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Recent progress in video object detection (VOD) has shown that aggregating features from other frames to capture long-range contextual information is very important to deal with the challenges in VOD, such as partial occlusion, motion blur, etc. To exploit more effective feature aggregation, we propose several improvements over previous works in this paper: (1) a class-aware pixel-level feature aggregation module, which characterizes a pixel by exploiting the context information lying in the instances from both the current frame and other frames. Different from the previous non-local operation, the proposed class-aware pixel-level feature aggregation filters out most of the noisy information from the large scope of background and objects in different classes, and only enhances representation of a foreground pixel with the same class instances with limited ambiguous information; (2) a class-aware instance-level feature aggregation module, which aggregates features for object proposals by learning two kinds of relations: the temporal dependencies among the same class object proposals from support frames sampled in a long time range or even the whole sequence, and spatial topology relation among proposals of different objects in the target frame. The homogeneity constraint in instance-level feature aggregation filters out many defective proposals, making the feature aggregation more accurate; and (3) a correlation-based feature alignment module embedded in the instance-level feature aggregation, which aligns the feature maps of the support and target proposals. Without bells or whistles, the proposed method achieves state-of-the-art performance on the ImageNet VID dataset without any post-processing methods. This project is publicly available https://github.com/LiangHann/Class-aware-Feature-Aggregation-Network-for-Video-Object-Detection.

Seismic responses of utility tunnel-soil system were studied via shaking table model tests with considerations of two kinds of double box utility tunnels: with and without joint connections. These two testing utility tunnel models were made of galvanized iron wire and micro-concrete, and the ground was simulated by the dry standard sand through layered tamping treatment. The utility tunnel-soil system was subjected to horizontal vibration in uniaxial direction perpendicular to the longitudinal direction of tunnel model. Via instrumentations of earth pressure gauges, accelerometers and strain gauges, the earth pressure response, acceleration response and bending moment response were measured. The testing results show that the joint connections in the utility tunnel along the longitudinal direction play an important role in determining the characteristic of earth pressure response and bending moment response, whereas the effect of joint connections on acceleration response is less significant. In addition, the partition wall exhibits the consistent acceleration response with the side-wall of double box utility tunnel model under seismic condition. Based on the testing results, it is suggested that the joint connection should be taken reasonably into consideration during design and construction for engineering practice.

Background The success of pulmonary vein isolation (PVI) is reduced in persistent AF (PsAF) compared to paroxysmal AF. Adjunctive ablation strategies have failed to show consistent incremental benefit over PVI alone in randomized studies. The left atrial posterior wall is a potential source of non-PV triggers and atrial substrate which may promote the initiation and maintenance of PsAF. Adding posterior wall isolation (PWI) to PVI had shown conflicting outcomes, with earlier studies confounded by methodological limitations. Objectives To determine whether combining PWI with PVI significantly improves freedom from AF recurrence, compared to PVI alone, in patients with PsAF. Methods This is a multi-center, prospective, international randomized clinical trial. 338 patients with symptomatic PsAF refractory to anti-arrhythmic therapy (AAD) will be randomized to either PVI alone or PVI with PWI in a 1:1 ratio. PVI involves wide antral circumferential pulmonary vein (PV) isolation, utilizing contact force sensing ablation catheters. PWI involves the creation of a floor line connecting the inferior aspect of the PVs, and a roof line connecting the superior aspect of the PVs. Follow up is for a minimum of 12 months with rhythm monitoring via implantable cardiac device and/or loop monitor, or frequent intermittent monitoring with an ECG device. The primary outcome is freedom from any documented atrial arrhythmia of > 30 seconds off AAD at 12 months, after a single ablation procedure. Conclusions This randomized study aims to determine the success and safety of adjunctive PWI to PVI in patients with persistent AF.

Objectives This study sought to report P-wave morphology (PWM) from a series of paraseptal (PS) atrial tachycardia (AT), revise then prospectively evaluate a simplified PWM algorithm against a contemporary consecutive cohort with focal AT. Background The 2006 PWM algorithm was useful in predicting the origin of focal AT. An updated algorithm was developed given advances in multipolar 3-dimensional mapping, potential limitations of PWM in separating PS sites, and a renewed interest in the P-wave in mapping non–pulmonary vein triggers. Methods The PWM from a consecutive series of 67 patients with PS AT were analyzed. PS sites included were coronary sinus ostium, perinodal, left and right septum, septal tricuspid annulus, superior mitral annulus, and noncoronary cusp. Next the P-wave algorithm was revised and prospectively evaluated by 3 blinded assessors. Results The P-wave for PS sites was neg/pos (n = 50), iso/pos (n = 10), or isoelectric (n = 4) in lead V1 (96%). The P-wave algorithm was modified and prospectively applied to 30 consecutive patients with focal AT who underwent successful ablation. Foci (n = 30) originated from the right atrium (33.3%), left atrium (30%), and PS (36.7%). Using the PW algorithm, the correct anatomic location was identified in 93%. Incorrect interpretation of the terminal positive P-wave component (n = 3) and initial negative P-wave deflection (n = 1) in lead V1 misidentified 4 paraseptal cases. Conclusions The revised PWM algorithm offers a simplified and accurate method of localizing the responsible site for focal AT. The P-wave remains an important first step in mapping atrial arrhythmias.

Older adults with lower education are at greater risk for dementia. It is unclear which brain changes lead to these outcomes. Longitudinal imaging-based measures of brain structure and function were examined in adult individuals (baseline age, 45–86 years; two to five visits per participant over 1–9 years). College degree completion differentiates individual-based and neighborhood-based measures of socioeconomic status and disadvantage. Older adults (~65 years and over) without a college degree exhibit a pattern of declining large-scale functional brain network organization (resting-state system segregation) that is less evident in their college-educated peers. Declining brain system segregation predicts impending changes in dementia severity, measured up to 10 years past the last scan date. The prognostic value of brain network change is independent of Alzheimer’s disease (AD)-related genetic risk (APOE status), the presence of AD-associated pathology (cerebrospinal fluid phosphorylated tau, cortical amyloid) and cortical thinning. These results demonstrate that the trajectory of an individual’s brain network organization varies in relation to their educational attainment and, more broadly, is a unique indicator of individual brain health during older age. A brain-imaging study in humans demonstrates that older age brain network decline varies in relation to an individual’s education and predicts future dementia severity beyond other markers of Alzheimer’s disease-related genetic risk and pathology.

BACKGROUND Venom-induced consumption coagulopathy (VICC) is characterized by coagulation dysfunction accompanied by decreased coagulation factor activity and fibrinogen (FBG) concentrations. We report a patient with VICC caused by snake bite who manifested persistent FBG deficiency without abnormal coagulation factor activity. This information may be helpful in diagnosing and treating VICC. CASE SUMMARY A 49-year-old man who had been bitten by a snake 13 h previously was admitted to the Emergency Department of our hospital with visible swelling of a finger and a bleeding puncture site. The provisional diagnosis was VICC, this being made based on persistent bleeding from the puncture site and subcutaneous hemorrhage. Laboratory evidence of coagulation abnormalities, including fibrinolysis, and findings on thromboelastography confirmed VICC. He had persistent afibrinogenemia requiring intravenous infusions of cryoprecipitate and fresh frozen plasma, together with continuous large doses of human FBG. After this treatment, the patient’s right upper limb swelling improved significantly and his subcutaneous hemorrhage resolved. All of his abnormal laboratory findings returned to normal by day 25. During 6 months’ of follow-up, the patient had no further hemorrhagic events. CONCLUSION Hemorrhagic snake venom can result in coagulation dysfunction characterized by persistent FBG deficiency without abnormal coagulation factor activity.

Objectives This study sought to describe expected changes in a mirror-image prone electrocardiogram (ECG) compared with normal supine, including a range of cardiac conditions. Background Unwell COVID-19 patients are at risk of cardiac complications. Prone ventilation is recommended but poses practical challenges to acquisition of a 12-lead ECG. The effects of prone positioning on the ECG remain unknown. Methods 100 patients each underwent 3 ECGs: standard supine front (SF); prone position with precordial leads attached to front (PF); and prone with precordial leads attached to back in a mirror image to front (PB). Results Prone positioning was associated with QTc prolongation (PF 437 ± 32 ms vs. SF 432 ± 31 ms; p, Central Illustration

Aggregating temporal features from other frames is verified to be very effective for video object detection to overcome the challenges in still images, such as occlusion, motion blur, and rare pose. Currently, proposal-level feature aggregation dominates this direction. However, there are two main problems for the holistic proposal-level feature aggregation. First, the object proposals generated by the region proposal network ignore the useful context information around the object which is proved to be helpful for object classification. Second, the traditional proposal-level feature aggregation regards the proposal as a whole without considering the important object structure information, which makes the similarity comparison between two proposals less effective when occlusion or pose misalignment occurs on proposal objects. To deal with these problems, we propose the Context and Structure Mining Network to better aggregate features for video object detection. In our method, we first encode the spatial-temporal context information into object features in a global manner, which can benefit the object classification. In addition, the holistic proposal is divided into several patches to capture the structure information of the object, and cross patch matching is conducted to alleviate the pose misalignment between objects in target and support proposals. Moreover, an importance weight is learned for each target proposal patch to indicate how informative this patch is for the final feature aggregation, by which the occluded patches can be neglected. This enables the aggregation module to leverage the most important and informative patches to obtain the final feature aggregation. The proposed framework outperforms all the latest state-of-the-art methods on the ImageNet VID dataset with a large margin. This project is publicly available https://github.com/LiangHann/Context-and-Structure-Mining-Network-for-Video-Object-Detection .

Blood–brain barrier (BBB) strictly controls matter exchange between blood and brain, and severely limits brain penetration of systemically administered drugs, resulting in ineffective drug therapy of brain diseases. However, during the onset and progression of brain diseases, BBB alterations evolve inevitably. In this review, we focus on nanoscale brain-targeting drug delivery strategies designed based on BBB evolutions and related applications in various brain diseases including Alzheimer's disease, Parkinson's disease, epilepsy, stroke, traumatic brain injury and brain tumor. The advances on optimization of small molecules for BBB crossing and non-systemic administration routes (e.g., intranasal treatment) for BBB bypassing are not included in this review., Graphical abstract Blood–brain barrier (BBB) is evolving during the onset and progression of brain diseases. BBB evolution-based nanoscale brain-targeting drug delivery strategies are summarized in this review for various brain diseases.Image 1

Breast cancer brain metastases (BCBMs) are one of the most difficult malignancies to treat due to the intracranial location and multifocal growth. Chemotherapy and molecular targeted therapy are extremely ineffective for BCBMs due to the inept brain accumulation because of the formidable blood‒brain barrier (BBB). Accumulation studies prove that low density lipoprotein receptor-related protein 1 (LRP1) is promising target for BBB transcytosis. However, as the primary clearance receptor for amyloid beta and tissue plasminogen activator, LRP1 at abluminal side of BBB can clear LRP1-targeting therapeutics. Matrix metalloproteinase-1 (MMP1) is highly enriched in metastatic niche to promote growth of BCBMs. Herein, it is reported that nanoparticles (NPs-K-s-A) tethered with MMP1-sensitive fusion peptide containing HER2-targeting K and LRP1-targeting angiopep-2 (A), can surmount the BBB and escape LRP1-mediated clearance in metastatic niche. NPs-K-s-A revealed infinitely superior brain accumulation to angiopep-2-decorated NPs-A in BCBMs bearing mice, while comparable brain accumulation in normal mice. The delivered doxorubicin and lapatinib synergistically inhibit BCBMs growth and prolongs survival of mice bearing BCBMs. Due to the efficient BBB penetration, special and remarkable clearance escape, and facilitated therapeutic outcome, the fusion peptide-based drug delivery strategy may serve as a potential approach for clinical management of BCBMs., Graphical abstract Brain-targeting drug delivery efficiency is boosted for therapy of brain metastases by fusion-peptide-decorated nanoparticles, via luminal LRP1-mediated BBB crossing and escaping from abluminal LRP1-mediated clearance through MMP1-triggered peptide cleavage.Image 1

Accumulating evidence indicates that the brain natriuretic peptide (BNP) and its receptor (natriuretic peptide receptor, NPR) are widely distributed in a variety of tissues including trigeminal ganglion (TG). Furthermore, recent studies support the involvement of the BNP-NPR-A pathway in acute and chronic pain. To investigate the role of this pathway in chronic pain, an infraorbital nerve-chronic constriction injury (ION-CCI) model of trigeminal neuralgia (TN) was produced in the rat. The time course of changes in mechanical pain threshold was examined. We observed an upregulation of BNP and NPR-A and a downregulation of large-conductance Ca2+-activated K+ (BKCa) mRNA and protein in rats subjected to ION-CCI. Patch clamping experiments in vitro found that BKCa currents were significantly reduced in rats subjected to ION-CCI. BNP increased BKCa currents in ION-CCI rats. These results suggest that BNP and NPR-A might serve as endogenous pain relievers in ION-CCI rats. Modulation of the BNP/NPR-A/BKCa channel pathway in TG may be a viable strategy for the treatment of TN.NEW & NOTEWORTHY BNP has been known to activate its receptor, NPR-A, to modulate inflammatory pain. However, the potential modulatory roles of BNP in TN have not been investigated in detail. We established an ION-CCI model of TN in the rat and observed an upregulation of BNP and NPR-A and a downregulation of BKCa in rats subjected to ION-CCI. Moreover, BNP can increase BKCa currents in ION-CCI rats. Thus, BNP and NPR-A might have inhibitory effects on trigeminal neuralgia through activating the BNP/NPR-A/BKCa channel pathway.

AIMS: The impact of atrial fibrillation (AF) ablation in early heart failure with preserved ejection fraction (HFpEF) is unknown. Our aim was to determine the impact of AF ablation on symptoms and exercise haemodynamic parameters of early HFpEF. METHODS AND RESULTS: Symptomatic AF patients referred for index AF ablation with ejection fraction ≥50% underwent baseline quality of life questionnaires, echocardiography, cardiac magnetic resonance imaging, exercise right heart catheterisation (exRHC), and brain natriuretic peptide (BNP) testing. HFpEF was defined by resting pulmonary capillary wedge pressure (PCWP) ≥15 mmHg or peak exercise PCWP ≥25 mmHg. Patients with HFpEF were offered AF ablation and follow-up exRHC ≥6 months post-ablation. Of 54 patients undergoing baseline evaluation, 35 (65%) had HFpEF identified by exRHC. HFpEF patients were older (64 ± 10 vs. 54 ± 13 years, P

Background Vaccines are needed to prevent coronavirus disease 2019 (Covid-19) and to protect persons who are at high risk for complications. The mRNA-1273 vaccine is a lipid nanoparticle-encapsulated mRNA-based vaccine that encodes the prefusion stabilized full-length spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19. Methods This phase 3 randomized, observer-blinded, placebo-controlled trial was conducted at 99 centers across the United States. Persons at high risk for SARS-CoV-2 infection or its complications were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo 28 days apart. The primary end point was prevention of Covid-19 illness with onset at least 14 days after the second injection in participants who had not previously been infected with SARS-CoV-2. Results The trial enrolled 30,420 volunteers who were randomly assigned in a 1:1 ratio to receive either vaccine or placebo (15,210 participants in each group). More than 96% of participants received both injections, and 2.2% had evidence (serologic, virologic, or both) of SARS-CoV-2 infection at baseline. Symptomatic Covid-19 illness was confirmed in 185 participants in the placebo group (56.5 per 1000 person-years; 95% confidence interval [CI], 48.7 to 65.3) and in 11 participants in the mRNA-1273 group (3.3 per 1000 person-years; 95% CI, 1.7 to 6.0); vaccine efficacy was 94.1% (95% CI, 89.3 to 96.8%; P Conclusions The mRNA-1273 vaccine showed 94.1% efficacy at preventing Covid-19 illness, including severe disease. Aside from transient local and systemic reactions, no safety concerns were identified. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427.).

Purpose To delineate anatomic and visual outcomes of injured eye globes with perforating, and to develop the prognostic indicators for perforating eyes. Methods The case series study, from a multicenter prospective cohort database. To the date of December 31st, 2018, of 63 perforating globes were selected. All cases underwent vitreoretinal surgeries or enucleations, and were followed up for at least 6 months. Demographic characteristics, basic examination for traumatized eyes, and intraocular tissue damages were recorded by surgery-in-chief. At the follow-up visit, best corrected VA, intraocular pressure, the intraocular tamponade material, retinal anatomic outcome of eye-globes, and phthisis or enucleation were evaluated. Results Fifty injured eyes (79%) were caused by sharp objects and 13 eyes (21%) were injured by a missiles. Twenty-two injured eyes can be anatomically restored with final vision of more than 4/200 through vitreoretinal surgery. The PVR-C (OR = 5.67, P = 0.01), area of retinectomy more than 2 times of optic disk (OR = 5.16, P = 0.04), and macular damage (OR = 6.38, P = 0.01) were correlated with unfavorable outcomes. Conclusion The injured eyes with perforation can be saved through vitreoretinal surgery, the PVR-C, retinectomy more than 2 times of optic disk, and macular damage were independent risk factors for poor long-term prognosis.

A humidity sensor based on photonic crystal fiber (PCF) is experimentally demonstrated, which was fabricated by sandwiching a taper between PCF and a standard single mode fiber (SMF). The taper and collapsed region in PCF excite high-order modes and couple them with core mode to form a Michelson interferometer (MI). Experiment results show that the reflection interference intensity linearly changes with humidity and the sensitivity is −0.166 dB/%RH in the range of 30-90 %RH, the sensor displayed a low temperature cross-sensitivity of 0.09 %RH/°C in the temperature range of 20-100 °C. In addition, a rise/recovery time of 400/200 ms was achieved respectively for human breathing test. The easy fabrication, high sensitivity and fast response indicate the sensor has broad practical prospects.

We study the impacts of the use of trade credit on SME financial performance and operational distress in a sample of 74,036 SMEs across 19 EU countries between 2006 to 2015. Under the premise that trade credit acts as a substitute for bank credit, our results show that supplying trade credit improves profitability, but we show little evidence that such an investment is more profitable for bank credit richer SMEs, although such firms did redistribute more bank fund through trade credit to their customers. For receivers, we show that the use of trade credit finance alleviates operational distress, especially for those SMEs facing liquidity constraints, such as those which have less access to bank credit or under credit tightened periods. This distress reduction effect is also reflected in their profitability indicators. However, the longer the average collection period and credit period, the less effective the trade credit effects respectively on improving SME profitability and reducing operational distress.

Higher requirements must be put forward about wireless signal transmission in harsh environments. Energy loss mitigation, channel estimation, noise interference reduction demands high quality of service in wireless communication. In the fifth generation wireless communication, massive multiple-input multiple-output (MIMO) networks have been used and play a significant role to fulfill the requirements. Cell-Free massive MIMO networks are recognized as possible solution in the future wireless communication. Spectral efficiency (SE) is a very important index in assessing massive MIMO networks. This article tries to optimize both SE and power control of cell-free massive MIMO networks. Both uplink and downlink transmission are included in the study. The optimization model contains both SE and power control of massive MIMO networks. To tackle the model, a novel ensemble method is developed inspired by ensemble learning. The ensemble method is built up on the neighborhood field optimization method. The goodness of the developed ensemble method is verified by comparing with genetic algorithm, gradient descent method and Newton method. Extensive simulations are performed to study the optimization of SE and power control. Different wireless sensors are taken into consideration to simulate different requirements of massive MIMO networks. The results demonstrate the effectiveness of the proposed method for applying in massive MIMO networks.

The rotation matching between synthetic aperture radar (SAR) and optical images is essential for their registration. In this article, we introduce a novel fast rotation matching method for SAR and optical images. In the method, the absolute directional derivative histograms (ADDHs) of SAR and optical images can be used to reflect the rotation difference between them, and then the rotation difference is removed by the cross correlation of the two images’ ADDHs. Subsequently, we generate the ADDHs by oriented Gaussian-Gamma-shaped operator. Then, the cross correlation based on fast Fourier transform is used to deal with the ADDHs of SAR and optical images in order to determine the rotation difference of the two images. The experiment results demonstrate that the proposed method can detect the rotation difference in various conditions and achieves rotation matching with high speed.

Objectives This study sought to determine the long-term outcomes of restoring sinus rhythm with catheter ablation (CA). Background The CAMERA-MRI (Catheter Ablation Versus Medical Rate Control in Atrial Fibrillation and Heart Failure—An MRI-Guided Multicenter Randomized Controlled Trial) study demonstrated that restoration of sinus rhythm with CA significantly improved left ventricular ejection fraction (LVEF) compared with medical rate control (MRC) at 6 months in persistent atrial fibrillation and otherwise unexplained systolic heart failure. However, the long-term outcomes have not been reported. Methods Patients enrolled in the CAMERA-MRI study were followed for 4 years with echocardiogram and cardiac magnetic resonance. CA involved pulmonary vein isolation and posterior left atrial wall isolation in 94%. Patients crossed over to CA after 6-month study duration. Arrhythmia burden was determined with implanted cardiac monitors or cardiac devices. Results Sixty-six patients (age 62 ± 10 years, atrial fibrillation duration of 22 ± 16 months, and LVEF 33 ± 9%) were randomized 1:1 to CA versus MRC. Eighteen of 33 patients crossed over from MRC group to CA group. At 4.0 ± 0.9 years, atrial fibrillation recurred in 27 patients (57%) in the CA group with a mean burden of 10.6 ± 21.2% after 1.4 ± 0.6 procedures. There was an absolute increase in LVEF with CA of 16.4 ± 13.3% compared with 8.6 ± 7.6% in MRC (p = 0.001). In the CA group, the absence of ventricular late gadolinium enhancement was associated with a greater improvement in absolute LVEF (19 ± 13% vs. 10 ± 11% in the late gadolinium enhancement–positive group; p = 0.04) and LVEF normalization in 19 patients (58%) versus 4 patients (18%) in the late gadolinium enhancement–positive group (p = 0.008) at 4.0 ± 0.9 years follow-up. Conclusions CA is superior to MRC in improving LVEF in the long term in patients with atrial fibrillation and systolic heart failure. The greatest recovery in systolic function was demonstrated in the absence of ventricular fibrosis on cardiac magnetic resonance.

This study aimed to examine impacts of gestational diabetes mellitus (GDM) on quality of life (QoL) domains in Chinese pregnant women.We recruited 13,358 pregnant women in Tianjin, China. GDM was diagnosed using the criteria of International Association of Diabetes and Pregnancy Study Group. QoL was measured using the 36-Item Short-Form Health Survey. General linear model was used to obtain β-coefficient and 95% confidence intervals (CI) of GDM for QoL domain and summary scores.7.25% of the pregnant women developed GDM. Among the QoL domain and summary scores, only general health (GH) score was lower in the GDM group than in the non-GDM group. GDM and advanced maternal age (i.e., ≥ versus30 years) were negatively associated with GH in multivariable analyses (β-coefficient: -1.17, 95%CI: -2.17 to -0.17-0.79, -1.40 to -0.18, respectively). In subgroup analyses, the β-coefficient of GDM for GH among women with maternal age ≥30 years was enhanced to -2.17 (-3.94 to -0.40) in multivariable analysis while the β-coefficient of GDM for GH among women aged30 years was attenuated to non-significance.GDM and advanced maternal age were associated with reducing GH, and presence of advanced maternal age markedly increased the effect of GDM on GH.

Brain metastases are intracranial recurrence of extracranial malignant tumors with a high incidence and poor prognosis. Owing to the particularity of intracranial localization, clinical diagnosis (neuroimaging and biopsy) of brain metastases is associated with shortcomings such as delayed diagnosis and biopsy invasiveness. Clinical treatment modalities consist of local therapies (resection and radiotherapy) and systemic therapies (chemotherapy, targeted therapy and immunotherapy). However, the efficiency of clinical therapies is severely hindered by 1) neurological impairment, 2) relapse, 3) blood-brain barrier, and 4) therapy resistance. Nanomedicine possesses great potentials in combating these clinical issues. This article reviewed backgrounds and recent advances of applying nanomedicine to address these above issues in clinical diagnosis and treatment of brain metastases.

Background Multipolar catheters provide high-density mapping which may reduce the procedural duration and improve the success of catheter ablation (CA) for focal arrhythmias. The high-density grid (HDG) catheter is a 16 electrode mapping catheter with bipole recordings at orthogonal splines. The aim of this study is to compare the clinical and procedural features from a cohort who underwent CA for focal arrhythmias using multipolar mapping (MPM) with age and case-matched cohort using point-by-point (PbyP) mapping. Methods Consecutive patients undergoing CA for focal arrhythmias between October 2018 and January 2020 guided by MPM were compared with PbyP mapping with the ablation catheter over a similar period. Demographics, procedural features, and outcomes were compared. Results A total of 54 patients (27 in MPM vs. 27 in PbyP mapping) underwent CA for 68 focal arrhythmias (26 atrial and 42 ventricular). In the MPM group, the electrogram at the successful site was significantly earlier (39 ± 11 ms) than in the PbyP group (33 ± 7 ms; p = .02). In the MPM group, the mapping time (35 ± 24 vs. 53 ± 31 min in PbyP; p = .03) and procedural duration (126 ± 42 vs. 153 ± 39 min in PbyP; p = .02) were significantly shorter. There was no significant difference in radiofrequency and fluoroscopy times, acute procedural success, and arrhythmia recurrence. Conclusion MPM with the HDG catheter for focal tachycardias identified earlier activation times and was associated with shorter mapping and procedure duration with equivalent success to PbyP mapping.

Background Synovitis is characterized by the infiltration of inflammatory cells and often accompanies the pathological progression of the clinical symptoms affecting the temporomandibular joint (TMJ), such as pain, snapping, and limited mouth opening. It has been suggested that the signal transduction pathway and resultant proinflammatory mediators play important roles in the pathogenesis of synovitis. Therefore, in this present research, we aimed to investigate the changes in the expressions of stromal cell‐derived factor 1 (SDF‐1) and interleukin (IL)‐1β in rats with occlusal interference. Materials and Methods We divided 36 male Wistar rats into the following groups: Group A (control group), Group B (occlusal interference group), and Group C (AMD3100 group). Synovial inflammation was induced in the rats in Groups B and C to establish the occlusal interference model. The inflammatory changes were detected, and the expressions of SDF‐1 and IL‐1β in the synovium were assayed via immunostaining and a real‐time quantitative polymerase chain reaction (PCR). Results In Group B, obvious inflammatory changes were observed in the synovial membranes; additionally, the SDF‐1 and IL‐1β expression levels were significantly higher at the protein and mRNA levels. However, in Group C, these experimental results were inhibited by an injection with AMD3100. Conclusion These results may indicate that SDF‐1 regulates the expression level of inflammatory factors, such as IL‐1β, in the synovial membranes of rats with occlusal interference. Our findings suggest that the SDF‐1 axis may contribute to the onset of synovitis during the development of TMJ joint disease.

Background Female gender is associated with an increased recurrence of atrial fibrillation (AF) after catheter ablation (CA). Although AF is more common in men, women constitute a significant proportion with persistent atrial fibrillation (PsAF). Objective The purpose of this study was to determine whether multiple ablation procedures improves arrhythmia outcomes in females with PsAF compared to men. Methods We performed a multicenter observational study to determine long-term arrhythmia outcomes in patients undergoing >1 CA for PsAF. CA involved pulmonary vein (PV) isolation with additional ablation including linear, posterior wall isolation, electrogram-guided, or a combination of these. Results A total of 281 patients had >1 ablation procedure for PsAF and were included in this analysis (mean age 58.7 ± 9.3 years; 86 [30.6%] female; left atrial [LA] area 27.0 ± 5.3 cm2; PsAF duration 1.7 ± 1.7 years). At mean follow-up of 45.5 ± 31.8 months, freedom from recurrent AF was present in 148 patients(52.7%) after 2.2 ± 0.5 procedures. After multivariate analysis, female gender (hazard ratio [HR] 2.10; P Conclusion Female gender was independently and strongly associated with arrhythmia recurrence in patients undergoing multiple procedures for PsAF. PV reconnection was less likely, and fewer reconnected PVs occurred in women. Further studies are required to better understand the mechanisms responsible for AF in females to assist in closing the gender gap in the success of CA.

Purpose Our study aimed to construct a visible model to evaluate the risk of infectious complications after gastrectomy. Methods The clinical data of 856 patients who underwent gastrectomy were used to retrieve medical records. Univariate and multivariate analyses were performed to correlate early postoperative NLR and operative variables with postoperative complications, and the construction of the nomogram was based on logistic regression. The concordance index and receiver operating characteristic curves were used to evaluate the model performance. Results The postoperative infectious and noninfectious complication rates after gastrectomy were 18.5% (158/856 cases) and 12.3% (105/856 cases) respectively. Postoperative NLR (within 24 h) independently predicted the development of postoperative infectious complication. Multivariate analysis revealed that age, diabetes, body mass index (BMI), intraoperative blood transfusion and postoperative NLR were independent risk factors. The nomogram model showed a good performance in terms of predicting infectious complications after gastrectomy (concordance index=0.718). Conclusion Age, diabetes, BMI, intraoperative blood transfusion and postoperative NLR were independent risk factors of postoperative infectious complications after gastrectomy, and a novel nomogram based on these results can be used to predict postoperative infection and has the advantages of simple application and easy access.

Device-to-device (D2D) communications and full-duplex (FD) communications, which can improve the spectrum efficiency (SE) of mobile communications, have received much attention. To further improve the SE, some researchers have begun to integrate FD into D2D communications, which will generate more transmission modes. Since different modes have different advantages and disadvantages, the mode selection problem needs further study. In this paper, we investigate the mode selection problem for FD-enabled two-way D2D communications to improve the SE. Four transmission modes, i.e., FD underlay mode, half-duplex (HD) underlay mode, FD overlay mode and HD overlay mode, are considered. For each mode, we maximize the system SE while fulfilling the minimum rate requirements and maximum transmit power constraints for both cellular and D2D users. For FD underlay mode, the optimization problem can be transformed into a difference of convex functions (D.C.) programming and the concave-convex procedure (CCCP) algorithm can solve the problem efficiently. For HD underlay mode and FD overlay mode, we can use search plus CCCP algorithm to solve the optimization problem. For HD overlay mode, we only need to search for the optimal solution. After obtaining the maximum SE of four modes, we can select the maximum one as the optimal mode. Numerical results are presented to illustrate the effects of the channel gains and self-interference cancellation ability on the maximum SE of four modes and the transmission mode selection.

BackgroundMany patients with pancreatic cancer (PC) suffer from abdominal pain and back pain. However, the cause of pain associated with PC is largely unclear. In this study, we tested the potential influence of the sonic hedgehog (sHH) signaling pathway on PC pain.MethodsSubstance P (SP) and calcitonin gene-related peptide (CGRP) expression was measured in cultured PC cells and dorsal root ganglions (DRG) by real-time PCR, western blotting analysis and ELISA. Small interfering RNA transfection and plasmid constructs were used to regulate the expression of sHH in the AsPc-1 and Panc-1 cell lines. Pain-related behavior was observed in an orthotopic tumor model in nude mice.ResultsIn this study, the results show that sHH increased the expression of SP and CGRP in DRGs in a concentration and time-dependent manner. Additionally, sHH secretion from PC cells could activate the sHH signaling pathway and, in turn, increase the expression of nerve growth factor (NGF), P75, and TrkA in DRGs. Furthermore, the sHH signaling pathway and NGF/NGF receptor contributed to pain sensitivity in a nude mouse model.ConclusionOur results demonstrate that PC pain originates from the sHH signaling pathway, and NGF mediates the pain mechanism via regulating SP and CGRP.

Objectives This study sought to determine the impact of rate and direction on left atrial (LA) substrate. Background The extent to which substrate mapped in sinus rhythm varies according to cycle length and direction of wave front propagation is unknown. Methods A total of 73 consecutive patients with atrial fibrillation (AF) underwent electroanatomic LA mapping before pulmonary vein isolation using multipolar catheter during distal coronary sinus (CS) pacing at 600 ms and 300 ms. Additional maps were created during left superior pulmonary vein pacing at 300 ms. Bipolar voltage, conduction velocity (CV), and complex signals were determined. Results Mean age was 61 ± 9 years, 67% were men, and 53% had persistent AF. Global mean voltage was lower with CS pacing at 300 ms compared with 600 ms (1.56 ± 0.47 mV vs. 1.74 ± 0.48 mV; p Conclusions In patients with AF, variation in cycle length and direction of wave front activation produce both generalized and regional changes in voltage, CV, and complex fractionation, resulting in significant changes in substrate maps. This study highlights the potential limitations of static low-voltage maps to identify the AF ablation target zone.

Copyright © 2021, The Author(s) Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data., Background: Core outcome sets (COS) should be relevant to key stakeholders and widely applicable and usable. Ideally, they are developed for international use to allow optimal data synthesis from trials. Electronic Delphi surveys are commonly used to facilitate global participation; however, this has limitations. It is common for these surveys to be conducted in a single language potentially excluding those not fluent in that tongue. The aim of this study is to summarise current approaches for optimising international participation in Delphi studies and make recommendations for future practice. Methods: A comprehensive literature review of current approaches to translating Delphi surveys for COS development was undertaken. A standardised methodology adapted from international guidance derived from 12 major sets of translation guidelines in the field of outcome reporting was developed. As a case study, this was applied to a COS project for surgical trials in gastric cancer to translate a Delphi survey into 7 target languages from regions active in gastric cancer research. Results: Three hundred thirty-two abstracts were screened and four studies addressing COS development in rheumatoid and osteoarthritis, vascular malformations and polypharmacy were eligible for inclusion. There was wide variation in methodological approaches to translation, including the number of forward translations, the inclusion of back translation, the employment of cognitive debriefing and how discrepancies and disagreements were handled. Important considerations were identified during the development of the gastric cancer survey including establishing translation groups, timelines, understanding financial implications, strategies to maximise recruitment and regulatory approvals. The methodological approach to translating the Delphi surveys was easily reproducible by local collaborators and resulted in an additional 637 participants to the 315 recruited to complete the source language survey. Ninety-nine per cent of patients and 97% of healthcare professionals from non-English-speaking regions used translated surveys. Conclusion: Consideration of the issues described will improve planning by other COS developers and can be used to widen international participation from both patients and healthcare professionals., This study is funded by the National Institute for Health Research (NIHR) Doctoral Research Fellowship Grant (DRF-2015-08-023). JMB is partially funded by the NIHR Bristol Biomedical Research Centre and the MRC ConDUCT-II Hub for Trials Methodology Research. PRW was funded by the MRC North West Hub for Trials Methodology Research (Grant ref: MR/K025635/01).

Immune checkpoint inhibitors (ICIs), which can enhance antitumor immunity and inhibit cancer growth, have revolutionized the treatment of multiple cancers and dramatically decreased mortality. However, treatment with ICIs is directly associated with immune-related adverse events (irAEs) because of inflammation in off-target organs and autoimmunity resulting from non-specific immune activation. These irAEs can cause rheumatic diseases and manifestations such as inflammatory arthritis, polymyalgia rheumatica, myositis, vasculitis, Sicca and Sjogen's syndrome, and systemic lupus erythematosus. Early diagnosis and treatment of these adverse events will improve outcomes and quality of life for cancer patients. The treatment of rheumatic diseases induced by ICIs requires multidisciplinary cooperation among physicians. Furthermore, the underlying mechanisms are not fully understood and it is difficult to predict and evaluate these side effects precisely. In this review, we summarize available studies and findings about rheumatic irAEs, focusing mainly on the clinical manifestations, epidemiology, possible mechanisms, and guiding principles for treating these irAEs.

Aim This meta-analysis aimed to explore potential risk factors for severe Covid-19. Methods We systemically and comprehensively retrieved the eligible study evaluating clinical differences between severe versus non-severe Covid-19. Main effect sizes were demographic characteristics, comorbidities, signs and symptoms, laboratory findings as well as radiological features of chest CT. Results A total of 2,566 Covid-19 people (771 in the severe group and 1,795 in the non-severe group) from 14 studies were eligible for this meta-analysis. It was demonstrated that older age and males were more likely to have severe Covid-19. Patients with underlying comorbidities, such as hypertension, diabetes, heart disease and COPD were significantly more susceptible to severe Covid-19. Patients with dyspnea were more likely to be severely ill. Depressed total lymphocytes were observed in this article. Meanwhile, although reticulation (30.8%), intrathoracic lymph node enlargement (20.5%) and pleural effusions (30.8%) were relatively infrequent, meta-analysis revealed that patients with these presentations in chest CT were associated with increased risk of severe Covid-19. Conclusions There are significant differences in clinical characteristic between the severe and non-severe Covid-19 patients. Many factors are related to the severity of the disease, which can help clinicians to differentiate severe patients from non-severe patients.

Humidity sensing plays an important role in the professional field and our daily life, such as chemical preparation process, environmental monitoring, and food storage. Herein, a wearable humidity sensor is designed based on a flexible plasmonic random laser. The random laser-based humidity sensor is fabricated by transferring an ultrathin light-emitting polymer membrane doped with silver nanoparticles onto the humidity-sensitive PEDOT:PSS film. Under optical pumping, random lasing with low-threshold is achieved, assisted by the strong plasmonic feedback of the silver nanoparticles. The random laser-based humidity sensor exhibits a good linear response with a coefficient of 0.997. Comparing with the emission intensity at initial relative humidity (RH) (34.8%), the peak intensity increases 5.5 times at an RH value of 93.5%. This phenomenon mainly results from the ambient humidity-sensitive relative refractive index difference between polymer membrane and PEDOT:PSS film. The random laser-based humidity sensor is flexible and nontoxic, which can be transplanted easily to achieve wearable laser devices.

The document analysis method mainly refers to the method of collecting, identifying, and collating documents, and forming a scientific understanding of facts through the analysis of the documents. Traditional Chinese medicine understands and classifies the cause of tumors under the guidance of the overall concept. Although modern medicine is the main treatment method for tumors, it still has many shortcomings. With the deepening of TCM’s understanding of tumors, it was discovered that TCM decoctions combined with treatment can increase efficacy and reduce toxicity. The ingredients in them play an important role in improving the body’s immune function and improving the diagnosis and treatment of TCM tumors. Based on this, this article has launched an analysis and research on the status quo of diagnosis and treatment of TCM tumors based on literature analysis methods. In this paper, we systematically searched the related literatures of TCM treatment of tumors, used TCM literature analysis methods, used prescriptions as clues, explored the law of TCM diagnosis and treatment of tumors, and summarized the similarities and differences between ancient and modern diagnosis and treatment of tumors. This article mainly uses the literature analysis method to summarize and analyze the domestic literature on the diagnosis and treatment of TCM tumors, to understand the development trends of Chinese scholars on TCM, and to have a clearer understanding of the status quo and development of TCM diagnosis and treatment of tumors in my country. Problems in the process, and propose corresponding solutions based on the problems found. In this paper, by consulting the literature, we will sort out the tumor’s pathogenic factors, pathogenesis, and the current status of Chinese medicine treatment, and systematically summarize and summarize the modern experimental basic research to provide a basis for the diagnosis and treatment of tumors. The results of literature analysis show that the total frequency of medication is 1021 times, the relative frequency is 1021 88%, indicating that these 8 types of traditional Chinese medicine occupies a dominant position in ancient prescriptions. It can be seen that tonic drugs are the core drugs used in modern Chinese medicine in the treatment of tumors.

This article assembles a distributed feedback (DFB) cavity on the sidewalls of the optical fiber by using very simple fabrication techniques including two-beam interference lithography and dip-coating. The DFB laser structure comprises graduated gratings on the optical fiber sidewalls which are covered with a layer of colloidal quantum dots. Directional DFB lasing is observed from the fiber facet due to the coupling effect between the grating and the optical fiber. The directional lasing from the optical fiber facet exhibits a small solid divergence angle as compared to the conventional laser. It can be attributed to the two-dimensional light confinement in the fiber waveguide. An analytical approach based on the Bragg condition and the coupled-wave theory was developed to explain the characteristics of the laser device. The intensity of the output coupled laser is tuned by the coupling coefficient, which is determined by the angle between the grating vector and the fiber axis. These results afford opportunities to integrate different DFB lasers on the same optical fiber sidewall, achieving multi-wavelength self-aligned DFB lasers for a directional emission. The proposed technique may provide an alternative to integrating DFB lasers for applications in networking, optical sensing, and power delivery.

Background: Wutou Decoction (WTD), as a classic prescription, has been generally used to treat rheumatoid arthritis (RA) for two thousand years in China. However, the potential protective effects of WTD on rheumatoid arthritis and its possible mechanism have rarely been reported.Purpose: The aim of this study was to explore the possible mechanism of WTD against RA and a promising alternative candidate for RA therapy.Methods: A model of collagen-induced arthritis (CIA) was constructed in rats to assess the therapeutic effects of WTD. Histopathological staining, immunofluorescence, and western blotting of synovial sections were conducted to detect the antiangiogenic effects of WTD. Then, cell viability assays, flow cytometry, scratch healing assays, and invasion assays were conducted to explore the effects of WTD on MH7A human fibroblast-like synoviocyte (FLS) cell proliferation, apoptosis, migration, and invasion in vitro. The ability of WTD to induce blood vessel formation after MH7A cell and human umbilical vein endothelial cell line (HUVEC) coculture with WTD intervention was detected by a tube formation assay. The mechanisms of WTD were screened by network pharmacology and confirmed by in vivo and in vitro experiments.Results: WTD ameliorated the symptoms and synovial pannus hyperplasia of CIA rats. Treatment with WTD inhibited MH7A cell proliferation, migration, and invasion and promoted MH7A apoptosis. WTD could inhibit MH7A cell expression of proangiogenic factors, including VEGF and ANGI, to induce HUVEC tube formation. Furthermore, the PI3K-AKT-mTOR-HIF-1α pathway was enriched as a potential target of WTD for the treatment of RA through network pharmacology enrichment analysis. Finally, it was confirmed in vitro and in vivo that WTD inhibits angiogenesis in RA by interrupting the PI3K-AKT-mTOR-HIF-1α pathway.Conclusion: WTD can inhibit synovial hyperplasia and angiogenesis, presumably by inhibiting the migration and invasion of MH7A cells and blocking the production of proangiogenic effectors in MH7A cells. The possible underlying mechanism by which WTD ameliorates angiogenesis in RA is the PI3K-AKT-mTOR-HIF-1α pathway.

Covid-19 is a serious public health problem worldwide. To date, it has spanned worldwide with 12.8 million infected and 566,909 confirm death. Covid-19 screening is indeed an important task and has to be done quickly as possible to many people so that early treatment can be done. The current world RT-PCR standard screening for Covid-19 detection no longer can cope to the demand of large world population. There is a need of other quick diagnosis procedure such as to use chest x-ray images and light computing algorithm to accelerate the covid-19 screening. This paper proposes Covid-19 detection based on chest X-ray image with a light computer processing. The proposed work introduces the combination of Gray Level Co-occurrence Matrix (GLCM) and Convolutional Neural Network (CNN) methods to detect Covid-19 symptom. The light version is coming from GLCM simplicity and convolutional neural network (CNN) single layer. It is fast and suitable method for places where computing resources are minimal. With light processing component, the proposed work gives the highest classification performance with 97.06% accuracy compared to other similar works.

This paper proposes multi-sensor information fusion algorithm for maneuvering target recognition and tracking based on mobile sensor networks (MSNs). In order to improve target recognition accuracy, the modified evidence combination rule is designed to obtain the identity information of target based on the Dempster-Shafer (DS) algorithm. The target recognition process is designed by two stages, namely, sensing stage and fusion stage. During the first stage, each sensor node in the MSNs can obtain the feature information of the target, which makes up the measurement information. In the information fusion stage, each sensor combine the information exchanged from neighboring nodes with local measurement information to obtain the high-precise identity information of the maneuvering target based on the improved DS algorithm. Then, the identity information can be used to obtain the accurate state estimation of the maneuvering target. For the purpose of obtaining the accurate state estimation of target, the target tracking process is designed by local filtering stage and fusion stage. Finally, a numerical simulation is designed to illustrate the effectiveness of the algorithm.

Immunotherapy, which takes advantage of the immune system to eliminate cancer cells, has been widely studied and applied in oncology. Immune checkpoint inhibitors (ICIs) prevent the immune system from being turned off before cancer cells are eliminated. They have proven to be among the most promising and effective immunotherapies, with significant survival benefits and durable responses in diverse tumor types. However, an increasing number of retrospective studies have found that some patients treated with ICIs experience unusual responses, including accelerated proliferation of tumor cells and rapid progression of the disease, with poor outcomes. Such unexpected adverse events are termed hyperprogressive disease (HPD), and their occurrence suggests that ICIs are detrimental to a subset of cancer patients. HPD is common, with an incidence ranging between 4 and 29% in several cancer types. However, the mechanisms of HPD remain poorly understood, and no clinical predictive factors of HPD have been identified. In this review, we summarize current findings, including retrospective studies and case reports, and focus on several key issues including the defining characteristics, predictive biomarkers, potential mechanisms of HPD, and strategies for avoiding HPD after ICI treatment.

Objective To determine the role of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) imaging to guide stereotactic biopsy for the diagnosis of intracranial angiitis. Case presentation In a 28-year-old woman who had experienced inactive headache and right limbs numbness for 4 days, preoperative magnetic resonance (MR) scanning, enhanced scanning, diffusion tensor imaging, magnetic resonance spectroscopy, diffusion-weighted imaging (DWI), and ADC image scanning were performed. Stereotactic biopsy was performed in one target where the area of edema detected with MR FLAIR, and two targets where the area shown as a high-value and a lower value area in the DWI/ADC image. Pathological examinations together with computed tomographic and enhanced MRI scans were conducted after surgery. A preoperative enhanced MRI scan showed a uniform low-intensity lesion in the patient’s left centrum semiovale, with a volume of 3.1 cm3. The DWI and ADC images showed uneven high-intensity signals and different ADC values in the lesion area, respectively. During surgery, tissues around the lesion and the lesion center were sampled at the three selected targets. The postoperative pathological diagnosis was primary angiitis of the central nervous system, and the patient was given anti-inflammatory medication and hormone therapy. The 3-year follow-up confirmed that the patient had recovered well, with a Glasgow Outcome Scale score of five. Conclusion DW-MRI and ADC images can be reliably used to determine the location of small intracranial lesions, and guide stereotactic biopsy to facilitate the diagnosis of primary vasculitis of the central nervous system.

BackgroundPerineural invasion (PNI) is an important pathologic feature of pancreatic cancer, and the incidence of PNI in pancreatic cancer is 70%-100%. PNI is associated with poor outcome, metastasis, and recurrence in pancreatic cancer patients. There are very few treatments for PNI in pancreatic cancer. Honokiol (HNK) is a natural product that is mainly obtained from Magnolia species and has been indicated to have anticancer activity. HNK also has potent neurotrophic activity and may be effective for suppressing PNI. However, the potential role of HNK in the treatment of PNI in pancreatic cancer has not been elucidated.MethodsIn our study, pancreatic cancer cells were treated with vehicle or HNK, and the invasion and migration capacities were assessed by wound scratch assays and Transwell assays. A cancer cell-dorsal root ganglion coculture model was established to evaluate the effect of HNK on the PNI of pancreatic cancer. Western blotting was used to detect markers of EMT and neurotrophic factors in pancreatic tissue. Recombinant TGF-β1 was used to activate SMAD2/3 to verify the effect of HNK on SMAD2/3 and neurotrophic factors. The subcutaneous tumor model and the sciatic nerve invasion model, which were established in transgenic engineered mice harboring spontaneous pancreatic cancer, were used to investigate the mechanism by which HNK inhibits EMT and PNI in vivo.ResultsWe found that HNK can inhibit the invasion and migration of pancreatic cancer cells. More importantly, HNK can inhibit the PNI of pancreatic cancer. The HNK-mediated suppression of pancreatic cancer PNI was partially mediated by inhibition of SMAD2/3 phosphorylation. In addition, the inhibitory effect of HNK on PNI can be reversed by activating SMAD2/3. In vivo, we found that HNK can suppress EMT in pancreatic cancer. HNK can also inhibit cancer cell migration along the nerve, reduce the damage to the sciatic nerve caused by tumor cells and protect the function of the sciatic nerve.ConclusionOur results demonstrate that HNK can inhibit the invasion, migration, and PNI of pancreatic cancer by blocking SMAD2/3 phosphorylation, and we conclude that HNK may be a new strategy for suppressing PNI in pancreatic cancer.

Background: Long non-coding RNAs (lncRNAs) are involved in regulation of immune response and could serve as biomarkers for tumors. Methods: WGCNA were used to construct an immune-related gene interaction network and elucidated possible functions of the lncRNAs by gene enrichment analyses. 6 lncRNAs were selected and used to construct an immune-related lncRNAs risk score (ILRS) classifier. Results: Patients with high and low ILRS showed significant differences in microenvironment and immune cell infiltration type. Furthermore, enrichment analyses showed that these lncRNAs regulated immune-related pathways. Finally, four clusters derived from LUAD patients showed a significant correlation with overall survival of patients. Conclusions: This work provide new insights for subsequent development of clinical strategies against the disease.

A novel method on fetal electrocardiogram (FECG) extraction utilizing LightGBM combined with Extended Kalman Filter (EKF) was proposed. Firstly, the nonlinear transform between maternal electrocardiogram (MECG) and MECG component in the abdominal signal was estimated using LightGBM. Then the optimal estimation of MECG component was obtained by MECG undergoing the estimated nonlinear transform. And noisy FECG was extracted by suppressing the estimated MECG component. At last, the FECG denoising was performed by use of EKF. The clinical data are adopted to validate the proposed FECG extraction method. The experimental results show that the proposed FECG extraction method is better than other conventional methods both on visual results and objective assessment.

Among the efforts to improve the performances of microlasers, optimization of the gain properties and cavity parameters of these lasers has attracted significant attention recently. Distributed feedback lasers, as one of the most promising candidate technologies for electrically pumped microlasers, can be combined with dual-gratings. This combination provides additional freedom for the design of the laser cavity. Here, a holographic dual-grating is designed to improve the distributed feedback laser performance. The holographic dual-grating laser consists of a colloidal quantum dot film with two parallel gratings, comprising first-order (210 nm) and second-order (420 nm) gratings that can be fabricated easily using a combination of spin coating and interference lithography. The feedback and the output from the cavity are controlled using the first-order grating and the second-order grating, respectively. Through careful design and analysis of the dual-grating, a balance is achieved between the feedback and the cavity output such that the lasing threshold based on the dual-grating is nearly half the threshold of conventional distributed feedback lasers. Additionally, the holographic dual-grating laser shows a high level of stability because of the high stability of the colloidal quantum dots against photobleaching.

Autoimmune diseases are a worldwide health problem with growing rates of morbidity, and are characterized by breakdown and dysregulation of the immune system. Although their etiology and pathogenesis remain unclear, the application of dietary supplements is gradually increasing in patients with autoimmune diseases, mainly due to their positive effects, relatively safety, and low cost. Quercetin is a natural flavonoid that is widely present in fruits, herbs, and vegetables. It has been shown to have a wide range of beneficial effects and biological activities, including anti-inflammation, anti-oxidation, and neuroprotection. In several recent studies quercetin has reportedly attenuated rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, and systemic lupus erythematosus in humans or animal models. This review summarizes the evidence for the pharmacological application of quercetin for autoimmune diseases, which supports the view that quercetin may be useful for their prevention and treatment.