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BACKGROUND Patients with lipopolysaccharide (LPS)-responsive beige-like anchor protein (LRBA) deficiency have a variety of clinical symptoms, but there is no apparent genotype–phenotype correlation, and patients carrying the same mutations may have different phenotypes. Therefore, it is not easy for doctors to make a decision regarding hematopoietic stem cell transplantation (HSCT) for LRBA-deficient patients. We hypothesized that there may be a protein–phenotype correlation to indicate HSCT for LRBA-deficient patients. AIM To report on three Chinese LRBA-deficient patients and determine the correlation between residual protein expression and disease phenotypes. METHODS Clinical data of three Chinese LRBA-deficient patients were collected, and protein levels were detected by Western blot analysis. In addition, LRBA mutation information of another 83 previously reported patients was summarized. RESULTS All the major clinical findings indicated enteropathy, but patients 1 and 3 presented with more severe symptoms than patient 2. Endoscopy and histology indicated nonspecific colitis for patients 1 and 3 but Crohn's disease-like colitis for patient 2. Compound heterozygous mutations in LRBA were found in patient 1, and homozygous mutations in LRBA were found in patient 2 and patient 3. Only patient 2 responded well to traditional immunosuppressive treatment. Residual expression of the LRBA protein in patients 1 and 3 was very low, but in patient 2, a more than 0.5-fold in expression of the LRBA protein was found compared to that in the control. After HSCT, patient 1 had increased LRBA protein expression. We summarized the genetic information of 86 patients, and the mutations in patients 1 and 3 were novel mutations. CONCLUSION We described three Chinese LRBA-deficient patients, two of whom carried novel mutations. These patients had no genotype-phenotype correlations, but their residual LRBA protein expression might be associated with disease outcome and could be an indicator for HSCT.

Objective To systematically describe the short stature of patients with Diamond-Blackfan anemia and to explore factors affecting the height development of patients with Diamond-Blackfan anemia. Study design This cross-sectional study was conducted at the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, and the height, weight, and clinical data of 129 patients with Diamond-Blackfan anemia were collected from June 2020 to September 2020. Results The median height-age-z score (HAZ) of children affected by Diamond-Blackfan anemia was −1.54 (−6.36-1.96). Short stature was found in 37.98% of the patients. Specific Diamond-Blackfan anemia growth curves were developed for weight, height, and body mass index, separately for male and female patients. Multivariable logistic regression models showed that female sex (aOR 4.92; 95% CI 1.29-18.71; P = .0195), underweight (aOR 10.41, 95% CI 1.41-76.98, P = .0217), cardiovascular malformations (aOR 216.65; 95% CI 3.29-14279.79; P = .0118), and RPL11(aOR 29.14; 95% CI 1.18-719.10; P = .0392) or RPS26 (aOR 53.49; 95% CI 1.40-2044.30; P = .0323) mutations were independent risk factors for short stature. In the subgroup of patients who were steroid-dependent, patients with a duration of steroid therapy over 2 years (OR 2.95; 95% CI 1.00-8.66; P = .0494) or maintenance dose of prednisone >0.1 mg/kg per day (OR 3.30; 95% CI 1.02-10.72; P = .0470) had a higher incidence of short stature. Conclusions Patients with Diamond-Blackfan anemia had a high prevalence of short stature. The risk of short stature increased with age and was associated with sex, underweight, congenital malformations, and RPL11 or RPS26 mutations. The duration of steroid therapy and maintenance dose of steroid was significantly associated with the incidence of short stature in steroid-dependent patients with Diamond-Blackfan anemia.

In construction and demolition waste (CDW), there are materials that are difficult to separate by density and magnetic characteristics alone. To realise a finer separation of these difficult-to-separate materials, a multi-sensor fusion method for the visual detection of CDW is proposed. This method consists of a red–green–blue–depth (RGBD) data collection method with high precision in the height direction and a multimodal data processing algorithm. To obtain comprehensive features accurately and efficiently, the proposed method uses two independent MobileNet branches to extract colour visual features and geometric features separately, and an encoder is used to control the frequency of the two models in real time to better match the two data types. The proposed method makes full use of the height data to filter out the background of the conveyor belt and the invalid areas generated by the region proposal networks to improve its robustness. Experiments show that the accuracy of the proposed visual detection method is over 90%. Additionally, computational efficiency reaches 1.67 frames per second (fps) on a central processing unit (CPU) and 30 fps on a graphics processing unit. The detection efficiency when running on the CPU could reach 25 000 CDW items per hour.

Background American ginseng (AG) is a valuable medicine widely consumed as a herbal remedy throughout the world. Huge price difference among AG with different growth years leads to intentional adulteration for higher profits. Thus, developing reliable approaches to authenticate the cultivation ages of AG products is of great use in preventing age falsification. Methods A total of 106 batches of AG samples along with their 9 physicochemical features were collected and measured from experiments, which was then split into a training set and two test sets (test set 1 and 2) according to the cultivation regions. Principle component analysis (PCA) was carried out to examine the distribution of the three data sets. Four machine learning (ML) algorithms, namely elastic net, k-nearest neighbors, support vector machine and multi-layer perception (MLP) were employed to construct predictive models using the features as inputs and their growth years as outputs. In addition, a similarity-based applicability domain (AD) was defined for these models to ensure the reliability of the predictive results for AG samples produced in different regions. Results A positive correlation was observed between the several features and the growth years. PCA revealed diverse distributions among different cultivation regions. The most accurate model derived from MLP shows good prediction power for the fivefold cross validation and the test set 1 with mean square error (MSE) of 0.017 and 0.016 respectively, but a higher MSE value of 1.260 for the test set 2. After applying the AD, all models showed much lower prediction errors for the test samples within AD (IDs) than those outside the AD (ODs). MLP remains the best predictive model with an MSE value of 0.030 for the IDs. Conclusion Cultivation years have a close relationship with bioactive components of AG. The constructed models and AD are also able to predict the cultivation years and discriminate samples that have inaccurate prediction results. The AD-equipped models used in this study provide useful tools for determining the age of AG in the market and are freely available at https://github.com/dreadlesss/Panax_age_predictor.

The pollution of heavy metals in irrigation water was related to the management-control of the risk of heavy metals in farmland and the safe production of crops. There were various sources of irrigation water in the suburb farmlands of Xijiang River. We investigated the sources and distribution characteristics of heavy metals in the irrigation water sources on a riverside and inside-dyke farmland of Xijiang River. According to sample test results, it was found that nearly 100% of heavy metals that we were concerned about were detected in the irrigation water sources in the study. The box plot showed that the average content of other elements ranged from 1.65 to 43.75 μg·L−1, and the average level of cadmium was 0.02 μg·L−1 in the studied area. According to quantitative evaluation index and analysis of distribution characteristics, most heavy metals were at relatively low concentration in the irrigation water sources, while mercury content was far greater than other elements, followed by arsenic. Arsenic and mercury had become increasingly prominent problems in local irrigation water sources. River quality was more likely to be affected by river water and agricultural activities, while groundwater quality was more likely to be affected by natural causes. According to single/comprehensive water-quality evaluations, the comprehensive water quality evaluation ranged from level I to level III, but the single-factor index evaluations of mercury in most water samples and arsenic in two groundwater samples were of ‘Inferior’ level. Attention should be paid to the monitoring of mercury and arsenic (in the groundwater) in the studied area. The disposal methods of farmland water inflow and drainage should be increased if necessary, and reducing the influence of human activities on the natural weathering and leaching of heavy metals was an effective measure to avoid risk of agricultural production. HIGHLIGHTS Nearly 100% of heavy metals that we were concerned about were detected in the irrigation water sources in the studied area in the early busy season of farming.; The studied area should reduce the frequency and use of groundwater irrigation.; The monitoring of mercury and arsenic should be strengthened immediately in the studied area.; Scientific research on the irrigation water sources in the early busy season of farming can react to the maximum anthropogenic influence on irrigation.

Dashboard visualizations are widely used in data-intensive applications such as business intelligence, operation monitoring, and urban planning. However, existing visualization authoring tools are inefficient in the rapid prototyping of dashboards because visualization expertise and user intention need to be integrated. We propose a novel approach to rapid conceptualization that can construct dashboard templates from exemplars to mitigate the burden of designing, implementing, and evaluating dashboard visualizations. The kernel of our approach is a novel deep learning-based model that can identify and locate charts of various categories and extract colors from an input image or sketch. We design and implement a web-based authoring tool for learning, composing, and customizing dashboard visualizations in a cloud computing environment. Examples, user studies, and user feedback from real scenarios in Alibaba Cloud verify the usability and efficiency of the proposed approach.

Ya-Xin Wang, Xiao-Wen Chen, Si-Bo Wang, Ling-Feng Gu, Ya-Fei Li, Yao Ma, Hao Wang, Lian-Sheng Wang Department of Cardiology, Jiangsu Province People’s Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, 210029, People’s Republic of ChinaCorrespondence: Lian-Sheng WangDepartment of Cardiology, Jiangsu Province People’s Hospital and Nanjing Medical University First Affiliated Hospital, 300 Guangzhou Road, Nanjing, 210029, People’s Republic of ChinaTel/Fax +86 25 83724440Email drlswang@njmu.edu.cnPurpose: This research aimed to investigate the correlation between androgenic alopecia (AGA) and coronary artery disease (CAD) and analyze its value in predicting the severity of coronary atherosclerosis in the Han Chinese male population.Patients and Methods: A total of 402 Han Chinese male patients aged 28– 75 years were enrolled and performed coronary angiography (CAG) after admission. According to the BASP classification, the participants were divided into mild, moderate and severe AGA. CAD was determined via CAG and defined as stenosis of ≥ 50% in at least one major coronary artery, and the Gensini score was calculated to evaluate the severity of coronary atherosclerosis.Results: In this study, CAD status (P = 0.002), dyslipidemia status (P = 0.002), age (P = 0.003) and coronary atherosclerosis severity (P < 0.001) were different in patients with different levels of AGA. Multivariate logistic regression analysis revealed that severe AGA was independently correlated to CAD risk (OR, 2.111; 95% CI 1.152 to 3.870, P = 0.016), while the relative CAD risk of early-onset AGA was 2.292 (OR, 2.292; 95% CI 1.132 to 4.640, P = 0.021). AGA status (OR, 2.247; 95% CI 1.396 to 3.617, P = 0.001), severe AGA (OR, 2.360; 95% CI 1.506 to 3.699, P < 0.001) and early-onset AGA (OR, 3.474; 95% CI 2.069 to 5.832, P < 0.001) were all independently associated with the severity of coronary atherosclerosis. The area under the receiver operating characteristic (ROC) curve plotted using severe AGA was 0.601, which is predictive of severe coronary atherosclerosis. Moreover, the presence of severe AGA increases the risk of developing CAD associated with obesity (SI = 1.663, SIM = 1.222, AP = 0.289), diabetes (SI = 2.239, SIM = 1.149, AP = 0.503) and dyslipidemia (SI = 1.062, SIM = 0.646, AP = 0.045).Conclusion: This study suggested that AGA is independently associated with CAD in a Han Chinese male population. AGA may be a simple and feasible method for screening CAD and indicative of the severity of coronary atherosclerosis.Keywords: coronary artery disease, coronary atherosclerosis, androgenic alopecia, coronary angiography, cardiovascular disease

As a key area of traffic safety research, crash severity modelling has attracted tremendous attention. Recently, there has been growing interest in applying machine learning (ML) methods in this ar...

Summary Anti-neurofascin-155 (NF155) antibodies have been observed in two cases with neuromyelitis optica spectrum disorders (NMOSD). This study investigated the prevalence of anti-NF155 antibodies in patients with NMOSD and the clinical features of anti-NF155 antibody-positive patients. Sera from 129 patients with NMOSD were screened with anti-NF155 antibodies by cell-based assay (CBA) and re-examined using immunostaining of teased mouse sciatic nerve fibres. Fifty-six patients with multiple sclerosis (MS) and 50 healthy controls (HC) were also enrolled for detecting anti-NF155 antibodies. A total of 12.40% (16 of 129) of patients with NMOSD were positive for anti-NF155 antibodies confirmed by both CBA and immunostaining. Immunoglobulin (Ig) G1 was the predominant subclass. However, none of 56 MS patients or 50 HC were positive for anti-NF155 antibodies. Anti-NF155 antibody-positive NMOSD patients had a higher proportion of co-existing with autoimmune diseases (p

Acute kidney injury (AKI) is increasingly being seen in patients with acute coronary syndromes (ACS) and it is associated with higher short-term and long-term morbidity and mortality. Therefore, it is of paramount importance to identify those ACS patients at risk for the development of AKI. The objective of this study was to evaluate two different plasma biomarkers calprotectin and neutrophil gelatinase-associated lipocalin (NGAL) in early detecting the development of AKI in ACS patients.172 ACS patients admitted to the Coronary Care Unit in Yantai Yuhuangding Hospital were prospectively enrolled. Their blood samples were obtained on admission and subjected to enzyme-linked immunosorbent assay to determine the levels of novel biomarkers. The clinical data and biomarkers were recorded and analyzed.In this study, 23 (13.4%) patients had a diagnosis of AKI. Statistical analysis demonstrated that in ACS patients with AKI, the following two biomarkers were significantly higher than these without AKI: plasma calprotectin (5942.26 ± 1955.88 ng/mL vs. 3210.29 ± 1833.60 ng/mL, p 0.001) and plasma NGAL (164.91 ± 43.63 ng/mL vs. 122.48 ± 27.33 ng/mL, p 0.001). Plasma calprotectin and NGAL could discriminate the development of AKI respectively with an area under the ROC curve (AUC) of 0.864 and 0.850. A combination of the two plasma biomarkers calprotectin and NGAL could early discriminate AKI in ACS patients with an AUC of 0.898.This study demonstrated a promising panel of plasma calprotectin and NGAL as early diagnostic biomarkers for AKI in ACS patients.

Background Endothelial canonical (Wnt/β‐catenin) and non‐canonical Wnt signalings (Wnt/PCP and Wnt/Ca2+) promote blood‐brain barrier (BBB) development and antagonize each other. However, the effects of ischemic stroke on endothelial canonical and non‐canonical Wnt signalings are unclear. Further, how non‐canonical Wnt signalings are influenced by upregulation of endothelial Wnt/β‐catenin signaling and subsequently affect BBB function following ischemic stroke have not been studied. Methods First, we determined the levels of Wnt signaling markers including TCF/LEF1 transcription activity, Axin2 mRNA, phospho‐JNKThr183/Tyr185, and NFAT in brain endothelial cells (ECs) with the deletion of Wnt receptor Frizzled (Fzd)4 or Fzd6, the two most abundant Fzds in brain ECs. Next, we observed the effect of ischemia/reperfusion injury on Wnt signalings in brain ECs and adult mice. Last, we assessed the changes of non‐canonical Wnt signalings and BBB injury in the early stage of ischemic stroke in mice with endothelial β‐catenin activation (β‐cat mice). Results Fzd4 or Fzd6 deletion dampened both Wnt/β‐catenin and Wnt/PCP signalings but enhanced Wnt/Ca2+ signaling in brain ECs. Both canonical and non‐canonical Wnt signalings in brain ECs were downregulated after ischemia/reperfusion injury in vitro and in vivo. Upregulating endothelial Wnt/β‐catenin signaling in β‐cat mice normalized the downregulated non‐canonical Wnt signalings, which did not compromise its protective effects on BBB integrity and endothelial tight junction following ischemic stroke. Conclusions The BBB protection induced by upregulation of endothelial Wnt/β‐catenin signaling may be not interfered by the normalization of non‐canonical Wnt signalings in the early stage of ischemic stroke., The BBB protection induced by upregulation of Wnt/β‐catenin signaling may be not interfered by the normalization of non‐canonical Wnt signalings in the early stage of ischemic stroke.

Purpose: To investigate the inhibitory effects of caffeoylxanthiazonoside (CYT) on airway inflammation in mice and its mechanism of action. Methods: An allergic asthma mice model was established by intraperitoneal injection and aerosol nebulization with ovalbumin (OVA). After treatment with CYT, the blood and bronchoalveolar lavage fluid (BALF) were collected from the mice. The leukocytes were classified and counted with Giemsa solution. Enzyme-linked immunosorbent assay (ELISA) was used to determine the serum levels of IgE, and IL-4, IL-5, IL-13 and IFN-γ in the BALF of mice. Lung tissues were obtained from the mice and MUC5AC protein expression was measured by western blot. Results: CYT significantly decreased the serum level of IgE in asthmatic mice. Inflammatory cells in BALF of mice were markedly reduced (p < 0.05) by CYT treatment at varying doses (10, 20, and 40 mg/kg). Treatment with CYT also significantly suppressed the cytokines of IL-4, IL-5 and IL-13 and increased the IFN-γ in the BLAF of OVA-induced allergic asthma mice (p < 0.05). Western blot results indicate that CYT treatment significantly decreased the expression of MUC5AC protein in the lung tissues of asthmatic mice. In addition, no significant effects on the body weight of the mice were found after CYT treatment. Conclusion: Caffeoylxanthiazonoside inhibits airway inflammation in allergic asthma mice by altering Th1/Th2 via re-balancing of related cytokines and downregulation of lung MUC5AC protein expression. Therefore, this compound can potentially be developed for the therapeutic management of inflammation in allergic asthma.

It is of great clinical importance to explore more efficacious treatments for OCD. Recently, cognitive-coping therapy (CCT), mainly focusing on recognizing and coping with a fear of negative events, has been reported as an efficacious psychotherapy. However, the underlying neurophysiological mechanism remains unknown. This study of 79 OCD patients collected Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and resting-state functional magnetic resonance imaging (rs-fMRI) scans before and after four weeks of CCT, pharmacotherapy plus CCT (pCCT), or pharmacotherapy. Amygdala seed-based functional connectivity (FC) analysis was performed. Compared post- to pretreatment, pCCT-treated patients showed decreased left amygdala (LA) FC with the right anterior cingulate gyrus (cluster 1) and with the left paracentral lobule/the parietal lobe (cluster 2), while CCT-treated patients showed decreased LA-FC with the left middle occipital gyrus/the left superior parietal/left inferior parietal (cluster 3). The z-values of LA-FC with the three clusters were significantly lower after pCCT or CCT than pretreatment in comparisons of covert vs. overt and of non-remission vs. remission patients, except the z-value of cluster 2 in covert OCD. CCT and pCCT significantly reduced the Y-BOCS score. The reduction in the Y-BOCS score was positively correlated with the z-value of cluster 1. Our findings demonstrate that both pCCT and CCT with large effect sizes lowered LA-FC, indicating that FCs were involved in OCD. Additionally, decreased LA-FC with the anterior cingulate cortex (ACC) or paracentral/parietal cortex may be a marker for pCCT response or a marker for distinguishing OCD subtypes. Decreased LA-FC with the parietal region may be a common pathway of pCCT and CCT. Trial registration: ChiCTR-IPC-15005969.

Both microgravity and radiation exposure in the spaceflight environment have been identified as hazards to astronaut health and performance. Substantial study has been focused on understanding the biology and risks associated with prolonged exposure to microgravity, and the hazards presented by radiation from galactic cosmic rays (GCR) and solar particle events (SPEs) outside of low earth orbit (LEO). To date, the majority of the ground-based analogues (e.g., rodent or cell culture studies) that investigate the biology of and risks associated with spaceflight hazards will focus on an individual hazard in isolation. However, astronauts will face these challenges simultaneously Combined hazard studies are necessary for understanding the risks astronauts face as they travel outside of LEO, and are also critical for countermeasure development. The focus of this review is to describe biologic and functional outcomes from ground-based analogue models for microgravity and radiation, specifically highlighting the combined effects of radiation and reduced weight-bearing from rodent ground-based tail suspension via hind limb unloading (HLU) and partial weight-bearing (PWB) models, although in vitro and spaceflight results are discussed as appropriate. The review focuses on the skeletal, ocular, central nervous system (CNS), cardiovascular, and stem cells responses.

Mobility services including carsharing and transportation network company (TNC) services have been growing rapidly in North America and around the world. Measuring the effects of these services on traveler behavior is challenging because the results of any such analysis are sensitive to how (1) outcomes are measured and (2) counterfactuals are constructed. The lack of good control groups or randomization of assignment leaves lingering uncertainty over the contributions of selection bias and treatment effects to reported differences in travel behavior between users and non-users of these services. This paper reports on two approaches for measuring the effects of mobility service adoption on travel rate and car ownership. We first tried a pretest-posttest randomized encouragement experiment to deal with the shortcomings of poor control groups. Then, we turned to the approach of self-reported effects based on hypothetical controls to investigate whether variations in survey question presentation could influence respondents’ answers and thus lead to changes in estimated effects. The data to conduct this study came from two sources: a panel survey administered by the authors at the University of Washington (UW), and a survey by Populus Technologies, Inc. (Populus). Various statistical tests were applied to analyze the data, and the results highlight the pivotal role that the research design plays in influencing the outcomes, and manifest the fundamental challenge of establishing credible estimates of the causal effects of adopting mobility services on travel behaviors.

BACKGROUND: Fibrous dysplasia (FD) is a common benign intramedullary fibro-osseous lesion. Involvement of the spine is rare, with the literature including only case reports, and cases of monostotic FD (MFD) in the sacrum are extremely rare. A correct preoperative diagnosis of spinal MFD is important for clinicians to select proper treatment. CASE SUMMARY: We retrospectively assessed a case report of MFD in the sacrum. This patient was examined by computed tomography (CT) and magnetic resonance imaging (MRI), and the diagnosis was confirmed by pathology. A review of the literature was performed to analyze the imaging characteristics and differential diagnoses of spinal MFD. For our patient, the CT scan showed the lesion to be expansile, with ground glass opacity and a sclerotic rim. On MRI, the lesion showed iso-low signal intensity on T1WI and iso-high signal intensity on T2WI. A low signal rim was found on T1WI and T2WI. Our patient was treated by posterior focal excision, decompression, bone grafting, fusion and pedicle screw fixation. A satisfactory result was achieved, with pain disappearance. No complications had occurred at the 1-year follow up. CONCLUSION: MFD is an expansile osteolytic change. Ground glass opacity and a sclerotic margin are obvious characteristics. The lesion often involves the vertebral body and posterior element. Knowledge of these imaging characteristics of spinal FD could be helpful for diagnosis and prevent unnecessary procedures.

Genetic changes have prognostic significance in cytogenetically normal acute myeloid leukemia (CN-AML). We set out to evaluate the prognostic of 6 gene mutations in CN-AML. We performed a mutational analysis and evaluated prognostic findings of six genes (NPM1, CEBPA, DNMT3A, FLT3-ITD, FLT3-TKD, and C-KIT) in 428 CN-AML patients at our center over 10 years. A total of 282 patients (65.9%) had at least one gene mutation, and the mutation frequencies were as follows: 29.7% (NPM1), 24.1% (CEBPA), 20.1% (FLT3-ITD), 4.0% (FLT3-TKD), 11.9% (DNMT3A), and 4.7% (C-KIT). Multivariate analysis indicated that FLT3-ITDmut and CEBPAwt were independent risk factors correlated with poor overall survival (OS) and disease-free survival (DFS) of CN-AML. Compared with patients who received chemotherapy as consolidation, hematopoietic stem cell transplantation (HSCT) significantly improved OS of CN-AML patients. For standard/high risk patients, HSCT improved both OS and DFS. Combined analysis showed that patients with CEBPAmut/FLT3-ITDwt had the best prognosis, and patients with CEBPAwt/FLT3-ITDmut had the worst OS, with 3-year OS of only 44%. In 212 patients who received HSCT, FLT3-ITD/CEBPA mutations and minimal residual disease (MRD) were correlated with OS and DFS in univariate analysis. We found that HSCT significantly improves the prognosis of standard/high risk CN-AML patients with superior OS and DFS. Molecular marker analyses, especially combined analysis of the FLT3-ITD and CEBPA status revealed a correlation with the prognosis of CN-AML. For patients who have received HSCT, MRD before transplantation was a strong prognostic marker predicting patient outcome.

Da-Huan Li,1,* Xue-Ying Liu,1,* Chao Huang,2 Chao-Nan Deng,3 Jia-Lu Zhang,1 Xiao-Wen Xu,1 Liang-Bi Xu1 1Department of the Digestive Endoscopy, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, People’s Republic of China; 2Department of the Emergency, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, People’s Republic of China; 3Department of the Pathology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liang-Bi XuDepartment of the Digestive Endoscopy, The Affiliated Hospital of Guizhou Medical University, No. 28 of Guiyi Street, Yunyan District, Guiyang, 550000, People’s Republic of ChinaTel +8615685178740Fax +86085186774297Email xuliangbi88_dr@163.comObjective: This study aims to analyze the endoscopic and pathological characteristics of colorectal laterally spreading tumors (LSTs) to assist malignant risk stratification to inform selection of the appropriate treatment strategy.Methods: Patients with colorectal LST were selected as retrospective study objects. Characteristics, including endoscopic findings and the most common site of LSTs of different diameters and histological types, were analyzed. The risk factors for malignancy in colorectal LST were explored by multivariate logistic regression analysis.Results: LSTs with diameters of ≥ 20 mm were found mainly in the rectum and mainly with granular-mixed (G-M) morphology (36% and 44.6%, respectively; p < 0.05), while LSTs with diameters of < 20 mm were found mainly in the ascending colon and mainly with granular-homogenous (G-H) morphology (40.9% and 46.2%, respectively; p < 0.05). Adenoma was the main histological type in patients with tumors of all diameters. However, the cancerization rate of LSTs was 31% in patients with tumor diameter ≥ 20 mm, while there was no invasive cancer in patients with tumor diameter < 20 mm. In the low-grade dysphasia (adenoma) group, most of the lesions were located in the ascending colon and most had the morphology LST-G-H (35.8% and 39.2%, respectively; p < 0.05). In the cancerization group, most of the lesions were located in the rectum, with the morphology LST-G-M (51.6% and 67.2%, respectively; p < 0.05), and the diameter was larger than that of the adenoma group (33.84 ± 17.99 mm vs 21.68 ± 8.99 mm).Conclusion: The rectum was the most common site for an LST with a diameter ≥ 20 mm and cancerization, of which the morphology was mainly LST-G-M (endoscopic submucosal dissection is the preferred treatment for this type of LST). LST malignancy was found to be correlated with lesion diameter, location, and morphological appearance.Keywords: colorectal laterally spreading tumors, colonic mucosa, colonoscopy, pathological features, malignant tumor

Cardiac dysfunction is a major cause leading to multiple organ failure in sepsis. Beclin-1-dependent autophagy has been evidenced to exert protective effects on hearts in sepsis. However, the mechanisms on how Beclin-1 and autophagy are regulated remains enigmatic. To explore the detailed mechanisms controlling Beclin-1-dependent autophagy in septic heart and whether melatonin could protect against sepsis via regulating cardiac autophagy, adult Sprague-Dawley (SD) rats were subjected to cecal ligation and puncture (CLP) to induce sepsis. Rats were intraperitoneally administrated with 30 mg/kg melatonin within 5-min post-CLP surgery. Our data showed that sepsis induced Becline-1 acetylation and inhibited autophagy in hearts, resulting in impaired cardiac function. However, melatonin treatment facilitated Beclin-1 deacetylation and increased autophagy in septic hearts, thus improved cardiac function. Moreover, melatonin increased the expression and activity of Sirtuin 1 (Sirt1), and inhibition of Sirt1 abolished the protective effects of melatonin on Beclin-1 deacetylation and cardiac function. In conclusion, increased Beclin-1 acetylation was involved in impaired autophagy in septic hearts, while melatonin contributed to Beclin-1 deacetylation via Sirt1, leading to improved autophagy and cardiac function in sepsis. Our study sheds light on the important role of Beclin-1 acetylation in regulating autophagy in sepsis and suggests that melatonin is a potential candidate drug for the treatment of sepsis.

Introduction The contribution made by e-cigarettes to smoking cessation continues to be controversial. Reports suggest that teenagers are becoming increasingly addicted to e-cigarettes and that e-cigarette use in adolescents is associated with subsequent cigarette smoking. Methods Systematic searches of eleven databases were conducted (January 2015 to June 2020). Systematic reviews, randomized controlled trials (RCTs) and cohort studies comparing e-cigarettes with placebo e-cigarettes, nicotine replacement therapy (NRT) or no e-cigarette use were included. The two primary outcomes were smoking cessation among smokers and smoking initiation among non-smoking teenagers. The secondary outcome was adverse events. Data were synthesized using risk ratio (RR) or adjusted odds ratio (AOR) with 95% confidence interval (CI). Results Six systematic reviews, 5 RCTs and 24 cohort studies were identified. For smoking cessation, findings from 4 systematic reviews indicated that e-cigarettes contributed to cessation while one found the opposite. Meta-analysis of 5 RCTs suggested that e-cigarettes were superior to NRT or placebo for smoking cessation (RR=1.55; 95% CI: 1.00–2.40; I 2 =57.6%; low certainty; 5 trials, n=4025). Evidence from 9 cohort studies showed that e-cigarette use was not associated with cessation (AOR=1.16; 95% CI: 0.88–1.54; I 2 =69.0%; n=22220). Subgroup analysis suggested that intensive e-cigarette use may be associated with cessation. In terms of smoking initiation, adolescents who ever used e-cigarettes had a greater risk for smoking initiation than non-users (AOR=2.91; 95% CI: 2.61–3.23; I 2 =61.0%; 15 trials, n=68943), the findings were consistent with one included systematic review. No serious adverse events were reported in the included studies. Conclusions Low certainty evidence suggests that e-cigarettes appear to be potentially effective for smoking cessation. The use of e-cigarettes in adolescents may be associated with smoking initiation. No serious adverse events were reported.

Background: Although international bronchiectasis guidelines recommended screening of nontuberculous mycobacteria (NTM) both at initial evaluation and prior to administration of macrolide treatment, data regarding NTM in bronchiectasis remain elusive. Objective: To establish the prevalence, species, and clinical features of NTM in adults with bronchiectasis. Methods: We searched PubMed, Embase, and Web of Science for studies published before April 2020 reporting the prevalence of NTM in adults with bronchiectasis. We only included studies with bronchiectasis confirmed by computed tomography and NTM identified by mycobacteria culture or molecular methods. Random-effects meta-analysis was employed. Results: Of the 2,229 citations identified, 21 studies, including 12,454 bronchiectasis patients were included in the final meta-analysis. The overall pooled prevalence of NTM isolation and pulmonary NTM disease were 7.7% (5.0%–11.7%) (n/N = 2,677/12,454) and 4.1% (1.4%–11.4%) (n/N = 30/559), respectively, with significant heterogeneity (I2 = 97.7%, p < 0.001 and I2 = 79.9%, p = 0.007; respectively). The prevalence of NTM isolation varied significantly among different geographical regions with the highest isolation at 50.0% (47.3%–52.7%) reported in the United States. Mycobacterium avium complex and Mycobacterium abscessus complex accounted for 66 and 16.6% of all species, respectively. Some clinical and radiological differences were noted between patients with and without the presence of NTM isolation although the results are inconsistent. Conclusions: Heterogeneity in prevalence estimates of NTM isolation indicated that both local surveys to inform development of clinical services tailored to patients with bronchiectasis and population-based studies are needed. The clinical features associated with NTM in bronchiectasis and their incremental utility in studying the association is unknown and merits further investigation.

Background:. It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011. Methods:. A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided). Results:. The number of different procedures during October 1, 2011−September 30, 2018 was more than twice that during October 1, 2004−September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004–September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011–September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P

Here, we report a rare case of a 12-year-old boy who was initially diagnosed with B cell lymphoblastic lymphoma (BLBL) and developed myeloid sarcoma (MS) eight months after chemotherapy. Next-generation sequencing (NGS) showed mutations of KRAS and NRAS genes in both the bone marrow and lymph node. He presented an abnormal karyotype of 46, XY, −9, der (16) t (9; 16) (q13; q12), +mar. He received chemotherapy according to the South China Children’s Leukemia Group 2016 protocol. Complete remission was achieved by the 15th day post-treatment. Eight months later and immediately prior to the start of maintenance therapy, the patient developed fever, skin nodules in both upper arms, and enlargement of bilateral testes. Pathological analysis of skin and testicular biopsies suggested the diagnosis of myeloid sarcoma (MS). Again, NGS examination showed mutations of KRAS and NRAS genes. The patient underwent haploidentical hematopoietic stem cell transplantation but unfortunately did not survive. The interval of eight-month interval between the initial disease onset and MS brings into question whether MS developed as part of the initial onset of disease or as a secondary tumor in association with chemotherapy. Thus, understanding the pathogenesis of MS involving abnormalities of lymphoid progenitors may assist in the prediction of prognosis and development of novel target therapies.

The blood–brain barrier (BBB) is an important physiological barrier that separates the central nervous system (CNS) from the peripheral circulation, which contains inflammatory mediators and immune cells. The BBB regulates cellular and molecular exchange between the blood vessels and brain parenchyma. Normal functioning of the BBB is crucial for the homeostasis and proper function of the brain. It has been demonstrated that peripheral inflammation can disrupt the BBB by various pathways, resulting in different CNS diseases. Recently, clinical research also showed CNS complications following SARS‐CoV‐2 infection and chimeric antigen receptor (CAR)‐T cell therapy, which both lead to a cytokine storm in the circulation. Therefore, elucidation of the mechanisms underlying the BBB disruption induced by peripheral inflammation will provide an important basis for protecting the CNS in the context of exacerbated peripheral inflammatory diseases. In the present review, we first summarize the physiological properties of the BBB that makes the CNS an immune‐privileged organ. We then discuss the relevance of peripheral inflammation‐induced BBB disruption to various CNS diseases. Finally, we elaborate various factors and mechanisms of peripheral inflammation that disrupt the BBB.

Objective. This study aimed to identify clinicopathological factors related to the extent of axillary lymph node (ALN) involvement in early-stage BC patients with positive sentinel lymph nodes (SLNs). Methods. This was a retrospective analysis of 566 patients in cT1-2N0M0 with 1-2 positive SLNs that underwent axillary lymph node dissection (ALND) at Sun Yat-Sen Memorial Hospital. The clinical and pathologic data from these patients were analyzed. Results. Of these 566 patients, 235 (41.5%) exhibited NSLN metastases. Multivariate analysis revealed that the number of positive SLNs (odds ratio (OR) = 1.511; P = 0.038 ), the ratio of metastatic/dissected SLNs (SLN metastasis rate) (OR = 2.124; P < 0.001 ), and lymphovascular invasion (LVI) (OR = 1.503; P = 0.022 ) were all independent predictors of NSLN metastasis. Patients with 0, 1, 2, or 3 of these risk factors exhibited NSLN metastases in 29.3%, 35.7%, 50.8%, and 68.3% of cases, respectively. We additionally found that the number of positive SLNs (OR = 3.582; P < 0.001 ), SLN metastasis rate (OR = 2.505; P = 0.001 ), LVI (OR = 2.010; P = 0.004 ), and HER2 overexpression (OR = 1.774; P = 0.034 ) were all independent predictors of N2 disease. When individuals had 0, 1, 2, 3, or 4 of these risk factors, they had four or more involved ALNs in 5.2%, 10.8%, 21.1%, 37.5%, and 70.6% of cases, respectively. Conclusion. These results suggest that the number of positive SLNs, the SLN metastasis rate, and LVI are all significant predictors of ALN status in BC patients that have 1-2 positive SLNs and that have undergone ALND. In addition, HER2 overexpression was a significant predictor of N2 disease.

Esophageal cancer patients are at a high risk of malnutrition. Both the disease itself and chemoradiotherapy will lead to the deterioration of nutritional status. The development of nutritional oncology promotes the application of enteral nutrition in tumor patients. Through nutritional support, prognosis is improved and the incidence of adverse chemoradiotherapy reactions is reduced, especially in those with head and neck or esophageal cancer. This review summarizes enteral nutritional support in esophageal cancer patients undergoing chemoradiotherapy in recent years, including a selection of nutritional assessment tools, the causes and consequences of malnutrition in esophageal cancer patients, types of access and effects of enteral nutrition. More patients with esophageal cancer will benefit from the development of enteral nutrition technology in the future.

The deepwater cable bending restrictor is an important protective device for risers, umbilicals and cables in offshore engineering, protecting cable structure by controlling minimum bending radius. Its mechanical properties are analysed based on the numerical analysis model and finite element analysis (FEM) of ø175. The sensitivity analysis of using quantity of bending restrictors is also performed to show the effect of the quantity on bending stiffness. A testing scheme of bending stiffness of the bending restrictor is then formulated based on its structure. From numerical analysis results through test simulation, the tolerance is less than 3 %, which verifies the reliability of the numerical analysis model. Performance of the bending restrictor and dynamic response are analysed according to environmental parameters that occur once per 100 years from offshore wind power farms and pipein-pipe models, respectively. The results show the bending restrictor can effectively protect cable structure, and the pipein-pipe model is suitable for calculating mechanical properties of interaction between the bending restrictor and cable.

Background Conjoined twins are a rare occurrence, and the majority of these malformations are detected during second trimester screening. Case summary Herein we report a case of conjoined twins, which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation. The two fetuses shared one heart and were diagnosed as thoracopagus twins. This is the first report of conjoined twins diagnosed at 8 wk gestation. The pregnancy was terminated electively at 9 wk gestation. Because some congenital malformations can be diagnosed earlier, a prenatal ultrasound examination at an early gestational stage cannot be dismissed. Conclusion This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound.

Increasing evidence has suggested a critical role for endothelial‐to‐mesenchymal transition (EndoMT) in a variety of pathological conditions. MicroRNA‐200c‐3p (miR‐200c‐3p) has been implicated in epithelial‐to‐mesenchymal transition. However, the functional role of miR‐200c‐3p in EndoMT and neointimal hyperplasia in artery bypass grafts remains largely unknown. Here we demonstrated a critical role for miR‐200c‐3p in EndoMT. Proteomics and luciferase activity assays revealed that fermitin family member 2 (FERM2) is the functional target of miR‐200c‐3p during EndoMT. FERMT2 gene inactivation recapitulates the effect of miR‐200c‐3p overexpression on EndoMT, and the inhibitory effect of miR‐200c‐3p inhibition on EndoMT was reversed by FERMT2 knockdown. Further mechanistic studies revealed that FERM2 suppresses smooth muscle gene expression by preventing serum response factor nuclear translocation and preventing endothelial mRNA decay by interacting with Y‐box binding protein 1. In a model of aortic grafting using endothelial lineage tracing, we observed that miR‐200c‐3p expression was dramatically up‐regulated, and that EndoMT contributed to neointimal hyperplasia in grafted arteries. MiR‐200c‐3p inhibition in grafted arteries significantly up‐regulated FERM2 gene expression, thereby preventing EndoMT and reducing neointimal formation. Importantly, we found a high level of EndoMT in human femoral arteries with atherosclerotic lesions, and that miR‐200c‐3p expression was significantly increased, while FERMT2 expression levels were dramatically decreased in diseased human arteries. Collectively, we have documented an unexpected role for miR‐200c‐3p in EndoMT and neointimal hyperplasia in grafted arteries. Our findings offer a novel therapeutic opportunity for treating vascular diseases by specifically targeting the miR‐200c‐3p/FERM2 regulatory axis. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.

We explored three resource capitals related to employability (human, personal-social, and organisational) to explain graduate work entry prospects in a developing country setting. Our study sample ...

Considering that the kidneys segmentation challenge for image processing because of the gray level from abdominal computer tomography (CT) scans is a great similarity of adjacent organs, partial volume effects and so on, a novel multi-feature sparse constraints strategy is proposed to diagnose the benign and malignant renal tumors, which can improve the accuracy and reliability of segmentation. The weighted sparse measure is defined by introducing weights in the l1-norm of vectors. The weight is inversely proportional to the similarity between data, therefore the weighted l1-norm penalty on the linear representation coefficients tends to force similar data be involved while dissimilar data uninvolved in the linear representation of a datum. The resulted representation can overcome the drawbacks of l1-norm penalty that the presentation coefficients are usually over sparse and not robust for highly correlated data. Experimental results and objective assessment indexes show that the proposed method can effectively segment CT images with good visual consistency. In addition, the dice coefficients of renal and renal tumors were 0.933 and 0.854, respectively. In addition, our method can also be used for the diagnosis of renal tumors, and has also achieved good performance.

Objective To study the effect of periostin gene on bone regeneration and mineralisation during distraction osteogenesis (DO) in a rabbit mandibular model. Subjects and methods A total of 54 New Zealand white rabbits underwent mandibular lengthening and were divided into group A and group B (n=27, each). At the end of the distraction, adenoviruses containing human POSTN/enhanced green fluorescent protein (Ad5-POSTN/EGFP) viruses or Ad5-POSTN viruses were injected into the distraction gaps in the group B or A, respectively. On the 4th and 8th week after distraction, eight samples, randomly selected from each group, were subjected to CT scanning and dual energy X-ray absorptiometry detection. All animals from each group were sacrificed for micro-CT, histology, and three-point bend testing eight weeks after DO. Results The CT images showed that callus in the distraction gap of group B was significantly better than that of group A. On the 4th and 8th weeks, the bone mineral densities (BMD) of the bone tissue in the distraction gap of the group B were 0.163±0.011g/cm2 and 0.239±0.024g/cm2, respectively, while the bone mineral contents (BMC) was 0.099±0.011g and 0.205±0.018g, respectively, which were significantly higher compared with group A. Histological sections showed that the trabecular bone in the distraction gap of group B was more coarse. On the basis of micro-CT images and micro-architecture parameters show that the microstructure of the distraction gap of the group B had more mature characteristics. The biomechanical strength of the distracted gap in the group B was 234.30±30.48N, which was 1.28 times higher than that in the group A (P=0.003). Conclusion Local transduction with human periostin gene would promote osteogenesis and mineralisation in a rabbit mandibular DO model. Periostin might be considered for clinical use if only there is a safe and effective administration method.

Background Lingual linear lesions (LLLs) are the oral linear lesions located on the dorsum, lateral borders, and/or ventral surface of tongue. It has been suggested that LLLs might be an early clinical sign of vitamin B12 deficiency. Here, a retrospective study was conducted to further investigate and validate the association between LLL and vitamin B12 deficiency. Methods Based on the clinical examination, patients with LLLs were enrolled and analyzed retrospectively. Data regarding clinical and laboratory features were obtained. Follow-up was done at least 6 months following appropriate supplementation therapy. Results A total of 57 patients, consisting of 20 males and 37 females with a mean age of 59.12 years (range, 18-80), were enrolled in this study. The hematological examination revealed that 56 (98.25%) of the 57 patients had severe serum vitamin B12 deficiency, and the other 1 patient had a borderline low level of vitamin B12 . All the enrolled patients responded well to cobalamin replacement therapy. Conclusion LLLs might be a clinical sign strongly suggestive of severe vitamin B12 deficiency.

Introduction: The delipid extracorporeal lipoprotein filter from plasma (DELP) has been approved for the treatment of acute ischemic stroke (AIS) by the China Food and Drug Administration, but its effectiveness and mechanism are not yet fully determined. The purpose of this study was to evaluate the effect of DELP treatment on AIS patients after intravenous thrombolysis. Methods: A retrospective study was performed on AIS patients with no improvement within 24 h after intravenous thrombolysis who were subsequently treated with or without DELP. Primary outcome was the proportion with a modified Rankin scale (mRS) of 0–1 at 90 days. Secondary outcomes were changes in National Institute of Health Stroke Scale (NIHSS) score from 24 h to 14 days after thrombolysis, and the rate of improvement in stroke-associated pneumonia (SAP). The main safety outcomes were the rates of symptomatic intracranial hemorrhage and mortality. To investigate its mechanisms, serum biomarkers were measured before and after DELP. Results: A total of 252 patients were recruited, 63 in the DELP group and 189 matched patients in the NO DELP group. Compared with the NO DELP group, the DELP group showed an increase in the proportion of mRS 0–1 at 90 days (p = 0.042). More decrease in NIHSS from 24 h to 14 days (p = 0.024), a higher rate of improvement in SAP (p = 0.022), and lower mortality (p = 0.040) were shown in DELP group. Furthermore, DELP decreased levels of interleukin (IL)-1β, E-selectin, malondialdehyde, matrix metalloprotein 9, total cholesterol, low-density lipoprotein, and fibrinogen, and increased superoxide dismutase (p< 0.05). Conclusions: DELP following intravenous thrombolysis should be safe, and is associated with neurological function improvement, possibly through multiple neuroprotective mechanisms. Prospective trials are needed.

Eicosapentaenoic acid (EPA), an omega-3 fatty acid, has been widely used to prevent cardiovascular disease (CVD) and treat brain diseases alone or in combination with docosahexaenoic acid (DHA). However, the impact of EPA and DHA supplementation on normal cognitive function and the molecular targets of EPA and DHA are still unknown. We show that acute administration of EPA impairs learning and memory and hippocampal LTP in adult and prepubescent mice. Similar deficits are duplicated by endogenously elevating EPA in the hippocampus in the transgenic fat-1 mouse. Furthermore, the damaging effects of EPA are mediated through enhancing GABAergic transmission via the 5-HT6R. Interestingly, DHA can prevent EPA-induced impairments at a ratio of EPA to DHA similar to that in marine fish oil via the 5-HT2CR. We conclude that EPA exhibits an unexpected detrimental impact on cognitive functions, suggesting that caution must be exercised in omega-3 fatty acid supplementation and the combination of EPA and DHA at a natural ratio is critical for learning and memory and synaptic plasticity., Acute administration of EPA impairs learning and memory and hippocampal LTP in mice that was mediated through enhancing GABAergic transmission via the 5-HT6R. DHA can prevent EPA-induced impairments at a ratio of EPA to DHA similar to that in marine fish oil via the 5-HT2CR.

In recent years, the technology and applications of visualizations on large high-resolution displays (LHDs) have received widespread attention because of its perceptual benefits and improved productivity. However, existing work on LHD visualization lacks both comprehensive guidance for design requirements and tools developed for its specific usage scenarios. In this paper, we present the scenarios, design, and implementation of DataV, a Software-as-a-Service (SaaS) visual deployment tool that enables rapid construction and cross-platform publishing of interactive visualization on LHDs. Our framework can support rich components for the high-performance rendering of multi-source heterogeneous data. DataV provides a full-fledged toolchain to help the user efficiently specify layout and interactions. We present its accessibility and impressive visual effects with examples and comparison with Tableau, Power BI, VisComposer, and iVisDesigner. We also report the performance of using DataV for 3D map rendering by comparing it with deck.gl.

Background. The predictive value of hemoglobin A1c (HbA1c) levels in non-diabetic patients with myocardial infarction undergoing percutaneous coronary intervention (PCI) is still controversial. This study aimed to evaluate whether HbA1c levels were independently associated with adverse clinical outcomes in non-diabetic patients with coronary artery disease (CAD) who had undergone PCI by performing a meta-analysis of cohort studies. Methods. This meta-analysis included non-diabetic patients with CAD who had undergone PCI. A systematic search for publications listed in the PubMed, Embase, and Cochrane Library databases from commencement to December 2018 was conducted. Studies evaluating the adverse clinical outcomes according to abnormal HbA1c levels in non-diabetic patients diagnosed with CAD who had undergone PCI were eligible. The primary outcomes were long-term all-cause deaths and long-term major adverse cardiac events, and the secondary outcome was short-term all-cause deaths. The meta-analysis was conducted with RevMan 5.3 and Stata software 14.0. Odds ratios (ORs) were pooled using a random or fixed-effects model, depending on the heterogeneity of the included studies. Sub-group analysis or sensitivity analysis was conducted to explore potential sources of heterogeneity, when necessary. Results. Six prospective cohort studies involving 10,721 patients met the inclusion criteria. From the pooled analysis, abnormal HbA1c levels were associated with increased risk for long-term all-cause death (OR 1.39, 95% confidence interval [CI] 1.16–1.68, P = 0.001, I2 = 45%). Sub-group analysis suggested that abnormal HbA1c levels between 6.0% and 6.5% predicted higher long-term major adverse cardiac event (including all-cause deaths, non-fatal myocardial infarction, target lesion revascularization, target vessel revascularization, recurrent acute myocardial infarction, heart failure requiring hospitalization, and stent thrombosis) risk (OR 2.05, 95% CI 1.46–2.87, P

The traditional construction and demolition waste (CDW) treatment process adopts the method of crushing and screening after mixing and combines the method with manual sorting for resource recycling. However, there is a problem of low recycling purity and low efficiency of manual sorting after mixed screening. This paper proposes a robot for sorting CDW, which is used to finely sort a large number of objects before mixing and crushing. The use of the robot improves the level of resource utilization of CDW. However, under actual working conditions, the adhesion and stacking of CDW on the conveyor belt and the irregularity of the shapes of CDW lead to errors in grasping-information. Thus, a deep learning method for grasping detection is proposed. The method generates some grasping rectangles through a searching algorithm, and inputs the rectangles to the neural network. Then, the network outputs the optimal grasping pose. The experiment demonstrated that the original accuracy of robotic grasping was only 70%. After deep learning for grasping detection, the accuracy was over 90%, which thoroughly meets the requirements of efficiency and accuracy for sorting CDW under actual working conditions.

An automatic sorting robot is designed in this report. The system makes use of height maps and near-infrared (NIR) hyperspectral images to locate the ROI of objects and to do online statistic pixel-based classification in contours. This approach has two advantages: (1) to generate training data for sorting without manual work; (2) to get more stable final result. Two kind of features in hyperspectral image were extracted, a scale-sensitive algorithm was used to identify amplitude feature and a scale-insensitive algorithm was used to identify trend feature. After location and classification, the robot grabs valuable targets based on their position and posture and places them into the corresponding recycling area based on their category. The prototype machine can automatically sort construction and demolition waste (C&DW) with a size range of 0.05–0.5 m. The sorting efficiency can reach 2028 picks/h, and the online recognition accuracy nearly reaches 100%.

Purpose Diabetes mellitus (DM)-induced brain damage is characterized by cellular, molecular and functional changes. The mechanisms include oxidative stress, neuroinflammation, reduction of neurotrophic factors, insulin resistance, excessive amyloid beta (Aβ) deposition and Tau phosphorylation. Both antidiabetic and neuroprotective effects of the phytoestrogen genistein have been reported. However, the beneficial effect of genistein in brain of the ob/ob mouse model of severe obesity and diabetes remains to be determined. Methods In this study, female ob/ob mice and lean control mice were fed with either a standard diet or a diet containing genistein (600mg/kg) for a period of 4 weeks. Body weight was monitored weekly. Blood was collected for the measurement of glucose, insulin and common cytokines. Mice brains were isolated for Western immunoblotting analyses. Results Treatment with genistein reduced weight gain of ob/ob mice and decreased hyperglycemia compared to ob/ob mice fed the standard diet. The main findings show that genistein treatment increased insulin sensitivity and the expression levels of the neurotrophic factors nerve growth factor (NGF) and brain-derived neurotrophic factors (BDNF). In these mice, genistein also reduced Aβ deposition and the level of hyper-phosphorylated Tau protein. Conclusion The results of our study indicate the beneficial effects of genistein in the obese diabetic mouse brain, including improving brain insulin signaling, increasing neurotrophic support, and alleviating Alzheimer's disease-related pathology.

Introduction To examine the effects and safety of oxytocin administered intramuscularly or intravenously for preventing postpartum hemorrhage (PPH) in the third stage of labor after vaginal deliveries. Material and methods Before data extraction, the review was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration No. CRD42019145912). We searched the published electronic databases, including Medline, EMBASE, PubMed, Web of Science, CNKI, VIP, Wanfang, the Cochrane Library, clinicaltrial.gov and PROSPERO database, from their inception until February 2019. We included all randomized controlled trials (RCTs) comparing intramuscular and intravenous oxytocin administered just after the birth of the anterior shoulder or soon after the birth of the baby during a vaginal delivery. The primary outcomes were the incidence of PPH and severe PPH. PPH was defined as a blood loss ≥500 ml within 24 hours after vaginal birth. Severe PPH refers to a clinically estimated blood loss equal to or greater than 1000 mL within 24 hours after vaginal birth. Statistical heterogeneity was assessed by the I2 test, the Cochran Q statistic and the Galbraith plot for heterogeneity. Results Six RCTs, including 7320 women undergoing vaginal delivery, were identified in the meta-analysis. Women who were randomized to have intravenous oxytocin for the third stage of labor had a significantly lower incidence of PPH (relative risk 1.35, 95% CI 1.11-1.64, p = 0.003), severe PPH (relative risk 1.61, 95% CI 1.05-2.46, p = 0.03) and blood transfusion (relative risk 2.50, 95% CI 1.37-4.59, p = 0.003) compared with those who were randomized to have intramuscular oxytocin during the third stage of labor after vaginal delivery. There was no significant difference with regard to changes in hemoglobin level, third stage of labor duration, mean postpartum blood loss, or the incidences of a need for additional uterotonics and of retained placenta or manual removal of placenta between groups. Conclusions For women in the third stage of labor who are undergoing a vaginal delivery, the use of intravenous oxytocin reduces the incidence of PPH, severe PPH and blood transfusion and does not increase the risk of adverse effects compared with intramuscular oxytocin.

Objective To explore the value of CT texture analysis (CTTA) for determining coronavirus disease 2019 (COVID-19) severity. Methods The clinical and CT data of 81 patients with COVID-19 were retrospectively analyzed. The texture features were extracted using LK2.1. The two-sample t test or Mann–Whitney U test was used to find the significant features. Minimum redundancy and maximum relevance (MRMR) method was performed to find the features with maximum correlation and minimum redundancy. These features were then used to construct a radiomics texture model to discriminate the severe patients using multivariate logistic regression method. Besides, a clinical model was also built. ROC analyses were conducted to evaluate the performance of two models. The correlations of clinical features and textural features were analyzed using the Spearman correlation analysis. Results Of the total cases included, 60 were common and 21 were severe. (1) For textural features, 20 radiomics features selected by MRMR showed good performance in discriminating the two groups (AUC > 70%). (2) For clinical features, chi-square tests or Mann–Whitney U tests identified 16 clinical features as significant, and 12 were discriminative (p 70%. (3) Prediction models for textural features and clinical features were established, and both showed high predictive accuracy. The AUC values of textural features and clinical features were 0.93 (0.86–1.00) and 0.95 (0.95–0.99), respectively. (4) The Spearman correlation analysis showed that most textural and clinical features had above-moderate correlations with disease severity (> 0.4). Conclusion Texture analysis can provide reliable and objective information for differential diagnosis of COVID-19. Key Points • CT texture analysis can well differentiate common and severe COVID-19 patients. • Some textural features showed above-moderate correlations with clinical factors. • CT texture analysis can provide useful information to judge the severity of COVID-19. Electronic supplementary material The online version of this article (10.1007/s00330-020-07012-3) contains supplementary material, which is available to authorized users.

The best surgical procedure of patients with secondary hyperparathyroidism (SHPT) has long been controversial. This meta-analysis was the first study to accurately limit the transplantation site to the forearm muscle and compare the efficacy of total parathyroidectomy with forearm muscle autotransplantation (TPTX+AT) versus subtotal parathyroidectomy (SPTX). A literature search was performed using PubMed, Cochrane, and EMBASE databases up to August 2019. The quality of the studies included was assessed using the Newcastle-Ottawa Scale (NOS). Data were analyzed using Stata version 12 (Stata Corp LP, College Station, TX, USA). A total of 11 studies comprising 984 patients were identified. Compared with SPTX, patients in the TPTX+AT group had significantly lower rates of persistent hyperparathyroidism (OR = 6.41; 95% CI 1.01 to 40.8; P = 0.049). No statistically significant difference was observed in symptomatic improvement (OR = 0.384; 95%CI, 0.12–1.27; P = 0.117), radiological changes (OR = 0.95; 95%CI, 0.03–27.82; P = 0.977), recurrence rate (OR = 1.23; 95% CI, 0.70–2.16; P = 0.473), reoperation rate (OR = 1.07; 95%CI, 0.55–2.07; P = 0.848), hypocalcemia rate (OR = 1.48; 95%CI, 0.78–2.78; P = 0.228), postoperative complications (OR = 0.71; 95%CI, 0.24–2.13; P = 0.537), and hypoparathyroidism rate (OR = 0.91; 95% CI; 0.20–4.18; P = 0.902) between SPTX and TPTX+AT groups. Both of the surgical approaches were effective in treating SHPT for chronic kidney disease (CKD) patients. It was suggested that TPTX+AT was superior to SPTX with reference to the rate of persistent hyperparathyroidism, but this conclusion still needed to be tested in large-scale prospective randomized controlled trials. TPTX+AT may be preferred for SHPT patients with convincing reasons to avoid neck reoperation.

Objective To determine the 5-year and temporal performance of TAVR versus SAVR. Background TAVR has become a valuable treatment for severe aortic stenosis but the long-term safety and efficacy remain unclear. Methods Databases were searched until October 6, 2019 for randomized trials with ≥5 years' follow-up. Primary outcome was all-cause mortality. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled with random-effects models. Results We included 4 trials with 3,758 patients. TAVR was associated with a significantly higher 5-year all-cause mortality than SAVR (OR, 1.19; 95% CI, 1.03-1.37; P = 0.02). Landmark analysis showed no significant difference within 2 years (OR, 0.92; 95% CI, 0.79-1.08; P = 0.33) but a statistically higher mortality in TAVR between 2 and 5 years (OR, 1.32; 95% CI, 1.14-1.52; P = 0.0002), with significant difference between these 2 temporal phases (P for interaction = 0.001). Similar interaction was found for cardiovascular mortality and several other outcomes. Rates of all-cause mortality or disabling stroke, permanent pacemaker implantation, aortic-valve rehospitalization, and reintervention were higher, but rates of major bleeding and new-onset fibrillation were lower in TAVR at 5 years. The incidences of myocardial infarction, stroke, and transient ischemic attack were not statistically different between TAVR and SAVR. Conclusions TAVR was associated with a significantly higher all-cause mortality at 5 years compared with SAVR. Of note, all-cause mortality presented a characteristic temporal pattern showing increased risk between 2 and 5 years but not within 2 years. Longer-term follow-up data are warranted.

For radar network, each radar can obtain the two-dimensional (2D) inverse synthetic aperture radar (ISAR) image from the corresponding observation angle independently. Taking advantage of the multi...

Ultrasound (US) can be used to evaluate the brain structure and nervous system damage. Patients with neurologic symptoms need rapid, noninvasive imaging with high spatial resolution and tissue contrast. Magnetic resonance imaging is currently the most sensitive and specific imaging method for evaluating neuropathologic conditions. This approach does present some challenges, such as the need to transport patients who may be seriously ill to the magnetic resonance imaging suite and the need for patients to remain for a considerable time. Cranial US provides a very valuable imaging method for clinicians, which can make a rapid diagnosis and evaluation without ionizing radiation. The main disadvantage of cranial US is its low sensitivity and specificity for subtle/early lesions. In recent years, with the rapid development of anatomic and functional US technology, the practicability of US diagnosis and intervention has been greatly improved. Ultrasound elastography may have the potential to improve the sensitivity and specificity of various cranial nerve conditions. Ultrasound elastography has received considerable critical attention, and an increasing number of studies have recognized its critical role in evaluating brain diseases. At present, US elastography has been applied to the evaluation of traumatic brain injury, ischemic stroke, intraoperative brain tumors, and hypoxic ischemic encephalopathy. The latest animal experiments and human clinical trial developments in the applications of US elastography for brain diseases are summarized in this review.