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Pathological cardiac hypertrophy serves as a significant foundation for cardiac dysfunction and heart failure. Recently, growing evidence has revealed that microRNAs (miRNAs) play multiple roles in biological processes and participate in cardiovascular diseases. In the present research, we investigate the impact of miRNA-34c-5p on cardiac hypertrophy and the mechanism involved. The expression of miR-34c-5p was proved to be elevated in heart tissues from isoprenaline (ISO)-infused mice. ISO also promoted miR-34c-5p level in primary cultures of neonatal rat cardiomyocytes (NRCMs). Transfection with miR-34c-5p mimic enhanced cell surface area and expression levels of foetal-type genes atrial natriuretic factor (Anf) and β-myosin heavy chain (β-Mhc) in NRCMs. In contrast, treatment with miR-34c-5p inhibitor attenuated ISO-induced hypertrophic responses. Enforced expression of miR-34c-5p by tail intravenous injection of its agomir led to cardiac dysfunction and hypertrophy in mice, whereas inhibiting miR-34c-5p by specific antagomir could protect the animals against ISO-triggered hypertrophic abnormalities. Mechanistically, miR-34c-5p suppressed autophagic flux in cardiomyocytes, which contributed to the development of hypertrophy. Furthermore, the autophagy-related gene 4B (ATG4B) was identified as a direct target of miR-34c-5p, and miR-34c-5p was certified to interact with 3′ untranslated region of Atg4b mRNA by dual-luciferase reporter assay. miR-34c-5p reduced the expression of ATG4B, thereby resulting in decreased autophagy activity and induction of hypertrophy. Inhibition of miR-34c-5p abolished the detrimental effects of ISO by restoring ATG4B and increasing autophagy. In conclusion, our findings illuminate that miR-34c-5p participates in ISO-induced cardiac hypertrophy, at least partly through suppressing ATG4B and autophagy. It suggests that regulation of miR-34c-5p may offer a new way for handling hypertrophy-related cardiac dysfunction.

Magnetic resonance guided radiotherapy (MRgRT), enabled by the clinical introduction of the integrated MRI and linear accelerator (MR-LINAC), is a novel technique for prostate cancer (PCa) treatment, promising to further improve clinical outcome and reduce toxicity. The role of prostate MRI has been greatly expanded from the traditional PCa diagnosis to also PCa screening, treatment and surveillance. Diagnostic prostate MRI has been relatively familiar in the community, particularly with the development of Prostate Imaging - Reporting and Data System (PI-RADS). But, on the other hand, the use of MRI in the emerging clinical practice of PCa MRgRT, which is substantially different from that in PCa diagnosis, has been so far sparsely presented in the medical literature. This review attempts to give a comprehensive overview of MRI acquisition techniques currently used in the clinical workflows of PCa MRgRT, from treatment planning to online treatment guidance, in order to promote MRI practice and research for PCa MRgRT. In particular, the major differences in the MRI acquisition of PCa MRgRT from that of diagnostic prostate MRI are demonstrated and explained. Limitations in the current MRI acquisition for PCa MRgRT are analyzed. The future developments of MRI in the PCa MRgRT are also discussed.

Background The overwhelming majority of hangman’s fractures cause anterior dislocation of C2. Hangman’s fracture with C2 posterior dislocation is extremely rare, only one paediatric case was reported in 2018 to date. This kind of injury cannot be catalogued using current classification schemes and no established treatment recommendations exist. The purpose of this article is to report a rare case of a hangman's fracture with C2 posterior dislocation, which does not fit into existing classification systems and discuss management technical notes to avoid pitfalls. Methods Description of case, review of relevant literatures and share our experience. Results A 31-year-old male sustained hangman’s fracture with C2 posterior dislocation after fell into a 50cm deep roadside ditch when riding a motorcycle. Radiograph and computed tomography (CT) on admission showed fractures through both pars of C2 and C2 posterior dislocation. Magnetic resonance imaging (MRI) on admission showed high T2-weighted signal intensity of cervical spinal cord and compression of cervical spinal cord by posterior dislocation of C2 vertebral body. A C2-3 anterior cervical discectomy and fusion (ACDF) was performed. At 6 months after operation, bony fusion was achieved, and MRI showed the T2-weighted signal hyperintensity of cervical spinal cord before surgery disappeared. Conclusion C2–C3 ACDF is recommended for hangman's fractures with C2 posterior dislocation. Traction before surgery is not recommended.

Switchable dielectric materials are attracting tremendous interest due to their low cost of manufacture, environment protection and structural flexibility. However, most of them have a single function. Here, we report one switchable dielectric material with high phase transition temperature based on 4-Ethylmorpholine. [4-Ethylmorpholine]2MnCl4 with the phase transition temperature of 425 K. What is more interesting is that this compound also has photoluminescence characteristic. Owing to the excellent switchable dielectric transition and efficacious Photoluminescence, this work may extend the application of switchable dielectric materials in the field of luminescence and multifunctional devices.

The human body contains more than 100 trillion microorganisms, including the oral cavity, the skin, and the gastrointestinal tract. After the gastrointestinal tract, the oral cavity harbors one of the most diverse microbial communities within the human body and harbors more than 770 species of bacteria. The composition of the oral and gut microbiomes is quite different, but there may be a microbiological link between the two mucosal sites during the course of disease. More studies indicate that oral bacteria can disseminate to the distal gut via enteral or hematogenous routes. This is mostly obvious in periodontitis, where specific bacteria, such as Fusobacterium nucleatum and Porphyromonas gingivalis, show this pathogenic feature. The translocation of oral microbes to the gut may give rise to a variety of gastrointestinal diseases, including colorectal cancer. However, the precise role that oral microbe play in colorectal cancer has not been fully illustrated. Here, we summarize the current researches on possible pathways of ectopic gut colonization by oral bacteria and their possible contribution to the pathogenesis of colorectal cancer. Understanding the correlation of the oral-to-gut microbial axis in the pathogenesis of colorectal cancer will contribute to precise diagnosis and effective treatment.

Whether the definition of hypertension according to 2017 AHA/ACC guidelines and blood pressure (BP) changes was related to the increased risk of chronic kidney disease (CKD) remained debated. This prospective cohort study aimed to investigate the association of BP and long‐term BP change with CKD risk with different glucose metabolism according to the new hypertension guidelines. This study examined 12 951 participants and 11 183 participants derived from the older people cohort study, respectively. Participants were divided into three groups based on blood glucose and the risks were assessmented by the logistic regression model. During a 10 years of follow‐up period, 2727 individuals developed CKD (21.1%). Compared with those with BP

Objective Helicobacter pyloriinfection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-basedH. pyloriinfection control and management to reduce the related disease burden. Methods Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements. Results Experts discussed and modified the original 23 statements on family-basedH. pyloriinfection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1)H. pyloriinfection and transmission among family members, (2) prevention and management ofH. pyloriinfection in children and elderly people within households, and (3) strategies for prevention and management ofH. pyloriinfection for family members. In addition to the ‘test-and-treat’ and ‘screen-and-treat’ strategies, this consensus also introduced a novel third ‘family-basedH. pyloriinfection control and management’ strategy to prevent its intrafamilial transmission and development of related diseases. Conclusion H. pyloriis transmissible from person to person, and among family members. A family-basedH. pyloriprevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.

Background: Few studies have investigated the association between cognition and brain volume associated with cerebral small vessel disease (CSVD). Objective: We investigated the association between cognition and brain volume and neuroimaging markers of CSVD in a community-dwelling population. Methods: Participants (n = 993, age≥35 years) from the community-based Shunyi Study were included to investigate the association between neuroimaging markers and cognition cross-sectionally. Magnetic resonance imaging markers included brain volume measurements of the total cerebrum, white matter, gray matter, and CSVD imaging markers. Cognitive performance was assessed using neuropsychological tests of the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Fuld Object Memory, digit span, Trail Making Test (TMT)-A, and TMT-B. Results: For brain volume measurement, subcortical white matter fraction was positively associated with MMSE score (β= 0.034, p = 0.0062) and MoCA score (β= 0.034, p = 0.0174), and negatively associated with TMT-A and TMT-B completion time (β= –2.319, p = 0.0002; β= –2.827, p = 0.0073, respectively). For evaluation of CSVD imaging markers, the presence of lacunes was positively associated with TMT-B completion time (β= 17.241, p = 0.0028). Conclusion: In community-dwelling populations, reduced white matter volumes, as a consequence of aging and vascular damage, are associated with worse global cognition and executive function. Our findings provide potential insights into the correlation between cognition and CSVD-associated subcortical white matter injury.

As recognition technology advances in various fields, the problem of requiring a large number of correct image recognition is also accompanied. So as to promote the correctness of image recognition...

Background The incidence of hand foot and mouth disease (HFMD) has increased in recent years, making it a very common childhood illness worldwide. The relationship between different enterovirus genotypes and disease severity is not clearly understood. Given that enteroviruses are transmitted through the gastrointestinal tract, we hypothesized that variation in intestinal microorganisms of the host might play a role in the prognosis of HFMD. Methods We carried out a meta-transcriptomic-wide association study of fecal samples obtained from a cohort of children (254 patients, 227 tested positive for enterovirus, including 16 patients co-infectied with 2 kinds of enterovirus) with mild and severe HFMD and healthy controls. Results We found there was no significant difference in the amount of each virus type between the mild and severe cases. Genes of enterovirus 71 (EV71) and coxsackievirus A (CV-A) from the severe and mild cases did not show significant clustering. Clostridium sp. L2-50 and Bacteroides stercoris ATCC 43183 were enriched in the guts of children with severe HFMD and KEGG enrichment was found between mild and severe cases. Conclusions Intestinal microorganisms appear to interact with enterovirus to determine the progression of HFMD. Genes of Bacteroides and Clostridium may be used as predictive markers for a more efficient prognosis and intervention. The enrichment of intestinal bacteria genes with functions may facilitate the development of severe symptoms for HFMD patients.

Background Alcohol consumption and smoking are the leading risk factors for laryngeal cancer (LC). Understanding the variations in disease burden of LC attributable to alcohol use and smoking is critical for LC prevention. Methods Disease burden data of LC were retrieved from the Global Burden of Disease Study 2019. We used estimated average percentage change (EAPC) to measure the temporal trends of the age-standardized mortality rate (ASMR) of LC. Results Globally, while the ASMR of LC decreased by 1.49% (95% CI, 1.41–1.57%) per year between 1990 and 2019, the number of deaths from LC has increased 41.0% to 123.4 thousand in 2019. In 2019, 19.4 and 63.5% of total LC-related deaths were attributable to alcohol use and smoking worldwide, respectively. The ASMR of alcohol- and smoking-related LC decreased by 1.78 and 1.93% per year, whereas the corresponding death number has increased 29.2 and 25.1% during this period, respectively. The decreasing trend was more pronounced in developed countries. In some developing countries, such as Guinea and Mongolia, the LC mortality has shown an unfavorable trend. Conclusion The ubiquitous decrease in LC mortality was largely attributed to the smoking control and highlighted the importance of smoking control policies. However, the disease burden of LC remained in increase and more effective strategies are needed to combat the global increase of alcohol consumption.

Background: Acute kidney injury (AKI) is a significant public health problem with high morbidity and mortality. Unfortunately, no definitive treatment is currently available for AKI. RNA interference (RNAi) provides a new and potent method for gene therapy to tackle this dilemma. Methods We engineered red blood cell-derived extracellular vesicles (REVs) with targeting peptides and therapeutic siRNAs to treat experimental AKI in a mouse model following renal ischemia/reperfusion (I/R) injury and unilateral ureteral obstruction (UUO). Phage display identified peptides that bind to the kidney injury molecule-1 (Kim-1). RNA-sequencing (RNA-seq) characterized the transcriptome of ischemic kidney to explore potential therapeutic targets. Results REVs targeted with Kim-1-binding LTH peptide (REVLTH) efficiently homed to and accumulated at the injured tubules in kidney following I/R injury. We identified transcription factors P65 and Snai1 that drive inflammation and fibrosis as potential therapeutic targets. Taking advantage of the established REVLTH, siRNAs targeting P65 and Snai1 were efficiently delivered to ischemic kidney and consequently blocked the expression of P-p65 and Snai1 in tubules. Moreover, dual suppression of P65 and Snai1 significantly improved I/R- and UUO-induced kidney injury by alleviating tubulointerstitial inflammation and fibrosis, and potently abrogated the transition to chronic kidney disease. Conclusions A red blood cell-derived extracellular vesicle platform targeted Kim-1 in acutely injured mouse kidney and delivered siRNAs for transcription factors P65 and Snai1, alleviating inflammation and fibrosis in the tubules.

Planes and edges are attractive features for simultaneous localization and mapping (SLAM) in indoor environments because they can be reliably extracted and are robust to illumination changes. However, it remains a challenging problem to seamlessly fuse two different kinds of features to avoid degeneracy and accurately estimate the camera motion. In this article, a plane-edge-SLAM system using an RGB-D sensor is developed to address the seamless fusion of planes and edges. Constraint analysis is first performed to obtain a quantitative measure of how the planes constrain the camera motion estimation. Then, using the results of the constraint analysis, an adaptive weighting algorithm is elaborately designed to achieve seamless fusion. Through the fusion of planes and edges, the solution to motion estimation is fully constrained, and the problem remains well-posed in all circumstances. In addition, a probabilistic plane fitting algorithm is proposed to fit a plane model to the noisy 3-D points. By exploiting the error model of the depth sensor, the proposed plane fitting is adaptive to various measurement noises corresponding to different depth measurements. As a result, the estimated plane parameters are more accurate and robust to the points with large uncertainties. Compared with the existing plane fitting methods, the proposed method definitely benefits the performance of motion estimation. The results of extensive experiments on public data sets and in real-world indoor scenes demonstrate that the plane-edge-SLAM system can achieve high accuracy and robustness. Note to Practitioners —This article is motivated by the robust localization and mapping for mobile robots. We suggest a novel simultaneous localization and mapping (SLAM) approach fusing the plane and edge features in indoor scenes (plane-edge-SLAM). This newly proposed approach works well in the textureless or dark scenes and is robust to the sensor noise. The experiments are carried out in various indoor scenes for mobile robots, and the results demonstrate the robustness and effectiveness of the proposed framework. In future work, we will address the fusion of other high-level features (for example, 3-D lines) and the active exploration of the environments.

A multifunctional frequency-selective surface reflector (FSSR) is found to be an applicable candidate for the realization of an antenna's radar cross-section reduction in or out of its operating frequency. In this letter, a polarization-selectable in-band switchable FSSR/absorber based on diodes is designed and experimentally demonstrated, which comprises a layer of active frequency-selective surface and a layer of metal-backed frequency-dispersive magnetic material (FDMM). The design realizes the switching functions of broadband absorption band from 3.5 to 12.0 GHz (110% bandwidth) with at least −10 dB reflectivity and a reflection band at 6.2 GHz with two-sided absorption bands (2.2–4.8 GHz, 74.3% bandwidth for the lower absorption band and 7.1–12.9 GHz, 58% bandwidth for the upper absorption band) by manipulating the on and off states of PIN diodes. Besides, due to the use of FDMM, the thickness of the FSSR is only 0.074 λL , making it easy to design the reflective surface of the antenna. A prototype of the proposed FSSR/absorber is fabricated and measured, where reasonable agreement is observed.

Background Urinary sediment messenger RNAs (mRNAs) have been shown as novel biomarkers of kidney disease. We aimed to identify targeted urinary mRNAs in diabetic nephropathy (DN) based on bioinformatics analysis and clinical validation. Methods Microarray studies of DN were searched in the GEO database and Nephroseq platform. Gene modules negatively correlated with estimated glomerular filtration rate (eGFR) were identified by informatics methods. Hub genes were screened within the selected modules. In validation cohorts, a quantitative polymerase chain reaction assay was used to compare the expression levels of candidate mRNAs. Patients with renal biopsy–confirmed DN were then followed up for a median time of 21 months. End-stage renal disease (ESRD) was defined as the primary endpoint. Multivariate Cox proportional hazards regression was developed to evaluate the prognostic values of candidate mRNAs. Results Bioinformatics analysis revealed four chemokines (CCL5, CXCL1, CXLC6 and CXCL12) as candidate mRNAs negatively correlated with eGFR, of which CCL5 and CXCL1 mRNA levels were upregulated in the urinary sediment of patients with DN. In addition, urinary sediment mRNA of CXCL1 was negatively correlated with eGFR (r = −0.2275, P = 0.0301) and CCL5 level was negatively correlated with eGFR (r = −0.4388, P Conclusions Urinary sediment CCL5 and CXCL1 mRNAs were upregulated in DN patients and associated with a decline in renal function and degree of renal interstitial fibrosis. Urinary sediment CCL5 mRNA could be used as a potential prognostic biomarker of DN.

The study aims to compare the efficacies of the immunosuppressants most commonly prescribed for patients with neuromyelitis optica spectrum disorder (NMOSD). The predictors, which might be associated with relapse and disability in NMOSD, were also analyzed. This retrospective study included NMOSD patients treated with azathioprine (AZA), mycophenolate mofetil (MMF), and rituximab (RTX). The annual relapse rate (ARR) and the incidence rates of adverse events were compared. Cox proportional-hazards model calculated the potential predictors of NMOSD relapse and disability. A total of 83 patients were included. The median treatment time of AZA group (n = 34), MMF group (n = 20), and RTX group (n = 29) were 19.5, 15.5, and 12 months, respectively. ARR of the three groups reduced significantly after treatment. In the three groups, 55.9%, 50%, and 79.3% of patients, respectively, were free from relapse. However, the difference among the three groups was of no statistical significance, possibly due to the small sample size. During the treatment, 32.4%, 15%, and 24.1% of patients experienced adverse events in the AZA group, MMF group, and RTX group, respectively. Additionally, the multivariate Cox analyses indicated that history of a severe attack and disease duration were associated with the risk of relapse after immunotherapy. Late-onset (≥ 50 years old) NMOSD patients were probably more susceptible to motor disability, and those with optic neuritis at onset were more likely to develop visual disability. AZA, MMF, and low-dose RTX were all effective in reducing the relapse rate in NMOSD. The age at onset, disease duration, history of severe attacks, and primary syndromes might be significant prognostic predictors in NMOSD.

Alzheimer's disease (AD) is a central disease with high incidence, and its pathological process is closely associated with changes of some biological indicators in the periphery. Among them, the intestinal flora mainly causes a series of pathological changes such as inflammation through the immune system, which may contribute to the pathological process of AD. In this paper, we mainly focused the relationship between gut microbiota and immune system disorder in the neuropathology of AD, underlining the significance of the advanced mechanism of inflammatory response and providing a new direction for the treatment of AD.

Background Peritoneal dialysis (PD) patients have a high incidence of poor clinical outcomes, which is related to the inflammatory and nutritional status of this population. Platelet-to-albumin ratio (PAR), recently identified as a useful biomarker to monitor inflammation and nutrition, can predict a poor prognosis in various diseases. The aim of this study was to investigate the association between PAR and technique failure and mortality in PD patients. Methods This single-center retrospective study enrolled 405 PD patients from 1 January 2011 to 31 December 2019 and collected complete demographic characteristics, clinical laboratory baseline data. The outcomes were technique failure and mortality. The associations between PAR and technique failure, death were analyzed by Cox proportional hazard models and competing risk regression models with kidney transplantation as a competing event. The areas under the curve (AUC) of receiver-operating characteristic analysis were used to determine the predictive values of PAR for technique failure and mortality. Results During a median follow-up period of 24.0 (range, 4.0–91.0) months, 139 (34.3%) PD patients experienced technique failure, 61 (15.1%) PD patients died. The patients with higher PAR levels had increased risk of technique failure and mortality. After adjustment for confounding factors, we found that high PAR levels were risk factor for both technique failure (subdistribution hazard ratio [SHR] 1.775; 95%CI, 1.157–2.720; p = 0.033] and mortality [SHR 3.710; 95%CI, 1.870–7.360; p

Baicalein is a biologically important flavonoid in extracted from the Scutellaria baicalensis Georgi, which can effectively inhibit the influenza virus. This study aimed to analyze the safety and pharmacokinetic (PK) characteristics of baicalein tablets in healthy Chinese subjects and provide more information for phase II clinical trials. In this multiple‐ascending‐dose placebo‐controlled trial, 36 healthy subjects were randomized to receive 200, 400, and 600 mg of baicalein tablet or placebo once daily on day 1 and day 10, 3 times daily on days 4–9. All groups were intended to produce safety and tolerability outcomes (lowest dose first). Blood and urine samples were collected from subjects in the 600 mg group for baicalein PK analysis. Our study had shown that Baicalein tablet was generally safe and well‐tolerated. All adverse events were mild and resolved without any intervention except one case of fever reported in the 600 mg group, which was considered as moderate but not related with baicalein as judged by the investigator. Oral baicalein tablets were rapidly absorbed with peak plasma levels being reached within 2 h after multiple administration. The highest urinary excretion of baicalein and its metabolites peaked in 2 h, followed by 12 h, with a double peak trend.

Cervical cancer, as the second most common female malignancy, brings a great health burden to women worldwide. Cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) are the most common histological subtypes of cervical cancer. CXC chemokines (CXCLs) within the tumor microenvironment can modulate carcinogenesis and progression. The present study aimed to explore the therapeutic and prognostic value of different CXCLs in CESC. ONCOMINE, GEPIA, cBioPortal, TRRUST, GeneMANIA, STRING and TIMER were utilized to explore the expression, mutation and function of CXCLs in CESC, as well as their correlation with pathological and survival features of CESC patients. We found that the mRNA expression levels of CXCL1/8/9/10/11/13/16/17 in CESC were upregulated compared with normal cervical tissues, whereas CXCL12 was downregulated. No significant correlation was found between the expression levels and pathological stage of CESC patients. CESC patients with high expression of CXCL1/2/3/4/5/8 were significantly associated with poor overall survival, additionally, low mRNA level of CXCL3 was associated with better disease-free survival. Besides, a high mutation rate (43%) of CXCLs in CESC was observed. Depicted by co-expression analysis, the expression of CXCL1/2/3/6/8 showed a modest to strong correlation, while that of CXCL9/10/11/13 showed a very strong correlation. Differentially expressed CXCLs primarily functioned in chemokine signaling pathway and inflammation response, such as cell chemotaxis, chemokine activity and chemokine receptor binding. We also found the association of CXCLs with the tumor-infiltration of six types of immune cells (B cells, CD8+ T cells, CD4+ T cells, macrophages, neutrophils and dendritic cells) in CESC patients. The present study elucidated that CXCLs may have the potential to be novel therapeutic targets and prognosis predictors of CESC patients.

Visual place recognition is a challenging problem in simultaneous localization and mapping (SLAM) due to a large variability of the scene appearance. A place is usually described by a single-frame image in conventional place recognition algorithms. However, it is unlikely to completely describe the place appearance using a single frame image. Moreover, it is more sensitive to the change of environments. In this article, a novel image-sequence-based framework for place detection and recognition is proposed. Rather than a single frame image, a place is represented by an image sequence in this article. Position invariant robust feature (PIRF) descriptors are extracted from images and processed by the incremental bag-of-words (BoWs) for feature extraction. The robot automatically partitions the sequentially acquired images into different image sequences according to the change of the environmental appearance. Then, the echo state network (ESN) is applied to model each image sequence. The resultant states of the ESN are used as features of the corresponding image sequence for place recognition. The proposed method is evaluated on two public datasets. Experimental comparisons with the FAB-MAP 2.0 and SeqSLAM are conducted. Finally, a real-world experiment on place recognition with a mobile robot is performed to further verify the proposed method.

Performance of 3D-T1W-TSE has been proven superior to 3D-MP-GRE at 3 T on brain metastases (BM) contrast-enhanced (CE) MRI. However, its performance at 1.5 T is largely unknown and sparsely reported. This study aims to assess image quality, lesion detectability and conspicuity of 1.5 T 3D-T1W-TSE on planning MRI of frameless BM radiotherapy. 94 BM patients to be treated by frameless brain radiotherapy were scanned using 3D-T1W-TSE with immobilization on multi-vendor 1.5 T MRI-simulators. BMs were jointly diagnosed by 4 reviewers. Enhanced lesion conspicuity was quantitatively assessed by calculating contrast ratio (CR) and contrast-to-noise ratio (CNR). Signal-to-noise ratio (SNR) reduction of white matter due to the use of flexible coil was assessed. Lesion detectability and conspicuity were compared between 1.5 T planning MRI and 3 T diagnostic MRI by an oncologist and a radiologist in 10 patients. 497 BMs were jointly diagnosed. The CR and CNR were 75.2 ± 39.9% and 14.2 ± 8.1, respectively. SNR reduced considerably from 31.7 ± 8.3 to 21.9 ± 5.4 with the longer distance to coils. 3 T diagnostic MRI and 1.5 T planning MRI yielded exactly the same detection of 84 BMs. Qualitatively, lesion conspicuity at 1.5 T was not inferior to that at 3 T. Quantitatively, lower brain SNR and lesion CNR were found at 1.5 T, while lesion CR at 1.5 T was highly comparable to that at 3 T. 1.5 T 3D-T1W-TSE planning MRI of frameless BM radiotherapy was comprehensively assessed. Highly comparable BM detectability and conspicuity were achieved by 1.5 T planning MRI compared to 3 T diagnostic MRI. 1.5 T 3D-T1W-TSE should be valuable for frameless brain radiotherapy planning.

Background:. Unawareness of stroke symptoms and low income are two barriers that affect the seeking of emergency medical service (EMS). This study aimed to assess the effect of unawareness and low income on seeking EMS and to investigate the regional distribution of the unawareness and low-income status and their associations with failing to call EMS in China. Methods:. A total of 187,723 samples from the China National Stroke Screening Survey was interviewed cross-sectionally. Four status of awareness and annual income were identified: unaware and low-income, unaware-only, low-income-only, and aware and regular income. The outcomes were whether they intended to call EMS or not. The regional distribution of each status and their associations with not calling EMS were presented. Results:. The status of unaware and low-income, unaware-only, and low-income-only accounted for 6.3% (11,806/187,673), 11.9% (22,241/187,673), and 21.5% (40,289/187,673) of the total sample, respectively. Not calling EMS was significantly associated with the status of unaware and low-income (odds ratio [OR]: 3.21, 95% confidence interval [CI]: 3.07–3.35), unaware-only (OR: 2.38, 95% CI: 2.31–2.46), and low-income-only (OR: 1.67, 95% CI: 1.63–1.71), compared with the aware and regular income status. The Midwest regions had higher percentages of people in the unaware and low-income status; the East, South, and Central had higher percentages of unaware-only status; the North and Northeast regions had a higher percentage of low-income-only status, compared with other regions. Conclusion:. The existence of the regional difference in unawareness and low income justifies the specific stroke education strategies for the targeted regions and population.

Oxygen homeostasis disturbances play a critical role in the pathogenesis of acute kidney injury (AKI). The transcription factor hypoxia-inducible factor-1 (HIF-1) is a master regulator of adaptive responses to hypoxia. Aside from posttranslational hydroxylation, the mechanism of HIF-1 regulation in AKI remains largely unclear. In this study, the mechanism of HIF-α regulation in AKI was investigated. We found that tubular HIF-1α expression significantly increased at the transcriptional level in ischemia-reperfusion-, unilateral ureteral obstruction-, and sepsis-induced AKI models, which was closely associated with macrophage-dependent inflammation. Meanwhile, NF-κB, which plays a central role in the inflammation response, was involved in the increasing expression of HIF-1α in AKI, as evidenced by pharmacological modulation (NF-κB inhibitor BAY11-7082). Mechanistically, NF-κB directly bound to the HIF-1α promoter and enhanced its transcription, which occurred not only under hypoxic conditions but also under normoxic conditions. Moreover, the induced HIF-1α by inflammation protected against tubular injury in AKI. Thus, our findings not only provide novel insights into HIF-1 regulation in AKI but also offer to understand the pathophysiology of kidney diseases.NEW & NOTEWORTHY Here, the mechanism of hypoxia-inducible factor-α (HIF-α) regulation in acute kidney injury (AKI) was investigated. We found that tubular HIF-1α expression significantly increased at the transcriptional level, which was closely associated with macrophage-dependent inflammation. Meanwhile, NF-κB was involved in the increasing expression of HIF-1α in AKI. Mechanistically, NF-κB directly bound to the HIF-1α promoter and enhanced its transcription. Our findings not only provide novel insights into HIF-1 regulation in AKI but also offer to understand the pathophysiology of kidney diseases.

Background: Mantle cell lymphoma (MCL) is widely considered an incurable malignancy even with current therapies and relapsed/refractory (R/R) disease to primary treatment remains common. With improved treatment guidelines and the advent of novel agents, patients are increasingly being treated with more lines of regimens. However, outcomes after each line of treatment remain poorly characterized, especially in the Asian population. In this paper, we described the survival outcomes in a group of R/R MCL patients. Methods: We retrospectively studied 35 patients with R/R MCL between 1998 and 2020 at the National Cancer Centre Singapore. Patients were followed longitudinally throughout their disease course. Overall survival (OS) and progression-free survival (PFS) were determined by the Kaplan-Meier method. Results: The median OS and PFS from diagnosis were 105 and 40 months, respectively. After first relapse, the median OS and PFS were 52 and 19 months, post-second relapse 32 and 8 months, and post-third relapse 12 and 6 months, respectively. Patients older than 65 years at first relapse had shorter survival (median OS: 22 vs. 55 months, P = 0.0417; median PFS: 9 vs. 29 months, P = 0.001). Early treatment failure after first line therapy was also associated with worse survival outcomes (median OS: 13 vs. 55 months, P < 0.001; median PFS: 9 vs. 26 months, P < 0.001). Conclusion: With each relapse, survival outcomes for patients with MCL are worse. Novel treatment and contemporary outcomes of R/R MCL are encouraging and support the need for continued research in this area. J Hematol. 2021;10(4):187-195 doi: https://doi.org/10.14740/jh890

The lower Yangtze Valley is a fruitful area to examine the interplay between the origins and intensification of agriculture and socio-political complexity. Most archaeological research on the emerg...

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has caused major public panic in China. Pregnant women may be more vulnerable to stress, which may cause them to have psychological problems. AIM To explore the effects of perceived family support on psychological distress in pregnant women during the COVID-19 pandemic. METHODS A total of 2232 subjects were recruited from three cities in China. Through the online surveys, information on demographic data and health status during pregnancy were collected. Insomnia severity index, generalized anxiety disorder 7-item scale, patient health questionnaire-9, somatization subscale of the symptom check list 90 scale, and posttraumatic stress disorder checklist were used to assess the psychological distress. RESULTS A total of 1015 (45.4%) women reported having at least one psychological distress. The women who reported having inadequate family support were more likely to suffer from multiple psychological distress (≥ 2 psychological distress) than women who received adequate family support. Among the women who reported less family support, 41.8% reported depression, 31.1% reported anxiety, 8.2% reported insomnia, 13.3% reported somatization and 8.9% reported posttraumatic stress disorder (PTSD), which were significantly higher than those who received strong family support. Perceived family support level was negatively correlated with depressive symptoms (r = -0.118, P < 0.001), anxiety symptoms (r = -0.111, P < 0.001), and PTSD symptoms (r = -0.155, P < 0.001). CONCLUSION Family support plays an important part on pregnant women’s mental health during the COVID-19 pandemic. Better family support can help improve the mental health of pregnant women.

Human fatty acid synthase (FASN) is the sole cytosolic enzyme responsible for de novo lipid synthesis. FASN is essential for cancer cell survival and contributes to drug and radiation resistance by up-regulating DNA damage repair but not required for most non-lipogenic tissues. Thus, FASN is an attractive target for drug discovery. However, despite decades of effort in targeting FASN, no FASN inhibitors have been approved due to poor pharmacokinetics or toxicities. Here, we show that the FDA-approved proton pump inhibitors (PPIs) effectively inhibit FASN and suppress breast cancer cell survival. PPI inhibition of FASN leads to suppression of non-homologous end joining repair of DNA damages by reducing FASN-mediated PARP1 expression, resulting in apoptosis from oxidative DNA damages and sensitization of cellular resistance to doxorubicin and ionizing radiation. Mining electronic medical records of 6754 breast cancer patients showed that PPI usage significantly increased overall survival and reduced disease recurrence of these patients. Hence, PPIs may be repurposed as anticancer drugs for breast cancer treatments by targeting FASN to overcome drug and radiation resistance.

Background/Purpose: Recent study suggested that type 2 diabetes (T2DM) attributed to body mass index (BMI) could be influenced by liver aminotransferase. We aim to ascertain the cut-off point of BMI associated with T2DM and the influence of both elevated aminotransferase (AST) and alanine aminotransferase (ALT). Materials and Methods: In our retrospective cohort study, T2DM was diagnosed when FBS ≥ 7.0 mmol/L, BMI of participants with baseline fasting (FBS) < 7.0 mmol/L was divided by percentiles and by aminotransferanse (ALT and AST ≥ 20 U/L, ALT or AST < 20 U/L). Hazard ratios and the turning point of BMI of high T2DM risk was estimated in totality and different aminotransferanse groups. Results: During an average follow-up time of 3.71 years of 33346 participants, 1486 developed T2DM, and the average baseline BMI of participants who developed T2DM was 26.22 kg/m2. Cumulative incidence of T2DM was more than 5% when ALT and AST ≥ 20U/L, age over 44, male sex or BMI over 25.39 kg/m2; The risk of T2DM incidence increased as the BMI grow. The turning point of BMI at high risk of T2DM was 25.0 kg/m2 in totality, 25.1 kg/m2 when ALT or AST < 20 U/L and 26.1 kg/m2 when ALT and AST ≥ 20U/L. Conclusions: BMI of 25.0 kg/m2 was the cutoff point for T2DM development, and there is greater association between BMI and T2DM when ALT or AST < 20 U/L.

Magnetic Resonance Fingerprinting (MRF) is a novel technique that simultaneously estimates multiple tissue-related parameters, such as the longitudinal relaxation time T1, the transverse relaxation time T2, off resonance frequency B0 and proton density, from a scanned object in just tens of seconds. However, the MRF method suffers from aliasing artifacts because it significantly undersamples the k-space data. In this work, we propose a compressed sensing (CS) framework for simultaneously estimating multiple tissue-related parameters based on the MRF method. It is more robust to low sampling ratio and is therefore more efficient in estimating MR parameters for all voxels of an object. Furthermore, the MRF method requires identifying the nearest atoms of the query fingerprints from the MR-signal-evolution dictionary with the L2 distance. However, we observed that the L2 distance is not always a proper metric to measure the similarities between MR Fingerprints. Adaptively learning a distance metric from the undersampled training data can significantly improve the matching accuracy of the query fingerprints. Numerical results on extensive simulated cases show that our method substantially outperforms state-of-the-art methods in terms of accuracy of parameter estimation.

Background and aims The diverse inflammatory response found in the liver of patients with autoimmune hepatitis (AIH) is well established, but identification of potentially pathogenic subpopulations has proven enigmatic. Approach and results We report herein that CD69+ CD103+ CD8+ tissue-resident memory T cells (TRM ) are significantly increased in the liver of patients with AIH compared to chronic hepatitis B, NAFLD, and healthy control tissues. In addition, there was a significant statistical correlation between elevation of CD8+ TRM cells and AIH disease severity. Indeed, in patients with successful responses to immunosuppression, the frequencies of such hepatic CD8+ TRM cells decreased significantly. CD69+ CD8+ and CD69+ CD103+ CD8+ T cells, also known as CD8+ TRM cells, reflect tissue residency and are well known to provide intense immune antigenic responses. Hence, it was particularly interesting that patients with AIH also manifest an elevated expression of IL-15 and TGF-β on inflammatory cells, and extensive hepatic expression of E-cadherin; these factors likely contribute to the development and localization of CD8+ TRM cells. Based on these data and, in particular, the relationships between disease severity and CD8+ TRM cells, we studied the mechanisms involved with glucocorticoid (GC) modulation of CD8+ TRM cell expansion. Our data reflect that GCs in vitro inhibit the expansion of CD8+ TRM cells induced by IL-15 and TGF-β and with direct down-regulation of the nuclear factor Blimp1 of CD8+ TRM cells. Conclusions Our data suggest that CD8+ TRM cells play a critical role in the pathogenesis of AIH, and GCs attenuate hepatic inflammation through direct inhibition of CD8+ TRM cell expansion.

Objective. Peer support is a concept of substantial significance to health scientists and practitioners today due to its focus shifting from disease treatment to health promotion. Effective incorporation peer relationships in support-enhancing interventions could improve quality care and health outcomes. More and more cases of chronic obstructive pulmonary disease (COPD) have been diagnosed in nonsmokers. In this study, the effects of peer-support nursing intervention on the pulmonary function and quality of life of nonsmoking patients with COPD were investigated. Methods. A total of 100 COPD nonsmoking patients admitted to our hospital from October 2018 to October 2020 were selected as study subjects. All nonsmoking patients were in accordance with the guidelines of COPD diagnosis and treatment issued by the Respiratory Medicine Branch of Chinese Medical Association, and they were not in the habit of smoking. According to the different interventions, the nonsmoking patients were divided into the control group (n = 50) and the observation group (n = 50). Among them, nonsmoking patients in the control group received routine care, and nonsmoking patients in the observation group received routine care and peer-support nursing. The difference on the scores of social support, self-management efficacy, healthy lifestyle, and the distance of six-minute walking were to be compared between the two groups before and after the intervention. Results. There was no significant statistical difference on the general information between the two groups in terms of age, gender, and course of disease ( P > 0.05 ). Before intervention, the social support score involving subjective support, objective support, utilization of support, and total score revealed slight difference between the two groups ( P > 0.05 ). However, after the intervention, the subjective support, utilization of support, and total score remained statistically different between the two groups ( P < 0.05 ), and the objective support showed no significant difference between the two groups ( P > 0.05 ). Before intervention, there was no statistical difference in the self-management efficacy scores such as positive attitude, stress reduction, self-decision-making, and total score between the two groups ( P > 0.05 ). After the intervention, the two groups indicated statistical difference in the self-management efficacy scores ( P < 0.05 ). Before intervention, there was no significant difference between the two groups in the healthy lifestyle score in terms of health responsibility, self-realization, interpersonal support, and stress management ( P > 0.05 ), and the abovementioned outcome measures indicated significant difference between the two groups after intervention ( P < 0.05 ). There was no statistical difference in six-minute walking distance between the two groups before the intervention ( P > 0.05 ), but after the intervention, the observation group revealed a significantly longer distance of six-minute walking compared to the control group ( P < 0.05 ). Conclusion. These data suggest that peer-support nursing intervention can effectively improve pulmonary function and quality of life of nonsmoking patients with COPD.

Large-scale events attracting many participants might have a strong negative impact on productivity, mobility, comfort, and safety in a city. Within the few years, serious accidents led by congestion have occurred, especially during sports events, religious ceremonies, festivals, and so on. To alleviate these serious accidents, predicting the occurrence of a large-scale event is much significant. When we know an event occurrence in advance, some of those who are not interested in the event might change their plans and/or might take a detour to avoid to get involved in a heavy congestion. In this paper, we present an early event detection technique named BusBeat . BusBeat uses GPS trajectory data collected from periodic-cars that are vehicles periodically traveling on a pre-scheduled route with a pre-determined departure time, such as a transit bus, shuttle, garbage truck, or municipal patrol car. BusBeat interpolates the missing GPS data by using the features of the periodic-cars. In addition, BusBeat uses the network-based analysis with a Time-dependent Congestion Network (TCN) in order to detect geo-spatial events. BusBeat achieves early event detection without incurring any privacy invasion, by using the continuous trajectories of the periodic-cars that provide the real-time traffic flow and speed. Since traffic towards an event venue would be slow before the event starts, BusBeat detects the geo-spatial events before the attendees gather. We evaluate our BusBeat using over 7,000-bus data collected in Beijing for 5 months and compare with the check-in data collected from a social network service.

Objective To explore the changes of proopiomelanocortin (POMC) and Agouti-Related Peptide (AgRP) expression in brain and kidney tissues under insulin intervention at different stages of diabetic nephropathy (DN) rats. Methods The male Sprague-Dawley (SD) rats of DN were treated with high-fat diet for 8 weeks and induced by intraperitoneally injection of streptozotocin (30 mg/kg) for one time. Then DN rats were also injected insulin subcutaneously at 2–5 U/(kg·24 h) from initiation of the streptozotocin. Kidney tissue, blood sample, and 24 h-urine were collected to detect the ratio of kidney/body weight, blood glucose and 24-h urinary albumin excretion rate at different stages (4, 8, 12, and 16 weeks). Immunohistochemistry assay was used to measure the expression of POMC and AgRP at different stages of DN rats. Results The DN rats were established successfully. With the progression of DN, blood glucose, 24-h urinary albumin excretion rate and kidney body weight ratio increased significantly, while decreased when insulin was injected. Immunohistochemistry showed that the expression levels of POMC were decreased gradually in brain and kidney tissues. Conversely, the expression of AgRP in kidney was highest at week 8 and then decreased gradually. The effect of insulin on normalizing POMC and AgRP expression in brain and renal tissues was also observed in DKD rats. Conclusion With the progression of DN, the expression of POMC and AgRP in kidney tissues was observed at different stages of disease, and their expressions were significantly normalized by insulin. The mechanism of in situ expression of POMC and AGRP in kidney to the progression of DN needs further investigations.

Aim Emperipolesis, the cell-in-cell structure, is one of the pathological diagnostic standard of AIH. We have already identified that CD8+ T cells participated in the emperipolesis process in liver tissue of AIH patients. In this study, we aimed to clarify the characteristics and molecular mechanisms of emperipolesis in the patients with AIH in vitro and in mice with α-GalCer-induced acute hepatitis. Methods Peripheral blood mononuclear cell (PBMC) of patients with variant chronic liver diseases and healthy controls were co-cultured with hepatic cell line to induce emperipolesis in vitro. Confocal staining was performed to illustrate the cellular types and potential mechanisms of emperipolesis in AIH. In addition, the mouse model of α-GalCer-induced acute hepatitis which mimics human AIH in several features, was used to confirm the role of CD44/p-ERM/F-actin in the emperipolesis process in vivo. Results In co-culture system with PBMC and hepatic cell line, emperipolesis was observed most common in the patients with AIH. CD8+ T cells were the major cells participated in the emperipolesis process, and penetrated into hepatocytes actively via CD44/p-ERM/F-actin pathway. As a result, most CD8+ T cells engulfed in hepatocytes undergo self-apoptosis. In α-GalCer-induced acute hepatitis model, emperipolesis was observed around the inflammatory foci, and was inhibited by Ezrin phosphorylation inhibitor NSC668394. Similarly, activated murine CD8+ T cells penetrated into primary hepatocytes via CD44/p-ERM/F-actin pathway in vitro. Conclusions CD8+ T cells penetrated into hepatocytes actively via CD44/p-ERM/F-actin signaling pathway and undergo apoptosis, may be a compensative mechanism to attenuate overwhelming immune attack in AIH. This article is protected by copyright. All rights reserved.

Yanhua Liang,1,* Shanglong Kou,1,2,* Xiaohe Li,1 Zhiyi Ke,1 Rongrong Zou,1 Yanchao Pan,1,3 Jing Yuan1 1Diagnosis and Treatment of Infectious Diseases Research Laboratory, Shenzhen Third People’s Hospital, Shenzhen, People’s Republic of China; 2College of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, People’s Republic of China; 3Institute of Chemical Biology, Shenzhen Bay Laboratory, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yanchao Pan; Jing YuanDiagnosis and Treatment of Infectious Diseases Research Laboratory, Shenzhen Third People’s Hospital, 29 Bulan Road, Buji District, Shenzhen, 518112, People’s Republic of ChinaTel +86 0755-61222333Fax +86 0755-61238928Email panychao@126.com; sz_yuanjing@163.comIntroduction: The novel coronavirus (COVID-19) has become a global pandemic with sharp rises in the number of confirmed cases and rapid spread across the world. Here, we looked at the effects of geographic differences on clinical manifestations of SARS-CoV-2 infected patients.Methods: A total of 114 confirmed COVID-19 patients were included in this study. The epidemiological, demographic, clinical, as well as laboratory findings were extracted from the electronic medical records of these patients.Results: We report the observation that patients from overseas residents diagnosed with COVID-19 were mildly symptomatic with cough and presented with lower inflammatory response and attenuated virus clearance rate, as well as correspondingly prolonged days of hospital stay than local Chinese patients. Moreover, the receiver-operating characteristic (ROC) analysis, performed to provide a measure of the difference between two groups, showed that serum albumin had the highest area under the curve value (0.81, p < 0.001).Discussion: Our results suggested that blood albumin level acted as a predictive value in distinguishing clinical features between local and overseas Chinese. This work underscores the need to identify distinguishably prognostic factors of geographical dissimilarity in COVID-19 patients.Keywords: geographic differences, clinical manifestations, inflammatory responses, COVID-19 patients

Background: Sympathetic and parasympathetic nerve remodeling play an important role in cardiac function after myocardial ischemia (MI) injury. Increasing evidence indicates that electroacupuncture (EA) can regulate cardiac function by modulating the autonomic nervous system (ANS), but little is known about its effectiveness on neural remodeling post-MI. Objectives: To investigate the role of EA in ANS remodeling post-MI. Methods: Adult male C57/BL6 mice were equally divided into the Control (Ctrl), MI and EA groups after generating the MI model by ligating the left anterior descending (LAD) coronary artery. Echocardiography and 2,3,5-triphenyltetrazolium (TTC) staining were employed to evaluate cardiac function and infarct size after EA treatment for five consecutive days. Serum norepinephrine (NE) levels were measured by ELISA to quantify sympathetic activation. Then, ANS remodeling was detected by immunohistochemistry (IHC), RT-qPCR, and Western blotting. Results: Our preliminary findings showed that EA increased ejection fraction and fractional shortening and reduced infarct area after MI injury. Serum NE levels in the EA group were significantly decreased compared with those in the MI group. IHC staining results demonstrated that the density of growth associated protein (GAP)43 and tyrosine hydroxylase (TH) positive nerve fibers in the EA group were decreased with increased choline acetyltransferase (CHAT) and vesicular acetylcholine transporter (VACHT). Meanwhile, the results verified that mRNA and protein expression of GAP43 and TH were significantly inhibited by EA treatment in the MI mice, accompanied by elevated CHAT and VACHT. Conclusions: EA treatment could improve cardiac function and reduce infarct size by modulating sympathetic and parasympathetic nerve remodeling post-MI, thus helping the cardiac ANS reach a new balance to try to protect the heart from further possible injury.

Facing with COVID-19 epidemic such a catastrophic health emergency, the mental health status of medical staff deserves attention. We conducted a two-stage of psychological status monitoring after the end of the assistance and 14 days of isolation, further targeted the vulnerable groups in need of intervention. The study is a cross-sectional survey on 1156 Yunnan medical staff aid to Hubei. Used Cluster sampling method to collect data at 2 time points (at the end of returning from Wuhan and the 14th day of isolation), from March 18, 2020 to April 6, 2020. Female and nurse had higher rates of depressive symptoms than male and doctors and other occupations. The proportion of female with mild and above moderate anxiety levels (22.91%, 2.61%) was higher than male (17.35%, 1.03%) (p

An interleaved LLC half-bridge series resonant converter having an integrated transformer includes a power supply, a magnetic core, a first converter, a second converter and an output load circuit. The magnetic core has first and second outer columns and a center column. The first converter includes a first switch circuit, a first resonant tank, a first transformer, and a first rectifier circuit. The first transformer is coupled to the first resonant tank and includes a first primary winding wound on the first outer column and a first secondary winding wound on the second outer column. The second converter includes a second switch circuit, a second resonant tank, a second transformer and a second rectifier circuit. The second transformer is coupled to the second resonant tank and includes a second primary winding wound on the first outer column and a second secondary winding wound on the second outer column.

Background To investigate the clinical efficacy of the MyoSure hysteroscopic tissue removal system in the treatment of endometrial and cervical polyps in women with an intact hymen. Methods Retrospective analysis was performed on the clinical data of 32 patients treated with the MyoSure hysteroscopic tissue removal system for endometrial and cervical polyps. Results All the patients successfully completed the procedure. No intraoperative complications, such as cervical trauma, uterine perforation or TURP syndrome, were reported. The surgical time ranged from 5 to 35 min, with an average time of 19.3 min, and the intraoperative blood loss ranged from 2 to 50 ml with an average blood loss of 10.8 ml. After surgery, all patients were shown to have intact hymens. No residual polyp tissues were observed under the microscope, and abnormal uterine bleeding was relieved. Conclusions The MyoSure hysteroscopic tissue removal system can be a safe and effective treatment for endometrial and cervical polyps in women with an intact hymen.

Target recognition is a challenging task for human following of mobile service robots. In this paper, we combine the principal-component-analysis (PCA)-based face recognition with the tracking-learning-detection applied to the human face (Face-TLD) to obtain an improvement, named as IFace-TLD. The proposed IFace-TLD can significantly improve the discrimination ability of the Face-TLD for ambiguous facial appearances. To further deal with motion uncertainties of the human head, especially the sudden motion change, which makes face-based target recognition methods unstable or even loses the target, a skeleton-based model is introduced to improve the accuracy and robustness of the target recognition. Specifically, within a walk half-cycle, the skeleton features are extracted from the upper-body three-dimensional skeleton coordinates. Then, the extracted skeleton features are fed into the support vector data description (SVDD) to identify the target person when the IFace-TLD becomes invalid. The seamless fusion of the skeleton recognition and the IFace-TLD, named as the SIFace-TLD, significantly enhances the robustness in complex scenarios, especially for people tracking from both front and behind. To achieve a complete human following system, the particle filter (PF) is adopted for estimating the state of the human motion. And then, a controller is designed to maintain the relative position between the robot and the target. Experimental results demonstrate that the proposed IFace-TLD is more accurate and flexible than the original Face-TLD. And the SIFace-TLD shows a robust performance to human motion uncertainties. Moreover, the developed controller can achieve a satisfactory human following performance.

Objective The aim of this study was to compare the efficacy, safety and treatment costs of superficial femoral artery revascularization (SFA) with drug-coated balloon(DCB) versus avoiding revascularization strategy for the treatment of symptomatic SFA disease. Methods This retrospective single-center study reviewed 96 patients (113 limbs) with severe stenosis and occlusive SFA disease. All patients underwent either DCB(Group 1: n ​= ​55 limbs) or nonrevascularization (Group 2: n ​= ​58 limbs) between March 2015 and June 2019. The improvement of Rutherford class, walking impairment questionnaire score(WIQ), target limb reintervention, perioperative major adverse events, the catheterization laboratory cost and length of hospital stay were compared. The limb salvage and survival rates were calculated using the Kaplan-Meier method. Univariate and multivariate logistic regression analysis were performed to assess the association between factors and the improvement of Rutherford category at 12 months. Results The median follow-up time of Groups 1 and 2 was 17 and 33 months, respectively. At 12 months, the Rutherford category significantly decreased in both groups (P ​, Highlights • Home-based walking excersie is the recommended treatment for patients with PAD. • The patent profunda femoral artery plays an important role in the case of SFA occlusion. • SFA nonrevascularization strategy may be a therapeutic option for chronic obstructive SFA disease.

The parameter identification of a non-cooperative target is a key problem of on-orbit servicing. Due to poor priori information about the motion and structure of non-cooperative targets, the traditional cooperative estimation architecture is inadequate. In addition, the existing method based on single observation spacecraft is difficult to ensure a good observation state for a long time. This paper proposes a method for observing and estimating attitude kinematic state of a non-cooperative space target based on multi-spacecrafts cooperative observation. The space target's 3D point cloud data is reconstructed based on the data with different viewpoints. The target's attitude change is calculated based on the 3D point cloud matching, and the kinematics information is estimated via EKF filtering. The simulation results demonstrate the efficiency of the proposed approach. As the proposed method does not require priori model, structural information or accurate motion information of the tumbling non-cooperative target, it can avoid the influence of occlusion or date missing in space observation, it is suitable for space on-orbit servicing with non-cooperative target in future.

Objective: To investigate if routine audiometry in Bell’s palsy patients has prognostic value. Methods: Retrospective case review was conducted on all Bell’s palsy patients (n=191) seen at the tertiary otolaryngology specialist outpatient clinic from 2015 to 2017. Correlation of ipsilesional audiometric thresholds with patients’ time-to-recovery and initial clinical severity (measured by House-Brackmann (HB) scoring) were used for the prognostic outcome measure. Audiometry results were analyzed using three contiguous frequency pure-tone average (1kHz, 2kHz, 4kHz). Statistical analysis was done via Stata (v13.1), significance tests were 2-sided at 5% significance level. Results: There was no significant difference between audiometric thresholds between the ipsilesional ear and the contralateral ear (p=0.87). Time-to-recovery was significantly longer for patients with severe initial presentation as compared to mild and moderate severity (p

Traditional object recognition algorithms are based on a commonly adopted closed-set hypothesis, assuming that the knowledge given in training is complete. However, real situations are often open and nonstatic, in which case the models only obtain incomplete knowledge during the training phase. This paper proposes a new type of conditional random field (CRF) model to solve a special case of incomplete knowledge, in which the visual appearance of certain objects changes significantly between training and testing, and as a result, certain unary features (features of individual objects) extracted from red green blue-depth (RGB-D) images are no longer reliable. Mirror nodes are introduced into the architecture based on the standard CRF model to build the mirrored conditional random field (Mirror-CRF) model, which integrates two types of object nodes: original nodes and mirror nodes. The mirror nodes have no unary features, only pairwise features, which describe relationships between two objects and are more reliable than unary features for object recognition in the case of appearance variation. The experimental results show that the Mirror-CRF model reduces the influence of significant changes in the appearance of certain objects and improves the object recognition ability under the condition of incomplete knowledge.

This article presents the hardware, software, and power codesign of an ultra-efficient data storage server with differential power processing (DPP). DPP can reduce the power conversion stress, improve the efficiency, and enhance the functionality of modular power electronics systems. The power inputs of a large number of hard disk drives (HDDs) were connected in series and supported by a multiport ac-coupled differential power processing (MAC-DPP) converter through a multiwinding transformer. Methods for controlling the multi-input multi-output power flow in the multiwinding transformer while avoiding core saturation were investigated. A ten-port MAC-DPP prototype with 700-W/in $^3$ power density was built to support a 450-W HDD storage system with ten series-stacked voltage domains. The prototype was tested on a 50-HDD server testbench, and the overall system loss is below 1 W (99.77% system efficiency). The server was able to maintain high-speed reading and writing operation of all 50 HDDs against the worst hot-swapping scenarios. A variety of hardware/software configurations and many cloud storage techniques were tested on the fully functioning server. Experimental results show that the energy efficiency of large-scale information systems (CPU/GPU clusters, memory banks, HDD arrays, etc.) can be greatly improved by software, hardware, and power codesign.

Highlights • The impact of a multimodal infection control strategy originally designed for containment of COVID-19 on the rates of other hospital-acquired-infections (HAIs) was evaluated over a 7-month period across the largest healthcare system in Singapore. • During the COVID-19 pandemic, methicillin-resistant Staphylococcus aureus acquisition rates declined significantly, together with central-line-associated-bloodstream infection rates; likely due to increased compliance with standard precautions. • Enhanced infection control measures resulted in the unintended positive consequences of containing health care-associated respiratory viral infections, with a significant and sustained decline for both enveloped and nonenveloped respiratory viruses. • The ongoing COVID-19 pandemic provided the impetus to demonstrate the potential benefit of heightened infection control measures in controlling HAIs and acquisition of multidrug-resistant-organisms., Background In the current COVID-19 pandemic, aggressive Infection Prevention and Control (IPC) measures have been adopted to prevent health care-associated transmission of COVID-19. We evaluated the impact of a multimodal IPC strategy originally designed for the containment of COVID-19 on the rates of other hospital-acquired-infections (HAIs). Methodology From February-August 2020, a multimodal IPC strategy was implemented across a large health care campus in Singapore, comprising improved segregation of patients with respiratory symptoms, universal masking and heightened adherence to Standard Precautions. The following rates of HAI were compared pre- and postpandemic: health care-associated respiratory-viral-infection (HA-RVI), methicillin-resistant Staphylococcus aureus, and CP-CRE acquisition rates, health care-facility-associated C difficile infections and device-associated HAIs. Results Enhanced IPC measures introduced to contain COVID-19 had the unintended positive consequence of containing HA-RVI. The cumulative incidence of HA-RVI decreased from 9.69 cases per 10,000 patient-days to 0.83 cases per 10,000 patient-days (incidence-rate-ratio = 0.08; 95% confidence interval [CI] = 0.05-0.13, P< .05). Hospital-wide MRSA acquisition rates declined significantly during the pandemic (incidence-rate-ratio = 0.54, 95% CI = 0.46-0.64, P< .05), together with central-line-associated-bloodstream infection rates (incidence-rate-ratio = 0.24, 95% CI = 0.07-0.57, P< .05); likely due to increased compliance with Standard Precautions. Despite the disruption caused by the pandemic, there was no increase in CP-CRE acquisition, and rates of other HAIs remained stable. Conclusions Multimodal IPC strategies can be implemented at scale to successfully mitigate health care-associated transmission of RVIs. Good adherence to personal-protective-equipment and hand hygiene kept other HAI rates stable even during an ongoing pandemic where respiratory infections were prioritized for interventions.

Objective: To explore differentially expressed miRNA in type 2 diabetes mellitus and the potential cell function of miRNA. Methods: We examined the plasma miRNA among 113 newly diagnosed untreated diabetic cases and 113 healthy controls by miRNA array screening and Taqman real-time PCR validation. The low-abundance proteins coded by miR-193b-3p target genes were explored in plasma among the same study population. We further investigated the potential cell function of differentially expressed miRNA in HepG2 cells. Results: The miR-193b-3p was differentially expressed (fold change = 2.01, P = 0.006) in diabetic cases compared with healthy controls. The levels of triosephosphate isomerase (TPI1) decreased in plasma of type 2 diabetes (fold change = 1.37, P =0.002). The effect of miR-193b-3p on TPI1 was validated after transfection with miR-193b-3p in HepG2 cells. Additionally, miR-193b-3p suppressed expression of YWHAZ/14-3-3ζ in PI3K-AKT pathway, subsequently altered the FOXO1 and PCK1 expression. When the cells were incubated in glucose free media for another 4h after transfection, the glucose level in media was significantly higher in cells with elevated miR-193b-3p level than negative control cells (P = 0.016). Additionally, elevated miR-193b-3p also decreased glucose uptake by suppressed insulin receptor (IR) and GLUT2 expression. Conclusion: miR-193b-3p was differentially expressed in plasma of patients with type 2 diabetes, and the level of TPI1 was decreased in both plasma and HepG2 cells with elevated miR-193b-3p level. Moreover, miR-193b-3p may impair the glucose metabolism by directly targeting to YWHAZ/14-3-3ζ and up-regulating the transcription factor FOXO1 in the downstream of PI3K-AKT pathway. Funding: This work was supported by the grants from the Program for HUST Academic Frontier Youth Team, the National Natural Science Foundation (grants NSFC-81473051 and 81522040), and the National Key R&D Program of China (2016YFC0900800). Declaration of Interest: None. Ethical Approval: The study protocol was approved by the Ethics and Human Subject Committee of School of Public Health, Tongji Medical College, Huazhong University of Science and Technology and Dongfeng General Hospital, DMC.