polarization gates are utilized to broaden the absorption bandwidth of PSMA as well as to improve the polarization purity of the array. Moreover, the process of the co-design of the phased array with PSMA is presented. The designed infinite array is able to achieve a 3:1 bandwidth from 6 to 18 GHz with the active VSWR $10 \times 10$ single-polarized prototype array is fabricated and measured. Measured results are in good agreement with simulated ones, thus demonstrating that the PSMA structure is able to reduce the scattering significantly throughout the operating band of the array under normal and oblique incidence.

It is very challenging to characterize surface/sub-surface defects for large-aperture optics. The first challenge is the conflict between high resolution and large field of view, namely how to reach a good balance between high resolution and high efficiency for detecting various defects with sub-micronover the meter-size surface of optics. The second challenge is how to classify defects accurately, which is very important for determining origin of defects and improving optics quality.In this paper, a multimodal inspection technique for surface/sub-surface defects of large-aperture optics is reported, in which a high speed laser scattering imaging with a sensitivity at 200-nm scale is used for defect discovery of large-aperture optics. The defect discovery provides a statistical result of defects of the optics. After that, a multifunctional microscopic method is used for local defect review. A photo thermal scanning microscopy is used for specific characterization of absorption defects, and a confocal microscopy is used for characterization of sub-surface defects. The defect review provides information for defect classification. Based on this multimodal technique, an inspection system is also developed and used for defect characterization of large optics.

This paper propose a modified Prototypical Networks based on the Class-covariance metric and Attention (PNCA) against the few-shot text classification issue. In this method, we use the Mahalanobis distance as the classification of class-specific feature vectors, furthermore, we add the word-level features and class-level features of attention mechanism, which highlight the standout knowledge of few-shot data and learn a more discriminative prototype representation. Our experiments based on the Chinese News Classification(CNC) Dataset show this model almost reach state-of-the-art, and the accuracy is 1%~2% higher than the existing models.

Chemotherapy is generally considered as the main treatment for metastatic gastric adenocarcinoma. The role of gastrectomy for metastatic gastric cancer without obvious symptoms is controversial. The objective of this study is to investigate survival outcomes of treatment modalities using a real-world data setting. A retrospective cohort study was designed using the Taiwan Cancer Registry database. We identified the treatment modalities and used Kaplan–Meier estimates and Cox regressions to compare patient survival outcomes. From 2008 to 2015, 5599 gastric adenocarcinoma patients were diagnosed with metastatic disease (M1). The median overall survival (OS) of patients with surgery plus chemotherapy had the longest survival of 14.2 months. The median OS of the patients who received chemotherapy alone or surgery alone was 7.0 and 3.9, respectively. Age at diagnosis, year of diagnosis, tumor grade, and treatment modalities are prognostic factors for survival. The hazard ratios for patients who received surgery plus chemotherapy, surgery alone, and supportive care were 0.47 (95% CI 0.44–0.51), 1.22 (95% CI 1.1–1.36), and 3.23 (95% CI 3.01–3.46), respectively, by multivariable Cox regression analysis when using chemotherapy alone as a referent. Chemotherapy plus surgery may have a survival benefit for some selected gastric adenocarcinoma patients with metastatic disease.

Radiofrequency ablation (RFA) is one of the safe and effective treatments of colorectal cancer with liver metastasis, which has the advantages of minimally invasive, fewer complications, short hospitalization time and repeatable operation. A special case with advanced transverse colon carcinoma was treated by RFA in our center. All the procedures were performed, which were recommended by the guideline. An intestinal perforation occurred on the second day after the RFA, then surgeon performed emergency surgery, unfortunately, anastomotic leakage occurred on the 21st day after the operation, yet after conservative medical treatment, the patient achieved remission of symptoms and discharged from the hospital. Rare complications occurred after RFA in the treatment of colorectal cancer with liver metastasis are unpredictable, which could affect the efficacy of RFA and performance status of patients. Further investigation of the mechanism of these complications is warranted urgently, which might offer more effective methods against these rare complications.

Background. The potential advantages of Jiedu granule (a compound Chinese herbal medicine) combined therapeutic strategies compared with non-Jiedu granule therapeutic strategies for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remain unclear. Thus, the purpose of the study was to investigate the safety and efficacy of Jiedu granule for HCC with PVTT. Methods. We retrospectively reviewed the clinical data of 190 patients (94 for non-Jiedu and 96 for Jiedu) with HCC and PVTT from March 2012 to October 2016. Patients were followed up by outpatient examination and telephone till November 2018. Results. It was statistically insignificant between the two groups in baseline characteristics. Procedure-related adverse events (AEs) were observed and compared and most of them were not serious which were easily controlled or subsided naturally. No AE-induced death happened. The median overall survival (OS) rates in the single TACE plus GKR and Jiedu granule combined group were 11.3 months (95% CI: 9.168-13.435) and 15.8 months (95% CI: 13.244-18.339), respectively (p = 0.00047). Conclusions. Jiedu granule combined with TACE plus GKR is safe in HCC patients with PVTT and this Chinese herbal medicine is worthy to be promoted because of better prognosis which needs further research.

The dismal outcome in patients with locally advanced or metastatic gastric cancer (GC) highlights the need for effective systemic neoadjuvant chemotherapy to improve clinical results. This study evaluated the correlation between the expression of three DNA repair genes, namely the excision repair cross-complementing group 1 (ERCC1), excision repair cross-complementing group 2 (ERCC2), and X-ray repair cross-complementing protein 1 (XRCC1) and the clinical outcome of patients with locally advanced or metastatic GC treated with mFOLFOX-4 neoadjuvant chemotherapy. Fifty-eight patients with histologically confirmed locally advanced or metastatic GC following neoadjuvant mFOLFOX-4 chemotherapy were enrolled between January 2009 and January 2018. We analyzed clinicopathological features and ERCC1, ERCC2, and XRCC1 expression to identify potential predictors of clinical response. Among the 58 patients, 16 (27.6%) were categorized into the response group (partial response) and 42 into the nonresponse group (stable disease in 24 patients and progressive disease in 18 patients). A multivariate analysis showed that ERCC1 overexpression (P = 0.003), ERCC2 overexpression (P = 0.049), and either ERCC1 or ERCC2 overexpression (P = 0.002) were independent predictors of response following mFOLFOX-4 neoadjuvant chemotherapy. Additionally, ERCC1 and ERCC2 overexpression did not only predict the response but also progression-free survival (both P < 0.05) and overall survival (both P < 0.05). ERCC1 and ERCC2 overexpression are promising predictive biomarkers for patients with locally advanced or metastatic GC receiving neoadjuvant mFOLFOX-4 chemotherapy and the potential clinical implication is mandatory for further investigation.

Fecal microbiota transplantation (FMT) is a method to directly change the recipient's gut microbiota to normalize the composition and gain a therapeutic benefit. The history of FMT has been traced back to the 4th century and has been highly regarded since 2013, when the United States Food and Drug Administration approved FMT for treating recurrent and refractory Clostridium difficile infection. Since then, the range of FMT applications extended rapidly and broadly not only in gastrointestinal disorders, but also in extra-gastrointestinal diseases. Donor selection with questionnaire, interview, blood tests, and stool examinations should be strictly performed before FMT to reduce and prevent occurrence of any adverse events. Step-by-step cautious fecal and recipient preparation along with adequately choosing delivery methods based on individual clinical situations are key points of the FMT process. Although current evidence deems FMT as a generally safe therapeutic method with few adverse effects, the long-term outcomes of FMT have not been completely elucidated. Therefore, establishing periodicity and length of regular follow-up after FMT to monitor the clinical efficacy and long-term adverse events are other essential issues. In the future, we will look forward to personalized FMT for different patients and conditions according to varied hosts and diseases. Keywords: Fecal microbiota transplantation, Intestinal microbiota

Representation learning is one of the most important aspects of multi-label learning because of the intricate nature of multi-label data. Current research on representation learning either fails to consider label knowledge or is affected by the lack of labeled data. Moreover, most of them learn the representations and incorporate the label information in a two-step manner. In this paper, due to the success of representation learning by deep learning we propose a novel framework based on neural networks named SERL to learn global feature representation by jointly considering all labels in an effective supervised manner. At its core, a two-encoding-layer autoencoder, which can utilize labeled and unlabeled data, is adopted to learn feature representation in the supervision of softmax regression. Specifically, the softmax regression incorporates label knowledge to improve the performance of both representation learning and multi-label learning by being jointly optimized with the autoencoder. Moreover, the autoencoder is expanded into two encoding layers to share knowledge with the softmax regression by sharing the second encoding weight matrix. We conduct extensive experiments on five real-world datasets to demonstrate the superiority of SERL over other state-of-the-art multi-label learning approaches.

The levels of fibroblast growth factor 23 (FGF23) rapidly increases after acute kidney injury (AKI). However, the role of FGF23 in AKI is still unclear. Here, we observe that pretreatment with FGF23 protein into ischemia-reperfusion induced AKI mice ameliorates kidney injury by promoting renal tubular regeneration, proliferation, vascular repair, and attenuating tubular damage. In vitro assays demonstrate that SDF-1 induces upregulation of its receptor CXCR4 in endothelial progenitor cells (EPCs) via a non-canonical NF-κB signaling pathway. FGF23 crosstalks with the SDF-1/CXCR4 signaling and abrogates SDF-1-induced EPC senescence and migration, but not angiogenesis, in a Klotho-independent manner. The downregulated pro-angiogenic IL-6, IL-8, and VEGF-A expressions after SDF-1 infusion are rescued after adding FGF23. Diminished therapeutic ability of SDF-1-treated EPCs is counteracted by FGF23 in a SCID mouse in vivo AKI model. Together, these data highlight a revolutionary and important role that FGF23 plays in the nephroprotection of IR-AKI.

With the rapid development of information sciences and communication networks, the security of digital images has been concerned seriously. However, many of the current image encryption mechanisms trend to adopt complex algorithms and functions, resulting in high calculation power consumption, which is not suitable for mobile devices. Aiming to this issue, a color image encryption mechanism using visual cryptography, SHA-512 and one-time password is proposed. Based on visual cryptography, the encryption mechanism works through split the plain image into several shares and encrypted for transmission. For image decryption, only XOR operations are required and the computation complexity is greatly reduced. Besides, the SHA-512 and one-time password are utilized to protect the security of cipher keys and reduce the possibility of correct cipher images be intercepted. The experimental results demonstrate that the proposed mechanism has high security with low computational time consumption.

BackgroundExtranodal natural killer/T-cell lymphoma (ENKTL) is a rare and extremely malignant tumor. The systemic inflammation score (SIS), which is based on the pretreatment level of lymphocyte-to-monocyte ratio (LMR) and serum albumin (Alb), has been shown to be of prognostic value in a number of cancers. We integrate several other pretreatment serum inflammatory indicators, including the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), serum C-reactive protein (CRP) and albumin (Alb) level, to establish a modified systemic inflammatory scoring system to predict clinical outcomes of ENKTL.MethodsA total of 184 patients with newly diagnosed ENKTL was retrospectively investigated. Systemic inflammatory indexes, including NLR, LMR, CRP, and Alb level were reviewed. Receiver operating characteristic (ROC) curve analysis was carried out to obtain the optimal cut-off value. The associations between cutoff values and overall survival (OS) were analyzed by Kaplan–Meier curves and Cox proportional models.ResultsThe median age of patients was 44.0 years, ranging from 15 to 82 years. There were 129 (70.1%) male patient. About 57.1% of patients had stage III or IV disease. The optimal cut-off values of NLR and LMR in predicting OS were 3.1 and 2.4, respectively. The clinical standard of CRP and Alb levels at 10 and 40 mg/L, respectively, were chosen as the optimal cut-off values. By multivariate analysis, hemophilic syndrome (hazard ratio [HR]: 10.540, 95% confidence interval [CI]: 3.440–32.291, P < 0.001), advanced Ann Arbor stages (III–IV) (HR: 4.606, 95% CI: 1.661–12.774, P = 0.003), paranasal sinus invasion (HR: 2.323, 95% CI: 1.069–5.047, P = 0.033), NLR ≥ 3.1 (HR: 3.019, 95% CI: 1.317–6.923, P = 0.009), Alb level of

Background: Endoscopic submucosal dissection is minimal invasive endoscopic procedure to deal with gastric tumor. Initially, it was developed to resect mucosal neoplasm since 2000 and extended its application to submucosal tumor in the following years. Although the basic ESD skills are similar in gastric mucosal tumor and subepithelial tumor, the success rate, complication may be different between the two types of gastric tumor resection. This retrospective study is conducted to analyze the ESD procedure in gastric mucosal tumor and subepithelial tumor. Methods: From 2007 to 2016, we reviewed all patients who underwent endoscopic submucosal dissection for gastric mucosal tumor and subepithelial tumor in Kaohsiung Medical University Hospital. Results: Totally, 35 patients with gastric subepithelial tumor and 41 patients with gastric mucosal tumor received endoscopic submucosal dissection are enrolled. Among 35 patients with subepithelial tumor, 32 (91.4%) patients achieved curative treatment. 1 patient received emergent operation and 2 patients received salvage operation to complete tumor resection. 8 patients (22.9%) occurred perforation and no delay bleeding was found. Among 41 patients with mucosal neoplasm, 30 (71.4%) patients achieved curative treatment. 2 patients received emergent operation and 9 patients received salvage operation to complete tumor resection. 9 patients (21.9%) occurred complication, 6 patients occurred delay bleeding and 3 patients had perforation. Conclusions: Comparing ESD between gastric mucosal tumor and subepithelial tumor, ESD had similar efficiency in curative treatment. However, ESD in subepethelial tumor encountered higher perforation and lesser delay bleeding.

Background. Patients with chronic kidney disease (CKD) with or without hemodialysis were considered to have bleeding tendency and higher risk for gastrointestinal (GI) bleeding. Previous studies had documented that hemodialysis may increase the gastroduodenal ulcer bleeding. Few studies evaluated the relationship between CKD and lower GI bleeding. Materials and Methods. An observational cohort study design was conducted. The end-stage renal disease (ESRD) patients receiving regular hemodialysis (dialysis CKD), CKD patients without dialysis (dialysis-free CKD), and controls were selected from 1 million randomly sampled subjects in the National Health Insurance Research Database of Taiwan. These three group subjects were matched by age, sex, comorbidity, and enrollment time in a 1 : 2 : 2 ratio. The Cox proportional hazard regression models were used to identify the potential risk factors for lower gastrointestinal bleeding. Results. Dialysis CKD patients (n=574) had a higher incidence of lower GI bleeding than dialysis-free CKD patients (n=1148) and control subjects (n=1148) (12.9% vs. 3.6% and 2.8%; both P<0.001). Multivariate analysis showed that extreme old age (age≥85), male gender, dialysis-free CKD, and dialysis CKD were independent factors of lower GI bleeding. Additionally, dialysis CKD patients also had a higher incidence of angiodysplasia bleeding compared to dialysis-free CKD patients and control subjects (1.1% vs. 0.1% and 0.1%, respectively; both P=0.003). Conclusion. Hemodialysis may have higher risk of lower GI bleeding and angiodysplasia bleeding.

The aim of this article is to propose a new innovative grouping approach using the genetic algorithm (GA) to enhance the interaction and collaboration among peers by considering the complementary degree of students’ learning status and their social relationships. In order to validate our approach, experiments were designed with a group of students and the outcomes were tested with an e-Learning system. The auto-grouping mechanism is developed using GA for better learning results, which is justified based on the performance of students tested on the e-Learning system. The outcomes clearly indicate that the proposed approach can generate a high degree of heterogeneous grouping and encourage students to learn better. The technical contribution of this article can be implemented in any massive open online course platforms with thousands of students, with regard to identifying peers for collaborative works.