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Objectives To develop and validate a general radiomics nomogram capable of identifying EGFR mutation status in non-small cell lung cancer (NSCLC) patients, regardless of patient with either contrast-enhanced CT (CE-CT) or non-contrast-enhanced CT (NE-CT). Methods A total of 412 NSCLC patients were retrospectively enrolled in this study. Patients’ radiomics features not significantly different between NE-CT and CE-CT were defined as general features, and were further used to construct the general radiomics signature. Fivefold cross-validation was used to select the best machine learning algorithm. Finally, a general radiomics nomogram was developed using general radiomics signature, and clinical and radiological characteristics. Two groups of data collected at different time periods were used as two test sets to access the discrimination and clinical usefulness. Area under the receiver operating characteristic curve (ROC-AUC) was applied to performance evaluation. Result The general radiomics signature yielded the highest AUC of 0.756 and 0.739 in the two test sets, respectively. When applying to same type of CT, the performance of general radiomics signature was always similar to or higher than that of models built using only NE-CT or CE-CT features. The general radiomics nomogram combining general radiomics signature, smoking history, emphysema, and ILD achieved higher performance whether applying to NE-CT or CE-CT (test set 1, AUC = 0.833 and 0.842; test set 2, AUC = 0.839 and 0.850). Conclusions Our work demonstrated that using general features to construct radiomics signature and nomogram could help identify EGFR mutation status of NSCLC patients and expand its scope of clinical application. Key Points • General features were proposed to construct general radiomics signature using different types of CT of different patients at the same time to identify EGFR mutation status of NSCLC patients. • The general radiomics nomogram based on general radiomics signature, and clinical and radiological characteristics could identify EGFR mutation status of patients with NSCLC and outperformed the general radiomics signature. • The general radiomics nomogram had a wider scope of clinical application; no matter which of NE-CT and CE-CT the patient has, its EGFR mutation status could be predicted.

The development of digital economy affects environmental pollution emission and green sustainable development. However, the relationship between digital economy and industrial wastewater discharge has rarely been examined. This study establishes the urban digital economy evaluation index system, measures the digital economy indexes of 281 prefecture-level cities in China from 2011 to 2016, and examines the impact effect of digital economy development on industrial wastewater discharge using the system generalized method of moment method and the intermediary effects model. The empirical results indicate that the digital economy reduces the industrial wastewater discharge. As evidence shows, the digital economy significantly promotes the upgrading of industrial structure, which is an important factor affecting the industrial wastewater discharge. Additionally, the inhibiting effect of digital economy on industrial wastewater discharge is more significant in big cities. This study provides a scientific base and guidance for reducing environmental pollution emissions and promoting the development of digital economy.

We conducted a crossover study employing air cleaner intervention among 125 schoolchildren aged 9-12 years in a boarding school in Beijing, China. The PM concentrations were monitored, and 27 biomarkers were analyzed. We used the linear mixed-effects model to evaluate the association of intervention/time-weighted PM concentrations with biomarkers. The outcomes showed that air cleaner intervention was associated with FeNO, exhaled breath condensate (EBC) IL-1β, and IL-6, which decreased by 12.57%, 10.83%, and 4.33%, respectively. Similar results were observed in the associations with PMs. Lag 1 day PMs had the strongest relationship with biomarkers, and significant changes were observed in biomarkers such as FEV1, FeNO, EBC 8-iso, and MCP-1. Boys showed higher percentage changes than girls, and the related biomarkers were FeNO, EBC 4-HNE, IL-1β, IL-6, and MCP-1. The results showed that biomarkers such as FeNO, EBC IL-6, MCP-1, and 4-HNE could sensitively reflect the early abnormal response of the respiratory system under short-term PM exposure among healthy schoolchildren and indicated that (1) air cleaners exert a protective effect on children's respiratory system. (2) PM had lag and cumulative effect, lag 1 day had the greatest effect. (3) The boys were more sensitive than the girls.

Nonlinear optical (NLO) switchable materials have attracted intense attention because of their promising applications in optoelectronic devices. However, previous studies are mainly limited to mole...

Background: Hepatocellular carcinoma (HCC) is a common type of cancer with a high mortality rate and is usually detected at the middle or late stage, missing the optimal treatment period. The current study aims to identify potential long non-coding RNA (lncRNAs) biomarkers that contribute to the diagnosis and prognosis of HCC. Methods: The differentially expressed lncRNAs (DElncRNAs) in HCC patientsThe differentially expressed lncRNAs (DElncRNAs) in HCC patients were detected from the Cancer Genome Atlas (TCGA) dataset. LncRNAs signature was screened by LASSO regression, univariate, and multivariate Cox regression. The models for predicting diagnosis and prognosis were established, respectively. The prognostic model was evaluated by Kaplan-Meier survival curve receiver operating characteristic (ROC) curve and stratified analysis. The diagnostic model was validated by ROC. The lncRNAs signature was further demonstrated by functional enrichment analysis. were detected from the Cancer Genome Atlas (TCGA) dataset. LncRNAs signature was screened by LASSO regression, univariate and multivariate Cox regression. The models for predicting diagnosis and prognosis were established respectively. The prognostic model was evaluated by Kaplan-Meier survival curve receiver operating characteristic (ROC) curve and stratified analysis. The diagnostic model was validated by ROC. The lncRNAs signature was further demonstrated by functional enrichment analysis. Results: We found the 13-lncRNAs signature that had a good performance in predicting prognosis and could help to improve the value of diagnosis. In the training set, testing set, and entire cohort, the low-risk group had longer survival than the high-risk group (median OS: 3124 vs. 649 days, 2456 vs. 770 days and 3124 vs. 755 days). It performed well in 1-, 3-, and 5-year survival prediction. 13-lncRNAs-based risk score, age, and race were good predictors of prognosis. The AUC of diagnosis was 0.9487, 0.9265, and 0.9376, respectively. Meanwhile, the 13-lncRNAs were involved in important pathways, including the cell cycle and multiple metabolic pathways. Conclusion: In our study, the 13-lncRNAs signature may be a potential marker for the prognosis of HCC and improve the diagnosis.

Domain adaptation is becoming increasingly important for learning systems in recent years, especially with the growing diversification of data domains in real-world applications, such as the genetic data from various sequencing platforms and video feeds from multiple surveillance cameras. Traditional domain adaptation approaches target to design transformations for each individual domain so that the twisted data from different domains follow an almost identical distribution. In many applications, however, the data from diversified domains are simply dumped to an archive even without clear domain labels. In this article, we discuss the possibility of learning domain adaptations even when the data does not contain domain labels. Our solution is based on our new model, named domain adaption using cross-domain homomorphism (DACH in short), to identify intrinsic homomorphism hidden in mixed data from all domains. DACH is generally compatible with existing deep learning frameworks, enabling the generation of nonlinear features from the original data domains. Our theoretical analysis not only shows the universality of the homomorphism, but also proves the convergence of DACH for significant homomorphism structures over the data domains is preserved. Empirical studies on real-world data sets validate the effectiveness of DACH on merging multiple data domains for joint machine learning tasks and the scalability of our algorithm to domain dimensionality.

Preoperative immune-nutritional status is correlated with postoperative outcomes. The Controlling Nutritional Status (CONUT) score is a useful tool for predicting the postoperative outcomes of cancer surgery. This study aimed to evaluate whether the CONUT score could predict postoperative complications in Crohn’s disease (CD) patients. In total, 202 CD patients were eligible. Univariate and multivariate analyses were performed to identify risk factors for postoperative complications. Receiver operating characteristic (ROC) curves were generated to examine the cutoff value for predictors of postoperative complications. Among all the patients, 66 developed postoperative complications. The cut-off value of the CONUT score was 3.5 for complications. Eighty-one patients had a low CONUT score ( 3.5). There was a significant difference in postoperative complications between the groups with low and high CONUT score (17.3% vs. 43.0%, p

We conducted a systematic review and meta-analysis to evaluate the association between parental diabetes mellitus and the risk of ADHD in offspring. The PubMed, EMBASE, Cochrane, and Web of Science databases were searched from inception to May 31, 2019. Thirteen observational studies containing 5,052,736 participants were included. Two reviewers independently extracted data and assessed the quality of the studies using predefined standard procedures. Random-effects model were used. We found that maternal pregestational diabetes mellitus (PGDM) was associated with an increased risk of ADHD in offspring (odds ratio [OR]: 1.40; 95% confidence interval [CI]:1.31-1.50) in adjusted analyses. Increased risks of ADHD in offspring were also observed among those with maternal preexisting type 1 diabetes (T1D) (OR: 1.39; 95% CI: 1.27-1.52) and paternal T1D (OR: 1.20; 95% CI: 1.13-1.28) in adjusted analyses. Sensitivity analyses supported the robustness of our findings. Future studies should use robust designs to address whether the association with parental diabetes mellitus is causal.

BACKGROUND Extremely premature infants have poor vascular conditions. Operators often choose deep veins such as the femoral vein and axillary vein to peripherally insert central catheters, and these vessels are often accompanied by arteries; thus, it is easy to mistakenly enter the artery. CASE SUMMARY The case of an extremely premature infant (born at gestational age 28+3) in whom the left upper extremity artery was accidentally entered during peripheral puncture of the central venous catheter is reported. On the 19th day of hospitalization, the index finger, middle finger and ring finger of the left hand were rosy, the left radial artery and brachial artery pulse were palpable, the recovery was 95%, and the improvement was obvious. At discharge 42 d after admission, there was no abnormality in fingertip activity during the follow-up period. CONCLUSION Arterial embolization in preterm infants requires an individualized treatment strategy combined with local anticoagulation and 2% nitroglycerin ointment for local tissue damage caused by arterial embolism in the upper limb. Continuous visualization of disease changes using image visualization increases the likelihood of a good outcome.

To quantify the spatial distribution of relative corneal refractive power shift (RCRPS) to investigate its association with axial length growth.Eighty myopic children were randomly assigned for fitting with type A or B lenses. Axial lengths and corneal topographies were measured at baseline and the 1-, 6-, and 12-months follow-up visits. Treatment-zone decentrations and sizes were derived from tangential maps. RCRPSs were computed by taking the difference between after-treatment and baseline axial maps and then subtracting the apex value. Values at the same radius were averaged to obtain an RCRPS profile, from which four distributional parameters were extracted: the peak value (Rmax), the location where the profile first reached its half peak (X50), and the powers summed within 4- and 8-mm diameter areas (Sum4 and Sum8, respectively). Linear mixed models were used to analyse the correlation between the AL growth and the distributional parameters.At baseline, no significant differences were observed between the two groups. After treatment, Axial length growth was significantly smaller in subjects fitted with type-B lenses (0.15 ± 0.16 vs 0.25 ± 0.22 mm,The spatial distribution of RCRPS is critical in retarding AL growth, and the ones reaching peak within a shorter distance from the apex may provide better myopia control.

Long non-coding RNAs (lncRNAs) constitute a group of >200-nucleotide ncRNA molecules. lncRNAs regulate several cell functions, such as proliferation, apoptosis, invasion and metastasis. Meanwhile, lncRNAs are abnormally expressed in human malignancies, where they suppress or promote tumor growth. The present study focused on growth arrest-specific transcript 5 (GAS5), a well-known lncRNA that acts as a tumor suppressor but is suppressed in multiple types of cancer, including mammary carcinoma, prostate cancer, colorectal cancer, gastric cancer, melanoma, esophageal squamous cell carcinoma, lung cancer, ovarian cancer, cervical cancer, gliomas, osteosarcoma, pancreatic cancer, bladder cancer, kidney cancer, papillary thyroid carcinoma, neuroblastoma, endometrial cancer and liver cancer. Notably, GAS5 is overexpressed in liver cancer, potentially functioning as an oncogene. In the present study, the diagnostic and therapeutic roles of GAS5 in different tumors were reviewed, with a summary of the potential clinical application of the lncRNA, which may help identify novel study directions for GAS5.

STUDY QUESTION Does the endometrial preparation protocol for frozen embryo transfer (FET) have an impact on perinatal outcomes? SUMMARY ANSWER Singleton newborns from conceptions after an artificial FET cycle had a higher risk of being large for gestational age (LGA). WHAT IS KNOWN ALREADY Most previous studies have concentrated on the clinical pregnancy, miscarriage and live birth rates of different endometrial preparation protocols for FET. However, the impacts of these cycle regimens on perinatal outcomes including birthweight, gestational age (GA) and related outcomes require more investigation. STUDY DESIGN, SIZE, DURATION We retrospectively analysed all singletons conceived by women who underwent non-donor FET cycles between July 2014 and July 2017. The propensity score matching (PSM) method using nearest neighbour matching at a proportion of 1:1 was established to adjust for factors that influence the probability of receiving different FET cycle regimens. The main outcomes of the study included birthweight and its related outcomes, Z-score, low birthweight (LBW, 4000 g). The study outcomes also included GA at birth, preterm delivery ( PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 9267 cycles with live-born singletons were included in the analysis in our centre between July 2014 and July 2017. Of these, 2224, 4299 and 2744 live-born singletons were conceived by natural cycle FET, stimulated cycle FET and artificial cycle FET, respectively. After PSM, 1947 cycles of natural cycle FET versus stimulated cycle FET, 1682 cycles of stimulated cycle FET versus artificial cycle FET and 2333 cycles of natural cycle FET versus artificial cycle FET were included in the analysis. MAIN RESULTS AND THE ROLE OF CHANCE A higher mean birthweight and Z-score were observed in the artificial cycle FET group than in the stimulated cycle FET group (P = 0.005; P = 0.004, respectively). Singleton newborns conceived after artificial cycle FET were more likely to be LGA than those born after natural cycle FET or stimulated cycle FET (19.92% versus 16.94% and 19.29% versus 16.12%, respectively). The adjusted ORs (95% CIs) were 1.25 (1.05, 1.49) for artificial cycle FET compared with natural cycle FET (P = 0.014) and 1.26 (1.08, 1.46) for artificial cycle FET compared with stimulated cycle FET (P = 0.003). Newborns conceived after stimulated cycle FET had a lower mean GA at birth and a lower mean birthweight than those born after natural cycle FET or artificial cycle FET. The stimulated cycle FET group had lower adjusted odds of being macrosomia than the natural cycle FET group. No significant differences between natural cycle FET and stimulated cycle FET were found for any of the other outcomes. LIMITATIONS, REASONS FOR CAUTION This study had the disadvantage of being retrospective, and some cases were excluded due to missing data. The original allocation process was not randomized, which may have introduced bias. We have chosen not to account for multiple comparisons in our statistical analysis. WIDER IMPLICATIONS OF THE FINDINGS LGA can have long-term consequences in terms of risk for disease, which means that the influences of artificial cycle FET are of clinical significance and deserve more attention. Furthermore, these findings are critical for clinicians to be able to make an informed decision when choosing an endometrial preparation method. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by grants from the National Natural Science Foundation of China (NSFC) (31770989 to Y.W.) and the Shanghai Ninth People’s Hospital Foundation of China (JYLJ030 to Y.W.). None of the authors have any conflicts of interest to declare.

The origins and spread of agriculture was one of the milestones in human history. When and how prehistoric agriculture spread to mainland Southeast Asia is highly concerned, which contributed to the formation of modern Austroasiatic in this region. Previous studies mainly focused on the time and route of rice agriculture’s introduction into Southeast Asia while millet agriculture was not paid proper attention. Here we analyze 312 14C dating data yielded from charred seeds of rice ( Oryza sativa ), foxtail millet ( Setaria italica ) and broomcorn millet ( Panicum miliaceum ) from 128 archaeological sites in China and mainland Southeast Asia. The result shows that millet farming was introduced to mainland Southeast Asia in the late third millennium BC and rice farming was in the late second millennium BC. The agriculture of mainland Southeast Asia might originate from three areas, Southwest China, Guangxi-West Guangdong and coastal Fujian. The spread route of ancient agriculture in Southwest China is close to the “Southwest Silk Road” recorded in literature, which implies there was possibly a channel of cultural exchanges on the eastern margin of Tibetan Plateau already in the late Neolithic period, laying the foundation for the Southwest Silk Road later.

STUDY QUESTION Does the quality of a single transferred blastocyst affect singleton birthweight in frozen-embryo transfer (FET) cycles? SUMMARY ANSWER The transfer of a poor-quality blastocyst was associated with lower mean birthweight and gestation-adjusted birthweight (Z-scores) when compared with the transfer of an excellent-quality blastocyst during FET cycles. WHAT IS KNOWN ALREADY Embryo quality is a strong predictor of IVF success rates. However, very few studies have examined the effect of embryo quality on singleton birthweight. STUDY DESIGN, SIZE, DURATION This retrospective study involved singleton live births born to women undergoing frozen-thawed single blastocyst transfers during the period from January 2010 to December 2017 at a tertiary care centre. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 1207 women who fulfilled the inclusion criteria were included and were grouped into four groups depending on the blastocyst quality: excellent, good, average and poor. The primary outcome measure was singleton birthweight. The Z-score was employed to calculate the birthweight adjusted for gestational age and newborn gender. Multiple linear regression analysis was performed to investigate the relationship between embryo quality and neonatal birthweight after adjustment for some potential confounders. MAIN RESULTS AND THE ROLE OF CHANCE In the primary multivariable model, singletons from the poor-quality blastocyst group weighed 183.5 g less than those from the excellent-quality blastocyst group (95% CI: −295.1 to −71.9 g, P = 0.001) in terms of mean birthweight after accounting for patient characteristics, IVF treatment parameters, the year of treatment and newborn gender. Likewise, poor-quality blastocyst transfer was associated with lower gestation-adjusted Z-scores than the transfer of excellent-quality blastocysts (β = −0.35, 95% CI: −0.59 to −0.12, P = 0.003). LIMITATIONS AND REASONS FOR CAUTION The current study was limited by its retrospective design and the fact that our analysis was restricted to women with singleton births from single blastocyst transfers. Future prospective studies are required to confirm our findings. WIDER IMPLICATIONS OF THE FINDINGS Our findings provide new insight into the relationship between embryo quality and neonatal outcomes by showing that poor-quality blastocyst transfer was associated with a decrease in singleton birthweight. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the National Key Research and Development Program of China (grant no. 2018YFC1003000), the National Natural Science Foundation of China (grant nos. 81771533, 81571397 and 31770989), and the China Postdoctoral Science Foundation (Grant no. 2018M630456). The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.

Considering the interaction between concrete shrinkage and concrete creep and between the relaxation of prestressing steel and concrete creep in the prestressed concrete member, a refined method fo...

Previous research focused on the qualitative discussion of the correlation between surgical time and mortality in acute pancreatitis (AP). Recommendations for surgical timing of necrotizing pancreatitis are delayed as far as possible, without recommendations for individuals. The aim of this article is to predict timing of surgical intervention in necrotizing pancreatitis with recurrent neural network (RNN). Time series data in AP were retrospectively extracted from a hospital in China (n = 15,813) to develop model, and the Cerner Health Facts database in the United States (n = 142,650) was used to externally validate. The developed model, time-aware Phased-Decay long short-term memory (LSTM), was used to predict timing of surgical intervention and critical clinical features in necrotizing pancreatitis based on laboratory tests, compared to other machine learning models. Area under the ROC curve (AUC) of RNN-based models was more than 0.70. The AUC of time-aware Phased-Decay LSTM (0.75) with more explanatory was similar to that (0.76) of Phased-Decay LSTM to predict surgical timing. The developed model visualized the specific surgical process and laboratory indicators changes for the patients with AP from the onset to discharge. Different clinical features had different contribution modes with time to the specific surgical event in AP. Heart function contributed the most to the prediction of surgical intervention at the onset and in the first week. Our developed model could monitor the specific surgical process from the onset of AP to discharge and extract the contribution modes of clinical features with time in necrotizing pancreatitis.

Food is the most important thing for people. Food safety concerns thousands of families. Due to various types of food and different censoring standards, the whole food safety management system has miscellaneous food information, which is not convenient for food safety management. At any time, food safety problems may cause public panic and affect the stability of domestic food safety. And big data mining with its characteristics of diversity, hierarchy, relevance, can promote the deficiency of food safety management, the basic information of the various types of food to effectively improve the reliability of the food quality, systematic management and analysis of the security situation of monitoring and associated products, actively respond to a potential food safety issues, as the national food security escort.

RbNaMgP2O7 is a newly reported nonlinear optical (NLO) crystal that displays remarkable second harmonic generation (SHG) enhancement upon heating. In this work, we carried out in situ neutron powde...

This paper differs from conventional science and socially oriented studies of climate by integrating concepts derived from both approaches. Based on interdisciplinary, trans-disciplinary multidisciplinary literature review, it defines microclimate and its essences of including natural, social and interactive microclimate from tourism discipline context. For in-depth development of tourism in China under the pressure of tourism supply-side structure revolution, this paper proposes microclimate tourism and analyzes basic on-site microclimate tourism mechanism, basic tourists attractions supply mechanism, and dynamic flows and flexible organisation mechanism of microclimate tourism. For sustainable development, it explores tangible tourists attractions safety, tourists safety and industrial security of microclimate tourism as well as measurements and suggestions for mitigating relative security and safety issues.

Study question Is there any association between the number of oocytes retrieved and neonatal outcomes following IVF/ICSI treatment for patients using a freeze-all strategy? Summary answer There was no increased risk of adverse neonatal outcomes in cycles with high number of oocytes retrieved (≥ 16) compared to those with 10–15 oocytes retrieved in freeze-all cycles. What is known already Recent studies have found that there is an increased risk of preterm birth (PTB, 20) of oocytes retrieved in fresh embryo transfer (ET) cycles. Other studies have found that there is an association between the number of oocytes retrieved and placenta praevia. However, the association between the number of oocytes retrieved and neonatal outcomes when using a freeze-all strategy is unknown. Study design, size, duration This retrospective cohort study included 14 170 women with singleton deliveries achieved by a freeze-all strategy performed between November 2006 and December 2017 in China. Only the first delivery from one episode of ovarian stimulation was included. Participants/materials, setting, methods Only cycles using a freeze-all strategy performed during the study period and resulting in singleton live births were included. Patients were categorized into five groups according to the number of oocytes retrieved: 1–3, 4–9, 10–15, 16–20 or >20 oocytes. In univariate and multivariate logistic regression analysis of the association between ovarian response and the outcomes of PTB, early PTB, LBW and other neonatal outcomes, the 10 to 15 oocyte category was used as a reference and other four groups were analysed as dummy variables. Multiple linear regression analysis was used to evaluate possible associations of birth weight z-scores and the number of oocytes retrieved (analysed as a continuous variable) with other confounding factors. Main results and the role of chance After adjusted for confounding factors, no significant differences were observed in the risk of PTB (P = 0.837), LBW (P = 0.974), early PTB (P = 0.341), very LBW (P = 0.848), congenital malformation (P = 0.916) and other adverse neonatal outcome among patients with different number of oocytes retrieved. There was a higher risk of early PTB among women with a poor ovarian response (1–3 oocytes) compared with women with a normal response (10–15 oocytes) (1.5% vs 0.8%), crude odds ratio (OR): 2.001, 95% CI: 1.159–3.465, P = 0.013. However, the difference was not significant after adjusting for confounders, adjusted OR: 1.753, 95% CI: 0.997–3.081, P = 0.051. Limitations, reasons for caution Data on some known confounders such as smoking and medical history of gestational diabetes mellitus and preeclampsia were lacking. As with any retrospective study, unknown confounders may affect outcomes. Wider implications of the findings In the freeze-all cycles, there was no association between number of oocytes retrieved and adverse neonatal outcomes. This is a reassuring finding for both clinicians and patients who are planning to use freeze-all cycles for a variety of indications. Study funding/competing interest(S) Grants from the National Natural Science Foundation of China (NSFC) (31770989 to Y.W.) and the Shanghai Ninth People’s Hospital Foundation of China (JYLJ030 to Y.W.). None of the authors have any conflicts of interest to declare.

Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot closely linked to the pathogenesis of heart failure (HF). But the molecular signatures related to the mechanism of HF have not been systematically explored. Here, we present comprehensive proteomic analysis of EAT in HF patients and non‐HF patients as controls. A total of 771 proteins were identified in liquid chromatography‐tandem mass spectrometry experiments. Amongst them, 17 increased in abundance in HF and seven decreased. They were involved in HF‐related processes including inflammation and oxidative stress response and lipid metabolism. Of these proteins, serine proteinase inhibitor A3 (Serpina3) levels in EAT were highly up‐regulated in HF, with HF/non‐HF ratio of 4.63 (P = .0047). Gene expression of Serpina3 via quantitative polymerase chain reaction was significantly increased in the HF group. ELISA analysis confirmed a significant increase in circulating plasma Serpina3 levels in the HF group (P = .004). In summary, for the first time, we describe that parts of EAT proteome may be reactive and work as modulators of HF. Our profiling provides a comprehensive basis for linking EAT with pathogenesis of HF. Understanding the role of EAT may offer new insights into the treatment of HF.

Intensive land use can support sustainable socioeconomic development, especially in the context of limited land resources and high population. It is measured by land-use intensity that reflects the degree of land-use efficiency. In order to support decision-making for efficient land use, we investigated the mechanism whereby natural and socioeconomic factors influence land-use intensity from the perspectives of overall, region-, and city-based analysis, respectively. This investigation was conducted in Chinese cities using the multiple linear stepwise regression method and geographic information system techniques. The results indicate that: (1) socioeconomic factors have more positive impact on land-use intensity than natural factors as nine of the top 10 indicators with the highest SRC values are in the socioeconomic category according to the overall assessment, (2) education input variously contributes to land-use intensity because of the mobility of a well-educated workforce between different cities, (3) the increase in transportation land may not promote intensive land use in remarkably expanding cities due to the defective appraisal system for governmental achievements, and that (4) in developed cities, economic structure contributes more to land-use intensity than the total economic volume, whereas the opposite is the case in less-developed cities. This study can serve as a guide for the government to prepare strategies for efficient land use, hence promoting sustainable socioeconomic development.

The tantalizing promise of quantum computational speedup in solving certain problems has been strongly supported by recent experimental evidence from a high-fidelity 53-qubit superconducting processor1 and Gaussian boson sampling (GBS) with up to 76 detected photons. Analogous to the increasingly sophisticated Bell tests that continued to refute local hidden variable theories, quantum computational advantage tests are expected to provide increasingly compelling experimental evidence against the Extended Church-Turing thesis. In this direction, continued competition between upgraded quantum hardware and improved classical simulations is required. Here, we report a new GBS experiment that produces up to 113 detection events out of a 144-mode photonic circuit. We develop a new high-brightness and scalable quantum light source, exploring the idea of stimulated squeezed photons, which has simultaneously near-unity purity and efficiency. This GBS is programmable by tuning the phase of the input squeezed states. We demonstrate a new method to efficiently validate the samples by inferring from computationally friendly subsystems, which rules out hypotheses including distinguishable photons and thermal states. We show that our noisy GBS experiment passes the nonclassicality test using an inequality, and we reveal non-trivial genuine high-order correlation in the GBS samples, which are evidence of robustness against possible classical simulation schemes. The photonic quantum computer, Jiuzhang 2.0, yields a Hilbert space dimension up to $10^{43}$, and a sampling rate $10^{24}$ faster than using brute-force simulation on supercomputers., 23 pages, 6 figures. Comments are welcome

Background The prognostic value of human epididymis protein 4 (HE4) in patients with ischemic cardiomyopathy (ICM) is unknown. Methods A total of 103 patients with ICM were prospectively enrolled in this study from Hunan Provincial People’s Hospital between February 2019 and June 2019. All patients were tested for HE4 levels at baseline and follow-up. Endpoints of the study included cardiovascular death and heart failure-related hospitalization. Results A total of 96 patients with ICM were included for analysis. After a mean follow-up period of 263 (153–313) days, cardiovascular events were observed in 45 patients. Serum HE4 levels in patients with events were significantly higher than those in patients without events [188.70 (113.35–326.82) pmol/L versus 92.90 (61.50–123.20) pmol/L, P 2: 9.602, hazard ratio (HR): 1.003, 95% confidence interval (CI): 1.001–1.005, P = 0.002] and age [χ2: 4.55, HR: 1.044, 95% CI: 1.003–1.085, P = 0.033] were independent predictors of events. After adjusting for age and sex, the risk of events in patients with HE4 > 100.2 pmol/L was higher than that in patients with HE4 ≤ 100.2 pmol/L [HR: 3.372, 95% CI: 1.409–8.065, P Conclusion HE4 is an independent predictor of cardiovascular death and heart failure-related rehospitalization in patients with ICM.

Object formation is considered the aim of perceptual organization, but such a proposition has been neglected in empirical studies. In the current study, we investigated the role of object formation in configural superiority. Essentially, discrimination on bar orientations was enhanced by adding a right angle to each of the bars. Such facilitation is due to the emergent feature (EF) of closure formed by combining the bars with right angles. To study object formation, visual stimuli were generated by random dot stereograms to form objects or holes in 3D. Behaviorally, we found that the EF of closure facilitated oddball discrimination on objects, as demonstrated by previous studies, but did not facilitate oddball discrimination on holes with the same shape as objects. Multivariate pattern analysis of functional magnetic resonance imaging (fMRI) data showed that the EF of closure increased the object classification accuracy compared to the holes in the lateral occipital cortex (LOC), where object information is encoded, but not in the early visual cortex (EVC). The neural representations of objects and holes with and without EFs were further investigated using representational similarity analysis. The results demonstrate that in the LOC, the neural representations of objects with EFs showed a greater difference than those of the other three, that is, objects without EFs and holes with or without EFs. However, the uniqueness of objects with EFs was not observed in the EVC. Thus, our results suggest that the EF of closure, which leads to the configural superiority effect, only emerges for objects but not for holes, and only in the LOC but not the EVC. Our study provides the first empirical evidence suggesting that object formation plays an indispensable role in perceptual organization.

BackgroundNeuromyelitis optica spectrum disorders (NMOSDs) are severe inflammatory diseases mediated mainly by humoral and cellular immunity. Circulating follicular helper T (Tfh) cells are thought to be involved in the pathogenesis of NMOSD, and serum C-X-C motif ligand 13 (CXCL13) levels reflect the effects of Tfh cells on B-cell-mediated humoral immunity. Immune cell and cytokine changes during the dynamic relapsing and remitting processes in NMOSD require further exploration.Patients and methodsBlood samples were collected from 36 patients in acute and recovery phases of NMOSD, 20 patients with other noninflammatory neurological diseases (ONND) and 20 age- and sex-matched healthy volunteers. CD4+CXCR5+PD-1+ Tfh cells were detected by flow cytometry, and serum CXCL13 levels were assessed by enzyme-linked immunosorbent assay (ELISA).ResultsThe percentage of CD4+CXCR5+PD-1+ Tfh cells was significantly higher during the acute phase than during the recovery phase, and serum CXCL13 levels were significantly higher in patients in the acute and recovery phases of NMOSD than in the ONND and control groups. The Tfh cell percentage was positively correlated with CXCL13 levels, and both were positively correlated with Expanded Disability Status Scale (EDSS) scores and cerebrospinal fluid protein levels in patients with acute NMOSD.ConclusionCirculating Tfh cells level has the potential to be a biomarker of disease severity.

Background Most infants infected with Toxoplasma gondii are completely asymptomatic at birth, yet they may develop ocular and neurological sequelae in the first few months of life. Cases of congenital toxoplasmosis with severe jaundice early after birth combined with pancytopenia and splenomegaly are extremely rare. Here, we report on a rare case of congenital toxoplasmosis presenting with severe jaundice and hemolysis early after birth combined with pancytopenia and splenomegaly. Case presentation A male preterm infant with severe jaundice and splenomegaly was admitted to our department. Laboratory examinations revealed severe hyperbilirubinemia, increased reticulocytes, and pancytopenia. After comprehensive analysis and examination, the final diagnosis was congenital toxoplasmosis, and the infant was treated with azithromycin and subsequently trimethoprim-sulfamethoxazole. Regular follow-up revealed congenital toxoplasmosis in both eyes, which was surgically treated, while neurofunctional assessment results were unremarkable. In this case of congenital toxoplasmosis combined with severe jaundice, we treated the infant with two courses of azithromycin, followed by trimethoprim-sulfamethoxazole after the jaundice resolved. Clinical follow-up indicated that this treatment was effective with few side effects; thus, this report may serve as a valuable clinical reference. Conclusions Timely diagnosis and adequate treatment are closely associated with congenital toxoplasmosis-related prognosis. Infants with congenital toxoplasmosis require long-term follow-up, focusing on nervous system development and ophthalmology.

OBJECTIVE To determine the relationship between ATP7B mutations and diabetes in Wilson disease (WD). RESEARCH DESIGN AND METHODS A total of 21 exons and exon-intron boundaries of ATP7B were identified by Sanger sequencing. RESULTS Two novel compound heterozygous mutations (c.525 dupA/ Val176Serfs*28 and c.2930 C>T/ p.Thr977Met) were detected in ATP7B. After d-penicillamine (D-PCA) therapy, serum aminotransferase and ceruloplasmin levels in this patient were normalized and levels of HbA1c decreased. However, when the patient ceased to use D-PCA due to an itchy skin, serum levels of fasting blood glucose increased. Dimercaptosuccinic acid capsules were prescribed and memory recovered to some extent, which was accompanied by decreased insulin dosage for glucose control by 5 units. CONCLUSIONS This is the first report of diabetes caused by WD.

There were conflictions and differences among the results of cross-sectional studies association between PM2.5 and COPD prevalence. We aimed to explore the real association between outdoor PM2.5 and COPD prevalence, analyze the possible cause to the differences and conflictions in previous cross-sectional studies. Cross-sectional literatures about the association between outdoor PM2.5 and COPD prevalence were selected up to 12 September 2018. Subgroup analysis was performed to explore the source of the heterogeneity. Publication bias was tested via funnel plot. Leave-one-out method was used to conduct influential analysis. Variance analysis was used to analyze the influence of concentration, literature quality and age (over 60 or not) on the ln (aOR) values. The initial search revealed 230 studies, of which 8 were selected. The heterogeneity in this study was significant (I2=62, P

The memory dysfunction is one of the disastrous outcomes for perinatal hypoxia ischemia. Erythropoietin (EPO) has been demonstrated as a neuroprotective agent with multiple effects in a series of neurological diseases. We hypothesized that disruption of neural network including synapses and neurites would contribute to memory dysfunction induced by hypoxia ischemia. The aim of the present study was to elucidate the involvement of EPO on synaptogenesis and neurite repair following perinatal hypoxia ischemia. Using a neonatal hypoxia ischemia rat model, we found that EPO rescued hypoxia ischemia-induced decrease of synaptic proteins including Synapsin1 and PSD95 rather than GluR1 in the cortex and hippocampus. In addition, EPO reduced the expression of APP (an axonal injury marker), induced the expression of microtubule-associated protein MAP-2 (a dendritic marker), and restored axonal density after hypoxia ischemia. These changes contributed to improving electrophysiological properties of synapses and spatial memory performance. In summary, our data revealed an important role of EPO in synaptogenesis and neurite repair, providing a new insight into cellular mechanisms underlying cognitive and memory dysfunction associated with perinatal hypoxia ischemia.

In this research, 30 provinces (municipalities and autonomous regions) in mainland China were selected as research subjects. Inputs elements such as coal, oil, natural gas, capital, and labor were selected, while GDP and carbon dioxide emissions in each province were taken as outputs elements, and distance function of carbon dioxide emissions was derived with the Malmquist index model. Shadow price and emission reduction cost of CO2 emission in each province were analyzed in order to measure the environmental cost of economic growth and the economic cost of pollution reduction.

The high complexity behind SQL language and database schemas has made database querying a challenging task to human programmers. In this paper, we present our new natural language database querying (NADAQ) system as an alternative solution, by designing new translation models smoothly fusing deep learning and traditional database parsing techniques. On top of the popular encoder-decoder model for machine translation, NADAQ injects new dimensions of schema-aware bits associated with the input words into encoder phase and adds new hidden memory neurons controlled by the finite state machine for grammatical state tracking into the decoder phase. We further develop new techniques to enable the augmented neural network to reject queries irrelevant to the contents of the target database and recommend candidate queries reversely transformed into natural language. NADAQ performs well on real-world database systems over human labeled workload, returning query results at 90% accuracy.

Superconducting nanowire single-photon detectors (SNSPDs) are typical switching devices capable of detecting single photons with almost 100% detection efficiency. However, they cannot determine the exact number of incident photons during a detection event. Multi-pixel SNSPDs employing multiple read-out channels can provide photon number resolvability (PNR), but they require increased cooling power and costly multi-channel electronic systems. In this work, a single-flux quantum (SFQ) circuit is employed, and PNR based on multi-pixel SNSPDs is successfully demonstrated. A multi-input magnetically coupled DC/SFQ converter (MMD2Q) circuit with a mutual inductance M is used to combine and record signals from a multi-pixel SNSPD device. The designed circuit is capable of discriminating the amplitude of the combined signals in accuracy of Φ 0/M with Φ 0 being a single magnetic flux quantum. By employing the MMD2Q circuit, the discrimination of up to 40 photons can be simulated. A 4-parallel-input MMD2Q circuit is fabricated, and a PNR of 3 is successfully demonstrated for an SNSPD array with one channel reserved for the functional verification. The results confirm that an MMD2Q circuit is an effective tool for implementing PNR with multi-pixel SNSPDs.

The origins and spreads of rice agriculture have been enduring topics, yet the timing and southward dispersal from the Yangtze River Basin have been difficult to trace, due to the scarcity of archaeobotanical data, especially systematic macro-plant remains examination, combined with the poor preservation in the humid climate and acidic soils of Chinas southern provinces. Here, we report new radiocarbon dating and preserved rice phytolith evidence, derived from three Late Neolithic archaeological sites in south China, dated about 5,000-4,100 cal a BP. Our results demonstrate that rice farming had spread southward through the mountainous regions of Wuyi and Nanling, then entered the areas of Western Fujian and North Guangdong by 5,000 cal a BP, followed by continued expansion into coastal areas of East China Sea and South China Sea, also crossing the Taiwan Strait, around 4,500-4,000 cal a BP. The North River, East River, Min River, and possibly other river systems likely were influential as pathways or conduits.

One-step hydrothermal approach was utilized to synthesize erythrocyte-like ZnS/ZnO composite under the pH condition of 9, which are assembled with ZnO and ZnS nanoparticles. By contrast experiments, it is found that the pH value greatly affects the chemical component of hydrothermal products, and pure ZnS microspheres can be obtained when the pH value decreases to 3. Compared with the pure ZnS and commercial ZnO, the ZnS/ZnO composite exhibits dramatically improved photocatalytic activities for the degradation of tetracycline (TC) (77.2%) under the visible light irradiation. In the cycling experiments, the ZnS/ZnO composite is also proved to show nice photostability and good photocatalytic activity for 5 runs.

Dogs served in a variety of capacities in prehistory. After their domestication in Paleolithic hunter-gatherer societies, the emergence of agriculture shifted their partnerships with people. However, the associations between dogs and early farmers are not readily visible in the archaeological record. In the present study, dog coprolites, uncovered from two groups of early agricultural societies in China during the Neolithic Age, the early rice agricultural site of Tianluoshan in the lower Yangtze River, and three early millet-rice mixed agricultural sites of Shuangdun, Yuhuicun, and Houtieying along the middle Huai River, were examined based on the comparisons of lipid and palynological results to reveal different relationships of dogs and humans. The Tianluoshan dogs showed a plant-dominated diet with higher contents of plant sterols and fatty alcohols with longer chain lengths. Dogs may have lived on foraging or been provisioned with refuse for the cleanness purpose. On the contrary, dogs from the sites of Shuangdun, Yuhuicun, and Houtieying showed a meat-dominated diet with higher proportions of animal sterols and short-chain fatty alcohols. It most probably referred to their assistance in hunting and thus being provisioned with meat. Furthermore, activity areas of the dogs also reflect different deployment strategies and agricultural systems, evidenced by pollen spectra from the coprolites. Dogs at Tianluoshan mostly appeared in the rice field area, in correspondence with the labor-consuming rice cultivation as the main targeted resource, showing their participation in daily agricultural activities. On the other hand, high concentrations of pollen from forest and grassland revealed that hunting dogs played a regular role in the early millet-rice mixed farming societies, probably related to the importance of hunting activities in the daily subsistence.

Few histological prognostic indicators for end-stage renal disease (ESRD) have been validated in diabetic patients. This biopsy-based study aimed to identify nephropathological risk factors for ESRD in Chinese patients with type 2 diabetes. Histological features of 322 Chinese type 2 diabetic patients with biopsy-confirmed diabetic nephropathy (DN) were retrospectively analysed. Cox proportional hazards analysis was used to estimate the hazard ratio (HR) for ESRD. Single glomerular proteomics and immunohistochemistry were used to identify differentially expressed proteins and enriched pathways in glomeruli. During the median follow-up period of 24 months, 144 (45%) patients progressed to ESRD. In multivariable models, the Renal Pathology Society classification failed to predict ESRD, although the solidified glomerulosclerosis (score 1: HR 1.65, 95% confidence interval [CI] 1.04–2.60; score 2: HR 2.48, 95% CI 1.40–4.37) and extracapillary hypercellularity (HR 2.68, 95% CI 1.55–4.62) were identified as independent risk factors. Additionally, single glomerular proteomics, combined with immunohistochemistry, revealed that complement C9 and apolipoprotein E were highly expressed in solidified glomerulosclerosis. Therefore, solidified glomerulosclerosis and extracapillary hypercellularity predict diabetic ESRD in Chinese patients. Single glomerular proteomics identified solidified glomerulosclerosis as a unique pathological change that may be associated with complement overactivation and abnormal lipid metabolism.

In order to more efficiently meet people’s in-depth needs for knowledge acquisition and research, and to more effectively develop and use "the Canton Canon" historical archives, we designed and constructed the Canton Revolutionary History Knowledge Graph based on the revolutionary archives of Canton during the Republic of China. We associated the knowledge graph with the document corpus, transformed and combined the traditional digital library from document information management to knowledge management, and proposed a double-Layer retrieval mode of the document corpus based on the knowledge graph. At the same time, we developed "the Canton Canon" digital library based on the knowledge graph, and introduced the design and application of the digital library. It provides a great example of how to use huge archives more efficiently and build a more open digital library. What’s more, it also opens up new ideas for the transformation of Chinese digital libraries from information management to knowledge management.

Background: The protective effect of air purifiers on the respiratory system of healthy children remains unclear so far. Method: We designed an air purifier intervention crossover study among 125 schoolchildren aged 9–12 years in a boarding school in Beijing, China. The indoor and outdoor PM10, PM2.5, and PM1 concentrations were monitored, and a total of 30 indices, including respiratory symptoms, pulmonary functions, inflammation, and oxidative stress indicators, were analyzed. We used the logistic mixed-effects model and the linear mixed-effects model to evaluate the correlation between exposure (intervention and time-weighted PM concentration) and effects (indicators). Findings: The findings showed that the air purifier intervention was associated with a 13.29% decrease in runny nose, 11.05% decrease in FeNO, 12.03% decrease in EBC IL-1β, and 4.2% decrease in IL-6. The patterns of associations with each 10 µg/m3 decrease in the PM10, PM2.5, and PM1 concentrations were consistent with those for filter intervention. Moreover, lower PM2.5 and PM1 were associated with lower EBC MCP-1, 5.47% and 13.56%, respectively. The pulmonary function indices were negatively associated with the intervention and PM. Interpretation: We screened out some sensitive indices (FeNO, IL-6, IL-1β, MCP-1) related to respiratory symptoms and inflammation, which could reflect the early abnormal response of the respiratory system under short-term PM exposure. Our findings suggested that air purifiers have a protective effect on children’s respiratory system. Funding: This work was supported by the National research program for key issues in air pollution control, China (Grant No. DQGG0405). Declaration of Interest: None to declare. Ethical Approval: The study was approved by the Ethics Review Committee of National Institute of Environmental Health, Chinese Center for Disease Control and Prevention (No. 201803) and the Biomedical Ethics Committee of Peking University (No. IRB00001052-18089). Parents and schoolchildren were informed about the study beforehand, and all the participants and their parents signed the informed consent.

Over the past 2 years, we have witnessed the emergence of a number of deep learning-based methods for cryo-electron tomography (cryo-ET) data analysis. As a result of better instruments and data collection software in recent years, cryo-ET data are collected at a faster and faster pace, into the rim of high-throughput methods. However, cryo-ET data analysis tasks are still very challenging due to the low signal-to-noise ratio. The deep learning approach is very promising to the cryo-ET research community because of its scalability and potential to improve the accuracy with a large amount of data. In this survey, we review a number of deep learning-based methods proposed for cryo-ET data analysis tasks including segmentation, classification, and others. This survey also discusses their advantages and drawbacks, which provide potential directions for future research.

Cryo-electron Tomography (cryo-ET) generates 3D visualization of cellular organization that allows biologists to analyze cellular structures in a near-native state with nano resolution. Recently, deep learning methods have demonstrated promising performance in classification and segmentation of macromolecule structures captured by cryo-ET, but training individual deep learning models requires large amounts of manually labeled and segmented data from previously observed classes. To perform classification and segmentation in the wild (i.e., with limited training data and with unseen classes), novel deep learning model needs to be developed to classify and segment unseen macromolecules captured by cryo-ET. In this paper, we develop a one-shot learning framework, called cryo-ET one-shot network (COS-Net), for simultaneous classification of macromolecular structure and generation of the voxel-level 3D segmentation, using only one training sample per class. Our experimental results on 22 macromolecule classes demonstrated that our COS-Net could efficiently classify macromolecular structures with small amounts of samples and produce accurate 3D segmentation at the same time.

With the rise of enterprise-government joint ventures, how to carry out the construction of corporate culture to promote the development of enterprise-government joint ventures has gradually become the focus of scholars’ research. However, at present, the articles on the cultural construction of enterprise-government joint venture companies are still insufficient, and the academic circles have not discussed it too deeply. Taking Changning Company as an example, this paper deeply analyzes the problems existing in promoting the construction of corporate culture in Changning Company as an enterprise-government joint venture company, and probes into the deeper causes of the corresponding problems, and then puts forward some countermeasures. Through this study, it fills up the deficiency in the research on the cultural construction of the enterprise-government joint venture company, and provides some reference for later researchers.

Ovarian cancer is a fatal female reproductive cancer because it has no specific clinical manifestations and effective screening methods in the early stage. When it is discovered, it is already an advanced stage with a low cure rate. Therefore, it is of great significance to improve the diagnostic ability of early screening for ovarian cancer. In this study, we feature engineered CA125 by calculating the rate of change of CA125 in addition to selecting a few top-ranked important features from PLCO ovarian cancer dataset. The dataset was extremely imbalanced; the imbalance ratio (ratio of negative samples in the majority class to positive examples in the minority class) was 143.7. Twenty-three types of class-imbalanced learning methods were used in this study to improve the predictive ability of the model. We identified the decision tree method with the highest AUC value among nine classic classifiers (decision tree, AdaBoost, etc.) to build a model with the class imbalance method, and showed their comparison. We identified the decision tree using SVMSMOTE has the most robust predictive ability for ovarian cancer, with a PPV of 0.9041, AUC of 0.9532, the sensitivity of 0.7792, and specificity of 0.9982. The high PPV shown by the model selected in this study indicates that the true positive samples predicted by the model account for 90.41%. Compared with other studies, the PPV of this study increased by 81.3%. This study helps to improve the accuracy of early screening for ovarian cancer and makes the diagnosis of ovarian cancer more reliable.

Segmentation is a prerequisite yet challenging task for medical image analysis. In this paper, we introduce a novel deeply supervised active learning approach for finger bones segmentation. The proposed architecture is fine-tuned in an iterative and incremental learning manner. In each step, the deep supervision mechanism guides the learning process of hidden layers and selects samples to be labeled. Extensive experiments demonstrated that our method achieves competitive segmentation results using less labeled samples as compared with full annotation., Comment: Accepted version to be published in the 42nd IEEE Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2020, Montreal, Canada

Objective To build a model for proximal junctional kyphosis (PJK) prognostication in Lenke 5 adolescent idiopathic scoliosis (AIS) patients undergoing long posterior instrumentation and fusion surgery by machine learning and analyze the risk factors for PJK. Materials and methods In total, 44 AIS patients (female/male: 34/10; PJK/non-PJK: 34/10) who met the inclusion criteria between January 2013 and December 2018 were retrospectively recruited from West China Hospital. Thirty-seven clinical and radiological features were acquired by two independent investigators. Univariate analyses between PJK and non-PJK groups were carried out. Twelve models were built by using four types of machine learning algorithms in conjunction with two oversampling methods [the synthetic minority technique (SMOTE) and random oversampling]. Area under the receiver operating characteristic curve (AUC) was used for model discrimination, and the clinical utility was evaluated by using F1 score and accuracy. The risk factors were simultaneously analyzed by a Cox regression and machine learning. Results Statistical differences between PJK and non-PJK groups were as follows: gender (p = 0.001), preoperative factors [thoracic kyphosis (p = 0.03), T1 slope angle (T1S, p = 0.078)], and postoperative factors [T1S (p = 0.097), proximal junctional angle (p = 0.003), upper instrumented vertebra (UIV) - UIV + 1 (p = 0.001)]. Random forest using SMOTE achieved the best prediction performance with AUC = 0.944, accuracy = 0.909, and F1 score = 0.667 on independent testing dataset. Cox model revealed that male gender and larger preoperative T1S were independent prognostic factors of PJK (odds ratio = 10.701 and 57.074, respectively). Gender was also at the first place in the importance ranking of the model with best performance. Conclusion The random forest using SMOTE model has the great value for predicting the individual risk of developing PJK after long instrumentation and fusion surgery in Lenke 5 AIS patients. Moreover, the combination of the outcomes of a Cox model and the feature ranking extracted by machine learning is more valuable than any one alone, especially in the interpretation of risk factors.

Emerging evidence has shown that nonalcoholic fatty liver disease (NAFLD) may be both a consequence and a cause of hypertension. Recent studies have demonstrated that phosphodiesterase 4 (PDE4)-cAMP signaling represents a pathway relevant to the pathophysiology of metabolic disorders. This study aims to investigate the impact and the underlying mechanism of PDE4 in the pathogenesis of NAFLD and its associated hypertension. Here we demonstrated that high-fat-diet (HFD) fed mice developed NAFLD and hypertension, with an associated increase in hepatic PDE4D expression, which can be prevented and even reversed by PDE4 inhibitor roflumilast. Furthermore, we demonstrated that hepatic overexpression of PDE4D drove significant hepatic steatosis and elevation of blood pressure. Mechanistically, PDE4D activated fatty acid translocase CD36 signaling which facilitates hepatic lipid deposition, resulting in TGF-β1 production by hepatocytes and excessive TGF-β1 signaling in vessels and consequent hypertension. Specific silencing of TGF-β1 in hepatocytes by siRNA using poly (β-amino ester) nanoparticles significantly normalized hepatic PDE4D overexpression-activated TGF-β1 signaling in vessels and hypertension. Together, the conclusions indicated that PDE4D plays an important role in the pathogenesis of NAFLD and associated hypertension via activation of CD36-TGF-β1 signaling in the liver. PDE4 inhibitor such as roflumilast, which is clinically approved for chronic obstructive pulmonary disease (COPD) treatment, has the potential to be used as a preventive or therapeutic drug against NAFLD and associated hypertension in the future.

Objective To investigate the associations between pre-pregnancy body mass index (BMI) and neonatal outcomes in women undergoing autologous frozen-thawed embryo transfer (FET). Design Retrospective cohort study. Setting(s) University-affiliated reproductive medical center. Patient(s) A total of 16,240 women with singleton deliveries achieved by autologous FET. Intervention(s) None. Main Outcome Measure(s) Neonatal outcomes included preterm birth (PTB), low birth weight (LBW), small-for-gestational age (SGA), large-for-gestational age (LGA), fetal macrosomia, and birth defects. Result(s) After adjusting for confounding factors, our study showed that in autologous FET cycles, the overweight women (23 kg/m2≤ BMI Conclusion(s) Among women undergoing FET, pre-pregnancy BMI affected neonatal outcomes of singletons. BMI in Asian categories for overweight and obese showed significant increases in PTB, macrosomia, and LGA; early PTB and very LBW only increased in obese cases. In addition, underweight status was associated with increased risk of SGA. In contrast, there was no association between pre-pregnancy BMI and birth defects in FET cycles.

A new strategy for enhancing the photoelectric activity of poly(5-formylindole) (P5FIn) was developed by introducing the inorganic semiconductor material (NiO) to form organic-inorganic heterojunctions. P5FIn/NiO heterojunctions were firstly prepared by combining hydrothermal synthesis and electrochemical polymerization. Due to the synergistic effect between P5FIn and NiO, the photoelectrochemical (PEC) performance of this heterojunction was significantly enhanced compared to pure P5FIn and NiO. The reason for the enhanced PEC performance is mainly attributed to the increased visible light utilization and the bandgap matching effect of the P5FIn/NiO heterojunctions. Based on the prepared P5FIn/NiO heterojunctions, a novel PEC sensor for aflatoxin B1 (AFB1) detection was also constructed with a wide linear range of 0.005–50 ng mL−1 and a limit of detection (LOD) of 0.0015 ng mL−1. Moreover, this constructed PEC sensor also had good stability, reproducibility, selectivity, and satisfactory actual sample detection ability. This strategy may inspire more design and application of high-performance photoelectric active material based on inorganic semiconductor and organic conducting polymer heterojunctions.