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The power distribution systems fault root cause classification is an important but challenging problem. Traditional classifiers fail to achieve high accuracy and good generalization performance due to data insufficiency. A large volume of unlabeled data is available, which can be utilized to improve classification performance. This paper proposes a novel classifier called Robust Semi-Supervised Prototypical Network (RSSPN) based on Prototypical Network architecture and semi-supervised learning to address this issue. The proposed method can mine information from unlabeled data to improve the generalization ability and classification accuracy. Furthermore, RSSPN adopts the idea of meta-learning to obtain the few-shot learning" ability for identifying new fault classes using very few samples encountered during the operation and update online. Experiments have been conducted on a dataset consisting of 1152 labeled samples belonging to 12 different classes and 10000 unlabeled samples. The accuracy of the proposed method is significantly better than the traditional classifiers.

Background Exact dose-response relationship between body mass index at transplantation and clinical outcomes after kidney transplantation remained unclear, and no specific body mass index threshold and pretransplant weight loss aim were recommended for kidney transplantation candidates among transplant centers. Methods PubMed, Embase, Web of Science, and Cochrane Library were searched for literature published up to December 31, 2019. The two-stage, random effect meta-analysis was performed to estimate the dose-response relationship between body mass index and clinical outcomes after kidney transplantation. Results Ninety-four studies were included for qualitative assessment and 50 for dose-response meta-analyses. There was a U-shaped relationship between graft loss, patient death, and body mass index. Body mass index with the lowest risk of graft loss was 25.2 kg/m2, and preferred body mass index range was 22–28 kg/m2. Referring to a body mass index of 22 kg/m2, the risk of graft loss was 1.088, 0.981, 1.003, and 1.685 for a body mass index of 18, 24, 28, and 40 kg/m2, respectively. Body mass index with the lowest risk of patient death was 24.7 kg/m2, and preferred body mass index range was 22–27 kg/m2. Referring to a body mass index of 22 kg/m2, the patient death risk was 1.115, 0.981, 1.032, and 2.634 for a body mass index of 18, 24, 28, and 40 kg/m2, respectively. J-shaped relationships were observed between body mass index and acute rejection, delayed graft function, primary graft nonfunction, and de novo diabetes. Pair-wise comparisons showed that higher body mass index was also a risk factor for cardiovascular diseases, hypertension, infection, longer length of hospital stay, and lower estimated glomerular filtration rate level. Conclusion Underweight and severe obesity at transplantation are associated with a significantly increased risk of graft loss and patient death. A target body mass index at kidney transplantation is 22–27 kg/m2.

Pseudolites (PLs) are ground-based satellites, providing users with navigation solutions. However, implementation of the PL system leads to the near-far problem. In this paper, we proposed an improved navigation PL signal structure of combing kasami sequences and the pulsing scheme to mitigate the near-far effect. The pulse modulation method is adopted to ensure that the PLs transmit signals at different timeslots and reduce the PL signals’ mutual interference. Additionally, we employ the small set of kasami sequences with good cross-correlation properties to improve the anti-interference ability. A simulation test based on software is carried out to evaluate the performance of the proposed signal. The simulation proves that the improved PL signal has an impulsive power spectral density (PSD), makes it a feasible solution to mitigate the near-far effect, and performs better in the capture.

Synthetic aperture radar (SAR) can be used to obtain remote sensing images of different growth stages of crops under all weather conditions. Such time-series SAR images can provide an abundance of temporal and spatial features for use in large-scale crop mapping and analysis. In this study, we propose a temporal feature-based segmentation (TFBS) model for accurate crop mapping using time-series SAR images. This model first extracts deep-seated temporal features and then learns the spatial context of the extracted temporal features for crop mapping. The results indicate that the TFBS model significantly outperforms traditional long short-term memory (LSTM), U-network, and convolutional LSTM models in crop mapping based on time-series SAR images. TFBS demonstrates better generalizability than other models in the study area, which makes it more transferable, and the results show that data augmentation can significantly improve this generalizability. The visualization of the temporal features extracted by the TFBS shows that there is a high degree of intraclass homogeneity among rice fields and interclass heterogeneity between rice fields and other features. TFBS also achieved the highest accuracy of the four deep learning models for multicrop classification in the study area. This study presents a feasible way of producing high-accuracy large-scale crop maps based on the proposed model.

Background The early identification of recipients at high risk of graft loss is clinically relevant after kidney transplantation. The authors explored whether the earlier monitoring of tacrolimus (Tac) time-in-therapeutic range (TTR) is predictive of and a subsequent gain in TTR improves transplant outcomes. Methods The TTR within 3, 6, 9, and 12 months was evaluated. Multivariate Cox analyses were performed to explore when TTR was predictive of transplant outcomes. Patients were divided into 3 groups based on incremental TTR change [TTR gain (increase >10%), TTR stable (maintained within 10%), and TTR loss (decrease >10%)] and 4 groups based on predefined cutoff values [low-low (LL), low-high (LH), high-low (HL), and high-high (HH)] using 6- and 12-month TTRs. Death-censored graft loss and patient death were primary outcomes. Results Nonlinear associations were observed between 6-, 9-, and 12-month TTR and death-censored graft and patient survival rates. In multivariate analysis, every 10% increase in 6-, 9-, and 12-month TTRs was associated with reduced patient death [hazard ratio (HR): 0.83; HR: 0.68; HR: 0.61, respectively] and graft loss (HR: 0.88; HR: 0.73; HR: 0.66, respectively). A nonlinear relationship was observed between transplant outcomes and incremental changes in TTR. TTR gain and stable TTR contributed to higher graft survival (HR: 0.20; HR: 0.21) and patient survival (HR: 0.14; HR: 0.15) rates than TTR loss, whereas the former 2 had comparable outcomes. Furthermore, compared with those in the HH group, the LL and HL groups had inferior graft survival (HR: 3.33; HR: 5.17) and patient survival (HR: 5.15; HR: 8.94) rates, whereas the LH group had similar outcomes (P = 0.63, P = 0.97). Nonadherence was the main controllable risk factor for low TTR. Conclusions The 6-month TTR identified patients at higher risk of worse outcomes. The subsequent gain of TTR may contribute to better transplant outcomes.

Computational fluid dynamics (CFD) has been used successfully in cardiovascular system research to analyze the physiological processes inside vessels. We evaluated the hydraulic information of urine through the lower urinary tract in a patient with posterior urethral valve (PUV) before and after valve ablation by CFD. A set of models of the lower urinary tract were developed based on geometrical data obtained by cystoscopy and voiding cystourethrography. Simulated assumptions and conditions were applied according to prior studies and urodynamic results. We used Fluent CFD 19.0 (Ansys Inc., USA) to compute the velocity and pressure of the fluid regions. The simplification of Bernoulli's formula was applied afterward to calculate the hydraulic energy of different positions. The urine flow rates of the NORMALst, the PUVst, and the POSTst at 5000 Pa were 18.08 ml/s, 11.14 ml/s, and 12.16 ml/s, respectively. Precipitous pressure change was observed around the valve in the PUVst, and the abnormal change was concentrated in the dilated urethra in the POSTst. Major energy dissipations were generated around the valve and the dilated urethra in the PUVst. The energy loss that occurred in the dilated urethra did not improve after the operation. Our findings are probably indicative of the hydrodynamics changes in the dilated urethra in PUV and need to be confirmed through more improved CFD models in the future. CFD may revolutionize pediatric urologists' perception in the management of urinary disease.

Ying-Tao Lin,1 Ying Chen,2 Tian-Xiu Liu,3 Fang Kuang,1 Ping Huang1 1Administration Office of Drug Clinical Trial, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of China; 2Management Office of Science and Technology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, 350014, People’s Republic of China; 3Department of Thoracic Radiotherapy, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, 350014, People’s Republic of ChinaCorrespondence: Ping HuangAdministration Office of Drug Clinical Trial, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of ChinaTel +86 13960908650Fax +86 0591 62752517Email 1967217973@qq.comPurpose: The aim of this study was to assess the cost-effectiveness of camrelizumab immunotherapy versus docetaxel or irinotecan chemotherapy as second-line therapy for advanced esophageal squamous cell carcinoma (ESCC), which was evaluated in the ESCORT trial.Materials and Methods: A partitioned survival model was developed to reflect the costs and effectiveness of the ESCORT trial. The clinical efficacy data, safety data, and health-related costs and utilities were derived from published data from clinical trials or health administration departments in China. Adverse event-related costs, drug administration, and other expenses were derived from a single center of Fujian Medical University Cancer Hospital in 2021. All survival analyses were performed with SPSS software. Overall survival was estimated with the Kaplan–Meier method, and progression-free survival was estimated with the life table method. Sensitivity analyses were conducted to assess the uncertainty of the model. Incremental cost, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) were calculated.Results: Camrelizumab therapy had 0.232 QALYs at an incremental cost of USD$9959.44 compared with the chemotherapy group with 0.158 QALYs at an incremental cost of USD$8601.67. The ICER was USD$18393.12/QALY. Probabilistic sensitivity analyses showed that when the willingness-to-pay threshold reached USD$31200/QALY, which is nearly three times the Chinese gross domestic product per capita, camrelizumab had an 80% possibility of being cost-effective versus docetaxel or irinotecan chemotherapy.Conclusion: Camrelizumab is a cost-effective option compared with docetaxel or irinotecan chemotherapy in patients with advanced ESCC as second-line therapy in China.Keywords: camrelizumab, chemotherapy, cost-effectiveness, esophageal squamous cell carcinoma

Background The COVID-19 global pandemic has had profound effects on mental health and wellbeing. The present study examined trends in distress and recovery in the aftermath of COVID-19 in China. Predictors that might increase risks or provide protections again distress were explored. Method Participants were recruited using social media during the COVID-19 pandemic to complete a baseline and 6-week follow-up survey (N = 241). The change patterns of PTSD symptoms from baseline to follow-up were characterized using latent class growth analysis (LCGA). A repeated-measures ANOVA was conducted to explore the differences in the depressive symptoms across trajectory groups. Multinominal logistic regression was performed to investigate potential predictors of the outcome trajectories. Results Four longitudinal outcome trajectories were identified: chronic (PTSD symptoms remained high; 14.9%), resilient (symptoms remained low; 43.2%), recovered (symptoms decreased from symptomatic levels to asymptomatic; 19.5%), and delayed (symptoms increased from asymptomatic levels to symptomatic; 22.4%). Hopelessness and maladaptive coping strategies were unique predictors of distress and resilience as well as longer-term trajectories. Conclusion Individuals evidenced four outcome trajectories of distress in the aftermath of COVID-19 in China. Despite the uncertainty and high levels of stress related to the pandemic, the majority of the sample demonstrated resilience and recovery. It is essential to identify individuals at risk for chronic and delayed distress in order to build resilience. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10036-8.

Mediastinoscopy was originally applied for lymph node biopsy and mediastinal tumor resection. Improved video imaging with spreadable working channels enabled mediastinoscopy for inspection and tissue biopsy in the superior mediastinum but it is rarely used in minimally invasive esophageal cancer surgery. In this prospective trial, the practicability and security of spreadable video-assisted mediastinoscopic combined with laparoscopic transhiatal esophagectomy (VAME) with video-assisted thoracoscopic esophagectomy (VATE) were compared. A total of 200 eligible patients with esophageal squamous cell carcinoma were randomly divided into VAME or VATE groups. Early postoperative outcomes and lymph node dissection between the two groups were compared. The operation time was significantly shorter (164.3 ± 47.0 min vs. 265.4 ± 47.2 min, P

Traffic flow data collected by traffic sensing devices is crucially important for transportation planning and transportation management. However, traffic sensing devices are typically distributed sparsely in road networks owing to their high installation and maintenance costs. The present study combines license plate recognition (LPR) data with taxi GPS trajectory data to develop a data-driven approach for estimating traffic flow in large road networks. The approach is applied to estimate traffic flow for an actual road network comprising 5,495 road segments using the traffic flow records of only 68 road segments (1.2% of the total). Five-fold cross validation is employed to verify the estimated traffic flow, and the data requirements for implementing the proposed method are analyzed. The developed data-driven approach provides an alternative and cost-efficient way of acquiring additional traffic flow information rather than installing more traffic sensing devices on roads.

Screen content coding (SCC) is increasingly used in mobile devices, and ultralow coding complexity is required for low power consumption. This article proposes an ultralow complexity string matching approach to SCC. The proposed approach has two essential features: 1) allowing only two types of most effective reference strings that have two most frequently occurring values of offset (i.e., displacement vector) named dual unity offset and 2) fully optimized coding of string matching parameters for maximum coding efficiency. Since at most only two offset values and corresponding reference string positions are allowed for any current string being coded, the optimal reference string searching process is extremely simple and only needs to select the best string from at most two candidates. Moreover, in the proposed approach, the value ranges of string matching parameters, i.e., the string offset vector and string length are very limited, resulting in few bits to code the two parameters and high coding efficiency. Compared with the AVS3 reference software HPM7.0 with IBC disabled, using AVS3 SCC common test condition and YUV test sequences in text and graphics with motion category, the proposed technique achieves Y average BD-rate reduction of 10.8% and 5.8% for all intra (AI) and low-delay B (LDB) configurations, respectively, at ultralow encoding and decoding complexity.

Objective: To explore treatment planning approaches using volumetric modulated arc therapy (VMAT) for head and neck cancer patients with metallic dental fillings. Methods: Fifty-six patients with metallic dental fillings treated with radiotherapy were selected, and three VMAT plans, the jaw-tracking plan, fixed-jaw plan, and non-coplanar plan, were designed for each patient. In the jaw-tracking plan, two coplanar partial arc fields that avoid the metal area were set, and the jaw was automatically tracked. In the fixed-jaw plan, different fields were set in three sections according to the fixed-jaw method. The fields were the same as those in the jaw-tracking plan for the section containing metal implants, while full arc fields were set in the nonmetal sections. In the non-coplanar plan, a non-coplanar arc field was added based on the jaw-tracking plan. The treatment plan in the jaw-tracking plan was optimized, and the constraints on the planning target volume (PTV) or organs at risk (OARs) in the jaw-tracking plan were copied to the other two plans. The dose distribution in PTV and OARs of the patients in the three treatment plans was compared. Results: There were no significant differences in the maximum doses to the spinal cord or optic nerves among the three treatment plans. However, compared with the jaw-tracking plan, the fixed-jaw plan showed lower mean doses to the pharynx [(42.9 ​± ​7.1) Gy vs. (44.1 ​± ​7.1) Gy, P ​

OBJECTIVE: To explore whether convalescent plasma therapy is beneficial to patients with severe acute respiratory infections and gave hints to the management of COVID-19. METHODS: A comprehensive literature search of PubMed, Web of Science, Embase, and Cochrane library was conducted for all eligible studies range from inception to February 29, 2020. Studies with control group were included. Treatment group received convalescent plasma therapy, and control group may receive any therapy other than convalescent plasma therapy. Odds ratios (ORs), mean differences (MDs) and 95% confidence intervals (CIs) were pooled for categorical and continuous outcomes. RESULTS: A total of 1997 patients from 13 studies were included, and seven studies were prospectively designed. Pooled analysis indicated convalescent plasma treatment significantly reduced the mortality by 51% (OR=0.49, 95% CI: 0.36 to 0.67). Subgroup analyses by publication time, study design, and influenza A revealed similar results. Sensitivity analyses suggested that the results were stable. In addition, convalescent plasma therapy reduced mechanical ventilation requirement (OR: 0.35, 95% CI: 0.21 to 0.59), while it was not associated with less use of extracorporeal membrane oxygenation (OR: 2.0, 95% CI: 0.83 to 4.83) and shorter length of hospital stay (MD: -2.20, 95% CI: -4.98 to 0.57days). Pooled estimates showed there was no difference in serious adverse effects between the convalescent plasma treatment and control groups (OR: 0.75, 95% CI: 0.50 to 1.13). CONCLUSION: Convalescent plasma therapy significantly reduced the mortality and mechanical ventilation requirements of patients with virus-induced severe acute respiratory infections, without serious adverse effects. More studies are needed to explore whether this treatment can be extrapolated into COVID-19.

This is a case report of a uterine cancer with the International Federation of Gynecology and Obstetrics staging 3c2 with the initial clinical presentation of postmenopausal vaginal bleeding in August 2015. Endometrium biopsy showed invasive nests of poorly differentiated grade 3 endometrioid adenocarcinoma. The patient received robotic surgery including total hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic lymph node dissection, para-aortic lymph node dissection, and washing cytology. The final pathology showed an endometrioid carcinoma with myometrium invasion up to 85% and para-aortic and pelvic lymph nodes invasion. The patient received six courses of adjuvant chemotherapy (paclitaxel and carboplatin) with concurrent chemoradiotherapy after the surgery. Later, immunotherapy with Picibanil (OK-432) and interleukin-2 (IL-2) was given, and cancer did not recur for 34 months until tumor recurrence at the liver dome and bilateral lung was noted by positron-emission tomography scan in July 2018. The patient received laparoscopic surgery for intra-abdominal tumor excision in December 2018, and the tumor found extended to the right diaphragm, liver surface, omentum, bilateral flank to pelvic peritoneum, Douglas pouch, and upper rectum. We continued the immunotherapy with OK-432, IL-2, Aldara cream (imiquimod), and later on, virotherapy (human papillomavirus vaccine). The immune risk profiles showed T–cells' proliferation and alteration of the Th1/Th2 activation after immunotherapy and virotherapy. Proctectomy with colon-anal anastomosis and cytoreduction surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) (doxorubicin and paclitaxel) was performed in January 2019. After the surgery, the patient received chemotherapy (topotecan, paclitaxel, lipodox, and carboplatin) and continued the immunotherapy. The immune risk profiles showed CD4, CD4/CD8 increase after HIPEC and immunotherapy. The patient continued the therapy until May 2020.

Qian Xu,1 Kang Wu,2 Yi Yang,2 Rui Chang,1 Hua Qiu,2 Yingying Wang,1 Tao Lin,2 Chaowei Fu,1 Yue Chen,3 Na Wang,1 Xiaonan Ruan2 1School of Public Health, Fudan University, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200032, People’s Republic of China; 2Pudong New Area Center for Disease Control and Prevention, Pudong Preventive Medicine Research Institute of Fudan University, Shanghai, 200136, People’s Republic of China; 3School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, CanadaCorrespondence: Na WangSchool of Public Health, Fudan University, Pudong Preventive Medicine Research Institute of Fudan University, No. 130, Dongan Road, Xuhui District, Shanghai, 200032, People’s Republic of ChinaTel/Fax +86 21-54237455Email na.wang@fudan.edu.cnXiaonan RuanPudong New Area Center for Disease Control and Prevention, Shanghai, 200136, People’s Republic of ChinaTel/Fax +86 21-50342409Email xnruan@pdcsc.sh.cnPurpose: Poor sleep quality and pain were common and had been proved as an important influenced factor of quality of life for patients with COPD. The association of sleep quality with pain has been observed in other population but remains unclear in mild patients with COPD from a community setting.Methods: A cross-sectional study was conducted to include eligible mild patients with COPD in Pudong New District of Shanghai. A structured questionnaire was used to collect general and clinical information for the patients. The Chinese version of Pittsburgh Sleep Quality Index (PSQI) and the short form of McGill Pain Questionnaire (SF-MPQ) was used to assess sleep quality and intensity of pain. Logistic regression was performed to test the association between sleeping quality and pain intensity.Results: Two hundred and sixty-four patients with COPD, with an average age of 64 years (SD 5.78 years), were enrolled, and of 52% were women. Seventy-one (26.9%) participants reported at least one exacerbation during the past year. About 28.2% of the patients were classified as having poor sleep quality. Sleep quality was significantly associated with PRI score (adjusted odds ratio (ORad)=2.16, 95% CI: 1.16– 4.00) and PPI rank (ORad=1.90, 95% CI: 1.08– 3.34). People with daytime disturbance were more likely to have pain (ORad =2.03, 95% CI: 1.18– 3.50).Conclusion: Poor sleep quality was common in mild patients with COPD in community and was associated with higher pain intensity. Pain may involve an impairment of sleep quality.Keywords: sleep, pain, chronic obstructive pulmonary disease, Pittsburgh sleep quality index, SF-MPQ

Urban green space (UGS) is essential for sustainable urbanization and human well-being. The utilization status of UGS is closely related to the provision of ecosystem services for urban residents. Limitations on data availability, however, have led to the absence of a comprehensive approach for evaluating the actual utilization status of UGS at a large scale. Furthermore, differences in actual UGS utilization between intra-urban and peri-urban areas have not received enough attention. This study used big data analysis by combining point of interest (POI) and land use and cover change (LUCC) to quantify the spatial patterns of UGS utilization, and to evaluate the actual utilization status of UGS in 366 cities on the Chinese mainland. We also explored the differences in the actual utilization of UGS in intra-urban and peri-urban areas. The results showed that 94.01% of UGS resources in China had not been utilized. There was a clear pattern of spatial mismatch between the stock and the actual utilization of UGS, especially in the northwestern region indicated by the Hu Huanyong Line. The actual utilization rate of UGS was closely related to the regional development level. There was a certain mismatch between the actual utilization and stock of intraurban green space (IUGS). The hot spots of the actual utilization rate of IUGS were in Yunnan, Guizhou, and Sichuan Provinces in southwestern China. The differences in UGS actual utilization rates between IUGS and peri-urban green space (PUGS) were small in eastern China, but large in southwestern and northwestern China. The actual utilization rate of IUGS in most Chinese cities was significantly larger than that of PUGS, indicating that PUGS were not well utilized. Our results provide scientific support for urban and regional planners in targeting specific areas for UGS design and development, and in optimizing future UGS planning in China.

Aim To analyze the frequency and core elements of nursing work interruptions in Chinese emergency nursing settings. Background Little is known about nursing interruptions, which affect the quality of services in Chinese emergency nursing setting. Method(s) A cross-sectional observational study was conducted in three units of an emergency department in a Chinese tertiary hospital. Participants comprised 60 nurses. Data were collected using a questionnaire developed by the researchers specifically for this study. Results In total, 25,965 minutes of work were observed and 2,333 interruptions were identified. Most interruptions were from patients, their families, and nurses. Therapeutic nursing and patient observation and documentation were the most frequently interrupted procedures. Most interruptions were negative, and a majority of the nurses immediately responded to interruptions. Significant differences existed in the overall distribution of the core elements among the three nursing units. Conclusions The frequency of emergency nursing interruptions were moderate. Most interruptions tend to lead to negative treatment outcomes for patients. Implications for nursing management Emergency nursing managers should recognize the importance of interruptions, understand work situations better, and develop ways to reduce the incidence of interruptions. Thus, nursing risks can be avoided by reducing the adverse outcomes caused by work interruptions.

Background Severe renal ischemia-reperfusion injury results in worse outcomes of kidney transplantation. Compared to the collecting duct, the proximal tubule is more likely to exhibit severe pyroptosis and damage during renal ischemia-reperfusion. Aquaporins were reported of having regulatory roles in pyroptosis. We explored whether aquaporin 2 overexpression in proximal tubular cells could alleviate ischemia-reperfusion injury related pyroptosis. Methods A renal ischemia-reperfusion model of mice was established, and human kidney 2 cells were treated with hypoxia-reoxygenation. Aquaporin 2 overexpression was achieved in human kidney 2 cells transfected with lentivirus, which were then cultured with murine cells. Renal tissues and serum of the mice, and human kidney 2 cells were subjected to histological, molecular, and biochemical examinations. Results Compared with the sham group, the renal function of the ischemia-reperfusion group was significantly decreased, and the tissue injury was severe and accompanied by more nuclear dissolved and necrosis. Besides, the expression of aquaporin 1-5 decreased significantly, while the expression of Toll-like receptor 4, caspase-1, kim-1 and interleukin 1β and 18 increased significantly in ischemia-reperfusion group. Similar results were observed in the human kidney 2 cells test. Overexpression of aquaporin 2 partially reversed the cell damage, pyroptosis, and molecular expression changes of human kidney 2 cells induced by hypoxia-reoxygenation. Conclusions Our findings suggest that aquaporin 2 overexpression can potentially reduce pyroptosis in proximal tubular cells, and thus might be a novel target for relieving pyroptosis and injury in renal ischemia-reperfusion injury.

Background Rapid and non-destructive infrared spectroscopy has been applied to both internal and external quality evaluations of food and agro-products. Various linear and nonlinear chemometric methods have been developed for spectral analysis. The generalizability of previous chemometric methods is hindered by changing noise under various detection conditions and biological variabilities. Recently, deep learning approaches have been developed for spectral noise reduction, feature extraction, and calibration regression modeling. Scope and approach This review discusses the current challenges of conventional chemometric methods and the emerging deep learning approach for spectral analysis. The current state-of-the-art techniques, including unsupervised feature extraction and noise reduction models and supervised multivariate regression approaches, have been addressed in this review. The research on exploring the learning mechanism of the ‘black box’ deep learning model is also discussed. This review focuses on the application of deep learning approaches on quality evaluation of food and agro-products, lessons from current studies, and future perspectives. Key findings and conclusions The deep learning approach combined with spectroscopic sensing techniques has shown great potential for quality evaluation of food and agro-products. Current advances in deep learning-based qualitative analysis include variety identification, geographical origin detection, adulteration recognition, and bruise detection, whereas quantitative analysis includes multiple component content prediction for fruits, grains, and crops. The main advantage of deep learning approach is the decreasing the dependence on human domain knowledge by end-to-end analysis and the improved precision and generalizability.

In this paper, an efficient photonics time-delayed mixer (PTDM) is proposed and demonstrated. It mainly consists of a dual-parallel Mach-Zehnder modulator (DPMZM) and a dispersion medium (DM). To eliminate the carrier component, the carrier-suppressed dual-sideband (CS-DSB) modulation is implemented without optical filters. Besides, the CS-DSB modulation is also the key to make the phase response is proportional to the converted frequency. Thanks to the controllable DC bias of the modulator, the power response of this PTDM is also tunable. Thus, this property also endows the PTDM able to resist the dispersion-induced power fading (DIPF) when considering the use of large dispersion medium. Experimental results verify the ability of wideband frequency up- and down-conversion. Moreover, a converted signal with linear phase-frequency response is also achieved, which implies the time delay capability. Time delay tuning is realized by altering the wavelength of the carrier with a stable power response. This structure is very compact and thus compresses the signal processing system volume, which is qualified to be integrated into a receiver/transmitter.

Wind load prediction is critical to the design of buildings, especially skyscrapers, because wind-induced dynamic loads and vibrations can often be a major concern that dominates the design. This paper presents a real-time wind load predictor for buildings by training an artificial neural network, with big data generated from a well-established software package for computational fluid dynamics (CFD), known as GSM-CFD. The cross-section of a building is idealized as a rectangle with various aspect ratios. The attack angles and velocity of the wind are also treated as variables in a wide range for building design considerations. We firstly establish a large number of computational models of major possible situations, and intensive computations using the GSM-CFD solver are conducted to generate detailed flow fields. Due to the high Reynold numbers of the flow fields, large eddy simulation (LES) model has been adopted in the calculation process. Both drag and lift coefficients are then computed based on the pressure distribution around the surface of the rectangular blocks. The GSM-CFD enables us to generate a mass of data considering different aspect ratios, wind velocities and attacking angles. Finally, an artificial neural network is trained to predict the drag coefficients for any given aspect ratios of the rectangular cross-sections of building subject to any given attack angles of wind with various velocities. The trained neural network is verified by comparing the results of the neural network predictions and that of the numerical simulations. The accuracy based on the test data set is found about 3.17%, which is sufficient for engineering design purposes. Our trained neural network model is applicable to other problems with a flow around rectangles with aspect ratios from 0.2 to 1, air-flow velocity of 34 m/s, and attack angles from 0° to 90°. The prediction is practically in real-time.

Brazilian grain production increased more than fourfold from 1980 to 2016. The grain boom was achieved primarily by soybean–corn double cropping and cropland expansion—both show changing spatiotemporal patterns since the 1980s. Here, we quantified the contributions of these two strategies to corn and soybean production in Brazil using municipality-level data from 1980 to 2016. We found the contribution of double cropping to the grain boom steadily increased to 35% and the largest driving force was the increasing demand for grain export. While double cropping dominated the conventional agricultural regions, cropland expansion was still the major strategy in agricultural frontiers such as the Centre-West and Matopiba. The implementation of double cropping offset the equivalent of 76.7 million ha of Brazilian arable land for grain production from 2003 to 2016. Double cropping in Brazil has the potential to help alleviate land burdens in other pantropical countries with increasing global food demand. Soybean and corn production in Brazil increased more than fourfold from 1980 to 2016, which was achieved by double cropping and cropland expansion. The contribution patterns of the two strategies were spatiotemporally specific, while double cropping shows increasing impacts over land expansion to the grain boom.

Identifying spatial distribution of crop planting in large-scale is one of the most significant applications of remote sensing imagery. As an active remote sensing system, synthetic aperture radar (SAR) provides high-resolution polarimetric information of land covers. Nowadays, it is possible to carry out continuous multi-temporal analysis of crops in large-scales since an increased number of spaceborne SAR systems has been launched. This paper formulates rice mapping as a semantic segmentation problem and proposes to use deep learning techniques to exploit the phenological similarity of rice production to identify the rice distribution in large-scales. The study area (i.e., about 58504 km2) located in Arkansas River Basin is selected to develop an adapted U-Net for large-scale rice mapping. The Sentinel-1 data in previous years (i.e., data collected in 2017 and 2018) are used to train and fine-tune the network, and current season data (i.e., data collected in 2019) is selected to test the robustness of the network. Experimental results show that the proposed method achieves the state-of-the-art performance as it benefits from the spatial characteristics and phenological similarity of rice. The experiments of rice extraction in different planting pattern regions and extracted features visual projection are conducted to explain the features mined by the adapted U-Net. Furthermore, the advantages of temporal generalization in large-scale are validated by the comparison between space migration and time migration, which indicates that the difference of rice in different years is smaller than that of rice in different spaces. Finally, the issues for operational implementation are discussed.

We aimed to explore the associations between the age at which children undergo surgery for hypospadias and a range of social and clinical factors in a single center. Our aim was to promote the early surgical treatment of children with hypospadias. For a 6-year period, social and clinical data were collected from all children undergoing surgery to repair hypospadias in Children's Hospital of Chongqing Medical University (Chongqing, China), located in southwest of China. We analyzed the correlations between age at surgery and a range of social and clinical factors. A total of 1611 eligible cases were recruited, with a mean age of 54.3 months and a median age of 42 months: 234 cases (14.5%) were classified into a "timely operation" group, 419 (26.0%) cases into a "subtimely operation" group, and 958 (59.5%) cases into a "delayed operation" group. According to multivariate regression analyses, the higher the regional economic level, the closer the urethral opening to the perineum, and the higher the educational level of the guardians was, the younger the children were when they underwent the initial surgery for hypospadias; this was also the case for families without other children. Our subgroup analysis showed that the primary educational level of the guardians was a risk factor for subtimely surgery in their children (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 1.08-2.15, P < 0.05). A lower regional economic level (OR = 1.87, 95% CI: 1.26-2.78, P < 0.01), a lower educational level of the guardians (OR = 3.84, 95% CI: 2.31-6.41, P < 0.01), and an anterior-segment urethral opening (OR1 [vs middle hypospadias] = 2.07, 95% CI: 1.42-3.03; OR2 [vs posterior hypospadias] = 2.63, 95% CI: 1.75-3.95; P < 0.01) were all risk factors for delayed surgery in children.

BackgroundCOVID-19 lockdowns may lead to physical inactivity, a major risk factor for non-communicable diseases. This study aims to determine: 1) the trajectory in daily step counts before, during and after the lockdown in China, and 2) the characteristics associated with the trajectories.MethodsFrom December 2019 to July 2020, smartphone-based step counts were continuously collected in 815 Chinese adults residing in Shanghai over 202 days across three phases: before, during, and after the lockdown. Participant characteristics were reported, and height, weight and body composition measured before the lockdown. A ‘sharp’ regression discontinuity design with cluster robust standard errors was used to test the effect of the lockdown and reopening on daily steps and a linear mixed model was used to examine the characteristics associated with trajectories during the observed period.ResultsBased on 164,630 person-days of data, we found a sharp decline in daily step counts upon the lockdown (24/01/2020) by an average of 3796 (SE = 88) steps, followed by a significant trend of increase by 34 steps/day (SE = 2.5;p p = 0.029). Those who were older, married, university educated, insufficiently active, had an ‘at risk’ body composition, and those in the control group, were slower at recovering step counts during the lockdown, and those who were older, married, without university education and with an ‘at risk’ body composition recovered step counts at a slower pace after the reopening.ConclusionsDespite later increases in step counts, COVID-19 lockdown led to a sustained period of reduced physical activity, which may have adverse health implications. Governments and health professionals around the world should continue to encourage and facilitate physical activity during the pandemic.

Deep brain stimulation (DBS) relieves motor dysfunction in Parkinson’s disease, and other movement disorders. Here, we demonstrate the potential benefits of DBS in a model of ataxia by targeting the cerebellum, a major motor center in the brain. We use the Car8 mouse model of hereditary ataxia to test the potential of using cerebellar nuclei DBS plus physical activity to restore movement. While low-frequency cerebellar DBS alone improves Car8 mobility and muscle function, adding skilled exercise to the treatment regimen additionally rescues limb coordination and stepping. Importantly, the gains persist in the absence of further stimulation. Because DBS promotes the most dramatic improvements in mice with early-stage ataxia, we postulated that cerebellar circuit function affects stimulation efficacy. Indeed, genetically eliminating Purkinje cell neurotransmission blocked the ability of DBS to reduce ataxia. These findings may be valuable in devising future DBS strategies., Deep brain stimulation (DBS) has potential for several movement disorders. Here the authors show that DBS improves motor function in a mouse model of ataxia.

A 48‐year‐old woman presented to our department and chest computed tomography (CT) revealed five pulmonary nodules, two of which were in the left upper lobe of the lung and three in the superior segment of the left lower lobe., All the lesions were resected for comprehensive histological assessment in order to distinguish synchronous multiple primary lung cancers (SMPLCs) from intrapulmonary metastases. The nodules were all successfully removed by minimally invasive surgery under the guidance of three dimensional (3D) reconstruction, in order to preserve as much lung function for the patient as possible. Postoperative histopathological examination demonstrated the presence of SMPLC. The patient was discharged from hospital on postoperative day 4 without any complications., In this case, there was a very special small pulmonary nodule in the anterior segment of the right upper lung. Using 3D reconstruction, as it was difficult to carry out a conventional pulmonary wedge resection, we determined that the nodule was located exactly between the roots of V3c and V3b+a. Therefore, we used electrocautery to strip the lung tissue along the boundary of V3c and V3b+a during the operation, and successfully removed the nodule.

Background In order to reduce the burden on organ shortage around the world, using potential infectious donor might be an option. However, scarce evidences have been published on kidney transplantation (KTx) from hepatitis B surface antigen (HBsAg) + donors to HBsAg- recipients [D (HBsAg+)/R(HBsAg-)] without hepatitis B virus (HBV) immunity. Here, we reported the results of D(HBsAg+/HBV DNA- or +)/R(HBsAg-) living KTx recipients with or without HBV immunity. Methods We retrospectively identified 83 D(HBsAg+)/R(HBsAg-) living KTx recipients, and 83 hepatitis B core antibody (HBcAb) + living donors to HBcAb- recipients [D(HBcAb+)/R(HBcAb-)] were used as control group by reviewing medical archives and propensity score matching. Treatment failure (defined as any HBV serology conversion, liver injury, graft loss, or recipient death) is the primary endpoint. Results Twenty-four donors (28.9%) were HBV DNA+, and 20 recipients had no HBV immunity in the D(HBsAg+)/R(HBsAg-) group pre-transplantation. HBV prophylaxis was applied in all D(HBsAg+)/R(HBsAg-) recipients, while none was applied in the D(HBcAb+)/R(HBcAb-) group. We observed a significant higher treatment failure in D(HBsAg+)/R(HBsAg-) than D(HBcAb+)/R(HBcAb-) group (21.7% vs. 10.8%, P Conclusion D(HBsAg+)/R(HBsAg-) should be considered for living kidney transplantation, but with extra caution on donors with HBV DNA+ and male candidates.

Encountering difficulties that emerge in programming learning are ubiquitous for novices. Those difficulties may reduce novices’ motivation for learning, even lead them to drop out. Automatically detecting the difficulties has been proved as an effective way to solve this problem. A potential method for the detection is to identify programmers’ behavioural patterns based on the sequences of programming events (e.g., editing, deleting, or debugging) when they experience programming difficulties. However, due to the diversity of these events, the plentiful difficulties generated from novices, and the naturally complicated behavioural patterns, accurately detecting the difficulties remains challenging. In this study, we propose a deep representation based on the programming events as the pre-treatment of a recurrent neural network with an attention mechanism to detect programming difficulty. This representation can be conducive to encode the complicated behavioural features (e.g., co-occurrence, sequences, and time intervals of the events) of the difficulty patterns for deep learning models. The results show that the accuracy of our method reaches 94%, which increases by 16% compared with the traditional machine learning model.

We proposed a compact and efficient polarization rotator (PR) based on an asymmetric hybrid plasmonics waveguide (HPW) on the lithium-niobate-on-insulator (LNOI) platform. We focus on the design of rotation angle and balance between the two hybrid modes. The presented device exhibits a polarization extinction ratio as high as 59.58 dB and an insertion loss of 1.44 dB with the rotation length of only 13.7 $\mu$m. The fabrication tolerances and a suitable process are also discussed to meet the state-of-art technology.

BackgroundTartary buckwheat (Fagopyrum tataricum) is a nutritionally balanced and flavonoid-rich crop plant that has been in cultivation for 4000 years and is now grown globally. Despite its nutraceutical and agricultural value, the characterization of its genetics and its domestication history is limited.ResultsHere, we report a comprehensive database of Tartary buckwheat genomic variation based on whole-genome resequencing of 510 germplasms. Our analysis suggests that two independent domestication events occurred in southwestern and northern China, resulting in diverse characteristics of modern Tartary buckwheat varieties. Genome-wide association studies for important agricultural traits identify several candidate genes, includingFtUFGT3andFtAP2YT1that significantly correlate with flavonoid accumulation and grain weight, respectively.ConclusionsWe describe the domestication history of Tartary buckwheat and provide a detailed resource of genomic variation to allow for genomic-assisted breeding in the improvement of elite cultivars.

In the past, string prediction (also known as string matching) was applied only to RGB and YUV 4:4:4 format screen content coding. This paper proposes a string prediction approach to 4:2:0 format screen content coding implemented in the third generation of Audio Video Standard (AVS3) in China. String prediction is applied to both YUV CU and Y CU. To further improve the coding performance, several improved technicals of string prediction are presented, including a mixed string searching strategy for finding the optimal reference string, a joint picture-level, CU-level, and pixel-level early termination strategy to reduce coding complexity, and two effective coding methods for string prediction parameters. For low-complexity hardware implementation of string prediction decoder, the memory access bandwidth is reduced by introducing string constraints. Meanwhile, string prediction reuses the reference pixel buffer of intra block copy (IBC). Compared with the newest AVS3 reference software HPM7.0 with string prediction disabled, the proposed string prediction approach achieves up to 18.48% Y BD-rate reduction. Using AVS3 Screen Content Coding (SCC) Common Test Condition and YUV test sequences in Text and Graphics with Motion category, the proposed technique achieves an average Y BD-rate reduction of 10.33%, 8.47%, 6.91% for All Intra (AI), Random Access (RA) and Low Delay (LD) configurations, respectively, with low additional encoding and decoding complexity. The proposed string prediction approach has been adopted in the newest AVS3 reference software HPM7.0.

What is already known on this topic? The morbidity and mortality of chronic obstructive pulmonary disease (COPD) is associated with adverse weather and air pollution. However, COPD patients are not able to be alerted in advance of high risk environments. What is added by this report? This prospective controlled trial conducted in Pudong New Area of Shanghai from October 2019 to April 2020 provided evidence of COPD risk forecasting service on the reductions in visits and costs of COPD patients in outpatient and emergency departments in China for the first time. What are the implications for public health practice? This study suggests that COPD risk forecasting service could be integrated into existing COPD management in public health to improve the health and economic outcomes.

The Internet of Things (IoT) has become the infrastructure to widely support ubiquitous services. In this setting, a large number of smart object devices provide IoT services for people to carry on day-to-day activities. These services are easy to access, and thus, can be easily used by different users with different requirements through service allocation and composition. Nevertheless, with the increasing adoption and presence of IoT services, it becomes more difficult to find the appropriate IoT service compositions that can maximize the service utility of all the users’ requests. Moreover, the IoT devices are usually resource constrained and cannot effectively finish some complex task of service requests, thereby reducing the service quality. To address this problem, we develop a novel IoT service allocation mechanism in collaborative device-edge-cloud architecture. First, prevalence of frequent function interaction is mined to help construct IoT service allocation index. Second, service requests’ priority and their preferences towards branch nodes are further set and estimated to help maximize the service composition utility of multiple user requests. Third, edge device is exploited to help service execution and guarantee service allocation utility by offloading task from IoT devices. The results are demonstrated by conducting a set of extensive experiments, which show that the proposed method performs better than the alternative techniques in reducing the total energy consumption and promoting the service utility maximum.

Background Kidneys obtained from deceased donors increase the incidence of delayed graft function (DGF) after renal transplantation. Here we investigated the influence of the risk factors of donors with DGF, and developed a donor risk scoring system for DGF prediction. Methods This retrospective study was conducted in 1807 deceased kidney donors and 3599 recipients who received donor kidneys via transplants in 29 centers in China. We quantified DGF associations with donor clinical characteristics. A donor risk scoring system was developed and validated using an independent sample set. Results The incidence of DGF from donors was 19.0%. Six of the donor characteristics analyzed, i.e., age, cause of death, history of hypertension, terminal serum creatinine, persistence of hypotension, and cardiopulmonary resuscitation (CPR) time were risk factors for DGF. A 49-point scoring system of donor risk was established for DGF prediction and exhibited a superior degree of discrimination. External validation of DGF prediction revealed area under the receiver-operating characteristic (AUC) curves of 0.7552. Conclusions Our study determined the deceased donor risk factors related to DGF after renal transplantation pertinent to the Chinese cohort. The scoring system developed here had superior diagnostic significance and consistency and can be used by clinicians to make evidence-based decisions on the quality of kidneys from deceased donors and guide renal transplantation therapy.

BACKGROUND Congenital nephrogenic diabetes insipidus (CNDI) is a rare hereditary renal disorder that is caused by mutations in AVPR2 or aquaporin 2 (AQP2). Up to now, there are few reports about CNDI in neonates. Early clinical manifestations of CNDI in neonates are atypical. A lack of understanding of the disease by clinicians causes frequent misdiagnoses or missed diagnoses, which may result in failure to administer treatments in time and ultimately leads to severe complications. In this study, clinical data of a case of AVPR2 gene mutation-induced CNDI, which was confirmed by genetic testing, were retrospectively analyzed to improve our understanding of this disease. CASE SUMMARY On February 1, 2020, a male neonate was hospitalized 17 d after birth due to a 7 d period of pyrexia. The patient’s symptoms included recurrent pyrexia, hypernatremia and hyperchloremia, which were difficult to treat. The patient was fed on demand, and water was additionally provided between milk intakes. A combination treatment of hydrochlorothiazide and amiloride was administered. After the treatment, body temperature and electrolyte levels returned to normal, the volume of urine was significantly reduced and the patient was subsequently discharged. Genetic tests confirmed that the patient carried the AVPR2 gene missense mutation c.541C>T (P.R181C), and the patient’s mother carried a heterozygous mutation at the same locus. After clinical treatment with a combination of hydrochlorothiazide and amiloride, the body temperature and electrolyte levels returned to normal. Up until the most recent follow-up examination, normal body temperature, electrolyte levels and growth and development were observed. CONCLUSION CNDI in the neonatal period is rare, and its clinical manifestations are unspecific with some patients merely showing recurrent fever and electrolyte disturbance. Genetic testing of AVPR2 and AQP2 can be used for screening and genetic diagnosis of CNDI.

To assess the accuracy of contralateral testis hypertrophy for predicting the fate of nonpalpable testis in Chinese boys at different ages.The data of patients who presented with unilateral impalpable testis and who underwent laparoscopy at the Children's Hospital of Chongqing Medical University between January 1, 2000 and January 1, 2018 were reviewed. The boys were divided into four groups: age-matched volunteers with no testicular abnormalities represented the control group (group I), boys with palpable undescended testis (group II), boys with nonpalpable testis (NPT)/viable testis (VT) (group III), and boys with NPT/non-viable testis (NVT) group (group IV). Scrotal testes were prospectively measured by ultrasonography for volume and size, and diagnostic laparoscopy was performed to determine the state of the cryptorchid testis.The mean contralateral testicular volume and length in the boys with an absent testis was 0.78mL and 17mm compared with 0.67mL and 15mm in the boys with a testis present and 0.63mL and 15mm in the controls, respectively (P0.05). The predictive accuracy, sensitivity, and specificity for an absent testis were 64.9%, 75%, and 49%, respectively, for volume and 64.2%, 56.3%, and 76.4%, respectively for length at the optimal cutoff value of 0.65mL volume and 16.55mm length. Contralateral testis volume was the most accurate in predicting monorchism in 0-2-year-olds (sensitivity: 75%, specificity: 70%, accuracy: 73.1%) and the contralateral testicular length was most accurate for 4-6-years-old (sensitivity: 68.6%; specificity: 77.8%; accuracy: 72.2%). We also included 29 patients with bilateral undescended testis (UDT) and with unilateral nonpalpable. Cutoff values for testicular volume and length were 0.6mL (sensitivity: 81.8%, specificity: 88.9%, accuracy: 86.2%) and 13.5mm (sensitivity: 63.6%, specificity: 77.8%, accuracy: 77.8%).The present results exclusively obtained from laparoscopic exploration suggest that a testis volume of0.65mL or a testis length of16.55mm could predict monarchism with an accuracy of about 65%. In younger patients aged 0-2 years and 4-6 years, the overall predictive accuracy increases to about 73% but laparoscopic exploration is still required.

Background Preoperative imaging examination is the primary method for diagnosing metastatic gastrointestinal stromal tumor (GIST), but it is associated with a high rate of missed diagnosis. Therefore, it is important to establish an accurate model for predicting occult peritoneal metastasis (PM) of GIST. Patients and methods GIST patients seen between April 2002 and December 2018 were selected from an institutional database. Using multivariate logistic regression analyses, we created a nomogram to predict occult PM of GIST and validated it with an independent cohort from the same center. The concordance index (C-index), decision curve analysis (DCA) and a clinical impact curve (CIC) were used to evaluate its predictive ability. Results A total of 522 eligible GIST patients were enrolled in this study and divided into training (n=350) and validation cohorts (n=172). Factors associated with occult PM were included in the model: tumor size (odds ratio [OR] 1.194 95% confidence interval [CI], 1.034-1.378; p=0.016), primary location (OR 7.365 95% CI, 2.192-24.746; p=0.001), tumor capsule (OR 4.282 95% CI, 1.209-15.166; p=0.024), Alb (OR 0.813 95% CI, 0.693-0.954; p=0.011) and FIB (OR 2.322 95% CI, 1.410-3.823; p=0.001). The C-index was 0.951 (95% CI, 0.917-0.985) in the training cohort and 0.946 (95% CI, 0.900-0.992) in the validation cohort. In the training cohort, the prediction model had a sensitivity of 82.8%, a specificity of 93.8%, a positive predictive value of 54.7%, and a negative predictive value of 98.4%; the validation cohort values were 94.7%, 85.0%, 43.9% and 99.2%, respectively. DCA and CIC results showed that the nomogram had clinical value in predicting occult PM in GIST patients. Conclusion Imaging and inflammatory indexes are significantly associated with microscopic metastases of GIST. A nomogram including these factors would have an excellent ability to predict occult PM.

Background. Estrogen is involved in the pathophysiological process of benign prostatic hyperplasia (BPH), in which epithelial-mesenchymal transition (EMT) plays an important role. Upregulation of aquaporin (AQP) 5, which is directly activated by estrogen, has been reported to promote EMT in multiple cells. This study aimed to examine the effects of AQP5 on estrogen-induced EMT in the prostate. Methods. Normal prostate (NP) tissue samples without any histopathological changes and BPH tissue samples with pathologically confirmed hyperplasia were obtained. An EMT cell model was subsequently established by adding estradiol (E2) to RWPE-1 cells, after which AQP5 knockdown was performed. Tissue morphological and immunohistochemical features were examined using hematoxylin-eosin and immunohistochemical staining. Western blot analysis was performed to determine the expression of AQPs, estrogen receptors, and EMT-related proteins. Cell proliferation was assessed and supernatants were collected for enzyme-linked immunosorbent assay to determine transforming growth factor-β1 (TGF-β1) concentrations. Immunofluorescence staining was performed to assess protein expressions in RWPE-1 cells. Results. BPH tissues exhibited greater EMT (TGF-β1: 1.362 ± 0.196 vs. 0.107 ± 0.067, P = 0.003; vimentin: 1.581 ± 0.508 vs. 0.221 ± 0.047, P

To systematically evaluate the efficacy, safety, and treatment-related outcomes between percutaneous radiofrequency ablation (PtRFA) and partial hepatectomy (PH) for small primary liver cancer meeting the Milan criteria.A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. A priori protocol was registered in the PROSPERO database, and a literature search of all relevant studies published on PubMed, Cochrane library, Web of Science database, and Science Direct until July 2019 was performed. Only randomized controlled trials published in English were eligible for inclusion.Of the 385 identified articles, only five randomized controlled trials involving 761 adult patients with small liver cancer were included in the final analysis. The 1-year, 2-year, 3-year, 4-year, 5-year overall survival and disease-free survival between PtRFA and PH did not reach significant difference (P-value0.05). The long-term recurrence rate was higher and the recurrence-free survival was lower in patients treated with PtRFA compared with those treated with PH (P-value0.05), but short-term (1-year) comparisons did not reach statistical significance. With regard to treatment-related complications, serious adverse event risks, analgesics needs, hospital stay and costs, PtRFA had significant superiority compared with PH.The overall treatment effects of PtRFA are comparable to PH for small liver cancer. Though patients with PtRFA have a higher long-term recurrence rate, these patients share less complications, few serious adverse event risks, less analgesics needs, shorter hospital stay, and lower costs. PtRFA may be recommended as the preferred treatment of solitary liver tumors3cm in diameter.

Background The effect of donor kidney morphology parameters on the prognosis of renal transplant recipients remains unclear. Methods We conducted a retrospective cohort study consisting of 290 pairs of donors and recipients who underwent living related renal transplantation in our center between December 2013 and December 2015. The donor kidney morphology parameters, demographic characteristics and renal function of the included participants were collected and analyzed. Results The univariate linear regression analysis revealed that the donor kidney weight (DKW)/recipient body weight (RBW), DKW/recipient body surface area (RBSA), DKW/recipient body mass index (RBMI), donor kidney volume (DKV)/RBW, DKV/RBSA, DKV/RBMI, and donor body weight (DBW)/RBW were significantly correlated with estimated glomerular filtration rate (eGFR) and serum creatinine in recipients within two years of transplantation. In our multivariate linear regression analysis, DKW/RBW and donor age significantly correlated with eGFR at 6, 12, 18 and 24 months after transplantation. DKW/RBW had the best prediction performance for good renal allograft function at 12 months after transplantation. We found that when the age of the donor was 55 years and above, the prediction performance of the nephron dosing to the recipient's metabolic demands mismatch was elevated. After grouping according to the donor's age and DKW/RBW, the allograft function from different donor ages improved as DKW/RBW increased. The number of recipients who were rejected in the high DKW/RBW group was significantly fewer than those in the low and medium groups the 1, 2, and 3-year graft and patient survival rates were comparable among these groups. Furthermore, we also identified that when the age of the donor was 55 years and above, the threshold of DKW/RBW was 3.09 g/kg via the receiver operating characteristic curve, which predicted a good renal function 12 months after transplantation. Conclusions The donor kidney morphology parameters were significantly associated with early renal allograft function, especially when the age of the donor was 55 years and above.

Exciton localization phenomena are considered here to comprehend the high internal quantum efficiency in InGaN/GaN multiple-quantum-well structures having discrete quantum dots (QDs) prepared by metal–organic-chemical-vapor deposition method on c-sapphire substrates. Spectroscopic results from the variable-temperature steady-state-photoluminescence and time-resolved photoluminescence (TRPL) are investigated. While the exciton localization is enhanced by strong localized states within the InGaN/GaN QDs–the impact of free carrier recombination cannot be ignored. The observed non-exponential decay in TRPL measurements is explained using a model by meticulously including localized exciton, non-radiative and free carrier recombination rates. A new method is proposed to calculate the internal quantum efficiency, which is supplementary to the traditional approach based on temperature-dependent photoluminescence measurement.

In this paper, an intelligent recognition system for insulator based on dimension correction and optimized faster region with convolutional neural network (R-CNN) is proposed. In the process of insulator pictures shooting, a laser radar is used to calculate the UAV correction vector. The position of the UAV is adjusted to ensure the consistency of the spatial dimensions of the pictures taken in different time dimensions. Based on the almost invariant spatial dimension, the faster R-CNN image recognition algorithm is optimized. When the target detection frame is generated, marked reference pictures are added to narrow the search range, improve the target detection frame generation speed, and reduce the number of pictures during training. Experiments and comparison analysis are included. They verify the optimized faster R-CNN image recognition algorithm requires less pictures and recognition time, and the recognition accuracy increased from 85.6 to 97.3%.

Human papillomavirus (HPV) is the well‐established etiologic factor for cervical neoplasia. Cervical conization constitutes an effective treatment for high‐grade cervical intraepithelial neoplasia (HG‐CIN). We conducted an observational study for long‐term outcomes and HPV genotype changes after conization for HG‐CIN. Between 2008 and 2014, patients with newly diagnosed HG‐CIN before conization (surveillance new [SN] group) and those who had undergone conization without hysterectomy (surveillance previous [SP] group) were enrolled. HPV testing and Pap smear were performed periodically for the SN and SP (collectively S) groups. All other patients receiving conization for HG‐CIN during the study period were identified from our hospital database. Those eligible but not enrolled into our study were assigned to the non‐surveillance (non‐S) group. For the S group (n = 493), the median follow‐up period was 74.3 months. Eighty‐four cases had recurrent CIN Grade 2 or worse (CIN2+) (5‐year cumulative rate: 14.8%), of which six had invasive cancer. Among the 84 patients, 65 (77.4%) exhibited type‐specific persistence in the paired HPV results, whereas only 7 (8.3%) harbored new HPV types that belonged to the 9‐valent vaccine types. Among the 7397 non‐S patients, 789 demonstrated recurrent CIN2+, of which 57 had invasive cancer. The stages distribution of those progressed to invasive cancer in the non‐S group were more advanced than the S group (P = .033). Active surveillance might reduce the severity of those progressed to cancer. Because a majority of the patients with recurrent CIN2+ had persistent type‐specific HPV infections, effective therapeutic vaccines are an unmet medical need., What's new? High‐grade cervical intraepithelial neoplasia (HG‐CIN), a cervical carcinoma precursor, frequently is caused by high‐risk human papillomavirus (hr‐HPV) infection. HG‐CIN can be treated by cervical conization, though the procedure does not eradicate hr‐HPV, potentially enabling CIN recurrence. Here, in Taiwanese patients, investigation of HPV genotype changes in relation to HG‐CIN status after conization shows that 77.4 percent of patients with recurrent CIN 2 grade or worse (CIN2+) after conization had persistent type‐specific HPV infections. Vaccination against the remaining high‐risk HPVs prevented recurrent CIN2+ in only 8.3 percent of patients, revealing an unmet need for effective therapeutic vaccines.

Intelligent driving plays a role in significantly improving the safety and efficiency of transportation systems. As the onboard capabilities of perception, comprehension, and decision making are limited, vehicles can employ the edge computing infrastructure of the smart road to enhance their intelligence. Therefore, the smart road is considered an intelligent Internet of Things system. It provides vehicles with not only the road space in the transportation domain, but also the communication, sensing, and computing resources in the information domain to improve the composite quality of intelligent driving. However, the resources in the information and transportation domains are complicatedly coupled, and the orchestration of these cross-domain resources is confronted with the huge state-action space, which cannot be solved in a real-time manner. In this article, we investigate the fundamental research challenges in cross-domain resource orchestration for the smart road, and design a multi-agent-based framework. Within the framework, each vehicle is associated with an exclusive agent on the edge cloud, and the agents utilize swarm intelligence to jointly optimize the traffic flow and information flow for their respective vehicles. Specifically, a value iteration network is used by agents to learn the routing behavior of vehicles, and a multi-agent deep reinforcement learning method is proposed, enabling agents to cooperatively learn decentralized resource optimization policies. To verify the effectiveness of the proposed framework, a cross-domain resource orchestration prototype is implemented and evaluated.

OBJECTIVES Nutrition status is of great significance to the clinical outcome after major abdominal surgery. However, the effect of preoperative short-term parenteral nutrition (PN) support among gastric cancer (GC) patients remains unknown and was evaluated in the current study. METHODS We retrospectively analyzed 455 nutritionally at-risk GC patients after radical resection from 2010 to 2016. We matched patients with 3-7 days of PN support to those without PN support. χ2 And Mann-Whitney U tests were used to compare differences between the PN and control groups. RESULTS The propensity-matched sample included 368 GC patients (PN group, n = 184; control group, n = 184). The PN and control groups did not differ regarding postoperative complications (P = .528). The incidence of anastomotic leakage in the PN group was lower than in the control group (P = .011), whereas other complications were not found to differ between the groups. The hospitalization cost of the PN group was significantly higher than that of the control group (P < .001), whereas other outcome indicators were similar. Subgroup analysis showed that short-term PN support may have an improved benefit for patients with serum albumin level

In this paper, a novel microwave photonic full-range phase shifter with simultaneous frequency-multiplying capability is proposed. The main device is a dual-drive Mach–Zehnder modulator (DMZM) embe...

Nerve defects are challenging to address clinically without satisfactory treatments. As a reliable alternative to autografts, decellularized nerve matrix scaffolds (DNM-S) have been widely used in clinics for surgical nerve repair. However, DNM-S remain inferior to autografts in their ability to support nerve regeneration for long nerve defects. In this study, we systematically and clearly presented the nano-architecture of nerve-specific structures, including the endoneurium, basement membrane and perineurium/epineurium in DNM-S. Furthermore, we modified the DNM-S by supplementing decellularized nerve matrix hydrogel (DNMG) and glial-derived neurotrophic factor (GDNF) and then bridged a 50-mm sciatic nerve defect in a beagle model. Fifteen beagles were randomly divided into three groups (five per group): an autograft group, DNM-S group and GDNF-DNMG-modified DNM-S (DNM-S/GDNF@DNMG) group. DNM-S/GDNF@DNMG, as optimized nerve grafts, were used to bridge nerve defects in the same manner as in the DNM-S group. The repair outcome was evaluated by behavioural observations, electrophysiological assessments, regenerated nerve tissue histology and reinnervated target muscle examinations. Compared with the DNM-S group, limb function, electrophysiological responses and histological findings were improved in the DNM-S/GDNF@DNMG group 6 months after grafting, reflecting a narrower gap between the effects of DNM-S and autografts. In conclusion, modification of DNM-S with DNMG and GDNF enhanced nerve regeneration and functional recovery, indicating that noncellular modification of DNM-S is a promising method for treating long nerve defects.

A novel photonic scheme to generate microwave frequency shift keying (FSK) signals with high frequency multiplication factors or flexible tuning carrier frequencies is proposed. A parallel structure is constructed in which the upper arm contains a dual parallel Mach–Zehnder modulator (DPMZM) while the lower one contains another DPMZM and a phase modulator (PM). From a theoretical analysis, the two DPMZMs can generate signals containing specific optical sidebands by properly biased, which serve as optical sidebands selector. The PM driven by a binary coding signal is employed to control the phase difference between the two arms. Simulation results show that when the output signal from the parallel structure is directly sent into a photodetector (PD), microwave FSK signals with frequency multiplication factors of 2/4 or 4/8 can be obtained. And when the output signal is mixed with a tunable optical source before being sent into the PD, microwave FSK signals with flexible tuning carrier frequencies can be obtained. The proposed scheme can generate two major categories of microwave FSK signal. Furthermore, polarization independence and good frequency tunability can be simultaneously achieved because no polarization multiplexing devices or frequency-dependent devices are applied. The impacts of phase deviation of phase shifter and non-ideal extinction radio of modulator are discussed.