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Background: Panax notoginseng Saponins (PNS) is used as a traditional Chinese medicine for ischemic stroke and cardiovascular disease; it has been proven to possess anticancer activity recently. Objective: In this study, we aimed to explore the curative anticancer effect and potential mechanisms of PNS in pancreatic cancer cells. Methods: Pancreatic cancer Miapaca2 and PANC-1 cells were treated with PNS and Gemcitabine (Gem), respectively. Then the cell viability was assessed by CCK-8 assay, cell proliferation was tested by colony formation assay and EdU cell proliferation assay, cell migration and invasiveness were tested by wound healing assay and transwell assay respectively, and cell apoptosis was detected by flow cytometry. Finally, we detected the expression levels of proteins related to migration, apoptosis and autophagy through Western blotting. Results: PNS not only inhibited the proliferation, migration, invasion and autophagy of Miapaca2 and PANC-1 cells, but also induced apoptosis and promoted chemosensitivity of pancreatic cancer cells to Gem. Conclusion: PNS may exhibit cytotoxicity and increase chemosensitivity of pancreatic cancer cells to Gem by inhibiting autophagy and inducing apoptosis, providing a new strategy and potential treatment option for pancreatic cancer.

More and more countries have become greying societies along with the burgeoning of digital devices. The older generation suffers from a sharp digital divide. Although the information infrastructure...

Image classification is one of the main drivers of the rapid developments in deep learning with convolutional neural networks for computer vision. So is the analogous task of scene classification in remote sensing. However, in contrast to the computer vision community that has long been using well-established, large-scale standard datasets to train and benchmark high-capacity models, the remote sensing community still largely relies on relatively small and often application-dependend datasets, thus lacking comparability. With this paper, we present a classification-oriented conversion of the SEN12MS dataset. Using that, we provide results for several baseline models based on two standard CNN architectures and different input data configurations. Our results support the benchmarking of remote sensing image classification and provide insights to the benefit of multi-spectral data and multi-sensor data fusion over conventional RGB imagery.

Purpose To report the anatomic and functional outcomes of autologous retinal transplantation (ART). Design Multicenter, retrospective, interventional, consecutive case series. Participants One hundred thirty eyes of 130 patients undergoing ART for the repair of primary and refractory macular holes (MHs), as well as combined MH-rhegmatogenous retinal detachment (MH-RRD), between January 2017 and December 2019. Methods All patients underwent pars plana vitrectomy and ART, with surgeon modification of intraoperative variables. A large array of preoperative, intraoperative, and postoperative data was collected. Two masked reviewers graded OCT images. Multivariate statistical analysis and subgroup analysis were performed. Main Outcome Measures Macular hole closure rate, visual acuity (VA), external limiting membrane and ellipsoid zone (EZ) band integrity, and alignment of neurosensory layers (ANL) on OCT. Results One hundred thirty ART surgeries were performed by 33 vitreoretinal surgeons worldwide. Patient demographics were: mean age of 63 ± 6.3 years, 58% female, 41% White, 23% Black, 19% Asian, and 17% Latino. Preoperative VA was 1.37 ± 0.12 logarithm of the minimum angle of resolution (logMAR; Snellen equivalent, approximately 20/500), which improved significantly to 1.05 ± 0.09 logMAR (Snellen equivalent, approximately 20/225; P Conclusions In this global experience, patients undergoing ART for large primary and refractory MHs and MH-RRDs achieved good anatomic and functional outcomes, with low complication rates despite complex surgical pathologic features.

Background Chronic kidney disease has been identified as a risk factor affecting stroke prognosis. High-grade carotid artery stenosis (CAS) is associated with distal hemodynamic compromise. The association between the estimated glomerular filtration rate (eGFR) and ischemic stroke (IS) outcome in patients with high-grade CAS remains unclear. We aimed to investigate the association between eGFR and outcomes of acute IS patients with high-grade CAS. Methods From January 1, 2007 to April 30, 2012, we enrolled 372 acute IS patients with high-grade CAS and prospectively observed them for 5 years. The eGFR on admission was assessed using the Modification of Diet in Renal Disease Study equation. Demographic features, vascular risk factors, comorbidities, and outcomes were compared between different eGFR levels. Results Among 372 individuals, 76 (20.4%) had an eGFR 2. Compared to other groups, in the eGFR 2 group, the prevalence rates of hypertension, diabetes mellitus, coronary artery disease, congestive heart failure, valvular heart disease, and gout were significantly higher (P = 0.013, P = 0.030, P = 0.001, P P = 0.043, and P 2 demonstrated lower hemoglobin and total cholesterol levels compared with other groups (P P = 0.048). The blood potassium and uric acid levels were significantly higher in patients with eGFR 2 (P P 2 was a significant risk factor for 5-year all-cause mortality in IS patients with high-grade CAS after adjusting for these variables (hazard ratio = 2.05; 95% CI = 1.31–3.21; P = 0.002). Conclusions eGFR 2 was associated with an increased risk of 5-year all-cause mortality in acute IS patients with high-grade CAS. Whether aggressive treatment of chronic kidney disease in IS patients with high-grade CAS can improve stroke outcomes should be confirmed in future studies.

Background and Purpose Oral anticoagulants (OACs) prevent stroke recurrence and vascular embolism in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF). Based on empirical consensus, current guidance recommends a “1–3–6–12 days” rule to resume OACs after AIS. This study investigated the suitability of guideline-recommended timing for OAC initiation. Methods Using data of 12,307 AF patients hospitalized for AIS, for the period 2012 to 2016, in Taiwan's National Health Insurance Research Database, we constructed a sequence of cohorts of OAC users and propensity score-matched nonusers, creating one cohort on each day of OAC initiation for 30 days since admission. Composite outcome included effectiveness (cardiovascular death, ischemic stroke, myocardial infarction, transient ischemic attack, systemic embolism, and venous thromboembolism) and safety (intracranial hemorrhage, gastrointestinal bleeding, and hematuria) outcomes. Comparing with nonusers, we examined the risks in the early OAC use (within 1–3–6–12 days) or guideline-recommended delayed use. Indirect comparison between the early and delayed use was conducted using mixed treatment comparison. Results Across the AIS severity, the risks of composite or effectiveness outcome were lower in OAC users than nonusers, and the risks were similar between the early and delayed use groups. In patients with severe AIS, early OAC use was associated with an increased risk of safety outcome, with a hazard ratio (HR) of 1.67 (confidence interval [CI]: 1·30–2·13) compared with nonusers and a HR of 1.44 (CI: 0·99–2·09) compared with the delayed use. Conclusion Our study findings support an early OAC initiation in AF patients with mild-to-moderate AIS and a routine delayed use of OACs can be considered in those with severe AIS to avoid a serious bleeding event.

Background: The coincidence of coronary artery disease (CAD) and carotid artery stenosis (CAS) was observed. However, the association between pre-existing CAD and ischemic stroke (IS) outcome in patients with high-grade CAS remains unclear. We aimed to investigate the association between pre-existing CAD and outcomes of acute IS patients with high-grade CAS. Methods: From January 1, 2007, to April 30, 2012, we enrolled 372 acute IS patients with high-grade CAS and prospectively observed them for 5 years. Demographic features, vascular risk factors, comorbidities, and outcomes were compared between patients with and without pre-existing CAD. Results: Among 372 individuals, 75 (20.2%) patients had pre-existing CAD and 297 (79.8%) patients did not have pre-existing CAD. The prevalence rates of hypertension, congestive heart failure, chronic kidney disease, and gout in patients with pre-existing CAD were significantly higher than in those without pre-existing CAD (p = 0.017, p < 0.001, p = 0.002, and p < 0.001, respectively). The multivariate Cox proportional hazards model revealed that pre-existing CAD was a significant risk factor for a 5-year all-cause mortality in acute IS patients with high-grade CAS (hazard ratio = 2.26; 95% confidence interval = 1.35–3.79; p = 0.002). Conclusion: Pre-existing CAD was associated with an increased risk of 5-year mortality in acute IS patients with high-grade CAS. Intensive treatment for the pre-existing CAD may reduce long-term mortality in acute IS patients with high-grade CAS.

Highlights • Developed two simple-to use nomograms for identifying COVID-19 positive patients. • Probabilities are provided to allow healthcare leaders to decide suitable cut-offs. • Variables are age, white cell count, chest x-ray appearances and contact history. • Model variables are easily available in the general hospital setting., Objectives To develop:(1) two validated risk prediction models for COVID-19 positivity using readily available parameters in a general hospital setting; (2) nomograms and probabilities to allow clinical utilisation. Methods Patients with and without COVID-19 were included from 4 Hong Kong hospitals. Database was randomly split 2:1 for model development database (n = 895) and validation database (n = 435). Multivariable logistic regression was utilised for model creation and validated with the Hosmer-Lemeshow (H-L) test and calibration plot. Nomograms and probabilities set at 0.1, 0.2, 0.4, 0.6 were calculated to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results 1330 patients (mean age 58.2 ± 24.5 years; 50.7% males; 296 COVID-19 positive) were recruited. First prediction model developed had age, total white blood cell count, chest x-ray appearances and contact history as significant predictors (AUC = 0.911 [CI = 0.880-0.941]). Second model developed has same variables except contact history (AUC = 0.880 [CI = 0.844-0.916]). Both were externally validated on H-L test (p = 0.781 and 0.155 respectively) and calibration plot. Models were converted to nomograms. Lower probabilities give higher sensitivity and NPV; higher probabilities give higher specificity and PPV. Conclusion Two simple-to-use validated nomograms were developed with excellent AUCs based on readily available parameters and can be considered for clinical utilisation.

Background/Objectives The purpose of this study was to present an association between the treatment response of diabetic macular edema (DME) to intravitreal ranibizumab (IVR) injections and different morphology patterns using spectral domain optical coherence tomography (SD-OCT). Subjects/Methods This retrospective study included 216 eyes of 142 subjects who received IVR for DME and were observed for at least 2 years. Medical charts and SD-OCT images of consecutive patients were reviewed at baseline, 1, 3, 6, 12, and 24 months after first IVR treatment. The OCT patterns were characterized as diffuse retinal thickening (DRT), cystoid macular edema (CME), serous retinal detachment (SRD), and vitreomacular interface abnormalities (VMIAs). All patients were classified into four groups based on the OCT findings. Results For a total of 216 eyes, 36 eyes were classified into the DRT group, 76 in the CME group, 42 in the SRD group, and 62 in the VMIA group. There were significant central macula thickness (CMT) improvements in all groups at the 1st month and the 2nd year, except for the DRT group at the 2nd year. Patients with OCT findings of hyperreflective dots (HRDs), metabolic parameters of hyperlipidemia, and coronary artery disease (CAD) had significantly less improvements in CMT at 2-year follow-up (P=0.029, 0.007

BackgroundCytokines are effective molecules of immune reactions. They work in inflammatory sites as well as circulate in the blood. Cytokines in the cerebrospinal fluid have been suggested to be markers of autoimmune encephalitis and reflect disease progression. However, studies on blood cytokines in autoimmune encephalitis are scarce. We report a case presenting with serial changes in blood cytokine levels in a male patient with anti-contactin-associated protein 2 (Caspr2) encephalitis.Case presentationA 61-year-old man without systemic disease presented with ataxia and speech disturbance 1 week. After admission, he further developed visual hallucinations, psychosis, and consciousness deterioration. Brain magnetic resonance imaging and infection and tumor surveillances were negative. 18F-fluorodeoxyglucose positron emission tomography of brain revealed frontal and occipital hypometabolism and anterior cingulate gyrus and mesial temporal hypermetabolism. Autoimmune studies confirmed Caspr2 antibodies in his blood. After receiving a diagnosis of anti-Caspr2 encephalitis, the patient received steroids, plasmapheresis, and zonisamide. He recovered well and was totally independent 6 months after disease onset.A cytokine profiler array kit was used to investigate neuroimmune mechanisms during the disease course. Several cytokines showed significant changes in plasma levels, such as B cell activating factor for B cell proliferation; thymus and activation-regulated chemokine for T cell chemoattraction; soluble CD40 ligand for Th2 cell mediation; C5/C5a for complement activation; brain-derived neurotrophic factor for neuronal survival response; and dipeptidyl peptidase 4, retinol binding protein, dickkopf-related protein, and epidermal growth factor for response to environmental provocation. The concentration of cytokines was verified using Luminex multiplexing assay.ConclusionsDue to their easy accessibility, blood cytokines are potential biomarkers of autoimmune encephalitis. Based on the investigating platform of this single case study, future larger scale studies are warranted.

With the rapid proliferation of online media sources and published news, headlines have become increasingly important for attracting readers to news articles, since users may be overwhelmed with the massive information. In this paper, we generate inspired headlines that preserve the nature of news articles and catch the eye of the reader simultaneously. The task of inspired headline generation can be viewed as a specific form of Headline Generation (HG) task, with the emphasis on creating an attractive headline from a given news article. To generate inspired headlines, we propose a novel framework called POpularity-Reinforced Learning for inspired Headline Generation (PORL-HG). PORL-HG exploits the extractive-abstractive architecture with 1) Popular Topic Attention (PTA) for guiding the extractor to select the attractive sentence from the article and 2) a popularity predictor for guiding the abstractor to rewrite the attractive sentence. Moreover, since the sentence selection of the extractor is not differentiable, techniques of reinforcement learning (RL) are utilized to bridge the gap with rewards obtained from a popularity score predictor. Through quantitative and qualitative experiments, we show that the proposed PORL-HG significantly outperforms the state-of-the-art headline generation models in terms of attractiveness evaluated by both human (71.03%) and the predictor (at least 27.60%), while the faithfulness of PORL-HG is also comparable to the state-of-the-art generation model., AAAI 2020

In the era of big data, the movement of the same object or person can be recorded by different devices with different measurement accuracies and sampling rates. Matching and conflating these heterogeneous trajectories help to enhance trajectory semantics, describe user portraits, and discover specified groups from human mobility. In this paper, we proposed a high-performance approach for matching spatiotemporal trajectories across heterogeneous massive datasets. Two indicators, i.e., Time Weighted Similarity (TWS) and Space Weighted Similarity (SWS), are proposed to measure the similarity of spatiotemporal trajectories. The core idea is that trajectories are more similar if they stay close in a longer time and distance. A distributed computing framework based on Spark is built for efficient trajectory matching among massive datasets. In the framework, the trajectory segments are partitioned into 3-dimensional space–time cells for parallel processing, and a novel method of segment reference point is designed to avoid duplicated computation. We conducted extensive matching experiments on real-world and synthetic trajectory datasets. The experimental results illustrate that the proposed approach outperforms other similarity metrics in accuracy, and the Spark-based framework greatly improves the efficiency in spatiotemporal trajectory matching.

Consumers’ attitude toward GM science is not only an important factor to determine the industry’s development, it is also a crucial topic across various countries. How people express their judgment of GM science, involves a highly complicated process. Because of this complexity, influence on attitude toward GM science has become a popular research topic and has been examined through various variables. This study sought to examine the effects of critical thinking styles and perceived transparency of GM science on attitude toward GM science. To fulfill the purpose of the research, an online survey was conducted. A total of 1,047 adults across the United States were recruited using non-probability sampling techniques. The results of the study found critical thinking style had a significant impact on the perceived transparency of GM science information and attitude toward GM science. However, consumers with higher perceived transparency of GM science information reported lower attitudes toward GM science than those who had lower perceived transparency. An interaction effect of critical thinking styles and perceived transparency of GM science on attitude toward GM science was found. Further research examining perceived transparency was recommended. In addition, it was recommended that extension agents or agricultural communicators could develop various communication strategies based on various attribution of consumers. Keywords: genetic modification science, critical thinking styles, perceived transparency, attitude

Background To evaluate the feasibility of a surgical technique using a sub-perfluoro-n-octane (PFO) injection of ocular viscoelastic device (OVD) to stabilize inverted internal limiting membrane (ILM) flap for the treatment of macular hole retinal detachment (MHRD). Methods This study was a retrospective, consecutive, interventional case series. Patients who underwent MHRD surgery with sub-PFO injection of OVD to stabilize inverted ILM flap onto the macular hole (MH) were reviewed. The color fundus and optical coherence tomography (OCT) images were collected and evaluated. The best-corrected visual acuity (BCVA) before and after surgery were compared as the functional outcome. Results The study included 8 eyes of 8 consecutive patients (mean age: 61.8 ± 7.1 years; mean follow-up period: 9.0 ± 2.5 months). All eyes (100%) achieved successful MH closure; 7 eyes (87.5%) demonstrated complete retinal reattachment, and 1 eye (12.5%) had minimal residual subretinal fluid parafoveally. Of the 8 patients, 7 patients (87.5%) had achieved improvement in BCVA after the primary surgery, whereas 1 eye remained stable. The average BCVA before and after the surgery at the last visit improved from 20/843 (1.63 ± 0.48 logMAR) to 20/200 (1.00 ± 0.39 logMAR) (P = 0.016). Anatomically, near-normal foveal contour was noted in five (62.5%) eyes at the final follow-up. Conclusions The use of sub-PFO injection of OVD in MHRD surgery could stabilize inverted ILM flaps, achieve good anatomical results and improve postoperative BCVA.

Background: Data mining builds a bridge between ancient books of traditional Chinese medicine and modern medicine. It provides a new perspective for the precise compatibility of prescriptions and the scheme of diagnosis and treatment. Meanwhile, the mechanism of schisandrae chinensis and its compound in treating diabetes and diabetic complications is not clear. This limits the clinical application of Schisandra chinensis. Methods: Apply TCMISS to mine the core drugs with the highest frequency of combined use with Schisandra chinensis to form a new prescription. And analyze the compatibility law. Use databases such as TCMSP, TCMID, PubChem, Swiss arget prediction, disgenet and Cytoscape software. The interaction between drugs and diseases and related pathways were analyzed. In addition, autodock Vina and other software are used to calculate the molecular docking and binding energy between compounds and key targets. Finally, the therapeutic effect of the new prescription of Fructus schisandrae chinensis S·(Core) on diabetic mice was evaluated by biological experiments.Results: The study employed a data mining S·(Core) was obtained. Using network pharmacology method, mainly containing target prediction, network construction, functional enrichment analysis, and molecular docking to systematically research the mechanisms of S·(Core) in treating diabetes. The putative targets of S·(Core) that treat diabetes mainly involved AKT1, GAPDH, IL-6, MAPK3, VEGFA and other targets. The functional enrichment analysis suggested that the produced therapeutic effect of S·(Core) against diabetes is mediated by synergistical regulation of several biological pathways, AGE-RAGE signaling pathway in diabetic complications , Insulin resistance, HIF-1 and Insulin signaling pathway. The results of molecular docking showed that the core chemical components of S·core had good affinity with the key targets of diabetes. In addition,We confirmed that S·Core can improve glucose and lipid metabolism in diabetic mice. Enhanced islet β Quantity and quality of cells. Reduce the inflammatory response in the body. Liver protection.Conclusion: This study explored the mechanism of action of S·(Core) in diabetes by multi-component and multi-target multi pathways, which could provide a theoretical basis for the development and clinical application of S·(Core).

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure 30 minutes, new or increase need of vasopressors or fluid bolus >15 mL/kg), severe hypoxemia (peripheral oxygen saturation

This case series reported a group of patients with Guillain–Barré syndrome (GBS) and their plasma cytokine changes before and after immunotherapy. We aimed to understand GBS's pathogenesis and pathophysiology through observing the interval differences of the representative cytokines, which were the thymus and activation regulated chemokine (TARC) for T-cell chemotaxis, CD40 ligand (CD40L) for cosimulation of B and T cells, activated complement component C5/C5a, and brain-derived neurotrophic factor (BDNF) for survival and regenerative responses to nerve injuries. The fluorescence magnetic bead-based multiplexing immunoassay simultaneously quantified the five cytokines in a single sample. From June 2018 to December 2019, we enrolled five GBS patients who had completed before–after blood cytokine measurements. One patient was diagnosed with paraneoplastic GBS and excluded from the following cytokine analysis. The BDNF level decreased consistently in all the patients and made it a potential biomarker for the acute stage of GBS. Interval changes of the other four cytokines were relatively inconsistent and possibly related to interindividual differences in the immune response to GBS triggers, types of GBS variants, and classes of antiganglioside antibodies. In summary, utilizing the multiplexing immunoassay helps in understanding the complex immune mechanisms of GBS and the variation of immune responses in GBS subtypes; this method is feasible for identifying potential biomarkers of GBS.

BACKGROUND Preclinical and clinical studies have shown that the extract of Cynanchum paniculatum (bunge) kitag and the fukeqianjin formulation have beneficial effects in pelvic inflammatory disease (PID). This study aimed to compare the effects of Cynanchum paniculatum and fukeqianjin with a new decoction, xiaoyuningkun, consisting of Melia toosendan, Angelica biserrata, and Cynanchum paniculatum, in a mouse model of PID. MATERIAL AND METHODS The mouse model of PID included injection of the upper genital tract with hydrochloric acid (HCl) and lipopolysaccharide (LPS). The control group underwent sham treatment with 0.9% physiological saline. Cynanchum paniculatum, fukeqianjin, and xiaoyuningkun decoction were administered orally for 15 days. Acetic acid-induced writhing and thermal nociception hot plate tests evaluated the analgesic effects of treatment. Mouse uterus and Fallopian tubes were examined histologically to evaluate the degree of inflammation. Immunohistochemistry was used to measure the protein expression of intercellular adhesion molecule-1 (ICAM-1) and vascular endothelial growth factor (VEGF). Enzyme-linked immunosorbent assay (ELISA) measured serum levels of inflammatory cytokines. RESULTS Treatment with xiaoyuningkun decoction significantly reduced the pain threshold in the mouse model of PID and the degree of inflammation in the uterus and Fallopian tubes compared with Cynanchum paniculatum and fukeqianjin. Cynanchum paniculatum decoction significantly reduced the serum levels of interleukin-1ß (IL-1ß), tumor necrosis factor-alpha (TNF-alpha), ICAM-1, and VEGF, and the expression of ICAM-1 and VEGF in the mouse uterus and Fallopian tubes. CONCLUSIONS The new xiaoyuningkun decoction had analgesic and anti-inflammatory effects in the mouse model of PID, possibly by inhibiting ICAM-1, VEGF, and inflammatory cytokines.

The association between gender and stroke outcome in patients with high-grade internal carotid artery (ICA) stenosis remains unclear. We investigate gender differences in clinical characteristics and outcomes in ischemic stroke patients with high-grade ICA stenosis. Three-hundred and seventy-two acute ischemic stroke patients with high-grade ICA stenosis were enrolled and followed up for 5 years. Demographic features, vascular risk factors, co-morbidities, and outcomes were compared between male and female genders. Two-hundred and seventy-three (73.4%) patients were males and 99 (26.6%) patients were females. The prevalence of diabetes mellitus and atrial fibrillation was higher in females (P = 0.031 and P = 0.043), whereas the prevalence of smoking was higher in males (P 0.001). The 5-year mortality rate was not different between males and females (P = 0.437), whereas the 5-year recurrent stroke rate was significantly higher in males (OR, 2.14; 95% CI, 1.22-3.75; P = 0.004). After adjusting for the established clinical predictors of adverse outcomes, the multivariate Cox regression revealed that male gender is a significant predictor of recurrent ischemic stroke (HR, 1.95; 95% CI, 1.19-3.20; P = 0.008). In conclusion, male gender is associated with increased risk of recurrent ischemic stroke in patients with high-grade ICA stenosis during 5-year follow-up. Further prospective trial to assess whether male gender may benefit from more aggressive vascular risk factors control and treatment strategies for stroke prevention is warranted.

Street-level imagery has covered the comprehensive landscape of urban areas. Compared to satellite imagery, this new source of image data has the advantage in fine-grained observations of not only physical environment but also social sensing. Prior studies using street-level imagery focus primarily on urban physical environment auditing. In this study, we demonstrate the potential usage of street-level imagery in uncovering spatio-temporal urban mobility patterns. Our method assumes that the streetscape depicted in street-level imagery reflects urban functions and that urban streets of similar functions exhibit similar temporal mobility patterns. We present how a deep convolutional neural network (DCNN) can be trained to identify high-level scene features from street view images that can explain up to 66.5% of the hourly variation of taxi trips along with the urban road network. The study shows that street-level imagery, as the counterpart of remote sensing imagery, provides an opportunity to infer fine-scale human activity information of an urban region and bridge gaps between the physical space and human space. This approach can therefore facilitate urban environment observation and smart urban planning.

The drug-injury relief system in Taiwan was implemented 20 years ago with the goal of providing timely relief for drug injuries incurred by the proper use of legal drugs. This system utilizes a nonlitigation expert review process to evaluate drug-injury relief applications, and 2,732 applications have been reviewed from 1999-2016. Of these, 1,572 applications received relief payments, an approval rate of 58%. Average review timeframes per application have decreased from 248 days (2003-2011) to 182 days (2012-2016). Most adverse drug reactions (ADRs) for approved cases involved skin and subcutaneous tissue disorders (67%), with allopurinol being the primary culprit drug. A recent decline observed for such ADRs may reflect the influences of promotional activities and policy initiatives carried out according to informed analysis from drug-injury relief applications, which suggests that the drug-injury relief system can also play an important public health role in enhancing drug safety.

The feeding preference of pear psylla (Cacopsylla chinensis) varies among pear cultivars. To clarify whether leaf structural factors are related to C. chinensis resistance, eleven pear cultivars of three pear species and their hybrids in China were studied. The population size of C. chinensis in plots of different cultivars was investigated, and leaf paraffin sections of each pear cultivar were observed. Correlation analysis results showed that the thickness of palisade tissue (PT) and the thickness ratio (TR) of PT to leaf (L) were the main factors influencing resistance to C. chinensis. The leaves of cultivar Wujiuxiang and those species from France and the USA exhibited the thickest PT and the highest TR; these three cultivars demonstrated much higher resistance to C. chinensis than did the other cultivars. The cultivar Gold Nijisseiki, with a large C. chinensis population size, showed low PT and TR. The findings of this study may provide valuable information to pear growers, experts and scientists regarding plant protection, cultivation and breeding when selecting suitable varieties to culture from the perspective of pest control.

To evaluate a surgical technique using a perfluoro-n-octane (PFO)-assisted autologous internal limiting membrane (ILM) plug for refractory macular holes (MHs). This study was a retrospective, consecutive, interventional case series. Patients with refractory MHs following PFO-assisted autologous ILM plugs were reviewed between October 1, 2017, and February 28, 2018. The anatomical results of MH preoperatively and postoperatively were evaluated by fundus examination and optical coherence tomography (OCT). The best-corrected visual acuities (BCVAs) before and after surgery were compared as the functional outcome. Six eyes of six consecutive patients with refractory MH were enrolled in this study. Successful MH closure and BCVA improvement after the surgeries were obtained in all eyes. There were four male and two female patients, and the mean age was 63.7 ± 11.1 years. Intraoperatively, the average number of autologous ILM grafts we harvested was 2.2 ± 0.4. The mean follow-up was 6.0 ± 1.7 months. The averaged BCVA before and after the surgery at the last visit improved from 20/356 to 20/153. The ILM graft tissue was still visible, as shown by OCT, in all 6 of 6 (100%) eyes during the follow-up period. This surgical technique using PFO-assisted autologous ILM plug may provide an option for the treatment of refractory MH.

Background Data on clinical outcome after drug-eluting stent (DES) vs. bare-metal stent (BMS) implantation in patients with end-stage renal disease (ESRD) under hemodialysis are limited and controversial.Methods and Results:We identified 4,970 patients under chronic hemodialysis from Taiwan National Health Insurance Research Database (NHIRD) who had their first coronary stenting between 1 January 2007 and 31 December 2012. After 1:1 propensity score matching, we evaluated clinical outcomes for 1,151 patients in the DES group and 1,151 patients in the matched BMS group. We used ICD-9 CM codes or operation code to identify all outcomes in the study cohort after the index procedure. Primary outcomes including composite endpoints of mortality, non-fatal myocardial infarction (MI), non-fatal stroke, and revascularization after the index procedure were similar in both groups (HR, 0.94; 95% CI: 0.81-1.09; P=0.399). The results were consistent in various generations of DES vs. BMS groups. Secondary outcomes including mortality, non-fatal MI, non-fatal stroke, revascularization, cardiovascular death, hospitalization for heart failure, peptic ulcer bleeding or blood transfusion were similar in both groups, except for a lower risk of peptic ulcer disease in the DES group (HR, 0.59; 95% CI: 0.41-0.83; P=0.003) than the BMS group. Conclusions In patients on chronic hemodialysis, implantation of DES did not have a better clinical outcome than BMS.

While previous studies have suggested that B3GNT3 is associated with tumorigenesis and progression of several tumors, its expression level and clinical significance in pancreatic adenocarcinoma (PAAD) remains unclear. Our study aimed to investigate the role of B3GNT3 in PAAD. B3GNT3 RNA sequencing and clinicopathological data were collected from the TCGA, GEO and GTEx databases. We assessed the expression and prognostic value of B3GNT3 in PAAD using R program and attached packages. Additionally, we investigate the correlation between B3GNT3 expression and tumor-infiltrating immune cells using CIBERSORT and the “correlation” module of GEPIA. Finally, gene set enrichment analysis (GSEA) was used to elucidate B3GNT3 related signaling pathways in PAAD. Results showed that B3GNT3 expression was significantly higher in tumor tissues compared to normal tissues (P

In recent years, there has been a phenomenal proliferation of multifunctional fitness apps (MFAs), many of which are deeply ingrained into modern daily life as an aid to trace, manage, and improve users’ health and fitness. With technological advancement, these emerging information technology (IT) artifacts have the potential to facilitate the sustainable development of society and the environment. However, MFAs are facing a critical predicament: how to ensure user stickiness and continuous use. Drawing on the social support theory, this study aims to investigate stickiness as a multi-dimensional construct and to explore the antecedents of continuance usage and continuance purchase intentions in MFAs. The research model is empirically tested with data collected from 328 users of mobile fitness apps. A structural equation modeling analysis reveals both instrumental stickiness and social stickiness exert statistically significant influences on continuance usage intentions and in-app purchase intentions. Appraisal support, information support, and network support are significant antecedents for instrumental stickiness. While emotion support, esteem support, network support, and tangible support are significant antecedents for social stickiness. In addition, two facets of user sustainability—instrumental stickiness and social stickiness—exert different levels of influence on continuance usage and continuance app purchase intensions, respectively. The findings of this study will provide valuable insights for practitioners and policymakers involved in designing sustainable health products and engendering e-health systems.

Aiming at the problems of high labor intensity and low efficiency in detecting dark spot eggs, a method of detecting dark spot eggs based on GoogLeNet model is proposed. This method uses Inception convolution module in GoogLeNet model to automatically extract dark spot eggs features and realize the detection. A device for collecting transparent images of eggs was set up in the experiment, and the sample collection experiments were designed to acquire samples. A total of 1200 dark spot eggs images and 8850 normal eggs images were obtained. Selecting 1200 samples of these two kinds for network modeling. The experimental results show that the detection accuracy of dark spotted eggs based on CNN GoogLeNet model is 98.19%. In order to further verify the GoogLeNet model, this paper repeats the above experiments using the VGG16 and VGG19 models of CNN model, and compares the accuracy. To further validate the GoogLeNet model, this paper repeats the above experiments using VGG16 and VGG19 models, and compares the accuracy. The results show that the three CNN models together have high detection accuracy, and the GoogLeNet model is highest, which provides a new method for egg quality detection.

Background To analyze multiple imaging modalities in patients with Bietti crystalline dystrophy (BCD) and to investigate which factors from these modalities are associated with best corrected visual acuity (BCVA). Methods In this retrospective study, 40 eyes from 22 patients with BCD were included and were separated into group 1 (BCVA ≤20/200) and group 2 (BCVA > 20/200). Data including BCVA and characteristic findings from near-infrared reflectance (NIR) imaging, fundus autofluorescence (FAF), and spectral domain-optic coherence tomography (SD-OCT) were analyzed and compared. The outcome measures of multimodal imaging were evaluated for correlation with BCVA. Results NIR is a good diagnostic tool for detecting either crystalline or sclerotic vessels in BCD. Patients in group 1 tended to have a thinner choroid (P = 0.047) with ellipsoid zone (EZ) disruption (P = 0.011). Calculation of the area under the curve indicated that EZ disruption detected on SD-OCT could be a good predictor of legal blindness in BCD. Conclusion For the diagnosis of BCD, NIR could be a good diagnostic tool. Of the studied imaging modalities, we found that EZ disruption at the fovea were strongly associated with legal blindness, which could be easily assessed by SD-OCT.

The quality grading of mangoes is a crucial task for mango growers as it vastly affects their profit. However, until today, this process still relies on laborious efforts of humans, who are prone to fatigue and errors. To remedy this, the paper approaches the grading task with various convolutional neural networks (CNN), a tried-and-tested deep learning technology in computer vision. The models involved include Mask R-CNN (for background removal), the numerous past winners of the ImageNet challenge, namely AlexNet, VGGs, and ResNets; and, a family of self-defined convolutional autoencoder-classifiers (ConvAE-Clfs) inspired by the claimed benefit of multi-task learning in classification tasks. Transfer learning is also adopted in this work via utilizing the ImageNet pretrained weights. Besides elaborating on the preprocessing techniques, training details, and the resulting performance, we go one step further to provide explainable insights into the model's working with the help of saliency maps and principal component analysis (PCA). These insights provide a succinct, meaningful glimpse into the intricate deep learning black box, fostering trust, and can also be presented to humans in real-world use cases for reviewing the grading results., Comment: Accepted to ICMLA 2020; 8 pages, 8 figures, 3 tables

Perimenopausal syndrome (PMS) has a high incidence rate and affects the physical and mental health of middle-aged and elderly women. The blockage of PMS is significant in improving the health of perimenopausal women. Currently, for PMS prevention and treatment, traditional Chinese medicine (TCM) has become an ideal choice because of its safety and effectiveness. This study aimed to explore the anti-PMS effects of Ziyin Bushen Decoction (DKTP) and the underlying mechanism. Thirty female Wistar rats were divided into 5 groups (n = 6): control group, low-dose DKTP group, medium-dose DKTP group, high-dose DKTP group, and nilestriol group. The estradiol (E2) level in rat peripheral blood was analyzed using an E2 Radioimmunoassay Kit, and uterine morphologic changes were examined by hematoxylin-eosin staining. Learning and memory ability of rats was assessed by Morris water maze (MWM) and novel object recognition (NOR) task. E2 synthesis, metabolism, and transport associated estrogen receptor-alpha (ERα), GnRHR, CYP17, CYP11A1, CYP19, 17βHSD, STS, and SHGB were assessed to explore the E2-promoting mechanism of DKTP during PMS treatment. The loss of learning and memory, the decreased estrous and uterine coefficient, and the presence of histopathological changes suggests a successful establishment of rat PMS model. Following DKTP or nilestriol treatment, the above results were reversed. E2 level in serum, uterine, and ovarian tissues was upregulated upon different concentrations of DKTP treatment, indicating that DKTP promotes the E2 level in a dose-dependent manner. DKTP also increased the expression of ERα, CYP17, CYP11A1, CYP19, 17βHSD, STS, and SHGB while decreased the GnRHR expression in uterine and ovarian tissues, revealing that these key molecules involved in estrogen synthesis, metabolism, and transport in PMS rats. We confirmed the anti-PMS effect of DKTP through enhancing E2 production. Exploring a novel drug based on improving E2 synthesis, metabolism, and transport may represent a novel strategy for PMS prevention and treatment.

Vascular endothelial growth factor (VEGF) is the principal growth factor responsible for the retinal neovascularization in the pathogenesis of retinopathy of prematurity (ROP). Current therapies for ROP include laser ablation and intravitreal anti-VEGF injection. However, these treatments either destroy the peripheral retina or associate with problems of persistent peripheral avascular retina or later recurrence of ROP. In the present study we investigated a new therapeutic approach by exploring the potential role of a specific microRNA, miR-126, in regulating VEGFA expression and retinal neovascularization in a rat oxygen-induced retinopathy (OIR) model. We demonstrated that miR-126 mimic and plasmid effectively suppresses VEGFA mRNA expression in both human and rat retinal pigment epithelium cell lines, quantified with qRT-PCR. Animal experiments on rat OIR model revealed that intravitreal injection of miR-126 plasmid efficiently downregulated VEGFA expression in the intraocular fluid and retinal tissues measured by ELISA, and significantly suppressed retinal neovascularization, which was confirmed by calculating sizes of neovascularization areas on fluorescence microscopic images of flat mounted retina stained with Alexa Fluor 594-conjugated isolectin B4 to visualize blood vessels. Together, these results showed that intravitreal injection of miR-126 plasmid could inhibit retinal neovascularization by down-regulating VEGFA expression, suggesting a potential therapeutic effect for ROP.

Insufficient high-intensity focused ultrasound (HIFU) can promote the rapid progression of the residual tumor through the hypoxia inducible factor-2α +(HIF-2α)/vascular endothelial growth factor A (VEGFA)/ephrin type-A receptor 2 (EphA2) pathway. Although sorafenib has been shown to significantly improve the survival of patients with advanced liver cancer, the use of sorafenib in residual tumor tissues following HIFU has rarely been elucidated. Thus, this study aimed to investigate the potential adjuvant therapeutic effects of sorafenib following HIFU in order to reduce the relapse rate following insufficient HIFU.Xenograft tumors were established using nude mice injected with liver cancer cells. At approximately 4 weeks after the inoculation of the tumor cells (tumors reached 1.3-1.5 cm), all mice were randomly divided into 3 groups as follows: i) The control group (no treatment); ii) the HIFU-alone group, and iii) the combination group (HIFU + sorafenib), with 6 mice per group. The residual tumor volume was determined among the different treatment groups. The protein expression levels of HIF-2α, VEGFA and EphA2 were determined by immunohistochemistry and western blotting, and the mRNA levels were detected by RT-qPCR. The microvessel density (MVD) was calculated by CD31 immunohistochemistry staining.The results revealed that by comparing the control group, insufficient HIFU promoted HIF-2α, VEGFA and EphA2 expression (P0.05). Compared with the HIFU-alone group, the protein and mRNA levels of HIF-2α, VEGFA and EphA2 were markedly decreased in the group that received combined treatment with HIFU and sorafenib (P0.05). Similar results were obtained for MVD expression. Synergistic tumor growth inhibitory effects were also observed between the control group and HIFU group (P0.05).The findings of this study demonstrate that the expression of HIF-2α, VEGFA and EphA2 can be inhibited by sorafenib, and that sorafenib is likely to provide an effective adjunct treatment for patients with HCC following HIFU ablation.

The effects of ketoanalogues (KA) supplementation on mortality and progression to dialysis in patients with pre-dialysis stage 5 chronic kidney disease (CKD) receiving a low-protein diet (LPD) remain ambiguous. From Taiwan&rsquo, s National Health Insurance Research Database during 1996&ndash, 2011, 165 patients with pre-dialysis CKD on an LPD (0.6 g/kg/day) with KA supplementation were matched with 165 patients with pre-dialysis CKD on an LPD without KA supplementation. Of the 165 patients with advanced CKD receiving KA supplementation, 34 (20.6%) died, and 124 (75.2%) underwent long-term dialysis during the study period. There was no significant difference in mortality between the KA-user group and the KA-nonuser group (adjusted hazard ratio [HR], 1.41, 95% confidence interval [CI], 0.68&ndash, 2.93, p = 0.355). KA supplementation significantly increased long-term dialysis risk (adjusted HR, 1.41, 95% CI, 1.04&ndash, 1.90, p = 0.025) and combined outcome risk (defined as long-term dialysis and death, adjusted HR, 1.37, 95% CI, 1.02&ndash, 1.83, p = 0.034). KA supplementation also increased long-term dialysis risk (adjusted HR, 1.49, 95% CI, 1.00&ndash, 2.20, p = 0.048) in the subgroup of pre-dialysis patients with diabetes mellitus (DM), but not in those patients without DM. In conclusion, KA supplementation might increase long-term dialysis risk in patients with advanced CKD receiving an LPD, but it did not increase mortality.

Despite numerous studies on the effect of a cold weather disaster on fisheries in 2008, no operational systems have been developed to monitor the threat of such an event to mariculturists in the Penghu Islands (PHI) region of Taiwan. The present study employed a suitable aquaculture site selection map of the inner bay of the PHI to reduce aquaculture losses and mortality rates of cobia (Rachycentron canadum) during extreme events. Daily marine environmental data, including sea surface temperature (SST), chlorophyll-a concentration (chl-a), and wind speed in the winter, were collected. An extreme event was defined as a period of over 11 days in a month of strong winds (>6 m/s). Four parameters in the PHI inner bay, including SST, cold-water intrusion days, chl-a, and offshore distance to the PHI coastline, were used to evaluate suitable aquaculture sites for cobia culture. The results indicated that La Niña events could not be used as a factor to detect cold-water intrusion events and select suitable aquaculture sites in the PHI. The evaluated suitable aquaculture site selection map, obtained using an arithmetic mean model and a geometric mean model, revealed that the avoidance sites during extreme events were concentrated in the northern and northwestern PHI. Suitable areas were concentrated in the southeastern areas. We further suggested that commercial cobia aquaculture operations in the PHI inner bay could be moved to the suitable sites in southeastern PHI during extreme events.

Chinese herbal formulas including the lung-cleaning and toxicity-excluding (LCTE) soup have played an important role in treating the ongoing COVID-19 pandemic (caused by SARS-CoV-2) in China. Applying LCTE outside of China may prove challenging due to the unfamiliar rationale behind its application in terms of Traditional Chinese Medicine. To overcome this barrier, a biochemical understanding of the clinical effects of LCTE is needed. Here, we explore the chemical compounds present in the reported LCTE ingredients and the proteins targeted by these compounds via a network pharmacology analysis. Our results indicate that LCTE contains compounds with the potential to directly inhibit SARS-CoV-2 and inflammation, and that the compound targets proteins highly related to COVID-19’s main symptoms. We predict the general effect of LCTE is to affect the pathways involved in viral and other microbial infections, inflammation/cytokine response, and lung diseases. Our work provides a biochemical basis for using LCTE to treat COVID-19 and its main symptoms., Deng-hai Zhang et al. report a network pharmacology analysis of the Traditional Chinese Medicine (TCM) lung-cleaning and toxicity-excluding (LCTE) soup. By exploring the chemical compounds that make up LCTE and the likely pathways and proteins that they target, the authors show that LCTE may have the potential to directly inhibit the SARS-CoV-2 virus and relieve inflammatory symptoms.

Highlights • Performance of the LightMix® E-gene kit for SARS-CoV-2 detection was evaluated • The LightMix® kit had better analytical and diagnostic sensitivity than comparator in-house assays • Cycle threshold values of the three assays showed excellent correlation • The LightMix® kit performed well as a stand-alone test for SARS-CoV-2 detection, Background Rapid and sensitive diagnostic assays for SARS-CoV-2 detection are required for prompt patient management and infection control. The analytical and clinical performances of LightMix® Modular SARS and Wuhan CoV E-gene kit, a widely used commercial assay for SARS-CoV-2 detection, have not been well studied. Objective To evaluate the performance characteristics of the LightMix® E-gene kit in comparison with well-validated in-house developed tests. Study design Serial dilutions of SARS-CoV-2 culture isolate extracts were used for analytical sensitivity evaluation. A total of 289 clinical specimens from 186 patients with suspected COVID-19 and 8 proficiency testing (PT) samples were used to evaluate the diagnostic performance of the LightMix® E-gene kit against in-house developed COVID-19-RdRp/Hel and COVID-19-N RT-PCR assays. Results The LightMix® E-gene kit had a limit-of-detection of 1.8 × 10-1 TCID50/mL, which was one log10 lower than those of the two in-house RT-PCR assays. The LightMix® E-gene kit (149/289 [51.6%]) had higher diagnostic sensitivity than the in-house assays (144/289 [49.8%] for RdRp/Hel and 146/289 [50.5%] for N). All three assays gave correct results for all the PT samples. Cycle threshold (Cp) values of the LightMix® E-gene kit and in-house assays showed excellent correlation. Reproducibility of the Cp values was satisfactory with intra- and inter-assay coefficient of variation values

Purpose To examine the risk of open-angle glaucoma (OAG) among patients receiving alpha1-adrenoceptor (α1-AR) antagonists for lower urinary tract symptoms (LUTS). Methods This was a nationwide, population-based, retrospective cohort study from Asia/Taiwan. One million beneficiaries were randomly sampled from among 27.38 million individuals enrolled in the National Health Insurance program, and subjects with a diagnosis of LUTS from 2001 to 2012 were identified (N = 105,341). After 1:1 propensity score matching by gender, age, comorbid medical diseases, number of all medical visits during the observational period, and index date, 4081 patients were enrolled in the study group, comprised of patients who had taken α1-AR antagonists, and 4081 patients were enrolled in the control group, comprised of patients who had never taken α1-AR antagonists. The incidence and risk of OAG (defined as two ambulatory visits with a ICD-9 diagnosis code 365, excluding ICD-9 diagnosis codes 365.2-365.6, 365.02, 365.03, 365.13, 365.14, and 365.8) were calculated. Results Patients taking α1-AR antagonists had a higher incidence ratio of 1.86 (95% confidence interval [CI], 1.30-2.65) for developing OAG. After adjusting for age, gender, and comorbidities, the hazard ratio (HR) for OAG for patients taking α1-AR antagonists was 1.66 (95% CI, 1.16-2.39; P = 0.006). Among patients with hypertension, the hazard ratio for OAG associated with taking α1-AR antagonists increased to 1.79 (95% CI, 1.07-2.99; P = 0.003). On the other hand, the association of α1-AR antagonists with OAG was not significant among patients with diabetes mellitus, hyperlipidemia, or older age. Conclusions The findings of our study suggest an increased risk for OAG among patients taking α1-AR antagonists for LUTS, especially in patients with hypertension.

Background Bone tumors are often treated with intralesional curettage. High-speed burring, an adjuvant therapy, was performed to maximize the tumor cell killing; however, tumor recurrence might still occur, which may be caused by residual tumor or local tumor spread during surgery. Methods A porcine cadaver (femur) was utilized to determine whether the use of a high-speed burr causes bone cement spray. To mimic residual tumor after curettage, luminescent cement was smeared on two locations of the bone cavity, the wall and the bottom. The cavity in the femoral bone was then placed in the middle of a sheet of drawing paper featuring 10 cm, 20 cm, and 30 cm concentric circles. The luminescent cement was then burred totally with a high-speed burr. Results The intensity of the area in the wall in circle I was 72.6% ± 5.8%; within circle II, it was 22.1% ± 4.2%; and within circle III, it was 5.4% ± 1.5%. The intensity of the area within the bottom of the femoral bone within circle I was 66.5% ± 6.1%, within circle II was 28.1 ± 4.8%, and within circle III, it was 5.4% ± 1.4%. The amount of luminescent cement seeding decreased with distance, but there was no difference while burring at different locations of the bone cavity. Under the handpiece cover, a greater amount of cement spray was retained in circle I during burring of the cement in the bottom of the cavity and less was sprayed out in circle III. Conclusions High-speed burring may cause explosive bone cement spray, which could extend to 20 cm. The intensities of spray did not decrease, even when the handpiece cover was used. The wide range of bone cement spray caused by high-speed burr was inspected in this pilot study, which may lead to tumor seeding. Level of evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

To control the COVID-19 pandemic and prevent its resurgence in areas preparing for a return of economic activities, a method for a rapid, simple, and inexpensive point-of-care diagnosis and mass screening is urgently needed. We developed and evaluated a one-step colorimetric reverse-transcriptional loop-mediated isothermal amplification assay (COVID-19-LAMP) for detection of SARS-CoV-2, using SARS-CoV-2 isolate and respiratory samples from patients with COVID-19 (n = 223) and other respiratory virus infections (n = 143). The assay involves simple equipment and techniques and low cost, without the need for expensive qPCR machines, and the result, indicated by color change, is easily interpreted by naked eyes. COVID-19-LAMP can detect SARS-CoV-2 RNA with detection limit of 42 copies/reaction. Of 223 respiratory samples positive for SARS-CoV-2 by qRT-PCR, 212 and 219 were positive by COVID-19-LAMP at 60 and 90 min (sensitivities of 95.07% and 98.21%) respectively, with the highest sensitivities among nasopharyngeal swabs (96.88% and 98.96%), compared to sputum/deep throat saliva samples (94.03% and 97.02%), and throat swab samples (93.33% and 98.33%). None of the 143 samples with other respiratory viruses were positive by COVID-19-LAMP, showing 100% specificity. Samples with higher viral load showed shorter detection time, some as early as 30 min. This inexpensive, highly sensitive and specific COVID-19-LAMP assay can be useful for rapid deployment as mobile diagnostic units to resource-limiting areas for point-of-care diagnosis, and for unlimited high-throughput mass screening at borders to reduce cross-regional transmission.

We have demonstrated world-record thermophotovoltaic (TPV) conversion efficiency in two materials systems operating at two different thermal emitter temperatures. A GaAs-based PV device under a 2330 °C thermal emitter produced an efficiency of (31 ± 2)%, and an In 0.53 Ga 0.47 As -based PV device under a 1300 °C thermal emitter produced an efficiency of (30 ± 2)%. The electrical output power densities of the cells were 2.45 W/cm2 and 0.658 W/cm2, respectively. Critical to these high efficiencies were the cells' high reflectance of photon energies below the absorber band gap. Unlike solar PV, for which sub-band gap (SBG) light is lost, a TPV cell can reflect SBG light back to the thermal emitter where it can be recycled. The demonstrations were made on a custom-built measurement platform in which a ~ 100 cm2 graphite thermal emitter was heated under vacuum. The TPV efficiencies were evaluated by comparing the measured electrical output power of the cell with the total power absorbed by the cell. The measured TPV efficiencies as a function of thermal emitter temperature were corroborated by our full system modeling. As far as the authors are aware, these are the highest TPV conversion efficiencies ever measured, and device improvements should yield > 40% efficiency in the near future.

Mobile/multi-access edge computing (MEC) is therefore developed to support the upcoming AI-aware mobile services, which require low latency and intensive computation resources at the edge of the network. One of the most challenging issues in MEC is service provision with mobility consideration. It has been known that the offloading and migration decision need to be jointly handled to maximize the utility of networks within the latency constraints, which is challenging when users are in mobility. In this paper, we propose Mobility-Aware Deep Reinforcement Learning (M-DRL) framework for mobile service provision problems in the MEC system. M-DRL is composed of two parts: DRL specialized in supporting multiple users joint training, and glimpse, a seq2seq model customized for mobility prediction to predict a sequence of locations just like a “glimpse” of future. Through integrating the proposed DRL and glimpse mobility prediction model, the proposed M-DRL framework is optimized to handle the service provision problem in MEC with acceptable computation complexity and near-optimal performance.

Background Olfactory dysfunction (OD) has been reported in coronavirus disease 2019 (COVID-19). However, there are knowledge gaps about the severity, prevalence, etiology, and duration of OD in COVID-19 patients. Methods Olfactory function was assessed in all participants using questionnaires and the butanol threshold test (BTT). Patients with COVID-19 and abnormal olfaction were further evaluated using the smell identification test (SIT), sinus imaging, and nasoendoscopy. Selected patients received nasal biopsies. Systematic review was performed according to PRISMA guidelines. PubMed items from January 1, 2020 to April 23, 2020 were searched. Studies that reported clinical data on olfactory disturbances in COVID-19 patients were analyzed. Results We included 18 COVID-19 patients and 18 controls. Among COVID-19 patients, 12 of 18 (67%) reported olfactory symptoms and OD was confirmed in 6 patients by BTT and SIT. Olfactory dysfunction was the only symptom in 2 patients. Mean BTT score of patients was worse than controls (P = .004, difference in means = 1.8; 95% confidence interval, 0.6–2.9). Sinusitis and olfactory cleft obstruction were absent in most patients. Immunohistochemical analysis of nasal biopsy revealed the presence of infiltrative CD68+ macrophages harboring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen in the stroma. Olfactory dysfunction persisted in 2 patients despite clinical recovery. Systematic review showed that the prevalence of olfactory disturbances in COVID-19 ranged from 5% to 98%. Most studies did not assess olfaction quantitatively. Conclusions Olfactory dysfunction is common in COVID-19 and may be the only symptom. Coronavirus disease 2019-related OD can be severe and prolonged. Mucosal infiltration by CD68+ macrophages expressing SARS-CoV-2 viral antigen may contribute to COVID-19-related OD., COVID-19-related olfactory dysfunction is common (67%, 12/18 patients). Recovery can be slow (>3 weeks). Sinusitis and olfactory cleft obstruction were absent in most patients. Immunohistochemical analysis of nasal biopsy specimens demonstrated infiltrative CD68+ macrophages expressing SARS-CoV-2 antigen in the stroma.

During the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak in Wuhan, China, we experienced a case of SARS-CoV-2 infection with atypical presentations in a patient with acute obstructive suppurative cholangitis (AOSC), who was initially admitted with jaundice and fever. The patient had no other typical symptoms of COVID-19 such as cough, dyspnea, nausea, vomiting, abdominal pain and diarrhea except for fever, but her epidemiological history was clear. COVID-19 was finally confirmed by repeated viral nucleic acid testing, but her repetitive lungs CT imaging findings had been atypical. After endoscopic-related operations and antiviral treatment, the patient was subsequently recovered and discharged. This particular case is being reported to provide a reference and guidance for the diagnosis and management of COVID-19 in AOSC.

In the era of big data, large amounts of detailed spatial interaction data are readily available due to the increasing pervasiveness of location-aware devices and techniques. Such data are often applied in the research of spatial structures, land use characteristics, and human activity regularities. However, visualizing such data on maps is a great challenge. Existing approaches either encounter overlapping and intersection problems, which may cause information loss or distortion, or are unable to present interaction characteristics. Consequently, the functional and positional features of places and human mobility trends are not fully demonstrated. We propose direction-based pattern maps, a new visualization method to display the spatial interaction pattern of every place by aggregating spatial interaction data in cardinal directions. This approach can well represent local interaction characteristics and is applicable to different spatial scales. Owing to regular hexagonal tessellations, it can avoid cluttering problems and maintain a geographical context. A case study using Beijing taxi trip data is conducted to validate the usefulness of our approach.

Purpose To investigate the visual outcomes of patients with traumatic maculopathy and massive subretinal hemorrhage (SRH) after closed-globe injury. Design Retrospective, noncomparative, and interventional case series. Participants Twenty-four patients with traumatic maculopathy and massive SRH after closed-globe injury. Methods In this retrospective observational case series, we included 25 eyes of 24 patients who had experienced closed-globe injury with massive SRH. Main Outcome Measures The demographics, clinical characteristics, and final visual acuity (VA) of the patients. Results Twenty-five eyes with massive SRHs involving the macula were studied with initial VAs from light perception to 4/200. At initial presentation, vitreous hemorrhages were present in 22 eyes, hyphema in 13 eyes, lid lacerations in 11 eyes, glaucoma in 8 eyes, iridodialysis in 7 eyes, afferent pupillary defect in 6 eyes, lens dislocation or subluxation in 5 eyes, and cyclodialysis clefts and hypotony in 2 eyes. Retinal detachment developed in 7 eyes during the follow-up period. Pars plana vitrectomy usually was performed in patients with persistent vitreous hemorrhage, retinal detachment, lens dislocation, and cyclodialysis cleft with hypotony. In final visual outcomes, 7 eyes achieved favorable visual outcomes with VA of 20/200 or more. Thirteen eyes showed VA of 2/200 or less with dense macular scars or foveal atrophy. Foveal atrophy showed encompassed foveal thinning, retinal pigment epithelial clumping, and the loss of external limiting membrane (ELM), ellipsoidal zone (EZ), and interdigital zone (IZ) on spectral-domain OCT. Fundus autofluorescence demonstrated interposed, reduced, and increased autofluorescence in traumatic pigment epitheliopathy. Conclusions Traumatic maculopathy and massive SRH after closed-globe injury often cause poor visual outcomes, especially in eyes with dense macular scars or foveal atrophy. Spectral-domain OCT findings in patients with good visual outcomes revealed partial to complete preservation of the foveal ELM, EZ, and IZ.

The aim of the study is to investigate the ability of phytochemicals to overcome the multiple drug resistance (MDR) of bladder cancer. 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) assay was used to evaluate the cytotoxic sensitivity of T24‐GCB cells, a GCB resistant cell line, to different phytochemicals, including capsaicin, quercetin, curcumin, and resveratrol, and their combination with gemcitabine. Western blot analysis was used to detect the expression of membranous ABCC2 and metabolic proteins, DCK, TK1, and TK2 in tumor cells. Animal models were used to confirm the treatment efficacy of phytochemicals in combination with gemcitabine to bladder cancer. The observed/expected ratio of cytotoxicity analysis revealed that capsaicin has synergistic effect with gemcitabine to T24‐GCB cells in a dose‐dependent pattern. Quercetin, curcumin, and resveratrol have additive effect with gemcitabine to T24‐GCB cells. Capsaicin and quercetin alone and combination with gemcitabine decreased the expression of ABCC2 and DCK and TKs, in T24‐GCB cells. On the contrary, resveratrol and curcumin alone and combination with gemcitabine increased the expression of ABCC2 but decreased cytoplasmic kinases simultaneously. In xenografted subcutaneous tumor model on nude mice, combination treatment of capsaicin and gemcitabine demonstrated the highest tumor suppression effect when compared to capsaicin or gemcitabine treatment alone. The MDR of bladder cancer is closely related to membranous ABCC2, cytoplasmic DCK, and TKs expression. Capsaicin owns the strongest synergistic cytotoxic effect of gemcitabine to T24‐GCB cells. This combination regimen may provide as an adjunctive treatment for overcoming MDR in bladder cancer.

Summary Background Effective antiviral therapy is important for tackling the coronavirus disease 2019 (COVID-19) pandemic. We assessed the efficacy and safety of combined interferon beta-1b, lopinavir–ritonavir, and ribavirin for treating patients with COVID-19. Methods This was a multicentre, prospective, open-label, randomised, phase 2 trial in adults with COVID-19 who were admitted to six hospitals in Hong Kong. Patients were randomly assigned (2:1) to a 14-day combination of lopinavir 400 mg and ritonavir 100 mg every 12 h, ribavirin 400 mg every 12 h, and three doses of 8 million international units of interferon beta-1b on alternate days (combination group) or to 14 days of lopinavir 400 mg and ritonavir 100 mg every 12 h (control group). The primary endpoint was the time to providing a nasopharyngeal swab negative for severe acute respiratory syndrome coronavirus 2 RT-PCR, and was done in the intention-to-treat population. The study is registered with ClinicalTrials.gov, NCT04276688. Findings Between Feb 10 and March 20, 2020, 127 patients were recruited; 86 were randomly assigned to the combination group and 41 were assigned to the control group. The median number of days from symptom onset to start of study treatment was 5 days (IQR 3–7). The combination group had a significantly shorter median time from start of study treatment to negative nasopharyngeal swab (7 days [IQR 5–11]) than the control group (12 days [8–15]; hazard ratio 4·37 [95% CI 1·86–10·24], p=0·0010). Adverse events included self-limited nausea and diarrhoea with no difference between the two groups. One patient in the control group discontinued lopinavir–ritonavir because of biochemical hepatitis. No patients died during the study. Interpretation Early triple antiviral therapy was safe and superior to lopinavir–ritonavir alone in alleviating symptoms and shortening the duration of viral shedding and hospital stay in patients with mild to moderate COVID-19. Future clinical study of a double antiviral therapy with interferon beta-1b as a backbone is warranted. Funding The Shaw-Foundation, Richard and Carol Yu, May Tam Mak Mei Yin, and Sanming Project of Medicine.

Focused ion beams (FIB) have been employed to applications from physical to life sciences because of their capabilities of machining features with nanoscale precision, making them a promising candidate for patterning graphene. Nevertheless, there are limited applications of patterning graphene using FIB due to ion-induced damages. In this work, we performed molecular dynamics simulations and Raman spectra mapping experiments to study defect formation in Cu-supported graphene sheets during gallium ion FIB processes. Our simulation results indicate that ion bombardment induced constrained scattering of carbon atoms and sputtered copper atoms, creating more defects in graphene than patterning on free-standing graphene. We propose two approaches to mitigate FIB-induced damages: (1) lowering ion beam energy; and (2) tilting ion beam incidence angles. The first approach can effectively suppress damages with ion energy down to 1 keV; however, this is not feasible for experiments. In the second approach, we demonstrated that tilting ion incident angles result in asymmetric damage distribution, which can be leveraged to pattern graphene/2D materials by utilizing the lightly-damaged side for device fabrication while discarding the heavily damaged side. The present study reveals the formation of FIB-induced damage on supported graphene, and proposes an approach to pattern graphene/2D materials using FIB.

The need for screening for retinopathy in patients with type 1 diabetes mellitus (T1DM) has been emphasised, but diagnostic delays were reported when screening was done at fixed intervals. To establish an individualised risk-prediction model to assist screening non-proliferative diabetic retinopathy (NPDR) in T1DM, we performed a retrospective cohort study enrolling participants in the Chang Gung Juvenile Diabetes Eye Study. There were 413 patients with 12 381 records analysed from 2005 to 2015. A time-dependent Cox proportional hazard analysis was used to evaluate the risks of NPDR development and a nomogram with risk-stratification indicators was established based on the results. During 97 months of follow-up, 43 of 413 patients (10.4%) developed NPDR. Male sex (HR: 0.4, 95% CI: 0.19–0.85), age 5–14 years at onset of T1DM (6.38, 2.41–16.87), duration of diabetes (1.57, 1.41–1.75), and hemoglobin A1c level (1.56, 1.35–1.80) were independently associated with NPDR. Using the nomogram offers a quick method in the clinical setting to interpret the risk of NPDR development. Based on its weighting, each of the independent factors is allocated a score, and the total points indicate the probabilities of NPDR occurring within 6 months, 1 year, and 3 years.