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In this article, we propose a novel method to simultaneously solve the data problem of dirty quality and poor quantity for person reidentification (ReID). Dirty quality refers to the wrong labels in image annotations. Poor quantity means that some identities have very few images (FewIDs). Training with these mislabeled data or FewIDs with triplet loss will lead to low generalization performance. To solve the label error problem, we propose a weighted label correction based on cross-entropy (wLCCE) strategy. Specifically, according to the influence range of the wrong labels, we first classify the mislabeled images into point label error and set label error. Then, we propose a weighted triplet loss (WTL) to correct the two label errors, respectively. To alleviate the poor quantity issue, we propose a feature simulation based on autoencoder (FSAE) method to generate some virtual samples for FewID. For the authenticity of the simulated features, we transfer the difference pattern of identities with multiple images (MultIDs) to FewIDs by training an autoencoder (AE)-based simulator. In this way, the FewIDs obtain richer expressions to distinguish from other identities. By dealing with a dirty and poor data problem, we can learn more robust ReID models using the triplet loss. We conduct extensive experiments on two public person ReID datasets: 1) Market-1501 and 2) DukeMTMC-reID, to verify the effectiveness of our approach.

Capturing long-range dependencies during feature extraction is crucial for video-based person re-identification (re-id) since it would help to tackle many challenging problems such as occlusion and dramatic pose variation. Moreover, capturing subtle differences, such as bags and glasses, is indispensable to distinguish similar pedestrians. In this paper, we propose a novel and efficacious Statistic Attention (SA) block which can capture both the long-range dependencies and subtle differences. SA block leverages high-order statistics of feature maps, which contain both long-range and high-order information. By modeling relations with these statistics, SA block can explicitly capture long-range dependencies with less time complexity. In addition, high-order statistics usually concentrate on details of feature maps and can perceive the subtle differences between pedestrians. In this way, SA block is capable of discriminating pedestrians with subtle differences. Furthermore, this lightweight block can be conveniently inserted into existing deep neural networks at any depth to form Statistic Attention Network (SANet). To evaluate its performance, we conduct extensive experiments on two challenging video re-id datasets, showing that our SANet outperforms the state-of-the-art methods. Furthermore, to show the generalizability of SANet, we evaluate it on three image re-id datasets and two more general image classification datasets, including ImageNet. The source code is available at http://vipl.ict.ac.cn/resources/codes/code/SANet code.zip.

STUDY DESIGN A meta-analysis. OBJECTIVE The aim is to compare the efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating Kummell's disease (KD) without neurological deficits. SUMMARY OF BACKGROUND DATA PVP and PKP are routine methods for the treatment of KD without neurological deficits; however, whether PVP or PKP is superior is a matter of debate. MATERIALS AND METHODS According to the Cochrane Handbook for Systematic Reviews of Interventions, PubMed, Embase, the Cochrane Library, and Web of Knowledge were searched for eligible randomized controlled trials or cohort studies. Two authors independently collected data and assessed the methodologic quality of the included studies. Intraoperative and postoperative clinical outcomes, cement leakage, refracture rate, and the costs during hospitalization were evaluated. RESULTS Five observational studies comparing 119 PVP and 128 PKP patients were included in qualitative and quantitative reviews. All of the included s studies had evidence of good quality, as assessed by the Newcastle-Ottawa scale. On the basis of meta-analysis the operation time [weighted mean difference: -10.65; 95% confidence interval (95% CI): -11.94 to -9.35; P

A subset of large non-functioning pituitary adenomas (lNFPA) and giant non-functioning pituitary adenomas (gNFPA) undergoes early progression/recurrence (P/R) after surgery. This study revealed the clinical and image predictors of P/R in lNFPA and gNFPA, with emphasis on solid tumor size. This retrospective study investigated the preoperative MR imaging features for the prediction of P/R in lNFPA (> 3 cm) and gNFPA (> 4 cm). Only the patients with a complete preoperative brain MRI and undergone postoperative MRI follow-ups for more than 1 year were included. From November 2010 to December 2020, a total of 34 patients diagnosed with lNFPA and gNFPA were included (median follow-up time 47.6 months) in this study. A total of twenty-three (23/34, 67.6%) patients had P/R, and the median time to P/R is 25.2 months. Solid tumor diameter (STD), solid tumor volume (STV), and extent of resection are associated with P/R (p p 3, with AUCs of 0.78 and 0.79 respectively. Kaplan–Meier analysis of tumor P/R trends showed that patients with larger STD and STV exhibited shorter progression-free survival (p

Peri‑implantitis, which is characterized by peri‑implant mucositis and alveolar bone resorption, significantly shortens the service life of dental implants. Melatonin is well-known for its anti-inflammatory and osteoprotective activities. Nevertheless, the effects and mechanisms of melatonin to prevent peri‑implantitis remain unknown. In this study, the lipopolysaccharide-induced peri‑implantitis model was established after the titanium implants were osseointegrated, and the rats received daily administrations of melatonin. The gingival fibroblasts and osteoclasts/osteoblasts were also co-cultured to simulate the inflammatory environment in vitro. We found that prophylactic administration of melatonin decreased proinflammatory cytokine levels and osteoclast numbers, attenuated alveolar bone resorption, and reduced the incidence of peri‑implantitis in vivo. Furthermore, melatonin suppressed osteoclastic formation and function in the inflammatory co-culture environment, while melatonin promoted osteoblastic differentiation and function in the in vitro model. Mechanistically, melatonin reduced TLR4 protein levels, and inhibited activation of NF-κB to downregulate the levels of TNF, IL-1β, and IL-6. These data showed that melatonin was a potent agent to prevent peri‑implantitis through inhibiting TLR4/NF-κB signaling. Our findings provide a novel strategy to prevent peri‑implantitis, and expand the applications of melatonin. Statement of significance Dental implants have become the first choice for restoring partial and full edentulism, but its service life is seriously affected by peri‑implantitis. Exploration of novel and effective approaches to prevent peri‑implantitis is an important and urgent need. In the present study, we have reported for the first time that prophylactic administration of melatonin delayed the occurrence and reduced the incidence of peri‑implantitis by decreasing proinflammatory cytokine levels, inhibiting osteoclastogenesis, and promoting osteogenesis. The study is expected to have an important significance on the prevention of peri‑implantitis.

Person reidentification (reID) by convolutional neural network (CNN)-based networks has achieved favorable performance in recent years. However, most of existing CNN-based methods do not take full advantage of spatial–temporal context modeling. In fact, the global spatial–temporal context can greatly clarify local distractions to enhance the target feature representation. To comprehensively leverage the spatial–temporal context information, in this work, we present a novel block, interaction–aggregation-update (IAU), for high-performance person reID. First, the spatial–temporal IAU (STIAU) module is introduced. STIAU jointly incorporates two types of contextual interactions into a CNN framework for target feature learning. Here, the spatial interactions learn to compute the contextual dependencies between different body parts of a single frame, while the temporal interactions are used to capture the contextual dependencies between the same body parts across all frames. Furthermore, a channel IAU (CIAU) module is designed to model the semantic contextual interactions between channel features to enhance the feature representation, especially for small-scale visual cues and body parts. Therefore, the IAU block enables the feature to incorporate the globally spatial, temporal, and channel context. It is lightweight, end-to-end trainable, and can be easily plugged into existing CNNs to form IAUnet. The experiments show that IAUnet performs favorably against state of the art on both image and video reID tasks and achieves compelling results on a general object categorization task. The source code is available at https://github.com/blue-blue272/ImgReID-IAnet .

Cytoreductive surgery (CRS) for colorectal cancer peritoneal carcinomatosis has been shown to prolong survival with acceptable morbidity rates. Total pelvic peritonectomy (TPP), or complete removal of all pelvic peritoneum, constitutes an important and technically challenging component of CRS. Here we report our experience and describe our technique of laparoscopic total pelvic peritonectomy (LTPP), using a photographic/videographic step-by-step guide. All patients who underwent LTPP for pelvic carcinomatosis from a colorectal origin were included in the study. Only patients with peritoneal cancer index (PCI) score of ≤ 10 were selected for CRS with LTPP. Patients who had extra-abdominopelvic cavity metastases were excluded. The final decision to proceed with CRS was made following laparoscopic assessment. From January 2017 to December 2020, 15 consecutive patients underwent LTPP for colorectal cancer pelvic carcinomatosis. Median patient age and PCI score was 53 years (range 33–78) and 8 (range 3–10), respectively. Complete cytoreduction was achieved in all patients. Thirteen patients (87%) underwent concomitant hyperthermic intraperitoneal chemotherapy (HIPEC). The median operative duration was 748 min (interquartile range [IQR] 681–850). Median intra-operative blood loss and length of hospital stay was 100 ml (IQR 50–300) and 10 days (IQR 8–12), respectively. Five patients (33%) experienced 30-day post-operative morbidity, with one (6.7%) experiencing a higher grade (Clavien–Dindo IIIa) complication. Median follow-up duration was 13 months (IQR 3–19), during which four (27%) had systemic recurrence and one (6.7%) died after 15 months following peritoneal and systemic recurrences. LTPP is a feasible option for low-volume pelvic carcinomatosis from colorectal cancer, offering the benefits of a minimally invasive approach. Strict patient selection is essential, and the procedure should be converted if the PCI score cannot be assessed or complete cytoreduction cannot be achieved. Proficiency at laparoscopic pelvic surgery is mandatory for performing LTPP.

Diabetes mellitus is a disease of endocrine and metabolism disorders, characterized by hyperglycemia, and increased risk of cardiovascular disease complications. Although oral hypoglycemic drugs have the effect of maintaining blood sugar control in diabetic patients, these drugs still have serious side effects for many patients, such as gastrointestinal diseases related to acarbose. Recently, certain food supplements and their bioactive ingredients have been shown to improve diabetes mellitus and can be readily found in the marketplace. This literature review focuses on food supplements with a hypoglycemic function, with an emphasis on their biologically active ingredients and pharmacological effects. The biologically active ingredients can be divided into 6 categories: polyphenols, polysaccharides, terpenoids, saponins, alkaloids, and others. The sources, models used for their study, efficacy, and mechanisms of action of food supplements are described. The sources, models used for their study, efficacy, and mechanisms of action of food supplements are described, including regulation of microflora, modulation of glucose metabolism, and improvement in insulin function. By classifying medicinal plants that can be used as food supplements and their activities, we have provided useful information to support further investigation and application of food supplements to prevent or improve diabetes mellitus.

Background Screw-retained implant crowns are considered more biologically compatible than cemented crowns due to the absence of excess cement. However, traditional screw-retained implant crowns are not viable when the access hole of the screw channel would need to be located in an esthetic area, which would compromise the esthetic outcome of the treatment. Purpose To evaluate the clinical, radiographic, and immunological outcomes of angulated screw-retained and cemented single-implant crowns in the esthetic region. Materials and methods The study was a single-center, open-label, randomized controlled clinical trial. Eligible patients were randomly placed in two groups: angulated screw-retained group (AG) and cemented group (CG). Implant survival rate, bleeding on probing rate (BOP%), probing depth (PD), modified plaque index (mPI), marginal bone loss (MBL), concentrations of pro-inflammatory cytokines (TNF-α, IL-6) in peri-implant crevicular fluid (PICF), mechanical complications, and pink esthetic score/white esthetic score (PES/WES) were evaluated. Results Fifty-six patients (AG: 29, CG: 27) attended the 1-year examination. The drop-out rate was 6.67%. No implant failure was found in both groups during the observation period. BOP% was significantly lower in the AG than that in the CG (mean, 21.84% ± 19.97% vs. 37.04% ± 26.28%, p = 0.018). The concentration of TNF-α in PICF was significantly higher in the AG than that in the CG (median, 13.54 vs. 4.62, p = 0.019). No significant difference of PD, mPI, MBL, IL-6, or mechanical complication rates was found between the two groups. Mean scores for PES/WES were 21.71 and 21.64 in the AG and CG, respectively. Conclusion Based on the present results, both treatment options showed acceptable clinical outcomes in the short term. Angulated screw-retained crowns might benefit the peri-implant soft tissue. However, studies with long-term follow-up are needed to confirm whether the higher concentration of TNF-α will compromise the long-term outcomes of treatment.

Blood pressure (BP) monitored within 24 h from the beginning of intravenous thrombolysis (IVT) with alteplase, is one of the important factors affecting the prognosis of patients with acute ischemic stroke (AIS). This study aimed to explore longitudinal BP trajectory patterns and determine their association with stroke prognosis after thrombolysis. From November 2018 to September 2019, a total of 391 patients were enrolled consecutively during the study period, and 353 patients were ultimately analyzed. Five systolic (SBP) and four diastolic blood pressure (DBP) trajectory subgroups were identified. The regression analysis showed that when compared with the rapidly moderate stable group, the continuous fluctuation‐very high level SBP group (odds ratio [OR]: 2.743, 95% confidence interval [CI]: 1.008–7.467) was associated with early neurological deterioration (END). Both the rapid drop‐high level SBP (OR: 0.448, 95% CI: 0.219–0.919) and DBP groups (OR: 0.399, 95% CI: 0.219–0.727) were associated with early neurological improvement (ENI). Moreover, there was a U‐shaped correlation between the OR value of SBP trajectory group and favorable outcome (the modified Rankin Scale [mRS] score 0–2) at 3 months: the slow drop‐low level SBP group represent a well‐established unfavorable outcome risk factor (OR:5.239, 95% CI: 1.271–21.595), and extremely high SBP—the continuous fluctuation‐very high level SBP group, are equally associated with elevated unfavorable outcome risk (OR:3.797, 95% CI: 1.486–9.697). The continuous fluctuation‐very high level DBP group was statistically significant in mRS (OR: 3.387, CI: 1.185–9.683). The BP trajectory groups show varying clinical features and risk of neurological dysfunction. The findings may help identify potential candidates for clinical BP monitoring, control, and specialized care.

BACKGROUND A systematic review and meta-analysis were conducted to explore the clinical efficacy and coagulation function of regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT) in critically ill patients, to provide an effective treatment options for CRRT in severe patients. METHODS The English databases Embase, Medline, PubMed, Ovid, Springer, and Web of Science were searched to screen for randomized controlled trials (RCTs) on RCA in the CRRT treatment of critically ill patients published before June 1, 2020. Meta analysis using the RevMan5.3 provided by the Cochrane collaboration network. The search terms included "citrate anticoagulation", "patient in severe condition", "CRRT", "clinical effect", and "coagulation function". RESULTS ten articles meeting requirements were included, comprising 1,411 subjects. Meta-analysis results showed that after treatment, total calcium/ionized calcium (totCa/ionCa) [mean difference (MD) =0.05; 95% confidence interval (CI): (-0.02 to 0.12); Z=1.31; P=0.19], prothrombin time [MD =4.51; 95% CI: (2.77, 6.24); Z=5.10; P

We have optimised a reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay for the detection of SARS-CoV-2 from extracted RNA for clinical application. We improved the stability and reliability of the RT-LAMP assay by the addition of a temperature-dependent switch oligonucleotide to reduce self- or off-target amplification. We then developed freeze-dried master mix for single step RT-LAMP reaction, simplifying the operation for end users and improving long-term storage and transportation. The assay can detect as low as 13 copies of SARS-CoV2 RNA per reaction (25-μL). Cross reactivity with other human coronaviruses was not observed. We have applied the new RT-LAMP assay for testing clinical extracted RNA samples extracted from swabs of 72 patients in the UK and 126 samples from Greece and demonstrated the overall sensitivity of 90.2% (95% CI 83.8–94.7%) and specificity of 92.4% (95% CI 83.2–97.5%). Among 115 positive samples which Ct values were less than 34, the RT-LAMP assay was able to detect 110 of them with 95.6% sensitivity. The specificity was 100% when RNA elution used RNase-free water. The outcome of RT-LAMP can be reported by both colorimetric detection and quantifiable fluorescent reading. Objective measures with a digitized reading data flow would allow for the sharing of results for local or national surveillance.

The choice between wedge resection and segmentectomy as a sublobar resection method for patients with cT1N0 lung cancer remains debatable. This study aimed to evaluate the clinical outcomes after wedge resection and segmentectomy for patients with cT1N0 lung adenocarcinoma. The study enrolled 1002 consecutive patients with cT1N0 lung adenocarcinoma who underwent sublobar resection at the authors’ institution between 2011 and 2017. A propensity score-matching analysis was used to compared the clinical outcomes between the wedge resection and segmentectomy groups. Wedge resection was performed for 810 patients (80.8%), and segmentectomy was performed for 192 patients (19.2%). Wedge resection resulted in better perioperative outcomes than segmentectomy. The multivariate analysis showed that the significant risk factors for poor disease-free survival (DFS) were elevated preoperative serum carcinoembryonic antigen levels, total tumor diameter greater than 2 cm, and a consolidation-to-tumor (C/T) ratio higher than 50%. After propensity-matching, no differences in overall survival or DFS were noted between the two matched groups. However, subgroup analysis showed that segmentectomy was associated with better DFS than wedge resection (p = 0.039) for the patients with a tumor diameter greater than 2 cm and a C/T ratio higher than 50%. Segmentectomy is the appropriate surgical method for sublobar resection in cT1N0 lung adenocarcinoma patients with a tumor diameter greater than 2 cm and a C/T ratio higher than 50%. Wedge resection may be a safe and feasible sublobar resection method for patients with a tumor diameter of 2 cm or smaller or a C/T ratio of 50% or lower.

Objective: To demonstrate differences in cardiovascular structure and function between diabetic and non-diabetic older adults. To investigate associations between acyl-carnitines and cardiovascular function as indexed by imaging measurements. Methods: A community-based cohort of older adults without cardiovascular disease underwent current cardiovascular imaging and metabolomics acyl-carnitines profiling based on current and archived sera obtained fifteen years prior to examination. Results: A total of 933 participants (women 56%, n=521) with a mean age 63±13 years were studied. Old diabetics compared to old non-diabetics had lower myocardial relaxation (0.8±0.2 vs 0.9±0.3, p=0.0039); lower left atrial conduit strain (12±4.3 vs 14±4.1, p=0.045), lower left atrial conduit strain rate (-1.2±0.4 vs -1.3±0.5, p=0.042) and lower ratio of left atrial conduit strain to left atrial booster strain (0.5±0.2 vs 0.7±0.3, p=0.0029). Higher levels of archived short chain acyl-carnitine were associated with present-day impairments in myocardial relaxation (C5:1; OR 1.03, p=0.011), worse left atrial conduit strain function (C5:1; OR 1.03, p=0.037). Increases in hydroxylated acyl-carnitines were associated with worse left atrial conduit strain [(C4-OH; OR 1.05, p=0.0017), (C16:2-OH; OR 1.18, p=0.037)]. Current, archived and changes in long chain acyl-carnitines were associated with cardiovascular functions [(C16; OR 1.02, p=0.002), (C20:3; OR 1.01, p=0.014), (C14:3; OR 1.12, p=0.033), (C18:1; OR 1.01, p=0.018), (C18:2; OR 1.01, p=0.028), (C20:4; OR 1.10, p=0.038)] (all p

Physical Unclonable Functions (PUFs) address the inherent limitations of conventional hardware security solutions in edge-computing devices. Despite impressive demonstrations with silicon circuits and crossbars of oxide memristors, realizing efficient roots of trust for resource-constrained hardware remains a significant challenge. Hybrid organic electronic materials with a rich reservoir of exotic switching physics offer an attractive, inexpensive alternative to design efficient cryptographic hardware, but have not been investigated till date. Here, we report a breakthrough security primitive exploiting the switching physics of one dimensional halide perovskite memristors as excellent sources of entropy for secure key generation and device authentication. Measurements of a prototypical 1 kb propyl pyridinium lead iodide (PrPyr[PbI3]) weak memristor PUF with a differential write-back strategy reveals near ideal uniformity, uniqueness and reliability without additional area and power overheads. Cycle-to-cycle write variability enables reconfigurability, while in-memory computing empowers a strong recurrent PUF construction to thwart machine learning attacks., Despite the impressive demonstrations with silicon and oxide memristors, realizing efficient roots of trust for resource-constrained hardware remains a challenge. Here, the authors exploit switching behavior in one dimensional perovskite memristors to design security primitives for key generation and device authentication.

The flourishing of Internet of Things (IoT) has rekindled on-premise computing to allow data to be analyzed closer to the source. To support edge Artificial Intelligence (AI), hardware accelerators, open-source AI model compilers and commercially available toolkits have evolved to facilitate the development and deployment of applications that use AI at its core. This paradigm shift in deep learning computations does not, however, reduce the vulnerability of deep neural networks (DNN) against adversarial attacks but introduces a difficult catch-up. This is because existing methodologies rely mainly on offline analysis to detect adversarial inputs, assuming that the deep learning model is implemented on a 32-bit floating-point graphical processing unit (GPU) instance. In this paper, we propose a new hardware-oriented approach for in-situ detection of adversarial inputs feeding through a spatial DNN accelerator architecture or a third-party DNN Intellectual Property (IP) implemented on the edge. Our method exploits controlled glitch injection into the clock signal of the DNN accelerator to maximize the information gain for the discrimination of adversarial and benign inputs. A light gradient boosting machine (lightGBM) is constructed by analyzing the prediction probability of unmutated and mutated models and the label change inconsistency between the adversarial and benign samples in the training dataset. With negligibly small hardware overhead, the glitch injection circuit and the trained lightGBM detector can be easily implemented alongside with the deep learning model on a Xilinx ZU9EG chip. The effectiveness of the proposed detector is validated against four state-of-the-art adversarial attacks on two different types and scales of DNN models, VGG16 and ResNet50, for a thousand-class visual object recognition application. The results show a significant increase in true positive rate and a substantial reduction in false positive rate on the Fast Gradient Sign Method (FGSM), Iterative-FGSM (I-FGSM), C&W and universal perturbation attacks compared with modern software-oriented adversarial sample detection methods. National Research Foundation (NRF) Accepted version This research is supported by the National Research Foundation, Singapore, under its National Cybersecurity Research & Development Programme / Cyber-Hardware Forensic & Assurance Evaluation R&D Programme (Award: CHFA-GC1-AW01).

Software should be a product that can be used easily and accurately by the user and should be improved quickly and accurately when problems arise. In many software development projects, software requirements are frequently modified during the design or development phase, which tests the development of specific designers’ or developers’ capabilities. Software development environmental factors (SDEFs), such as differences in mutual work recognition among users, developers, and testers or knowledge differences, can hinder communication, which may lead to faulty development owing to erroneous job definition. Because the exact size and scope of the software cannot be calculated, the risk of excessive requirements, such as schedule, cost, and manpower, may increase. This study aims to investigate 32 SDEFs to examine the influence of factors affecting the reliability of software developed by Korean companies to identify factors with high influence and compare differences with previous studies. Moreover, we found whether any new SDEFs from the top 10 rankings only affected Korean companies, and also US companies included in previous studies. A factor analysis revealed several potential factors to identify the mutually independent characteristics of the factors. Through statistical analysis methods, the difference between the group means and the impact on improving the software reliability were found in Korean companies. These findings can provide useful benefits to software developers and managers working in countries with different or similar cultures and help increase working efficiency, i.e., work versus time investment and software reliability improvement.

BACKGROUND. PI-RADS version 2.1 (v2.1) introduced a number of key changes to the assessment of transition zone (TZ) lesions. OBJECTIVE. The purpose of this study was to evaluate interobserver agreement and diagnostic accuracy for detecting TZ prostate cancer (PCa) and clinically significant PCa (csPCa) by use of PI-RADS v2 and PI-RADS v2.1 among radiologists with different levels of experience. METHODS. This retrospective study included 355 biopsy-naive patients who from January 2017 to March 2020 underwent prostate MRI that showed a TZ lesion and underwent subsequent biopsy. PCa was diagnosed in 93 patients (International Society of Urological Pathology [ISUP] grade group 1, n = 34; ISUP grade group ≥ 2, n = 59) and non-cancerous lesions in 262 patients. Five radiologists with varying experience in prostate MRI scored lesions using PI-RADS v2 and PI-RADS v2.1 in sessions separated by at least 4 weeks. Interobserver agreement was evaluated with kappa and Kendall W statistics. ROC curve analysis was used to evaluate performance in detection of TZ PCa and csPCa. RESULTS. Interobserver agreement among all readers was higher for PI-RADS v2.1 than for PI-RADS v2 (mean weighted κ = 0.700 vs 0.622; Kendall W = 0.805 vs 0.728; p = .03). The pooled AUC values for detecting TZ PCa and csPCa were higher among all readers using PI-RADS v2.1 (0.866 vs 0.827 for TZ PCa; 0.929 vs 0.899 for TZ csPCa; p < .001). For detecting TZ PCa, the pooled sensitivity, specificity, and accuracy were 86.9%, 79.4%, and 75.4% among all readers for PI-RADS v2.1 compared with 79.4%, 71.8%, and 73.8% for PI-RADS v2. For detecting TZ csPCa, the pooled sensitivity, specificity, and accuracy were 84.8%, 90.9%, and 89.9% among all readers for PI-RADS v2.1 compared with 81.4%, 89.9%, and 88.5% for PI-RADS v2. Reader 1, who had the least experience, had the lowest sensitivity, specificity, and accuracy (78.0%, 89.2%, and 87.3%). Reader 5, who had the most experience, had the highest sensitivity, specificity, and accuracy (88.1%, 92.9%, and 92.1%) in detecting csPCa. CONCLUSION. PI-RADS v2.1 had better interobserver agreement and diagnostic accuracy than PI-RADS v2 for evaluating TZ lesions. Reader experience continues to affect the performance of prostate MRI interpretation with PI-RADS v2.1. CLINICAL IMPACT. PI-RADS v2.1 is more accurate and reproducible than PI-RADS v2 for the diagnosis of TZ PCa.

Background Peripheral nerve injuries result in muscle denervation and apoptosis of the involved muscle, which subsequently reduces mitochondrial content and causes muscle atrophy. The local injection of mitochondria has been suggested as a useful tool for restoring the function of injured nerves or the brain. Objective To determine outcomes following the administration of isolated mitochondria into denervated muscle after nerve injury that have not been investigated. Methods Muscle denervation was conducted in a sciatic nerve crushed by a vessel clamp and the denervated gastrocnemius muscle was subjected to 195 μg hamster green fluorescent protein (GFP)-mitochondria intramuscular infusion for 10 min. Results The mitochondria were homogeneously distributed throughout the denervated muscle after intramuscular infusion. The increases in caspase 3, 8-oxo-dG, Bad, Bax, and ratio of Bax/Bcl-2 levels in the denervated muscle were attenuated by mitochondrial infusion, and the downregulation of Bcl-2 expression was prevented by mitochondrial infusion. In addition, the decrease in the expression of desmin and the acetylcholine receptor was counteracted by mitochondrial infusion; this effect paralleled the amount of distributed mitochondria. The restoration of the morphology of injured muscles and nerves was augmented by the local infusion of mitochondria. Mitochondrial infusion also led to improvements in sciatic functional indexes, compound muscle action potential amplitudes, and conduction latencies as well as the parameters of CatWalk (Noldus) gait analysis. Conclusion The local infusion of mitochondria can successfully prevent denervated muscle atrophy and augment nerve regeneration by reducing oxidative stress in denervated muscle.

Plant cytochrome P450s play key roles in the diversification and functional modification of plant natural products. Although over 200,000 plant P450 gene sequences have been recorded, only seven crystalized P450 genes severely hampered the functional characterization, gene mining and engineering of important P450s. Here, we combined Rosetta homologous modeling and MD-based refinement to construct a high-resolution P450 structure prediction process (PCPCM), which was applied to 181 plant P450s with identified functions. Furthermore, we constructed a ligand docking process (PCPLD) that can be applied for plant P450s virtual screening. 10 examples of virtual screening indicated the process can reduce about 80% screening space for next experimental verification. Finally, we constructed a plant P450 database (PCPD: http://p450.biodesign.ac.cn/), which includes the sequences, structures and functions of the 181 plant P450s, and a web service based on PCPCM and PCPLD. Our study not only developed methods for the P450-specific structure analysis, but also introduced a universal approach that can assist the mining and functional analysis of P450 enzymes.

Scan-based side-channel attacks have become a new threat to cryptographic chips. Existing countermeasures require a secret test key to unlock the scan chain before in-field testing is allowed. However, test key disclosure poses tremendous risks to multiple crypto chips that share a common test key. We address this open problem of in-field testing by leveraging physical unclonable function (PUF) to make the derived test key unique to each chip. The PUF’s response is invoked only once and hardened into a one-time programmable pad. The PUF response required by the designer to derive a test key of each crypto chip can only be recovered at the time of locking the scan chains without directly reading it out. The manufacturer can test the chip normally with no test time penalty before the passed chips are locked. The proposed solution is analyzed to be secure against all known scan-based side-channel attacks and the overhead incurred for the added security is negligibly small. Ministry of Education (MOE) Accepted version This research was supported in part by the National Natu- ral Science Foundation of China under Grant 61672182, the Guangdong Natural Science Foundation under Grant 2016A030313662 and the Shenzhen Overseas High-Level Talent Innovation Foundation under Grant KQJSCX20160226202510, and in part by the Singapore Ministry of Education Tier 1 Grant MOE2018-T1-001-131 (RG87/18).

Background: With the increase in the integration degree of the three-dimensional Integrated Circuit ( 3D I C) , the thermal power consumption per unit volume increases greatly, which makes the chip temperature rise. High temperature could affect the performance of the devices and even lead to thermal failure. So, the thermal management for 3D ICs is becoming a major concern. Objective: The aim of the research is to establish a micro-channel cooling model for a three-dimensional integrated circuit(3D IC) considering the through-silicon vias(TSVs). Methods: By studying the structure of the TSVs, the equivalent t hermal resistance of each layer was formulated. Then the one-dimensional micro-channel cooling thermal analytical model considering the TSVs was proposed and solved by the existing sparse solvers such as KLU. Results: The results obtained in this paper reveal that the TSVs can effectively improve the heat dissipation, and its maximal temperature reduction is about 10.75%. The theoretical analysis is helpful to optimize the micro-channel cooling system for 3D ICs. Conclusion: The TSV has an important influence on the heat dissipation of 3D IC, which can improve its heat dissipation characteristic.

Objective To assess the accuracy of dynamic computer-assisted implant surgery. Materials and methods An electronic search up to March 2020 was conducted using PubMed, Embase, and the Cochrane Central Register of Controlled Trial to identify studies using dynamic navigation in implant surgery, and additional manual search was performed as well. Clinical trials and model studies were selected. The primary outcome was accuracy. A single-arm meta-analysis of continuous data was conducted. Meta-regression was utilized for comparison on study design, guidance method, jaw and systems. Results Ten studies, four randomized controlled trials (RCT) and six prospective studies, met the inclusion criteria. A total of 1298 drillings and implants were evaluated. The meta-analysis of the accuracy (five clinical trials and five model studies) revealed average global platform deviation, global apex deviation and angular deviation were 1.02 mm, CI: 95% [0.83, 1.21], 1.33 mm, CI: 95% [0.98, 1.67], and 3.59°, CI: 95% [2.09, 5.09]. Meta-regression shown no difference between model studies and clinical trials (p=0.295, 0.336, 0.185), drilling holes and implant (p =0.36, 0.279, 0.695), maxilla and mandible (p =0.875, 0.632, 0.281) and five different systems (p =0.762, 0.342, 0.336). Conclusion Accuracy of dynamic computer-aided implant surgery reaches a clinically acceptable range and has potential in clinical usage, but more patient-centered outcomes and socio-economic benefits should be reported.

Introduction Natural orifice specimen extraction is the next step in minimally invasive colorectal surgery but can be technically challenging, with additional risks, especially for oncologic surgery. For several key reasons, sigmoid volvulus is well suited for natural orifice specimen extraction surgery. We describe our method and experience with double-stapled anastomosis transrectal natural orifice specimen extraction for sigmoid volvulus. Technique Using 3- or 4-port laparoscopy, the mesentery is separated from the long sigmoid loop. After the distal bowel is tied off and washed out, the rectum is completely transected and the proximal bowel delivered transrectally through a wound protector. Proximal transection is performed externally, and the circular stapler anvil is set before the bowel is returned into the abdominal cavity. The rectum stump is closed with an endoscopic linear stapler, and a circular-stapled anastomosis is performed. Results After successful endoscopic decompression, 6 patients underwent elective laparoscopic sigmoidectomy with natural orifice specimen extraction for volvulus at China Medical University Hospital from 2015 to 2020. The median operative time was 179 minutes (range, 151-236 min). No intraoperative complications were encountered. The median postoperative length of stay was 4 days (range, 2-9 d). One patient experienced postoperative small-bowel ileus resulting in readmission. The median follow-up duration was 12 months (range, 2-49 mo). One recurrence of volvulus was recorded 27 months postsurgery. Conclusion Uncomplicated sigmoid volvulus can be treated effectively with sigmoidectomy and natural orifice specimen extraction. Surgeons who attempt this procedure should be well versed with conventional laparoscopy but do not necessarily need to be experienced with natural orifice specimen extraction for successful surgery.

Esophageal stricture is a distressing issue for patients with early esophageal cancer following extensive endoscopic submucosal dissection (ESD), and the current steroid-based approaches are unsatisfactory for stricture prophylaxis. We evaluated the efficacy of oral hydrocortisone sodium succinate and aluminum phosphate gel (OHA) for stricture prophylaxis after extensive ESD.Patients undergoing 3/4 circumferential ESD were randomized to either the endoscopic loco-regional triamcinolone acetonide injection (ETI) plus oral prednisone group or the OHA group. The primary endpoint was incidence of esophageal stricture, and the secondary endpoints included adverse events (AEs) and endoscopic balloon dilations (EBDs).The incidence of esophageal stricture in OHA group (per-protocol analysis, 9.4%, 3/32; intention-to-treat analysis, 12.1%, 4/33) was significantly less than that of control group (per-protocol analysis, 35.5%, 11/31, P = 0.013; intention-to-treat analysis, 39.4%, 13/33, P = 0.011). Two sessions of EBD were necessary to release all strictures in the OHA group, while the similar EBDs (median 2, range 1-4) for 11 of the control. Operation-related AEs included infection (control vs. OHA group = 9.7% vs. 31.3%, P = 0.034), operation-related hypokalemia (19.4% vs. 31.3%, P = 0.278), perforation (3.2% vs. 3.1%), post-ESD hemorrhage (6.5% vs. 0%), and cardiac arrhythmia (0% vs. 6.3%). Steroid-related AEs included steroid-related hypokalemia (16.1% vs. 25%) and bone fracture (3.2% vs. 0%). Multivariate logistic regression analysis demonstrated that OHA was an independent protective factor for stricture (OR 0.079; 95%CI 0.011, 0.544; P = 0.01) and mucosal defect 11/12 circumference was an independent risk factor (OR 49.91; 95%CI 6.7, 371.83; P 0.001).OHA showed significantly better efficacy in preventing esophageal stricture after 3/4 circumferential ESD compared to ETI plus oral prednisone.

Renal fibrosis (RF) is a pathological process of progression from chronic kidney disease to end-stage renal disease. Amygdalus mongolica is a traditional Chinese medicine, and our previous studies demonstrated that the n-butanol extract (BUT) and amygdalin extract (AMY) from its seeds can prevent RF. However, the underlying mechanism remains unclear. The present study investigated the exact mechanism of the protective effect of A. mongolica on RF. A renal fibrosis rat model was induced with unilateral ureteral obstruction. Biochemical indicators were measured and combined with histopathology of renal tissue to evaluate the anti-RF effects. A serum metabonomic method was used to clarify the changes in the metabolic profile. The tubulointerstitial damage and fibrosis were significantly improved and metabolic perturbations were restored after treatment with BUT and AMY. Thirty-eight metabolites associated with RF progression and related to the regulation of arginine and proline metabolism, nicotinate and nicotinamide metabolism, and histidine metabolism were identified. They were restored to levels similar to those in controls after treatment. Moreover, no significant differences in efficacy were observed between the BUT and AMY groups. This study reveals and compares the potential mechanisms of the renoprotective effects after treatment with BUT and AMY from a metabolomic perspective.

Background/Purpose Sjogren's syndrome (SS) is an autoimmune disease and its conventional treatment has exhibited limited therapeutic efficacy. Traditional Chinese medicine has been demonstrated to ameliorate the sicca symptoms of SS by decreasing the level of TH1 and TH2 cytokines and increasing salivary flow rate. A newly designed traditional Chinese medicine, SS-1, showed improved efficacy in alleviating the dryness symptoms of SS patients in the National Taiwan SS cohort investigation. Here, we investigated the effect of SS-1 on T cell responses. Methods SS-1 was authenticated and its major compounds were verified by high-performance liquid chromatography. We examined the effects of SS-1 on the activation and TH1, TH2, and TH17 polarization of murine T cells. We also determined the level of TH1, TH2, and TH17 cytokine RNA in peripheral blood mononuclear cells of SS patients before and after SS-1 treatment. Results SS-1 treatment inhibits the activation and TH1, TH2, and IL-17A+IFNγ+ TH polarization of murine T cells. SS-1 treatment also significantly reduces IFN-γ, IL-4, and IL-13 expression, and moderately reduces IL-17A expression in peripheral blood mononuclear cells of SS patients. Conclusion Our results suggest that SS-1 inhibits T cell activation and diminishes TH1, TH2, and IL-17+IFN-γ+ TH responses in SS patients.

Big data analytics have gained tremendous successes in mining valuable information in various fields. However, its potential to solve complex problems in hardware security has not been adequately tapped. This paper presents a non-invasive approach to identify the state registers of a finite state machine (FSM) in an integrated chip. The state registers of the FSM are mined from the scan-dump data by exploiting the strongly connected property and chronologically correlated state codes of the FSM. The sequence of data scanned out of each scan register is partitioned into non-overlapping strings of high weighted frequencies by a string-matching algorithm. A coherency between a pair of registers is defined and computed based on the partitioned strings. The dimension of the coherency matrix is first reduced by pruning some registers of low influence by a regression analysis. The registers are then clustered to minimize the within-cluster variances based on their coherency values. The proposed scheme is applied to some IP cores from OpenCores. The experimental results show that our scheme can correctly identify the FSM state registers in most designs with high hit rate. Submitted/Accepted version This work was supported in part by the National Natural Science Foundation of China under Grant 62174045, in part by the Guangdong Basic and Applied Basic Research Foundation under Grant 2021A1515011862, and in part by the Shenzhen Fundamental Science Research Foundation under Project JCYJ20190806143203510 and Project GXWD20201230155427003-20200824112646001.

In this work, an AlGaN/GaN enhancement-mode high electron mobility transistor (HEMT) with two-step gate recess and electroless plating (EP) approaches is reported. Scanning electron microscopy and atomic force microscopy surface analysis are used to analysis the related properties of the EP-gate structure. A positive threshold voltage Vthof 0.68 V is obtained for the enhancement-mode EP-HEMT. In addition, a traditional HEMT based on thermal-evaporation gate is compared for the demonstration of the studied EP-HEMT with the improved performance, such as a higher maximum drain saturation current of 228.9 mA/mm, a higher maximum transconductance of 107.2 mS/mm, a lower gate leakage current of 1.2 × 10–7 mA/mm, and a higher ON/OFF drain current ratio of 4.57 × 105.

Location is an important distinguishing information for instance segmentation. In this paper, we propose a novel model, called Location Sensitive Network (LSNet), for human instance segmentation. LSNet integrates instance-specific location information into one-stage segmentation framework. Specifically, in the segmentation branch, Pose Attention Module (PAM) encodes the location information into the attention regions through coordinates encoding. Based on the location information provided by PAM, the segmentation branch is able to effectively distinguish instances in feature-level. Moreover, we propose a combination operation named Keypoints Sensitive Combination (KSCom) to utilize the location information from multiple sampling points. These sampling points construct the points representation for instances via human keypoints and random points. Human keypoints provide the spatial locations and semantic information of the instances, and random points expand the receptive fields. Based on the points representation for each instance, KSCom effectively reduces the mis-classified pixels. Our method is validated by the experiments on public datasets. LSNet-5 achieves 56.2 mAP at 18.5 FPS on COCOPersons. Besides, the proposed method is significantly superior to its peers in the case of severe occlusion.

Lightweight implementation of security primitives, e.g., physical unclonable functions (PUFs) and true random number generator, in field programmable gate array (FPGA) is crucial replacement of the conventional decryption key stored in battery-backed random access memory or E-Fuses for the protection of field reconfigurable assets. A slice is the smallest reconfigurable logic block in an Xilinx FPGA. The entropy exploitable from each slice of an FPGA is an important factor for the design of security primitives. Previous research has shown that the locations of slices can impact the quality of delay-based PUF designs implemented on FPGAs. To investigate the effect of the placement of each single-bit PUF cell free from the routing resource constraint between slices, single-bit ring oscillator (RO) and identity-based PUF design (Pi-coPUF) cells that can each be fully fitted into a single slice are evaluated. To accurately evaluate their statistical performance, data from a large number of devices are required. To this end, 217 Xilinx Artix-7 FPGAs has been employed to provide a large-scale comprehensive analysis for the two designs. This is the first time single-slice disorder-based security entities have been investigated and compared on 28-nm Xilinx FPGA. Uniqueness, uniformity, correlation, reliability, bit-aliasing and inentropy of each type of cell are evaluated for four different types of cell placement. Our experimental results corroborate that the location of both cell types in the FPGA affects their performances. For both cell types, the lower the correlation between devices, the higher the min-entropy and uniqueness. Overall, the min-entropy, correlation and uniqueness of PicoPUF are slightly higher than those of RO. Otherwise, the uniformity, bit-aliasing and reliability of the PicoPUF are slightly lower than those of the RO. Comparing the resource usage and metrics of the PicoPUF, ring oscillator PUF and some existing memory-based PUF implementations, PicoPUF stands out as a lightweight FPGA-based weak PUF design. The raw data for the PicoPUF design are made publicly available to enable the research community to use them for benchmarking and/or validation. Ministry of Education (MOE) Published version This work is supported by grants from the Engineering and Physical Sciences Research Council (EPSRC) (EP/N508664/- CSIT2), the Singapore Ministry of Education AcRF Tier 1 Grant No. 2018-T1-001-131, the National Natural Science Foundation of China (62022041 and 61871216), the Fundamental Research Funds for the Central Universities China (NE2019102) and the Six Talent Peaks Project in Jiangsu Province (2018XYDXX-009).

Vehicle re-identification (re-ID) has numerous applications in real life, such as video surveillance, information retrieval, and public security. However, it suffers from the misalignment of vehicles, which is a critical problem caused by inaccurate detection and different views. This paper proposes a novel network named Part Alignment Network (PAN) which can properly handle the misalignment of vehicles. It is therefore adapted to the vehicle re-ID task, avoiding the use of any additional pre-processing steps such as the annotation of vehicle key points and part segmentation by hand. In PAN, cross-correlation is adopted to the alignment of vehicle parts. Then, an effective network architecture is designed to extract the discriminative aligned features. By combining complementary aligned features and original features, more robust feature representations are learned. To show the effectiveness of PAN, this paper conducts experiments on three vehicle re-ID databases (VD1, VD2, and VehicleID), on which it improves the current state-of-the-art performance.

Background: As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. Objective: During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. Methods: An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. Results: There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; p = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18–1.31; p < 0.01), depression (OR = 1.23; 95% CI 1.17–1.29; p < 0.01), somatization (OR = 1.20; 95% CI 1.14–1.25; p < 0.01), hostility (OR = 1.24; 95% CI 1.18–1.30; p < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34–1.66; p < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78–0.89; p < 0.01), subjective support (OR = 0.84; 95% CI 0.80–0.88; p < 0.01), utilization of support (OR = 0.80; 95% CI 0.72–0.88; p < 0.01), social support (OR = 0.90; 95% CI 0.87–0.93; p < 0.01), and global well-being (OR = 0.30; 95% CI 0.22–0.41; p < 0.01) were negatively associated. Conclusions: In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

NPM1 mutation status and the allelic ratio (AR) of FLT3-internal tandem duplication (FLT3-ITD) are routinely tested for disease risk stratification in patients with normal karyotype (NK) acute myelogenous leukemia (AML); however, the predictive impact of immunophenotypic markers on different NPM1/FLT3 genotypes remains unclear. We performed a retrospective analysis of 423 patients with NK-AML subclassified into groups based on NPM1/FLT3 genotype. Allogeneic hematopoietic stem cell transplantation (HSCT) was performed in 124 of 423 patients (29%) and was significantly associated with longer event-free survival (EFS) and overall survival (OS), except for patients with the favorable genotype, defined as mutated NPM1 (NPM1mut) combined with normal FLT3 status (FLT3-ITDneg) or FLT3-ITD AR

Mega construction projects (MCPs) are inherently high-risk and complex. The challenge of safety management for mega construction projects is that safety risk factors constantly change and interact with each other in the long-term construction period. Few of the prior studies have enabled the prediction of the safety state in a dynamic and connected overview, which is a critical characteristic of safety risks in MCPs. Therefore, a hybrid approach for the dynamic simulation of risk factors is proposed. A three-stage procedure review of explicit documents, including accident investigation reports and construction standards, was carried out to identify safety risk factors and the causal relationships among them. Subsequently, the likelihood exposure and consequence (LEC) assessment method was applied to define the changes in risk factors over time. A system dynamics (SD) model was established to integrate the interacting risks and simulate the developing trend of the overall safety risk state. Moreover, a sensitivity analysis was provided to rank risk factors and simulate optimal risk mitigation strategies. Finally, the model was applied to the urban rail transit Line 9 project in China as a case study. The results indicated that the proposed hybrid approach performed satisfactorily under complex interrelated risk factors. Therefore, this study provides a practical framework to simulate and predict the safety state dynamically in a timely process for MCPs, either ahead of a project theoretically or during a project with real data.

The aim of this study was to investigate the effect of low-dose ruxolitinib (daily dose ≤ 10 mg) for the treatment of myelofibrosis (MF). A retrospective analysis was performed on a total of 88 patients with myeloproliferative neoplasm-associated MF (MPN-MF) who were diagnosed and treated in West China Hospital, Sichuan University, China. A total of 44 MPN-MF patients received a low dose of ruxolitinib (daily dose ≤ 10 mg), while another 44 patients received 10-25 mg twice daily. Low-dose ruxolitinib treatment resulted in slow, but gradual spleen response. Compared with baseline, the mean changes in palpable spleen length in the low- and high-dose groups were -26.9 and -49.0% after 12 weeks of treatment, respectively, and -46.7 and -64.1% after 48 weeks of treatment, respectively. In the low dose group, the median myeloproliferative neoplasm symptom assessment form (MPN-SAF) total symptom score (TSS) decreased by 37.8 and 35.9% at the 12 weeks and 48 weeks after treatment, respectively. No statistical difference was observed in MPN-SAF TSS among different dose groups. After 48 weeks of treatment, bone marrow (BM) fibrosis improved in 43.3% (13/30) of evaluated patients and was stable in 56.7% (17/30) patients. In the low-dose treated group, BM fibrosis improved in 50% patients and was stable in remaining 50%. Low-dose ruxolitinib is effective in treating MF.

The adverse implications of obesity extend beyond physical health to include negative impact on quality of life (QoL), mood, and eating habits. While bariatric surgery provides successful weight loss and metabolic benefits, studies describe conflicting results on QoL and mood-related outcomes. Patients (n = 140) with class II/III obesity and T2DM were recruited from 2015 to 2019, and stratified based on medical or surgical treatment. Questionnaires including the Hospital Anxiety and Depression Scale, Euro QoL visual analogue scale (EQ-VAS), and Revised 21-item Three-Factor Eating Questionnaire (TFEQ-R21) were recorded at baseline, 6 months, and 12 months after treatment. At baseline, the surgical group (n = 55) and medical group (n = 85) had no significant difference in questionnaire outcomes. At 6 and 12 months, EQ-VAS was higher in the surgical group (12 months surgical 82.00 ± 12.64, medical 72.81 ± 16.56, p = 0.001), with greater improvement from baseline. HADS-D scores at 12 months were lower in the surgical group (surgical 2.60 ± 2.88, medical 3.90 ± 3.58, p = 0.025). At 12 months, the surgical group also had better TFEQ-R21 scores, with higher cognitive restraint scores (surgical 19.09 ± 3.00, medical 16.69 ± 3.61, p

Parry–Romberg syndrome (PRS) is a rare condition characterized by progressive, unilateral facial atrophy. We hypothesize that patients with this condition may have involvement of the ocular structures. Here, we report our ophthalmic, clinical and anatomical findings in an observational study of six patients with long-standing PRS. Patients diagnosed with PRS were invited to participate in a clinic visit during which the following tests were administered and data recorded: best-corrected vision, refractive error, Ishihara color plates, Hertel exophthalmometry, gonioscopy, complete slit-lamp and dilated fundus examination, Intra Ocular Lens Master measurements and keratometry. Two-sample T tests were used to compare data between affected and unaffected eyes, as well as affected eyes and a normative population. Six patients underwent complete eye examinations. The mean spherical equivalent of the affected eye was + 3.83 D, while that of the unaffected eye was + 0.13 D. The atrophic hemiface averaged 2.8 mm of enophthalmos on Hertel exophthalmometry. The axial length of the atrophic eye was 0.91 mm shorter than the unaffected eye. Compared to normative data, in patients with PRS, the difference between eyes was statistically different for each of the following variables: visual acuity, spherical equivalent, corneal diameter, axial length and flat and steep keratometry. This is one of the first quantitative, exploratory studies with ophthalmic measurements in patients with PRS. Our results suggest the globe may demonstrate atrophic changes similar to other soft tissues in the face known to be affected by this condition.

Background. This study aimed to clarify whether Parkinson’s disease (PD) and depression were independent risk factors or with synergic effects in dementia. Methods. Newly diagnosed PD (n = 1213) patients and control subjects (n = 4852) were selected from the Taiwan National Health Insurance Research Database from January 2001 through December 2008. Follow-up ended in 2011 with an outcome of dementia occurring or not. This cohort was divided into controls with or without depression, PD only, and PD with depression. The incident rate of dementia and hazard ratio (HR) using Cox’s regression analysis were calculated for each group. Results. When compared with controls without depression as HR 1.00, the adjusted HR for dementia was 3.29 (p<0.001) in the PD only group, 2.77 (p<0.001) in the PD with depression group, and 1.55 (p=0.024) in the depression only group. The incident rate of dementia was 29.2 (per 1000 person-years) in the PD only group and 13.2 in the PD with depression group. The effect of PD on dementia in the depression group produced a HR of 0.97 (p=0.905). Conclusions. Parkinson’s disease served as a risk factor for dementia. By comparison, depression was not a risk factor for dementia in PD patients, although it did act as a risk factor for dementia.

Objective The aim of the present study was to report 10-year results of osteotome sinus floor elevation (OSFE) without grafting severely atrophic maxilla (residual bone height ≤4 mm). Materials and methods Patients undergoing OSFE without grafting and implant placement were included for 10-year examinations. Implant survival, complication-free survival, modified bleeding index (mBI), modified plaque index (mPI), pocket probing depth (PPD), peri-implant marginal bone loss (MBL), endo-sinus bone gain (ESBG) and mean cost of recurrence were evaluated. Results Overall, 23 patients with 35 implants attended 10-year examination. Cemented implant crowns or implant-supported fixed dental prostheses were delivered to the patients. Kaplan-Meier implant survival was 89.2% at implant level and 84.1% at patient level. Complication-free survival was 26.0% at patient level and 37.0% at implant level. The average complication-free survival time was 74.6 months (95% CI: 63.2-86.0 months) at implant level and 69.1 months (95% CI: 54.8-83.4 months) at patient level. The mBI, mPI, PPD, MBL and ESBG at 10-year follow-up were 0.91 ± 0.58, 0.48 ± 0.51, 2.94 ± 0.79 mm, 1.63 ± 0.83 mm and 2.72 ± 0.51 mm, respectively. The cost of managing recurrence was 43.6% of the initial cost of treatment. Conclusion The results of the present study indicate that OSFE without grafting is a reliable treatment option in severely atrophic maxilla. Acceptable survival rate, stable MBL and ESBG could be achieved within 10 years. Low complication-free survival and high costs of recurrence management need to be considered.

Acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) generally confers poor prognosis; however, the clinical outcome remains heterogeneous. We sought to further stratify this subentity of AML by performing a retrospective analysis of 179 adult patients with AML-MRC diagnosed at our institution. Based on 2016 World Health Organization diagnostic criteria, 44 (25%) patients had multilineage dysplasia alone (AML-MRC-M), 74 (41%) had history of myelodysplastic syndrome (MDS) or myelodysplastic/myeloproliferative disease (AML-MRC-H), and 61 (34%) had MDS-related cytogenetics (AML-MRC-C). AML-MRC-M and hematopoietic stem cell transplantation (HSCT) were associated with prolonged event-free survival (EFS) (P = 0.0051 and P 0.0001, respectively) and overall survival (OS) (P = 0.0015 and P 0.0001, respectively), whereas AML-MRC-C and age ≥60 years were associated with shorter EFS (P = 0.028 and P = 0.015, respectively) and OS (P = 0.021 and P = 0.013, respectively). Of note, NPM1

A clinically reliable non-invasive test for endometriosis is expected to reduce the diagnostic delay. Although varieties of biomarkers have been investigated for decades, and cancer antigen-125, cancer antigen-199, interleukin-6, and urocortin were the most studied ones among hundreds of biomarkers, no clinically reliable biomarkers have been confirmed so far. Some emerging technologies including “omics” technologies, molecular imaging techniques, and microRNAs are promising in solving these challenges, but their utility to detect endometriosis has yet to be verified. New combinations of researched indicators or other non-invasive methods and further exploration of the emerging technologies may be new targets and future research hotspots for non-invasive diagnosis of endometriosis. In conclusion, researches of biomarkers for the detection of endometriosis are still ongoing and may benefit from novel molecular biology, bioinformatics methods and a combination of more diverse monitoring methods. Though it will be a daunting task, the identification of a specific set of diagnostic biomarkers will undoubtedly improve the status of endometriosis.

INTRODUCTION Examination of a blood film is the second most common hematology test, after the complete blood count. Interpretation of a peripheral blood film by trained laboratory professionals provides valuable diagnostic information. The Institute for Quality Management in Healthcare (IQMH) Hematology Scientific Committee developed a questionnaire to gather information regarding current practices for manual blood film review and reporting from laboratories participating in IQMH Morphology proficiency testing (PT) surveys. METHODS An online survey was distributed to 174 laboratories, 97% submitted results. RESULTS Of the respondents, the majority (82%) indicated affiliation with small- or medium-sized hospitals (

Measure effect of late-afternoon communication and patient planning (CAPP) rounds to increase early electronic discharge orders (EDO).We enrolled 4485 patients discharged from six subspecialty medical services. We implemented late-afternoon CAPP rounds to identify patients who could have morning discharge the subsequent day. After an initial successful implementation of the intervention, we identified lack of sustainability. We made changes with sustained implementation of the intervention. This is a before-after study of a quality improvement intervention.Primary measures of intervention effectiveness were percentage of patients who received EDO by 11 am and patients discharged by noon. Additional measure of effectiveness were percent of patients admitted to the correct ward, emergency department (ED)-to-ward transfer time compared between intervention and nonintervention periods. We compared the overall expected LOS and the average weekly discharges to assess for comparability across the control and intervention time periods. We used the readmission rate as balancing measure to ensure that the intervention was not have unintended negative patients consequences.Expected length of stay based upon discharge diagnosis/comorbidities and readmission rates were similar across the intervention and control time periods. The average weekly discharges were not statistically significant. Percentage of EDO by 11 am was higher in the first intervention period, second intervention period and combined intervention periods (28.9% vs. 21.8%,Afternoon CAPP rounds to identify early patient discharges the following day led to increase in EDO entered by 11 am and discharges by noon without an adverse change in readmission rates and LOS.

Objective To describe caregiving work outcomes and related indirect (ie, productivity) and direct (ie, caregiving hours and expenses) costs. Methods A national, population-based survey to identify employed caregivers assisting a person with treatment-resistant depression (TRD) and a comparison group of employed caregivers assisting others (No TRD). Results Screening identified 169 TRD caregivers and 1070 No TRD caregivers providing 23.3 and 14.6 mean weekly caregiving hours, respectively. Adjusted annual indirect cost estimates were $11,121 for caregivers of TRD and $7761 for caregivers in the No TRD group (P ≤ 0.0001). At-work productivity loss (presenteeism) was the largest component. Adjusted annual direct cost estimates were $29,805 for caregivers of TRD and $20,642 for caregivers in the No TRD group (P ≤ 0.0001). Conclusions TRD exacts a toll on caregivers and their employers exceeding that for other caregivers.