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The replacement of small cations with bulkier organic cations containing long alkyl chains or benzene rings to form a thin two-dimensional (2D) perovskite passivation layer on three-dimensional (3D) perovskite (2D/3D) has become a promising strategy for improving both the efficiency and stability of perovskite solar cells (PSCs). The 2D layer defines the interfacial chemistry and physics at the 2D/3D bilayer and endows the 2D/3D structure with better chemical and thermal stability. Herein, 2D/3D (CF3-PEA)2FA0.85MA0.15Pb2I7/FA0.85MA0.15PbI3 planar heterojunction perovskite was produced using a facile interfacial ion exchange process. The 2D (CF3-PEA)2FA0.85MA0.15Pb2I7 capping layer can not only passivate the FA0.85MA0.15PbI3 film but also act as super-hydrophobic layer to inhibit water diffusion and significantly enhance the stability. The 2D capping layer can also establish a unique graded band structure at the perovskite/Spiro-OMeTAD interface and lead to p-type doping for Spiro-OMeTAD layer which is beneficial for efficient charge transport. Optimized PSCs based on this 2D/3D heterojunction yield a champion power conversion efficiency (PCE) of 23.1% and improved stability. The device maintains 84% output for 2400 h aging under ambient environmental conditions without encapsulation, and maintains 81% for 200 h under illumination with encapsulation. This work will inspire the design of more fluorinated 2D perovskite interfaces for advanced photovoltaics and beyond.

Over the last decade, there has been a steady increase in the number of cities in China and around the world adopting License Plate-based Restriction (LPR) policies, whereby vehicles are permitted to enter a defined road or area on the basis of a specific digit on the registration, license or number plate, to help mitigate traffic congestion and its associated impacts. Although the costs and benefits of implementing a LPR policy have been recognized, the public acceptance of a LPR policy has been less well studied. To better understand the factors affecting the public acceptance of a LPR policy, we improved the theoretical model by adding two factors related to attitude and new supposed deeper level effects between different factors. Accordingly, the theoretical model on exploring the factors affecting the public acceptance of such a scheme were explored in a questionnaire completed by 619 local residents in Xi’an, China and analyzed using a partial least square structural equation model (PLS-SEM). In addition, we carried out heterogeneity analysis to compare the differences between residents with various socio-economic attributes in factors with respect to affecting the acceptance of a LPR policy. The results show that problem perception, perceived effectiveness, perceived value and social norms exert a significant direct and indirect impact on the acceptance of a LPR policy. Important aims to reach can only indirectly affect the acceptance of a LPR policy by perceived effectiveness and perceived value, while policy cognition, attribution of responsibility have no significant influence on the acceptance of a LPR policy. Important aims and perceived effectiveness directly and direct affect the acceptance of a LPR policy by residents who are young, high-income and car-owning. The findings of this study can assist policy makers to design a more acceptable policy to further mitigate congestion situations.

Background Glomerular deposition of C4d is a widely used biomarker for activation of the lectin pathway in the complement system and is reported to be associated with kidney progression in immunoglobulin A nephropathy (IgAN). The aim of this study was to evaluate whether glomerular C4d deposition, as a new biomarker, improves the prediction of kidney prognosis in IgAN. Study Design Systematic review and meta-analysis. Setting & Population Patients with biopsy-proven primary IgAN without age limitations. Selection Criteria for Studies: Cross-sectional or cohort studies reporting the prevalence of glomerular C4d deposition or evaluating its association with IgAN progression. Predictor Glomerular C4d deposition. Outcome Composite progression event of a >30% decline in estimated glomerular filtration rate or end-stage kidney disease. Results 12 studies with 1,251 patients were included. The prevalence of glomerular C4d deposition was 34% (95% CI, 27%-41%), with large heterogeneity (I2 = 86%; P

Modern complex chemical process operations produce a large amount of process monitoring and control time series data, which are potentially useful to extract valuable operating experiences and manipulating rules to improve the intelligence of process operations. Previous researches show that time series clustering is an effective method to mine historical control sequences. However, the actual working conditions often deviate from the historical data, making it difficult to reconstruct accurate process regulation manipulating strategies. In response to this problem, this paper proposes a manipulation strategies reconstruction method using a convolutional neural network model (MSR-CNN). Therein, the time series are hierarchically clustered according to the Levenshtein distance to obtain different classes of process disturbance states, and the corresponding manipulated sequences fragments obtained are treated with a symbolic aggregation approximation. Then the improved convolutional neural network is used for deep learning and manipulation strategies reconstruction of the process disturbance states and the corresponding manipulating sequences strings. Finally, applying to a numerical example and an ethanol–water distillation tower unit, the proposed method is proved to be effective. Compared with traditional supervisory control methods, our contributions can help well construct complex chemical process control strategies less dependent on human operators’ operating experiences.

Breast cancer is one of the most lethal malignancies among women; however, the underlying molecular mechanism involved in the progression and metastasis of breast cancer remains unclear. Numerous studies have confirmed that long noncoding RNAs are abnormally expressed in breast cancer and play crucial roles in cell proliferation and metastasis. In the study, we evaluated the functional role and detailed mechanism of DGUOK-AS1 in breast cancer progression and metastasis. DGUOK-AS1 knockdown suppressed proliferation, migration, and invasion of breast cancer cells in vitro and in vivo. Mechanistically, miR-204-5p was identified as an inhibitory target of DGUOK-AS1, which served as a tumor suppressor in breast cancer. Significantly, we found that the ectopic expression of miR-204-5p could counteract DGUOK-AS1-mediated promotion of cell proliferation and metastasis in breast cancer. Moreover, IL-11 was found to be the downstream target of miR-204-5p, and DGUOK-AS1 could protect IL-11 from miR-204-5p-mediated degradation. DGUOK-AS1 overexpression promoted breast cancer cell migration, angiogenesis, and macrophage migration, mediating by the increased secretion of IL-11, which was extremely important for cancer progression. Collectively, our studies reveal that DGUOK-AS1/miR-204-5p/IL-11 axis plays a significant role in the progression and metastasis of breast cancer, and DGUOK-AS1 might be a novel biomarker and therapeutic target for breast cancer., Graphical abstract, LncRNA DGUOK-AS1 is proved to promote the expression and secretion of IL-11 in breast cancer through sponging miR-204-5p, which significantly enhances the progression and metastasis of breast cancer. These results not only identify DGUOK-AS1 as an oncogene, but also provide a potential biomarker and therapeutic target for breast cancer.

Immune checkpoints are the crucial regulators of immune system and play essential roles in maintaining self-tolerance, preventing autoimmune responses, and minimizing tissue damage by regulating the duration and intensity of the immune response. Furthermore, immune checkpoints are usually overexpressed in cancer cells or noninvasive cells in tumor tissues and are capable of suppressing the antitumor response. Based on substantial physiological analyses as well as preclinical and clinical studies, checkpoint molecules have been evaluated as potential therapeutic targets for the treatment of multiple types of cancers. In the last few years, extensive evidence has supported the immunoregulatory effects of traditional Chinese medicines (TCMs). The main advantage of TCMs and natural medicine is that they usually contain multiple active components, which can act on multiple targets at the same time, resulting in additive or synergistic effects. The strong immune regulation function of traditional Chinese medicine on immune checkpoints has also been of great interest. For example, Astragalus membranaceus polysaccharides can induce anti-PD-1 antibody responses in animals, and these antibodies can overcome the exhaustion of immune cells under tumor immune evasion. Furthermore, many other TCM molecules could also be novel and effective drug candidates for the treatment of cancers. Therefore, it is essential to assess the application of immune checkpoints in the development of new drugs and TCMs. In this review, we focus on research progress in the field of immune checkpoints based on three topics: (1) immune checkpoint targets and pathways, (2) development of novel immune checkpoint-based drugs, and (3) application of immune checkpoints in the development of TCMs., Graphical abstract In this review, we provide a discussion of the applications of immune checkpoints in the development of novel drugs and TCMs.Image 1

The consensus guidelines for branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) of the pancreas are mostly based on imaging features. This study aimed to determine imaging features and their diagnostic accuracy for predicting high-grade dysplasia (HGD)/malignancy in BD-IPMN, including mixed type. The PubMed, Embase, and Cochrane databases were searched, and data were extracted from relevant studies. As the main diagnostic accuracy index, diagnostic odds ratios (DORs) of imaging features for diagnosing HGD/malignancy in BD-IPMNs were pooled using the random-effects model. A bivariate random-effects approach was used to construct summary receiver operating characteristic curves for sensitivity and specificity estimation. The pooled DOR was the highest for the enhanced solid component/mural nodule (MN) (DOR, 12.21; 95 % confidence interval [CI], 6.14–24.27), followed by a main pancreatic duct (MPD) diameter of 10 mm or greater (DOR, 7.93; 95 % CI, 3.02–20.83), solid component (DOR, 4.85; 95 % CI, 2.49–9.42), lymphadenopathy (DOR, 4.84; 95 % CI, 1.11–21.06), MN (DOR, 4.48; 95 % CI, 3.15–6.39), an MPD diameter of 5 mm or greater (DOR, 3.69; 95 % CI, 2.62–5.19), abrupt change in MPD caliber with distal pancreatic atrophy (DOR, 2.65; 95 % CI, 1.66–4.24), thickened/enhancing walls (DOR, 2.38; 95 % CI, 1.57–3.60), and cyst size of 3 cm or larger (DOR, 1.98; 95 % CI, 1.48–2.64). The largest area under the curve (0.89 and 0.95, respectively) and high specificity (0.95 and 0.98, respectively) also were found for enhanced solid component/MN and an MPD diameter of 10 mm or greater, albeit with low sensitivity (0.38 and 0.14, respectively). The aforementioned imaging features could aid in predicting HGD/malignancy of BD-IPMN. Furthermore, enhanced solid component/MN and an MPD diameter of 10 mm or greater were the most important predictors of HGD/malignancy in BD-IPMN and should be considered as indications for surgery.

Aim We aimed to clarify whether snacking habits decrease the risk of all-cause mortality in an older Japanese population. Methods The study participants were 64- or 65-year-old community-dwelling residents recruited each survey year from 1996 through 2005. Data on the frequency of snacking and other lifestyle factors were obtained during the baseline survey using self-administered questionnaires, and the participants were followed up annually until the end of 2017. In total, 2943 participants (1484 men and 1459 women) were eligible. All-cause mortality was compared among participants grouped by frequency of snacking (no snacking, one to four times/week, or every day). Results The number of deaths recorded over the study period of 43 204 person-years was 357 (24.1%) for men and 173 (11.9%) for women. The mean +/- standard deviations for the follow-up period were 14.2 +/- 4.9 years in men and 15.2 +/- 4.5 years in women. Cox proportional hazard regression analyses showed that after adjusting for potential confounding factors, the hazard ratios for women were 0.64 (95% confidence interval [CI], 0.43-0.94) in the group that had a habit of snacking one to four times/week, and 0.93 (95% CI 0.63-1.36) in the group that had a habit of snacking every day compared with those in the no snacking group. These associations were not observed among men. Conclusions A moderate frequency of snacking slightly decreases the risk of all-cause mortality among women. Our findings might be useful for improving the nutrition statuses in older female adults. Geriatr Gerontol Int center dot center dot; center dot center dot: center dot center dot-center dot center dot Geriatr Gerontol Int 2021; center dot center dot: center dot center dot-center dot center dot.

Background We aimed to examine the association of three mineral metabolism markers, including serum calcium, inorganic phosphorus, and intact parathyroid hormone with the risk of chronic kidney disease (CKD) at all stages. Methods This retrospective cohort study involved 3563 participants, including 3274 CKD patients and 289 healthy controls. CKD is diagnosed according to clinical guidelines from the 2012 KDIGO. Effect sizes are expressed odds ratio (OR) and 95 confidence interval (CI). Results After propensity score matching, per 0.5 mg/dL increment of inorganic phosphorus was significantly associated with 1.33-, 1.61-, and 2.85-fold increased risk of CKD at stages 1–2, 4, and 5, respectively. Regarding per 8 pg/mL increment of intact parathyroid hormone, significance was only noted for stage 5. In subsidiary analyses, the risk prediction of mineral metabolism markers under study was more evident in males and hypertensive subjects. A nomogram prediction model was constructed based on age, sex, and three mineral metabolism markers for CKD, with decent accuracy. Conclusions Our findings indicate that serum calcium was associated with all-stage CKD risk, whereas the association for inorganic phosphorus and intact parathyroid hormone was significant at advanced stages.

Fast time-varying channel parameters and large penetration losses for signals passing through train carriages are two well-known challenges for wireless communications on high speed rails (HSRs). In this paper, we introduce, for the first time, backscatter technology into HSR wireless communications, which can address these two challenges and yet have low complexity of signal processing and low cost of circuit implementation compared with traditional solutions such as relaying or beamforming. Specifically, we propose a backscatter aided wireless transmission (BAWT) scheme and demonstrate that it outperforms the existing direct wireless transmission (DWT) scheme. We derive the upper and lower bounds of channel capacity for BAWT and prove that it exceeds that of DWT on certain conditions. We also propose the transceiver design for both BAWT and DWT, including joint carrier frequency offset and channel estimator, and signal detector. We show that BAWT, rather than DWT, can obtain the channel statistical information in practical applications due to fixed train antennas and unchanged tracks, which can be utilized to facilitate channel estimation. Finally, simulation results are provided to corroborate the proposed solutions.

Background IKBKB/IKKβ, as the core catalytic subunit of IκB kinase complex, participates in mediation of the classical NF-κB pathway, which has been linked to inflammation and tumorigenesis. Previous studies have shown that single nucleotide polymorphisms in IKBKB have been related to gastric cancer, but how they associate to the clinical outcome is not yet clear. In this study, we retrospectively investigated the associations between single nucleotide polymorphisms located in IKBKB and gastric cancer survival. Materials and Methods IKBKB rs2272736 was genotyped in 1210 patients with primary gastric cancer in a Han Chinese population, and the relationships between rs2272736 and overall survival were evaluated. We conducted Cox proportional hazards regression, which was performed to estimate the effects of single nucleotide polymorphisms on the overall survival of patients, adjusted for potential confounding variables. Results We found that patients with rs2272736 A allele in IKBKB had significantly prolonged overall survival time compared to those with the G allele (HR = 0.83, 95% CI = 0.68-1.00, P = 0.050). In addition, AA genotype was demonstrated to have reduced risk of death for gastric cancer compared with that associated with the GG/GA genotypes, which was more common in patients with cardiac carcinoma, well-differentiated and moderately differentiated tumors, TNM Ⅰ/Ⅱ stages and intestinal type. Conclusion Our findings have shown that single nucleotide polymorphism rs2272736 in IKBKB may be a promising prognostic biomarker which should promote personalized treatment.

Background We studied patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a virus that originated in Wuhan, China, and is spreading over the country including Jiangsu Province. We studied the clinical characteristics and therapies of severe cases in Jiangsu Province. Methods A multicenter retrospective cohort study was conducted to analyze clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection in Jiangsu Province between January 24, 2020 and April 20, 2020. The improvement and deterioration subgroups were compared to identify predictors of disease progression. Results A total of 653 infected cases with COVID-19 were reported in Jiangsu Province, of which 60 severe cases were included in this study. Up until April 20, 2020, the mortality of severe patients was 0%. The median age was 57 years. The average body mass index (BMI) of these patients was 25 kg/m². White blood cell counts decreased in 45.0% of patients, lymphopenia in 63.3%, thrombocytopenia in 13.3%, and procalcitonin levels in 88.3% of the patients were less than 0.5 ng/mL. There were no statistically significant differences in immunoglobulin therapy and glucocorticoids therapy between the improvement and deterioration subgroups. Logistic regression analysis identified higher levels of troponin T (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.00-1.08; P=0.04), antiviral therapy with aerosol inhalation of interferon (OR: 6.33; 95% CI: 1.18-33.98; P=0.03), and the application of non-invasive mechanical ventilation (OR: 1.99; 95%CI: 1.17-3.41; P=0.01) as predictors of disease progression, whereas higher lymphocyte count (OR: 0.11; 95% CI: 0.02-0.57; P=0.01) and early prone ventilation were associated with improvement (OR: 0.11; 95% CI: 0.01-0.98; P=0.04). Conclusions COVID-19 infection had a low mortality rate in Jiangsu Province, China. The higher levels of troponin T and lower lymphocyte count were predictors of disease progression. Early prone ventilation may be an effective treatment for severe cases.

Background Pre-treatment PLR (platelet-lymphocyte ratio) was reported to be associated with the prognosis in gastric cancer (GC), but the results remain inconclusive. This meta-analysis aimed to investigate the prognostic potential of the pre-treatment PLR in gastric cancer. Methods We performed a systematic literature search in PubMed, Embase, and the Cochrane Library to identify eligible publications. The hazard ratio (HR)/odds ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated. Results A total of 49 studies (51 cohorts), collecting data from 28,929 GC patients, were included in the final analysis. The pooled results demonstrated that the elevated pre-treatment PLR was significantly associated with poor overall survival (OS) (HR 1.37, 95% CI 1.26–1.49, p < 0.001; I2 = 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95% CI 1.22–1.90, p < 0.001, I2 = 88.6%, Ph < 0.001). Furthermore, the patients with the elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI 1.02–1.33, p = 0.023), serosal invasion (T3+T4) (OR = 1.34, 95% CI 1.10–1.64, p = 0.003), and increased advanced stage (III+IV) (OR = 1.20, 95% CI 1.06–1.37, p = 0.004). Conclusions An elevated pre-treatment PLR was a prognostic factor for poor OS and DFS and associated with poor clinicopathological parameters in GC patients.

Inflammatory bowel disease (IBD) has become a global disease with accelerating incidence worldwide in the 21st century while its accurate etiology remains unclear. In the past decade, gut microbiota dysbiosis has consistently been associated with IBD. Although many IBD-associated dysbiosis have not been proven to be a cause or an effect of IBD, it is often hypothesized that at least some of alteration in microbiome is protective or causative. In this article, we selectively reviewed the hypothesis supported by both association studies in human and pathogenesis studies in biological models. Specifically, we reviewed the potential protective bacterial pathways and species against IBD, as well as the potential causative bacterial pathways and species of IBD. We also reviewed the potential roles of some members of mycobiome and virome in IBD. Lastly, we covered the current status of therapeutic approaches targeting microbiome, which is a promising strategy to alleviate and cure this inflammatory disease.

The deep learning methods in the field of computer vision and big data are becoming more and more mature. Through the application of big data and deep learning technology, the diagnosis of artificial intelligence medical image can be realized, which provides a new opportunity for the automatic analysis of obstetrics medical image and the assistance of doctors to realize high-precision intelligent diagnosis of diseases. The current medical obstetric image diagnosis platform mainly targets low-resolution medical obstetric image files, and does not consider the data-sharing problem of the distributed file system in different storage nodes, which greatly reduces the efficiency of obstetric image storage and diagnosis. Based on this, this article designs an obstetric image diagnostic platform based on cloud computing technology. First, a medical imaging platform was designed by combining cloud computing technology, caching technology, and a distributed file system. Secondly, the use of contrast-enhanced ultrasound technology provides a more accurate ultrasound image for assessing the structure, size, location, and developmental abnormalities of the placenta. Finally, the effectiveness of the obstetric imaging diagnostic platform proposed in this paper is verified by experiments. The results show that the platform has fast data processing speed and convenient use, which greatly reduces the cost of medical equipment and improves efficiency. The hospital only needs to collect the obstetric image of the patient at the front end, transfer it to the cloud for image processing, and finally diagnose the disease.

Background Gait was proved to be strongly associated with global cognitive function and multiple cognitive domains; however, previous research usually concentrated on individual gait parameters. This study used wearable sensors to measure gait parameters in different aspects and comprehensively explored the association of gait with global cognitive function and cognitive domains. Methods The data of this cross-sectional study were obtained from 236 community-dwelling Japanese older adults (125 men and 111 women) aged 70–81 years. Gait was measured by asking participants to walk a 6-m course and back using the Physilog® sensors (GaiUp®, Switzerland). Global cognitive function and cognitive domains were evaluated by face-to-face interviews using the Japanese version of the Montreal Cognitive Assessment. Twenty gait parameters were summarized as independent gait factors using factor analysis. A generalized linear model and linear regression model were used to explore the relationship of gait with global cognitive function and cognitive domains adjusted for several confounding factors. Results Factor analysis yielded four gait factors: general cycle, initial contact, propulsion, and mid-swing. Among them, general cycle factor was significantly associated with global cognitive function (β = − 0.487, [− 0.890, − 0.085]) and executive function (P = 0.049); initial contact was associated with executive function (P = 0.017). Conclusion General cycle of gait might be the better marker of global cognitive function and gait is most strongly associated with executive function. The longitudinal relationships should be examined in future cohort studies.

Background: Academic research is one of the main avenues through which humans can fight the threat of infectious diseases. However, there has been concerns regarding whether academic system has provided sufficient efforts to fight infectious diseases we potentially face. Answering these questions could contribute to evidence-based recommendations for setting research priorities and third-mission policies. Methods: With a focus on one of the most common categories of communicable diseases, infectious and parasitic diseases (IPDs), we searched Web of Science for articles and reviews relevant to IPDs published during 2000-2019 and acquired WHO data of disease burden in corresponding years. The academic response patterns were explored by IPD subcategory, and by human development level (an index established by the UN). We in particular conduct the analysis to gain insight on the dynamic relationship between disease burden and research effort on IPD, scientific efforts contributed by countries with different development levels, and the variation trends in international joint efforts. Results: The greatest burden of IPD disease is clustered in the developing regions of Africa, but has received academic response from both developed and developing countries. Highly developed countries dominate the ranks of academic research in this area, yet there is also a clear increase of research efforts from the countries most affected, despite their low human development scale. In fact, the overall analysis reveals an improved capability of addressing local problems from African regions. In terms of international collaboration, highly developed countries, such as the US and UK, have commonly collaborated with needy regions, whereas prolific but developing nations, like China, have not. Conclusions: From a global perspective, academia has positively responded to health need caused by IPD. Although the relevant research output is primarily contributed by the highly developed countries, the concentrated efforts from the undeveloped regions to ease their local burdens can be clearly observed. Our findings also indicate the tendency on focusing more on local health needs for both developed and undeveloped regions. The insights revealed in this study should benefit a more informed and systemic plan of research priorities.

Background Phytosterols have anticancer effects and have been shown to inhibit various forms of cancer. However, epidemiological studies on the relationship between phytosterols and esophageal cancer risk are quite limited. The aim of this study was to investigate dietary phytosterol intake in relation to esophageal squamous cell carcinoma (ESCC) in the Chinese population. Methods A case–control study was conducted from July 2011 to June 2013, recruiting 856 eligible ESCC cases plus 856 controls. Dietary information was collected by using a validated food frequency questionnaire. The OR and 95% CI of ESCC risk were assessed by multivariable logistic regression models. Results The total phytosterols was found to be associated with a 56% (95% CI: 0.32- 0.61) reduction in ESCC risk when comparing the highest with the lowest tertiles, after adjusting for various confounders. An inverse association was also found between the consumption of β-sitostanol, β-sitosterol, campesterol and ESCC risk. No statistically significant association was found between rapesanol and ESCC risk. Conclusions These data indicated that the consumption of total phytosterols, β-sitostanol, β-sitosterol, campesterol is inversely associated with ESCC risk in a Chinese population Key messages Phytosterols consumption may contribute to the prevention of esophageal squamous cell carcinoma

Background Previous studies reported that physical activity (PA) could prevent frailty, but the longitudinal evidence between PA volume and frailty is scarce. Additionally, the impact of daily walking time on the risk of frailty is unclear. This study aimed to examination the association of incident frailty with PA volume and daily walking time among Japanese community-dwelling older adults. Methods About 485 participants aged 70–74 years from the Japan Gerontological Evaluation Study were included in this study. Frailty was assessed at baseline and 3 years later by using the Kaigo-Yobo Checklist. PA was assessed using the short-term International Physical Activity Questionnaire. Logistic regression was performed to calculate relative risk (RR) with 95% confidence intervals (CIs) after adjusting for potential confounders. Results After 3 years of follow-up, 46 new frailty cases were recorded. The association of frailty incidence with both PA volume and daily walking time presented a U-shaped curve, albeit not statistically significant. After adjusting for potential confounding factors, walking for 0.5–1 h per day displayed a greater association with decreased frailty risk (RR, 0.35; 95% CI, 0.12–0.98) than higher levels of daily walking time. We did not observe an association between PA volume and subsequent frailty. Conclusions Walking for 0.5–1 hour/day significantly decreases frailty risk. Incorporating a moderate level of regular walking into the daily lives of older adults may postpone the onset of frailty and improve the ageing process. Further studies are needed to investigate the impact of higher PA levels on frailty risk.

Background Dietary diversity is thought to reduce risk of malnutrition although it is also linked to obesity. We examined whether dietary diversity is associated with all-cause mortality in Japanese elderly by body mass index (BMI). Methods The current study included 2,944 people aged 64-65 years who participated in the NISSIN project in 1996-2005. Dietary diversity was measured by the Food Variety Score (FVS) which calculates frequency of all food items consumed daily using a self-administered food frequency questionnaire. Participants were divided into tertiles according to their FVS (1st: low, 2nd: middle, 3rd: high). Multivariate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using the Cox proportional hazard regression model. In stratified analysis, BMI was used to divide the participants into 3 groups: lean (BMI Results Overall, 454 (30.7%) men and 222 (15.2%) women died over the median follow-up period of 16.6 years. No significant association between FVS and all-cause mortality was observed overall. However, when grouped by BMI, in the lean, multivariate adjusted HRs were 0.32 (CI: 0.17-0.59) in the middle FVS and 0.41 (CI: 0.19 -0.91) in the high FVS, compared with the low FVS. No significant association was found for normal and overweight/obese. Conclusions These findings indicate dietary diversity should be promoted for lean older adults. Key messages BMI should be considered when promoting dietary diversity.

Yan Du,1,&ast; Xueru Duan,1,&ast; Murui Zheng,2,&ast; Wenjing Zhao,3,&ast; Jun Huang,4 Lixian Lao,5 Fan Weng,6 Dan-Er Lin,7 Zhenxiao Yang,1 Haiyi Li,1 Xudong Liu,1 Hai Deng5 1Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Guangzhou Center for Disease Control and Prevention, Guangzhou, People’s Republic of China; 3Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan; 4Department of Geriatrics, Institute of Geriatrics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Science, Guangzhou, People’s Republic of China; 5Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Science, Guangzhou, People’s Republic of China; 6Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, People’s Republic of China; 7Guangzhou Baiyun District Center for Disease Control and Prevention, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xudong Liu; Hai Deng Tel +86-20-87330619; +86-20-83827812-10263Email liuxudong@mail.sysu.edu.cn; doctordh@hotmail.comObjective: The effect of dietary factors on OSA remains unclear. This study was to investigate the association of obstructive sleep apnea (OSA) with individual and overall effects of eating habits among adult Chinese.Methods: A total of 9733 participants were selected from the baseline survey of the Guangzhou Heart Study. OSA was ascertained by Berlin Questionnaire. Food consumption was collected using a food frequency questionnaire, and eating patterns were extracted by principal component analysis. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated by the logistic regression model.Results: After adjustment for confounders, fried food intake with ≥ 1/week was associated with an increased risk of OSA (OR: 1.77, 95% CI: 1.37– 2.27), while fruit consumption of ≥ 1/day was associated with a 26% reduced risk of OSA (OR: 0.74, 95% CI: 0.62– 0.88). Three eating patterns were defined and labeled as pattern I, II, and III. Eating pattern III which had higher factor loadings of animal innards, fried food, salted food, carbonate, and non-carbonated beverages was associated with an increased risk of OSA (OR: 1.30, 95% CI: 1.09– 1.55) when comparing the highest with the lowest tertile of pattern score, after adjusting for confounders; every 1-unit increment of pattern III score was associated with an increased risk of OSA (OR: 1.09, 95% CI: 1.04– 1.14). Neither pattern I nor pattern II was observed to be associated with OSA risk.Conclusion: A higher frequency intake of fruits was associated with a reduced OSA risk and a diet with higher levels of consumption of animal innards, fried food, salted food, carbonated beverages, and non-carbonated beverages may increase the risk of OSA.Keywords: obstructive sleep apnea, eating habits, diet, fruits, fried food

Triple-negative breast cancer (TNBC) is highly heterogeneous and has a poor prognosis. It is therefore important to identify the underlying molecular mechanisms in order to develop novel therapeutic strategies. Although emerging research has revealed long noncoding RNAs (lncRNA) as vital to carcinogenesis and cancer progression, their functional involvement in TNBC has not been well defined. In this study, we utilized the The Cancer Genome Atlas (TCGA) database and analyzed clinical samples to show that the long noncoding antisense transcript of nicotinamide phosphoribosyltransferase (NAMPT), NAMPT-AS, is upregulated in TNBC and is associated with poor prognosis, lymph node involvement, metastasis, and advanced stage. NAMPT-AS was cotranscribed with NAMPT from a bidirectional promoter, where the distributions of H3K4me3 and H3K27Ac chromatin modifications were enriched based on ENCODE and FANTOM5, suggesting the potential enhancer-RNA characteristics of NAMPT-AS. NAMPT-AS epigenetically regulated the expression of NAMPT in two divergent ways: NAMPT-AS recruited POU2F2 to activate the transcription of NAMPT, and NAMPT-AS acted as a competing endogenous RNA to rescue NAMPT degradation from miR-548b-3p. NAMPT-AS/NAMPT promoted tumor progression and regulated autophagy through the mTOR pathway in vitro and in vivo. In a cohort of 480 breast cancer patients, NAMPT was associated with breast cancer-specific survival and overall survival. These results demonstrate that NAMPT-AS is an oncogenic lncRNA in TNBC that epigenetically activates NAMPT to promote tumor progression and metastasis. Furthermore, these data identify NAMPT-AS/NAMPT as promising therapeutic targets in patients with TNBC. SIGNIFICANCE: Upregulation of the long noncoding antisense RNA of NAMPT gene (NAMPT-AS) is associated with metastasis and poor prognosis in TNBC.

Emerging evidence suggests that circular RNAs (circRNAs) have crucial roles in various processes, including cancer development and progression. However, the functional roles of circRNAs in breast cancer remain to be elucidated. In this study, we identified a novel circRNA (named circBMPR2) whose expression was lower in breast cancer tissues with metastasis. Moreover, circBMPR2 expression was negatively associated with the motility of breast cancer cells and significantly downregulated in human breast cancer tissues. Functionally, we found that circBMPR2 knockdown effectively enhanced cell proliferation, migration, and invasion. Moreover, circBMPR2 knockdown promoted tamoxifen resistance of breast cancer cells through inhibiting tamoxifen-induced apoptosis, whereas circBMPR2 overexpression led to decreased tamoxifen resistance. Mechanistically, we demonstrated that circBMPR2 could abundantly sponge miR-553 and that miR-553 overexpression could attenuate the inhibitory effects caused by circBMPR2 overexpression. We also found that ubiquitin-specific protease 4 (USP4) was a direct target of miR-553, which functions as a tumor suppressor in breast cancer. Our findings demonstrated that circBMPR2 might function as a miR-553 sponge and then relieve the suppression of USP4 to inhibit the progression and tamoxifen resistance of breast cancer. Targeting this newly identified circRNA may help us to develop potential novel therapies for breast cancer patients. Keywords: breast cancer, circBMPR2, tumor suppressor, tamoxifen resistance, miR-553, USP4

The improvement of color similarity between stereo images can bring better performance to stereo matching algorithms. For this purpose, we present a color correction method to alleviate the color discrepancy between a pair of stereo images, so that the color appearance of one image, i.e., the target image, is consistent with the other image, i.e., the source image. Our method starts with decomposing both the target image and the source image into two intrinsic layers, i.e., the reflectance layer and the shading layer, using intrinsic decomposition. The purpose of intrinsic decomposition is to distinguish and then process different color discrepancies caused by different factors (shading and reflectance) separately and appropriately. Then, a practical and effective consistent segmentation algorithm, which applied to the original stereo images, is proposed to establish the region correspondences. Next, luminance correction method and color correction method, based on the local region correspondences, are adopted to correct the shading layer and the reflectance layer in the target image, respectively, making them as similar as possible to those of the source image. Eventually, the two corrected layers of the target image are combined to yield the final corrected image. The experimental results demonstrate that the proposed method, which using intrinsic decomposition to handle color discrepancy caused by different factors, not only enhances the visual color similarity between the stereo images but also improves the accuracy of their stereo matching.

Purpose There still exist some arguments regarding the use of postmastectomy radiotherapy (PMRT) for patients with breast cancer carrying one to three positive axillary lymph nodes considering the heterogeneity of this cohort. Here, we developed a prognostic nomogram to estimate the probability of long-term outcome in patients receiving or not receiving PMRT in order to assist in making individually locoregional treatment decisions for this particular cohort. Methods Altogether, 20,336 women, aged 18 to 80 years, diagnosed with breast cancer, and carrying one to three positive nodes were identified in the Surveillance, Epidemiology, and End Results (SEER) database. We applied multivariant Cox hazard model to determine the impact of covariates on disease-specific survival (DSS) and overall survival (OS). Then, the nomogram was built accordingly. Internal and external validations were performed to examine the accuracy of nomograms. Results Age of diagnosis, tumor grade, size, estrogen and progesterone receptor status, and number of positive nodes were independent factors of DSS and OS in the multivariate analysis. Incorporating these factors into the constructed nomogram showed high accuracy when predicting 5- and 10-year survival, with internally and externally bootstrap-corrected concordance indexes in the range of 0.6 to 0.8. Conclusion Besides the number of involved nodes, extra variables existed as predictors of survival outcomes in this cohort; therefore, the recommendation of PMRT or no PMRT requires comprehensive consideration. This clinically validated nomogram provided a useful tool that could aid decision making by estimating DSS and OS benefits from PMRT, useful in predicting 5- and 10-year DSS and OS for patients with one to three positive nodes after mastectomy. Implications for Practice This study evaluated population-based data to identify prognostic factors associated with patients with breast cancer with one to three lymph nodes and help clinicians to weigh the benefit of postmastectomy radiotherapy (PMRT). Surveillance, Epidemiology, and End Results (SEER) data were used to develop a prognostic nomogram to predict the likelihood of long-term survival with and without PMRT in order to optimize the individual locoregional control strategy for this particular cohort. This clinically validated nomogram provides a useful tool to predict 5- and 10-year disease-specific survival and overall survival for patients with one to three positive nodes and can aid tailored clinical decision making by estimating predicted benefit from PMRT.

Background:The gene metastasis-associated in colon cancer-1 (MACC1) has been reported to be overexpressed in diverse human malignancies, and an increasing amount of evidence suggests that its overexpression is associated with the development and progression of many human tumors. However, the prognostic and clinicopathological value of MACC1 in gastric cancer remains inconclusive. Therefore, we conducted this meta-analysis to investigate the effect of positive MACC1 expression on clinicopathological features and survival outcomes in gastric cancer.Methods:Medline, Web of Science, and EMBASE databases were searched for relevant articles published up to 10 April 2018. The correlation of MACC1 expression levels with overall survival and clinicopathological features was analyzed.Results:In this meta-analysis, nine studies with a total of 2103 gastric cancer patients were included. Our results showed that high expression of MACC1 was significantly related to a poor overall survival. Moreover, our meta-analysis showed that MACC1 overexpression was significantly linked to distant metastasis and vascular invasion. There were no significant correlations between positive MACC1 expression and gender, localization, tumor-node-metastasis (TNM) stage, tumor extent (T stage) and lymph node involvement (N stage)Conclusions:MACC1 expression levels can serve as a novel prognostic factor in gastric cancer patients.

Macrophages in the intestinal mucosa can rapidly engage Toll-like receptor [TLR]-mediated inflammatory responses to protect against pathogen invasion, but these same innate immune responses can also drive the induction of colitis. Our previous research revealed that metadherin [MTDH] is overexpressed in multiple cancers and plays vital roles in tumour progression. However, the role of MTDH in intestinal inflammation is largely unknown. In this study, we found the MTDH expression in colonic lamina propria [CLP] macrophages was positively correlated with inflammatory colitis severity. MTDH-/- mice were protected against the symptoms of dextran sodium sulphate [DSS]-induced colitis; however, adoptive transfer of MTDH wild-type [WT] monocytes partially restored the susceptibility of MTDH-/- mice to DSS-induced colitis. TLR stimulation was sufficient to induce the expression of MTDH, whereas the absence of MTDH was sufficient to suppress TLR-induced production of inflammatory cytokines by macrophages. From a mechanistic perspective, MTDH recruited TRAF6 to TAK1, leading to TRAF6-mediated TAK1 K63 ubiquitination and phosphorylation, ultimately facilitating TLR-induced NF-κB and MAPK signalling. Taken together, our results indicate that MTDH contributes to colitis development by promoting TLR-induced pro-inflammatory cytokine production in CLP macrophages and might represent a potential therapeutic approach for intestine inflammation intervention.

Long non-coding RNAs(lncRNAs) play an important role in cancer initiation and progression. However, hub lncRNAs involved in breast cancer still remain underexplored. In this study, integrated bioinformatics analysis was used to define LINC01977 as a key oncogenic driver in breast cancer. Subsequently, in vitro assays showed that LINC01977 could significantly promote breast cancer progression and chemoresistance to doxorubicin. To further investigate its biological mechanism, we performed dual-luciferase reporter assay, real-time PCR, RNA immunoprecipitation (RIP), and rescue assay. Our results indicated that LINC01977 may function as ceRNA to prevent GOLM1 gene from miRNA-mediated repression by sponging miR-212-3p. Overall, LINC01977 can serve as a novel prognostic indicator, and help develop more effective therapeutic approaches for breast cancer patients.

Objectives. Molecular subtypes are employed as a guide for targeted treatment and important prognostic factors. This study focused on investigating the association of serum levels of CEA, CA15-3, and CA125 with clinicopathological characteristics of breast cancer to find prognostic markers for breast cancer and provide precise targeted therapy. Materials and Methods. In this study, 961 breast cancer patients with preoperative serum levels of CEA, CA15-3, and CA125 and molecular subtypes were analyzed. Cut-off values of 5 ng/ml, 25 U/ml, and 35 U/ml were used for CEA, CA15-3, and CA125, respectively. The χ 2 test and Fisher exact test along with logistic multivariate regression analysis were performed for investigating the correlation of CEA, CA15-3, and CA125 serum levels with molecular subtypes and associated factors. Results. An increase in the serum concentrations of CEA, CA15-3, and CA125 was discovered in 48 (4.99%), 54 (5.62%), and 55 (5.72%) breast cancer patients, respectively. Univariate analysis demonstrated that the levels of CEA ( p < 0.01 ) and CA15-3 ( p < 0.05 ) were significantly linked with molecular types of breast cancer. Moreover, patients having larger tumor size ( p < 0.01 , p < 0.0001 , and p < 0.05 , respectively) along with nodal metastasis ( p < 0.05 , p = 0.0001 , and p < 0.05 , respectively) exhibited higher rates of elevated CEA, CA15-3, and CA125 levels. Status of Her-2 positive ( p < 0.01 ) had a significant connection with elevated CEA levels. Multivariate analysis further indicated that molecular subtypes were independent factors associated with CEA and CA15-3 levels. Also, Her-2 status was significantly and independently related to CEA levels. Conclusion. Preoperative serum levels of CEA and CA15-3 were independently associated with molecular subtypes of breast cancer. CEA and CA15-3 might improve the prognostic prediction for patients with breast cancer and inform the selection of specific therapies. A further biological analysis is needed for investigating the relationship between Her-2 expression and CEA levels.

Color constancy refers to the ability to make the color of an object not change with the change of the light color of the scene. The use of convolutional neural networks improves the accuracy and stability of color constancy. But the traditional convolutional neural network structure cannot apply the semantic features in the image to the color constancy, which makes the illumination estimation fuzzy, greatly reduces the quality of network training. In order to solve this problem, in this work we propose a new network structure called multi-path feature fusion weighted fully convolutional neural network structure. The network structure contains three convolutional neural network branches for fully extracting semantic features in images. After that, the extracted features are fused and weighted to accurately estimate the light source. Experimental results show that the multi-path feature fusion weighted network structure can make fully use of the semantic feature information in the image to accurately estimate the scene light source. At the same time, it is a more lightweight network, which achieves the simultaneous improvement of the accuracy and speed of light source estimation, meets the requirements of mobile devices for lightweight network models.

Purpose This study aimed to develop a model based on radiomics features extracted from computed tomography (CT) images to effectively differentiate between minimally invasive adenocarcinomas (MIAs) and invasive adenocarcinomas (IAs) manifesting as pure ground-glass nodules (pGGNs) larger than 10 mm. Method This retrospective study included patients who underwent surgical resection for persistent pGGN between November 2012 and June 2018 and diagnosed with MIAs or IAs. The patients were randomly assigned to the training and test cohorts. The correlation coefficient method and the least absolute shrinkage and selection operator (LASSO) method were applied to select radiomics features useful for constructing a model whose performance was assessed by the area under the receiver operating characteristic curve (AUC-ROC). The radiomics model was compared to a standard CT model (shape, volume and mean CT value of the largest cross-section) and the combined radiomics-standard CT model using univariate and multivariate logistic regression analysis. Results The radiomics model showed better discriminative ability (training AUC, 0.879; test AUC, 0.877) than the standard CT model (training AUC, 0.820; test AUC, 0.828). The combined model (training AUC, 0.879; test AUC, 0.870) did not demonstrate improved performance compared with the radiomics model. Radiomics_score was an independent predictor of invasiveness following multivariate logistic analysis. Conclusions For pGGNs larger than 10 mm, the radiomics model demonstrated superior diagnostic performance in differentiating between IAs and MIAs, which may be useful to clinicians for diagnosis and treatment selection.

Zhao, W.; Zhao. G.; Yang, J.; Xu, M., and Kou, J., 2020. Assessment of the ecological security of the coastal zone of the Guangdong/Hong Kong/Macao greater bay area. In: Jung, H.-S.; Lee, S.; Ryu, J.-H., and Cui, T. (eds.), Advances in Geospatial Research of Coastal Environments. Journal of Coastal Research, Special Issue No. 102, pp. 287-295. Coconut Creek (Florida), ISSN 0749-0208.With the impact of global climate change and the acceleration of urbanization, the coastal zone of the Guangdong/Hong Kong/Macao Greater Bay area (GBA) faces the pressures of biodiversity reduction, loss of coastal wetlands, eutrophication of coastal waters and frequent marine pollution events, all of which affect the ecology of this environment and threaten high-quality development of the GBA coastal zone. This study looked at the coastal zones adjacent to nine cities in the GBA, and analyzed the temporal and spatial changes in key ecological and environmental factors using remote sensing, field observations and data collection. A pressure-state-response model was used to build coastal zone ecological security evaluation indexes. The resulting assessments based on the ecological security index of each administrative region in the GBA were used to evaluate their ecological security status, diagnose their existing problems and analyze the causes in each of them. The results showed that the state grade of the GBA coastal zone follows a V-shape, with the eastern and western parts in better ecological condition than the central part. With regard to the current management of the coastal ecological environment, this paper suggests six future policies for improvements to coastal protection in an effort to promote high-quality development in GBA coastal zones, including strengthening top-level planning, optimizing port design and strengthening supervision.

The aim of this population-based case-control study was to investigate the association between dietary consumption of the total flavonoids, subclasses, and specific flavonoids and the risk of esophageal squamous cell carcinoma (ESCC) among adults in a high-risk area of China.We recruited 820 ESCC participants and 863 control participants from Yanting County. Dietary flavonoids were assessed using a validated 76-item food frequency questionnaire. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression after considering potential confounders.Comparing the highest and lowest intake quartiles, we observed a negative association of ESCC risk with consumption of isoflavones (OR = 0.34, 95% CI = 0.23-0.50, P for trend0.001), daidzein (OR = 0.31, 95% CI = 0.21-0.45, P for trend0.001), genistein (OR = 0.34, 95% CI = 0.23-0.50, P for trend0.001), and glycitein (OR = 0.32, 95% CI = 0.22-0.48, P for trend0.001) after adjustment for potential confounders. A more pronounced negative association was observed when comparing the third quartile, rather than the fourth, with the lowest quartile for consumption of anthocyanidins (OR = 0.58, 95% CI = 0.42-0.80, P for trend = 0.004), delphinidin (OR = 0.57, 95% CI = 0.41-0.78, P for trend = 0.004), and cyanidin (OR = 0.48, 95% CI = 0.35-0.66, P for trend = 0.003) after considering potential confounders. Consumption of total flavonoids, flavones, flavonols, and six other specific flavonoids (quercetin, myricetin, kaempferol, luteolin, apigenin, and peonidin) was not associated with ESCC risk.The results suggest that increased dietary intake of isoflavones and moderate consumption of anthocyanidins were associated with a decreased risk of ESCC. Future nutritional guidelines may emphasize foods or supplements rich in specific isoflavones and anthocyanidins for ESCC chemoprevention.

Fast time-varying channel parameters and large penetration loss for signals passing through train carriages are two well-known challenges for wireless communications on high speed rails (HSRs). In this paper we introduce, for the first time, backscatter technology into wireless communication systems on HSRs which can address the two challenges and meanwhile have low complexity of signal processing and low cost of circuit implementation compared with traditional solutions such as relay or beamforming technology. Specifically, we propose a backscatter aided wireless transmission (BAWT) scheme and compare its performance with existing direct wireless transmission (DWT) scheme. We also propose the transceiver design for both BAWT and DWT, including joint carrier frequency offset (CFO) and channel estimator, and signal detector. We show that BAWT, instead of DWT, can obtain the channel statistical information in practical applications due to fixed train antennas and unchanged tracks, which can be utilized to facilitate channel estimation. Finally simulation results are provided to corroborate the proposed studies.

This aim of this study was to investigate the association of physical activity with OSA risk among adult Chinese. Participants were selected from baseline survey of the Guangzhou Heart Study. OSA was ascertained by using Berlin Questionnaire, and the physical activity, including leisure-time physical activity (LTPA), occupational activity, and transport activity, was measured with modified Global Physical Activity Questionnaire. Principal component analysis was used to extract the patterns of LTPA with varimax orthogonal transformation. Odds ratios (OR) with 95% confidence interval (95% CI) were calculated by using the logistic regression method. For all 9733 participants, aged 35 to 74 years, LTPA (high vs. inactive, OR: 0.81, 95% CI: 0.64–1.03), occupational activity (vigorous vs. retirement, OR:1.28, 95% CI: 0.93–1.75) and transport activity (high vs. retirement, OR: 1.05, 95% CI: 0.69–1.60) were not associated with OSA risk after considering potential confounders. Any specific component of LTPA and two LTPA patterns were also not associated with OSA risk. Stratified analysis yielded similar nonsignificant association of OSA risk with three dimensions of physical activity in both the retirement group and non-retirement group. This study found that three dimensions of physical activity, including LTPA, transport activity, and occupational activity, were not associated with any risk of OSA. Future studies with longitudinal design are needed.

This study was to evaluate the associations of dietary intake of total and specific phytosterols and risk of esophageal squamous cell carcinoma (ESCC) and to explore their joint effects with PLCE1 rs2274223 polymorphisms. A population-based case–control study was conducted in a Chinese rural population and 856 eligible incident ESCC cases and 856 controls were included. A validated food frequency questionnaire was used to collect dietary consumption and PLCE1 rs2274223 polymorphisms were genotyped. Unadjusted and adjusted odds ratios (ORs) with 95% confidence interval (CI) were assessed via logistic regression model. When comparing the highest with lowest intake quartiles, β-sitosterol, campesterol, stigmasterol, β-sitostanol, campestanol, and total phytosterols were all associated with a decreased risk of ESCC, with adjusted ORs being 0.32 (95% CI 0.20–0.48), 0.18 (95% CI 0.11–0.27), 0.45 (95% CI 0.29–0.70), 0.13 (95% CI 0.08–0.20), 0.14 (95% CI 0.09–0.22) and 0.28 (95% CI 0.18–0.43), respectively. An exposure—response relationship was also observed for both total and five specific phytosterols (all P for trend

ObjectiveThe physical and neuromental development of infants remains uncertain after fetal exposure to tenofovir disoproxil fumarate (TDF) for the prevention of mother-to-child transmission of HBV. We aimed to investigate the safety of TDF therapy during the third trimester of pregnancy.DesignInfants from a previous randomised controlled trial were recruited for our long-term follow-up (LTFU) study. Mothers with chronic hepatitis B were randomised to receive TDF therapy or no treatment during the third trimester. Infants’ physical growth or malformation, bone mineral density (BMD) and neurodevelopment, as assessed using Bayley-III assessment, were examined at 192 weeks of age.ResultsOf 180 eligible infants, 176/180 (98%) were enrolled and 145/176 (82%) completed the LTFU (control group: 75; TDF-treated group: 70). In the TDF-treated group, the mean duration of fetal exposure to TDF was 8.57±0.53 weeks. Congenital malformation rates were similar between the two groups at week 192. The mean body weight of boys in the control and TDF-treated groups was significantly higher (19.84±3.46 kg vs. 18.47±2.34 kg; p=0.03) and within the normal range (18.48±2.35 kg vs. 17.80±2.50 kg; p=0.07), respectively, when compared with the national standard. Other prespecified outcomes (head circumference, height, BMD, and cognitive, motor, social–emotional, and adaptive behaviour measurements) were all comparable between the groups.ConclusionInfants with fetal exposure to TDF had normal physical growth, BMD and neurodevelopment at week 192. Our findings provide evidence on the long-term safety of infants after fetal exposure to maternal TDF therapy for preventing hepatitis B transmission.Trial registration numberNCT01488526.

Grid remapping is an important mechanism for data transfer between different grids in the Earth modeling system, and searching for relevant points is one of the most complex and time-consuming operations. At present, there are few efficient and robust searching algorithms for unstructured grids. However, with the rise of unstructured grid based model and the improvement of model resolution, providing an efficient search algorithm for unstructured grid is in urgent need in engineering practice. In order to improve the performance of searching process between unstructured grid and other grids when remapping, this paper implements two search algorithms based on KD (K-dimension) tree (the nearest neighbor search and range search). Compared with the performance of brute force search, it is found that the efficiency of search algorithms based on KD tree are much higher than that of brute force search, including the nearest neighbor search and range search. The experimental results provide practical experience for the development of remapping software in the future.

Background: Prolyl 4-hydroxylase, beta polypeptide (P4HB) and Glucose‑regulated protein 78 (GRP78) represent for poor prognosis of various cancers, while rare research investigate correlation of them. This study aimed to explore the correlation and prognostic value of P4HB and GRP78 expression combined with clinical features in gastric cancer (GC).Methods: 150 GC tissue samples evaluated P4HB and GRP78 protein expression by immunohistochemistry separately. Association of the expression with clinicopathological features was analyzed. To explore correlation between their mRNAs and pathways, bioinformatics analyses were performed. Kaplan-Meier analyses were taken to compare survival curves. Univariate and multivariate Cox regression models were used to analyze potential prognostic factors of overall survival (OS). Basing on the multivariate Cox regression model, a prognostic nomogram was constructed, discrimination ability and clinical usefulness of which were compared to TNM stageResults: P4HB and GRP78 expression were both associated with tumor invasion and lymph node metastasis. P4HB protein positive correlated with GRP78, as the same tendency of mRNAs in both GC tissue and cell databases. Bioinformatics analyses indicated that P4HB and GRP78 may be associated with protein folding and response to ER stress, as well as with the protein processing in ER pathway. High single expression or co-expression of P4HB and GRP78 indicated a shorter OS. When stratified by postoperative adjuvant chemotherapy, high co-expression was only represented for unfavorable prognosis in the group with chemotherapy, especially in advanced stage. Multivariate Cox regression analysis identified differentiation (P = 0.020, HR = 1.846, 95% CI: 1.099-3.101), TNM stage (P < 0.001, HR = 3.124, 95% CI: 1.870-5.217), postoperative adjuvant chemotherapy (P = 0.005, HR = 0.507, 95% CI: 0.317-0.810) and P4HB and GRP78 co-expression (P = 0.002, HR = 2.304, 95% CI: 1.355-3.915) were independent prognostic factors for OS. The nomogram was better than TNM stage in discrimination ability and clinical usefulness from the receiver operating characteristic (ROC) and decision curve analysis (DCA) curves.Conclusion: P4HB may positive correlate with GRP78 expression in GC. Co-expression of them can be an independent prognostic factor, serving as a predictive biomarker for GC patients, especially for advanced stage with postoperative adjuvant chemotherapy. And the nomogram may be better than TNM stage in discrimination ability and clinical usefulness.

Background Symptomatic knee osteoarthritis (KOA) is common in China. Pharmacological therapy is not the first recommendation because of its safety issues. Nonpharmacological therapy, such as lifestyle adjustments, weight loss, muscle strengthening, and aerobic exercise programs, is strongly recommended for KOA. However, these approaches may fail due to poor patient compliance. There is a lack of high-quality randomized controlled trials of acupotomy, an effective treatment for KOA. This study was designed to investigate the efficacy of acupotomy in patients with KOA. Methods A total of 136 patients will be enrolled at the First Affiliated Hospital of Guangzhou University of Chinese Medicine and assigned to the acupotomy group or sham acupotomy group according to the block randomization scheme. Patients in the acupotomy group will receive 2 sessions of acupotomy for 2 weeks (once a week). Patients in the sham group will receive 2 sessions of sham stimulation for 2 weeks (once a week). All patients will use indomethacin cream externally. The primary outcome will be the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the secondary outcomes will be the visual analog scale (VAS) score, plantar pressure distribution test result, X-ray examination findings, musculoskeletal ultrasound findings, maximum knee circumference, joint mobility, and quality of life. Measurements will be taken at baseline, 1 week after the end of treatment, and at the 3- and 6-month follow-ups. Discussion To the best of our knowledge, this will be the first single-blind, sham-controlled study of acupotomy. The outcome assessors will also be blinded. The aim of this work is to demonstrate the efficacy of acupotomy in treating KOA. Trial registration Chinese Clinical Trial Registry ChiCTR2000033047. Registered on 18 May 2020.

Background The effects of dietary factors on prognosis of esophageal cancer remain unclear. This systematic review and meta-analysis aimed to assess the association between dietary intake and the risk of mortality among patients with esophageal cancer. Methods Six electronic databases (PubMed, Web of Science, OVID, ProQuest, CNKI and Wanfang) were searched for studies published up to Oct. 2019 that examined the association between dietary intake and all-cause mortality, esophageal cancer-specific mortality and esophageal cancer recurrence. The pooled hazard ratio (HR) with 95% confidence interval (CI) were derived by comparing the highest with the lowest categories of each dietary item and by using random effect models. Results A total of 15 cohort studies were included in this study and all reported pre-diagnosis dietary exposure; two focused on dietary folate, 12 on alcohol consumption and three on other dietary components (sugary beverages, phytochemicals and preserved vegetables). When comparing the highest with the lowest categories, dietary folate intake was associated with a reduced risk of esophageal cancer-specific mortality in patients with esophageal squamous cell carcinoma (HR: 0.41, 95% CI: 0.25–0.69), with low heterogeneity (I2 = 0%, P = 0.788). When comparing the highest with the lowest categories of alcohol consumption, alcohol consumption was associated with an increased risk of all-cause mortality in patients with esophageal squamous cell carcinoma (HR: 1.29, 95% CI: 1.07–1.55; heterogeneity: I2 = 53%, P = 0.030), but this increased risk was not significant in patients with esophageal adenocarcinoma (HR = 1.05, 95% CI: 0.84–1.32). Conclusions This review with pre-diagnostic dietary exposure showed that dietary folate intake was associated with a reduced risk of mortality of esophageal squamous cell carcinoma, whereas alcohol consumption was associated with an increased risk. More studies are needed to investigate effect of dietary factors, especially post-diagnosis dietary consumption, on esophageal cancer prognosis.

Background Thunder-fire moxibustion originated in China and contains traditional Chinese medicine. It can produce strong firepower, infrared thermal radiation, and medicinal effects when burning on the acupoints. Thunder-fire moxibustion is commonly used in patients with neck pain, but its efficacy has rarely been systematically demonstrated. We designed a randomized trial of thunder-fire moxibustion on cervical spondylotic radiculopathy (CSR) to investigate whether it is more effective than ibuprofen sustained-release capsules. Methods One hundred patients will be recruited and randomly divided into thunder-fire moxibustion and ibuprofen groups. The intervention consists of ten treatments and will last for 2 weeks. The Yasuhisa Tanaka 20 Score Scale is used as the primary outcome measure. It contains a combination of the self-conscious symptom in patients, objective clinical evaluation from doctors, and social evaluation (the ability to work and live). The objective and comprehensive evaluation of CSR patients before and after treatment is particularly needed. The Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), Neck Disability Index score scale (NDI), and the Quality of Life Assessment (SF-36) are applied as secondary outcome measures. The assessment will take place at the baseline and the first and second weekends of treatment. If an adverse event (AEs) occurs, it will be reported. Discussion The aim of this trial is to determine whether thunder-fire moxibustion is more effective than ibuprofen in the treatment of patients with CSR. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR1800018820. Registered on 11 October 2018.

Effective surface defect detection are of great significance for the production of high quality products. Aiming at real-time detection of surface defect, we propose a reusable and high-efficiency Inception-based MobileNet-SSD method for surface defect inspection in industrial environment. First, convolutional layers for feature extraction used in SSD were replaced by depthwise separable convolutions utilized in MobileNet so that the speed of the network can be faster. Then, the layer in the base network as convolutional feature layer is constructed as Inception which can extract more rich features through multiple convolution combinations of different scales. Finally, predictions from multiple feature maps with different resolutions are combined by the network to naturally handle objects of various sizes. Experimental results on a surface defect dataset containing 2750 images of 5 classes we established confirm that our network has competitive accuracy and is much faster. For 300 × 300 input, ours network achieves 96.1% mAP on DAGM 2007 test at 73FPS on a NVIDIA GTX 1080Ti, outperforming a comparable state-of-the-art FCN model.

Background. Multiple studies have reported the significance of the systemic immune-inflammation index (SII) in the prognosis of colorectal cancer (CRC), but no consensus has yet been reached. The purpose of this study was to systematically assess the prognostic value of SII in patients with CRC. Materials and Methods. We performed a systematic literature search in PubMed, Embase, and the Cochrane Library for eligible studies. The correlation between pretreatment SII and overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) in CRC patients was evaluated by combining the hazard ratio (HR) and 95% confidence interval (CI). Results. Twelve studies involving 3919 patients were included. Comprehensive analysis results showed that high SII indicated poor OS in CRC patients ( HR = 1.777 , 95% CI: 1.328-2.376). Compared with patients with low SII values, patients with high SII had lower PFS ( HR = 1.658 , 95% CI: 1.189-2.311). Subgroup analysis further verified the above results. Conclusions. SII may be a noninvasive and powerful tool for predicting survival outcomes in CRC patients. However, more well-designed studies are needed to validate our findings.

Background: Patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which originated in Wuhan, China, and spreading over the country including Jiangsu Province. Our study aimed to study the epidemiological, clinical characteristics and therapies of these severe cases in Jiangsu Province.Methods: A multicenter retrospective cohort study was conducted to extract and analyze epidemiological, clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection from 12 large hospitals in Jiangsu Province between Jan 24 and Feb 23, 2020. Cases were identified by real-time reverse transcription polymerase chain reaction (RT-PCR). The improvement and deterioration subgroups were compared to identify predictors of disease progression. Clinical outcomes were followed up until Feb 23, 2020.Results: A total of 631 infected cases with COVID-19 in Jiangsu Province, 60 of which were severe cases. Up until Feb 23, 2020, the mortality rate of these severe patients was 0%. The median age was 57 years (range, 26 to 97), and 58.3% were man. The body mass index (BMI) of these patients was higher, with an average of 25 kg/m². More than 90 percent of the patients had a history of contact with an infected patient or dined together, and two patients were infected while staying in the same train compartment with a confirmed patient. 51.7% of severe cases had at least one underlying disease, and low fever (80.0%) and dry cough (51.7%) were the most common symptoms. Mean acute physiology and chronic health evaluation (APACHE) II score on admission was 14±5. Acute respiratory distress syndrome (ARDS) appeared in 15% of the patients. White blood cell counts decreased in 45.0% of patients, lymphopenia in 63.3%, thrombocytopenia in 13.3%, and procalcitonin levels in 88.3% of the patients were less than 0.5 ng/mL. There were no statistically significant differences in immunoglobulin therapy and glucocorticoids therapy between the improvement and deterioration subgroups (P>0.05). Logistic regression analysis indentified higher levels of troponin T (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.00-1.08; P=0.04), antiviral therapy with interferon (OR: 6.33; 95% CI: 1.18-33.98; P=0.03), and the application of non-invasive mechanical ventilation (OR: 1.99; 95%CI: 1.17-3.41; P=0.01) as predictors of disease progression, whereas higher lymphocyte count (OR: 0.11; 95% CI: 0.02-0.57; P=0.01) and early prone ventilation were associated with improvement (OR: 0.11; 95% CI: 0.01-0.98; P=0.04).Conclusions: The COVID-19 infection had a low mortality rate in Jiangsu Province, China. The higher levels of troponin T and lower lymphocyte count were predictors of disease progression. Antiviral therapy with interferon was not recommended. The early prone ventilation may be an effective treatment for severe cases.

This study was designed to determine the incidence and predictive factors for lateral lymph node metastasis (LNM) in patients with papillary thyroid microcarcinoma (PTMC). From January 2014 to July 2015, a retrospective review was conducted of 215 patients with PTMC who underwent total thyroidectomy and central lymph node dissection (LND) with lateral LND. Correlations of lateral LNM with clinicopathological features were examined using univariate analyses. Risk factors for lateral LNM were identified by multivariate analysis. Lateral LNM was observed in 163(75.8%) cases of 215 patients and often involved in level III (82.2%) and level IV (65.6%), with most found in two-levels (41.1%) and single-level (33.7%) models. Multivariate analyses showed that central LNM (odds ratio [OR]: 8.28, 95% confidence interval [CI]: 3.43–19.98, p

Accurate classification of power quality disturbance is the premise and basis for improving and governing power quality. A method for power quality disturbance classification based on time-frequency domain multi-feature and decision tree is presented. Wavelet transform and S-transform are used to extract the feature quantity of each power quality disturbance signal, and a decision tree with classification rules is then constructed for classification and recognition based on the extracted feature quantity. The classification rules and decision tree classifier are established by combining the energy spectrum feature quantity extracted by wavelet transform and other seven time-frequency domain feature quantities extracted by S-transform. Simulation results show that the proposed method can effectively identify six types of common single disturbance signals and two mixed disturbance signals, with fast classification speed and adequate noise resistance. Its classification accuracy is also higher than those of support vector machine (SVM) and k-nearest neighbor (KNN) algorithms. Compared with the method that only uses S-transform, the proposed feature extraction method has more abundant features and higher classification accuracy for power quality disturbance.