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The aim of the current study was to evaluate the protective effects and mechanisms of isoliquiritigenin (ISO) on acute renal injury. CCK-8 assays were applied to assess the effects of ISO at different doses (20, 40, and 80 μg/mL) on oxidative damage in human renal HK-2 cells incubated with high glucose. After the diabetic nephropathy (DN) rat model was established, the model animals were randomly assigned to saline-treated control, three model groups received the 10, 20 and 40 mg/kg ISO, respectively, using the healthy Sprague-Dawley (SD) rats as normal control. The blood biochemical indexes, renal functions, oxidative stress, morphological changes, fibrosis- and JAK2/STAT3-related factors in DN model rats were all assessed. The cellular viability of the renal HK-2 cells with oxidative damages were all markedly ameliorated via the incubation of ISO between 10 and 80 μg/mL compared with negative control. In addition, the significantly down-regulated ROS content and up-regulated expression levels of GSH, SOD2, and GPX1 were all observed in ISO-treated groups. Long-term administration of ISO at different doses in DN rats effectively improved general diabetic characteristics and renal morphology. Furthermore, long-term administration of ISO could ameliorate excessive oxidation stress, down-regulate the expression levels of renal fibrosis- and inflammation-related factors, as well as inhibit the JAK2/STAT3 signaling pathway. In conclusion, ISO at all three dosages could efficiently improve the renal injury induced by STZ via ameliorating renal fibrosis, oxidative stress, and inhibiting JAK2/STAT3 signaling pathways in the DN rats.

This study aimed to evaluate the value of [68 Ga]Pentixafor PET/CT for the detection of lesions in central nervous system lymphoma (CNSL) patients before chemotherapy, during treatment and suspected CSNL recurrence, compared with 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT). Twenty-six patients with newly or previously diagnosed CNSL who underwent [68 Ga]Pentixafor PET/CT were included retrospectively. Histopathological results, magnetic resonance imaging (MRI), and follow-up were used as the standard reference. The accuracy of lesion detection, maximum standardized uptake value (SUVmax) of tumors, and ratio of tumor-to-normal brain (T/N) with [68 Ga]Pentixafor PET/CT were calculated and compared to those obtained with [18F]FDG PET/CT. CXCR4 expression was analyzed through immunohistochemistry. Of 26 patients, 18 were newly diagnosed with a total of 23 lesions, 4 had recurrent with 4 lesions, and 4 underwent a mid-term treatment assessment after 4 cycles of chemotherapy (3 achieved complete response (CR), 1 experienced progressive disease (PD) with a total of 8 lesions). Thirty-five lesions were all clearly detected with favorable contrast by [68 Ga]Pentixafor PET/CT (accuracy, 100%), consistent with the results of contrast-enhanced magnetic resonance imaging (CE-MRI). The SUVmax of positive lesions in [68 Ga]Pentixafor PET/CT was correlated with tumor size (r = 0.555, P = 0.001). In 21 patients, compared with [18F]FDG PET/CT, [68 Ga]Pentixafor PET/CT showed a remarkably higher T/N ratio (21.93 ± 10.77 vs 4.29 ± 2.16, P = 0.000) and detected 5 more lesions in the mid-term treatment assessment of patients (P = 0.026). The CXCR4 expression of CNSL lesions was correlated with SUVmax of [68 Ga]Pentixafor PET/CT (r = 0.772, P = 0.000). CXCR4-directed PET/CT using [68 Ga]Pentixafor, with excellent tumor-to-background contrast, might be a more promising agent for the detection of lesions in CNSL patients than [18F]FDG PET/CT.

The objective of the study was to characterize benign lesions showing increased 68Ga-FAPI-04 uptake on FAPI PET/CT. We retrospectively reviewed 182 patients with suspected various cancers who were performed 68Ga-FAPI-04 PET/CT imaging from August 2020 to December 2020. The diagnoses of the benign lesions were made by the CT findings (CT), other imaging information (OII) (contrast enhance CT, FDG PET, ultrasound, MRI or others), clinical information (CI) (medical history, laboratory examination, symptom, physical sign and follow-up information) or histological biopsy (HB). A total of 185 primary malignant tumors were detected by FAPI PET/CT with the median SUVmax of 9.0 (range from 0.97 to 25.71). There were 360 benign lesions with increased FAPI uptake were detected in 146 (146/182, 80.2%) patients with the median SUVmax of 3.64 (range from 1.39 to 21.56), including inflammatory processes (n = 231, 64.2%), exostosis (n = 54, 15%), hemorrhoid (n = 47, 13.1%), fracture (n = 17, 4.7%), hepatic fibrosis (n = 4, 1.1%), and others (n = 7, 1.9%). Benign lesions with increased 68Ga-FAPI-04 uptake are common. The overall SUVmax of benign lesions is lower than that of malignant tumors, however there is a large overlap of SUVmax range. Similar to FDG PET, some benign lesions can be easily diagnosed by combining CT findings, special location and clinical data, but there are still some lesions that may be confused with malignant lesions, which need to be paid more attention. NIH ClinicalTrials.gov (NCT04499365).

Background We aim to investigate the clinical characteristics and survival rate of coronavirus disease 2019 (COVID-19) patients. Methods Ninety-seven COVID-19 patients were enrolled. The laboratory results, lung imaging and medical treatment were compared. Patients were followed up after 1 year, and the Kaplan-Meier test was used for survival analysis. Results Compared with the non-severe group, the age of the severe group was older, and the proportion of concomitant diseases were higher. As fever was the primary clinical manifestation, dyspnea and anorexia were more common in severe patients. Lung imaging manifestations and laboratory indicators were worse in the severe group. Accordingly, the treatment of glucocorticoid, antibiotics, and advanced life support were in high proportion. Of the 97 patients with COVID-19, 4 severe patients died within one month during the 1-year follow-up, with the median survival time of 47.0 weeks (95% CI: 45.1-48.9). Conclusions Severe cases of COVID-19 are characterized by advanced age, more concomitant diseases and complications, which lead to a decreased short-term survival rate. However, there were no deaths after one month, which implied a good prognosis if the risk period were passed smoothly.

Background Antibiotics play an important role in the treatment of infectious diseases. However, the overuse of antibiotics increases the spread of drug-resistant bacteria and causes dysbiosis of the intestinal microbiota. Few studies have addressed the longitudinal effects of antibiotics on the microbiome and host immunity. Materials and methods In this study, the short-term effect of fluoroquinolone (levofloxacin) and β-lactam antibiotics (meropenem, cefoperazone/sulbactam, and aztreonam) on the gut microbiota of mice was evaluated by 16S rRNA gene sequencing. The susceptibility of Bifidobacterium longum, Lactobacillus lactis, Enterococcus faecium, and Clostridium butyricum to these antimicrobial agents was assessed using the disc diffusion method. Results Our results showed that 4-day antibiotic exposure significantly reduced the alpha and beta diversity of gut bacteria and increased serum inflammatory cytokines, and these changes persisted long after antibiotic withdrawal and did not return to pre-treatment levels. Nonetheless, the bacterial community composition tended to return to pre-treatment levels after discontinuing treatment. The tested probiotic strains were resistant to aztreonam but were sensitive to meropenem and cefoperazone/sulbactam. Conclusion Short-term antibiotic treatment led to significant changes in the intestinal flora with a tendency to recover. The antibiotics had different effects on the intestinal microbial community and probiotic strains. This study provides guidance for the concomitant use of probiotics and antibiotics, and the results emphasize the importance of using broad-spectrum antibiotics responsibly to prevent the long-term disruption of the native microbiota.

Multimode fiber (MMF) based endoscopy could reach high resolution and is fine enough for vivo imaging. However, the received images are speckles due to the mode crosstalk and sensitivity to environment of MMF, which makes image reconstruction the main challenge. We propose to use pre-trained autoencoder for image reconstruction from speckles to original images, which shows high performance and fast convergence speed. The network architecture includes two parts, i.e ., encoder and decoder. In the first step, we pre-train the network to initialize the parameters of the decoder. In the second step, the network can learn the mapping relation between speckle patterns and original images. We conduct experiment of transmitting over one-meter MMF with 50- $\mu \text{m}$ -core to verify this method. Structural similarity (SSIM), peak signal-to-noise ratio (PSNR), and mean square error (MSE) are measured to evaluate the performance. Compared with U-net, the SSIM increases by 11% with pre-trained autoencoder. Moreover, the training of pre-trained autoencoder is both fast and steady.

BackgroundCoronavirus disease 2019 (COVID-19) is an emerging serious global health problem. Gastrointestinal symptoms are common in COVID-19 patients, and severe acute respiratory syndrome coronavirus 2 RNA has been detected in stool specimens. However, the relationship between the gut microbiome and disease remains to be established.MethodsWe conducted a cross-sectional study of 30 patients with COVID-19, 24 patients with influenza A(H1N1), and 30 matched healthy controls (HCs) to identify differences in the gut microbiota by 16S ribosomal RNA gene V3–V4 region sequencing.ResultsCompared with HCs, COVID-19 patients had significantly reduced bacterial diversity; a significantly higher relative abundance of opportunistic pathogens, such as Streptococcus, Rothia, Veillonella, and Actinomyces; and a lower relative abundance of beneficial symbionts. Five biomarkers showed high accuracy for distinguishing COVID-19 patients from HCs with an area under the curve (AUC) up to 0.89. Patients with H1N1 displayed lower diversity and different overall microbial composition compared with COVID-19 patients. Seven biomarkers were selected to distinguish the 2 cohorts (AUC = 0.94).ConclusionsThe gut microbial signature of patients with COVID-19 was different from that of H1N1 patients and HCs. Our study suggests the potential value of the gut microbiota as a diagnostic biomarker and therapeutic target for COVID-19, but further validation is needed.

Full matrix focusing method of ultrasonic phased array has been proved with advantages of good signal-to-noise ratio and imaging resolution in the field of Ultrasonic NDT. However, it is still suffering from the time-consuming data acquisition and processing. In order to solve the problem, two simplified matrix focusing methods are provided in the paper. One provided method is a triangular matrix focusing algorithm based on the principle of reciprocity for the multi-channel ultrasonic system. The other provided method is a trapezoidal matrix focusing algorithm based on the energy weight of the different channel to the focusing area. Time of data acquisition and computational is decreased with the provided simplified matrix focusing methods. In order to prove the validity of two provided algorithms, both side-drilled holes and oblique cracks are used for imaging experiments. The experimental results show that the imaging quality of the triangular matrix focusing algorithm is basically consistent to that of the full matrix focusing method. And imaging quality of the trapezoidal matrix focusing algorithm is slightly reduced with the amount of multi-channel data decreasing. Both data acquisition and computational efficiency using the triangular matrix focusing algorithm and the trapezoidal matrix focusing algorithm have been improved significantly compared with original full matrix focusing method.

A 52-year-old man with newly diagnosed gastric neuroendocrine tumor (NET) underwent 68Ga-NODAGA-JR11 and 68Ga-DOTATATE imaging. 68Ga-DOTATATE PET/CT showed no 68Ga-DOTATATE uptake in the lesion, where 68Ga-NODAGA-JR11 showed intense uptake. The patient subsequently received endoscopic submucosal dissection and en bloc resection of the lesion, which was pathologically confirmed as gastric NET (G2). The positive findings of 68Ga-NODAGA-JR11 in the current case highlighted that 68Ga-NODAGA-JR11 PET/CT may be a promising molecular imaging technique for the detection of NETs with high sensitivity.

A novel passive twist morphing concept is examined for helicopter blades. The concept is demonstrated using a thin-walled rectangular composite beam created with symmetric layup to obtain bend-twist property. The twist of a rotor blade is proposed to be actuated though a movable mass at the blade tip which is able to provide a range of lagwise bending moment during rotation as a result of the centrifugal force. First a set of static bending test is performed which provides detailed characterisation of the deformation and strain distribution of the composite beam subjected to a number of bending loads. The results of the experiment fully verify numerical predictions including finite element approach (FE) and beam cross sectional analysis. A series of simulations are then conducted using the verified numerical model to demonstrate how the desired twist can be effectively achieved by manipulating the size and location of the mass.

A 78-year-old man with a newly diagnosed gastric adenocarcinoma underwent 18F-FDG and 68Ga-FAPI-04 PET/CT before treatment. Both 18F-FDG and 68Ga-FAPI-04 PET/CT demonstrated intense radioactivity in the gastric cancer. However, the benign Schmorl node in the inferior endplate of the T5 vertebrae showed increased uptake of 68Ga-FAPI-04, which was not FDG avid. Two months after radical gastrectomy of the gastric cancer (pT1aN0M0, IA), a follow-up CT showed that the Schmorl node in T5 vertebrae remained unchanged.

Introduction: Given the ongoing coronavirus disease 2019 (COVID-19) pandemic and the consequent global healthcare crisis, there is an urgent need to better understand risk factors for symptom deterioration and mortality among patients with COVID-19. This systematic review aimed to meet the need by determining the predictive value of chronic diseases for COVID-19 severity and mortality.Methods: We searched PubMed, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Complete to identify studies published between December 1, 2019, and December 31, 2020. Two hundred and seventeen observational studies from 26 countries involving 624,986 patients were included. We assessed the risk of bias of the included studies and performed a cumulative meta-analysis.Results: We found that among COVID-19 patients, hypertension was a very common condition and was associated with higher severity, intensive care unit (ICU) admission, acute respiratory distress syndrome, and mortality. Chronic obstructive pulmonary disease was the strongest predictor for COVID-19 severity, admission to ICU, and mortality, while asthma was associated with a reduced risk of COVID-19 mortality. Patients with obesity were at a higher risk of experiencing severe symptoms of COVID-19 rather than mortality. Patients with cerebrovascular disease, chronic liver disease, chronic renal disease, or cancer were more likely to become severe COVID-19 cases and had a greater probability of mortality.Conclusions: COVID-19 patients with chronic diseases were more likely to experience severe symptoms and ICU admission and faced a higher risk of mortality. Aggressive strategies to combat the COVID-19 pandemic should target patients with chronic diseases as a priority.

PurposeThis prospective trial aimed to evaluate the safety, dosimetry, biodistribution, and diagnostic efficacy of a novel theranostic probe 68Ga-DOTA-DiPSMA. Also, we have performed the first comparison with 68Ga-PSMA-11 in prostate cancer (PCa) patients.MethodsFive healthy volunteers and ten PCa patients with a previous clinical 68Ga-PSMA-11 PET/CT were injected with an intravenous bolus of 68Ga-DOTA-DiPSMA with a dose of 1.85MBq/kg. Healthy volunteers received serial whole-body PET scans from the time of injection up to 60 min post-injection, with a second PET/CT scanning at 120 min post-injection. In PCa patients, low-dose CT scan, whole-body PET was performed with 2 min per bed position in 40 min post-injection. In addition, 68Ga-PSMA-11 scanning was performed on PCa patients within 10 days under the same acquisition procedure. Absorbed organ doses and effective doses were calculated using OLINDA/EXM. Normal organ uptake and tumor lesion uptake (SUVmax) were measured. A lesion-by-lesion analysis was performed.Results 68Ga-DOTA-DiPSMA administration was safe and well-tolerated. The kidneys received the highest absorbed dose (114.46 ± 29.28 uSv/MBq), followed by the urinary bladder wall (100.82 ± 46.22 uSv/MBq) in accordance with the expected PSMA renal excretion of the tracer. The mean effective dose was 19.46 ± 1.73 μSv/MBq. The SUVmax of 68Ga-PSMA-11 and 68Ga-DOTA-DiPSMA PET/CT for PCa lesions, bone metastases, and lymph node metastases were 11.2 ± 10.76 vs. 4.41 ± 2.72, 7.6 ± 1.58 vs. 2.95 ± 1.11 and 4.86 ± 1.94 vs. 3.26 ± 1.2, respectively.ConclusionInjection of 68Ga-DOTA-DiPSMA is safe and associated with low absorbed and effective doses. Compared to 68Ga-PSMA-11, 68Ga-DOTA-DiPSMA shows comparable pharmacokinetics and detection ability in PCa patients that warrant further head-to-head comparison. Low non-specific uptake in salivary glands and kidneys of 68Ga-DOTA-DiPSMA indicates potential radioligand therapy (RLT) application when labeled with 177Lu, 90Y, or 225Ac.

Background Retinol binding protein 4 (RBP4) has been proposed to play a role in the pathophysiology of coronary artery disease (CAD), but previous findings on the association of RBP4 levels with CAD are inconsistent. Methods A meta-analysis based on observational studies was conducted to evaluate the association between circulating RBP4 levels and CAD. Databases including PubMed, Web of Science, Embase, Google Scholar and ClinicalTrials.gov database were searched for eligible studies published up to 12 July 2021. Standard mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using the inverse variance heterogeneity (IVhet) and random-effects model for data with moderate and high heterogeneity (I2 > 30%) and data with low heterogeneity were analysed using a fixed-effects model (I2 ≤ 30%). Moreover, a bias-adjusted quality-effects model was generated, and the prediction interval was also calculated under the random-effects model. Results Two nested case-control studies, one cohort study and twelve case–control studies with a total of 7111 participants were included. Circulating RBP4 levels in patients with CAD were comparable to those in the controls under the IVhet model (SMD: 0.25, 95% CI: − 0.29-0.79, I2: 96.00%). The quality-effects model produced consistent results. However, the association turned to be significant under the random-effect model (SMD: 0.46, 95% CI: 0.17–0.75, I2: 96.00%), whereas the 95% predictive interval (PI) included null values (95% PI: − 0.82-1.74). Subgroup analyses illustrated a positive relationship between CAD and RBP4 levels in patients with complications (SMD: 1.34, 95% CI: 0.38–2.29, I2: 96.00%). The meta-regression analysis revealed that the mean BMI of patients (P = 0.03) and complication status (P = 0.01) influenced the variation in SMD. Conclusions There was low-quality evidence that patients with CAD exhibited similar circulating RBP4 levels compared with controls, and high inter-study heterogeneity was also observed. Thus, RBP4 might not be a potential risk factor for CAD. Comparisons among different subtypes of RBP4 with larger sample size are needed in the future.

PURPOSE: To demonstrate the marginal corneal vascular remodelling using optical coherence tomography angiography (OCTA) after pterygium surgery. METHODS: Twenty-two eyes of 19 patients (8 males, 11 females; age, 58.68 ± 0.34 years) with primary grade-T3 nasal pterygium were enroled in this study. The eyes underwent excision of the pterygium followed by a free limbal-conjunctival autograft. OCTA was performed in the nasal limbal area before surgery and at 10 days, 1 month, and 3 months after surgery. The scans were analyzed in terms of postoperative vascular remodelling of the autograft and marginal corneal vascular arcades (MCAs). RESULTS: Preoperatively, the pterygium presented as abnormal centripetal vascular growth in OCTA scans. The conjunctival vessel density in the nasal quadrant was 29.26% ± 1.00%, 15.80% ± 0.83%, 19.80% ± 0.88%, and 20.26% ± 0.89% before and 10 days, 1 month, and 3 months, respectively, after surgery (F = 1.55, P

Aim To investigate the count of circulating tissue factor-positive (TF+) procoagulant microparticles (MPs) in patients with type 1 diabetes mellitus (T1DM). Methods This case-control study included patients with T1DM and age and sex-matched healthy volunteers. The counts of phosphatidylserine-positive (PS+) MPs and TF+PS+MPs and the subgroups derived from different cell types were measured in the peripheral blood sample of the two groups using multicolor flow cytometric assay. We compared the counts of each MP between groups as well as the ratio of the TF+PS+MPs and PS+MPs (TF+PS+MPs/PS+MPs). Results We recruited 36 patients with T1DM and 36 matched healthy controls. Compared with healthy volunteers, PS+MPs, TF+PS+MPs and TF+PS+MPs/PS+MPs were elevated in patients with T1DM (PS+MPs: 1078.5 ± 158.08 vs 686.84 ± 122.04/μL, P

The Internet of Things (IoT) is a new technology rapidly developed in various fields in recent years. With the continuous application of the IoT technology in production and life, the network security problem of IoT is increasingly prominent. In order to meet the challenges brought by the development of IoT technology, this paper focuses on network security situational awareness. The network security situation awareness is basic of IoT network security. Situation prediction of network security is a kind of time series forecasting problem in essence. So it is necessary to construct a modification function that is suitable for time series data to revise the kernel function of traditional support vector machine (SVM). An improved network security situation awareness model for IoT is proposed in this paper. The sequence kernel support vector machine is obtained and the particle swarm optimization (PSO) method is used to optimize related parameters. It proves that the method is feasible by collecting the boundary data of a university campus IoT network. Finally, a comparison with the PSO-SVM is made to prove the effectiveness of this method in improving the accuracy of network security situation prediction of IoT. The experimental results show that PSO-time series kernel support vector machine is better than the PSO-Gauss kernel support vector machine in network security situation prediction. The application of the Hadoop platform also enhances the efficiency of data processing.

AIM: To conduct a systematic review and Meta-analysis of the published literature to evaluate the pooled prevalence rate of amblyopia in patients with congenital ptosis. METHODS: We searched the PubMed, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Data, and Chongqing VIP databases for studies reporting the prevalence of amblyopia in patients with congenital ptosis. The reference lists of relevant studies were scanned. Heterogeneity of effect sizes across studies was tested. We calculated prevalence ratios to compare prevalence estimates for different causes of amblyopia in patients with congenital ptosis, as well as for different geographical regions, year of publication and sample size in subgroup analyses. A systematic review and Meta-analysis were performed. RESULTS: We identified 29 eligible surveys with a total population of 2436. Prevalence rates of amblyopia ranged from 13.8% to 69%. We noted substantial heterogeneity in prevalence estimates for amblyopia in congenital ptosis (Cochran's χ(2) significant at P

Purpose: Facial paralysis (FP) leads to diverse periocular complications which threats visual acuity and affects corneal nerve functionally and morphologically. This study aims to summarize the clinical ophthalmic outcomes, corneal sensation, and morphological alterations of subbasal nerve and dendritic cells (DCs) in patients with facial paralysis.Methods: We performed a cross-sectional study of 48 consecutive patients with facial paralysis at one tertiary hospital. Forty-eight healthy participants were enrolled as controls. The images of corneal nerves and epithelial DCs were detected by in vivo confocal microscopy (IVCM). Each patient received thorough ophthalmic examination, tear film function tests, corneal fluorescence staining and Cochet-Bonnet esthesiometry test. Clinical and morphologic data were compared with controls.Results: Forty patients (83.3%) showed corneal injuries from punctate epithelial defects to corneal ulcers and scars. Visual impairment and eyelid malposition were observed. Corneal sensitivity remarkably decreased (25.1 ± 23.8 mm) in the affected eyes and was correlated to diminished subbasal nerve density (P = .019, r = 0.387). Numbers of corneal main nerve trunks and branches were significantly reduced (P < .0001) while DCs were increased (P < .0001) in patients with FP when compared with controls. Nerve fiber density showed inverse association with DC density (P = .019, r = -0.389).Conclusions: Ocular complications including corneal erosions, loss of corneal sensation, visual impairment and eyelid malposition have largely affected patients with facial paralysis. Morphological changes of diminished corneal subbasal nerve and increased DCs were detected by IVCM. Corneal epithelial defect, corneal opacity, corneal sensation, dendritic cell density are factors associated with corneal subbasal nerve density. Patients with FP are suggested to have complete ophthalmic evaluation and early instruction on ocular prevention.

Both magnetic flux leakage (MFL) and magnetic field distortion (MFD) techniques are promising methods for surface defect detection in ferromagnetic components. The two techniques are based on different physical principles. However, their defect sizing and shape reconstruction abilities are seldom comparatively explored. In this study, finite element simulations and experiments were performed to achieve magnetic scanning imaging of a defective plate with both MFD and MFL techniques. First, the curves of voltage extracted from the lines crossing the center of cylindrical-hole defect (CHD) were used to evaluate the performance of several feature parameters in sizing the diameter and the depth of CHD. Second, the profiles of the normalized magnetic scanning imaging results were analyzed with a threshold plane to evaluate the abilities of MFD and MFL on reconstructing the shape of 8-shaped and cross-type through wall defects. Under the condition that the Hall device for measuring both the normal component of MFL and MFD has same lift-off distance as 1 mm, the MFD technique showed the advantages in defect shape reconstruction at the cost of available detection depth as compared with MFL techniques.

The novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic of the coronavirus disease 2019 (COVID-19), which elicits a wide variety of symptoms, ranging from mild to severe, with the potential to lead to death. Although used as the standard method to screen patients for SARS-CoV-2 infection, real-time PCR has challenges in dealing with asymptomatic patients and those with an undetectable viral load. Serological tests are therefore considered potent diagnostic tools to complement real-time PCR-based diagnosis and are used for surveillance of seroprevalence in populations. However, the dynamics of the antibody response against SARS-CoV-2 currently remain to be investigated. Here, through analysis of plasma samples from 84 patients with COVID-19, we observed that the response of virus-specific antibodies against three important antigens, RBD, N and S, dynamically changed over time and reached a peak 5–8 weeks after the onset of symptoms. The antibody responses were irrespective of sex. Severe cases were found to have higher levels of antibody response, larger numbers of inflammatory cells and C-reactive protein levels. Within the mild/moderate cases, pairwise comparison indicated moderate association between anti-RBD vs. anti-N, anti-RBD vs. anti-S1S2, and anti-N vs. anti-S1S2. Furthermore, the majority of cases could achieve IgM and IgG seroconversion at 2 weeks since the disease onset. Analysis of neutralizing antibodies indicated that these responses were able to last for more than 112 days but decline significantly after the peak. In summary, our findings demonstrate the longitudinally dynamic changes in antibody responses against SARS-CoV-2, which can contribute to the knowledge of humoral immune response after SARS-CoV-2 infection and are informative for future development of vaccine and antibody-based therapies.

Cervical cancer is a global health challenge in women. Neoadjuvant chemotherapy (NACT) is a recent prospect for alternative cervical cancer treatments. This study investigated the efficacy of NACT against resectable cervical cancer based on the medium and long-term survival of patients with the disease. We searched through PubMed, Web of Science, EBSCO and Cochrane Library for relevant reports published by June 2020. The primary outcomes were 3-year and 5-year progression-free survival (PFS) and overall survival (OS) of patients with resectable cervical cancer. Overall, 22 publications encompassing 5627 patients fulfilled the inclusion criteria. We found NACT not to affect both 3-year PFS and OS as well as 5-year PFS of patients with resectable cervical cancer. However, NACT significantly improves the 5-year OS of patients with resectable cervical cancer (HR = 0.83, 95% CI: 0.73–0.94, p = 0.013). Subgroup analysis (RCTs, non-RCTs, NACT + surgery + AT vs. surgery + AT, NACT + surgery + AT vs. CCRT/RT/CRT) further revealed NACT had no significant effect on 5-year PFS of patients with resectable cervical cancer, converse to the 5-year OS subgroup analysis, which validated the beneficial effect of NACT in patients with resectable cervical cancer. In addition, the effect of NACT was most significant in the non-RCTs subgroup (p = 0.012). NACT may improve the long-term prognosis of patients with resectable cervical cancer. However, further large-scale multicenter studies are needed to validate this finding.

Liver fibrosis (LF) is a continuous wound healing process caused by numerous chronic hepatic diseases and poses a major threat to human health. Activation of hepatic stellate cells (HSCs) is a critical event in the development of hepatic fibrosis. Long non-coding RNAs (lncRNAs) that are involved in HSC activation, participate in the development of LF and are likely to be therapeutic targets for LF. In the present review, the cellular signaling pathways of LF with respect to HSCs were discussed. In particular, this present review highlighted the current knowledge on the role of lncRNAs in activating or inhibiting LF, revealing lncRNAs that are likely to be biomarkers or therapeutic targets for LF. Additional studies should be performed to elucidate the potential of lncRNAs in the diagnosis and prognosis of LF and to provide novel therapeutic approaches for the reversion of LF.

PURPOSE The aim of this study was to explore the effect of congenital ptosis on the visual function of patients and observe the improvement in visual function after the correction of ptosis at different surgical times. METHODS We performed a retrospective study of 265 patients (346 eyes) with congenital ptosis at the same hospital. Each patient underwent an ophthalmic examination, including optometry and measurement of the affected palpebral fissure height and upper eyelid margin reflex distance. Preoperative clinical and morphologic data were compared with postoperative data. RESULTS The refractive error of the patient population was significantly different from that of the general population (P < 0.01). The rates of strabismus and amblyopia were 12.45% and 36.98%, respectively, in the ptosis patients, both of which are higher than the rates in the general population (P < 0.01), especially for unilaterally affected patients and patients with the optical axis covered. The refractive error of patients younger than 5 years was improved postoperatively (P < 0.05). The number of cases of amblyopia and strabismus was reduced, as was the percentage of cases of with-the-rule astigmatism (P < 0.05). CONCLUSION Congenital ptosis can result in refractive error, strabismus, and amblyopia, which could seriously impair the visual function of patients. The impairment is more pronounced in unilaterally affected patients. Surgery is conducive to the recovery of visual function, especially in patients younger than 5 years. Satisfactory curative effects can be obtained before the age of 3 years; thus, unilaterally affected patients, severely affected patients, and patients with impaired visual function should undergo surgery as soon as possible.

Background: COVID-19 is a new and highly contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, there is a paucity of data regarding long-term CT findings and pulmonary function in COVID-19 survivors. The aim of this study was to investigate the influence of COVID-19 pneumonia on pulmonary function and chest high-resolution computed tomography (CT) in convalescent patients. Methods: A retrospective study of COVID-19 pneumonia patients in the Beijing Youan Hospital, Capital Medical University, was conducted. Serial assessments, including pulmonary volumes (TLC), spirometry (VC, FVC, FEV1), pulmonary diffusing capacity for carbon monoxide (DLCO, DLCO/VA), and chest high-resolution CT were collected 3 months after discharge. Results: Forty-six patients completed the serial assessments. There were 38 non-severe and 8 severe cases. Abnormalities were detected in pulmonary function tests in 17 patients (37.8%). One (2.2%), 2 (4.3%), and 17 (37.8%) patients had FEV1/FVC ratio, TLC, and DLCO values less than 80% of predicted values, respectively. Twenty-eight patients (60.9%) had abnormal CT findings. Compared with patients with non-severe disease, those with severe disease had higher chest CT scores but a similar incidence of DLCO impairment. Similarly, patients who received glucocorticoids had higher chest CT scores but a similar incidence of DLCO impairment than those in the nonglucocorticoid group. Conclusions: Three months after discharge from the hospital, impaired diffusing capacity and CT abnormalities were detected in more than one third of COVID-19 patients. Compared with patients with non-severe disease, those with severe illness had a higher incidence of lung imaging abnormalities and similar lung function impairment.

Morphing aircraft structures usually introduce greater compliance into aerodynamic sections, and therefore will affect the aeroelasticity with the potential risk of increased flutter. A low-fidelity model of an active camber morphing wing and its aeroelastic model are developed in order to investigate the potential critical speed by exploiting its chord-wise dimension and flexibility. Such a model may be used for conceptual design, where low fidelity models are used to explore and optimise a wide range of configurations. The morphing camber concept is implemented using a continuous representation of a two-segment structure with a rigid segment and a deformable part. The aeroelastic model is developed based on both steady and unsteady aerodynamic models, so that different parameters can be easily modified to examine changes in the flutter solutions. Of particular interest are the ratio of the morphing segment length to the chord, and its relative stiffness, as such morphing camber is potential operated using the deformable part as a flap. By comparing the results of the quasi-steady and unsteady aerodynamic models, it is shown that the quasi-steady aerodynamic model gives a more conservative prediction of the flutter speed. In addition, responses in phase space are simulated to show the fundamental aeroelastic behaviour of the morphing camber wing. It is also shown that the active compliant segment can be used to stabilise the morphing aircraft by using feedback control. This paper provides a system-level insight through mathematical modelling, parameter analysis and feedback control into dynamics applications of morphing camber.

Coronavirus disease 2019 (COVID-19) is a highly contagious infectious disease. Similar to H7N9 infection, pneumonia and cytokine storm are typical clinical manifestations of COVID-19. Our previous studies found that H7N9 patients had intestinal dysbiosis. However, the relationship between the gut microbiome and COVID-19 has not been determined. This study recruited a cohort of 57 patients with either general (n = 20), severe (n = 19), or critical (n = 18) disease. The objective of this study was to investigate changes in the abundance of ten predominant intestinal bacterial groups in COVID-19 patients using quantitative polymerase chain reaction (q-PCR), and to establish a correlation between these bacterial groups and clinical indicators of pneumonia in these patients. The results indicated that dysbiosis occurred in COVID-19 patients and changes in the gut microbial community were associated with disease severity and hematological parameters. The abundance of butyrate-producing bacteria, such as Faecalibacterium prausnitzii, Clostridium butyricum, Clostridium leptum, and Eubacterium rectale, decreased significantly, and this shift in bacterial community may help discriminate critical patients from general and severe patients. Moreover, the number of common opportunistic pathogens Enterococcus (Ec) and Enterobacteriaceae (E) increased, especially in critically ill patients with poor prognosis. The results suggest that these bacterial groups can serve as diagnostic biomarkers for COVID-19, and that the Ec/E ratio can be used to predict death in critically ill patients.

Highlights l This is the first study to understand the psychological impacts and depression in the front-line non-medical workers in Wuhan, the first and the worst hit place by COVID-19. l The results showed that 50.3% (96) front-line non-medical workers reported the clinically significant symptoms of depression. l The post-90s (the generation born after 1990s) and females showed increased risk for depression. l Targeted psychological intervention measures should be developed to improve the mental health of non-medical workers on the front-line of COVID-19 epidemic., Background: The outbreak of Coronavirus Disease 2019 (COVID-19) has been raising global anxiety and fear to the real or perceived health threat from the virus. This study aimed to investigate the psychological impacts and depression in the front-line non-medical workers in Wuhan, the first and the worst hit place by COVID-19. Methods: A total of 191 front-line non-medical workers in Wuhan were recruited by online survey. The Positive and Negative Affect Schedule (PANAS), the Stress Reaction Questionnaire (SRQ) and the Patient Health Questionnaire-9 (PHQ) were used. The results showed that 50.3% (96) participants reported the clinically significant symptoms of depression. Results: Among them, 33.0% (63) participants were with mild depression, 10.5% (20) participants with moderate depression, 5.8% (11) with moderately severe depression, and 1% (2) with severe depression. Participants with depression tend to be post-90s (the generation born after 1990s), females, with increased levels of stress reactions, increased negative affects, but lower positive affects compared to these without depression. The stepwise logistic regression analysis revealed that post-90s (β = 0.908, P = 0.016), the emotional reaction (β = 0.122, P = 0.005) and physical reaction (β = 0.124, P = 0.020) in SQR were significant independent responsible for the development of depression. Conclusion: The findings of the present study suggest the targeted psychological intervention measures should be developed to improve the mental health of non-medical workers on the front-line of COVID-19 epidemic, especially the females and younger individuals.

Aim To investigate the factors associated with the duration of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) RNA shedding in patients with coronavirus disease 2019 (COVID‐19). Methods A retrospective cohort of COVID‐19 patients admitted to a designated hospital in Beijing was analyzed to study the factors affecting the duration of viral shedding. Results The median duration of viral shedding was 11 days (IQR, 8‐14.3 days) as measured from illness onset. Univariate regression analysis showed that disease severity, corticosteroid therapy, fever (temperature>38.5℃), and time from onset to hospitalization were associated with prolonged duration of viral shedding (p38.5℃) (OR 5.1, 95%CI: 1.5‐18.1), corticosteroid therapy (OR 6.3, 95%CI: 1.5‐27.8), and time from onset to hospitalization (OR 1.8, 95%CI: 1.19‐2.7) were associated with increased odds of prolonged duration of viral shedding. Conclusions Corticosteroid treatment, fever (temperature>38.5℃), and longer time from onset to hospitalization were associated with prolonged viral shedding in COVID‐19 patients. This article is protected by copyright. All rights reserved.

In recent years, the popularity of depth sensors and 3D scanners has led to a rapid development of 3D point clouds. Semantic segmentation of point cloud, as a key step in understanding 3D scenes, has attracted extensive attention of researchers. Recent advances in this topic are dominantly led by deep learning-based methods. In this paper, we provide a survey covering various aspects ranging from indirect segmentation to direct segmentation. Firstly, we review methods of indirect segmentation based on multi-views and voxel grids, as well as direct segmentation methods from different perspectives including point ordering, multi-scale, feature fusion and fusion of graph convolutional neural network (GCNN). Then, the common datasets for point cloud segmentation are exposed to help researchers choose which one is the most suitable for their tasks. Following that, we devote a part of the paper to analyze the quantitative results of these methods. Finally, the development trend of point cloud semantic segmentation technology is prospected.

It is the great priority to detect colorectal cancer (CRC) as early as possible, finally to reduce the incidence and mortality of CRC. However, although colonoscopy is recommended in many consensuses, yet no one systematic review is conducted to figure out how colonoscopy could change the incidence and mortality. In our study, we conducted a comprehensive meta-analysis to evaluate the association between colonoscopy screening and the incidence or mortality of CRC. PubMed, EMBASE, and PMC database were systematically searched from their inception to June 2020. A total of 13 cohort and 16 case-control studies comprising 4,713,778 individuals were obtained in this review. Our results showed that colonoscopy was associated with a 52% RR reduction in incidence of CRC (RR: 0.48, 95% CI: 0.46-0.49) and 62% RR reduction in mortality of CRC (RR: 0.38, 95% CI: 0.36-0.40). Subgroup analysis of different interventions, study design, country, sample size, age or sex showed that the incidence and mortality reduction remained consistent, and colonoscopy screening had the same effect on people below and above 50. Our study indicated that colonoscopy could significantly reduce the incidence and mortality of CRC.

Objectives: In this study, we conducted a longitudinal evaluation of changes in medication adherence and the role of psychosocial and interpersonal factors in these changes among Blacks with type 2 diabetes mellitus (T2DM), and determined barriers and facilitators of T2DM medication adherence. Methods: We used an explanatory sequential mixed methods design for a sample of 287 black adult patients with T2DM in Wisconsin. Two surveys quantitatively evaluated changes in medication adherence, psychosocial factors, and interpersonal factors over time. We conducted 10 semi-structured qualitative interviews to explore participants' perceptions of these changes. Data integration of the quantitative and qualitative findings elucidated barriers and facilitators of medication adherence. Results: Increased adherence was significantly correlated with less concerns about medicines (r = -0.31), higher self-efficacy (r = 0.47), lesser depressive symptoms (r = -0.26), and lesser negative illness perceptions (r = -0.26) at both baseline and follow-up. Patient perceptions of adherence changes included adherence motivators, social support, and complex medication regimens. Integration showed that barriers and facilitators both existed in individuals who had an increase or a decrease in adherence over time. Conclusions: Specific beliefs of Blacks towards T2DM medications must be addressed to improve their adherence. Interventions must be tailored using interpersonal factors.

Objective Hepatocellular carcinoma (HCC) has become a pressing health problem facing the world today due to its high morbidity, high mortality, and late discovery. As a diagnostic criteria of HCC, the exact threshold of Alpha-fetoprotein (AFP) is controversial. Therefore, this study was aimed to systematically estimate the performance of AFP in diagnosing HCC and to clarify its optimal threshold. Methods Medline and Embase databases were searched for articles indexed up to November 2019. English language studies were included if both the sensitivity and specificity of AFP in the diagnosis of HCC were provided. The basic information and accuracy data included in the studies were extracted. Combined estimates for sensitivity and specificity were statistically analyzed by random-effects model using MetaDisc 1.4 and Stata 15.0 software at the prespecified threshold of 400 ng/mL, 200 ng/mL, and the range of 20-100 ng/mL. The optimal threshold was evaluated by the area under curve (AUC) of the summary receiver operating characteristic (SROC). Results We retrieved 29,828 articles and included 59 studies and 1 review with a total of 11,731 HCC cases confirmed by histomorphology and 21,972 control cases without HCC. The included studies showed an overall judgment of at risk of bias. Four studies with AFP threshold of 400 ng/mL showed the summary sensitivity and specificity of 0.32 (95%CI 0.31-0.34) and 0.99 (95%CI 0.98-0.99), respectively. Four studies with AFP threshold of 200 ng/mL showed the summary sensitivity and specificity of 0.49 (95%CI 0.47-0.50) and 0.98 (95%CI 0.97-0.99), respectively. Forty-six studies with AFP threshold of 20-100 ng/mL showed the summary sensitivity and specificity of 0.61 (95%CI 0.60-0.62) and 0.86 (95%CI 0.86-0.87), respectively. The AUC of SROC and Q index of 400 ng/mL threshold were 0.9368 and 0.8734, respectively, which were significantly higher than those in 200 ng/mL threshold (0.9311 and 0.8664, respectively) and higher than those in 20-100 ng/mL threshold (0.8330 and 0.7654, respectively). Furthermore, similar result that favored 400 ng/mL were shown in the threshold in terms of AFP combined with ultrasound. Conclusion AFP levels in serum showed good accuracy in HCC diagnosis, and the threshold of AFP with 400 ng/mL was better than that of 200 ng/mL in terms of sensitivity and specificity no matter AFP is used alone or combined with ultrasound.

Background Goldenhar syndrome has variable presentations and can affect multiple regions of the body. Diagnoses are based on clinical manifestations. The association of Goldenhar syndrome with blepharophimosis and limb deformities has not previously been reported. Here, we describe a patient who was diagnosed with Goldenhar syndrome in association with blepharophimosis, ocular hypertelorism, hearing loss and limb deformities. Case presentation A 10-year-old male was first referred to our ophthalmology clinic on 2009–2-11 for ocular hypertelorism and microphthalmia when he had chin-up position. In the first ophthalmic examination, his palpebral fissure length was 19 mm on the right and 20 mm on the left, both palpebral fissure height was 4 mm, the inner intercanthal distance was 63 mm, both upper margin reflex distances were − 1 mm, the myodynamia of the levator palpebrae muscle was 2 mm on the right and 3 mm on the left, and his visual acuity was 20/40 on the right and 20/32 on the left. A physical examination revealed the patient had developed limb deformities in his hands, wrists, elbows and shoulders along with hearing loss. The patient was diagnosed with Goldenhar syndrome because his clinical presentations included ocular hypertelorism, hearing loss, and multiple acral joint deformities. He underwent a first operation in 2009 and a second in 2015. The second operation achieved a satisfactory result in which the horizontal fissure length was 28 mm on both sides, both palpebral fissure height was 10 mm, the inner intercanthal distance was 30 mm, and both of the upper margin reflex distances were 4 mm. He continued to wear hearing aids as usual. His hearing loss and joint deformities were slated for long-term follow-up at his parents’ request. Conclusion The patient, diagnosed with Goldenhar syndrome in association with blepharophimosis, ocular hypertelorism, hearing loss and limb deformities, underwent two operations and achieved a satisfactory result. The patient was submitted to long-term follow-up observations and symptomatic treatments that vary with age and systemic associations, as needed. When treating patients with Goldenhar syndrome, ophthalmology specialists should cooperate with a multi-disciplinary team of clinicians and reach agreement regarding the appropriate systemic and comprehensive treatments.

BackgroundCombination antiplatelet therapy with clopidogrel and aspirin may reduce the rate of recurrent stroke during the first 3 months after a minor ischemic stroke or transient ischemic attack (TIA). A trial of combination antiplatelet therapy in a Chinese population has shown a reduction in the risk of recurrent stroke. We tested this combination in an international population.MethodsIn a randomized trial, we assigned patients with minor ischemic stroke or high-risk TIA to receive either clopidogrel at a loading dose of 600 mg on day 1, followed by 75 mg per day, plus aspirin (at a dose of 50 to 325 mg per day) or the same range of doses of aspirin alone. The dose of aspirin in each group was selected by the site investigator. The primary efficacy outcome in a time-to-event analysis was the risk of a composite of major ischemic events, which was defined as ischemic stroke, myocardial infarction, or death from an ischemic vascular event, at 90 days.ResultsA total of 4881 patients were enrolled at 269 international sites. The trial was halted after 84% of the anticipated number of patients had been enrolled because the data and safety monitoring board had determined that the combination of clopidogrel and aspirin was associated with both a lower risk of major ischemic events and a higher risk of major hemorrhage than aspirin alone at 90 days. Major ischemic events occurred in 121 of 2432 patients (5.0%) receiving clopidogrel plus aspirin and in 160 of 2449 patients (6.5%) receiving aspirin plus placebo (hazard ratio, 0.75; 95% confidence interval [CI], 0.59 to 0.95; P=0.02), with most events occurring during the first week after the initial event. Major hemorrhage occurred in 23 patients (0.9%) receiving clopidogrel plus aspirin and in 10 patients (0.4%) receiving aspirin plus placebo (hazard ratio, 2.32; 95% CI, 1.10 to 4.87; P=0.02).ConclusionsIn patients with minor ischemic stroke or high-risk TIA, those who received a combination of clopidogrel and aspirin had a lower risk of major ischemic events but a higher risk of major hemorrhage at 90 days than those who received aspirin alone. (Funded by the National Institute of Neurological Disorders and Stroke; POINT ClinicalTrials.gov number, NCT00991029 .).

Purpose Service quality (SQ) is considered an organizational performance indicator that largely depends on employees’ attitudes and behaviors. Therefore, the purpose of this paper is to examine the mediating effect of employees’ citizenship behavior (OCB) on the relationship between affective commitment (AC) and SQ. Design/methodology/approach The current study has relied on two questionnaire surveys to gather cross-sectional data from 800 employees and 400 customers of telecommunications companies in Kuwait. Structural equation modeling via AMOS22 was used to build and test the hypothesized model. Findings The results show that OCB significantly and positively affects SQ dimensions except empathy which demonstrates insignificant association. Also, AC was found to be a strong predictor of OCB. More interestingly, the results show that AC does not show any effect on either responsiveness or empathy, while a partial mediation was found between AC and tangibles, reliability, and assurance. Practical implications The findings of the current study provide managers and practitioners with empirically validated model of how SQ can be achieved. The model indicates that managers need to increase the level of citizenship behavior through leveraging their employees’ AC, which in turn can result in a positive perception of SQ. Originality/value This study is considered among the first to investigate the causal effect of both OCB and AC on achieving high SQ. Also, the findings of this study further support the indirect relationship of AC and SQ. Moreover, this study is unique in its attempt to link both AC and OCB to the dimensions of SQ. Finally, this study is considered the first empirical investigation of SQ in the telecommunication sector in Kuwait.

We propose to use autoencoder and a two-stage training strategy for image reconstruction in multimode fiber imaging system. Compared with the conventional method of U-net, this approach achieves higher reconstruction accuracy and faster convergence speed.

Purpose. To evaluate changes in corneal sensitivity and subbasal nerve density after pterygium excision. Methods. This prospective trial included 22 eyes with nasal primary pterygium and 18 controls. Corneal sensitivity was evaluated using a Cochet–Bonnet esthesiometer in the nasal, superior, temporal, inferior, and center quadrants of the cornea before surgery and 10 days, 1 month, and 3months after surgery. The central cornea was analyzed using in vivo confocal microscopy (IVCM) before surgery and 1 and 3 months after surgery. Subbasal nerve density and other nerve parameters were analyzed using NeuronJ. Nerve tortuosity was evaluated and graded in individual IVCM scans. The tear film break-up time (TBUT) test and Schirmer’s test were performed before surgery, as well as 1 and 3 months after surgery. All the same tests were performed in the controls. Results. All affected eyes showed a significant increase in corneal sensitivity in the nasal corneal quadrant after surgery when compared with preoperative data (F = 37.3; P<0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P<0.01), fewer nerve trunks (P<0.01), and fewer nerve branches (P<0.05). However, an increased central corneal subbasal nerve density was observed 1 month after surgery compared with preoperative data, after which the density became stable (F = 9.62; P<0.01). Nerve tortuosity showed no difference between the two groups or across different time points in patients. Similarly, patients with pterygium demonstrated a decrease in TBUT (P<0.01) when compared with controls. A tendency toward increase was observed in the TBUT test after pterygium excision (F = 2.873; P=0.07). However, no difference was observed in Schirmer’s test. Conclusion. Pterygium patients demonstrated deteriorated corneal subbasal nerve fibers when compared with healthy controls in terms of nerve length, nerve trunks, and nerve branches. Therefore, pterygium excision improves corneal sensitivity and increases corneal subbasal nerve density.

A novel meta-material has been designed and implemented into a rotor blade to enhance aerodynamic efficiency by achieving a passive twist during rotation. The twist is induced by bend-twist coupling exhibited in the meta-material, which is created to possess anisotropic elastic properties at the bulk level. A concept design of a rectangular blade spar is proposed where the metamaterial is used as the core material to induce twist. Using finite element analysis(FEA) we demonstrate how the bend-twist property of the blade spar is governed by cell geometries of the core material. The twist is activated by a lagwise bending moment generated from a movable mass at the blade tip due to off-centre centrifugal forces. The relationship between the twist, mass location and rotational speed has been explored. Moreover, it was found that the bend-twist property achieved by the proposed blade spar is more effective compared to that of an anisotropic thin-walled composite beam.

Importance Hyperglycemia during acute ischemic stroke is common and is associated with worse outcomes. The efficacy of intensive treatment of hyperglycemia in this setting remains unknown. Objectives To determine the efficacy of intensive treatment of hyperglycemia during acute ischemic stroke. Design, Setting, and Participants The Stroke Hyperglycemia Insulin Network Effort (SHINE) randomized clinical trial included adult patients with hyperglycemia (glucose concentration of >110 mg/dL if had diabetes or ≥150 mg/dL if did not have diabetes) and acute ischemic stroke who were enrolled within 12 hours from stroke onset at 63 US sites between April 2012 and August 2018; follow-up ended in November 2018. The trial included 1151 patients who met eligibility criteria. Interventions Patients were randomized to receive continuous intravenous insulin using a computerized decision support tool (target blood glucose concentration of 80-130 mg/dL [4.4-7.2 mmol/L]; intensive treatment group: n = 581) or insulin on a sliding scale that was administered subcutaneously (target blood glucose concentration of 80-179 mg/dL [4.4-9.9 mmol/L]; standard treatment group: n = 570) for up to 72 hours. Main Outcomes and Measures The primary efficacy outcome was the proportion of patients with a favorable outcome based on the 90-day modified Rankin Scale score (a global stroke disability scale ranging from 0 [no symptoms or completely recovered] to 6 [death]) that was adjusted for baseline stroke severity. Results Among 1151 patients who were randomized (mean age, 66 years [SD, 13.1 years]; 524 [46%] women, 923 [80%] with diabetes), 1118 (97%) completed the trial. Enrollment was stopped for futility based on prespecified interim analysis criteria. During treatment, the mean blood glucose level was 118 mg/dL (6.6 mmol/L) in the intensive treatment group and 179 mg/dL (9.9 mmol/L) in the standard treatment group. A favorable outcome occurred in 119 of 581 patients (20.5%) in the intensive treatment group and in 123 of 570 patients (21.6%) in the standard treatment group (adjusted relative risk, 0.97 [95% CI, 0.87 to 1.08],P = .55; unadjusted risk difference, −0.83% [95% CI, −5.72% to 4.06%]). Treatment was stopped early for hypoglycemia or other adverse events in 65 of 581 patients (11.2%) in the intensive treatment group and in 18 of 570 patients (3.2%) in the standard treatment group. Severe hypoglycemia occurred only among patients in the intensive treatment group (15/581 [2.6%]; risk difference, 2.58% [95% CI, 1.29% to 3.87%]). Conclusions and Relevance Among patients with acute ischemic stroke and hyperglycemia, treatment with intensive vs standard glucose control for up to 72 hours did not result in a significant difference in favorable functional outcome at 90 days. These findings do not support using intensive glucose control in this setting. Trial Registration ClinicalTrials.gov Identifier:NCT01369069

ObjectiveTo assess the added value of neurite orientation dispersion and density imaging (NODDI) compared with conventional diffusion tensor imaging (DTI) and anatomical MRI to detect changes in presymptomatic carriers of chromosome 9 open reading frame 72 (C9orf72) mutation.MethodsThe PREV-DEMALS (Predict to Prevent Frontotemporal Lobar Degeneration and Amyotrophic Lateral Sclerosis) study is a prospective, multicentre, observational study of first-degree relatives of individuals carrying the C9orf72 mutation. Sixty-seven participants (38 presymptomatic C9orf72 mutation carriers (C9+) and 29 non-carriers (C9−)) were included in the present cross-sectional study. Each participant underwent one single-shell, multishell diffusion MRI and three-dimensional T1-weighted MRI. Volumetric measures, DTI and NODDI metrics were calculated within regions of interest. Differences in white matter integrity, grey matter volume and free water fraction between C9+ and C9− individuals were assessed using linear mixed-effects models.ResultsCompared with C9−, C9+ demonstrated white matter abnormalities in 10 tracts with neurite density index and only 5 tracts with DTI metrics. Effect size was significantly higher for the neurite density index than for DTI metrics in two tracts. No tract had a significantly higher effect size for DTI than for NODDI. For grey matter cortical analysis, free water fraction was increased in 13 regions in C9+, whereas 11 regions displayed volumetric atrophy.ConclusionsNODDI provides higher sensitivity and greater tissue specificity compared with conventional DTI for identifying white matter abnormalities in the presymptomatic C9orf72 carriers. Our results encourage the use of neurite density as a biomarker of the preclinical phase.Trial registration numberNCT02590276.

Background and Study Aim Vascular-targeted photodynamic therapy (V-PDT) has been used for several benign vascular diseases. The aim of this pilot study was to demonstrate the potential benefits of VPDT in the treatment of gastric antral vascular ectasia (GAVE). Patients and Methods Data from patients with GAVE (n = 5) who underwent endoscopic V-PDT were analyzed retrospectively. Pre- and post-V-PDT clinical and endoscopic features, hemoglobin levels, and transfusion requirement were compared. Results The five GAVE patients received one to four sessions of V-PDT. The hemoglobin levels of all five patients increased steadily following V-PDT. Within 6–48 months of follow-up, gastrointestinal bleeding and melena disappeared in all five patients and none of the patients needed a transfusion. Endoscopy examinations showed that the dilated vessels had disappeared without scar formation. No significant side effects or adverse reactions were reported. Conclusion This preliminary study indicates the good selectivity, safety, and efficacy of V-PDT in the treatment of patients with GAVE. Larger prospective studies are needed to further confirm the feasibility of using V-PDT to treat patients with GAVE.

At present, the globalization of the world economy continues to intensify, and the pace of technological modernization is accelerating. Artificial intelligence methods such as big data and financial sharing are gradually replacing traditional working methods in all walks of life, and the accounting industry is no exception. Under the dual impact of globalization and the development of artificial intelligence, the demand for training international compound accounting professionals is large and increasing, "CPA examination system" as one of the most authoritative examinations in the field of accounting, its matching with the current environment is particularly important. Starting from the current status of CPA examination, the author has made an in-depth investigation and study on the CPA examination systems in many countries including China, the United States, Britain, Japan, Germany and Australia by consulting a large number of relevant literature. Meanwhile, they systematically analyzed the CPA examination systems in various countries from four dimensions: examination organization, examination threshold, examination cycle and examination subjects, explored the similarities and differences of CPA examination systems in the world's mainstream countries, and summarized the common problems and the advantages that can be used for reference, which has practical significance for the design and update of the CPA examination system in China. At the same time, it provides reference significance for improving the professional quality of accounting personnel and accelerating the pace of changing the functions of accounting personnel.

Enriching terminology base (TB) is an important and continuous process, since formal term can be renamed and new term alias emerges all the time. As a potential supplementary for TB enrichment, electronic health record (EHR) is a fundamental source for clinical research and practise. The task to align the set of external terms in EHRs to TB can be regarded as entity alignment without structure information. Conventional approaches mainly use internal structural information of multiple knowledge bases (KBs) to map entities and their counterparts among KBs. However, the external terms in EHRs are independent clinical terms, which lack of interrelations. To achieve entity alignment in this case, we proposed a novel automatic TB enrichment approach, named semantic & structure embeddings-based relevancy prediction (S2ERP). To obtain the semantic embedding of external terms, we fed them with formal entity into a pre-trained language model. Meanwhile, a graph convolutional network was used to obtain the structure embeddings of the synonyms and hyponyms in TB. Afterwards, S2ERP combines both embeddings to measure the relevancy. Experimental results on clinical indicator TB, collected from 38 top-class hospitals of Shanghai Hospital Development Center, showed that the proposed approach outperforms baseline methods by 14.16% in Hits@1.

The outbreak of Coronavirus Disease (COVID-19) in Wuhan have affected more than 250 countries and regions worldwide. However, most of the clinical studies have been focused on Wuhan, and little is known about the disease outside of Wuhan in China. In this retrospective cohort study, we report the early clinical features of 80 patients with COVID-19 admitted to the hospital in Beijing. The results show that 27 (33.8%) patients had severe illness. Six (7.5%) patients were admitted to the ICU, and 3 (3.8%) patients died. Forty-eight percent (39/80) of the patients had a history of living/traveling in Wuhan. Patients with severe- illness were significantly older (average age, 71 years old vs 44 years old) and had a high incidence of expectoration (59.3% vs 34.0%), shortness of breath (92.6% vs 9.4%), anorexia (51.9% vs 18.9%) and confusion(18.5% vs 0%) compared with nonsevere patients. The systolic blood pressure (median, 130 mmHg vs 120 mmHg) was higher and the oxygen saturation (median, 98.3% vs 92.0%) was significantly lower in severe patients than nonsevere patients. In addition, myoglobin (median, 56.0 ng/mL vs 35.0 ng/mL), troponin I (median, 0.02 pg/mL vs 0.01 pg/mL), C-reactive protein (median, 69.7 mg/L vs 12.9 mg/L) and neutrophils (median, 3.3×109/L vs 2.2×109/L) were significantly increased, while lymphocytes (median, 0.8×109/L vs 1.2×109/L), albumin (mean, 32.8 g/L vs 36.8 g/L) and the creatinine clearance rate (median, 91.2 vs 108.2 ml/min/1.73m2) were significantly decreased among severe patients. Our study revealed that older patients with high levels of C-reactive protein, myoglobin, troponin I, and neutrophil and high systolic blood pressure as well as low levels of lymphocytes, and albumin and a low creatinine clearance rate and oxygen saturation were more likely to have severe disease.

Increasing evidence shows that ambient temperature has extensive effects on reproductive health outcomes, including hypertensive disorders, preterm birth, and childhood health. In this chapter, related studies published in Chinese or in English were searched from electronic sources and references lists of identified sources, to obtain a whole picture on the updated association between ambient temperature exposure and reproductive health outcomes in Chinese population.

In this paper, a new concept for morphing composite blades is proposed, and how this concept changes the twist distribution of the blade is explained. A change in the blade twist is obtained by add...

There is a lot of red clay along the Yuzhan expressway. In order to use local materials, improve the efficiency of economy and protect the environment, it is proposed to use red clay of Guangxi as roadbed material. Through the experiments, the influence of different mix amount of sand and lime on red clay properties, feasibility of soil improvement is demonstrated and the influence regularities of strength index are analyzed. The results provide important reference for design and construction of expressway.

Action recognition is one significant yet challenging task in computer vision. Recent methods mainly model an end-to-end one-stage non-deep or deep learning networks to distinguish different action categories. In this paper we introduce one novel hierarchical action classification framework: Unlike existing one-stage recognition models, the proposed work improves the recognition accuracy by: 1) developing a hierarchical coarse-to-fine action classification framework by dividing the recognition processing into two stages: coarse- grained classification and fine-grained classification, and 2) representing actions in different stages with different granularity features representation: global features are utilized for coarse classifiers while more body parts patterns for fine-grained classifiers are aggregated. Experiments on two widely-tested benchmark datasets show that our method can achieve state-of-the-art or competitive performance compared with existing results using one-stage models, with advantages regarding the recognition accuracy and robustness.