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In this article, we aim to address the following research question: How can a construction organization reduce and contain errors in its projects and mitigate rework and failures? We adopt an organizing sense-making perspective to acquire a sense of order of quality (e.g., rework) and to understand its relationship with safety (e.g., unsafe behavior) in construction. We undertook semistructured interviews from a range of employees involved with delivering a construction organization's projects. Also, documentary sources were accessed to supplement the rework and safety incidents that were referenced during the interviewing process. We found that the construction organization's prevailing culture focused on error prevention, which stymied its ability to learn and reduce rework in projects. The organization consciously enacted a trade-off between quality and safety. The upshot of this either/or framing of competing values was the suppression by senior management of nonconformances, which then led to deviant behavior manifesting in projects. We also revealed that safety incidents tended to arise when people engaged in unsafe behaviors while performing rework. The empirical evidence supports our call for construction organizations to engage in error management so that they can cultivate mindfulness where individuals and project teams can improvise and better handle errors, so they are not repeated.

Federated learning enables collaborative deep learning over multiple clients without sharing their local data, and it becomes increasingly popular due to the good balance between data privacy and model usability. Generally, it faces the heavy communication overhead when a large number of clients are involved and the low convergence rate incurred by non-IID data. However, few existing solutions cannot simultaneously address the communication and statistic challenges. In this paper, we propose a computation and communication efficient federated learning via adaptive sampling. By capturing different data distribution among clients, we utilize the concept of self-paced learning to adaptively adjust thresholds to filter training data for each client and also to select suitable clients to be involved in each global learning round. We prove its correctness through theoretical analysis and also evaluate its performance through experimental evaluations on real-world datasets. Detailed experimental results show that it can effectively reduce the communication cost while achieving the good trade-off between accuracy and efficiency.

Mathematical morphology operations are widely used in image processing such as defect analysis in semiconductor manufacturing and medical image analysis. These data-intensive applications have high requirements during hardware implementation that are challenging for conventional hardware platforms such as central processing units (CPUs) and graphics processing units (GPUs). Computation-in-memory (CIM) provides a possible solution for highly efficient morphology operations. In this study, we demonstrate the application of morphology operation with a novel memristor-based auto-detection architecture and demonstrate non-neuromorphic computation on a multi-array-based memristor system. Pixel-by-pixel logic computations with low parallelism are converted to parallel operations using memristors. Moreover, hardware-implemented computer-integrated manufacturing was used to experimentally demonstrate typical defect detection tasks in integrated circuit (IC) manufacturing and medical image analysis. In addition, we developed a new implementation scheme employing a four-layer network to realize small-object detection with high parallelism. The system benchmark based on the hardware measurement results showed significant improvement in the energy efficiency by approximately 358 times and 32 times more than when a CPU and GPU were employed, respectively, exhibiting the advantage of the proposed memristor-based morphology operation.

Self-centering rocking shear wall (SCRSW) is an innovative structural system which is designed to achieve low damage after strong earthquake shaking. In this paper, an effective damage quantification method is developed to quantify the damages of SCRSWs. The procedure is applied in the performance evaluation and damage quantification for 24 SCRSWs. An equation of the critical parameter β in the damage model is proposed. The results show that increasing stirrup reinforcement ratio, self-centering parameter and concrete strength can reduce the damage developed in SCRSWs effectively, while higher prestress in post-tensioned (PT) tendons tends to increase the damage. An empirical equation between the critical parameter β and structural features is proposed. The critical parameter is then used to quantify the damage index (DI) of SCRSW. The result shows that the proposed β can be used to evaluate and quantify the damages developed in SCRSWs efficiently and accurately.

With the rising global population, increasing energy demand and rapid climate change, great concerns have been raised for environment and energy security in future. Solar-driven CO2 reduction provides a promising way to deal with energy crisis and global warming, which has been widely concerned. Photoelectrocatalysis technology can effectively utilize solar energy and avoid to use high-temperature and high-voltage reduction environment by integrating the vantages of both photocatalysis and electrocatalysis, which exhibits a broad application prospect of CO2 reduction with a high efficiency and excellent selectivity. In this review, basic principles of CO2 reduction by photocatalysis, electrocatalysis and photoeletrocatalysis are briefly reviewed, also comparing the technical characteristics of the above technologies. Different photoelectrocatalytic systems for CO2 reduction are described and compared. The several key influencing factors of photoelectrocatalytic performance of CO2 reduction are discussed, including interaction between reaction molecules and catalysts, reaction conditions and influence of photoelectrode. Then, the advances on reaction mechanisms and strategies of performance enhancement by optimizing photoexcitation, charge separation efficiency and surface reaction were reviewed. Besides, the challenges and prospects of photoelectrocatalytic CO2 reduction will be also discussed.

Early diagnosis and timely surgical Kasai portoenterostomy greatly improve the survival of patients with biliary atresia (BA), a neonatal cholestatic disease, which has encouraged investigators to develop newborn screening for BA. In this study, we used ultraperformance liquid chromatography-triple quadrupole mass spectrometry-based targeted metabolomics profiling to identify potential BA biomarkers in dried blood spots (DBS) collected from BA patients (n = 21) and healthy controls (n = 100). A distinctive metabolic profile comprising eight significantly differentially expressed metabolites, taurohyocholic acid (THCA), glutamic acid, 2-hydroxyglutaric acid, ketoleucine, indoleacetic acid, alpha-ketoisovaleric acid, glycocholic acid, and taurocholic acid (TCA), clearly distinguished BA infants from control neonates. Three metabolites, THCA, 2-hydroxyglutaric acid, and indoleacetic acid, were selected using linear regression and receiver operating characteristic (ROC) curve analysis and model construction. The area under the ROC curve for this model to discriminate between BA and comparison infants was 0.938 (95% confidence interval, CI: 0.874-1.000). A cutoff value of -0.336 produced a sensitivity of 90.48% (95% CI: 69.62% - 98.83%) and specificity of 92% (95% CI: 84.84% - 96.48%). In conclusion, the results suggest that metabolic markers in DBS obtained from newborns have a great potential for BA screening.

With increasing demand to achieve higher performance after strong earthquake shakings, novel high-performance systems have been developed. Self-centering rocking shear wall (SCRSW) is one of the high-performance structural systems which has been developed. To quantify the performance of SCRSWs, a robust performance evaluation model is needed. In this paper, the damage model developed in the companion paper (part 1) is adopted to evaluate the performance of 24 SCRSWs. The results of the performance evaluation are used to quantify the damage indexes (DI) for SCRSWs at different damage states. Design performance objectives, including the maximum and residual deformations corresponding to various performance levels are suggested based on the performance evaluation targeting different damage states. The proposed DI intervals and design performance objectives can be used by other researchers to design SCRSWs to achieve different performance objectives.

INTRODUCTION Nonsteroidal anti-inflammatory drugs (NSAIDs) are regarded as nephrotoxins. Children commonly use NSAIDs and are susceptible to nephropathy, but the relationship between acute kidney injury (AKI) and use of NSAIDs is not well examined yet. OBJECTIVE To evaluate the relationship between AKI and use of NSAIDs in hospitalized pediatric patients who are susceptible to nephropathy. METHODS We conducted this systematic review and meta-analysis of observational studies by searching PubMed, Embase, and Cochrane Database for articles published up to June 1, 2020. Reports included involved children (age

The neuroimaging method of multimodal magnetic resonance imaging (MRI) can identify the changes in brain structure and function caused by Alzheimer's disease (AD) at different stages, and it is a practical method to study the mechanism of AD progression. This paper reviews the studies of methods and biomarkers for predicting AD progression based on multimodal MRI. First, different approaches for predicting AD progression are analyzed and summarized, including machine learning, deep learning, regression, and other MRI analysis methods. Then, the effective biomarkers of AD progression under structural magnetic resonance imaging, diffusion tensor imaging, functional magnetic resonance imaging, and arterial spin labeling modes of MRI are summarized. It is believed that the brain changes shown on MRI may be related to the cognitive decline in different prodrome stages of AD, which is conducive to the further realization of early intervention and prevention of AD. Finally, the deficiencies of the existing studies are analyzed in terms of data set size, data heterogeneity, processing methods, and research depth. More importantly, future research directions are proposed, including enriching data sets, simplifying biomarkers, utilizing multimodal magnetic resonance, etc. In the future, the study of AD progression by multimodal MRI will still be a challenge but also a significant research hotspot.

BackgroundMETamplification plays an important role in the development of non-small-cell lung cancer (NSCLC) either de novo or in resistance to epidermal growth factor receptor tyrosine–kinase inhibitor (EGFR-TKI) settings. Fluorescence in situ hybridization (FISH) is the standard method forMETamplification. With more and more discoveries of oncogenic driver genes, next-generation sequencing (NGS) plays a significant role in precision oncology. Meanwhile, the role of NGS inMETamplification remains uncertain.MethodsForty patients diagnosed with advanced NSCLC were included. FISH and NGS were conducted prior to MET inhibitors treatment.METamplification by FISH was defined as a MET/CEP7 ratio of > 2.0 and/or copy number (CN) > 5.METamplification by NGS was defined as gene copy number (GCN) ≥ 5.ResultsThe concordance rate among FISH and NGS was 62.5% (25/40).METamplification identified by FISH showed the optimal predictive value. The partial response (PR) rate was 68.0% (17/25 withMETamplification) vs. 6.7% (1/15 withoutMETamplification); the median progression-free survival (PFS) was 5.4 months versus 1.0 months (P METamplification identified by NGS failed to distinguish significant clinical outcomes. The PR rate was 60.0% (6/10, withMETGCN ≥ 5) vs. 40.0% (12/30, withMETGCN ConclusionsMETamplification identified by FISH remains the optimal biomarker to identify suitable candidates for MET-TKI therapy. In comparison, amplification identified by NGS seems not as robust to be effective predictive biomarker. Further exploration is needed regarding the focal amplification by NGS in predicting the efficacy.

Background Although open reduction and internal fixation (ORIF) is recommended for lateral condylar humerus fractures (LCHFs) displaced by > 4 mm, several studies have reported the use of closed reduction and percutaneous pinning (CRPP) to treat LCHFs with significant displacement. However, little is known about the clinical differences between these two surgical techniques. This study aimed to compare the therapeutic effects of CRPP and ORIF in treating LCHFs displaced by > 4 mm. Methods We retrospectively reviewed pediatric LCHFs displaced by > 4 mm treated with either CRPP or ORIF at our center from June 2019 to October 2020. Song and Milch fracture classifications were used. Variables such as age at injury, sex, side injured, fracture displacement, fracture type, operating time, postoperative treatment, and complications were compared between the two techniques. Results One hundred twenty LCHFs met inclusion criteria. There were 36 Milch type I and 84 type II LCHFs, and 69 Song stage 4 and 51 stage 5 LCHFs. CRPP was performed in 45 cases and ORIF in 75 cases. No differences were found in age, sex, side injured, preoperative displacement, postoperative displacement, and length of immobilization between the CRPP and ORIF groups. There was a difference between operation time and pin duration. The CRPP group had shorter operation times and pin duration, and required no additional operations to remove internal pins. The average follow-up duration was 13.9 months. All patients achieved fracture union, and no complications such as infection, nonunion, delayed union, osteonecrosis, fishtail deformity, cubitus varus or valgus, or pain were recorded during follow-up. Bone spurs, lateral prominences, and decreased carrying angle were common complications in all groups. No obvious cubitus varus was observed. Unaesthetic scars were only observed in the ORIF groups. No differences in range of motion or elbow function was found among the different therapies. Conclusions Both CRPP and ORIF can achieve satisfactory clinical outcomes in treating LCHFs displaced by > 4 mm. No differences were found in complications or prognoses between the two groups. However, CRPP shows some advantages over ORIF, like less invasive surgery, no obvious scarring, and no need for secondary surgery with anesthesia for pin removal.

Patients with cardiovascular comorbidity are less tolerant to cardiotoxic drugs and should be treated with reduced doses to prevent cardiotoxicity. However, the safe‐equivalent dose of antitumor drugs in patients with cardiovascular disease/risk is difficult to predict because they are usually excluded from clinical trials as a result of ethical considerations. In this study, a translational quantitative system pharmacology‐pharmacokinetic‐pharmacodynamic (QSP‐PK‐PD) model was developed based on preclinical study to predict the safe‐equivalence dose of doxorubicin in patients with or without cardiovascular disease. Virtual clinical trials were conducted to validate the translational QSP‐PK‐PD model. The model replicated several experimental and clinical observations: the left ventricular ejection fraction (LVEF) was reduced and the left ventricular end‐diastolic volume (LVEDV) was elevated in systolic dysfunction rats, the LVEF was preserved and LVEDV reduced in diastolic dysfunction rats, and patients with preexisting cardiovascular disease were more vulnerable to doxorubicin‐induced cardiac dysfunction than cardiovascular healthy patients. A parameter sensitivity analysis showed that doxorubicin‐induced cardiovascular dysfunction was mainly determined by the sensitivity of cardiomyocytes to cardiotoxic drugs and the baseline value of LVEDV, reflected in LVEF change percentage from the baseline. Blood pressure was the least sensitive factor affecting doxorubicin‐induced cardiotoxicity.

A fully metallic partially open corrugated waveguide (CW) is employed to construct the Ka -band linearly polarized (LP) and circularly polarized (CP) frequency-scanning (FS) periodic leaky-wave antennas (PLWAs) with the spatial coverages from backward ( $\theta ) to forward ( $\theta > 0$ ). The waveguide structure is obtained by cutting a conventional CW in half along its longitudinal symmetry plane. The $n =-1$ space harmonic is generated effectively by the half-wavelength radiating slots on the corrugations. The broadside frequency is about 31.5 GHz. The LP and CP radiations are realized by rotating the radiating slots to different angles. The measured scanning ranges of the LP and CP PLWAs are from −42.7° to 16.5° in the band of 26.5–33.5 GHz and from −48° to 22.7° in the band of 26.5–34 GHz, respectively. The measured axial ratio of the CP PLWA is below 3 dB in the mainlobe directions varied with frequency. The prototypes and experimental results make contributions to the polarization control, scanning rate improvement, and profile reduction in the frequency-controlled millimeter-wave imaging and radar systems.

Background Previous studies reported the prognostic value of the atherogenic index of plasma (AIP) in the course of atherosclerosis and other cardiovascular diseases (CVDs). Still, the predictive utility of the AIP is unknown among patients with type 2 diabetes mellitus (T2DM). Methods This was a secondary analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which randomized 10,251 patients with long-lasting T2DM. ROC curve analysis was used to determine an optimal threshold for AIP, and the study population was divided into high and low AIP groups. Univariable and multivariable Cox proportional hazards regression analyses were used to determine the association between AIP and primary (major adverse cardiovascular events [MACEs], including nonfatal myocardial infarction, nonfatal stroke, and/or death from cardiovascular causes) and secondary outcomes (all-cause mortality). Stratified analyses were performed to control for the confounding factors. Results AIP was an independent risk factor for the prognosis of T2DM (HR = 1.309; 95% CI 1.084–1.581; P = 0.005). The threshold for AIP was determined to be 0.34 in the study population. After adjustments for confounding factors, multivariable analysis showed that AIP was associated with the risk of MACEs (Model 1: HR = 1.333, 95% CI 1.205–1.474, P P = 0.016; Model 3: HR = 1.194, 95% CI 1.049–1.360, P = 0.007), all-cause mortality (Model 1: HR = 1.184, 95% CI 1.077–1.303, P P P = 0.036), and nonfatal myocardial infarction (Model 1: HR = 1.447, 95% CI 1.255–1.669, P P = 0.015; Model 3: HR = 1.284, 95% CI 1.071–1.539, P = 0.007). Subgroup stratified analyses showed that AIP might interact with sex, a classical risk factor of cardiovascular events. Conclusions This study showed that AIP might be a strong biomarker that could be used to predict the risk of cardiovascular events in patients with T2DM. Trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000620.

The efficacy of traditional treatment for post-traumatic stress disorder (PTSD) is still unsatisfactory. Repetitive transcranial magnetic stimulation (rTMS) has been widely used in the treatment of various types of mental disorders, including PTSD. Although rTMS has been demonstrated to be effective in many cases, there are still arguments regarding its mechanism and protocol. This review aims to summarize the origin, development, principle, and future direction of rTMS and introduce this neuro-stimulation therapy to relevant clinicians.

Background Heart transplantation (HTx) remains the gold-standard treatment for end-stage heart failure. The aim of this study was to establish a risk-prediction model for assessing prognosis of HTx using machine-learning approach. Methods Consecutive recipients of orthotopic HTx at our institute between January 1st, 2015 and December 31st, 2018 were included in this study. The primary outcome was 1-year mortality. Least absolute shrinkage and selection operator method was used to select variables and seven different machine-learning approaches were employed to develop the risk-prediction model. Bootstrap method was used for model validation. Shapley Additive exPlanations (SHAP) method was used for model interpretation. Results 381 recipients were included with average age of 43.783 years old. Albumin, recipient age and left atrium diameter ranked top three most important variables that affected the 1-year mortality of HTx. Other important variables included red blood cell, hemoglobin, lymphocyte%, smoking history, use of lyophilized rhBNP, use of Levosimendan, hypertension, cardiac surgery history, malignancy and endotracheal intubation history. Random Forest (RF) model achieved the best area under curves (AUC) of 0.801 and gradient boosting machine (GBM) showed the best sensitivity of 0.271. SHAP method was introduced to display the RF model's predicting processes of “survival” or “death” in individual level. Conclusions We established the risk-prediction model for postoperative prognosis of HTx patients by using machine learning method and demonstrated that the RF model performed the highest discrimination with the largest AUC when validated. This prediction model could help to recognize high-risk HTx recipients, provide personalized therapy plan and reduce organ wastage.

Interleukin (IL)‐7 is known to enhance the macrophages cytotoxic activity and that macrophages play a pivotal role in the development and progression of myocardial ischaemia/reperfusion (I/R) injury. However, the effects of IL‐7 on macrophages infiltration and polarization in myocardial I/R injury are currently unclear. This study aimed to evaluate the effects of the IL‐7 expression on myocardial I/R injury and their relationship with macrophages. The data showed that IL‐7 expression in mouse heart tissue increases following I/R injury and that IL‐7 knockout or anti‐IL‐7 antibody treatment significantly improve I/R injury, including reduction in myocardial infarction area, a serum troponin T level decreases and an improvement in cardiac function. On the other hand, recombinant IL‐7 (rIL‐7) supplementation induces opposite effects and the anti‐IL‐7 antibody significantly reduces the cardiomyocyte apoptosis and macrophage infiltration. rIL‐7 cannot directly cause apoptosis, but it can induce cardiomyocyte apoptosis through macrophages, in addition to increase the macrophages migration in vitro. Anti‐IL‐7 antibody affects the cytokine production in T helper (Th) 1 and Th2 cells and also promotes the macrophages differentiation to M2 macrophages. However, anti‐IL‐7 antibody does not reduce the M1 macrophage number, and it only increases the ratio of M2/M1 macrophages in mice heart tissues after I/R injury. Taking together, these data reveal that IL‐7 plays an intensifying role in myocardial I/R injury by promoting cardiomyocyte apoptosis through the regulation of macrophage infiltration and polarization.

BACKGROUND: In recent years, ultrasound elastography (USE) has been the main diagnostic technique for benign and malignant thyroid nodules. However, it cannot display the blood flow signals of nodules with smaller diameters clearly, which decreases its diagnostic accuracy. METHODS: Chinese and English databases were searched using “ultrasonic elastography”, “benign and malignant thyroid nodules”, and “diagnose” as the search terms. RevMan 5.3 software was used for meta-analysis. RESULTS: A total of 11 randomized controlled trials (RCTs) were included. Eight articles analyzed clinical symptoms, and the heterogeneity test results were Chi(2) =7.46, df=7, I(2)=6%, and P=0.38; and Z=11.44, OR =14.58, 95% confidential interval (CI): 9.21–23.07, and P

Objective The Corona Virus Disease-19 (COVID-19) pandemic has evolved into the largest public health event in the world. Earlier COVID-19 studies have reported that the pandemic caused widespread impacts on mental health and sleep in the general population. However, it remains largely unknown how the prevalence of mental health problems and sleep disturbance developed and interacted in adolescents at different times in the epidemic. Methods 831 teenagers (aged 14–19) underwent a longitudinal follow-up study to evaluate the prevalence of mental health problems and sleep disturbance among adolescents before, during, and after the COVID-19 breakout in China and to explore the interaction between mental health and sleep across the three measurements. The chronotype, anxiety and depression level, sleep quality, and insomnia were investigated during each measurement. Results The adolescents had delayed sleep onset and sleep offset time, longer sleep duration during the quarantine than before and after the epidemic, whereas their chronotype tended to morning type during the epidemic. Yet, the highest prevalence of anxiety, depression, poor sleeper, and insomnia symptoms were observed before but not during the COVID-19 breakout. The females and adolescents who were eveningness type showed significantly higher anxiety and depression levels, poorer sleep quality, and severe insomnia status than the males and the intermediate and morning types. Sleep disturbance was positively associated with mental problems among three measurements. Pre-measured depression level significantly predicted sleep disturbance level at follow-ups. Conclusion These findings suggested that adolescents' high prevalence of mental health and sleep problems occurred before the COVID breakout and decreased during and after the epidemic. Gender and chronotype were significant risk factors associated with affective and sleep disturbances. Depression positively predicted later sleep problems, but not vice versa.

We aimed to establish and validate a user-friendly and clinically practical nomogram for estimating the probability of echocardiographic left ventricular hypertrophy (echo-LVH) indexed to BSA among hypertensive patients from northern China.A total of 4954 hypertensive patients were recruited from a population-based cohort study from January 2012 to August 2013. The dataset was randomly split into two sets: training (n = 3303) and validation (n = 1651). Three nomograms were initially constructed. That is the Cornell product nomogram, the non-ECG nomogram, and the integrated nomogram which integrated non-ECG risk factors and Cornell-voltage duration product. The least absolute shrinkage and selection operator strategies were employed to screen for non-ECG features. The performance of the nomograms was evaluated using discrimination, calibration, and decision curve analysis (DCA). The net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were also calculated.The AUCs, NRIs, IDIs, and DCA curves of the nomograms demonstrated that the integrated nomogram performed best among all three nomograms. The integrated nomogram incorporated age, sex, educational level, hypertension duration, SBP, DBP, eGFR, sleep duration, tea consumption, and the Cornell-voltage duration product. The AUC was 0.758 and had a good calibration (Hosmer-Lemeshow test, P = 0.73). Internal validation showed an acceptable AUC of 0.735 and good calibration was preserved (Hosmer-Lemeshow test, P = 0.19). The integrated nomogram was clinically beneficial across a range of thresholds of 10-50%.The integrated nomogram is a convenient and reliable tool that enables early identification of hypertensive patients at high odds of LVH and can assist clinicians in their decision-making.

Under the current situation of epidemic prevention and control, to ensure the continuous progress of student learning, Chinese Ministry of Education put forward the initiative of "suspension of classes without suspension of school". Primary and secondary schools have adopted online learning at home for students to "open schools in the cloud. There is a big difference between online learning and classroom learning. In this process, problems such as increased teaching burden of teachers, lack of interaction between teachers and students, and students' lack of active learning are also exposed. Video learning are a new type of teaching resource. It can improve the efficiency of primary school mathematics teaching by using video learning reasonably. Based on the above analysis, the purpose of this research is to investigate the development of primary school students' logical reasoning ability through the use of video leanings for auxiliary teaching. The research method adopts the experimental method and is divided into the experimental class and control class. The subjects of the study were 72 students from a primary school in Indonesia. Experimental results show that video learning for auxiliary teaching can effectively develop students' logical reasoning ability.

Metastasis is the leading cause of death in breast cancer patients. Osthole, as an active compound detected in the traditional Chinese medicine Wenshen Zhuanggu Formula, has shown a promising anti-metastatic activity in human breast cancer cells, but the underlying mechanisms remain ambiguous. In this study we elucidated the anti-metastatic mechanisms of osthole in highly metastatic breast cancer cells and a zebrafish xenograft model. We showed that the expression of integrin α3 (ITGα3) and integrin β5 (ITGβ5) was upregulated in highly metastatic MDA-MB-231, MDA-MB-231BO breast cancer cell lines but was downregulated in poorly metastatic MCF-7 breast cancer cell line, which might be the key targets of osthole's anti-metastatic action. Furthermore, we showed that knockdown of ITGα3 and ITGβ5 attenuated breast cancer cell migration and invasion possibly via suppression of FAK/Src/Rac1 pathway, whereas overexpression of ITGα3 and ITGβ5 caused the opposite effects. Consistently, osthole significantly inhibited breast cancer metastasis by downregulating ITGα3/ITGβ5 signaling in vitro and in vivo. These results provide new evidence that osthole may be developed as a candidate therapeutic drug for metastatic breast cancer.

Wearable gas sensors can improve early warning provision for workers in special worksites and can also be used as flexible electronic platforms. Here, the flexible multifunctional gas sensor was prepared by grafting graphene oxide (GO)-Ag onto cotton fabric after swelling. The maximum bacterial inhibition rate of GO-150/cotton fabric was 95.6% for E. coli and 87.6% for S. aureus, while retaining the original high moisture permeability of cotton fabric. So GO/cotton fabric can resist the multiplication of bacteria. At the same time, GO can greatly improve the UV protection performance of cotton fabric used in garments. With increase of the GO concentration, the UV protection ability of composite fabric is enhanced. Finally, GO-Ag/cotton fabric sensors had stable NH3 gas-sensitive properties and good washing stability. In conclusion, these cotton fabric sensors with antibacterial properties, UV resistance and highly sensitive gas-sensitive properties have potential applications in wearable early warning devices and textile products.

Kangxian ruangan (KXRG) is a traditional Chinese medicine (TCM) formula consisting of 12 herbs. TCM syndrome differentiation proposes that KXRG exerts pharmacological effects against nonalcoholic fatty liver disease (NAFLD) fibrosis. This work investigates the effect of KXRG on NAFLD fibrosis in vivo and in vitro. In vivo, the NAFLD fibrosis model was constructed in Wistar rats using methionine- and choline-deficient (MCD) diet, followed by KXRG (0.92 g/kg/d) treatment for 8 weeks. In vitro, primary hepatic stellate cells (HSCs) were activated using platelet-derived growth factor (PDGF) and treated with KXRG. Molecular mechanisms underlying fibrosis were investigated. After 8 weeks, compared with the control groups, the histological lesions, degree of fibrosis, and inflammatory reaction increased with the MCD diet as demonstrated by histological changes and increased fibrosis-related (α-SMA, TGF-β, COL1A1, and desmin, P < 0.01 ) and inflammation-related factors (TNF-α, MCP-1, and F4/80, P < 0.01 ), whereas they decreased with KXRG treatment ( P < 0.01 ). KXRG not only inhibited the proliferation of activated HSCs and promoted their apoptosis but also resulted in G0-G1 arrest. Furthermore, KXRG suppressed HSC activation ( P < 0.01 ), collagen synthesis ( P < 0.01 ), and α-SMA expression ( P < 0.01 ) with PDGF stimulation. In both the MCD diet-induced animal model and PDGF-induced cell model, KXRG inhibited TGF-β and TLR4 signaling ( P < 0.01 ), similar to corresponding small-molecule inhibitors. These results demonstrated that KXRG might exert suppressive effects against NAFLD fibrosis via regulating TGF-β and TLR4 signaling. KXRG may act as a natural and potent therapeutic agent against NAFLD.

BackgroundTo verify the efficacy and safety of an inexpensive standardized regimen for multidrug-resistant tuberculosis (MDR-TB) with low resistance to isoniazid (INH), a multicenter prospective study was conducted in eastern China.MethodsPatients diagnosed as MDR-TB with low concentration INH resistance and rifampicin resistance, second-line/injectable agents sensitive were prospectively enrolled, given the regimen of Amikacin (Ak)–Fluoroquinolones (FQs)–Cycloserine (Cs)–Protionamide (Pto)–PasiniaZid (Pa)–Pyrazinamide (Z) for 6 months followed by 12 months of FQs–Cs–Pto–Pa–Z, and then followed up for treatment outcomes and adverse events (AEs).ResultsA total of 114 patients were enrolled into the study. The overall favorable treatment rate was 79.8% (91/114). Among 91 cases with favorable treatment, 75.4% (86/114) were cured and 4.4% (5/114) were completed treatment. Regarding to unfavorable outcomes, among 23 cases, 8.8% (10/114) had failures, 8.8% (10/114) losing follow up, 0.9% (1/114) had treatment terminated due to intolerance to drugs and 1.8% (2/114) died. Treatment favorable rate was significantly higher in newly treated MDR-TB (91.7%, 33/36) than that in retreated MDR-TB (74.4%, 58/78,p0.03). The investigators recorded 42 AEs occurrences in 30 of 114 patients (26.3%). Clinicians rated most AEs as mild or moderate (95.24%, 40/42).ConclusionsThe regimen was proved to be effective, safe and inexpensive. It is suitable for specific drug resistant population, especially for newly-treated patients, which could be expected to be developed into a short-course regimen.Clinical trials registrationChina Clinical Trial Registry ChiCTR-OPC-16009380

Herein, a novel Au nanoclusters/Cu2O (Au NCs/Cu2O) heterostructure exhibited exceptionally strong electrochemiluminescence (ECL) emission, in which the p-type semiconductor Cu2O was defined as the electrosensitizer to provide the electrogenerated holes for rapidly transferring the electrogenerated hot electrons of Au NCs. Thus, the fast charge transfer of Au NCs/Cu2O was achieved by the electrosensitizer compared to the sluggish one via intramolecular covalent bond charge transfer of traditional Au NCs, resulting in a greatly higher ECL efficiency (63.8%) than that of pure Au NCs (2.7%) versus the standard [Ru(bpy)3]2+. It solved one main challenge of electrochemiluminophore-based metal NCs: high efficiency with energic charge-transport kinetics. As a proof of concept, Au NCs/Cu2O was successfully employed in an ultrasensitive ECL biosensing platform for determining the biological antioxidant glutathione with a limit of detection (LOD) as low as 6.3 pM. The heterostructure as an ECL emitter is a very promising start for guiding the rational design of efficient electrochemiluminophores in intense light-emitting devices and high-definition ECL imaging.

To solve the problems of unbalanced network loads, poor network throughput, and low user transmission rate in 5th generation (5G) vehicular networks, a user-centric data communication service (UCDCS) strategy is proposed for 5G vehicular networks. First, the UCDCS model is established. The access roadside unit group (ARSUG) is updated in real-time according to predictions of vehicle mobility. Then, a data communication service resource allocation algorithm based on game theory that considers the network load cost, throughput cost, and vehicle benefit is developed. Based on the results of the algorithm, roadside unit (RSU) selection based on entropy weight is performed and the best RSU for data communication is selected according to the different service preferences of each vehicle. This improves the transmission rate for users and realizes network load balance to ensure the quality of service for users. The simulation results show that the transmission rate of the UCDCS strategy is 35.16%, 23.46%, and 47.74% higher than those of the traditional handover management (THOM), improved mobility management (IMM), and network-centric network selection strategies (NCNS), respectively; correspondingly, the link reliability is at least 0.07% higher, and the network delay is at least 5.96% smaller for the UCDCS strategy.

BACKGROUND The aim of our study is to investigate the impact of the simple breathing exercises (LHP's respiratory rehabilitation for pulmonary fibrosis, LHP's RRPF) on patients with idiopathic pulmonary fibrosis (IPF). METHODS (I) The safety and effectiveness of LHP's RRPF were first verified in 20 healthy individuals. (II) A total of 101 patients with IPF administrated in Shanghai Pulmonary Hospital between January 2015 and May 2017 were screened, and 82 cases were randomly assigned to receive a 12-month LHP's RRPF program (exercise group) or usual medical care (control group). Lung function, chest X-ray, 6-minute walk distance (6MWD), quality of life (St. George's Respiratory Questionnaire, SGRQ), and EKG were measured at the 6th and 12th month during the trial. RESULTS At the 6th month visit, the exercise group showed improved SGRQ score and lung function parameters (FVC, FEV1, and DLCO). At the 12th months visit, the exercise group had significantly improved SGRQ score, 6MWD, and lung function (FVC, FEV1, and DLCO) compared to the control group (P

Purpose Skin cancer is the most common, yet oftentimes preventable, cancer type in the United States. Exposure to ultraviolet radiation from sunlight is the most prominent environmental risk factor for skin cancer. Besides environmental exposure, demographic characteristics such as race, age, and socioeconomic status may make some groups more vulnerable. An exploratory spatial clustering method is described for identifying clusters of vulnerability to skin cancer incidence and mortality based on composite indices, which combine data from environmental and demographic risk factors. Methods Based on county-level ultraviolet data and demographic risk factors, two vulnerability indices for skin cancer were generated using an additive percentile rank approach. With these indices, univariate local Moran's I spatial autocorrelation identified significant clusters, or hotspots, of neighboring counties with high overall vulnerability indices. Clusters were identified separately for skin cancer incidence and mortality. Results Counties with high vulnerabilities were spatially distributed across the United States in a pattern that generally increased to the South and West. Clusters of counties with high skin cancer incidence vulnerability were mostly observed in Utah and Colorado, even with highly conservative levels of significance. Meanwhile, clusters for skin cancer mortality vulnerability were observed in southern Alabama and west Florida as well as across north Alabama, north Georgia and up through the Tennessee-North Carolina area. Conclusions Future skin cancer research and screening initiatives may use these innovative composite vulnerability indices and identified clusters to better target resources based on anticipated risk from underlying demographic and environmental factors.

The food packaging industry is rapidly growing as a consequence of the development of nanotechnology and changing consumers' preferences for food quality and safety. In today's globalization of markets, active packaging has achieved many advantages with the capability to absorb or release substances for prolonging the food shelf life over the traditional one. Therefore, it is critical to developing multifunctional active packaging materials from biodegradable polymers with active agents to decrease environmental challenges. This review article addresses the recent advances in nanocelluloses (NCs)- baseds nanohybrids with new function features in packaging, focusing on the various synthesis methods of NCs-based nanohybrids, and their reinforcing effects as active agents on food packaging properties. The applications of NCs-based nanohybrids as antioxidants, antimicrobial agents, and UV blocker absorbers for prolonging food shelf-life are also reviewed. Overall, these advantages make the CNs-based nanohybrids with versatile properties promising in food and packaging industries, which will impact more readership with concern for future research.

The case study reported in the paper investigated the effect of Project-based learning on students training to be mathematics teachers, pursuing their final projects. The final projects had as an aim of designing attractive and interactive mathematics learning material. This study used a qualitative method to assess the impact on the trainee teachers in terms of their creative design thinking. The research made use of the Hawgent dynamic mathematics software package. The study participants were all students at Guangxi Normal University, China. The students were divided into three groups, each with four or five members. The results presented show that selecting material and combining it with art using dynamic mathematics software can improve the communication skills, problem-solving and creative thinking skills, and improve the prospective teachers' self-confidence. Moreover, it was found that prospective mathematics teachers need motivation and support during their projects' lifecycle and that motivation has a positive effect on improving self-confidence.

Background Microwave ablation (MWA) and radiofrequency ablation (RFA) have recently attracted interest as minimally invasive treatment modalities for papillary thyroid carcinoma (PTC). However, the ablation outcomes of T1N0M0 PTC are not well characterized. Purpose To evaluate the efficacy and safety of thermal ablation (MWA or RFA) of solitary T1N0M0 PTC in patients who were ineligible for (due to presence of comorbid cardiovascular disease, renal failure, other malignancy, etc) or who refused surgery. Materials and Methods This was a retrospective multicenter study of 847 patients (660 women) who underwent thermal ablation for PTC (673 T1a, 174 T1b) between March 2015 and March 2020; of these patients, 645 underwent MWA and 202 underwent RFA. The mean age of patients was 46 years ± 11 (standard deviation) (age range, 18-81 years); the mean follow-up time was 22 months ± 13 (range, 6-60 months). Changes in tumor size and volume and the rates of technical success, tumor disappearance, disease progression, and complications were assessed. Results The technical success rate was 100%. Relative to preablation measurements, the maximum diameter and volume of the ablation zone increased during the 1st month after ablation (P < .001), whereas there was no difference by the 3rd month; subsequently, the tumors showed reduction in size at 6, 9, and 12 months (all P < .001). Complete disappearance of tumors occurred in 68% of patients (577 of 847; 69% [466 of 673] in the T1a group vs 64% [111 of 174] in the T1b group; P < .001). The postablation disease progression rate was 1.1% (nine of 847 patients; 0.9% [six of 673 patients] in the T1a group vs 1.7% [three of 174 patients] in the T1b group; P = .54). The overall complication rate was 3.4% (29 of 847 patients; 2.7% [18 of 673 patients] in the T1a group vs 6.3% [11 of 174 patients] in the T1b group; P = .02). Conclusion This multicenter study provided evidence that thermal ablation is an effective and safe treatment option in selected -patients with solitary T1N0M0 papillary thyroid carcinoma. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Baek and Cho in this issue.

Introduction D-CARE, an international, phase 3, randomized, double-blind, placebo-controlled study in women with early-stage breast cancer at high risk of disease recurrence, failed to meet its primary endpoint—improvement in bone metastasis-free survival (BMFS) with adjuvant denosumab vs placebo injections. As a result of the limitations of assessing BMFS, which includes relapse in bone with and without extraskeletal recurrences and deaths from any cause, the prespecified exploratory bone endpoints’ analysis may provide a more clinically meaningful effect of denosumab in this disease setting. Methods The study enrolled women (aged ≥ 18 years) with histologically confirmed stage II/III breast cancer. Patients treated with adjuvant/neoadjuvant chemotherapy meeting inclusion criteria were randomly assigned 1:1 to receive either denosumab (120 mg) or placebo subcutaneously every 3–4 weeks for about 6 months and then every 3 months for a total treatment duration of 5 years. Five prespecified exploratory bone endpoints and post hoc subgroup analysis based on age (

Conventional concrete frames are designed to dissipate the earthquake energy through inelastic deformation of the structural elements. It leads to hefty repairment costs and prolonged down time after earthquakes. Self-centering concrete frames (SCCF) have been introduced to minimize the unrecoverable structural damages and post-earthquake repairment costs. SCCF exhibits predictable yield mechanism and self-centering capacity. This paper presents an energy-based seismic design (EBSD) procedure for SCCFs. Based on a proposed damage model, hysteretic energy demand, EH, is introduced as a key design parameter. The desired damage state and structural deformations can be considered in design process. EBSD allows designers to select various performance objectives at different seismic intensities. A prototype building is designed using the proposed EBSD procedure. The performance of SCCF designed using EBSD is compared with the same prototype structure designed using direct displacement-based design method (DDBD). The results show that SCCF has high performance with low residual drift. The performance of the EBSD designed SCCF exhibits more controlled damage compared with the DDBD designed SCCF.

This paper presents a displacement-based seismic design method for building structures equipped with viscoelastic dampers (VEDs) featuring strong nonlinear characteristics. First, major insights from recent analytical and experimental research on this type of VEDs, including their behavior and sources of nonlinearity, are briefly introduced. Then, a simplified response spectra-based method for estimation of the peak seismic response of the structure without and with VEDs is proposed. Here, the undamped and damped structures are reduced to equivalent single-degree-of-freedom (SDOF) systems through linearization procedures. The simplified analysis method allows for the assessment of the effects of VEDs on the structural response through a set of analytical expressions formulated in terms of two parameters controlling the design of the dampers: (1) the VED design strain; and (2) the stiffness ratio of the dampers to the main structure. In the displacement-based design procedure proposed here, the VED design strain is obtained from response history analyses of the base frame, whereas the stiffness ratio is determined through iterative calculations based on the simplified analysis method. Then, the design parameters are extended to the multi-degree-of-freedom (MDOF) system of the actual structure and VEDs are sized at each story. Finally, verification of the design layout is done through nonlinear time-history analysis. The use of time domain analysis procedures and simplified analysis tools to find the design parameters of the dampers provide the proposed methodology with a balance between accuracy and effectiveness. To illustrate the design process, the paper concludes with a design example of supplemental VEDs for the seismic retrofit of a 7-story reinforced concrete frame building.

This paper investigates optimal configurations of combined damped outrigger systems (CDOs) using the newly proposed frequency domain analysis-based simplified models. The CDOs are constructed by the viscous-damper outrigger and the buckling-restrained-brace outrigger arranged vertically in different heights. This paper includes two types, CDO_11 (buckling-restrained-brace outrigger above viscous-damper outrigger), and CDO_22 (viscous-damper outrigger above buckling-restrained-brace outrigger). First, the paper proposes a simplified analytical model of a general outrigger system to derive a theoretical solution for the dynamic response of the structure in the time domain. Then, the solution in the time domain is transformed to the frequency domain via the Laplace transformation. The first-mode frequency response function is used to obtain the optimal locations for different types of outrigger systems. Finally, this paper compares the vibration characteristics of the outrigger systems in terms of the amplitude, phase, and variance of the response.

Pediatric lymphoma is a kind of malignant tumor with high mortality. The complexity of pediatric lymphoma shows a great challenge for effective diagnosis and treatment. In order to meet the challenge, the combination of pseudotargeted and targeted metabolomics was used to analyze the serum metabolites in pediatric lymphoma patients and healthy controls for discovering the metabolites related to pediatric lymphoma. The serum samples were obtained from the treatment group ( n = 43 ), the control group ( n = 26 ), and the patients group ( n = 18 ). A total of 17 serum metabolites, including carnitine, leucine, creatine, urea, (6Z,9Z,12Z)-octadecatrienoic acid, linoleate, octadecenoic acid, L-palmitoylcarnitine, hexadecanoic acid, tetradecanoic acid, (9Z)-hexadecenoic acid, uric acid, glucose, 1-methylnicotinamide, hypoxanthine, L-glutamine, and taurine, were found to be related to pediatric lymphoma. They could provide a scientific diagnostic basis and therapeutic target for pediatric lymphoma and elucidate the mechanism of pediatric lymphoma.

BACKGROUND To explore the clinical efficacy, safety, and prevention of major adverse reactions of the non-steroidal anti-inflammatory drug celecoxib combined with OxyContin and Pregabalin in the treatment of cancerous pudendal neuralgia. METHODS A total of 51 patients presenting with pelvic malignancies with cancerous pudendal neuralgia were selected, and random number table method was used to allocate them to either the experimental group (n=27) or control group (n=24). The control group was treated with OxyContin combined with Pregabalin, and the experimental group was treated with Celecoxib on the basis of the control group. RESULTS At 24 hours after treatment, the clinical effective rate of the experimental group was 92.6%, which was significantly higher than the 66.7% of the control group (P

Background The optimal dose and fractionation scheme of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) remains unclear due to different tolerated liver volumes and degrees of cirrhosis. In this study, we aimed to verify the dose-survival relationship to optimize dose selection for treatment of HCC. Methods This multicenter retrospective study included 602 patients with HCC, treated with SBRT between January 2011 and March 2017. The SBRT dosage was classified into high dose, moderate dose, and low dose levels: SaRT (BED10 ≥ 100 Gy), SbRT (EQD2 > 74 Gy to BED10 2 Results The median tumor size was 5.6 cm (interquartile range [IQR] 1.1–21.0 cm). The median follow-up time was 50.0 months (IQR 6–100 months). High radiotherapy dose correlated with better outcomes. After classifying into the SaRT, SbRT, and ScRT groups, three notably different curves were obtained for long-term post-SBRT survival and intrahepatic control. On multivariate analysis, higher radiation dose was associated with improved OS, PFS, and intrahepatic control. Conclusions If tolerated by normal tissue, we recommend SaRT (BED10 ≥ 100 Gy) as a first-line ablative dose or SbRT (EQD2 ≥ 74 Gy) as a second-line radical dose. Otherwise, ScRT (EQD2

Contains fulltext : 235277.pdf (Publisher’s version ) (Closed access) BACKGROUND: Balancing the risks of recurrent ischaemic stroke and intracranial haemorrhage is important for patients treated with antithrombotic therapy after ischaemic stroke or transient ischaemic attack. However, existing predictive models offer insufficient performance, particularly for assessing the risk of intracranial haemorrhage. We aimed to develop new risk scores incorporating clinical variables and cerebral microbleeds, an MRI biomarker of intracranial haemorrhage and ischaemic stroke risk. METHODS: We did a pooled analysis of individual-patient data from the Microbleeds International Collaborative Network (MICON), which includes 38 hospital-based prospective cohort studies from 18 countries. All studies recruited participants with previous ischaemic stroke or transient ischaemic attack, acquired baseline MRI allowing quantification of cerebral microbleeds, and followed-up participants for ischaemic stroke and intracranial haemorrhage. Participants not taking antithrombotic drugs were excluded. We developed Cox regression models to predict the 5-year risks of intracranial haemorrhage and ischaemic stroke, selecting candidate predictors on biological relevance and simplifying models using backward elimination. We derived integer risk scores for clinical use. We assessed model performance in internal validation, adjusted for optimism using bootstrapping. The study is registered on PROSPERO, CRD42016036602. FINDINGS: The included studies recruited participants between Aug 28, 2001, and Feb 4, 2018. 15 766 participants had follow-up for intracranial haemorrhage, and 15 784 for ischaemic stroke. Over a median follow-up of 2 years, 184 intracranial haemorrhages and 1048 ischaemic strokes were reported. The risk models we developed included cerebral microbleed burden and simple clinical variables. Optimism-adjusted c indices were 0·73 (95% CI 0·69-0·77) with a calibration slope of 0·94 (0·81-1·06) for the intracranial haemorrhage model and 0·63 (0·62-0·65) with a calibration slope of 0·97 (0·87-1·07) for the ischaemic stroke model. There was good agreement between predicted and observed risk for both models. INTERPRETATION: The MICON risk scores, incorporating clinical variables and cerebral microbleeds, offer predictive value for the long-term risks of intracranial haemorrhage and ischaemic stroke in patients prescribed antithrombotic therapy for secondary stroke prevention; external validation is warranted. FUNDING: British Heart Foundation and Stroke Association.

The Multi-Attribute Method (MAM) Consortium was initially formed as a venue to harmonize best practices, share experiences, and generate innovative methodologies to facilitate widespread integration of the MAM platform, which is an emerging ultra-high-performance liquid chromatography-mass spectrometry application. Successful implementation of MAM as a purity-indicating assay requires new peak detection (NPD) of potential process- and/or product-related impurities. The NPD interlaboratory study described herein was carried out by the MAM Consortium to report on the industry-wide performance of NPD using predigested samples of the NISTmAb Reference Material 8671. Results from 28 participating laboratories show that the NPD parameters being utilized across the industry are representative of high-resolution MS performance capabilities. Certain elements of NPD, including common sources of variability in the number of new peaks detected, that are critical to the performance of the purity function of MAM were identified in this study and are reported here as a means to further refine the methodology and accelerate adoption into manufacturer-specific protein therapeutic product life cycles.

Background Critical illness is associated with cognitive, physical, and psychological impairments; however, evidence of the severity and frequency of impairments in Chinese survivors of mechanical ventilation in an intensive care unit (ICU) remains limited. Our aim was to investigate the incidence and severity of impairments in Chinese survivors of mechanical ventilation in ICU and to explore risk factors influencing specific impairments. Methods Patients discharged alive after mechanical ventilation in a large general ICU for ≥2 days were enrolled in this single-center cross-sectional study. Survivors were evaluated using measures of functional disability (Activity of Daily Living Scale), and post-traumatic stress disorder (PTSD, The Impact of Event Scale-Revised) via telephone interview. Multivariable analysis was conducted. Results Data were obtained from 130 consenting survivors. At follow-up (mean: 19.64 months), among those in part-time or full-time employment prior to admission, only 45.1% had returned to work. Further, 29.2% of survivors had clear disabilities affecting daily living. Deficits in activities of daily living (ADL) were mainly characterized by impairment of instrumental ADL. Predictors of ADL in mechanically ventilated survivors included age, ICU admission diagnosis, and Acute Physiology And Chronic Health Evaluation II (APACHE II) score, which accounted for 33.5% of total variance. Furthermore, 17.7% of participants had symptoms consistent with PTSD. ICU length of stay was the only predictor of PTSD, and accounted for 7.5% of total variance. Conclusions ICU survivors of mechanical ventilation in China face negative impacts on employment, and commonly have ADL impairment and PTSD. Age, ICU admission diagnosis, and APACHE II score were key factors influencing ADL, while ICU length of stay was the only factor affecting PTSD. These findings suggest that some survivors who have had certain exposures may warrant closer follow-up, and systematic interventions for these high-risk survivors should be developed in China.

Background In many countries, nurses are ill-prepared to provide care to patients with terminal illnesses. Limited education and training affect their ability to deliver proper palliative care. Only a few studies have explored appropriate and effective training methods of palliative care in China. Therefore, we aimed to provide evidence for a palliative care training system by appraising the effects of a mixed-method intervention on participants’ knowledge of palliative care and attitudes towards dying patients and death. Methods An e-learning intervention approach was adopted for 97 nurses from oncology departments across five hospitals, using a mobile terminal combined with a virtual forum and face-to-face interactions. We conducted a pre- and post-training evaluation through the Palliative Care Quiz of Nursing (PCQN), Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B), and Death Attitude Profile-Revised (DAP-R). Results After a three-week intervention, there was a significant increase in the PCQN and FATCOD-B scores as compared to the baseline. For PCQN, the total score increased from 10.3 ± 1.9 to 11.1 ± 2.2 (p = .011) and the score for management of pain and other symptoms increased from 7.7 ± 1.7 to 8.4 ± 1.7 (p = .003). FATCOD-B scores increased noticeably from 100.6 ± 7.9 to 102.9 ± 8.9 (p = .019). The DAP-R scores showed no obvious difference between pre- and post-intervention results. Conclusions The mixed-method intervention was effective in improving participants’ knowledge and attitudes about palliative care. The implementation of training for nurses at appropriate intervals during both education and professional life is required, especially regarding the improvement in participants’ attitudes towards death. Therefore, palliative care training in China should receive more attention.

BACKGROUND Computed tomography (CT) and magnetic resonance imaging (MRI) are both capable of predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC). However, which modality is better is unknown. PURPOSE To intraindividually compare CT and MRI for predicting MVI in solitary HCC and investigate the added value of radiomics analyses. STUDY TYPE Retrospective. SUBJECTS Included were 402 consecutive patients with HCC (training set:validation set = 300:102). FIELD STRENGTH/SEQUENCE T2-weighted, diffusion-weighted, and contrast-enhanced T1-weighted imaging MRI at 3.0T and contrast-enhanced CT. ASSESSMENT CT- and MR-based radiomics signatures (RS) were constructed using the least absolute shrinkage and selection operator regression. CT- and MR-based radiologic (R) and radiologic-radiomics (RR) models were developed by univariate and multivariate logistic regression. The performance of the RS/models was compared between two modalities. To investigate the added value of RS, the performance of the R models was compared with the RR models in HCC of all sizes and 2-5 cm in size. STATISTICAL TESTS Model performance was quantified by the area under the receiver operating characteristic curve (AUC) and compared using the Delong test. RESULTS Histopathologic MVI was identified in 161 patients (training set:validation set = 130:31). MRI-based RS/models tended to have a marginally higher AUC than CT-based RS/models (AUCs of CT vs. MRI, P: RS, 0.801 vs. 0.804, 0.96; R model, 0.809 vs. 0.832, 0.09; RR model, 0.835 vs. 0.872, 0.54). The improvement of RR models over R models in all sizes was not significant (P = 0.21 at CT and 0.09 at MRI), whereas the improvement in 2-5 cm was significant at MRI (P