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Libo Wang,1 Gan Li,1 Chang Yuan,1 Yuele Yang,1 Gongxia Ling,1 Jinyu Zheng,1 Yiyang Zhou,1 Tianlei Zhang,1 Wei Lin,2 Zhenlang Lin2 1Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People’s Republic of China; 2Department of Pediatrics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People’s Republic of ChinaCorrespondence: Wei Lin; Zhenlang Lin Email linwei1110@163.com; lzlprof2020@163.comAbstract: Coronavirus disease 2019 (COVID-19) has been circulating in many countries around the world, characterized by long incubation period, strong infectivity, strong variability, high population susceptibility and diversified transmission methods. Its causative agent is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Compared with adult patients, the clinical manifestations of COVID-19 in children are often dominated by mild or asymptomatic infections, but children are also important virus carriers and play an important role in the transmission of the virus. In addition, some children will show excessive inflammatory response and experience serious complications such as multisystem inflammatory syndrome in children (MIS-C). At present, the research on COVID-19 in children is still imperfect. This article will review epidemiological characteristics, the mechanism of action, variant characteristics, clinical manifestations, auxiliary examinations and treatment of children with COVID-19, in order to provide help for the diagnosis, treatment and research of children with COVID-19.Keywords: children, COVID-19, mutation, clinical manifestations, treatment

A low profile ultra-wideband tightly coupled dipole array is studied. The antenna elements are fed by Marchand baluns of small size and low cost. A metasurface based wide-angle impedance matching (MSWAIM) layer is introduced to replace the traditional dielectric WAIM, improving the beam scan performance and reducing the antenna profile. The simulation shows that the proposed antenna array can operate over 2.4-12.4 GHz, approximately 5:1 bandwidth with maximum scanning angle of 50o for both E plane and 45o for H plane. The antenna profile above the ground is only 0.578λH at the highest operating frequency. This antenna array can find its application in the forthcoming massive MIMO beamforming systems for 5G.

Link adaptation in coherent wireless communications has sparked great research enthusiasm. However, adaptive techniques are equally important for non-coherent counterparts although relatively less attention has been dedicated to. This letter studies the adaptive modulation for the energy detection (ED)-based non-coherent systems. Specifically, we consider a massive single-input multiple-output (SIMO) network, where a single-antenna user communicates with a base station (BS) with tens/hundreds of antennas. In particular, an optimization problem is formulated in order to find the signal-to-noise ratio (SNR) switching thresholds that maximize the average spectral efficiency (ASE). After deriving the SNR distribution and symbol error rate (SER), this problem is solved by applying the Lagrangian method. With switching thresholds, rate and power adaptation are made based on the instantaneous SNR. Numerical results indicate for the proposed scheme, there exists a trade-off between the target SER and ASE. That is, the ASE falls if one wishes to reduce the target SER. Under this circumstance, mounting more antennas can avoid the loss in ASE.

To report the blood pressure (BP) data obtained in the May Measurement Month (MMM) 2019 in China. Study participants were recruited if ≥18 years of age and had ideally not had their BP measured for ≥1 year. BP was measured three times consecutively with a 1-min interval in the sitting position, using a validated electronic BP monitor. Trained volunteer investigators administered a questionnaire to collect information on lifestyle, medical history, and use of medications. The measurement was performed in 238 387 participants in 250 sites across 31 China provinces. The majority of screening took place in hospitals or clinics (78.7%), with 17.1% in outdoor public areas and 4.2% in other settings. The study participants included 127 853 women (53.6%) and had a mean (±SD) age of 48.9 ± 16.2 years. The mean (of readings two and three) systolic/diastolic BP was 121.8/73.8 mmHg. In all hypertensive patients (n = 66 181, 27.8%), the awareness, treatment, and control rates of hypertension were 51.5%, 48.4%, and 29.1%, respectively. Linear regression models showed differences in systolic and diastolic BP according to sex and age and several other major characteristics, such as previous stroke, myocardial infarction, and diabetes mellitus, antihypertensive medication use and known hypertension, previous hypertension in pregnancy and current pregnancy, alcohol intake and current smoking, and body mass index. The MMM 2019 campaign has been successful in measuring BP in a large member of participants in China.

Phase transitions of hybrid materials have aroused widespread concern and call for an in-depth study on its structure design, because the structure and characteristics are closely related, which promote potential applications in the field of temperature sensors, dielectric switches, and actuators. However, designing materials with multiple phase transitions and a high phase transition temperature (Tr) remains a huge challenge. In order to deal with this key hurdle, we tried to regulate the structural components and successfully synthesized [MASD]

Electric spring (ES) has been proposed to suppress the fluctuations of critical load voltage under the condition of the increasing proportion of renewable energy in the power grid, but existing popular control methods have not fully released its application potential. Therefore, a novel control strategy that enables it to operate in the entire scope is proposed in this study, which differs from the conventional methods since the fully known of all system parameters is not indispensable. Furthermore, a seamless operating mode switching method is discussed, which is important for practical application. In the end, the simulation results in PSCAD/EMTDC verify that the ES can operate stably in various regions, and can seamlessly switch between capacitive and inductive modes.

Highlights • Potential risk of impertinent adminstration of Methylprednisolone in lumbar spine surgery. • The diagnosis of Addisonian crisis on perioperative duration in spine surgery when patient accepts intravenous Methylprednisolone. • The management strategies of perioperative Addisonian crisis induced by postoperative routine cessation of intravenous Methylprednisolone., Introduction Several complications of intravenous administration of Methylprednisolone in spine surgery have been reported previously. However, perioperative Addisonian crisis resulting from postoperative routine cessation of intravenous Methylprednisolone has been rarely reported. We here report a case of perioperative Addisonian crisis induced by postoperative routine cessation of intravenous Methylprednisolone. Presentation of case To report a 56-year-old lady was diagnosed with Addisonian crisis on postoperative duration of lumbar spine surgery after routine cessation of intravenous Methylprednisolone on postoperative day 5. Discussion There are potential risk and medical complexity of the intravenous administration of Methylprednisolone perioperatively when patients underwent spine surgery, especially the patients with a history of adrenal insufficiency or hypothyroidism, and other endocrine diseases. The early diagnosis and effective replacement therapy after cessation of intravenous glucocorticoid to keep normal serum hormone levels can reduce risk and complication of Addisonian crisis. Conclusion Addisonian crisis may be triggered by the discontinuation of exogenous glucocorticoid. Physicians need to be immediately aware of this potentially lethal complication in patients with endocrine system diseases.

The molecular machines are the smallest ideal model motor and won the 2016 Nobel Prize. They are famous for their unmatched performance and high availability in the fields of artificial micro-intelligence, storage and sensing, micro robots, precision medicine, biological manufacturing, etc. However, the physical and chemical mechanisms of motor motion at the micro scale are not completely clear, and the stability and controllability are both real challenges to be solved urgently. This hasgreatly hindered the progress and exploration of molecular motors. In view of this, we have designed a class of molecular machines that can be manipulated by heat or an electric field. This type of external field control is non-touching, non-destructive, energy-adjustable and structurally stable. Therefore, it is a completely random controllable molecular machine. The use of the macrocyclic crown ether phase transition materials we report here is a very feasible strategy to completely meet the above mentioned advantages. The two molecular motors, [(ClCH2CH2NH3)-(18-crown-6)][ClO4] (I) and [(ClCH2CH2NH3)-(18-crown-6)][PF6] (II), show dielectric and SHG (second harmonic generation) “ON” or “OFF” switching at 363 K and 343 K, respectively. Moreover, this presents an effective strategy for regulating the phase transition point (Tc) and SHG intensity with anions. In short, it is expected that this will open up new horizons for constructing switchable artificial molecular motors through phase transition materials.

Summary: To review the efficacy and complications of 125I seeds combined with percutaneous vertebroplasty for the treatment of metastatic spinal tumors. We searched PubMed/MEDLINE from its inception to November 2018 for articles on metastatic spinal tumors treated with 125I seeds combined with percutaneous vertebroplasty. A total of 273 articles were identified in PubMed/MEDLINE based on the search criteria. After deleting duplicate articles including two retrospective studies and three case control studies, five studies were included in this systematic review. In total, 161 patients aged from 49.2 to 62 years were included. The operative levels consisted of the thoracic vertebrae and lumbar vertebrae. Bone cement leakage occurred in 7 cases. None of the patients developed radiation myelopathy. Percutaneous vertebroplasty plus 125I seeds implantation is an effective palliative treatment and can alleviate back pain and enhance vertebral body strength in patients with end-stage spinal metastatic tumors. In future research, the effective dosage of 125I seeds implantation, the anchoring of seeds with safe distance, and the bone cement distribution in the vertebral body will be next research hotspot. Keywords: 125I seeds, Percutaneous vertebroplasty, Radioactive injury, Metastatic spinal tumor

At present, the absolute positioning accuracy and control accuracy of industrial serial robots need to be improved to meet the accuracy requirements of precision manufacturing and precise control. An accurate dynamic model is an important theoretical basis for solving this problem, and precise dynamic parameters are the prerequisite for precise control. The research of dynamics and parameter identification can greatly promote the application of robots in the field of precision manufacturing and automation. In this paper, we study the dynamical modeling and dynamic parameter identification of an industrial robot system with six rotational DOF (6R robot system) and propose a new method for identifying dynamic parameters. Our aim is to provide an accurate mathematical description of the dynamics of the 6R robot and to accurately identify its dynamic parameters. First, we establish an unconstrained dynamic model for the 6R robot system and rewrite it to obtain the dynamic parameter identification model. Second, we establish the constraint equations of the 6R robot system. Finally, we establish the dynamic model of the constrained 6R robot system. Through the ADAMS simulation experiment, we verify the correctness and accuracy of the dynamic model. The experiments prove that the result of parameter identification has extremely high accuracy and the dynamic model can accurately describe the 6R robot system mathematically. The dynamic modeling method proposed in this paper can be used as the theoretical basis for the study of 6R robot system dynamics and the study of dynamics-based control theory.

Advanced glycation end product (AGE) clearance may cause renal tubular injuries, such as changes in sodium reabsorption. We hypothesize that AGEs interact with sodium metabolism to influence blood pressure (BP). The study participants were outpatients who were suspected of having hypertension but had not been treated with antihypertensive medication. Clinic and ambulatory blood pressures were measured at baseline (n = 989) and during follow-up (median, 4.4 years, n = 293). Plasma AGE concentrations were measured by enzyme-linked immunosorbent assay. Twenty-four-hour urine was collected for measurements of creatinine, sodium and lithium. In a cross-sectional analysis (n = 989), subjects in the top quintile versus quintiles 1-4 of plasma AGE concentration had significantly (P ≤ 0.004) lower fractional excretion of lithium (18.3% vs. 21.6%) and fractional distal reabsorption rate of sodium (95.0% vs. 95.8%) but similar BP (P ≥ 0.25). However, there was an interaction between plasma AGE concentration and urinary sodium excretion in relation to diastolic BP (P ≤ 0.058). Only in participants with low urinary sodium chloride excretion (≤6 grams/day, n = 189), clinic (84.3 vs. 80.2 mmHg), 24-h (83.9 vs. 80.4 mmHg), daytime (87.8 vs. 84.8 mmHg) and nighttime (75.1 vs. 72.1 mmHg) diastolic BP at baseline were higher (P ≤ 0.05) in the top quintile than in quintiles 1-4 of plasma AGE concentration. In the longitudinal study (n = 383), similar trends were observed, with significant (P ≤ 0.05) differences in the increment in daytime diastolic BP (6.8 vs. -1.7 mmHg) and incidence of ambulatory and treated hypertension (hazard ratio 3.73) during follow-up. In conclusion, AGEs were associated with high BP, probably via enhanced proximal sodium handling and on low dietary sodium intake.

Image-based virtual try-on systems with the goal of transferring a target clothing item onto the corresponding region of a person have received great attention recently. However, it is still a challenge for the existing methods to generate photo-realistic try-on images while preserving non-target details(Fig. 1). To resolve this issue, we present a novel virtual try-on network, DP-VTON. First, a clothing warping module combines pixel transformation with feature transformation to transform the target clothing. Second, a semantic segmentation prediction module predicts a semantic segmentation map of the person wearing the target clothing. Third, an arm generation module generates arms of the reference image that will be changed after try-on. Finally, the warped clothing, semantic segmentation map, arms image and other non-target details (e.g. face, hair, bottom clothes) are fused together for try-on image synthesis. Extensive experiments demonstrate our system achieves the state-of-the-art virtual try-on performance both qualitatively and quantitatively.1

Background Hypertension and diabetes mellitus are often jointly present, especially in early onset cases of either disease. We investigated clinical characteristics of hypertensive patients with newly diagnosed diabetes and diabetic patients with newly diagnosed hypertension. Methods Our study subjects were recruited in a China nationwide multicenter registry of hypertension and diabetes (n = 2510). We performed logistic regression to compare patients seen for hypertension in cardiology, with newly diagnosed diabetes (n = 137) and patients seen for diabetes mellitus in endocrinology, with newly diagnosed hypertension (n = 155). Albuminuria was defined as a urinary albumin-to-creatinine ratio of ≥ 30 mg/g, and left ventricular hypertrophy according to the Cornell product index. Results These two groups of patients with both hypertension and diabetes mellitus were similar in most of the characteristics (P ≥ 0.06). However, hypertensive patients with newly diagnosed diabetes, compared to diabetic patients with newly diagnosed hypertension, had a significantly greater body mass index (26.3 vs. 25.4 kg/m2, P = 0.03) and slower heart rate (73.7 vs. 78.1 beats/min, P = 0.01). In logistic regression analyses adjusted for sex (48.3% women) and age (mean 60.0 ± 11.5 years), the odds ratio for newly diagnosed diabetes mellitus versus newly diagnosed hypertension was 1.27 (95% CI 1.03–1.56) and 0.80 (95% CI 0.66–0.96) for body mass index (+ 3 kg/m2) and heart rate (+ 10 beat/min), respectively. Hypertensive patients with newly diagnosed diabetes also had a lower prevalence of albuminuria (16.0% vs. 30.1%, P = 0.02) and slightly and non-significantly higher prevalence of left ventricular hypertrophy (5.1% vs. 1.9%, P = 0.14) than diabetic patients with newly diagnosed hypertension. Conclusions Earlier or later onset of hypertension than diabetes mellitus may have different risk factors and organ damage.

Prior research suggests that the use of third party (independent) consultants to review on-going projects is an effective way to recognize and prevent escalation of commitment. This study uses an experiment to investigate whether the type of consultant (internal or external) and the stated purpose of the task assigned to the consultant influences willingness to communicate concerns about a project manager’s decision to escalate an unprofitable project to top management. We find that explicitly asking internal consultants to communicate concerns reduces both their tendency to disagree with the project manager’s escalation decision and their willingness to communicate their concerns. In contrast, external consultants’ willingness to communicate escalation concerns is not affected by the stated purpose of their assigned task. Our findings have implications for organizations seeking to engage consultants as part of their management control to prevent project escalation.

As building information modeling (BIM) technology becomes mature, there is an increasing demand for the interaction or interoperability between BIM tools and various facility management (FM) systems, especially in semiconductor fabrication plants (FABs). Customized BIM services, i.e., plugin programs, have been developed for FM systems to reuse BIM data or functionality. However, such development may make an FM system more vulnerable to external changes such as BIM tool upgrades. The quality of BIM models reused may deteriorate sharply even if a slight change occurs in any of the upstream BIM services. Based on the model-driven architecture defined by Object Management Group, this research proposes a semi-automated FM system factory called EncapsulatingBIM4FM to formalize the reuse process of BIM services so that changes on BIM tools will not propagate to an FM system. A pilot system for selected FM tasks for an FAB in Taiwan was crafted using EncapsulatingBIM4FM. The tests demonstrated that BIM and FM systems can achieve software interoperability, and they can evolve independently based on individual requirements. BIM's central role in the management of a facility's lifecycle information could be established if EncapsulatingBIM4FM is utilized to develop associated FM systems for the facility.

Chemokines are important regulators of immune, inflammatory, and neuronal responses in peripheral and central pain pathway. The aim of this study was to investigate whether chemokine (C-X-C motif) ligand 13 (CXCL13) and its receptor (C-X-C chemokine receptor type 5, CXCR5) involve in the development of bone cancer pain (BCP) and the regulation of morphine analgesia in rats. The change of pain behaviors in BCP rats were measured by testing paw withdrawal threshold (PWT). The levels of CXCL13, CXCR5 and signal pathway proteins (p-p38, p-ERK and p-AKT etc.) in the spinal cord were measured via western blots. The expression of CXCL13 and CXCR5 in spinal cord was increased in BCP rats. The BCP rats showed decrease of PWTs, which was relieved by CXCR5i. Intrathecally injection of murine recombinant CXCL13 (mrCXCL13) decreased the PWTs of BCP rats and opposed morphine-induced analgesia in BCP rats. In BCP rats, the signal pathway proteins (p38, ERK and AKT) in the spinal cord were activated. CXCL13 and morphine had contrary effect on the phosphorylation of these proteins. MrCXCL13 directly increased the levels of p-p38, p-ERK and p-AKT in BCP rats. However, morphine decreased the levels of these proteins in BCP rats. While blocking the activation of p-p38, p-ERK and p-AKT, morphine analgesia was enhanced. These results suggest CXCL13 participated in bone cancer pain and opposed morphine analgesia via p38, ERK and AKT pathways. It may be a target to enhance pain management in cancer pain patients.

Causal discovery is crucial to obtain a deep understanding of the actual mechanism behind the online social network, e.g., identifying the influential individuals and understanding the interaction among user behavior sequences. However, detecting causal directions and pruning causal redundancy of online social networks are still the great challenge of existing research. This paper proposed a constraint-based approach, minimal causal network (MCN), to mine hidden non-redundant causal relationships behind user behavior sequences. Under the MCN, the transfer entropy with the adaptive causal time lag is used to detect causal directions and find causal time lags, while a permutation-based significance test is proposed to prune redundant edges. Experiments on simulated data verify the effectiveness of our proposed method. We also apply our approach to real-world data from Sina Weibo and reveal some interesting discoveries.

Currently, the aim of differentiating malignant from benign breast tumors and diagnosing early breast cancer is more accurately fulfilled with the addition of ultrasound (US) scans. Some studies have shown that three-dimensional (3D) imaging opens a new diagnostic window because of a better and more detailed impression of the spatial arrangement of focal breast masses. Therefore, we carried out this study to assess the efficacy of 3D-US diagnostic techniques for the detection of breast cancer using systemic analyses. We searched the MEDLINE, Pubmed, EMBASE, and Cochrane Library for using 3D-US for the diagnosis of breast cancer. The terms used were "three-dimensional ultrasound", "breast neoplasms", "sensitivity and specificity", and "accuracy". Patients were adults. The quality of the studies was checked according to Quality Assessment of Diagnostic Accuracy Studies criteria. We calculated the diagnostic accuracy rates and developed a meta-analysis to synthesize the results. Twelve studies of diagnostic tests were selected, which were of moderate to high quality. The pooled sensitivity was 0.923 (95% confidence interval [CI], 0.896-0.945), and the pooled specificity was 0.872 (95% CI, 0.849-0.893). The meta-analysis detected a threshold effect and heterogeneity between studies. The pooled positive likelihood ratio was 6.965 (95% CI, 5.242-9.255), the negative likelihood ratio was 0.106 (95% CI, 0.079-0.142), and the diagnostic odds ratio was 84.239 (95% CI, 52.237-135.84). This meta-analysis indicates that 3D-US has acceptable diagnostic accuracy rates in differentiating malignant from benign breast tumors.

As a new alternative to power transmission, low-frequency alternating current (LFAC) transmission system has a bright future for offshore wind power transmission. As a core equipment for LFAC system, modularised multi-level matrix converter (M3C) is a direct electric energy conversion device, which can achieve bi-directional power flow and provide any value of the power factor. In this study, the application of LFAC transmission system based on M3C (M3C-LFAC) for offshore wind farms is studied. For the characteristics of LFAC transmission system for offshore wind power, four types of LFAC offshore wind power grid-connected topological structure are proposed, and related control strategies are designed. By use of PSCAD/EMTDC to verify the feasibility of the proposed schemes, the advantages of the proposed topologies are verified through different working conditions.

We investigated associations of blood pressure (BP) with albuminuria and left ventricular hypertrophy (LVH) in young, middle and older aged patients with hypertension and/or diabetes mellitus.Study participants were treated patients with hypertension or diabetes, enrolled in a China nationwide registry. The 2510 patients were classified into young (45 years,The prevalence of albuminuria and ECG-LVH was 17.8 and 6.5%, respectively. Mean (±SD) systolic/diastolic BP was 132.0 ± 16.5/85.2 ± 11.9 mmHg, 136.8 ± 17.9/81.7 ± 11.2 mmHg, and 139.8 ± 16.7/75.8 ± 10.4 mmHg in the young, middle and older age groups. In the young age group, the prevalence of albuminuria increased from 8.8% in systolic/diastolic BP120/80 mmHg to 14.6, 16.0% and 16.5% in 120-129/80-84, 130-139/85-89 and ≥140/90 mmHg, respectively. The corresponding values were 8.9, 7.0, 18.1 and 22.2%, respectively, in the middle age group, and 21.2, 15.5, 16.4 and 24.4%, respectively, in the older age group. Adjusted analyses confirmed the J-shaped relation between BP and albuminuria in the older but not young age group. The prevalence of ECG-LVH was significantly (The association between BP and organ damage seems to differ in young, middle and older aged patients for albuminuria but not ECG-LVH.

For a rotating 2D lidar, the inaccurate matching between the 2D lidar and the motor is an important error resource of the 3D point cloud, where the error is shown both in shape and attitude. Existing methods need to measure the angle position of the motor shaft in real time to synchronize the 2D lidar data and the motor shaft angle. However, the sensor used for measurement is usually expensive, which can increase the cost. Therefore, we propose a low-cost method to calibrate the matching error between the 2D lidar and the motor, without using an angular sensor. First, the sequence between the motor and the 2D lidar is optimized to eliminate the shape error of the 3D point cloud. Next, we eliminate the attitude error with uncertainty of the 3D point cloud by installing a triangular plate on the prototype. Finally, the Levenberg&ndash, Marquardt method is used to calibrate the installation error of the triangular plate. Experiments verified that the accuracy of our method can meet the requirements of the 3D mapping of indoor autonomous mobile robots. While we use a 2D lidar Hokuyo UST-10LX with an accuracy of &plusmn, 40 mm in our prototype, we can limit the mapping error within &plusmn, 50 mm when the distance is no more than 2.2996 m for a 1 s scan (mode 1), and we can limit the mapping error within &plusmn, 50 mm at the measuring range 10 m for a 16 s scan (mode 7). Our method can reduce the cost while the accuracy is ensured, which can make a rotating 2D lidar cheaper.

Background. Monolithic restorations made of translucent yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) have become popular over the past few decades. However, whether aging affects the color and translucency of monolithic translucent Y-TZP is unclear. Objective. The aim of this systematic review and meta-analysis of in vitro studies was to evaluate the effects of aging on the color and translucency of monolithic translucent Y-TZP ceramics. Materials and Methods. This systematic review/meta-analysis was reported according to the PRISMA statement and registered in the OSF registries (https://osf.io/5qjmu). Four databases including Medline via the PubMed, Embase, and Web of Science databases and the Cochrane Library were searched using no publication year and language limits. The last search was executed on November 20, 2020. In vitro studies comparing the translucency and/or color of monolithic translucent Y-TZP ceramics before and after simulated aging were selected. Meta-analyses were performed using Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK) with random-effects models at a significance level of 0.05. A risk-of-bias assessment was also performed for the included studies. Results. Of the 188 potentially relevant studies, 13 were included in the systematic review. The hydrothermal aging duration ranged from 1 to 100 h at relatively similar temperatures (~134°C). In the general meta-analyses, the aged Y-TZP ceramics exhibited similar translucency parameter (TP), L ∗ , and b ∗ values compared with the nonaged controls ( P = .73 , P = .49 , and P = .62 , respectively). Moreover, there was a significant difference between the aged and nonaged Y-TZP ceramics in the a ∗ value ( P = .03 ; MD = − 0.26 ; 95% CI = − 0.51 to − 0.02 ), favoring the nonaged Y-TZP ceramics. The subgroup analyses showed that the duration of aging contributed to changes in the translucency and color of the Y-TZP ceramics. Conclusions. The optical properties of monolithic translucent Y-TZP ceramics were stable after hydrothermal aging at 134°C and 0.2 MPa for ≤20 h. Moreover, clinically unacceptable changes in the translucency and color of monolithic translucent Y-TZP ceramics were found after hydrothermal aging for >20 h.

Purpose Identifying factors that place patients at high risk for developing postoperative delirium is an important first step to reduce incidence. Frailty is associated with poor postoperative outcomes. This meta-analysis aims to determine the association between preoperative frailty and postoperative delirium. Design This is a systematic review and meta-analysis. Methods We used PubMed, Scopus, Embase, CINAHL, Cochrane, and Web of Science as databases for the search up to April 23, 2020. We included cohort studies that assessed postoperative delirium as the outcome and described the prevalence of delirium among participants during the postoperative period. Odds ratio and 95% confidence interval were calculated to examine the association. Findings Twenty cohort studies met our inclusion criteria, which included a total of 4,568 patients. We found that preoperative frailty was significantly associated with an increased risk of postoperative delirium (crude odds ratio: 3.28; 95% confidence interval: 2.51 to 4.28; I2 = 46.7%) (adjusted odds ratio: 2.45; 95% confidence interval: 1.58 to 3.81; I2 = 88.6%). Conclusions This meta-analysis showed that preoperative frailty is an independent risk factor for postoperative delirium. In patients undergoing cardiovascular surgery, there is a lower association between frailty and postoperative delirium. In patients with other types of surgery, preoperative frailty is closely related to postoperative delirium.

In this paper, we developed and integrated an AI-edge emotion recognition platform using multiple wearable physiological signals sensors: Electroencephalogram (EEG), electrocardiogram (ECG), and photoplethysmogram (PPG) sensors. The emotion recognition platform used two combined machine learning approaches based on two systems input and preprocessing: An EEG-based emotion recognition system and an ECG/PPG-based system. The EEG-based system is a convolution neural network (CNN) that classifies three emotions, happiness, anger and sadness. The inputs of the CNN are extracted from the EEG signals using short-time Fourier transform (STFT), and the average accuracy for a subject-independent classification reached 76.94%. The ECG/PPG-based system used a similar CNN with an extracted features vector as input. The subject-dependent ECG/PPG classification system reached an average accuracy of 76.8%. The proposed system was integrated using the RISC-V processor and FPGA platforms to implement realtime monitoring and classification on edge. A 3-to-1 Bluetooth piconet was deployed to transmit all physiological signals on a single platform access point and to make use of low power wireless technologies.

The application of building information modeling to facility management system has proven to help reduce management costs during operation and maintenance phase. However, whenever this type of facility management system is built and changed, it is often necessary to communicate with 1) programmers and facility experts, 2) facility experts, and 3) facility experts and systems. The study established a framework for abstracting the information of BIM to the architecture and attributes of ontology model based on interviews with several facility experts. Also, write a transition function that transforms UML to SWRL. Finally, the execution result of ontology model is automatically obtained through the ontology platform. Therefore, the experts only need to systemize the domain knowledge to form the UML, and then the result of the logic flow chart can be obtained. In the result section, the facility management system is developed to assist the emergency response through different facility managers and firefighters. The results of the implementation found that in the case of no need for programmers and personally establish and alter the system, the facilities related personnel have higher grasp and trust in the system, and save more time in addition to the convenience of personnel communication.

Sutong GIL utility tunnel project is a significant part of Huainan-Nanjing-Shanghai UHV AC transmission project. Sutong GIL connects 1000kV over-head transmission lines from Taizhou and Suzhou stations, and its length is about 5.5km. High voltage and large power flow of UHV AC transmission lines produce large induction current, which will cause difficult-extinguished secondary arc and reclosing failure.To solve the above problem, induction current rapid release devices are installed at both sides of Sutong GIL. Thus, there are four grounding devices for the same loop of Taizhou-Suzhou transmission lines, and the induction voltage and current are different under various grounding conditions, which should be concerned during system commissioning. Sutong GIL project divides Taizhou-Suzhou transmission lines into two parts, and the both open-looped over-head parts are earlier completed. This may cause voltage control and electromagnetic transient problems in system commissioning of the over-head parts of Huainan-Nanjing-Shanghai UHV AC transmission project. This paper focuses on key technical problems of system commissioning Sutong GIL utility tunnel project as well as Huainan-Nanjing-Shanghai UHV AC transmission project. Simulation studies have been carried out, and corresponding measures have been proposed, which have been applied in field commissioning.

Bacillus Calmette‑Guérin (BCG) is considered to be a successful biotherapy for treating bladder cancer (BCa). However, the underlying mechanisms of BCG have not been completely clarified, to date. The role of macrophages in BCG therapy for BCa has still not been determined in vivo. In the present study, the role and potential mechanism of BCG (0.25, 1.25 and 6.25 µg/mouse; intravenous) immunotherapy for BCa was investigated in a NOD/scid IL2Rg‑/‑ (NSI) mouse model by targeting macrophages in vivo. Notably, it was observed that NSI mice with T24 BCa cells displayed high levels of the macrophage marker CD11b+ F4/80+ after injection via the tail vein of live BCG, as well as a significant reduction in tumor volume. The levels of the inflammatory and macrophage maturation cytokines, such as tumor necrosis factor‑α, interleukin (IL)‑1β, IL‑6, IL‑12P70, TNF superfamily member 11 and monocyte chemotactic protein 1, were significantly increased in the serum and the tumor supernatant compared to that in normal control subjects. Furthermore, BCG promoted the expression of the pro‑differential genes Spi‑1 proto‑oncogene, early growth response protein 1, nuclear factor (NF)‑κB and proto‑oncogene c‑Fos in bone marrow. In conclusion, these observations indicate that the injection of live BCG can target macrophages against bladder tumor growth in vivo. The mechanism is likely related to the promotion of macrophage maturation, immune activation and increased numbers of macrophages infiltrating the bladder tumor.

We investigated association between blood pressure and glucose control and the prevalence of albuminuria and left ventricular hypertrophy (LVH) in patients with hypertension and diabetes. Our study participants were treated patients with both diseases, enrolled in a China nationwide registry. The 773 patients were classified into four groups according to the control status of hypertension (systolic/diastolic blood pressure [BP] ≤140/90 mm Hg) and diabetes (HbA1c

Background. Gastric cancer (GC) is one of the most common malignant tumors in the digestive system with high mortality globally. However, the biomarkers that accurately predict the prognosis are still lacking. Therefore, it is important to screen for novel prognostic markers and therapeutic targets. Methods. We conducted differential expression analysis and survival analysis to screen out the prognostic genes. A stepwise method was employed to select a subset of genes in the multivariable Cox model. Overrepresentation enrichment analysis (ORA) was used to search for the pathways associated with poor prognosis. Results. In this study, we designed a seven-gene-signature-based Cox model to stratify the GC samples into high-risk and low-risk groups. The survival analysis revealed that the high-risk and low-risk groups exhibited significantly different prognostic outcomes in both the training and validation datasets. Specifically, CGB5, IGFBP1, OLFML2B, RAI14, SERPINE1, IQSEC2, and MPND were selected by the multivariable Cox model. Functionally, PI3K-Akt signaling pathway and platelet-derived growth factor receptor (PDGFR) were found to be hyperactive in the high-risk group. The multivariable Cox regression analysis revealed that the risk stratification based on the seven-gene-signature-based Cox model was independent of other prognostic factors such as TNM stages, age, and gender. Conclusion. In conclusion, we aimed at developing a model to predict the prognosis of gastric cancer. The predictive model could not only effectively predict the risk of GC but also be beneficial to the development of therapeutic strategies.

This study aimed to determine the risk of severe postoperative complications (SPCs) in patients with gastric cancer and to construct a nomogram based on independently related factors to identify high-risk patients. We conducted a prospective study of 636 consecutive patients with gastric cancer who underwent radical gastrectomy. Degrees of sarcopenia and obesity were calculated before surgery. Factors contributing to SPCs were determined using univariate and multivariate analysis. A nomogram consisting of the independent risk factors was constructed to quantify the individual risk of SPCs. Logistic analysis revealed that sarcopenic obesity, age, open surgery, and combined resection were independent prognostic factors for SPCs. Sarcopenic obese patients have the highest risk in all patients (sarcopenic obesity vs normal, OR = 6.575 p = 0.001; sarcopenic obesity vs obesity, OR = 5.833 p = 0.001; sarcopenic obesity vs sarcopenia, OR = 2.571 p = 0.032), while obese patients share the similar rate of SPCs with normal people (obesity vs normal, OR = 1.056 p = 0.723). The nomogram we constructed was able to quantify the risk of SPCs reliably (c-index, 0.737). Sarcopenic obesity, together with age, open surgery, and combined resection are independent predictors of SPCs. Obesity will significantly increase the risk of SPCs in sarcopenic patient with gastric cancer, but it will not bring higher risk to normal patients. Our nomogram is a simple and practical instrument to identify patients at high risk of surgical complications.

Background: For critical patients in resuscitation room, the early prediction of potential risk and rapid evaluation of disease progression would help physicians with timely treatment, leading to improved outcome. In this study, it focused on the application of National Early Warning Score on predicting prognosis and conditions of patients in resuscitation room. The National Early Warning Score was compared with the Modified Early Warning Score) and the Acute Physiology and Chronic Health Evaluation II. Objectives: To assess the significance of NEWS for predicting prognosis and evaluating conditions of patients in resuscitation rooms. Methods: A total of 621 consecutive cases from resuscitation room of Xuanwu Hospital, Capital Medical University were included during June 2015 to January 2016. All cases were prospectively evaluated with Modified Early Warning Score, National Early Warning Score, and Acute Physiology and Chronic Health Evaluation II and then followed up for 28 days. For the prognosis prediction, the cases were divided into death group and survival group. The Modified Early Warning Score, National Early Warning Score, and Acute Physiology and Chronic Health Evaluation II results of the two groups were compared. In addition, receiver operating characteristic curves were plotted. The areas under the receiver operating characteristic curves were calculated for assessing and predicting intensive care unit admission and 28-day mortality. Results: For the prognosis prediction, in death group, the National Early Warning Score (9.50 ± 3.08), Modified Early Warning Score (4.87 ± 2.49), and Acute Physiology and Chronic Health Evaluation II score (23.29 ± 5.31) were significantly higher than National Early Warning Score (5.29 ± 3.13), Modified Early Warning Score (3.02 ± 1.93), and Acute Physiology and Chronic Health Evaluation II score (13.22 ± 6.39) in survival group ( p Conclusion: The performance of National Early Warning Score for predicting intensive care unit admission and 28-day mortality was inferior than Acute Physiology and Chronic Health Evaluation II but superior than Modified Early Warning Score. It was able to rapidly predict prognosis and evaluate disease progression of critical patients in resuscitation room.

The objective of the present study was to identify differential modules in ankylosing spondylitis (AS) by integrating network analysis, module inference and the attract method. To achieve this objective, four steps were conducted. The first step was disease objective network (DON) for AS, and healthy objective network (HON) inference dependent on gene expression data, protein-protein interaction networks and Spearman's correlation coefficient. In the second step, module detection was performed by utilizing a clique-merging algorithm, which comprised of exploring maximal cliques by clique algorithm and refining or merging maximal cliques with a high overlap. The third part was seed module evaluation through module pair matches by Jaccard score and module correlation density (MCD) calculation. Finally, in the fourth step, differential modules between the AS and healthy groups were identified based on a gene set enrichment analysis-analysis of variance model in the attract method. There were 5,301 nodes and 28,176 interactions both in DON and HON. A total of 20 and 21 modules were detected for the AS and healthy group, respectively. Notably, six seed modules across two groups were identified with Jaccard score ≥0.5, and these were ranked in descending order of differential MCD (ΔC). Seed module 1 had the highest ΔC of 0.077 and Jaccard score of 1.000. By accessing the attract method, one differential module between the AS group and healthy group was identified. In conclusion, the present study successfully identified one differential module for AS that may be a potential marker for AS target therapy and provide insights for future research on this disease.

As our world becomes more connected, globalized education becomes increasingly important. Drawing from educational cosmopolitanism and disciplinary inquiry, this collective case study focused on Chinese and US students’ demonstrations of the four capacities of Wahlstrom’s (2014) educational cosmopolitanism, i.e., hospitality, self-reflexivity, intercultural dialogue, and transactions of perspectives, throughout the phases of a cross-cultural collaborative inquiry project referred to as Project-Based Inquiry (PBI) Global. Data sources included (a) semi-structured student focus groups (post-PBI Global), (b) our observations and interactions with students throughout the process, (c) the students’ posts and uploads in their shared writing space, Quip, and (d) the students’ PBI Global products. Results shed light on how cross-cultural collaborative disciplinary inquiry fosters students’ demonstration and development of educational cosmopolitan capacities.

Detection of road or lane is indispensable for the environmental perception of advanced driver assistance systems. It has been an active field of research with a wide application prospect. However, due to the complex illumination and interferences, such as vehicles and shadows in the real driving environment, lane detection is still a challenging task today. To address these issues, a robust method for road segmentation and lane detection based on a normal map is proposed. The first step of this approach is to generate the normal map by using the depth information and then extract a segmented road pavement without vehicles and buildings based on the normal map. Second, we improve an adaptive threshold segmentation method and denoising operations to enhance the lane markings. Third, the combination of Hough transform and vanishing point makes it more accurate to determine the starting points of host lanes, and then the lanes in the following image sequence can be detected in the adaptive region of interest. Compared with the state-of-the-art methods, the experimental results on the data sets in two countries demonstrate that our approach produces more credible performance under various light conditions or dense traffic.

Intra-site prophylactic vancomycin in spine surgery is an effective method of decreasing the incidence of postsurgical wound infection. However, there are differences in the prophylactic programs used for various spinal surgeries. Thus, this systematic review and meta-analysis aimed to evaluate the effectiveness of using intra-wound vancomycin during spinal surgery and to explore the effects of dose-dependence and the method of administration in a subgroup analysis. A total of 628 citations or studies were searched in PubMed, Ovid, Web of Science, and Google Scholar that were published before August 2016 with the terms "local vancomycin", "intra-wound vancomycin", "intraoperative vancomycin", "intra-site vancomycin", "topical vancomycin", "spine surgery", and "spinal surgery". Finally, 19 retrospective cohort studies and one prospective case study were eligible for inclusion in the systematic review and meta-analysis. The odds of developing postsurgical wound infection without prophylactic local vancomycin use were 2.83-fold higher than the odds of experiencing wound infection with the use of intra-wound vancomycin (95% confidence interval, 2.03-3.95; P = 0.083; I2 = 32.2%). The subgroup analysis including the dosage and the method of administration, revealed different results compared to previous research. The value of I2 in the 1-g group was 27.2%, which was much lower than in the 2-g group (I2 = 57.6%). At the same time, the value of I2 was 0.0% (P = 0.792, OR = 2.70) when vancomycin powder was directly sprinkled into all layers of the wound. However, there is high heterogenicity (I2 = 60.0%, P = 0.007, OR = 2.83) when vancomycin powder is not exposed to the bone graft and instrumentation. There are differences found with the method of local application of vancomycin for reducing postoperative wounds and further studies are necessary, including investigations focusing on the dose-dependent effects during spinal or the topical pharmacokinetic and other orthopaedic surgeries.

Background/Objective: To compare the curative effect of single-stage and two-stage Fowler–Stephens (F–S) laparoscopic orchidopexy for intraabdominal high testis and explore the appropriate surgical approach. Methods: We performed a prospective analysis of the clinical data of 28 patients who underwent F-S laparoscopic orchidopexy for intraabdominal high testis in our department from May 2012 to April 2015, including 15 cases of the single-stage F-S operation and 13 cases of the two-stage F-S operation. By comparing the two groups preoperative and postoperative (6 months) clinical data of testicular position, testicular volume, and sex hormone levels [testosterone (T), follicle stimulating hormone (FSH), and estradiol (E2)], we analyzed the difference in efficacy between the two procedures. Results: Twenty-eight patients completed laparoscopic surgery, no case was converted, and no testis was excised. All patients were followed up for 9–25 months after the operation, with an average follow-up of 16.2 months. The postoperative testicular volume of the single-stage and two-stage F-S groups was not significantly reduced (p>0.05). In both groups, the postoperative T levels were significantly increased compared to the preoperative levels (p0.05). In the single-stage F-S group, the testes were located in the scrotum in 13 cases and retracted to the lower groin in two cases. In the two-stage F-S group, the testes were located in the scrotum in 12 cases and retracted to the lower groin in one case. The difference in postoperative testicular position between the two groups was not significant (p>0.05). Conclusion: In the case of testis with good collateral circulation, single-stage F-S laparoscopic orchidopexy had the same safety and efficacy as the two-stage F-S procedure. Surgical options should be based on comprehensive consideration of intraoperative testicular location, testicular ischemia test, and collateral circumstances surrounding the testes. Under the appropriate conditions, we propose single-stage F-S laparoscopic orchidopexy be preferred. It may be appropriate to avoid unnecessary application of the two-stage procedure that has a higher cost and causes more pain for patients.

Mullet roe is a product of high economic value in a number of Asian countries, particularly Taiwan. However, actual mullet roe is commonly adulterated by the addition of other species, such as escolar and oilfish. The purpose of this study was to develop a method to detect the ingredient of mullet roe products. Based on the TaqMan real-time PCR assay, we designed the specific primers-probe set (mullet) that targets the mitochondrial 16S ribosomal RNA gene. Meanwhile, the positive amplification control is designed based on the eukaryotic 18S rRNA gene. The PCR amplicon used to identify fish species in processed roe products is smaller than 200 bp. Method specificity was evaluated by analyzing tissue samples of 29 food fish and 9 puffer fish species. No indications of cross-reactivity toward non-target species were observed. Sensitivity and linearity tests were conducted using five-fold serial dilutions of target DNA from processed mullet roe, and we determined that our proposed method has a sensitivity of 1.2 ng. Further tests on a random survey of commercial fish roe products demonstrated the efficacy of the technique in the detection of mullet DNA. The real-time PCR methods developed in this study could be used to verify the labeling of actual mullet roe products.

Coexistence of Wi-Fi and Bluetooth (BT) systems is often necessary in various handheld devices. Due to nonlinearities of radio frequency front-end components, leakage signals from one transmitter to the other transmitter would produce out-of-band (OOB) interference and corrupt adjacent frequency bands outside the spectral masks defined in standards. In this letter, we propose an adaptive OOB interference suppression scheme based on a modified normalized least mean-squared algorithm for coexistent Wi-Fi and BT transceivers. Computer simulation results show that the proposed approach provides pretty good performance in transmitter leakage cancellation and effectively relieves the OOB interference issue.

In an 8‐week randomized trial of patients with mild or moderate hypertension, the authors investigated the efficacy and tolerability of initial high (5.0 mg/d) vs low (2.5 mg/d) doses of S‐(‐)‐amlodipine (equivalent to 5 and 10 mg of racemic amlodipine, respectively). In the S‐(‐)‐amlodipine 2.5‐mg group (n=263), 24‐hour ambulatory systolic/diastolic blood pressure (±standard deviation) decreased from 131.5±15.0/82.1±10.7 mm Hg at baseline to 126.0±13.5/78.5±9.5 mm Hg at 8 weeks of follow‐up by a least square mean (±standard error) change of 6.0±0.6/3.8±0.4 mm Hg. In the S‐(‐)‐amlodipine 5‐mg group (n=260), the corresponding changes were from 133.6±13.7/83.1±9.9 mm Hg to 125.0±12.0/78.2±8.9 mm Hg by 8.1±0.6/4.7±0.4 mm Hg, respectively. The between‐group differences in changes in 24‐hour systolic/diastolic blood pressure were 2.1/0.9 (P=.02/.17) mm Hg. Similar trends were observed for daytime and nighttime ambulatory and clinic blood pressure. The incidence rate was similar for all adverse events. An initial high dose of S‐(‐)‐amlodipine improved ambulatory blood pressure control with similar tolerability as an initial low dose in hypertension.

In this work, we proposed an edge AI CNN chip design for EEG-based affective Computing system by using TSMC 28nm technology. To improve the performance, Artifact Subspace Reconstruction (ASR) and Short-Time Fourier Transform (STFT) were used for our signal pre-processing and features extraction. The time-frequency EEG feature map was obtained with a multi-channel Differential Asymmetry (DASM) method on 6 EEG channels: FP1, FP2, F3, F4, T7, and T8 according to 10–20 system. The total power consumption of the proposed CNN chip was 71.6mW in training mode and 29.5mW in testing mode. We used 32 subjects data from the DEAP database to validate the proposed design, achieving mean accuracies of 83.7%, 84.5%, and 70.51% for Valence-Arousal binary classification and quaternary classification respectively, showing significant performance improvement over the current related works.

We analyze the far-field pattern symmetry of the planar spiral antenna backed by a ground plane. And a method to improve the pattern symmetry is proposed. By reducing the back radiation of the higher frequency band, an improved spiral antenna configuration is presented. This configuration replaces the center section of the planar spiral with a conical spiral. The broadside gain, axial ratio and pattern symmetry are compared. The results show that this novel configuration can achieve better far-field symmetry at a wider band.

A $5\times 5$ broadside slot array backed by a single cavity containing a mode filter is designed. The resonant slot length is obtained by using a waveguide slot model. The simulated and measured results show that this array achieves more than 8% −10dB return loss and 3dB gain bandwidth.

This work aims at building robust model for human mental state classification using EEG signals. We elaborated a highly reliable data validation set for emotion detection and chose support vector machine (SVM) as the classifier. The results of classification were evaluated by the characteristics observed on the output probability curve. The average accuracy and the maximum accuracy among the subjects of the proposed model achieved 78.28% and 97.50% respectively for the binary-class task.

Purpose The aim of this study was to evaluate the role of mesh technique in the reconstruction of the extensor mechanism after resection of proximal tibial tumors. Methods We retrospectively analyzed the cases of 14 patients who were diagnosed with proximal tibial tumors at our center and reconstructed with tumor prosthesis, gastrocnemius muscle, and mesh between 2012 and 2017. The treatment strategies for patellar tendon reconstruction primarily involve gastrocnemius reconstruction to cover the tumor prosthesis and mesh reconstruction for the patellar ligament. Results Among the 14 patients, the mean was 1.57° (range 0–12°) for active extension versus 105.00° (range 80–120°) for active flexion. The mean for passive extension was 0°. The passive flexion mean was 115.00° (range 90–120°). The extensor lag averaged 1.57° (range 0–12°), and the mean Musculoskeletal Tumor Society score (MSTS) was 23.57 (range 19–27). The average follow-up for all patients was 23.50 months (range 14–37). During the recent follow-up, all patients were able to walk without crutches. Two patients underwent above-the-knee amputation for local recurrence of the tumor, and lung metastasis occurred in three patients after operation. There were no postoperative complications. Conclusions Extensor lag was remarkably reduced in the surgery group in comparison to previous study reports. Surgical resection is a simple, reliable, and effective method to remove and control the tumor. Mesh reconstruction of patellar ligament is effective to reconstruct the extensor mechanism of the knee after excision of tumor.

Percutaneous vertebroplasty is often used to acquire the stability of the spine and relieve the pain caused by osteoporotic vertebral compressive fracture (OVCF). 125I seeds have been used for application of local therapy for tumors. A combined treatment was reported in previous literatures. Thus, this case report is aimed at reporting a patient with an occurrence of delayed radioactive myelopathy, who accepted percutaneous vertebroplasty combined with interstitial implantation of 125I seeds for metastatic spinal tumors, and at reviewing the published literatures.

By moving a commercial 2D LiDAR, 3D maps of the environment can be built, based on the data of a 2D LiDAR and its movements. Compared to a commercial 3D LiDAR, a moving 2D LiDAR is more economical. A series of problems need to be solved in order for a moving 2D LiDAR to perform better, among them, improving accuracy and real-time performance. In order to solve these problems, estimating the movements of a 2D LiDAR, and identifying and removing moving objects in the environment, are issues that should be studied. More specifically, calibrating the installation error between the 2D LiDAR and the moving unit, the movement estimation of the moving unit, and identifying moving objects at low scanning frequencies, are involved. As actual applications are mostly dynamic, and in these applications, a moving 2D LiDAR moves between multiple moving objects, we believe that, for a moving 2D LiDAR, how to accurately construct 3D maps in dynamic environments will be an important future research topic. Moreover, how to deal with moving objects in a dynamic environment via a moving 2D LiDAR has not been solved by previous research.