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The maximum radiation efficiency can be obtained when the feed array excitation of a reflector antenna is synthesized by the conjugate field matching (CFM) method. However, the CFM method can only get the strongly tapered feeding power distribution. This will lead to most of power amplifiers (PAs) working in low efficiency states and reduce the Equivalent Isotropic Radiated Power (EIRP) with the limited power consumption. In this work, combining the radiation efficiency and the PA efficiency, the radiated power efficiency (RPE) is defined as the new design goal and is to be raised to achieve higher EIRP. For this reason, a method based on the near-field pattern synthesis is proposed. In this method, all the on-state PAs are required to work in the highest efficiency state. Then, with well-trained support vector machine (SVM), the on-off states of the PAs are adjusted so that the reflected focal field can be better synthesized by the near-field pattern of the feed array. Thus, the loss of the radiation efficiency is minimized. As a result, the RPE is about 22% higher than that of the CFM method and about 10% higher than that of the optimum CFM truncation case.

Background Microvascular decompression (MVD) has become accepted as an effective therapeutic option for hemifacial spasm (HFS); however, the curative rate of MVD for HFS varies widely (50–98%) in different medical centers. This study could contribute to the improvement of the MVD procedure. Methods We retrospectively analyzed 32 patients in whom initial MVD failed in other hospitals and who underwent a second MVD at our center. The clinical characteristics, operative findings, outcome of the second MVD, and complications were recorded. Results There were 18 women and 14 men (56.3 and 43.7%, respectively). The left-to-right ratio was 19:13. The mean age of the patients was 59.8 years. We found an undiscovered conflict site located in zone 4 in 10 patients and in the root entry zone in 8 patients. The initial MVD failed in nine patients because of ignorance of the arterioles that originate from the anterior inferior cerebellar artery. There were no special findings in four patients. No Teflon felts were found in the whole surgical field in one patient. Conclusion Omission of the offending vessel is the most common cause of an unsuccessful MVD. Intraoperative abnormal muscle response associated with the Z-L response is a good measure to correctly identify the involved arterioles.

Background:. Nitinol-containing devices are widely used in clinical practice. However, there are concerns about nickel release after nitinol-containing device implantation. This study aimed to compare the efficacy and safety of a parylene-coated occluder vs. a traditional nitinol-containing device for atrial septal defect (ASD). Methods:. One-hundred-and-eight patients with ASD were prospectively enrolled and randomly assigned to either the trial group to receive a parylene-coated occluder (n = 54) or the control group to receive a traditional occluder (n = 54). The plugging success rate at 6 months after device implantation and the pre- and post-implantation serum nickel levels were compared between the two groups. A non-inferiority design was used to prove that the therapeutic effect of the parylene-coated device was non-inferior to that of the traditional device. The Cochran–Mantel–Haenszel chi-squared test with adjustment for central effects was used for the comparison between groups. Results:. At 6 months after implantation, successful ASD closure was achieved in 52 of 53 patients (98.11%) in both the trial and control groups (95% confidence interval (CI): [−4.90, 5.16]) based on per-protocol set analysis. The absolute value of the lower limit of the 95% CI was 4.90%, which was less than the specified non-inferiority margin of 8%. No deaths or severe complications occurred during 6 months of follow-up. The serum nickel levels were significantly increased at 2 weeks and reached the maximum value at 1 month after implantation in the control group (P 0.05). Conclusions:. The efficacy of a parylene-coated ASD occluder is non-inferior to that of a traditional uncoated ASD occluder. The parylene-coated occluder prevents nickel release after device implantation and may be an alternative for ASD, especially in patients with a nickel allergy.

Under the effects of internal factors and the external environment, some customer requirements can be extremely sensitive to change; these are known as sensitive requirements. These requirements drive the identification and design of the relevant engineering characteristics. This study defines such characteristics as agile engineering characteristics (AECs), which are crucial for redesigning products and prolonging their service life but attract limited research and practice attention. The research question of identifying the product AECs is answered in this study, and three key issues are solved in the proposed methodology. First, the contribution of product engineering characteristics to customer requirements is calculated using an orthogonal experimental design, and the optimal level combination of engineering characteristics to satisfy the customer requirements is determined through the analysis of variation. Subsequently, the relative importance of engineering characteristics is calculated based on data envelopment analysis. Next, an agility index is defined by integrating the customer satisfaction degree, the relative importance degree of engineering characteristics, and the variation of the level of engineering characteristics, to identify the AECs. Finally, based on the identification of the AECs of an electric vehicle air-conditioning heat pump scroll compressor, the results are analysed and compared to illustrate the feasibility and effectiveness of the proposed method.

Mesenchymal stem/stromal cell (MSC)-based therapeutics is already available for treatment of a range of diseases or medical conditions. Autologous or allogeneic MSCs obtained from self or donors have their own advantages and disadvantages in their medical practice. Therapeutic benefits of using autologous vs. allogeneic MSCs are inconclusive. Transplanted MSCs within the body interact with their physical microenvironment or niche, physiologically or pathologically, and such cells in a newly established tissue microenvironment may be impacted by the pathological harmful environmental factors to alter their unique biological behaviors. Meanwhile, a temporary microenvironment/niche may be also altered by the resident or niche-surrounding MSCs. Therefore, the functional plasticity and heterogeneity of MSCs caused by different donors and subpopulations of MSCs may result in potential uncertainty in their safe and efficacious medical practice. Acknowledging a connection between MSCs’ biology and their existing microenvironment, donor-controlled clinical practice for the long-term therapeutic benefit is suggested to further consider minimizing MSCs potential harm for MSC-based individual therapies. In this review, we summarize the advantages and disadvantages of autologous vs. allogeneic MSCs in their therapeutic applications. Among other issues, we highlight the importance of better understanding of the various microenvironments that may affect the properties of niche-surrounding MSCs and discuss the clinical applications of MSCs within different contexts for treatment of different diseases including cardiomyopathy, lupus and lupus nephritis, diabetes and diabetic complications, bone and cartilage repair, cancer and tissue fibrosis.

BACKGROUND Hypereosinophilia (HE) is defined as a peripheral blood eosinophil count of > 1.5 × 109/L and may be associated with tissue damage. The clinical presentations of HE vary; however, myocardial fibrosis and thrombosis can threaten the lives of patients with sustained eosinophilia. Cerebral venous sinus thrombosis (CVST) in the setting of eosinophil-related diseases has seldom been reported. Here, we review the literature on HE with CVST to increase knowledge and encourage early diagnosis. CASE SUMMARY A previously healthy 41-year-old man was admitted to hospital with diarrhea and abdominal pain. He was treated with antibiotics for suspected acute colitis. Three days later, he experienced headache and vomiting. Brain computed tomography (CT) revealed thrombosis of the left jugular vein to the left transverse sinus vein. Platelet (PLT) count decreased to 60 × 1012/L, and absolute eosinophil count (AEC) increased to 2.41 × 109/L. He was treated with low-molecular-weight heparin. PLT count progressively decreased to 14 × 109/L, and we terminated anticoagulation and performed PLT transfusion. Six days after admission, he complained of a worsening headache. Brain CT revealed right temporal lobe and left centrum semiovale intracerebral hemorrhage, and AEC increased to 7.65 × 109/L. We used prednisolone for HE. The level of consciousness decreased, so emergency hematoma removal and decompressive craniectomy for right cerebral hemorrhage were performed. The patient was alert 2 d after surgery. He was treated with anticoagulation again 2 wk after surgery. Corticosteroids were gradually tapered without any symptomatic recurrence or abnormal laboratory findings. CONCLUSION HE can induce CVST, and we need to focus on eosinophil counts in patients with CVST.

Population and income growth are increasing global food demand at a time when a third of the world’s agricultural soils are degraded and climate variability threatens the sustainability of food production. Intercropping, the practice of growing two or more spatially intermingled crops, often increases yields, but whether such yield increases, their stability and soil fertility can be sustained over time remains unclear. Using four long-term (10–16 years) experiments on soils of differing fertility, we found that grain yields in intercropped systems were on average 22% greater than in matched monocultures and had greater year-to-year stability. Moreover, relative to monocultures, yield benefits of intercropping increased through time, suggesting that intercropping may increase soil fertility via observed increases in soil organic matter, total nitrogen and macro-aggregates when comparing intercropped with monoculture soils. Our results suggest that wider adoption of intercropping could increase both crop production and its long-term sustainability. Growing demand for food is confronting constraints to its sustainable production. This study finds that intercropping increases grain yields and their stability and that yield benefits increase over time.

Recently, orbital angular momentum (OAM) has been adopted to measure the shape of static objects and the translation motion of moving objects in optical remote sensing. Most of these studies rely on measuring the intensity variation of OAM beams. However, the OAM intensity does not change with the rotation of the spinning object, but its phase changes. The phase variation is proved to be proportional to the object’s angular velocity. Since a rotating object will cause the OAM phase dependent on time, the OAM phase needs to be measured instantaneously, to support the OAM-based angular velocity measurement. In this work, we report a scheme to measure the angular velocity of a spinning object using a photonic OAM phase spectrum. A phase-to-intensity strategy is implemented to enable the real-time multi-OAM phase measurement, in which the phase can be determined with the intensities of four focal spots in a two-dimensional array generated by a phase-only spatial light modulator. The experimental results show that the average error of the measured angular velocity could be under 2.45% by detecting the phase of two OAM modes. This OAM-based angular velocity detection method provides a complementary approach to characterize the rotational Doppler effect, especially for slow angular motion.

BACKGROUND Intrahepatic biliary cystadenoma (IBC) is a rare benign hepatic tumor that is often misdiagnosed as other hepatic cystic diseases. Therefore, imaging examinations are required for preoperative diagnosis. Contrast-enhanced ultrasound (CEUS) has gained increasing popularity as an emerging imaging modality and it is considered the primary method for screening IBC because of its specificity of performance. We describe an unusual case of monolocular IBC and emphasize the performance of CEUS. CASE SUMMARY A 45-year-old man complained of epigastric pain lasting 1 wk. He had no medical history of hepatitis, liver cirrhosis or parasitization. Physical examination revealed a mass of approximately 6 cm in size in the upper abdomen below the subxiphoid process. Tumor marker tests found elevated CA19-9 levels (119.3 U/mL), but other laboratory tests were unremarkable. Ultrasound and computerized tomography revealed a round thick-walled mass measuring 83 mm × 68 mm located in the left lateral lobe of the liver that lacked internal septations and manifested as a monolocular cystic structure. CEUS demonstrated that in the arterial phase, the anechoic area manifested as a peripheral ring with homogeneous enhancement. The central part presented with no enhancement. During the portal phase, the enhanced portion began to subside but was still above the surrounding liver tissue. The patient underwent left partial liver lobectomy and recovered well without tumor recurrence or metastasis. Eventually, the results of pathological examination confirmed IBC. CONCLUSION A few IBC cases present with monolocular characteristics, and the lack of intracystic septa in imaging performance cannot exclude IBC.

Background Deterioration of sleep quality has been reported to contribute to the incidence of diabetes and may be responsible for glycemic status in diabetes. The present study explored the relationship between sleep quality and glycemic variability in patients with type 2 diabetes (T2D). Methods We recruited 111 patients with T2D for this cross-sectional study. Each patient underwent flash glucose monitoring for 14 days to obtain glycemic variability parameters, such as standard deviation of glucose (SD), coefficient of variation of glucose (CV), mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD), and time in glucose range of 3.9–10 mmol/L (TIR3.9–10). After 14 days of flash glucose monitoring, each patient received a questionnaire on the Pittsburgh Sleep Quality Index (PSQI) to evaluate subjective sleep quality. HbA1c was also collected to assess average glucose. Results HbA1c was comparable among the subgroups of PSQI score tertiles. Across ascending tertiles of PSQI scores, SD, CV and MAGE were increased, while TIR3.9–10 was decreased (p for trend p for trend = 0.090). Moreover, PSQI scores were positively correlated with SD, CV, MODD and MAGE (r = 0.322, 0.361, 0.308 and 0.354, respectively, p < 0.001) and were inversely correlated with TIR3.9–10 (r = − 0.386, p < 0.001). After adjusting for other relevant data by multivariate linear regression analyses, PSQI scores were independently responsible for SD (β = 0.251, t = 2.112, p = 0.041), CV (β = 0.286, t = 2.207, p = 0.033), MAGE (β = 0.323, t = 2.489, p = 0.018), and TIR3.9–10 (β = − 0.401, t = − 3.930, p < 0.001) but not for MODD (β = 0.188, t = 1.374, p = 0.177). Conclusions Increased glycemic variability assessed by flash glucose monitoring was closely associated with poor subjective sleep quality evaluated by the PSQI in patients with T2D.

Semiconductor materials for energy storage are the core and foundation of modern information society and play important roles in photovoltaic system, integrated circuit, spacecraft technology, lighting applications, and other fields. Unfortunately, due to the long experiment period and high calculation cost, the high-precision band gap (the basic characteristic parameter) of semiconductor is difficult to obtain, which hinders the development of new semiconductor materials. Since the traditional Perdew–Burke–Ernzerhof (PBE) functional not only requires a long calculation time, but also significantly underestimates the band gap, we developed a deep learning model that can predict the more precise Heyd–Scuseria–Ernzerhof (HSE06) band gaps in milliseconds for 1,503 binary metallic oxides, nitrides, and sulfides, with a mean absolute error (MAE) of 0.35 eV, a mean squared error (MSE) of 0.21 eV, and a coefficient of determination (R2) of 0.98. Based on transfer learning, only 106 crystals), which is of great significance for the screening and discovery of new semiconductor energy storage materials.

Background Hemichorea usually results from vascular lesions of the basal ganglia. Most often, the lesion is contralateral to the affected limb but rarely, it may be ipsilateral. The pathophysiology of ipsilateral hemichorea is still poorly understood. We review the literature on hemichorea due to ipsilateral cerebral infarction and explore possible mechanisms for its occurrence. Case summary A 72-year-old woman presented with complaints of involuntary movements of the muscles of the left side of the face and mild weakness of the right limbs. Her symptoms had started suddenly 1 d earlier. After admission to the hospital, the involuntary movements spread to involve the left limbs also. Magnetic resonance imaging revealed a left thalamic infarction. The patient's hemichorea subsided after treatment with haloperidol (2 mg per time, 3 times/d) for 3 d; the hemiparesis resolved with rehabilitation physiotherapy. She is presently symptom free and on treatment for prevention of secondary stroke. We review the literature on the occurrence of ipsilateral hemichorea following thalamic infarction and discuss the possible pathomechanisms of this unusual presentation. Conclusion Ipsilateral hemichorea following a thalamic stroke is rare but it can be explained by structure of the extrapyramidal system. The thalamus is a relay station that exerts a bilateral control of motor function.

Objective The aim of this study was primarily to determine efficacy after alcohol septal ablation (ASA) in mildly symptomatic patients (NYHA class II) with hypertrophic obstructive cardiomyopathy (HOCM), as compared to medical therapy. Methods This retrospective study included 163 mildly symptomatic patients with HOCM evaluated in Beijing Anzhen Hospital between March 2001 and August 2019, consisting of the medical group (n = 105) and the ASA group (n = 58). All‐cause mortality and HCM‐related death were mainly observed. Results Follow‐up was completed in 161 patients and the median follow‐up was 6.0 years. Compared to medically treated patients, patients post‐ASA had comparable survival free of all‐cause mortality (98.3% and 95.1% vs. 93.0% and 83.1% at 5 and 10 years, respectively; p = 0.374). Survival free of HCM‐related death was also similar between ASA and medical groups (98.3% and 95.1% vs. 94.3% and 86.2% at 5 and 10 years, respectively; p = 0.608). However, compared to medical therapy, ASA had advantages on the improvement of NYHA class (1.4 ± 0.6 vs. 2.1 ± 0.5, p = .000) and lower occurrence of new‐onset atrial fibrillation (AF) (7.8% vs. 20.4%, p = .048). Multivariate analysis demonstrated that resting LVOT gradient at the last clinical check‐up was an independent predictor of all‐cause mortality (HR = 1.021, 95%CI 1.002–1.040, p = .027). Conclusion This registry suggests that mildly symptomatic patients with HOCM treated with ASA have comparable survival to that of medically treated patients, with the improvement of NYHA class and lower occurrence of new‐onset AF. All‐cause mortality is independently associated with resting LVOT gradient at the last clinical check‐up.

Background Health-related quality of life (HRQOL) has become an important part of the evaluation of clinical efficacy and prognosis in gastric cancer. This study aimed to assess the HRQOL of patients with gastric cancer using the a five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and explore the factors influencing patients' perceived quality of life. For those significant factors, we can take appropriate measures to intervene to extend patient survival and improve the quality of life. Methods A cross-sectional questionnaire survey was administered to 243 patients with gastric cancer in the First Affiliated Hospital of Suzhou University from December 2018 to December 2020. HRQOL was measured by the Chinese version of the EQ-5D-5L. Nonparametric test analyses and a Tobit regression model were used to identify the independent variables associated with the EQ-5D-5L utility scores. Results In this research, the mean score was 0.810, and the median was 0.893. Approximately 25% of patients reported no problems at all in any of the five dimensions. Problems in pain and discomfort were the most frequently reported (64.2%). Nonparametric test analyses showed that patients who did not have health insurance, or who had a history of alcohol use, a family history of cancer, had received surgery only, or had an interval of less than 1 week between taking this survey and their last treatment, demonstrated lower EQ-5D-5L scores. The Tobit regression model confirmed that health insurance, family history, and treatment were significantly associated with EQ-5D-5L scores. Conclusions The HRQOL of gastric cancer patients can be measured by EQ-5D-5L, and the results may provide a guide for choosing an appropriate individualized treatment plan.

A high-gain Fabry–Perot cavity antenna (FPCA) with wide 1 dB gain bandwidth in the S -band is proposed. A partially reflective surface with a positive phase gradient in a wideband is adopted to effectively improve the radiation characteristics of the designed broadband source antenna. The proposed FPCA has a measured –10 dB impedance bandwidth of 2.9–3.95 GHz (30.65%), and a 1 dB gain bandwidth is 2.9–3.6 GHz (21%). In such a wideband, the realized gain is enhanced by up to 6 dB, and the measured maximum aperture efficiency is 39.3%.

Several nairo-like viruses have been discovered in ticks in recent years, but their relevance to public health remains unknown. Here, we found a patient who had a history of tick bite and suffered from a febrile illness was infected with a previously discovered RNA virus, Beiji nairovirus (BJNV), in the nairo-like virus group of the order Bunyavirales. We isolated the virus by cell culture assay. BJNV could induce cytopathic effects in the baby hamster kidney and human hepatocellular carcinoma cells. Negative-stain electron microscopy revealed enveloped and spherical viral particles, morphologically similar to those of nairoviruses. We identified 67 patients as BJNV infection in 2017–2018. The median age of patients was 48 years (interquartile range 41–53 years); the median incubation period was 7 days (interquartile range 3–12 days). Most patients were men (70%), and a few (10%) had underlying diseases. Common symptoms of infected patients included fever (100%), headache (99%), depression (63%), coma (63%), and fatigue (54%), myalgia or arthralgia (45%); two (3%) patients became critically ill and one died. BJNV could cause growth retardation, viremia and histopathological changes in infected suckling mice. BJNV was also detected in sheep, cattle, and multiple tick species. These findings demonstrated that the newly discovered nairo-like virus may be associated with a febrile illness, with the potential vectors of ticks and reservoirs of sheep and cattle, highlighting its public health significance and necessity of further investigation in the tick-endemic areas worldwide.

In this article, a 2×2 broadband circularly polarized antenna array using the sequential rotation (SR) technique in the feed network is presented. This antenna covers the 5G-band of 3.5–3.6 GHz and...

Instead of inscribing the discrete phases into each local period of the seed HLPG, an equivalent approach to realize the phase-only sampled multichannel helical long-period fiber grating (HLPG) has been demonstrated both theoretically and experimentally which is realized by superposing the so-called sampling HLPGs with the seed HLPG in a same region of the fiber. The proposed approach can greatly facilitate the fabrication processes of the multichannel HLPG by using the direct CO2 laser writing technique, meanwhile it enables to provide much more design and fabrication flexibilities for high channel-count HLPG than the previous methods. As examples, a 3-channel and a 5-channel HLPG have been successfully demonstrated. Moreover, the orbital angular momentum (OAM) modes inherently existed at all channels of the fabricated HLPG have also been verified, which highlights that the proposed HLPGs could find application to multi-wavelength OAM mode converter as well.

Background Nonketotic hyperglycemia (NKH) is characterized by hyperglycemia with little or no ketoacidosis. Diverse neurological symptoms have been described in NKH patients, including choreoathetosis, hemiballismus, seizures, and coma in severe cases. Homonymous hemianopia, with or without occipital seizures, caused by hyperglycemia is less readily recognized. Case summary We describe a 54-year-old man with NKH, who reported seeing round, colored flickering lights with right homonymous hemianopia. Cranial magnetic resonance imaging demonstrated abnormalities in the left occipital lobe, with decreased T2 signal of the white matter, restricted diffusion, and corresponding low signal intensity in the apparent diffusion coefficient map. He responded to rehydration and a low-dose insulin regimen, with improvements of his visual field defect. Conclusion Patients with NKH may present focal neurologic signs. Hyperglycemia should be taken into consideration when making an etiologic diagnosis of homonymous hemianopia.

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), continues to spread around the world. While prophylactic vaccines against SARS-CoV-2 are making great progress, there is still a need to explore safe and effective therapies with biological products for COVID-19. Currently clinical trial efforts are planned and ongoing using different biological agents for anti-inflammatory therapies, immunomodulation, and therapeutic repair in COVID-19. Targeting inflammatory cytokines with antibodies or inhibitors may be an urgent therapeutic strategy for COVID-19. Importantly, it is critical for an in-depth understanding of these new clinical therapeutic agents in their conditions that are probably involved in both physiological and pathological host responses. In this article, we analyze the potential implications for the current clinical trials of therapeutic biologics and address issues for the development of the COVID-19-related biological therapies.

Background Primary hyperoxaluria(PH)is a rare autosomal recessive genetic disease that contains three subtypes (PH1, PH2 and PH3). Approximately 80% of PH patients has been reported as subtype PH1, this subtype of PH has been related to a higher risk of renal failure at any age. Several genetic studies indicate that the variants in gene AGXT are responsible for the occurrence of PH1. However, the population heterogeneity of the variants in AGXT makes the genetic diagnosis of PH1 more challenging as it is hard to locate each specific variant. It is valuable to have a complete spectrum of AGXT variants from different population for early diagnosis and clinical treatments of PH1. Case presentation In this study, We performed high-throughput sequencing and genetic analysis of a 6-year-old male PH1 patient from a Chinese family. Two variants (c.346G > A: p.Gly116Arg; c.864G > A: p.Trp288X) of the gene AGXT were identified. We found a nonsense variant (c.864G > A: p.Trp288X) that comes from the proband’s mother and has never been reported previously. The other missense variant (c.346G > A: p.Gly116Arg) was inherited from his father and has been found previously in a domain of aminotransferase, which plays an important role in the function of AGT protein. Furthermore, we searched 110 pathogenic variants of AGXT that have been reported worldwide in healthy local Chinese population, none of these pathogenic variants was detected in the local genomes. Conclusions Our research provides an important diagnosis basis for PH1 on the genetic level by updating the genotype of PH1 and also develops a better understanding of the variants in AGXT by broadening the variation database of AGXT according to the Chinese reference genome.

Atopic dermatitis (AD) is a common disease clinically characterized by chronic recurrent eczematous lesions, dry skin, and pruritus. AD can negatively impact patients’ quality of life. The prevalence of AD in China has been increasing during the past few decades. Based on the most recent advances in the treatment of AD, we updated the 2014 version of the Guidelines for Diagnosis and Treatment of Atopic Dermatitis in China regarding the definition, epidemiology, pathogenesis, clinical classification, diagnosis, prevention, and treatment of AD.

Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of ossification of the posterior longitudinal ligament (OPLL). Its prognostic factors for decompression have not been well studied. Additionally, no detailed radiological standard has been set for hoisting the vertebrae-OPLL complex (VOC) in ACAF.To identify the possible prognostic factors for decompression outcomes after ACAF for cervical OPLL, to determine the critical value of radiological parameters for predicting good outcomes, and to establish a radiological standard for hoisting the VOC in ACAF.This was a retrospective multicenter study.A total of 121 consecutive patients with OPLL who underwent ACAF at a point between January 2017 and June 2018 at any one of seven facilities and were monitored for at least 1 year afterward were enrolled in a multicenter study.Japanese Orthopedic Association (JOA) scores, recovery rate (RR) of neurologic function, and surgical complications were used to determine the effectiveness of ACAF.Patients were divided into two groups according to their RR for neurologic function. Patients with an RR of ≥50% and an RR of50% were designated as having good and poor decompression outcomes, respectively. The relationship between various possible prognostic factors and decompression outcomes was assessed by univariate and multivariate analysis. The receiver operating characteristic curve was used to determine the optimal cutoff value of the radiological parameters for prediction of good decompression outcomes. Next, the patients were redivided into three groups according to the cutoff value of the selected radiological parameter (postoperative anteroposterior canal diameter [APD] ratio). Patients with postoperative APD ratios of ≤80.7%, 80.7%-100%, and ≥100% were defined as members of the incomplete, optimal, and excessive antedisplacement groups, respectively. Differences in decompression outcomes among the three groups were compared to verify the reliability of the postoperative APD ratio and assess the necessity of excessive antedisplacement.Multivariate logistic regression analysis showed that patients' age at surgery (odds ratio [OR]=1.18; 95% confidence interval [CI]=1.08-1.29; p.01) and postoperative APD ratio (OR=0.83; 95% CI=0.77-0.90; p.01) were independently associated with decompression outcomes. The optimal cutoff point of the postoperative APD ratio was calculated at 80.7%, with 86.2% sensitivity and 73.5% specificity. There were no significant differences in the postoperative JOA scores and RRs between the excessive antedisplacement group and optimal antedisplacement group (p.05). However, a lower incidence of cerebrospinal fluid leakage and screw slippage was observed in the optimal antedisplacement group (p.05).Patients' age at surgery and their postoperative APD ratio are the two prognostic factors of decompression outcomes after ACAF. The postoperative APD ratio is also the most accurate radiological parameter for predicting good outcomes. Our findings suggest that it is essential for neurologic recovery to restore the spinal canal to more than 80.7% of its original size (postoperative APD ratio80.7%), and restoration to less than its original size (postoperative APD ratio100%) will help reduce the incidence of surgical complications. This may serve as a valuable reference for establishment of a radiological standard for hoisting the VOC in ACAF.

Allostatic load (AL), a composite index, has been used to capture variation in life-course stresses. However, few studies have been carried out among breast cancer patients. In this study, we examined the cross-sectional association of AL with demographics, healthy behaviors, tumor characteristics, and mitochondrial DNA copy number in breast cancer patients. The study used a sub-sample of 934 women with newly diagnosed breast cancer at M.D. Anderson from 2013 to 2018. To construct the AL score, the study used a battery of seventeen factors that represents the activity of five physiological systems: metabolic, cardiovascular, immunological, renal, and liver. AL was positively associated with the age of disease diagnosis (P = 0.002), and was higher in Black and Hispanic populations than White (P = 0.001 and 0.032, respectively). AL was also found more abundant in those who experienced marital dissolution (P = 0.006), lacked a college education (P = 0.045), currently smoked (P = 0.011), and had low levels of physical activity (P = 0.037) than their counterparts. The study then found that higher AL was associated with increased odds of having poorly differentiated tumors (Odds ratio (OR): 1.40, 95% confidence interval (CI): 1.28, 1.62). An additional significant association was observed between AL with estrogen receptor negative (ER-) (OR = 1.56, 95%CI: 1.02, 2.36) among Black patients. Finally, we observed a significant positive correlation between AL with leukocyte mitochondrial DNA copy number variation (P

The use of natural gas (NG) in dual-fuel heavy-duty engines has the potential to reduce pollutant and greenhouse gas (GHG) emissions from the transport sector when compared to the conventional diesel engines. However, NG composition and methane slip are of interest because both can adversely affect the benefits of NG as an alternative fuel, especially when considering GHG emissions. Therefore, this study experimentally investigated the effects of NG fuel properties on the performance and emissions of both conventional dual-fuel and reactivity-controlled compression ignition (RCCI) engine operations. Three different gas mixtures were selected to simulate typical NG compositions available in the world market, with methane numbers (MN) of 80.9, 87.6 and 94.1. These fuels were tested in a single-cylinder compression ignition engine operating at 0.6, 1.2 and 1.8 MPa net indicated mean effective pressure (IMEP). A high-pressure common rail system allowed for the use of various diesel injection strategies while a variable valve actuation system enabled the effective compression ratio to be adjusted via late intake valve closing (LIVC). The RCCI combustion was found to be more sensitive to changes in MN than the conventional NG-diesel dual-fuel operation. The gas mixture with the lowest MN reduced both total unburned hydrocarbons emissions and methane slip at the expense of higher nitrogen oxides (NOx) emissions. The effects of MN on the net indicated efficiency were more significant at 0.6 MPa IMEP, yielding differences of up to 4.9% between the RCCI operations with the lowest and highest MN fuels. Overall, this work revealed that the combination of the RCCI combustion and LIVC can achieve up to 80% lower methane slip and NOx emissions and relatively higher net indicated efficiency than the conventional dual-fuel regime, independent of the NG composition.

High-pressure direct-injection (HPDI) of natural gas is one of the most promising solutions for future ship engines, in which the combustion process is mainly controlled by the chemical kinetics. However, the employment of detailed chemical models for the multi-dimensional combustion simulation is significantly expensive due to the large scale of the marine engine. In the present paper, a reduced n-heptane/methane model consisting of 35-step reactions was constructed using multiple reduction approaches. Then this model was further reduced to include only 27 reactions by utilizing the HyChem (Hybrid Chemistry) method. An overall good agreement with the experimentally measured ignition delay data of both n-heptane and methane for these two reduced models was achieved and reasonable predictions for the measured laminar flame speeds were obtained for the 35-step model. But the 27-step model cannot predict the laminar flame speed very well. In addition, these two reduced models were both able to reproduce the experimentally measured in-cylinder pressure and heat release rate profiles for a HPDI natural gas marine engine, the highest error of predicted combustion phase being 6.5%. However, the engine-out CO emission was over-predicted and the highest error of predicted NOx emission was less than 12.9%. The predicted distributions of temperature and equivalence ratio by the 35-step and 27-step models are similar to those of the 334-step model. However, the predicted distributions of OH and CH2O are significantly different from those of the 334-step model. In short, the reduced chemical kinetic models developed provide a high-efficient and dependable method to simulate the characteristics of combustion and emissions in HPDI natural gas marine engines.

Background and objectives Haemovigilance involves surveillance of the whole chain of blood transfusion with the aim of identifying adverse events and errors and improving outcomes for patients. The Chinese Haemovigilance Network, founded in August 2017, has witnessed a rapid development in the last three years. Materials and methods Based on the 1,022 cases in 2019, we analysed the adverse reactions (ARs) by blood component, clinical outcome severity and demography of recipients in an effort to publish the first annual Chinese haemovigilance report. Results The AR rate associated with blood transfusion in 2019 was 0·2% in China. Allergic reactions and FNHTR were the two most common adverse symptoms, accounting for 97·7% of the reports. Two-thirds of the TAD, AHTR and TACO and all of the HTR and DHTR resulted in hospitalization or prolongation of hospitalization. Plasma and AP were usually associated with allergic reaction (81·1%), whereas red cells more commonly cause FNHTR (68·8%) and all the AHTR, HTR, DSTR and DHTR. 84·1% of patients were aged 16 years or over, and the majority of the TAD, AHTR, TACO and HTR involved patients aged 60 and above. The ratio of serious adverse reactions (SARs) was 8·2%. Allergic reaction and FNHTR were top two (85·7%) SARs. The first case related to anti-D immunoglobulin was detected in a DHTR report. Conclusion This report provides the world's first overview of transfusion-related adverse reactions in China. This report is useful for better understanding transfusion risks in China.

Hydrogenation reactions are an important process in today's chemical industry. Typically, hydrogenation reactions involve the removal of an unsaturated bond in olefins or other polyenes via thermal catalysis using hydrogen. As hydrogenation reactions are often carried out at temperatures up to several hundred degrees, they require significant energy input which typically comes from burning fossil fuels. In order to conserve fossil fuels and reduce CO2 emissions, researchers are now developing photothermal catalysts for hydrogenation reactions, which harness concentrated sunlight to achieve the required reaction temperatures or introduce sunlight into thermal-driven reaction systems to reduce the reaction temperatures. Photothermal catalysts thus need to be able to efficiently absorb sunlight, whilst also being able to drive the desired hydrogenation reaction with high activity and selectivity. In this review, we summarize recent research aimed at the development of photothermal catalysts for CO2/CO hydrogenation and alkene/alkyne/aromatic hydrogenation. Particular emphasis is placed on uncovering the reaction mechanisms at the molecular level, which in turn guides the rational design of photothermal catalysts with better performance.

With the rapid development of industrial production and aerospace, how to measure the plasma density has also developed rapidly. So a radio-frequency plasma transducer based on a three-layer dielec...

Background Ageing is an inevitable physiology process of humans, and skin biophysical parameters change owing to genetic and environmental factors in different ethnic populations. Aim To gain comprehensive data on the skin biophysical parameters of different anatomical regions and to explore the change trend of the skin characteristics associated with age for the indicated regions by generalized additive model. Methods We measured various skin biophysical parameters on forehead, cheek, chin and inner forearm of 178 Chinese women aged between 20 and 64 years living in Beijing. These parameters comprised skin hydration, transepidermal water loss (TEWL), sebum content, erythema index (EI), melanin index (MI), L*a*b* values, individual typology angle (ITA) and pH, which were quantified by non-invasive instruments. Results Comparing the skin parameters among the four test areas, we observed that the hydration, TEWL, EI and a* values were significantly higher for the face than for the forearm, but the L* and ITA values were just the opposite. The cheek was the lightest and brightest region with lowest sebum content, while the chin was much darker and the forehead was yellowish. Considering the change of the skin parameters with age, TEWL, sebum content and melanin and erythema indices had a linear relationship with age, whereas skin hydration, L, a, b, ITA and pH values exhibited a non-monotonic relationship. The turning points of these curves appeared almost at the thirties, showing the lightest and evenest skin color and more hydration, with lower pH values. Conclusion This study indicates that the skin biophysical characteristics of Chinese women were significantly affected by age and body regions.

The efficient synthetic route was disclosed to prepare optically active triarylborane-based [5]helicenes, 7B-PhHC and 7B5N-PhHC. Their emission wavelengths are tunable by both the chemical structure modification and the tuning of excited state charge transfer dynamics via selection of appropriate solvents or addition of external F-, enabling the full-color circularly polarized luminescence with moderate to good quantum yields (0.07-0.51) and high luminescence dissymmetry factors (glum > 5 × 10-3).

BACKGROUND Cerebrotendinous xanthomatosis (CTX) is a treatable autosomal recessive inherited metabolic disorder. It results from a deficiency of sterol 27-hydroxylase (CYP27A1), which is a mitochondrial cytochrome P450 enzyme that catalyzes the hydroxylation of cholesterol and modulates cholesterol homeostasis. Patients with CYP27A1 deficiency show symptoms related to excessive accumulation of cholesterol and cholestanol in lipophilic tissues such as the brain, eyes, tendons, and vessels, resulting in juvenile cataracts, tendon xanthoma, chronic diarrhea, cognitive impairment, ataxia, spastic paraplegia, and peripheral neuropathy. CTX is underdiagnosed as knowledge of the disorder is mainly based on case reports. CASE SUMMARY A Chinese family with CTX consisting of one patient and four heterozygous carriers was studied. The patient is a 47-year-old male, who mainly had psychiatric signs but without some cardinal features of CTX such as cataracts, cerebellar ataxia, pyramidal signs and chronic diarrhea. There was a significant increase in the concentration of free fatty acid compared to normal range. Doppler ultrasound of the urinary system showed multiple left kidney stones, a right kidney cyst, and a hypoechoic area in the bladder, which could move with body position. Sagittal and axial magnetic resonance imaging (MRI) of the right ankle joint showed apparent enlargement of the right Achilles tendon and upper medial malleolus flexor tendon, abnormal thickening of the plantar fat, and a small amount of exudation around the fascia in front of the Achilles tendon. Cerebral MRI suggested white matter (WM) demyelination and slight cerebral atrophy. The diagnosis was confirmed by targeted sequencing, which identified compound heterozygous mutations in exon 2 and intron 7 of the CYP27A1 gene (c.435G>T, c.1263+1G>A). Treatment for 3 wk with a combination of lipid-lowering and antipsychotic therapy improved his psychiatric symptoms and normalized the levels of serum free fatty acid. Sediments in the bladder disappeared after therapy. CONCLUSION CYP27A1 genetic analysis should be the definitive method for CTX diagnosis. This case suggests that urinary system diseases may be neglected in CTX patients. The clinical, biological, radiological, and genetic characteristics of CTX are summarized to promote early diagnosis and treatment of this disease.

Acute ischemic stroke is one of the leading causes of death in developed countries and the most common cause of disability in adults worldwide. Despite advances in the understanding of stroke pathophysiology, therapeutic options remain limited. In this study, we explored the interaction of Shrm4 and the metabotropic gamma-aminobutyric acid (GABA) receptors (GABAB ) in ischemic stroke. A transient middle cerebral artery occlusion (MCAO) model was induced by filament insertion in Shrm4+/+ and wild-type C57BL/6J mice, followed by reperfusion for up to 7 days. Baclofen was administered was used to activate GABAB in vivo during reperfusion. Neurological deficits, motor and memory functions, and infarct volume were determined in the various mouse groups. Furthermore, we also developed an oxygen-glucose deprivation (OGD) cell model in primary neurons to test Shrm4/GABAB interactions in vitro. Shrm4 was observed to decrease infarct volume and neuronal cell loss in penumbra, and rescue neurological deficits in MCAO mice. Notably, Shrm4 also increased pole climbing speed, reduced foot faults, and increased escape latency in the Morris water maze test, while reducing neuron autophagy through an interaction with GABAB receptors. GABAB activation using baclofen further reduced OGD-induced neuron damage in culture and stroke outcomes of MCAO, relative to Shrm4 alone. Taken together, Shrm4-mediated GABAB activation confers neuroprotection by reducing neuronal autophagy in acute ischemic stroke.

Backgrounds Postoperative percutaneous choledochoscopy via T tube sinus tract is a common modality for treating retained intrahepatic stones in China. We report a rare complication of postoperative choledochoscopy for treating retained hepatolithiasis: T tube sinus tract duodenal fistula. Methods From January 2003 to December 2018, intrahepatic duct stones with or without common bile duct stones were detected in 1031 patients. Fifteen of the 1031 patients with intrahepatic stones developed a T tube sinus tract duodenal fistula that was diagnosed by cholangiography and choledochoscopy. Results The incidence of T tube sinus tract duodenal fistula in patients with retained intrahepatic stones being treated by postoperative choledochoscopy is 1.45% (15/1031) in this series. The chi-squared test showed that hypoalbuminemia (P = 0.003), long duration of T tube (P = 0.002), and high frequency of procedure (P = 0.008) might be associated with the occurrence of T tube sinus tract duodenal fistula. The logistic regression analysis demonstrated that hypoalbuminemia might be the independent risk factor for this special fistula (P = 0.037). Conclusions Hypoalbuminemia, long time placement of T tube in situ and high frequency of procedure are probably the main causes of the T tube sinus tract duodenal fistula. Placement of T tube in correct way and improving nutritional status may be the key points to prevent the formation of T tube sinus tract duodenal fistula.

OBJECTIVE: Coagulopathy is one of the characteristics observed in critically ill patients with coronavirus disease 2019 (COVID-19). Antiphospholipid antibodies (aPLs) contribute to coagulopathy, though their role in COVID-19 remains unclear. This study was undertaken to determine the prevalence and characteristics of aPLs in patients with COVID-19. METHODS: Sera collected from 66 COVID-19 patients who were critically ill and 13 COVID-19 patients who were not critically ill were tested by chemiluminescence immunoassay for anticardiolipin antibodies (aCLs), anti-s2 -glycoprotein I (anti-s2 GPI) (IgG, IgM, and IgA), and IgG anti-s2 GPI-domain 1 (anti-s2 GPI-D1) and IgM and IgG anti-phosphatidylserine/prothrombin (anti-PS/PT) antibodies were detected in the serum by enzyme-linked immunosorbent assay. RESULTS: Of the 66 COVID-19 patients in critical condition, aPLs were detected in 31 (47% ). Antiphospholipid antibodies were not present among COVID-19 patients who were not in critical condition. The IgA anti-s2 GPI antibody was the most commonly observed aPL in patients with COVID-19 and was present in 28.8% (19 of 66) of the critically ill patients, followed by IgA aCLs (17 of 66, or 25.8%) and IgG anti-s2 GPI (12 of 66, or 18.2%). For multiple aPLs, IgA anti-s2 GPI + IgA aCLs was the most common antibody profile observed (15 of 66, or 22.7%), followed by IgA anti-s2 GPI + IgA aCL + IgG anti-s2 GPI (10 of 66, or 15.2%). Antiphospholipid antibodies emerge ~35-39 days after disease onset. A dynamic analysis of aPLs revealed 4 patterns based on the persistence or transient appearance of the aPLs. Patients with multiple aPLs had a significantly higher incidence of cerebral infarction compared to patients who were negative for aPLs (P = 0.023). CONCLUSION: Antiphospholipid antibodies were common in critically ill patients with COVID-19. Repeated testing demonstrating medium to high titers of aPLs and the number of aPL types a patient is positive for may help in identifying patients who are at risk of developing cerebral infarction. Antiphospholipid antibodies may be transient and disappear within a few weeks, but in genetically predisposed patients, COVID-19 may trigger the development of an autoimmune condition similar to the antiphospholipid syndrome (APS), referred to as "COVID-19-induced APS-like syndrome." Long-term follow-up of COVID-19 patients who are positive for aPLs would be of great importance in understanding the pathogenesis of this novel coronavirus.

Based on the original text information, this paper converts the users' theme preferences and text sentiment features into attention information and combines different forms with the LSTM (Long Short-Term Memory) model to predict the personality characteristics of social network users. Finally, the experimental results of multiple groups’ show that the Attention-based LSTM model proposed in the paper can achieve better results than the currently popular methods in the recognition of user personality traits and that the model has good generalization ability.

Spinal cord injury (SCI) is a devastating disorder that often results in temporary and/or permanent functional impairment below the injured level. To date, few satisfactory therapeutic strategies are available to treat SCI. Hence, exploring novel strategies for SCI is an essential public health concern. Cell transplantation therapy, which is associated with neuroprotection, immunomodulation, axon regeneration, neuronal relay formation and myelin regeneration, provides a promising therapeutic strategy for SCI. The neuronal stem cell (NSC) preconditioning method is an emerging approach, which facilitates NSC survival and neuronal differentiation after implantation. The aim of the present study was to develop a feasible candidate for cell‑based therapy following SCI in rats and to investigate the role of high mobility group box‑1 (HMGB1) in NSC activation. The results of the present study showed that transplantation of NSCs, preconditioned with 1 ng/ml HMGB1, facilitated functional improvement of injured spinal cords, as indicated by Basso, Beattie and Bresnahan mean scores, mechanical hypersensitivity and cold stimulation. Meanwhile, the histological examination of hematoxylin and eosin staining indicated that engraftment of HMGB1‑preconditioned NSCs resulted in decreased atrophy of the injured spinal cord. Meanwhile, the transplantation of HMGB1‑preconditioned NSCs resulted in an increased number of functional Nissl bodies in neurons, as detected by Nissl staining, and an increase in the number of βIII‑tubulin+ cells in the epicenter of injured spinal cords in rats with SCI. In addition, the results also demonstrated that 1 ng/ml HMGB1 promoted the differentiation of NSCs into neurons, and that the ERK signaling pathway played an important role in this process. In conclusion, the present data indicated that the preconditioning strategy with 1 ng/ml HMGB1 may present a feasible candidate for cell‑based therapy following SCI in rats, which may enlarge the scope of HMGB1 in NSC activation.

Significant variations in experience of the COVID-19 pandemic have been observed in the United States. Increased risk of COVID-19-related death has been reported among cancer survivors, but due to limited sample size in those studies, to what extent the previous cancer diagnosis may play a role in the determination of COVID-19-related death is still unclear. In this study, using aggregated real-world data extracted from TriNetx electronic medical record data from 34 hospitals around United States, we assessed the relationship between prior cancer diagnosis in the past 5 years and COVID-19-related death within one month after the diagnosis of virus contraction. A total of 24,534 patients aged 18-80 years old who contracted COVID-19 were identified from January 20th to May 4th, 2020. Among them, 3,619 were cancer survivors. In the univariate analysis, we found that cancer patients had 2.55-fold increased risk ratio (RR) of death than those without cancer (RR=2.55, 95% Confidence Interval (CI): 2.25, 2.88), although the risk was decreased but still significant (RR=1.42, 95% CI: 1.21, 1.67) after adjustment for demographics (e.g., age, gender, and race) and other pre-existing chronic diseases, including obesity, diabetes, hypertension, chronic ischemic heart disease, chronic kidney disease, asthma, and COPD. When stratified by cancer sites, significant associations were observed between respiratory and intrathoracic, oral, digestive, breast, male genital, urinary, blood, and skin cancers with COVID-19-related death in the univariate analysis. As expected, the most significant cancer site was respiratory and intrathoracic cancer with an RR of 6.49 (95% CI: 5.21, 8.07). However, after adjustment for demographics and other pre-existing chronic diseases, the significant associations remained for respiratory and intrathoracic, digestive, and blood cancers (RR=1.89, 95% CI: 1.31, 2.73; RR=1.59, 95% CI: 1.06, 2.38; RR=2.08, 95% CI: 1.51, 2.86, respectively). In addition, among cancer survivors, men were found to have higher RR of death than women (RR=1.41, 95% CI: 1.12, 1.78), but the RR did not differ between Blacks and Whites. In summary, our data show significant increased COVID-19-related death among cancer survivors. The elevated risk was particularly evident among those who had respiratory and intrathoracic, digestive, and blood cancers. Citation Format: Jie Shen, Hua Zhao. Increased risk of COVID-19-related death among cancer survivors [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S10-03.

This article uses extracted bridge mode shapes to detect bridge damage, including both local damage such as that due to a bridge strike and global damage such as that due to foundation scour. Typic...

A real-time vehicle monitoring is crucial for effective bridge maintenance and traffic management because overloaded vehicles can cause damage to bridges, and in some extreme cases, it will directly lead to a bridge failure. Bridge weigh-in-motion (BWIM) system as a high performance and cost-effective technology has been extensively used to monitor vehicle speed and weight on highways. However, the dynamic effect and data noise may have an adverse impact on the bridge responses during and immediately following the vehicles pass the bridge. The fast Fourier transform (FFT) method, which can significantly purify the collected structural responses (dynamic strains) received from sensors or transducers, was used in axle counting, detection, and axle weighing technology in this study. To further improve the accuracy of the BWIM system, the field-calibrated influence lines (ILs) of a continuous multi-girder bridge were regarded as a reference to identify the vehicle weight based on the modified Moses algorithm and the least squares method. In situ experimental results indicated that the signals treated with FFT filter were far better than the original ones, the efficiency and the accuracy of axle detection were significantly improved by introducing the FFT method to the BWIM system. Moreover, the lateral load distribution effect on bridges should be considered by using the calculated average ILs of the specific lane individually for vehicle weight calculation of this lane.

The coronavirus disease 2019 (COVID-19) global pandemic continues and antiviral agents and vaccines are currently under investigation. Mesenchymal stem cell (MSC)-based therapy can be a suitable option for management of patients with COVID-19 at the urgent time of virus outbreak. Currently, MSCs are being explored against the novel infectious disease due to their therapeutic properties of anti-inflammation, immunomodulation and tissue repair and regeneration, albeit the precise mechanisms of MSC action toward COVID-19 remain unclear. To date, rigorous results from clinical trials using MSCs in human have been weakly positive. The pervasive uncertainty of using MSC therapeutic products as an effective combatant against COVID-19 requires rigorous resolution on several fronts, including MSC fate after infusion, safety issue, homing capability, and MSC resistance to the disease microenvironment. Focusing on these facets, a few important ones will be critically analyzed and addressed in this article for the development of safe and effective MSC-based therapies for COVID-19.

We retrospectively evaluated the echocardiographic data of ambrisentan-treated patients with pulmonary arterial hypertension (PAH) (NCT01808313).Change from baseline in right ventricle (RV) systolic function, right heart structure, and pulmonary artery systolic pressure (PASP) prognosis to Weeks 12 and 24 was evaluated by echocardiography.In the overall population, the mean tissue Doppler-derived tricuspid lateral annular systolic velocity (S') increased by 0.6 cm/s at both Weeks 12 (p 0.001) and 24 (p = 0.004) and tricuspid annular plane systolic excursion increased by 0.13 cm at Week 12 and 0.15 cm at Week 24 (both p 0.001). A marked decrease in transverse and longitudinal RV and RA diameter at Weeks 12 and 24 was observed. A significant decrease in diastolic eccentricity index at both Weeks 12 (-0.1; p = 0.02) and 24 (-0.1; p = 0.001). The decrease in PASP from baseline was significant at both Weeks 12 (-9.5 mmHg; p0.001) and 24 (-7.6 mmHg; p0.001), while a decrease in the estimated right atrium pressure was found to be significant at Week 24 (-0.8mmHg; p = 0.01).Significant improvements in a number of RV echocardiographic parameters were observed at Weeks 12 and 24 after ambrisentan treatment in patients with PAH.

China faces the greatest challenge from stroke in the world. The death rate for cerebrovascular diseases in China was 149.49 per 100 000, accounting for 1.57 million deaths in 2018. It ranked third among the leading causes of death behind malignant tumours and heart disease. The age-standardised prevalence and incidence of stroke in 2013 were 1114.8 per 100 000 population and 246.8 per 100 000 person-years, respectively. According to the Global Burden of Disease Study 2017, the years of life lost (YLLs) per 100 000 population for stroke increased by 14.6%; YLLs due to stroke rose from third highest among all causes in 1990 to the highest in 2017. The absolute numbers and rates per 100 000 population for all-age disability-adjusted life years (DALYs) for stroke increased substantially between 1990 and 2017, and stroke was the leading cause of all-age DALYs in 2017. The main contributors to cerebrovascular diseases include behavioural risk factors (smoking and alcohol use) and pre-existing conditions (hypertension, diabetes mellitus, dyslipidaemia and atrial fibrillation (AF)). The most prevalent risk factors among stroke survivors were hypertension (63.0%-84.2%) and smoking (31.7%-47.6%). The least prevalent was AF (2.7%-7.4%). The prevalences for major risk factors for stroke are high and most have increased over time. Based on the latest national epidemiological data, 26.6% of adults aged ≥15 years (307.6 million adults) smoked tobacco products. For those aged ≥18 years, age-adjusted prevalence of hypertension was 25.2%; adjusted prevalence of hypercholesterolaemia was 5.8%; and the standardised prevalence of diabetes was 10.9%. For those aged ≥40 years, the standardised prevalence of AF was 2.31%. Data from the Hospital Quality Monitoring System showed that 3 010 204 inpatients with stroke were admitted to 1853 tertiary care hospitals during 2018. Of those, 2 466 785 (81.9%) were ischaemic strokes (ISs); 447 609 (14.9%) were intracerebral haemorrhages (ICHs); and 95 810 (3.2%) were subarachnoid haemorrhages (SAHs). The average age of patients admitted was 66 years old, and nearly 60% were male. A total of 1555 (0.1%), 2774 (0.6%) and 1347 (1.4%) paediatric strokes (age

Background The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, also called 2019-nCoV) causes different morbidity risks to individuals in different age groups. This study attempts to quantify the age-specific transmissibility using a mathematical model. Methods An epidemiological model with five compartments (susceptible–exposed–symptomatic–asymptomatic–recovered/removed [SEIAR]) was developed based on observed transmission features. Coronavirus disease 2019 (COVID-19) cases were divided into four age groups: group 1, those ≤ 14 years old; group 2, those 15 to 44 years old; group 3, those 45 to 64 years old; and group 4, those ≥ 65 years old. The model was initially based on cases (including imported cases and secondary cases) collected in Hunan Province from January 5 to February 19, 2020. Another dataset, from Jilin Province, was used to test the model. Results The age-specific SEIAR model fitted the data well in each age group (P β43 = 7.71 × 10− 9; SAR43 = 3.86 × 10− 8), followed by group 3 to 4 (median: β34 = 3.07 × 10− 9; SAR34 = 1.53 × 10− 8), group 2 to 2 (median: β22 = 1.24 × 10− 9; SAR22 = 6.21 × 10− 9), and group 3 to 1 (median: β31 = 4.10 × 10− 10; SAR31 = 2.08 × 10− 9). The lowest transmissibility was from age group 3 to 3 (median: β33 = 1.64 × 10− 19; SAR33 = 8.19 × 10− 19), followed by group 4 to 4 (median: β44 = 3.66 × 10− 17; SAR44 = 1.83 × 10− 16), group 3 to 2 (median: β32 = 1.21 × 10− 16; SAR32 = 6.06 × 10− 16), and group 1 to 4 (median: β14 = 7.20 × 10− 14; SAR14 = 3.60 × 10− 13). In Jilin Province, the highest transmissibility occurred from age group 4 to 4 (median: β43 = 4.27 × 10− 8; SAR43 = 2.13 × 10− 7), followed by group 3 to 4 (median: β34 = 1.81 × 10− 8; SAR34 = 9.03 × 10− 8). Conclusions SARS-CoV-2 exhibits high transmissibility between middle-aged (45 to 64 years old) and elderly (≥ 65 years old) people. Children (≤ 14 years old) have very low susceptibility to COVID-19. This study will improve our understanding of the transmission feature of SARS-CoV-2 in different age groups and suggest the most prevention measures should be applied to middle-aged and elderly people.

A new method enabling the simultaneous generation of the first- and the second-order orbital angular momentum (OAM) modes has been proposed and experimentally demonstrated, which is realized by using two consecutively- cascaded helical long-period fiber gratings (HLPGs). As a typical example, the first-order (l = 1) OAM mode with a conversion efficiency of 94% and the second-order (l = -2 ) OAM mode with a conversion efficiency of 83% have been successfully obtained. This is the first report for simultaneous generation of the first- and second-order OAM modes by using the HLPGs only. The proposed method may provide a new way to realize multiple OAM modes in a fiber.