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OBJECTIVE To investigate the effectiveness of a circulating tumor cell (CTC)-based classifier in stratifying stage IB lung adenocarcinoma (LUAD). SUMMARY BACKGROUND DATA Stage IB LUADs have an approximately 70% 5-year survival rate. The clinical application of adjuvant chemotherapy (ACT) is controversial due to inconsistent results in a series of trials and few useful guide biomarkers. Thus, there is a pressing need for robust biomarkers to stratify stage IB patients to define which group would most likely benefit from ACT. METHODS 212 stage IB LUAD patients were enrolled and were divided into three independent cohorts. The aptamer-modified NanoVelcro system was used to enrich the CTCs. RESULTS A cutoff of < 4 or ≥ 4 CTCs as the optimal prognostic threshold for stage IB LUAD was generated to stratify the patients in a 70-patient cohort into low-risk and high-risk groups. Patients with ≥ 4 CTCs in the training cohort had shorter progression-free survival (PFS, P < 0.0001) and overall survival (OS, P < 0.0001) than patients with < 4 CTCs. CTC number remained the strongest predictor of PFS and OS even in a multivariate analysis including other clinicopathological parameters. Furthermore, a nomogram based on the CTC count was developed to predict the 3-year and 5-year survival in the training cohort and performed well in the other two validation cohorts (C-index: 0.862, 0.853 and 0.877). CONCLUSION The presence of ≥ 4 CTCs can define a high-risk subgroup, providing a new strategy to make optimal clinical decisions for stage IB LUAD.

Specific patterns of lung ultrasound (LUS) images are used to assess the severity of coronavirus disease 2019 (COVID-19) pneumonia, while such assessment is mainly based on clinicians' qualitative and subjective observations. In this study, we quantitatively analyze the LUS images to assess the severity of COVID-19 pneumonia by characterizing the patterns related to the pleural line (PL) and B-lines (BLs). Twenty-seven patients with COVID-19 pneumonia, including 13 moderate cases, seven severe cases, and seven critical cases, are enrolled. Features related to the PL, including the thickness (TPL) and roughness of the PL (RPL), and the mean (MPLI) and standard deviation (SDPLI) of the PL intensities are extracted from the LUS images. Features related to the BLs, including the number (NBL), accumulated width (AWBL), attenuation coefficient (ACBL), and accumulated intensity (AIBL) of BLs, are also extracted. The correlations of these features with the disease severity are evaluated. The performances of the binary severe/non-severe classification are assessed for each feature and support vector machine (SVM) classifiers with various combinations of features as input. Several features, including the RPL, NBL, AWBL, and AIBL, show significant correlations with disease severity (all ). The classification performance is optimal using the SVM classifier using all the features as input (area under the receiver operating characteristic (ROC) curve = 0.96, sensitivity = 0.93, and specificity = 1). These findings demonstrate that the proposed method may be a promising tool for automatic grading diagnosis and follow-up of patients with COVID-19 pneumonia.

Background. Breast cancer is the most common cancer in women. miR-520b had binding sites with PTEN through the bioinformatics prediction. But few studies have been conducted on miR-520b and PTEN in breast cancer. We aimed to explore the effect of miR-520b and PTEN on breast cancer and the mechanisms involved. Methods. Clinical samples of breast cancer were collected. Bioinformatics analysis was performed to screen the differentially expressed miRNAs. CD4 T cells and CD8 T cells were cocultured with MCF-7 cells in the Transwell system. Moreover, MCF-7 cells and M0 macrophage cocultured cell lines were constructed. qRT-PCR, IF, western blot, flow cytometry, and ELISA were performed to detect related factors expression. Starbase and dual-luciferase reporter assay verified the binding of miR-520b to PTEN. The tumor formation model was established to study miR-520b and PTEN effects in vivo. Results. The differentially expressed miR-520b was screened via miRNAs sequencing and cell verification. miR-520b expression was high, PTEN was low in tumor tissues, T cells and NK cells were inhibited, and macrophages were transformed into M2 type, promoting immune escape. In addition, miR-520b bound to PTEN. Then, splenic CD4 T cells and CD8 T cells were successfully sorted. During CD4 T cell differentiation to Th1 and Treg, Th1 was inhibited, and Treg was activated. We found the polarization of macrophages was related to breast cancer. The proportion of CD206 cells increased and CD68 cells decreased in the miR-520b mimics group compared with the mimic NC group. Compared with the inhibitor NC group, the proportion of CD206 cells decreased, and CD68 cells increased in the miR-520b inhibitor group. In vivo experiments showed that miR-520b inhibitor inhibited tumor growth and promoted PTEN expression. The proportion of CD3, CD4, CD8, NK1.1, CD4+IFNγ, and CD68 cells increased, while FOXP3 and CD206 cells decreased in the miR-520b inhibitor group compared with the inhibitor NC group. However, the proportion of CD3, CD4, CD8, NK1.1, CD4+IFNγ, and CD68 cells decreased, while FOXP3 and CD206 cells increased after the addition of siPTEN. Conclusions. miR-520b inhibited PTEN and aggravated breast tumors. miR-520b inhibitor enhanced CD4 and CD8 cell populations in the tumor immune microenvironment and inhibited tumor growth.

The present study aimed to investigate the associations between the trajectory of blood pressure (BP) change and the risk of subsequent dementia and to explore the differences in age, gender, and hypertension subgroups. We included 10,660 participants aged ≥ 60 years from 1998 to 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Latent growth mixture models were used to estimate BP trajectories. Cox-proportional hazard models were used to analyze the effects of BP trajectories on the risk of dementia. According to the results, stabilized systolic BP (SBP) was found to be associated with a higher risk of dementia compared with normal SBP [adjusted hazard ratio (aHR): 1.62; 95% confidence interval (CI): 1.27-2.07] and elevated SBP (aHR: 2.22; 95% CI: 1.51-3.28) in and only in the subgroups of the oldest-old, women, and subjects without hypertension at baseline. Similarly, stabilized pulse pressure (PP) was associated with a higher risk of dementia compared with normal PP (aHR: 1.52; 95% CI: 1.24-1.88) and elevated PP (aHR: 2.12; 95% CI: 1.48-3.04) in and only in the subgroups of the oldest-old, women, and subjects with hypertension at baseline. These findings suggest that stabilized SBP and PP have predictive significance for the occurrence of dementia in late life, and the factors of age, gender, and late-life hypertension should be considered when estimating the risk of BP decline on dementia.

BACKGROUND Liver cancer is one of the most common malignant tumors, and ranks as the fourth leading cause of cancer death worldwide. Microvascular invasion (MVI) is considered one of the most important factors for recurrence and poor prognosis of liver cancer. Thus, accurately identifying MVI before surgery is of great importance in making treatment strategies and predicting the prognosis of patients with hepatocellular carcinoma (HCC). Radiomics as an emerging field, aims to utilize artificial intelligence software to develop methods that may contribute to cancer diagnosis, treatment improvement and evaluation, and better prediction. AIM To investigate the predictive value of computed tomography radiomics for MVI in solitary HCC ≤ 5 cm. METHODS A total of 185 HCC patients, including 122 MVI negative and 63 MVI positive patients, were retrospectively analyzed. All patients were randomly assigned to the training group (n = 124) and validation group (n = 61). A total of 1351 radiomic features were extracted based on three-dimensional images. The diagnostic performance of the radiomics model was verified in the validation group, and the Delong test was applied to compare the radiomics and MVI-related imaging features (two-trait predictor of venous invasion and radiogenomic invasion). RESULTS A total of ten radiomics features were finally obtained after screening 1531 features. According to the weighting coefficient that corresponded to the features, the radiomics score (RS) calculation formula was obtained, and the RS score of each patient was calculated. The radiomics model exhibited a better correction and identification ability in the training and validation groups [area under the curve: 0.72 (95% confidence interval: 0.58-0.86) and 0.74 (95% confidence interval: 0.66-0.83), respectively]. Its prediction performance was significantly higher than that of the image features (P < 0.05). CONCLUSION Computed tomography radiomics has certain predictive value for MVI in solitary HCC ≤ 5 cm, and the predictive ability is higher than that of image features.

Vectorial optical fields (VOFs) exhibiting arbitrarily designed wavefronts and polarization distributions are highly desired in photonics. However, current methods to generate them either require complicated setups or exhibit limited functionalities, which is unfavorable for integration-optics applications. Here, we propose a generic approach to efficiently generate arbitrary VOFs based on metasurfaces exhibiting full-matrix yet inhomogeneous Jones-matrix distributions. We illustrate our strategy with analytical calculations on a model system and an experimental demonstration of a meta-device that can simultaneously deflect light and manipulate its polarization. Based on these benchmark results, we next experimentally demonstrate the generation of a far-field VOF exhibiting both a vortex wavefront and an inhomogeneous polarization distribution. Finally, we design/fabricate a meta-device and experimentally demonstrate that it can generate a complex near-field VOF—a cylindrically polarized surface plasmon wave possessing orbital angular momentum—with an efficiency of ~34%. Our results establish an efficient and ultracompact platform for generating arbitrary predesigned VOFs in both the near- and far-fields, which may find many applications in optical manipulation and communications.

As the ageing population increases, it is essential to manage human resources with residual life prediction, especially for the ageing population. Thus, this study aims to predict residual life using the available information of health statuses, such as the performances in activities of daily living (ADL) and memory. In this study, the principal components of ADL and memory information are extracted for prediction. The relationship between the principal components and residual life is established based on the concept of the proportional residual, which states that the residual life may be proportional to the changes in ADL and memory performance. A recursive model for residual life prediction is formulated and fitted for the Chinese Health and Nutrition Survey data. Finally, a goodness-of-fit test is conducted, and an example case is presented. The results show that the fitted model in this study is more accurate and precise than the original, unfitted model to estimate the residual life of human beings. This study is advantageous over existing studies in two aspects: (1) the model is formulated using a recursive method based on stochastic filtering; (2) the data include both physical status and mental status.

Aim: The objective of the study was to investigate the evaluation indices (diagnostic test accuracy and agreement) of 15 combinations of ultrawide field scanning laser ophthalmoscopy (UWF SLO) images in myopic retinal changes (MRC) screening to determine the combination of imaging that yields the highest evaluation indices in screening MRC. Methods: This is a retrospective study of UWF SLO images obtained from myopes and were analyzed by 2 retinal specialists independently. Five field UWF SLO images that included the posterior (B), superior (S), inferior (I), nasal (N), and temporal (T) regions were obtained for analysis and its results used as a reference standard. The evaluation indices of different combinations comprising 1 to 4 fields of the retina were compared to determine the abilities of each combination screens for MRC. Results: UWF SLO images obtained from 823 myopic patients (1,646 eyes) were included for the study. Sensitivities ranged from 50.0 to 98.9% (95% confidence interval (CI), 43.8–99.7%); the combinations of B + S + I (97.3%; 95% CI, 94.4–98.8%), B + T + S + I (98.5%; 95% CI, 95.9–99.5%), and B + S + N + I (98.9%; 95% CI, 96.4–99.7%) ranked highest. Furthermore, the combinations of B + S + I, B + T + S + I, and B + S + N + I also revealed the highest accuracy (97.7%; 95% CI, 95.1–100.0, 98.6; 95% CI, 96.7–100.0, 98.8; 95% CI, 96.9–100.0%) and agreement (kappa = 0.968, 0.980, and 0.980). For the various combinations, specificities were all higher than 99.5% (95% CI, 99.3–100.0%). Conclusions: In our study, screening combinations of B + S + I, B + T + S + I, and B + S + N + I stand out with high-performing optimal evaluation indices. However, when time is limited, B + S + I may be more applicable in primary screening of MRC.

Background A number of studies have reported the association between dietary patterns and the risk of chronic kidney disease (CKD), however a consistent perspective hasn’t been established to date. Herein, we conducted this systematic review and meta-analysis of observational studies to assess the association between dietary patterns and CKD. Methods MEDLINE, EBSCO and references from eligible studies were searched for relevant articles published up to 9 May 2020 that examined the association of common dietary patterns and CKD. The heterogeneity among studies was assessed by Cochran’s Q test and I2 methods. Results Seventeen eligible studies, involving 149,958 participants, were included in our systematic review and meta-analysis. The highest compared with the lowest category of healthy dietary pattern was significantly associated with a lower risk of CKD (OR=0.69; CI: 0.57, 0.84; P=0.0001). A higher risk of CKD was shown for the highest compared with the lowest categories of Western-type dietary pattern (OR=1.86; CI: 1.21, 2.86; P=0.005). There were evidence of a lower risk of CKD in the highest compared with the lowest categories of light-moderate drinking pattern (OR=0.76; CI: 0.71, 0.81; PP Conclusions The results of this systematic review and meta-analysis show that a healthy dietary pattern and alcohol drinking were associated with lower risk of CKD, whereas a Western-type dietary pattern was associated with higher risk of CKD.

Airy beams exhibit intriguing properties such as nonspreading, self-bending, and self-healing and have attracted considerable recent interest because of their many potential applications in photonics, such as to beam focusing, light-sheet microscopy, and biomedical imaging. However, previous approaches to generate Airy beams using photonic structures have suffered from severe chromatic problems arising from strong frequency dispersion of the scatterers. Here, we design and fabricate a metasurface composed of silicon posts for the frequency range 0.4–0.8 THz in transmission mode, and we experimentally demonstrate achromatic Airy beams exhibiting autofocusing properties. We further show numerically that a generated achromatic Airy-beam-based metalens exhibits self-healing properties that are immune to scattering by particles and that it also possesses a larger depth of focus than a traditional metalens. Our results pave the way to the realization of flat photonic devices for applications to noninvasive biomedical imaging and light-sheet microscopy, and we provide a numerical demonstration of a device protocol.

BACKGROUND Multiple studies demonstrate that fluctuating blood glucose level produces greater damage compared with sustained hyperglycemia. Flash glucose monitoring system is an effective method in documenting blood glucose variability, contributing to better glucose management and reduced hypoglycemic event occurrence. AIM To investigate the improvement in glycemic variability (GV), blood glucose level, and metabolic indexes of patients with type 2 diabetes mellitus after combined treatment of exenatide once weekly (EXQW) and metformin. METHODS Twenty-five patients with type 2 diabetes mellitus suffering from poor blood glucose control under metformin treatment were recruited. The recruited patients were prescribed with oral metformin only (maintaining a dosage of metformin at ≥ 1500 mg/day) for 2 wk (screening period), and then given EXQW (2 mg, subcutaneous injection) for 12 wk (experimental period). The flash glucose monitoring system was used to document blood glucose values during the screening period and the last 2 wk of the experimental period. RESULTS Four patients were excluded for various reasons, yielding a total of 21 patients, including 17 males and 4 females, with an average age of 48.8 years, who completed this study. The estimated glycated hemoglobin, mean blood glucose, fasting and postprandial blood glucose levels, and percentage of blood glucose above 7.8 mmol/L decreased compared to those at baseline (P = 0.003, 0.003, 0.008, 0.010, 0.014, 0.017, and 0.005, respectively), while the percentage of blood glucose between 3.9 and 7.8 mmol/L significantly increased (P = 0.005). Parameters of GV including standard deviation of blood glucose, mean amplitude of glycemic excursions, mean of daily difference, area under the curve difference between percentiles 25 and 75, and area under the curve difference between percentiles 10 and 90 were significantly lower compared to that of baseline (P = 0.017, 0.006, 0.000, 0.024, 0.036, respectively). The durations of blood glucose below 3.9 mmol/L during the day and nocturnal periods significantly increased after treatment (P = 0.041 and 0.028, respectively), but there was no significant increase in severe hypoglycemia (< 3.0 mmol/L) compared with that at baseline (P = 0.207). In addition, some metabolic indicators improved after EXQW treatment. CONCLUSION EXQW combined with metformin can effectively improve blood glucose levels, reduce GV, and improve metabolic indicators. However, there is still a risk of nocturnal hypoglycemia, and careful attention should be paid to patients with EXQW treatment.

Objective To assess the accuracy of injury-related hospitalization diagnoses by physicians in China. Methods 62,269 hospitalizations between 2014 and 2016 at a large hospital in Changsha, China were assessed. We considered three types of diagnostic errors: under-reporting, lack of cause specificity, and misclassification across injury causes. Diagnosis and coding of diseases were ascertained by professional coders based on the tenth International Classification of Disease (ICD-10). Chi square tests examined the proportion difference across subgroups of patient demographics, injury intent, and injury cause. Results The 62,269 records included 1011 injury-induced hospitalizations, but physicians’ diagnoses only reported 405 (40%) of the 1011 hospitalizations as injury-related. The proportions of under-reporting, lack of cause specificity, and misclassification errors, respectively, were 50.5%, 7.9% and 1.5%. The proportion of diagnostic errors was relatively similar across patient sex, intent of injury, and cause of injury subgroups, but varied substantially across patient age groups. Conclusion Physicians’ diagnoses frequently omitted injury-induced hospitalizations. Such errors will impact injury research and policy-making when they are undetected and uncorrected.

Coupled photonic systems exhibit intriguing optical responses attracting intensive attention, but available theoretical tools either cannot reveal the underlying physics or are empirical in nature. Here, we derive a rigorous theoretical framework from first principles (i.e., Maxwell’s equations), with all parameters directly computable via wave function integrations, to study coupled photonic systems containing multiple resonators. Benchmark calculations against Mie theory reveal the physical meanings of the parameters defined in our theory and their mutual relations. After testing our theory numerically and experimentally on a realistic plasmonic system, we show how to utilize it to freely tailor the lineshape of a coupled system, involving two plasmonic resonators exhibiting arbitrary radiative losses, particularly how to create a completely “dark” mode with vanishing radiative loss (e.g., a bound state in continuum). All theoretical predictions are quantitatively verified by our experiments at near-infrared frequencies. Our results not only help understand the profound physics in such coupled photonic systems, but also offer a powerful tool for fast designing functional devices to meet diversified application requests., Plasmonics: developing a theory for coupled photonic systems A new theoretical framework can help clarify the underlying physics of coupled photonic systems whose interacting oscillating particles lead to interesting applications in nanolasing and information transport. The theory, developed by Lei Zhou of Fudan University and colleagues in China, is based on foundational Maxwell’s equations and capable to predict the optical lineshapes of arbitrarily coupled systems. The team tested their theory in simulations and an experiment where near-infrared light was shone on specially placed and shaped nanostructures, obtaining the expected spectroscopic results. They also used it to choose a specific coupling between two nanostructures that achieves a bound state in continuum: waves that remain localized despite coexisting with radiating waves that can carry their energy away. The scientists hope the theory can help improve the theoretical understanding of coupled photonic systems, which has so far been lacking.

Spatial differentiator is the key element for edge detection, which is indispensable in image processing, computer vision involving image recognition, image restoration, image compression, and so on. Spatial differentiators based on metasurfaces are simpler and more compact compared with traditional bulky optical analog differentiators. However, most of them still rely on complex optical systems, leading to the degraded compactness and efficiency of the edge detection systems. To further reduce the complexity of the edge detection system, a monolithic metasurface spatial differentiator is demonstrated based on asymmetric photonic spin-orbit interactions. Edge detection can be accomplished via such a monolithic metasurface using the polarization degree. Experimental results show that the designed monolithic spatial differentiator works in a broadband range. Moreover, 2D edge detection is experimentally demonstrated by the proposed monolithic metasurface. The proposed design can be applied at visible and near-infrared wavelengths by proper dielectric materials and designs. We envision this approach may find potential applications in optical analog computing on compact optical platforms.

Background. Since December 2019, novel coronavirus- (SARS-CoV-2) infected pneumonia (COVID-19) has rapidly spread throughout China. This study is aimed at describing the characteristics of COVID-19 patients in Wuhan. Methods. 199 COVID-19 patients were admitted to Wuhan Red Cross Hospital in China from January 24th to March 15th. The cases were divided into diabetic and nondiabetic groups according to the history of taking antidiabetic drugs or by plasma fasting blood glucose level at admission, and the difference between groups were compared. Results. Among 199 COVID-19 patients, 76 were diabetic and 123 were nondiabetic. Compared with nondiabetics, patients with diabetes had an older age, high levels of fasting plasma glucose (FPG), D-dimer, white blood cell, blood urea nitrogen (BUN) and total bilirubin (TBIL), lower levels of lymphocyte, albumin and oxygen saturation (SaO2), and higher mortality (P<0.05). The two groups showed no difference in clinical symptoms. Diabetes, higher level of D-dimer at admission, and lymphocyte count less than 0.6×109/L at admission were associated with increasing odds of death. Antidiabetic drugs were associated with decreasing odds of death. Treatment with low molecular weight heparin was not related to odds of death. Conclusion. The mortality rate of COVID-19 patients with diabetes was significantly higher than those without diabetes. Diabetes, higher level of D-dimer, and lymphocyte count less than 0.6×109/L at admission were the risk factors associated with in-hospital death.

Background This study aims to present the performance data on stent-graft and multilayer bare stents (MBS) joint technique in the treatment of high-risk thoracoabdominal aortic aneurysm (TAAA). Methods From May 2012 to December 2015, 8 selective TAAA cases (ages 46–75 years) ineligible for surgical repair underwent the stent-graft and MBS joint procedure, and were closely followed up for a median of 32 months (range 14–58). Using computed tomography images, the aneurysm size, luminal blood flow diameter, and the covered visceral branches were analyzed. Results Technical success was achieved in all patients (100%, 8/8). Twenty-four visceral branches were covered by MBS in total. There was no complication or death during hospital stay. During follow-up period, no death or complication occurred. Aneurysm shrinkage (maximum diameter decrease ≥5 mm) was observed in 7 patients. No aneurysm expansion was observed. Total aneurysm sac thrombosis was observed in all patients. The majority of covered side branches (23/24) were successfully preserved. No visceral ischemia or bleeding complications was observed during follow-up. Conclusions Total endovascular repair of TAAA using stent-graft and MBS joint technique may be a safe and effective alternative in high surgical risk patients. More approving clinical evidences about the safety and efficacy of this procedure are anticipated.

To evaluate the efficacy and safety of artemether emulsion treating patients with mild-to-moderate acne vulgaris.A total of 73 (randomized 1:1) patients were externally administered either artemether emulsion (1%) or fusidic acid emulsion (5g: 0.1g) twice daily for 12 weeks. Efficacy and safety evaluations were performed at weeks 0 and 12 by Global acne Grading System (GAGS), the number of acne and papule, as well as the rate of clinical respond.After 12 weeks, patients randomized to the artemether emulsion group received artemether emulsion had significantly lower GAGS scores (5.08 ± 1.99 versus 13.75 ± 4.87,Artemether emulsion had better effect in improving mild-to-moderate AV compared to fusidic acid emulsion with barely AEs.

Metamaterial-based electromagnetic absorbers have attracted much attention recently, but most previous realizations suffer from issues of narrow bandwidth, time-consuming and high-cost fabrication methods, and/or fixed functionalities, and so are unfavorable for practical applications. Here, we demonstrate experimentally a large-scale, broadband, polarization-independent, and tunable metamaterial absorber, which works for both visible and near-infrared light. A lithography-free and low-cost method was utilized to fabricate a centimeter-sized metamaterial sample in a metal-insulator-metal (MIM) configuration with nano-scale precision, in which a phase-change material, Ge2Sb2Te5 (GST), was adopted as the insulating spacer of the MIM structure. With two different resonance mechanisms working together, the proposed device was shown to exhibit high absorptivity (>80%) within a broad wavelength band (480-1020 nm). By thermally tuning the phase state of the GST layer, we can dramatically enlarge the working bandwidth of the metamaterial absorber by shifting one absorption peak by about 470 nm. These findings may stimulate many potential applications in, for example, solar cells, energy harvesting, smart sensing/imaging, and color printing.

Background and aims: there remains a need to develop a non-invasive, accurate and easy-to-use tool to identify patients with non-alcoholic steatohepatitis (NASH). Successful clinical and preclinical applications demonstrate the ability of quantitative ultrasound (QUS) techniques to improve medical diagnostics. We aimed to develop and validate a diagnostic tool, based on QUS analysis, for identifying NASH.Methods: a total of 259 Chinese individuals with biopsy-proven non-alcoholic fatty liver disease (NAFLD) were enrolled in the study. The histological spectrum of NAFLD was classified according to the NASH clinical research network scoring system. Radiofrequency (RF) data, raw data of iLivTouch, was acquired for further QUS analysis. The least absolute shrinkage and selection operator (LASSO) method was used to select the most useful predictive features.Results: eighteen candidate RF parameters were reduced to two significant parameters by shrinking the regression coefficients with the LASSO method. We built a novel QUS score based on these two parameters, and this QUS score showed good discriminatory capacity and calibration for identifying NASH both in the training set (area under the ROC curve [AUROC]: 0.798, 95% confidence interval [CI] 0.731-0.865; Hosmer-Lemeshow test, P = .755) and in the validation set (AUROC: 0.816, 95% CI 0.725-0.906; Hosmer-Lemeshow test, P = .397). Subgroup analysis showed that the QUS score performed well in different subgroups.Conclusions: the QUS score, which was developed from QUS, provides a novel, non-invasive and practical way for identifying NASH.

Acute lung injury (ALI) is a common life-threatening lung disease, which is mostly associated with severe inflammatory responses and oxidative stress. Tanreqing injection (TRQ), a Chinese patent medicine, is clinically used for respiratory-related diseases. However, the effects and action mechanism of TRQ on ALI are still unclear. Recently, STING as a cytoplasmic DNA sensor has been found to be related to the progress of ALI. Here, we showed that TRQ significantly inhibited LPS-induced lung histological change, lung edema, and inflammatory cell infiltration. Moreover, TRQ markedly reduced inflammatory mediators release (TNF-α, IL-6, IL-1β, and IFN-β). Furthermore, TRQ also alleviated oxidative stress, manifested by increased SOD and GSH activities and decreased 4-HNE, MDA, LDH, and ROS activities. In addition, we further found that TRQ significantly prevented cGAS, STING, P-TBK, P-P65, P-IRF3, and P-IκBα expression in ALI mice. And we also confirmed that TRQ could inhibit mtDNA release and suppress signaling pathway mediated by STING in vitro. Importantly, the addition of STING agonist DMXAA dramatically abolished the protective effects of TRQ. Taken together, this study indicated that TRQ alleviated LPS-induced ALI and inhibited inflammatory responses and oxidative stress through STING signaling pathway.

Background Metabolic abnormalities in patients with gastric adenocarcinoma lead to drug resistance and poor prognosis. Therefore, this study aimed to explore biomarkers that can predict the prognostic risk of gastric adenocarcinoma by analyzing drug metabolism‐related genes. Methods The RNA‐seq and clinical information on gastric adenocarcinoma were downloaded from the UCSC and gene expression omnibus databases. Univariate and least absolute shrinkage and selection operator regression analyses were used to identify the prognostic gene signature of gastric adenocarcinoma. The relationships between gastric adenocarcinoma prognostic risk and tumor microenvironment were assessed using CIBERSORT, EPIC, QUANTISEQ, MCPCounter, xCell, and TIMER algorithms. The potential drugs that could target the gene signatures were predicted in WebGestalt, and molecular docking analysis verified their binding stabilities. Results Combined with clinical information, an eight‐gene signature, including GPX3, ABCA1, NNMT, NOS3, SLCO4A1, ADH4, DHRS7, and TAP1, was identified from the drug metabolism‐related gene set. Based on their expressions, risk scores were calculated, and patients were divided into high‐ and low‐risk groups, which had significant differences in survival status and immune infiltrations. Risk group was also identified as an independent prognostic factor of gastric adenocarcinoma, and the established prognostic and nomogram models exhibited excellent capacities for predicting prognosis. Finally, miconazole and niacin were predicted as potential therapeutic drugs for gastric adenocarcinoma that bond stably with NOS3 and NNMT through hydrogen interactions. Conclusions This study proposed a drug metabolism‐related eight‐gene signature as a potential biomarker to predict the gastric adenocarcinoma prognosis risks., Objective: Metabolic abnormalities in patients with gastric adenocarcinoma (GA) lead to the development of drug resistance and a poor prognosis. Therefore, this study aims to explore biomarkers that can predict the prognostic risk of GA from the perspective of drug metabolism. Methods: RNA‐seq and clinical information of GA were downloaded from UCSC and GEO. The univariate and LASSO regression analyses were used to identify prognostic gene signatures of GA. The relationships between GA prognostic risk and tumor microenvironment were assessed by CIBERSORT, EPIC, QUANTISEQ, MCPCounter, Xcell and TIMER algorithms. The potential drugs of feature genes were predicted in Webgestal and molecular docking analysis was generated to verify their binding stabilities. Results: Combined with clinical information, 8 gene signatures including GPX3, ABCA1, NNMT, NOS3, SLCO4A1, ADH4, DHRS7 and TAP1 were identified from drug‐metabolism‐related gene‐set. Based on their expressions, risk scores were calculated and patients were grouped into high‐risk and low‐risk. Survival analyses showed that patients in the high‐risk group had poorer outcomes. The risk group was also detected as an independent prognostic factor of GA, and the established prognostic and nomogram models both showed excellent capacities in predicting GA prognosis. Furthermore, we also revealed significant differences in immune cell infiltrations between risk groups. Finally, Miconazole and Niacin were predicted as potential therapeutic drugs of GA that bond stably with NOS3 and NNMT through hydrogen interactions. Conclusions: This study proposed 8 gene signatures related with drug metabolism as potential biomarkers to predict the prognostic risk of patients with GA.

Background Untreated maternal postpartum depression has consequences for infant weight, which may vary with infant growth time and postpartum depression duration. Dynamic assessment of the association between maternal postpartum depression and infant weight growth is crucial for early detection of the suspicious abnormal effects of maternal postpartum depression on infant weight growth and taking corresponding intervention measures. But, none of published studies continuously and dynamically evaluated these effect changes on infant weight growth. This study was aimed to evaluate the dynamic effects of maternal postpartum depression on infant weight growth at a prospective birth cohort. Methods 960 mother-infant pairs between 2015 to 2018 in Changsha, China were followed up at ages of 1, 3, 6, 8, and 12 months. Data were obtained through household surveys. Depression of mothers was assessed at 1 month postpartum. Linear mixed models and generalized estimating equation models were used to test the connection and its changes between maternal postpartum depression and infant weight growth at five different periods of 1–12 months. Results 8.0% of mothers reported postpartum depression. Adjusted linear mixed models showed a negative association between maternal depression at 1-month postpartum and infant weight at 1 month, 1–3 months, 1–6 months, 1–8 months, and 1–12 months, in which infants with depressed mothers were the lighter weight of 0.14kg (95%CI:0.02, 0.25), 0.13kg (95%CI:0.02, 0.24), 0.13kg (95%CI:0.02, 0.24), 0.13kg (95%CI:0.02, 0.24), and 0.16kg (95%CI:0.04, 0.27) relative to not depressed respectively. Generalized estimating equation models showed a positive association between maternal depression at 1-month postpartum and infant underweight at 1 month and 1–3 months, in which infants of maternal depression had higher risk ratio of underweight in 3.19 (95%CI:1.38, 7.34) and 3.19(95%CI:1.32, 7.70) compared to those mothers were not depressed accordingly. Conclusions Maternal postpartum depression was continuously associated with a lighter weight of ifants from 1 to 12 months and higher risk of being underweight in infants from 1 to 3 months. It seems important to put early prevention, screening, diagnosis, and treatment of maternal depression into practice as soon as possible to avoid adverse consequences.

Diabetes mellitus can lead to diabetic kidney disease (DKD), which is a kind of chronic kidney diseases (CKDs). Compared with other renal diseases, DKD deteriorates more rapidly to end-stage renal disease, and the 5-year renal survival rate is about 61%. Therefore, monitoring of progression of DKD is vital for improving the survival rate and quality of life for diabetic patients. However, non-invasive and quantitative diagnostic tools are still lacking currently. It has been reported that the occurrence and development of DKD would lead to the changes of renal microvasculature and perfusion. Recently, ultrasound localization microscopy (ULM) has been demonstrated to break the diffraction limit of ultrasound and obtain the microvasculature morphology and blood flow speed map by localizing and tracking the flowing microbubbles. In this study, ULM was performed on kidneys of DKD rat models and control rats to investigate its feasibility in assessment of DKD in vivo. In addition, conventional clinical inspections (urine and serum tests) and conventional ultrasound imaging (Doppler and contrast-enhanced ultrasound imaging) were performed to verify the successful development of diabetes for DKD group. Statistical differences are observed between the clinical inspections-related parameters (urine and serum), CEUS-related parameters [time to peak (TTP) and area under curve (AUC)], and ULM-related parameter (mean blood flow speed of interlobular arterioles). In conclusion, this study shows the potential of ULM in the assessment of DKD in vivo.

This paper proposes a quantitative analysis method for lung ultrasound (LUS) images to evaluate the severity of COVID-19 pneumonia. Specifically, biomarkers related to the pleural line, including the thickness of pleural line (TPL) and the roughness of pleural line (RPL), and biomarkers related to the B-lines, including the accumulated width of B-lines (AWBL) and the acoustic coefficient of B-lines (ACBL), are extracted from LUS images to characterize the image patterns associated with the disease severity. 27 patients of COVID-19 pneumonia are enrolled in this study, including 13 moderate cases, 7 severe cases, and 7 critical cases. Patients of moderate cases are regarded as non-severe patients, and patients of severe and critical cases are regarded as non-severe patients. Biomarkers among different cases are compared, and the performances in the binary diagnosis of severe and non-severe patients are assessed using a support vector machine (SVM) classifier with all the biomarkers as the input. The classification performance is optimal using the SVM classifier (area under the receiver operating characteristics curve = 0.93, sensitivity = 0.93, specificity = 0.85). The proposed method may be a promising tool for the automatic grading and follow-up of patients with COVID-19 pneumonia.

Spinal cord tumor (SCT) is a critical disease with low incidence but high disability rate and morbidity. Surgical resection is a primary and effective treatment of SCT, but intraoperative detection of SCT highly depends on the clinical experience. Pathological studies show that microvascular proliferation (MP) occurs in some kinds of SCTs but it cannot be observed by conventional medical imaging modalities such as magnetic resonance imaging (MRI). Ultrasound microvascular imaging (UMI) has been developed to map tumor-related microvasculature. In this study, we introduced UMI into the visualization of microvessels in two types of human SCTs (i.e., ependymoma and schwannoma) and their corresponding normal tissues. For quantitative evaluation, microveseel density (MD) and power Doppler density (PDD) in the tumor region and normal tissue region of the two SCTs were calculated, respectively. Results show that the MDs and PDDs in the tumors are significantly higher than those in the normal tissues. Qualitative and quantitative results demonstrate that MP occurs in the tumor region compared with normal tissue, which is consistent with the results of immunohistochemical staining examination. In conclusion, this study demonstrate the feasibility of UMI in the intraoperative detection of human SCT.

The image reconstruction process in medical imaging can be treated as solving an inverse problem. The inverse problem is usually solved using time-consuming iterative algorithms with sparsity or other constraints. Recently, deep neural network (DNN)-based methods have been developed to accelerate the inverse-problem-solving process. However, these methods typically adopt supervised learning scheme, which requires ground truths, or labels of the solutions, for training. In many applications, it would be challenging or even impossible to obtain the ground truth, such as the tissue reflectivity function in ultrasound beamforming. In this study, a general framework based on self-supervised learning (SSL) scheme is proposed to train a DNN to solve the inverse problems. In this way, the measurements can be used as both the inputs and the labels during the training of DNN. The proposed SSL method is applied to four typical linear inverse problems for validation, i.e., plane wave ultrasound and photoacoustic image reconstructions, compressed sensing-based synthetic transmit aperture dataset recovery and deconvolution in ultrasound localization microscopy. Results show that, using the proposed framework, the trained DNN can achieve improved reconstruction accuracy with reduced computational time, compared with conventional methods., Comment: to be published in Proceedings of IEEE IUS 2021

Ultrasound microvascular imaging (UMI) has been developed to visualize microvasculature to reveal the conditions and pathologies of diseases. The key of UMI is extraction of blood flow signals by suppressing tissue clutters and background noise. However, the suppression of noise is unsatisfactory when we only use common clutter filtering methods without additional processing of denoising. Spatiotemporal non-local means (stNLM) filtering method has been used to effectively reject noise in ultrasound localization microscopy. In this study, we implemented stNLM in UMI to better suppress the background noise for improved microvascular visualization using the spatiotemporal discontinuity of noise. For comparison, the proposed stNLM-based UMI method was compared with three methods, i.e., method without NLM filtering (conventional UMI), NLM filtering on power Doppler image (PDI), and NLM filtering in the spatial domain (sNLM) of filtered blood flow RF data. The denoising superiority of the proposed method was validated in a human spinal cord tumor in vivo. Quantitative indexes including contrast-to-noise ratio (CNR) and peak-to-side level (PSL) were calculated. Results show that stNLM-based UMI can achieve nearly 15 dB improvement in CNR and nearly 30 dB improvement in PSL compared with conventional UMI. The proposed stNLM-based UMI has the potential of achieving high-quality UMI.

Studies have shown that the perivascular space (PVS) plays an important role in regulation of cerebrospinal fluid (CSF) flow and elimination of endogenous metabolites, and the fluid dynamics of the PVS is related to certain physiological and pathological conditions. Benefiting from high-frame-rate plane wave imaging and advanced clutter filters, ultrafast power Doppler imaging (uPDI) has been developed to visualize microvessels which are invisible using conventional power Doppler imaging. In this study, we explore the feasibility of uPDI in the detection of PVS by injecting microbubbles (MBs) into the cisterna magna of rats and acquiring the ultrasound data in the sections of cerebral ventricle and common carotid artery. Results showed that aggregation of MBs was observed in the cerebral ventricle, which proved that there is a pathway for the CSF flow between the cisterna magna and the cerebral ventricle. After unilateral ligation of the common carotid artery, region of the PVS became larger than before MBs injection and ligation. It suggests that unilateral ligation of the common carotid artery causes unilateral cerebral ischemia, which leads to influx of CSF with MBs into the PVS and further causes expansion of PVS. In conclusion, this study demonstrates that uPDI can be used in the detection of PVS and has the potential to monitor the hemodynamic of PVS in the pathological conditions.

Dynamically controlling terahertz (THz) wavefronts in a designable fashion is highly desired in practice. However, available methods working at microwave frequencies do not work well in the THz regime due to lacking suitable tunable elements with submicrometer sizes. Here, instead of locally controlling individual meta-atoms in a THz metasurface, we show that rotating different layers (each exhibiting a particular phase profile) in a cascaded metadevice at different speeds can dynamically change the effective Jones-matrix property of the whole device, thus enabling extraordinary manipulations on the wavefront and polarization characteristics of a THz beam impinging on the device. After illustrating our strategy based on model calculations, we experimentally demonstrate two proof-of-concept metadevices, each consisting of two carefully designed all-silicon transmissive metasurfaces exhibiting different phase profiles. Rotating two metasurfaces inside the fabricated devices at different speeds, we experimentally demonstrate that the first metadevice can efficiently redirect a normally incident THz beam to scan over a wide solid-angle range, while the second one can dynamically manipulate both the wavefront and polarization of a THz beam. Our results pave the way to achieving dynamic control of THz beams, which is useful in many applications, such as THz radar, and bio- and chemical sensing and imaging.

Since the outbreak of novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19), numerous medical staff are fighting on the frontline. However, the possibility of occult infection in medical staff is ignored in many recent studies. Herein, we collected data in a COVID-19 designated hospital from January 22, 2020 to March 10, 2020. A total of 33 medical staff had at least one nucleic acid test of throat swab, immunoglobulin G (IgG) or IgM serum antibody test, and chest computed tomography (CT), were enrolled. Finally, we identified 25 cases (75.8%) were isolated for hospitalized treatment after positive virus detection. In addition, 4 cases who were all negative for nucleic acid test detection with no clinical symptoms, and none of their chest CT were abnormal. However, the results of serum IgG or IgM antibody test in these 4 cases were positive, suggesting the presence of occult infection. In conclusion, data from our single center indicated that SARS-CoV-2 had a high medical infection rate (29/33 = 87.9%) and might have a potential risk of occult infection.

Objective: To assess the efficacy and safety of artemether emulsion in patients with papulopustular rosacea.Methods: A total of 130 (randomized 1:1) were externally administered either artemether e...

Previous studies have shown that toxic metal exposure can have adverse effects on the nervous system of children, but the toxicology of metal co-exposure on neurodevelopment remains to be clarified. Brain derived neurotrophic factor (BDNF) plays an important role in nervous system development, but the possible effects of metal co-exposure on the serum BDNF concentrations of children remain unknown. A total of 561 children living in Taizhou City, China were recruited to participate in our cross-sectional multicenter survey. We measured their blood Pb, Hg, Al and Mn levels and serum BDNF concentrations as well as determined their associations in the total and within sex subgroups. The geometric means of the blood Pb, Hg, Al and Mn levels in all the participants were 67.18 μg/L, 1.01 μg/L, 52.03 μg/L and 18.26 μg/L, respectively. The serum BDNF concentration in children was 19.45 ng/mL. After adjusting for confounders, the blood Pb levels were significantly negatively associated with the serum BDNF concentrations in all the subjects and boys but not in girls. In addition, a significantly negative interaction between blood Pb and blood Hg and a positive interaction between blood Pb and blood Al on serum BDNF concentrations were also observed in boys but not in girls. Our findings highlight the toxic effects of metal co-exposure on serum BDNF levels in pre-school children and indicate that these effects might differ by gender, which suggest that special attention should be paid to the sex-specific effects of metal exposure.

The unrestricted control of circularly polarized (CP) terahertz (THz) waves is important in science and applications, but conventional THz devices suffer from issues of bulky size and low efficiency. Although Pancharatnam–Berry (PB) metasurfaces have shown strong capabilities to control CP waves, transmission-mode PB devices realized in the THz regime are less efficient, limiting their applications in practice. Here, based on Jones matrix analysis, we design a tri-layer structure (thickness of ~λ/5) and experimentally demonstrate that the structure can serve as a highly efficient transmissive meta-atom (relative efficiency of ~90%) to build PB metadevices for manipulating CP THz waves. Two ultrathin THz metadevices are fabricated and experimentally characterized with a z-scan THz imaging system. The first device can realize a photonic spin Hall effect with an experimentally demonstrated relative efficiency of ~90%, whereas the second device can generate a high-quality background-free CP Bessel beam with measured longitudinal and transverse field patterns that exhibit the nondiffracting characteristics of a Bessel beam. All the experimental results are in excellent agreement with full-wave simulations. Our results pave the way to freely manipulate CP THz beams, laying a solid basis for future applications such as biomolecular control and THz signal transportation., Metasurfaces: efficient terahertz control Ultrathin metasurfaces that can efficiently manipulate circularly polarized terahertz waves in transmission rather reflection have been demonstrated by scientists in China. The devices were fabricated by Min Jia and colleagues from Fudan University and Capital Normal University. The tri-layer structures operate at frequencies of around 0.6 THz and suit future on-chip applications for terahertz photonics. Various designs were tested resulting in a circularly polarized terahertz Bessel beam generator and a device exhibiting the photonic spin Hall effect. The metasurfaces consist of a periodic array of meta-atoms, each composed of three thin layers of metal in a U-shape that are separated and surrounded by polyimide. Changing the angular orientation of the meta-atoms allows different phase gradients to be programmed into the metasurfaces bringing the desired functionality.

A large number of EGFR mutant non-small cell lung cancer patients primordially benefit from first-line treatment with first-generation EGFR-tyrosine kinase inhibitors (TKIs), such as gefitinib and erlotinib. However, multiple acquired resistance mechanisms have been described that limit the clinical efficacy of first-generation EGFR-TKIs. Herein, we report a rare case of lung adenocarcinoma harboring an EGFR exon 19-deletion mutation before the administration of target therapy. This patient acquired resistance to first-generation EGFR-TKIs through small cell lung cancer (SCLC) transformation accompanied by the T790M mutation. Unexpectedly, this SCLC patient maintained a sensitive response to the third-generation EGFR-TKI osimertinib. This special case may indicate that osimertinib represents an effective target drug for SCLC patients who harbor an EGFR T790M mutation.

In the era of social network big data, marketing will indeed face many opportunities and opportunities, which will maximize the business and sales interests of enterprises, but at the same time, it will also face many challenges and risks, such as information security risks. To eliminate these hidden dangers, seize the opportunity and turn the challenge into opportunity, so that enterprises can effectively use social network big data, and make its value in marketing effectively play. Based on the analysis of the current situation of social network big data in marketing, this paper puts forward the research on the advantages of social network big data in marketing. Through the investigation and analysis of 180 marketing personnel and consumers, as well as the comparative analysis of data after using social network big data in marketing, this paper discusses and analyzes the results, and puts forward the advantages and Strategies of social network big data in marketing, which provides guarantee for the development of marketing. The research in this paper is of great significance for the further integration and development of the two, to find problems and to put forward constructive suggestions on the application strategy of social network big data in marketing.

To observe the correlation of osteoprotegerin, soluble receptor activator of nuclear factor-κB ligand (sRANKL), inflammatory factors and epicardial adipose tissue volume (EATV) with the severity of coronary heart disease (CHD).We studied 390 patients who were admitted to the Department of Cardiology of our hospital because of chest pain and underwent coronary angiography (CAG) from August 2018 to December 2019. According to CAG, 209 patients had non-CHD and 181 patients had CHD. Demographic data, biochemical indicators including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), lipoprotein a (Lp(a)), apolipoprotein B (apoB), apolipoprotein AI (apoAI), creatine kinase isoenzyme (CK-MB), osteoprotegerin, sRANKL, inflammatory factors (hs-CRP, FIB and IL-6), and EATV were collected.The number of males, age, diabetes and hypertension in the CHD group was higher than those in the non-CHD group (P .05). LDL-C, TC and apoB in the two groups were not significantly different (P .05); HDL-C and apoAI in the CHD group were lower than those in the non-CHD group, and Lp(a) and CK-MB were higher than those in the control group (P .05). Osteoprotegerin, IL-6, hs-CRP, EATV and FIB in the CHD group were higher than those in the non-CHD group, while sRANKL was lower than that in the control group (P .05). Pearson correlation analysis showed that osteoprotegerin, sRANKL, inflammatory factors (hs-CRP, FIB and IL-6) and EATV were correlated with the severity of CHD (P .05). Multivariate logistic regression analysis showed that CK-MB, osteoprotegerin, sRANKL, inflammatory factors (hs-CRP, FIB and IL-6) and EATV were risk factors for CHD, while HDL-C, Lp(a), apoAI were protective factors.Osteoprotegerin, sRANKL, inflammatory factors and EATV were positively correlated with the severity of CHD, which had certain value for the diagnosis of CHD.

As a powerful tool for studying molecular dynamics in bioscience, single-molecule fluorescence detection provides dynamical information buried in ensemble experiments. Fluorescence in the near-infrared (NIR) is particularly useful because it offers higher signal-to-noise ratio and increased penetration depth in tissue compared with visible fluorescence. The low quantum yield of most NIR fluorophores, however, makes the detection of single-molecule fluorescence difficult. Here, we use asymmetric plasmonic nano-antenna to enhance the fluorescence intensity of AIEE1000, a typical NIR dye, by a factor up to 405. The asymmetric nano-antenna achieve such an enhancement mainly by increasing the quantum yield (to ~80%) rather than the local field, which degrades the molecules’ photostability. Our coupled-mode-theory analysis reveals that the enhancements stem from resonance-matching between antenna and molecule and, more importantly, from optimizing the coupling between the near- and far-field modes with designer asymmetric structures. Our work provides a universal scheme for engineering single-molecule fluorescence in the near-infrared regime., This work achieves drastic fluorescence enhancement of NIR single-molecule based on asymmetric plasmonic nano-antenna, by fine-tuning the near- and far- field properties of plasmonic mode.

Background To investigate the effect of complete rupture of the posterior cruciate ligament (PCL) on the biomechanics and histology of the medial collateral ligament (MCL). Materials and methods Seventy-two male rabbits were randomly divided into two groups: the ruptured group was treated with complete PCL amputation, while the intact group was only subjected to PCL exposure without amputation. Eighteen rabbits were randomly sacrificed at 8, 16, 24, and 40 weeks after the operation, and their specimens were processed for mechanical tensile testing, nano-indentation experiments, hematoxylin-eosin (HE) staining, and picrosirius-polarization staining. Results There was no significant difference in the length and maximum displacement of the MCL between the ruptured group and the intact group at each time point. The maximum load of the ruptured group was significantly smaller than that of the intact group at 40 W. The elastic modulus and micro-hardness of the ruptured group increased significantly at 24 W and decreased significantly at 40 W. At 16 W and 24 W after PCL rupture, the number of type I collagen fibers and type III collagen fibers in the MCL of the ruptured group was significantly increased compared with that of the intact group. While the type I collagen fibers of the ruptured group were significantly decreased compared with the intact group at 40 W, there was no significant difference in type III collagen fibers between the ruptured group and the intact group. Conclusion PCL rupture has no significant effect on the mechanical and histological properties of MCL in a short period of time under physiological loading, but the histological and mechanical properties of MCL decrease with time.

BackgroundIncome level is an important factor that influences the occurrence of gestational diabetes. Thus, this systematic review and network meta-analysis aimed at evaluating the correlation between income levels and the prevalence of gestational diabetes. MethodsRelevant published studies were searched in Pubmed, Web of Science, Cochrane library, and Ovid from the establishment time of database to January 3, 2020. Finally, 13 eligible clinical studies involving 1,817,801 women were selected from a total of 3776 studies and included in this study. The statistical softwares Revman5.3 and Stata14.0 were used to compare the prevalence of gestational diabetes in five different income levels; low, lower middle, medium, upper middle, and high. ResultsThe incidences of gestational diabetes in people with different economic income levels were: high income

The pathogenesis of type 2 diabetes mellitus (T2DM) is very complicated. The currently well-accepted etiology is the “Ominous Octet” theory proposed by Professor Defronzo. Since presently used drugs for T2DM have limitations and harmful side effects, studies regarding alternative treatments are being conducted. Analyzing the pharmacological mechanism of biomolecules in view of pathogenesis is an effective way to assess new drugs. Sphingosine 1 phosphate (S1P), an endogenous lipid substance in the human body, has attracted increasing attention in the T2DM research field. This article reviews recent study updates of S1P, summarizing its effects on T2DM with respect to pathogenesis, promoting β cell proliferation and inhibiting apoptosis, reducing insulin resistance, protecting the liver and pancreas from lipotoxic damage, improving intestinal incretin effects, lowering basal glucagon levels, etc. With increasing research, S1P may help treat and prevent T2DM in the future.

Aside from well-performed light confinement, practical and scalable plasmonic perfect absorbers also depend on stable material scenario, as well as compact design and convenient fabrication. However, it still remains a challenge to make enclosed (no air exposure), multi-scale plasmonic nanostructure for constructing perfect absorbers. Herein, we report a direct self-organization growth of ultrathin (∼130 nm) multi-scale Ag nanostructures in SiO2 matrix on quartz or plastic substrates via sputtering. Based on the elaborate microstructure design, the cavity-mode excitation, local plasmon resonances and their lightning-rod effects are synergistically activated, yielding a near constant absorptance of over 95% across the 300–1700 nm wavelength even with some reflectance loss from the quartz surface and more than 98% visible absorptance with a simple antireflection treatment. Further, due to the enclosed nanostructures, the wide-angle absorbers present outstanding light-to-heat capability and thermal robustness under concentrated solar illumination. The simple material recipe (Ag, SiO2) and fabrication scheme suggest that our approach is with easy scalability. We anticipate that the proposed concept in this study can facilitate the rapid development of highly efficient ultrathin perfect absorbers.

Spoof surface plasmons (SSPs) play crucial roles in terahertz (THz) near‐field photonics. However, both high‐efficiency excitation and wavefront engineering of SSPs remain great challenges, which hinder their wide applications in practice. Here, a scheme is proposed to simultaneously achieve these two goals efficiently using a single ultracompact device. First, it is shown that a gradient meta‐coupler constructed by high‐efficiency Pancharatnam–Berry (PB) meta‐atoms can convert circularly polarized (CP) THz beams into SSPs with absolute efficiency up to 60%. Encoding a parabolic phase profile into the meta‐coupler based on the PB mechanism, it is demonstrated that the device can covert CP beams into SSPs with focusing or defocusing wavefronts, dictated by the chirality of the incident wave. Finally, two distinct chirality‐dependent phase distributions are encoded into the meta‐coupler design by combining the PB and resonance phase mechanisms, and it is demonstrated that the resulting meta‐device can achieve SSP excitations with chirality‐delinked bifunctional wavefront engineering. THz near‐field experiments are performed to characterize all three devices, in excellent agreement with full‐wave simulations. The results pave the road to realize ultracompact devices integrating different functionalities on near‐field manipulations, which can find many applications (e.g., optical sensing, imaging, on‐chip photonics, etc.) in different frequency domains., High‐efficiency bifunctional manipulations on surface‐plasmon wavefronts are enabled by a single ultracompact meta‐device. Constructed with meta‐atoms possessing both geometric and resonant phases, the meta‐device exhibits distinct phase profiles for impinging lights with different spins, thus generating independent surface‐plasmon profiles. These findings may find many applications in integration photonics, such as coupling on‐chip optical devices and enhancing light–matter interactions.

Compared with conventional delay-and-sum (DAS) beamforming method, sparse regularization (SR) techniques can reconstruct higher quality ultrasound (US) images from plane wave (PW) transmission. However, these methods suffer from long reconstruction time, owing to the high computational complexity inherently associated with its iterative process. In this work, a deep neural network (DNN) is trained to reconstruct plane wave ultrasound (PWUS) images from RF channel data with significantly reduced computational time. To overcome the lack of gold standard of ideal US images, a self-supervised learning scheme is employed to utilize the RF channel data as both the inputs and the labels during the training process. Using simulation data, the proposed method achieves comparable spatial resolution and 3.2-dB higher CNR, compared with the SR method.

Ultrasound localization microscopy (ULM) has been developed in recent years to significantly improve the spatial resolution of ultrasound imaging by localizing the microbubbles (MBs) flowing in microvasculature. Nevertheless, challenges remain in ULM. In our previous work (IEEE Trans. Med. Imaging, 10.1109/TMI.2020.2986781), by using a modified sub-pixel convolutional neural network (CNN), we have implemented ULM with fast data-processing speed, high imaging accuracy, short data-acquisition time, and high flexibility characteristics. However, the signal intensities of MBs are not quantitatively recovered, as similar to many other ULM techniques. To overcome this limitation, in this work, we propose a new deep-learning (DL) method, termed as qULM-DL, to recover the true distributions (positions and intensities) of the MBs in ULM. A series of numerical simulations and in vivo experiment are performed to evaluate the performance of qULM-DL. The results show that qULM-DL can not only super-resolve the complex structures but also quantitatively recover MBs intensities in these structures.

Ultrasound localization microscopy (ULM) enables unprecedented subwavelength spatial resolution by localizing the ultrasound contrast microbubbles (MBs). In conventional ULM methods, low-concentration MB solutions are used to ensure that the MBs are sufficiently sparse to enable localization of individual MB. This leads to a long data-acquisition time (i.e., microbubble-accumulation time) to accumulate enough MBs events using plane wave (PW) imaging. Considering the continuity of the microvessels and redundancy of MB tracks, in this study, we present a method that leverages deep neural network (DNN) to predict microvasculature using significantly reduced data-acquisition time and achieve quality comparable to that obtained using full data-acquisition time. Phantom experiments show that the proposed method significantly improves the density of localized MBs compared with the conventional method. Besides, in vivo experiments demonstrate that the proposed method is capable of reconstructing ULM images using reduced data-acquisition time with small difference, compared with the conventional method.

Spinal cord (SC) is the relay station and reflex center of central nervous system, its function is therefore very important for nerve conduction pathway. Spinal tumor (ST) is the typical disease of SC. In clinic, the standard treatment of ST is resection and a series of sequelae occur with imprecise surgical removal. Therefore, the delineation of the lesion boundaries of ST is very critical in surgery. Magnetic resonance (MR) imaging and intraoperative frozen section biopsy (IFSB) are usually used to assist in determining ST boundaries or boundary type, However, they suffer from severe limitations, such as unclear boundaries of certain types of ST in MR imaging and the inaccuracy of IFSB. Ultrasound localization microscopy (ULM) with contrast microbubbles (MBs) have been developed by several groups and may have potential in determining ST boundaries during surgery. Therefore, we apply ULM to human SC to distinguish pathological tissue from normal tissue in SC. In this study, intramedullary cavernous malformation (ICM), a typical ST, is imaged to demonstrate the feasibility of ULM of SC. Maximum intensity projection (MIP) images of filtered MBs of normal SC and ICM are obtained for comparison. Results indicate that the boundaries of normal SC and ICM in ULM images are more definite than those in MIP images. Quantitatively, the microvessel intensity (MVI) in normal SC is higher than that in ICM, while other indexes, such as direction entropy (DE), mean velocity (MEV), minimum velocity (MinV), and maximum velocity (MaxV), are similar in normal SC and ICM, which suggests the potential of ULM in surgery of SC in terms of distinguishing pathological tissue.