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Existing programming practices for building Android apps mainly follow the one-size-fits-all strategy to include lots of functions and adapt to most types of devices. However, this strategy can result in software bloat and many serious issues, such as slow download speed, and large attack surfaces. Existing solutions cannot effectively debloat an app as they either lack flexibility or require human efforts. This work proposes a novel feature-oriented debloating approach and builds a new tool, named XDebloat, to automate this process in a flexible manner. First, XDebloat supports feature location approaches at a fine granularity. It also makes the feature location results editable and changeable. Second, XDebloat considers several Android-oriented issues (i.e., callback, UI dependencies), which are not covered in the state-of-art approaches. Third, XDebloat support two major debloating strategies: pruning-based and module-based debloating. We evaluate XDebloat with 200 open-source and 1,000 commercial apps. The results show that XDebloat can successfully remove unwanted features from apps or transform them into on-demand modules within 10 minutes. For the pruning-based debloating strategy, on average, XDebloat can remove 32.1% code from an app. For the module-based debloating strategy, XDebloat can help developers build modules automatically.

BackgroundWe aimed to investigate corneal densitometry and correlations with corneal morphological parameters in bilateral keratoconus (KCN) patients with unilateral Vogt's striae.MethodsOne hundred and-twelve patients (224 eyes) with bilateral KCN and unilateral Vogt's striae were enrolled in this cross-sectional contralateral eye study. Corneal densitometry and morphological parameters were measured using Pentacam HR.ResultsOur study revealed that corneal densitometry values of the anterior 0–2 mm and 2–6 mm, intermediate 0–2 mm and 2–6 mm, posterior 2–6 mm, and total cornea 2–6 mm in eyes with Vogt’s striae were significantly higher than those in eyes without Vogt's striae (P P P P P

The default mode network (DMN) is related to brain functions and its abnormalities were associated with mental disorders’ pathophysiology. To further understand the common and distinct DMN alterations across disorders, we capitalized on the probability tracing method and graph theory to analyze the role of DMN across three major mental disorders. A total of 399 participants (156 schizophrenia [SCZ], 90 bipolar disorder [BP], 58 major depression disorder [MDD], and 95 healthy controls [HC]) completed magnetic resonance imaging (MRI)-scanning, clinical, and cognitive assessment. The MRI preprocessing of diffusion-tensor-imaging was conducted in FMRIB Software Library and probabilistic fiber tracking was applied by PANDA. This study had three main findings. First, patient groups showed significantly lower cluster coefficient in whole-brain compared with HC. SCZ showed significantly longer characteristic path compared with HC. Second, patient groups showed inter-group specificity in abnormalities of DMN connections. Third, SCZ was sensitive to left_medial_superior_frontal_gyrus (L_SFGmed)-right_anterior_cingulate_gyrus (R_ACG) connection relating to positive symptoms; left_ACG-right_ACG connection was the mania’s antagonistic factor in BP. This trans-diagnostic study found disorder-specific structural abnormalities in the fiber connection of R_SFGmed-L_SFGmed-R_ACG_L_ACG within DMN, where SCZ showed more disconnections compared with other disorders. And these connections are diagnosis-specifically correlated to phenotypes. The current study may provide further evidence of shared and distinct endo-phenotypes across psychopathology.

STEAP3 (Six-transmembrane epithelial antigen of the prostate 3, TSAP6, dudulin-2) has been reported to be involved in tumor progression in human malignancies. Nevertheless, how it participates in the progression of human cancers, especially HCC, is still unknown. In the present study, we found that STEAP3 was aberrantly overexpressed in the nuclei of HCC cells. In a large cohort of clinical HCC tissues, high expression level of nuclear STEAP3 was positively associated with tumor differentiation and poor prognosis (p

Refereed/Peer-reviewed During the COVID-19 pandemic, countries applied trade restrictions to insulate their domestic markets from the world market. However, these trade policies could have amplified international market price fluctuations. This paper explores the effects of trade restrictions on international agricultural price volatility. A theoretical model is developed to quantify how trade policies amplify the initial shock. Using panel data covering 71 countries from January 2020 to July 2021, we examine empirically the effects of trade policies on world agricultural price volatility. The results show that trade distortions further induced volatility of world agricultural prices by around 22 percent during the COVID-19 pandemic. The multiplier effects are much more substantial in agricultural exporting countries than in importing countries. Large countries like China and the US could make significant contributions to stabilizing world prices by limiting the extent of unilateral trade policy interventions.

Background: Alzheimer’s disease (AD) is a degenerative disorder, accompanied by progressive cognitive decline, for which there is no cure. Recently, the close correlation between AD and type 2 diabetes mellitus (T2DM) has been noted, and a promising anti-AD strategy is the use of anti-T2DM drugs. Objective: To investigate if the novel glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic polypeptide (GIP) receptor agonist DA4-JC shows protective effects in the triple APP/PS1/tau mouse model of AD. Methods: A battery of behavioral tests were followed by in vivo recording of long-term potentiation (LTP) in the hippocampus, quantified synapses using the Golgi method, and biochemical analysis of biomarkers. Results: DA4-JC improved cognitive impairment in a range of tests and relieved pathological features of APP/PS1/tau mice, enhanced LTP in the hippocampus, increased numbers of synapses and dendritic spines, upregulating levels of post-synaptic density protein 95 (PSD95) and synaptophysin (SYP), normalized volume and numbers of mitochondria and improving the phosphatase and tensin homologue induced putative kinase 1 (PINK1) - Parkin mitophagy signaling pathway, while downregulating amyloid, p-tau, and autophagy marker P62 levels. Conclusion: DA4-JC is a promising drug for the treatment of AD.

This study aimed to explore the threshold of self-rating AD8 in mild cognitive impairment (MCI) and dementia screening among community-dwelling older adults with and without education. 523 participants in Chengdu, China, were recruited: 346 with normal cognitive function, 160 with MCI and 17 with dementia. At the cut-off score of 2, the area under the receiver operator characteristic curves (AUC) of self-rating AD8 for MCI and dementia screening was 0.607 and 0.931 regardless of educational level, respectively. Grouping by educational level, the cut-off in MCI screening was 1 for literate (AUC=0.662) and 2 for illiterate individuals (AUC=0.588). For dementia screening, the cut-off was 2 for illiterate (AUC=0.912) and 4 for literate individuals (AUC=0.963). We concluded that the self-rating AD8 was ideal for dementia screening in community-dwelling older adults, with a cut-off score of 2 for illiterate and 4 for literate people, while its effectiveness for MCI screening required further evaluation.

Background & Aims Acute viral hepatitis (AVH) represents an important global health problem; however, the progress in understanding AVH is limited because of the priority of combating persistent HBV and HCV infections. Therefore, an improved understanding of the burden of AVH is required to help design strategies for global intervention. Methods Data on 4 major AVH types, including acute hepatitis A, B, C, and E, excluding D, were collected by the Global Burden of Disease (GBD) 2019 database. Age-standardized incidence rates and disability-adjusted life year (DALY) rates for AVH were extracted from GBD 2019 and stratified by sex, level of socio-demographic index (SDI), country, and territory. The association between the burden of AVH and socioeconomic development status, as represented by the SDI, was described. Results In 2019, there was an age-standardized incidence rate of 3,615.9 (95% CI 3,360.5–3,888.3) and an age-standardized DALY rate of 58.0 (47.3–70.0) per 100,000 person-years for the 4 major types of AVH. Among the major AVH types, acute hepatitis A caused the heaviest burden. There was a significant downward trend in age-standardized DALY rates caused by major incidences of AVH between 1990 and 2019. In 2019, regions or countries located in West and East Africa exhibited the highest age-standardized incidence rates of the 4 major AVH types. These rates were stratified by SDI: high SDI and high-middle SDI locations recorded the lowest incidence and DALY rates of AVH, whereas the low-middle SDI and low SDI locations showed the highest burden of AVH. Conclusions The socioeconomic development status and burden of AVH are associated. Therefore, the GBD 2019 data should be used by policymakers to guide cost-effective interventions for AVH. Lay summary We identified a negative association between socioeconomic development status and the burden of acute viral hepatitis. The lowest burden of acute viral hepatitis was noted for rich countries, whereas the highest burden of acute viral hepatitis was noted for poor countries.

Supplemental Digital Content is available in the text., Despite that immune checkpoint inhibitors (ICIs) had tremendous improved the survival of multiple solid tumors, only a limited proportion of patients are responsive to ICIs. Therefore, effective variables are urgently needed to predict the probability of response to ICIs. Systematic searches were conducted from inception up to May, 2020. Prospective or retrospective studies of ICIs that investigated the association between body mass index (BMI) and survival outcomes, including overall survival (OS) and/or progression-free survival (PFS), were selected. The association between each BMI category and survival outcomes was calculated using Cox proportional hazard regression models and quantified as hazard ratio (HR) with corresponding 95% confidence interval. Seven clinical studies involving data from 3768 individual patients were included. The median OS was 15.5 months (95% confidence interval: 14.7–16.2 mo) and the median PFS was 5.7 months (5.2–6.3 mo). The median OS was significantly longer in overweight/obese patients than in nonoverweight patients (20.7 vs. 11.3 mo; P

A seismic steel damper designed to deform inelastically in an in-plane flexural bending mode for more efficient utilisation of the material was investigated. This proposed device, referred to as an in-plane elliptical damper (i-PED), consists of two circular arches with intermediate straight arms connected in a closed form to eliminate end rotation at the symmetric axis in order to enhance the ultimate capacity. Test results obtained from a series of component tests on i-PEDs with various dimensions indicated that the energy-dissipation capacities of the dampers under cyclic loads were rich and consistently stable. The i-PED with a shorter arm length and smaller radius of curvature of arch exhibited higher strength and energy-dissipation capacity. Empirical formulae for estimating the mechanical properties of the dampers were developed for preliminary design purposes. The numerical predictions were found to correlate well with the experimental results, demonstrating that using the Bouc–Wen model is sufficient for simulating the inelastic mechanical behaviour of steel dampers. Furthermore, shaking table tests of a five-storey modal frame implemented with i-PEDs were conducted, with non-linear time history analyses carried out for comparison. Encouraging results on seismic response control with good numerical prediction were obtained, suggesting the feasibility of the proposed damper and design scheme for practical application.

Background Growing experimental evidence has identified neovascularization from the adventitial vasa vasorum and induced intraplaque hemorrhage (IPH) as critical indicators during the development of vulnerable atherosclerotic plaques. In this study, we propose a mathematical model incorporating intraplaque angiogenesis and hemodynamic calculation of the microcirculation, to obtain the quantitative evaluation of the influences of intraplaque neovascularization and hemorrhage on vulnerable plaque development. A two-dimensional nine-point model of angiogenic microvasculature is generated based on the histology of a patient’s carotid plaque. The intraplaque angiogenesis model includes three key cells (endothelial cells, smooth muscle cells, and macrophages) and three key chemical factors (vascular endothelial growth factors, extracellular matrix, and matrix metalloproteinase), which densities and concentrations are described by a series of reaction–diffusion equations. The hemodynamic calculation by coupling the intravascular blood flow, the extravascular plasma flow, and the transvascular transport is carried out on the generated angiogenic microvessel network. We then define the IPH area by using the plasma concentration in the interstitial tissue, as well as the extravascular transport across the capillary wall. Results The simulational results reproduce a series of pathophysiological phenomena during the atherosclerotic plaque progression. It is found that the high microvessel density region at the shoulder areas and the extravascular flow across the leaky wall of the neovasculature contribute to the IPH observed widely in vulnerable plaques. The simulational results are validated by both the in vivo MR imaging data and in vitro experimental observations and show significant consistency in quantity ground. Moreover, the sensitivity analysis of model parameters reveals that the IPH area and extent can be reduced significantly by decreasing the MVD and the wall permeability of the neovasculature. Conclusions The current quantitative model could help us to better understand the roles of microvascular and intraplaque hemorrhage during the carotid plaque progression.

Background: Alzheimer’s disease (AD) is a neurodegenerative disease characterized by progressive decline in cognitive function. Type 2 diabetes mellitus (T2DM) is an important risk factor for AD. Glucose-dependent insulinotropic polypeptide (GIP) has been identified to be effective in T2DM treatment and neuroprotection. Objective: The present study investigated the neuroprotective effects and possible mechanisms of DAla2GIP-Glu-PAL, a novel long-lasting GIP analogue, in APP/PS1 AD mice. Methods: Multiple behavioral tests were performed to examine the cognitive function of mice. In vivo hippocampus late-phase long-term potentiation (L-LTP) was recorded to reflect synaptic plasticity. Immunohistochemistry and immunofluorescence were used to examine the Aβ plaques and neuroinflammation in the brain. IL-1β, TNF-α, and cAMP/PKA/CREB signal molecules were also detected by ELISA or western blotting. Results: DAla2GIP-Glu-PAL increased recognition index (RI) of APP/PS1 mice in novel object recognition test, elevated spontaneous alternation percentage of APP/PS1 mice in Y maze test, and increased target quadrant swimming time of APP/PS1 mice in Morris water maze test. DAla2GIP-Glu-PAL treatment enhanced in vivo L-LTP of APP/PS1 mice. DAla2GIP-Glu-PAL significantly reduced Aβ deposition, inhibited astrocyte and microglia proliferation, and weakened IL-1β and TNF-α secretion. DAla2GIP-Glu-PAL also upregulated cAMP/PKA/CREB signal transduction and inhibited NF-κB activation in the hippocampus of APP/PS1 mice. Conclusion: DAla2GIP-Glu-PAL can improve cognitive behavior, synaptic plasticity, and central pathological damage in APP/PS1 mice, which might be associated with the inhibition of neuroinflammation, as well as upregulation of cAMP-/PKA/CREB signaling pathway. This study suggests a potential benefit of DAla2GIP-Glu-PAL in the treatment of AD.

As one of the vital technological factors influencing the machining quality, machine tool fixture has been regarded as an important research object by scholars at home and abroad. In this paper, a new method for rapid evaluation of clamping scheme was presented based on the study of machining deformation of aerospace complex thin-walled parts. Firstly, Through the modal analysis of the thin-walled parts, the weak links of the structure and the direction of the large vibration displacement of the nodes are found. Then, the maximum displacement and natural frequency of the main vibration direction under different clamping schemes were obtained after intercepting several nodes and analyzing through FE software. The optimal clamping scheme was obtained through the result comparison. Finally, based on the existing research results, a mathematical model of evaluating the complexity of fixture characteristics was constructed. In this model, the stiffness values of multiple joints were considered, and the characteristic machining stiffness and the average value ∆K were obtained so as to evaluate the deformation resistance of the thin-walled parts. The influence of different clamping schemes on machining quality was quantitatively evaluated by the index. On the basis of the proposed method, a case study of aerospace thin-walled parts was conducted, and then the rapid evaluation and optimization of the milling clamping scheme for thin-walled parts were realized.

The development of programmed cell death-1 inhibitor (PD-1) has shed light on the treatment of tumors with deficiencies in DNA mismatch repair system or microsatellite instability (dMMR/MSI). However, predicting the subset in this group that will benefit from PD-1 blockade remains a challenge. In this study, we aimed to investigate the relationship between the degree of microsatellite instability and the responses to anti-PD-1 immunotherapy. 33 patients with colorectal adenocarcinoma who had a known MSI status and received anti-PD-1 immunotherapy were included. PCR results for MSI of the whole cohort were collected and treatment response was evaluated. Our data indicated that objective response rate (ORR) in instability-high group (instability loci ≥ 3) was significantly higher than ORR in instability-intermediate group (13/16 versus 6/17, P = 0.008). Besides, patients in instability-high group had significant longer progression-free survival (log-rank test, P = 0.004), and a significant increase in T lymphocyte infiltration and cytolytic activity in tumors. Future study might implement the intensity of microsatellite instability for more delicate selection for anti-PD-1 therapy in patient with dMMR/MSI-H tumors.

Purpose To further clarify the association between abnormal levels of serum lipid components as the main features of dyslipidaemia and hepatocellular carcinoma, which remains unclear. Patients and Methods We examined the serum level of lipids and apolipoproteins pattern in 471 patients undergoing curative resection for HCC, 193 patients with chronic liver disease, and 104 patients with benign liver diseases. We performed uni- and multivariate analyses to evaluate the predictive roles of lipids and apolipoproteins for recurrence and survival of HCC in a training cohort of 242 patients and then validated in a cohort of 229 patients. Results The majority circulating lipid and apolipoprotein levels such as ApoA1, HDL, and LDL in chronic liver disease and HCC were slightly significantly decreased as compared to those in benign lesion. But no significant differential expression patterns of lipids and apolipoproteins were observed between chronic liver hepatitis and HCC. Multivariable analysis identified ApoA1 as a key parameter related to recurrence and survival in both training and validation cohorts. Moreover, we further demonstrated that low ApoA1 was an independent prognostic factor of poor early recurrence in two cohorts. Conclusion Although the alterations of circulating lipids and apolipoproteins were observed in HCC, none of lipids or apolipoproteins could serve as a diagnostic marker. Serum ApoA1 merits consideration as a novel prognostic marker for patients with HCC undergoing surgery since it predicts early recurrence and survival, especially for early stage patients and may improve the prognostic stratification of patients for clinical management and promote HCC clinic outcomes.

Purpose: Stable angina is ischemic chest pain on exertion or with emotional stress. Despite guideline-directed therapy, up to 30% of patients have suboptimal pain relief. The aims of this study were to: (1) determine the feasibility and acceptability of a randomized controlled trial (RCT) of acupuncture; and (2) evaluate preliminary efficacy of acupuncture with respect to reduction of pain and increased functional status and health-related quality of life (HRQoL). Methods: Participants with stable angina for ⩾1 month received either a standardized acupuncture protocol, twice per week for 5 weeks, or an attention control protocol. Measures included the McGill Pain Questionnaire (average pain intensity (API), pain now) and the Seattle Angina Questionnaire–7 (functional status, symptoms, and HRQoL). Feasibility was defined as ⩾80% recruitment, ⩾75% retention following enrollment, and ⩾80% completion. Descriptive statistics and mixed-effects linear regression were used for analysis. Results: The sample (n = 24) had a mean age of 59 ± 12 years, was predominantly female (63%), and represented minority groups (8% White, 52% Black, 33% Hispanic, and 8% Other). Feasibility was supported by 79% retention and 89% completion rates. The recruitment rate (68%) was slightly lower than expected. Acceptability scores were 87.9% for the acupuncture group and 51.7% for the control group. Outcomes were significantly better for the acupuncture versus control groups (API, b = −2.1 (1.1), p = 0.047; functional status, b = 27.6 (7.2), p Conclusions and implications: Acupuncture was feasible and acceptable in our diverse sample. We were slightly under the recruitment target of 80%, but participants who started the study had a high likelihood of completing it. Acupuncture shows promise for stable angina, but its effectiveness needs to be confirmed by a larger, adequately powered RCT. Trial registration number: NCT02914834 (ClinicalTrials.gov).

Background:. Minimal change nephropathy (MCD) is a common pathological type of nephrotic syndrome and is often associated with acute kidney injury (AKI). This study aimed to investigate the clinical characteristics and related factors of AKI in patients with MCD and nephrotic syndrome. Methods:. Patients from Chinese People's Liberation Army General Hospital who were diagnosed with pathological renal MCD with clinical manifestations of nephrotic syndrome were included from January 1, 2013 to December 31, 2017. Patients diagnosed with membranous nephropathy (MN) by renal biopsy from January 1, 2013 to December 31, 2017 are included as a control population. We retrospectively analyzed the clinical and pathological characteristics of patients as well as the percentages and clinical characteristics of AKI in different age groups. We assessed the correlation of pathological characteristics with serum creatinine using multivariate linear regression analysis. Results:. A total of 367 patients with MCD were included in the analysis, with a sex ratio of 1.46: 1 (male: female) and an age range of 6 to 77 years. Among all the patients, 109 developed AKI (29.7%), and of these patients, 85 were male (78.0%). In the 586 patients with MN, 27 (4.6%) patients developed AKI. The percentage of AKI in MCD patients was significantly higher than that in MN patients (χ2 = 41.063, P

Background & Aims Although abnormal liver chemistries are linked to a higher risk of coronavirus disease 2019 (COVID‐19)‐related death, liver manifestations may be diverse and even confusing. Thus, we performed a meta‐analysis of published liver manifestations and described the liver damage in patients with COVID‐19 who died or discharged alive. Approach & Results We searched PubMed, Google Scholar, medRxiv, bioRxiv, the Cochrane Library, Embase, and three Chinese electronic databases through April 22, 2020. We analyzed pooled data on liver chemistries stratified by the main clinical outcome of COVID‐19, using a fixed or random‐effects model. In our meta‐analysis of 19 studies, which included a total of 4,103 patients, the pooled mean alanine aminotransferase and aspartate aminotransferase levels were respectively 31.7 and 51.0 IU/L in the patients with COVID‐19 who died and 27.7 and 32.9 IU/L in those discharged alive (both p < 0.0001). Compared with the patients discharged alive, those who died tended to have lower albumin levels but longer prothrombin time and higher international standardized ratio. Conclusions In this meta‐analysis, according to the main clinical outcome of COVID‐19, we comprehensively described three patterns of liver impairment related to COVID‐19, hepatocellular injury, cholestasis, and hepatocellular disfunction. The patients who died from COVID‐19 tended to have different liver chemistries from those discharged alive. Special caution should be given to the patients with relatively higher index of liver chemistries.

This article proposes a class of cognitive diagnosis models (CDMs) for polytomously scored items with different link functions. Many existing polytomous CDMs can be considered as special cases of the proposed class of polytomous CDMs. Simulation studies were carried out to investigate the feasibility of the proposed CDMs and the performance of several information criteria (Akaike’s information criterion [AIC], consistent Akaike’s information criterion [CAIC], and Bayesian information criterion [BIC]) in model selection. The results showed that the parameters of the proposed CDMs could be recovered adequately under varied conditions. In addition, CAIC and BIC had better performance in selecting the most appropriate model than AIC. Finally, a set of real data was analyzed to illustrate the application of the proposed CDMs.

Advanced fibrosis and portal hypertension influence short-term mortality. Lipocalin 2 (LCN2) regulates infection response and increases in liver injury. We explored the role of intrahepatic LCN2 in human alcoholic hepatitis (AH) with advanced fibrosis and portal hypertension and in experimental mouse fibrosis. We found hepatic LCN2 expression and serum LCN2 level markedly increased and correlated with disease severity and portal hypertension in patients with AH. In control human livers, LCN2 expressed exclusively in mononuclear cells, while its expression was markedly induced in AH livers, not only in mononuclear cells but also notably in hepatocytes. Lcn2−/− mice were protected from liver fibrosis caused by either ethanol or CCl4 exposure. Microarray analysis revealed downregulation of matrisome, cell cycle and immune related gene sets in Lcn2−/− mice exposed to CCl4, along with decrease in Timp1 and Edn1 expression. Hepatic expression of COL1A1, TIMP1 and key EDN1 system components were elevated in AH patients and correlated with hepatic LCN2 expression. In vitro, recombinant LCN2 induced COL1A1 expression. Overexpression of LCN2 increased HIF1A that in turn mediated EDN1 upregulation. LCN2 contributes to liver fibrosis and portal hypertension in AH and could represent a new therapeutic target.

Context The double burden of malnutrition (DBM), undernutrition in early life and an obesogenic environment later on, influences later risk of chronic disorders. The Great Famine in China from 1959 to1962 and remarkable economic development from the 1980s provided such a burden for a large number of people in their 60s. Objective We aimed to analyze the effect of economic status on the association between famine exposure in early life and hyperuricemia in adulthood. Design and Setting Participants numbering 12 666 were enrolled in China based on the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) Study from 2014 to 2016. Participants Participants with fetal or childhood famine exposure (birth year 1949-1962) formed the exposure group. Main Outcome Measure Hyperuricemia was defined as uric acid (UA) > 420 μmol/L for men and > 360 μmol/L for women. The association of famine with hyperuricemia was assessed via regression analyses. Results Early-life famine exposure was negatively associated with UA levels (P = .045) but was not associated with hyperuricemia (P = .226) in the whole study population. Economic status could moderate the association of famine exposure with UA and hyperuricemia (P ≤ .001). In participants with high economic status, early-life famine exposure was positively associated with UA levels (unstandardized coefficients 7.61, 95% CI 3.63-11.59, P < .001), and with hyperuricemia (odds ratio 1.47, 95% CI 1.19-1.81, P < .001). Conclusions Economic status could moderate the association between exposure to famine in early life and hyperuricemia in adulthood, indicating that the DBM might affect hyperuricemia in an opposite direction of the effects of undernutrition in early life alone.

Currently, measurement tools to assess patient-reported outcomes for drug dependence are limited in their latent trait to adapt to the needs of individual patients while also maintaining comparability of scores across patients.

Background: Kallistatin and ENOX1 are regulators of inflammation and oxidative stress which are typical pathological reactions in atherosclerosis. However, there is limited information of kallistatin and ENOX1 in coronary heart disease (CHD). Methods: Fifty healthy controls, 56 stable angina pectoris (SAP) patients, and 47 acute coronary syndrome (ACS) patients were included in this study. Levels of kallistatin and ENOX1 in serum were measured by ELISA. χ2 test was performed to analyze categorical data. ANOVA, Pearson correlation analysis, and multiple linear regression were performed to analyze the numerical data. Finally, receiver operating characteristic (ROC) curve was applied to assess the diagnostic value of kallistatin in CHD. Results: Among the 153 participants, 59.5% were male and the average age was 63.8 ± 11.39 years. Compared with the control group, kallistatin expression was decreased in the SAP and ACS groups while expression of ENOX1 was increased in the ACS group (p < 0.05). Pearson correlation analysis showed that the kallistatin level was negatively correlated with the Gensini score (r = −0.210, p < 0.01), white blood cell (WBC) count (r = −0.283, p < 0.001), and triglyceride levels (r = −0.242, p < 0.01) and positively correlated with age (r = 0.353, p < 0.001) and high-density lipoprotein cholesterol (r = 0.310, p < 0.001). ENOX1 expression was positively correlated with WBC count (r = 0.244, p < 0.01), international normalized ratio (r = 0.177, p < 0.05), and Gensini score (r = 0.201, p < 0.05). Multiple linear regression showed that Cr, alanine transaminase, glucose, and kallistatin are independent predictors for Gensini score. The ROC curve showed that kallistatin had the highest diagnostic significance (p = 0.007) when the area under curve was 0.636, with a sensitivity of 0.735 and a specificity of 0.495. Conclusion: Expression of kallistatin was decreased in CHD patients and that of ENOX1 was increased in ACS patients. Kallistatin and ENOX1 were closely connected with the severity of CHD, and kallistatin may be helpful in the diagnosis of CHD.

Cognitive impairments and circadian rhythm disorders are the main clinical manifestations of Alzheimer’s disease (AD). Orexin has been reported as abnormally elevated in the cerebrospinal fluid of AD patients, accompanied with cognitive impairments. Our recent research revealed that suvorexant, a dual orexin receptor antagonist, could improve behavioral circadian rhythm disorders in 9-month-old APP/PS1 mice. Here we further observed whether suvorexant could ameliorate the cognitive decline in APP/PS1 mice by using behavioral tests, and investigated the possible mechanisms by in vivo electrophysiological recording, western blot, and immunochemistry. The results showed that suvorexant treatment effectively ameliorated the cognitive impairments, alleviated in vivo hippocampal long-term potentiation suppression, restored the circadian phosphorylated CREB expression in the hippocampus, and reduced amyloid-β protein deposition in the hippocampus and cortex in APP/PS1 mice. These results indicate that the neuroprotective effects of suvorexant against AD are involved in the reduction of amyloid-β plaques, improvement of synaptic plasticity, and circadian expression of phosphorylated CREB, suggesting that suvorexant could be beneficial to the prevention and treatment of AD.

Oesophageal squamous cell carcinoma (ESCC) is a common and aggressive malignancy. Although many molecular alterations have been observed in ESCC, the mechanisms underlying the development and progression of this disease remain unclear. In the present study, miR-1224-5p was identified to be downregulated in ESCC tissues compared to normal tissues, and its low expression was correlated with shorter survival time in patients. In vitro experiments showed that miR-1224-5p inhibited the proliferation, colony formation, migration and invasion of ESCC cells. Mechanistic investigation revealed that miR-1224-5p directly targeted TNS4 and inhibited its expression, which led to the inactivation of EGFR-EFNA1/EPHA2-VEGFA (vascular endothelial growth factor A) signalling. Experiments in vivo confirmed the suppressive effect of miR-1224-5p on oesophageal cancer cells. By immunohistochemistry analysis of ESCC specimens, we found that TNS4 expression was positively correlated with that of VEGFA, and was significantly associated with lymph node metastasis and shorter survival time in patients. Together, our data suggest that miR-1224-5p downregulation is a frequent alteration in ESCC that promotes cell proliferation, migration, invasion and tumour growth by activating the EGFR-EFNA1/EPHA2-VEGFA signalling pathway via inhibition of TNS4 expression. Decreased miR-1224-5p and elevated TNS4 are unfavourable prognostic factors for ESCC patients.

Background Small hepatocellular carcinoma (sHCC) is a special subtype of HCC with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes. Surgical resection or radiofrequency ablation provides the greatest chance for cure; however, many patients still undergo tumor recurrence after primary treatment. To date, there is no clinical applicable method to assess biological aggressiveness in solitary sHCC. Methods In the current study, we retrospectively evaluated tumor necrosis of 335 patients with solitary sHCC treated with hepatectomy between December 1998 and 2010 from Sun Yat-sen University Cancer Center. Results The presence of tumor necrosis was observed in 157 of 335 (46.9%) sHCC patients. Further correlation analysis showed that tumor necrosis was significantly correlated with tumor size and vascular invasion (P = 0.026, 0.003, respectively). The presence of tumor necrosis was associated closely with poorer cancer-specific overall survival (OS) and recurrence-free survival (RFS) as evidenced by univariate (P P = 0.005; hazard ratio, 2.208; 95% CI, 1.272–3.833). Notably, the combined model by tumor necrosis, vascular invasion and tumor size can significantly stratify the risk for RFS and OS and improve the ability to discriminate sHCC patients’ outcomes (P Conclusions Our results provide evidence that tumor necrosis has the potential to be a parameter for cancer aggressiveness in solitary sHCC. The combined prognostic model may be a useful tool to identify solitary sHCC patients with worse outcomes.

Alterations in DNA damage response (DDR) genes are common in advanced prostate tumors and are associated with unique genomic and clinical features. ATM is a DDR kinase that has a central role in coordinating DNA repair and cell-cycle response following DNA damage, and ATM alterations are present in approximately 5% of advanced prostate tumors. Recently, inhibitors of PARP have demonstrated activity in advanced prostate tumors harboring DDR gene alterations, particularly in tumors with BRCA1/2 alterations. However, the role of alterations in DDR genes beyond BRCA1/2 in mediating PARP inhibitor sensitivity is poorly understood. To define the role of ATM loss in prostate tumor DDR function and sensitivity to DDR-directed agents, we created a series of ATM-deficient preclinical prostate cancer models and tested the impact of ATM loss on DNA repair function and therapeutic sensitivities. ATM loss altered DDR signaling, but did not directly impact homologous recombination function. Furthermore, ATM loss did not significantly impact sensitivity to PARP inhibition but robustly sensitized to inhibitors of the related DDR kinase ATR. These results have important implications for planned and ongoing prostate cancer clinical trials and suggest that patients with tumor ATM alterations may be more likely to benefit from ATR inhibitor than PARP inhibitor therapy. Significance: ATM loss occurs in a subset of prostate tumors. This study shows that deleting ATM in prostate cancer models does not significantly increase sensitivity to PARP inhibition but does sensitize to ATR inhibition. See related commentary by Setton and Powell, p. 2085

The surgery for esophageal cancer arising after prior gastrectomy is technically difficult with high morbidity and mortality. Endoscopic submucosal dissection (ESD) is a minimally invasive endoscopic treatment for superficial SCC with high curative resection rate. But few studies are concerned about ESD under these circumstances. The aim of this study was to elucidate the short- and long-term outcomes of ESD for superficial esophageal squamous cell cancer (SCC) in patients with prior gastrectomy. From January 2009 to January 2019, 37 patients with prior gastrectomy who underwent ESD for superficial esophageal SCC were retrospectively enrolled at the Zhongshan Hospital, Fudan University in Shanghai, China. Rates of en bloc resection, complete resection, curative resection, incidence of postoperative bleeding, perforation and postoperative stricture were evaluated as short-term outcomes. Overall survival, and local recurrence-free survival were evaluated as long-term outcomes. The rate of en bloc resection, complete resection and curative resection were 94.6%, 86.5% and 78.4%, respectively. No perforation was observed. 1 (2.7%) patient experienced postoperative bleeding. During the median observation of 43 months, 3 (8.6%) patients experienced esophageal stricture, successfully managed by balloon dilation. 3(8.6%) patients had local recurrence after ESD with 5-year local recurrence-free survival rate of 91.4%. During the observation period, 4 patients died of other reasons. The 1, 3, 5-year overall survival rates were 97.1%, 97.1% and 91.4%. The short-term outcomes indicate ESD is technically difficult with lower resection completeness in patients after gastrectomy, while the long-term outcomes are rather favorable.

Objectives In order to continuously promote the rational clinical application of antibacterial drugs and provide data support for hospital scientific management decision-making, we evaluated the use rate of antibiotics in outpatients in 2010 - 2018. Materials and methods A retrospective analysis of the use rate of antibiotics in outpatients from January 2010 to October 2018 was performed in our hospital. We analyzed the antibacterial use rate in each month in outpatients and evaluated the changes in the antibacterial use rate in outpatients over the past 9 years. Autoregressive integrated moving average (ARIMA) model was established and verified, and we predicted the trends of antibacterial use rate in outpatients from November 2018 to March 2019. Results The level of clinical rational drug use management in our hospital is continually improving. The average monthly use rate of antibiotic drugs in outpatients in 2010 - 2013 decreased from 13.04 to 12.28% in 2014 - 2018 (p = 0.002). The goodness-of-fit of the ARIMA model is high. The verification results show that the model can accurately predict the changing trend. The average absolute error of the actual value and the fitted value of the antibiotic drug use rate was 0.76% from January to October 2018. The established ARIMA model can better simulate the trend of antibacterial use rate in outpatients. Conclusion The model can be applied to the short-term prediction and dynamic analysis of antibacterial use rate in outpatients, helping hospitals to reasonably evaluate and monitor the use of clinical antibiotics and provide decision-making services for hospital management.

Objectives To investigate the clinicopathological features and prognostic value of endometriosis in young patients with ovarian endometrioid carcinoma (OEC) and ovarian clear cell carcinoma (OCCC). Methods The medical files and clinical follow-up data of patients aged 40 years or younger with OEC or OCCC between January 2006 and December 2017 who had undergone complete surgical staging followed by systemic chemotherapy were retrospectively reviewed. Results A total of 94 women were included in this study. Univariate analysis revealed that the progression-free survival (PFS) and overall survival (OS) rates of patients with endometriosis-associated ovarian carcinoma (EAOC) did not improve compared with those of patients without EAOC (5-year PFS: 80.0% vs. 75.9% and 5-year OS: 85.0% vs. 86.0%, respectively). Multivariate analyses confirmed that FIGO stage (II–IV), cytology-positive ascites or peritoneal washes and residual disease > 1 cm were independent predictors of PFS and that residual disease > 1 cm was the only predictor of OS. Conclusions Endometriosis is not independently associated with the prognosis of OEC and OCCC among young patients. The intrinsic relationship between endometriosis and ovarian cancer warrants further investigation.

Background: Aberrant activation of the complement system plays an important role in the pathogenesis and development of immunoglobulin A nephropathy (IgAN). The relationship between serum complement and the clinical-histopathological features and outcomes of IgAN is controversial. This retrospective study aimed to examine the relationship between the complement 3/4 (C3/C4) ratio and the clinicopathologic changes and prognosis of patients with IgAN. Methods: A total of 397 patients with primary IgAN from January 2007 to December 2012 at the Chinese People’s Liberation Army General Hospital were included in this study. The correlation test and Chi-square test or one-way analysis of variance test were performed to evaluate the relationship between the C3/C4 ratio and other clinical-pathological factors. Propensity score matching and a multivariate Cox regression model were used to calculate the risk factors of renal outcome. Results: The median follow-up period was 75 months. During the follow-up period, 62 patients (15.6%) developed into the end-stage renal disease (ESRD). The C3/C4 ratio at baseline was associated with the level of serum creatinine (SCr), 24 h urinary protein excretion (24 h Upre), global glomerular sclerosis, and tubulointerstitial lesion. The level of SCr and 24 h Upre and the degree of chronic kidney injury were statistically different among groups defined by different C3/C4 ratio levels. The survival rates of patients among groups with different C3/C4 ratio levels were different. After propensity score matching, eighty-eight pairs of patients were successfully matched, and the C3/C4 ratio was an influencing factor for the patients’ outcome (hazard ratio 0.587, 95% confidence interval 0.329-0.880). Patients with a C3/C4 ratio

Summary: Cells deficient in ataxia telangiectasia mutated (ATM) are hypersensitive to ionizing radiation and other anti-cancer agents that induce double-strand DNA breaks. ATM inhibitors may therefore sensitize cancer cells to these agents. Some cancers may also have underlying genetic defects predisposing them to an ATM inhibitor monotherapy response. We have conducted a genome-wide CRISPR screen to identify genetic vulnerabilities that sensitize lung cancer cells to ATM inhibitors. Knockout of genes in the Fanconi anemia (FA)/BRCA pathway results in hypersensitivity to the ATM inhibitor M3541. Knockdown of either an FA gene or of ATM results in reduced double-strand break end resection, enhanced non-homologous end joining (NHEJ) repair, and decreased homologous recombination repair. Knockout of both the FA/BRCA pathway and ATM strongly inhibits end resection and generates toxic levels of NHEJ, thereby elucidating a mechanism of cellular death by synthetic lethality. ATM inhibitors may therefore be useful for the treatment of tumors with a defective FA/BRCA pathway. : ATM inhibitors are currently in clinical development as anti-cancer agents. Using a genome-wide CRISPR screen, Cai et al. demonstrate that cancer cells with Fanconi anemia (FA) pathway deficiency are sensitive to ATM inhibition. The authors also show that synthetic lethality between ATM and the FA pathway is due to reduced DNA resection and increased toxic NHEJ. Keywords: ATM inhibitor, CRISPR sgRNA screening, Fanconi anemia pathway, NHEJ, end resection

The diagnosis of schizophrenia is thought to embrace several distinct subgroups. The manifold entities in a single clinical patient group increase the variance of biological measures, deflate the group-level estimates of causal factors, and mask the presence of treatment effects. However, reliable neurobiological boundaries to differentiate these subgroups remain elusive. Since cortical thinning is a well-established feature in schizophrenia, we investigated if individuals (patients and healthy controls) with similar patterns of regional cortical thickness form naturally occurring morphological subtypes. K-means algorithm clustering was applied to regional cortical thickness values obtained from 256 structural MRI scans (179 patients with schizophrenia and 77 healthy controls [HCs]). GAP statistics revealed three clusters with distinct regional thickness patterns. The specific patterns of cortical thinning, clinical characteristics, and cognitive function of each clustered subgroup were assessed. The three clusters based on thickness patterns comprised of a morphologically impoverished subgroup (25% patients, 1% HCs), an intermediate subgroup (47% patients, 46% HCs), and an intact subgroup (28% patients, 53% HCs). The differences of clinical features among three clusters pertained to age-of-onset, N-back performance, duration exposure to treatment, total burden of positive symptoms, and severity of delusions. Particularly, the morphologically impoverished group had deficits in N-back performance and less severe positive symptom burden. The data-driven neuroimaging approach illustrates the occurrence of morphologically separable subgroups in schizophrenia, with distinct clinical characteristics. We infer that the anatomical heterogeneity of schizophrenia arises from both pathological deviance and physiological variance. We advocate using MRI-guided stratification for clinical trials as well as case–control investigations in schizophrenia.

Background Fabry disease (FD) is an X-linked lysosomal storage disorder caused by the mutation of the GLA gene, encoding the α-galactosidase, which is responsible for the catabolism of neutral glycosphingolipids. Microalbuminuria or low-grade proteinuria, and continuously progressive renal failure are common manifestations in FD males. However, sudden onset of nephrotic syndrome in FD, is rarely reported. Case report A 32-year-old Chinese man was admitted to our hospital because of sudden onset of generalized edema due to nephrotic syndrome. He denied hypohidrosis, nocturia, and any history of episodic hand or foot pain. A few scattered angiokeratoma can be found on the low back skin on examination. Except for the similar locating pattern of angiokeratoma, no evident abnormality was found in the laboratory work up and physical examination of his younger brother. The patient was diagnosed with FD companying with minimal change disease by renal biopsy. Genetic analysis on our patient and his sibling revealed a nonsense GLA gene variant (c.707G > A, p.Trp236*), which has been previously reported in FD. Immunotherapy alone (steroids and tacrolimus), but without enzyme replacement therapy, much improved the massive proteinuria. Follow up to date, his 24-h urine protein is stable at about 0.5 g, and renal function keeps normal. Conclusion Sudden onset of nephrotic syndrome, although rare, may occur in FD, even as the primary renal manifestation, but this usually suggests additional renal disease. Immunosuppressive treatment should be considered in such FD patient companying with nephrotic syndrome.

To explore the performance of the ground source thermal energy management system under the cold and heat sources, based on the cold and heat auxiliary technology, a ground source thermal energy composite management system is constructed and simulated. The constructed ground source heat pump-refrigeration unit-hybrid heating management system of urban heating networks, as well as the simple system, are analyzed and investigated in terms of power consumption and underground temperature control. The research results show that the constructed ground source heat pump-refrigeration unit-hybrid heating management system of the urban heating network has lower power and energy consumption than a simple system during the same period, which meets the economic requirements and guarantees the system with relatively low energy consumption. For underground temperature control, the constructed system is more stable than a simple system without excessive temperature fluctuations. The operation control strategy of the constructed system is mainly for chiller units, heat pump units, cooling towers, source side, and side circulation water pump modules. In summary, the constructed ground source heat pump-refrigeration unit-hybrid heating management system of an urban heating network based on the ground source heat pump meets the requirements for energy consumption and temperature control and can operate the control strategy normally. The results are significant for subsequent researches on the ground source thermal energy management system based on cold and heat auxiliary technology.

Cognitive diagnostic computerized adaptive testing (CD-CAT) purports to combine the strengths of both CAT and cognitive diagnosis. Currently, large number of CD-CAT researches focus on the dichotomous data. In our knowledge, there are no researches on CD-CAT for polytomously scored items or data. However, polytomously scored items have been broadly used in a variety of tests for their advantages of providing more information about examinee, and fewer polytomous items can achieve the same precision compared with dichotomous items. Therefore, it is an interesting topic on CD-CAT with polytomously scored items, which need promote the research in polytomous cognitive diagnostic computerized adaptive testing (called PCD-CAT). This study aims to construct a framework of PCD-CAT, including the construction of the item bank, the item selection method, the parameter estimation, and the termination rule.

Laser triangulation and image processing are two major methods for surface quality inspection. The former has the advantage of three-dimensional information, while the latter can provide more detailed characteristics. However, there are few researches on effective integration of the two methods. In this paper, a lab scale laser braze quality inspection system utilizing information from laser triangulation scanning and optical image acquisition was able to inspect an automotive laser braze at a scanning speed of 1.5 m/min with 100% accuracy. The process started with defect zoning to sort out braze areas with and without defect based on the joint surface profile reconstructed from laser triangulation. Feature extraction was then carried out on the images of defect-containing braze areas, in which the location, size, geometry, and texture features of the defects were extracted from the gray-scale images, and since these features were extracted from only defect-containing areas, a lot of computational cost was saved, which reduced time consumed greatly. For defect classification, in the training stage the extracted features were processed by the principal component analysis and the first three principal components were calculated for 5 typical defects: surface cavity, pore, hump, burn-through, and lack-of-braze. In the test stage, the first three principal components of the images of interest were calculated and compared with the established principal component values of the 5 defect types for defect classification.

In recent years, the incidence and the mortality rate of cervical cancer have been gradually increasing, becoming one of the major causes of cancer-related death in women. In particular, patients with advanced and recurrent cervical cancers present a very poor prognosis. In addition, the vast majority of cervical cancer cases are caused by human papillomavirus (HPV) infection, of which HPV16 infection is the main cause and squamous cell carcinoma is the main presenting type. In this study, we performed screening of differentially expressed genes (DEGs) based on The Cancer Genome Atlas (TCGA) database and GSE6791, constructed a protein–protein interaction (PPI) network to screen 34 hub genes, filtered to the remaining 10 genes using the CytoHubba plug-in, and used survival analysis to determine that RPS27A was most associated with the prognosis of cervical cancer patients and has prognostic and predictive value for cervical cancer. The most significant biological functions and pathways of RPS27A enrichment were subsequently investigated with gene set enrichment analysis (GSEA), and integration of TCGA and GTEx database analyses revealed that RPS27A was significantly expressed in most cancer types. In this study, our analysis revealed that RPS27A can be used as a prognostic biomarker for HPV16 cervical cancer and has biological significance for the growth of cervical cancer cells.

Alpha-fetoprotein hardly increased due to nasopharyngeal cancer. In this article, we reported a 57-year-old male nasopharyngeal carcinoma patient who had posttreatment subscapular metastasis with high serum alpha-fetoprotein but negative plasma Epstein–Barr virus DNA. Pathology results indicated that the scapular mass was undifferentiated non-keratinizing carcinoma originated in the nasopharynx. Moreover, no liver lesion was detected by imaging examination. In view of the positive alpha-fetoprotein and alpha-fetoprotein messenger RNA staining result in the right scapular mass fine needle aspiration biopsy sample, we considered the diagnosis of alpha-fetoprotein-producing nasopharyngeal carcinoma that had never been reported before.

To generate robust patient-derived xenograft (PDX) models for epithelial ovarian cancer (EOC), analyze the resemblance of PDX models to the original tumors, and explore factors affecting engraftment rates, fresh cancer tissues from a consecutive cohort of 158 patients with EOC were collected to construct subcutaneous PDX models. Paired samples of original tumors and PDX tumors were compared at the genome, transcriptome, protein levels, and the platinum-based chemotherapy response was evaluated to ensure the reliability of the PDXs. Univariate and multivariate analyses were used to determine the factors affecting the engraftment rates. The engraftment success rate was 58.23% (92/158) over 3–6 months. The Ki-67 index and receiving neoadjuvant chemotherapy can affect the engraftment rate in primary patients. The PDX models generated in this study were found to retain the histomorphology, protein expression, and genetic alteration patterns of the original tumors, despite the transcriptomic differences observed. Clinically, the PDX models demonstrated a high degree of similarity with patients in terms of the chemotherapy response and could predict prognosis. Thus, the PDX model can be considered a promising and reliable preclinical tool for personalized and precise treatment.

Inter-set peripheral cooling can improve high-intensity resistance exercise performance. However, whether foot cooling (FC) would increase 1 repetition maximum (RM) lower-limb strength is unclear. This study investigated the effect of intermittent FC on 1 RM leg press strength. Ten recreational male lifters performed three attempts of 1 RM leg press with FC or non-cooling (NC) in a repeated-measures crossover design separated by 5 days. FC was applied by foot immersion in 10 °C water for 2.5 min before each attempt. During the 1 RM test, various physiological measures were recorded. The results showed that FC elicited higher 1 RM leg press strength (Δ [95% CI], Cohen's d effect size [ES], 13.6 [7.6–19.5] kg, ES = 1.631) and electromyography values in vastus lateralis (57.7 [ 8.1–107.4] μV, ES = 0.831) and gastrocnemius (15.1 [-3.1–33.2] μV, ES = 0.593) than in NC. Higher arousal levels (felt arousal scale) were found in FC (0.6 [0.1–1.2], ES = 0.457) than in NC. In conclusion, the preliminary findings, although limited, suggest intermittent FC has a potential ergogenic role for recreational athletes to enhance maximal lower-limb strength and may partly benefit strength-based competition events.

The coronavirus disease 2019 (COVID-19) pandemic has spurred an unprecedented paradigm shift to telemedicine across healthcare fields in order to limit exposure to the virus. At the West China Hospital of Sichuan University, telemedicine has been used to perform COVID-19-related tele-education to health professionals and the general population, as well as tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, many older adults could not make appointments with doctors due to difficulty using the internet-based platform. Careful attention needs to be paid by future researchers and policymakers in order to mitigate barriers older adults face when using telemedicine.

ObjectiveTo investigate whether systematic lymph node dissection can confer clinical benefits in patients with apparent early-stage low-grade epithelial ovarian cancer.MethodsPatients with apparent early-stage low-grade epithelial ovarian cancer seen at Peking Union Medical College Hospital from January 1, 2005, to December 31, 2015, were retrospectively enrolled. Patients with other histological types and those who did not receive necessary adjuvant chemotherapy were excluded. Data collection and long-term follow-up were performed. According to the removed lymph node number, three groups based on surgical methods were used: abnormal lymph node resection, pelvic lymphadenectomy, and systematic lymph node dissection to control surgical quality. Their effects on prognosis were analyzed in pathological subgroups.ResultsA total of 196 patients were enrolled; 30.1% of patients had serous, 42.3% of patients had mucinous, and 27.6% of patients had endometrioid carcinoma, of which 51 (26.0%), 96 (49.0), and 49 (25.0%) patients were treated with the above surgical methods, respectively. The occult lymph node metastasis rate was 14 (7.1%), and only five (2.6%) of apparent early-stage patients were upstaged due to lymph node metastasis alone. Systematic lymph node dissection did not benefit progression-free survival or disease-specific overall survival of apparent early-stage low-grade mucinous and endometrioid epithelial ovarian cancer but prolonged progression-free survival of apparent early-stage low-grade serous patients (OR, 0.231, 95% CI, 0.080, 0.668, p = 0.007).ConclusionsSystematic lymph node dissection may be abolished in patients with apparent early-stage low-grade mucinous and endometrioid epithelial ovarian cancer but may be considered for apparent early-stage low-grade serous patients.

Objective: To explore the accuracy of estimated 24-h urinary iodine excretion (24-h UIEest) in assessing iodine nutritional status. Design: Fasting venous blood, 24-h and spot urine samples were collected during the day. The urinary iodine concentration (UIC) and urinary creatinine concentration (UCrC) were measured, and the urinary iodine-to-creatinine ratio (UI/Cr), 24-h UIEest, and 24-h urinary iodine excretion (24-h UIE) were calculated. At the population level, correlation and consistency between UIC, UI/Cr, 24-h UIEest and 24-h UIE were assessed using correlation analysis and Bland–Altman plots. At the individual level, receiver operating characteristic (ROC) curves were used to analyse the accuracy of the above indicators for evaluating insufficient and excessive iodine intake. The reference interval of 24-h UIEest was established based on percentile values. Setting: Indicator can accurately evaluate individual iodine nutrition during pregnancy remains controversial. Participants: Pregnant women (n 788). Results: Using 24-h UIE as standard, the correlation coefficients of 24-h UIEest from different periods of the day ranged from 0·409 to 0·531, and the relative average differences ranged from 4·4 % to 10·9 %. For diagnosis of insufficient iodine intake, the area under the ROC curve of 24-h UIEest was 0·754, sensitivity and specificity were 79·6 % and 65·4 %, respectively. For diagnosis of excessive iodine intake, the area of 24-h UIEest was 0·771, sensitivity and specificity were 66·7 % and 82·0 %, respectively. The reference interval of 24-h UIEest was 58·43–597·65 μg. Conclusions: Twenty-four-hour UIEest can better indicate iodine nutritional status at a relatively large sample size in a given population of pregnant women. It can be used for early screening at the individual level to obtain more lead time for pregnant women.

Successful translational studies within the field of Traumatic Brain Injury (TBI) are concerned with determining reliable markers of injury outcome at chronic time points. Determination of injury severity following Fluid Percussion Injury (FPI) has long been limited to the measured atmospheric pressure associated with the delivered pulse. Duration of unresponsiveness to toe pinch (unconsciousness) was next introduced as an extra marker of injury severity. The current study is an effort to assess the utilization of acute injury-induced biological responses (duration of toe pinch unresponsiveness, percent body weight change, quantification of brain edema, and apnea duration) to predict cognitive performance at a subacute time point following developmental brain injury. Cognitive performance, when measured at a subacute phase, after developmental FPI was negatively correlated with the following variables, duration of toe pinch unresponsiveness, percent weight change, and quantified level of brain edema. These finding suggest the potential utilization of reliable severity assessment of injury-induced biological responses in determining outcome measures at subacute time points.

Digital subtraction angiography (DSA) is a fluoroscopic technique used extensively in interventional radiology for visualizing blood vessels. It has also been used to evaluate blood perfusion. However, the perfusion obtained in previous techniques was extracted from signal intensity rather than by the transport of contrast material (CM) through blood flow. The main aim of this study is to evaluate the morphological effects on the hemodynamics and the CM concentration in the middle cerebral artery (MCA) stenosis. We proposed a quantitative parameter, i.e., contrast material remaining time (CMRT), to describe the variation in the transport of CM over time. Computational fluid dynamics simulations were performed on both reconstructive synthetic and patient-derived models. In the synthetic models, we evaluated the variation of flow patterns and the transport of CM with different degrees of stenosis and the location of the lesion. It was found that an increase in the degree of stenosis (from 30 to 80%) resulted in a significant increase in CMRT at the anterior cerebral artery (ACA) outlet (p = 0.0238) and a significant decrease in CMRT at the MCA outlet (p = 0.012). The patient-derived models were reconstructed from the pre- and post-interventional DSA images of a patient with MCA stenosis. Both blood flow velocity and CMRT increased at the ACA outlet but decreased at the MCA outlet. The perfusion analysis demonstrated that the perfusion function was improved after interventional surgery. In conclusion, changes in stenotic degree at MCA may lead to apparent differences in the hemodynamic distribution and the transport of CM. CMRT could be a quantitative indicator to evaluate the changes in blood perfusion after the intervention for MCA stenosis.

We demonstrate an optical phased array that consists of two subarrays based on the silicon on insulator (SOI) platform, each subarray including 16 independent channels. The demonstrated field of view of the optical phased array is 36.6 ∘ × 32.6 ∘ with a spot size of 1.68 ∘ × 0.0673 ∘ . A steering range of 32.6° is achieved by combining two subarrays with different periods and tuning the wavelength from 1500 nm to 1600 nm. In another dimension, the steering is realized by introducing phase differences between channels.

Background and Aims Esophageal squamous cell cancer (ESCC) is one of the leading malignant cancers with a high incidence and mortality. Exploring novel serum biomarkers will help improve the management and monitoring of ESCC. Methods In the present study, we first used a ProcartaPlex Array to screen for serum proteins that were increased in 40 ESCC patients compared with matched normal controls; we found that eight proteins (IL‐2, IL‐5, IP‐10, IL‐8, eotaxin, TNF‐α, HGF, and MIP‐1b) had higher serum levels in ESCC patients than in normal controls. We further verified the clinical relevance of the candidate biomarkers with a larger sample of sera. Results In the 174 tested ESCC patients and 189 normal controls, the serum levels of eotaxin and IP‐10 were significantly higher in patients than in normal controls (p = 0.0038, 0.0031). In particular, these two proteins were also elevated in the sera of patients with early‐stage (0‐IIA) ESCC (p = 0.0041, 0.0412). When combining CEA and CYFRA21‐1 (in use clinically) with eotaxin or IP‐10, the effectiveness of detecting ESCC was superior to that of CEA and/or CYFRA21‐1 alone. Moreover, the serum level of eotaxin dropped significantly after surgical resection of primary tumors compared with that in preoperative ESCC samples (p, Serum samples from 40 ESCC patients and 40 normal controls were used to screen protein candidates by using ProcartaPlex Array in the biomarker discovery stage. The diagnostic values of the candidate IL‐2, IL‐5, IP‐10, IL‐8, eotaxin, TNF‐α, HGF, MIP‐1b using ELISA were further evaluated in 363 serum samples in the biomarker assessment stage and were finally evaluation value of protein panels for the detection and therapy monitoring of ESCC.