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The lane lines’ length, width, and direction are very regular, serialized, and structurally associated, which are not easily affected by the environment. To enhance lane detection in a complicated environment, an approach combines visual information with the spatial distribution. Firstly, the grid density of the target detection algorithm YOLOv3 (you only look once V3) is improved from S×S to S×2S, aiming at the particular points in the bird’s-eye view where the lane lines had different densities in the horizontal and vertical directions. The obtained YOLOv3 (S×2S) is more suitable for detecting objects with small and large aspect ratios. It also identifies image features along with balances the detection speed and accuracy. Secondly, based on a bi-directional gated recurrent unit (BGRU), a new lane line prediction model BGRU-Lane (BGRU-L) based on the distribution of lane lines is proposed using the characteristic of lane line serialization and structural correlation. Finally, Dempster-Shafer (D-S) algorithm based on confidence was used to integrate the results of YOLOv3 (S×2S) and BGRU-L to improve the lane line detection ability under complex environments. The experiment was carried out on the Karlsruhe Institute of Technology and Toyota Technological Institute (KITTI) dataset, while Euro Truck Simulator 2 (ETS2) is used as a supplement dataset. After fusing YOLOv3 (S×2S) and BGRU-L models in the D-S model, the detection results have high accuracy in a complex environment by 90.28 mAP. The detection speed is 40.20fps, which enables real-time detection.

An open neural tube defect (ONTD) features an exposed, unclosed neural plate in the form of an expanded, flat, and frequently hefty neural placode. Traditional philosophy of ONTD repair aims at preserving function at any cost, which often means stuffing the entire thick and unwieldy but non-functional placode into a tight dural sac, increasing the likelihood of future tethering of the spinal cord. The same philosophy of attempting to save the whole perimetry of the placode also sometimes leads to inadvertent inclusion of parts of the squamous epithelial membrane surrounding the placode into the reconstructed product, only to form inclusion dermoid cyst causing further injury to the neural tissues. Lastly, defective closure of the caudal primary neural tube usually results in abolition of secondary and junctional neurulation, leaving a defective conus and sacral nerve roots, clinically presenting in most cases with neurogenic bladder and bowel dysfunction. Preserving this trapped but locally active sacral micturition center, isolated from suprasegmental inhibitory moderation, leads to a spastic, hyperactive, low compliance, and high-pressure bladder predisposing to upstream kidney damage, without benefits of normal bladder function. We report the post-natal surgical treatment of 8 newborn infants with ONTD, in which we resected the non-functional portion of the neural placode identified as such by direct spinal cord/placode and nerve root stimulation, as well as by transcortical evoked motor responses to check for suprasegmental corticospinal connectivity. Any part of the placode without local function or upstream connections was resected, and the small caudal spinal cord stump closed with pia-to-pia microsutures. The patients were followed for pre- and post-operative neuro-urological status and with serial magnetic resonance imaging (MRI) at 3 weeks, 6 months, and 2 years post-repair. Follow-up period ranged from birth to 3 years (mean of 24 months). Of the 8 patients analyzed, 7 had a terminal and one a segmental ONTD. Pre-operative neurological level ranged from L4 to S2. Applying our new surgical paradigm, we found no neurological worsening post-operatively. All patients had a neurogenic bladder and bowel dysfunction but none had a high-pressure bladder on urodynamics studies. Early and late MRIs all showed a loose and capacious neural placode to dural sac relationship. None had an inclusion dermoid cyst. We propose a new paradigm for the surgical repair of open neural tube defects with intraoperative neuromonitoring and introduce a safe and reliable technique of placode debulking.

Objectives Early mortality, defined as death within 120 days after initiated antitumor therapy, is an important issue especially for elder patients with B-cell lymphoma. This study aimed to evaluate the clinical value of comprehensive geriatric assessment (CGA) in early mortality prediction in elderly patients with B-cell lymphoma receiving immunochemotherapy. Methods Seventy-six consecutive patients with newly diagnosed B-cell lymphoma receiving immunochemotherapy from a medical center in Taiwan were prospectively enrolled. Patients were divided into fit (n = 49) and frail (n = 27) groups per pretreatment CGA for early mortality comparison. Results The early mortality rate in our patient cohort was 16% (n = 12): from 6% in patients with no CGA domain impairment to 43% in patients with ≥4 CGA domain impairment. The early mortality rate was 6% and 33% in fit and frail patients (odds ratio, 7.67; 95% CI, 1.86-31.6; P = .005), respectively. Frailty was the significant predictor for early mortality in univariate and multivariate analysis. Conclusion In this study, the number of geriatric domain impairment is positively associated with the early mortality risk in elderly patients with B-cell lymphoma. Therefore, CGA can help clinicians to identify the risk of early mortality in elderly patients and provide alternative treatment.

Introduction: Splenectomy is an important and potentially curative treatment for immune thrombocytopenia (ITP). Laparoscopic splenectomy (LS) has replaced open splenectomy (OS) as the standard approach. The prognostic role of platelet count and the clinical indication of preoperative platelet transfusion are not entirely clear. Methods: We designed a study to explore the prognostic impact of surgical methods, platelet count, and platelet transfusion in a large, single-institute, long-term cohort of ITP patients. Result: In 118 ITP patients, there was no difference between OS and LS in response and surgical complications. The overall response rate was 77% and the complete response (CR) rate was 70%. Patients with a CR had a trend towards a higher baseline platelet count. A stable platelet count 14–28 days after splenectomy was associated with a sustained long-term response. Patients requiring preoperative platelet transfusion had a lower preoperative platelet count and were more likely to need postoperative transfusion of red blood cells and platelets. They also had a lower postoperative platelet count than the nontransfusion group. Relapse-free survival did not differ. Conclusions: Baseline and postoperative platelet counts are apparently associated with the treatment response to splenectomy but the difference did not reach statistical significance. Preoperative platelet transfusion did not overcome the disadvantage of thrombocytopenia and was not recommended when other preparative measures are available.

Background: The purpose of this study was to analyze cases of AO31-A2 intertrochanteric fractures (ITFs) and to identify the relationship between the loss of the posteromedial support and implant failure. Methods: Three hundred ninety-four patients who underwent operative treatment for ITF from January 2003 to December 2017 were enrolled. Focusing on posteromedial support, the A2 ITFs were divided into two groups, namely, those with (Group A, n = 153) or without (Group B, n = 241) posteromedial support post-operatively, and the failure rates were compared. Based on the final outcomes (failed or not), we allocated all of the patients into two groups: failed (Group C, n = 66) and normal (Group D, n = 328). We separately analyzed each dataset to identify the factors that exhibited statistically significant differences between the groups. In addition, a logistic regression was conducted to identify whether the loss of posteromedial support of A2 ITFs was an independent risk factor for fixation failure. The basic factors were age, sex, American Society of Anesthesiologists (ASA) score, side of affected limb, fixation method (intramedullary or extramedullary), time from injury to operation, blood loss, operative time and length of stay. Results: The failure rate of group B (58, 24.07%) was significantly higher than that of group A (8, 5.23%) (χ2 = 23.814, P < 0.001). Regarding Groups C and D, the comparisons of the fixation method (P = 0.005), operative time (P = 0.001), blood loss (P = 0.002) and length of stay (P= 0.033) showed that the differences were significant. The logistic regression revealed that the loss of posteromedial support was an independent risk factor for implant failure (OR = 5.986, 95% CI: 2.667–13.432) (P < 0.001). Conclusions: For AO31-A2 ITFs, the loss of posteromedial support was an independent risk factor for fixation failure. Therefore, posteromedial wall reconstruction might be necessary for the effective treatment of A2 fractures that lose posteromedial support. Key words: Intertrochanteric fractures; AO 31-A2; Loss of posteromedial support; Implant fixations; Implant failure

Background: Reverse intertrochanteric fractures are usually initially treated with closed reduction. However, sometimes these fractures are not amenable to closed reduction and require open reduction. To date, few studies have been conducted on predictors of and reduction techniques for irreducible reverse intertrochanteric fractures. Therefore, this study aimed to summarize the displacement patterns of irreducible reverse intertrochanteric fractures and corresponding reduction techniques, and explore predictors of irreducibility. Methods: We reviewed 1174 cases of trochanteric fractures treated in our hospital from January 2006 to October 2018, 113 of which were reverse intertrochanteric fractures. An irreducible fracture was determined according to intra-operative fluoroscopy imaging after closed manipulation. Fractures were assessed for displacement patterns, radiographic features of irreducibility, and reduction techniques. Logistic regression analysis was performed on potential predictors for irreducibility, including gender, age, body mass index, AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification, and radiographic features. Results: Seventy-six irreducible fractures were identified, accounting for 67% of reverse intertrochanteric fractures. Six patterns of fracture displacement after closed manipulation were identified; the most common pattern was medial displacement and posterior sagging of the femoral shaft relative to the head-neck fragment. Multivariate logistic regression analysis identified three predictors of irreducibility: a medially displaced femoral shaft relative to the head-neck fragment on the anteroposterior (AP) view (odds ratio [OR], 8.00; 95% confidence interval [CI], 3.04-21.04; P < 0.001), a displaced lesser trochanter (OR, 3.61; 95% CI, 1.35-9.61; P = 0.010), and a displaced lateral femoral wall (OR, 2.92; 95% CI, 1.02-8.34; P = 0.046). Conclusions: A high proportion of reverse intertrochanteric fractures are not amenable to closed reduction. Six patterns of fracture displacement after closed manipulation were identified. Different reduction techniques are required for different displacement patterns. Predictors of irreducibility include a medially displaced femoral shaft relative to the head-neck fragment on the AP view, a displaced lesser trochanter, and a displaced lateral femoral wall. These patients warrant special consideration in terms of recognition and management. Key words: Intertrochanteric hip fractures; Irreducible; Predictors; Reduction techniques; Reverse oblique

We find that in a suitably designed photonic crystal (PC) certain high-order photonic bands are less affected by the refractive-index ratio (RIR) than low-order bands, enabling the realization of a robust and complete two-dimensional (2D) photonic bandgap in a moderate refractive-index-ratio PC. A detailed theoretical investigation of low- and high-order bandgaps in a series of PCs with different configurations is performed that shows that high-order bands may favor substantial complete photonic bandgaps (CPBGs) for systems with a moderate RIR. Furthermore, the importance of the geometry and structural parameters on achieving a high-order CPBG is found. Specifically, a hexagonal lattice PC of annular-hole-peripheral connecting rods is proposed, which can support a CPBG with a refractive-index ratio (RIR) as low as n h i g h : n l o w = 2.1 ; to the best of our knowledge, this is the lowest RIR used to obtain a 2D CPBG in a PC.

Hepatocarcinogenesis is driven by necroinflammation or metabolic disorders, and the underlying mechanisms remain largely elusive. Here, we interestingly found that DEN-induced hepatocarcinogenesis was enhanced while NASH-induced hepatocarcinogenesis was abolished by hepatocyte-specific RIG-I deficiency. Further, IL-6 decreased RIG-I expression in HCC progenitor cells (HcPCs), which then viciously promoted IL-6 effector signaling and drove HcPCs to fully established HCC. RIGI expression was increased by HFD, which then enhanced cholesterol synthesis and steatosis, and the in-turn NASH and NASH-induced hepatocarcinogenesis. Mechanistically, RIG-I was constitutively monomethylated at K18 and K146, and demethylase JMJD4-mediated RIG-I demethylation suppressed IL6STAT3 signaling. The constitutive methylated RIG-I associated with AMPKα to inhibit HMGCR phosphorylation, thus promoting HMGCR enzymatic activity and cholesterol synthesis. Together with clinical data that RIGI was decreased in hepatic precancerous dysplastic nodules while increased in NAFLD, we conclude that decreased RIGI in HcPCs promotes necroinflammationinduced hepatocarcinogenesis, while increased constitutive methylated RIG-I enhances steatosis and NASH-induced hepatocarcinogenesis.

Objective To investigate the involvement of microRNAs (miRNAs) in the pathogenesis of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods In this study, we investigated miRNA profiles in the upper airway (UA) skeletal muscles of four patients with OSAHS and four matched controls using the miRCURY miRNA array. In another cohort of 12 OSAHS cases and 7 controls, the mRNA expression levels of interleukin (IL)-6 and Lin-28 homolog A (Lin28A), targets of the downregulated let-7 family members, were measured by real-time quantitative-PCR. The potential targets of the miRNAs were predicted by miRNA target prediction databases miRanda, Microcosm, and Targetscan. Results The array identified 370 differentially expressed miRNAs, of which 181 were upregulated and 189 were downregulated in OSAHS patients (based on a fold-change >2.0 and p Conclusion This study demonstrated profoundly altered miRNA expression profiles in upper airway muscular tissues of patients with OSAHS, which might contribute to the formation and development of OSAHS.

Objective To analyse the application of a new narrow-band imaging (NBI) classification in the diagnosis of vocal cord leukoplakia by laryngologists with different levels of laryngoscopic experience and to explore the impact of NBI training programmes on laryngologists' identification of benign and malignant leukoplakia. Design Prospective multicentre study. Setting Tertiary hospitals. Participants Sixteen laryngologists were divided into less-experienced and experienced groups and received NBI training course. Thirty cases of vocal cord leukoplakia were investigated. Main outcome measures Diagnostic accuracy and interobserver agreement under white light imaging (WLI), before and after NBI training, were analysed among doctors with varying levels of experience. Results The accuracy in the less-experienced group was significantly lower than that of experience group (0.59 vs 0.69) under WLI. There was no significant difference in the diagnostic accuracy between the less-experienced group and the experienced group before NBI training (0.75 vs 0.74) and after NBI training (0.79 vs 0.83). NBI training could improve the interobserver agreement from fair or moderate to good agreement. Conclusion The new NBI diagnostic classification is helpful for identifying benign and malignant vocal cord leukoplakia. In addition, the NBI training programme can improve the diagnostic accuracy and interobserver agreement of less-experienced doctors to the level of experienced laryngologists.

Background and purpose Oral mucositis remains one of the most common complications of radiation therapy for patients with head and neck cancer. This study aimed to investigate the dynamic shifts in the oral mucosal microbiota and their association with the progression and aggravation of mucositis in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy. Materials and methods In this study, oropharyngeal mucosa of patients were examined regularly, and sampled longitudinally in eight stages of their radiation treatment program: before radiation, and then after 10, 20, 30, 40, 50, 60, and 70 Gy. Based on 16S rRNA gene sequencing and bioinformatics analysis, the characteristics of dynamic variations in oral microbiota during their treatment were investigated. Results The results showed that the mucosal bacterial alpha diversity (richness and evenness) did not change significantly during the entire course of these patient treatments. Notwithstanding 20 genera were found to be significantly positively associated with their radiation dose, whereas 10 genera were negatively associated with it. Notably, two bacterial co-abundance groups (CAG 1 and 2) were identified and the majority of bacteria clustered within the CAG 2 were indeed periodontal disease-associated genera. Most strikingly, many of them, especially Prevotella, Fusobacterium, Treponema and Porphyromonas, showed obvious dynamic synchronous variations in their abundances throughout the course of radiation therapy, where their peaks frequently coincided with the onset of severe mucositis. Conclusion Our results suggest that dysbiosis of oral mucosal microbiota may contribute to exacerbating the severity of mucositis in patients undergoing radiotherapy for nasopharyngeal carcinoma.

OBJECTIVE To explore the relationship between obstructive sleep apnea (OSA) and cognitive impairment by combining event-related evoked potentials (ERPs) and China-Wechsler Younger Children Scale (C-WISC) in children with sleep-disordered breathing (SDB) with vs. without OSA. METHODS This was a retrospective case-control study of all consecutive children (n = 148) with adenoid tonsil hypertrophy between July 2017 and March 2019 at the Hospital. RESULTS The children were divided into the OSA (n = 102) and non-OSA (n = 46) groups. The apnea-hypopnea index (AHI), obstructive apnea index (OAI), and obstructive apnea-hypopnea index (OAHI) in the OSA group were elevated compared with those of the non-OSA group (all P

Circle of Willis (CoW) is the most critical collateral pathway that supports the redistribution of blood supply in the brain. The variation of CoW is closely correlated with cerebral hemodynamic and cerebral vessel-related diseases. But what is responsible for CoW variation remains unclear. Moreover, the visual evaluation for CoW variation is highly time-consuming. In the present study, based on the computer tomography angiography (CTA) dataset from 255 patients, the correlation between the CoW variations with age, gender, and cerebral or cervical artery stenosis was investigated. A multitask convolutional neural network (CNN) was used to segment cerebral arteries automatically. The results showed the prevalence of variation of the anterior communicating artery (Aco) was higher in the normal senior group than in the normal young group and in females than in males. The changes in the prevalence of variations of individual segments were not demonstrated in the population with stenosis of the afferent and efferent arteries, so the critical factors for variation are related to genetic or physiological factors rather than pathological lesions. Using the multitask CNN model, complete cerebral and cervical arteries could be segmented and reconstructed in 120 seconds, and an average Dice coefficient of 78.2% was achieved. The segmentation accuracy for precommunicating part of anterior cerebral artery and posterior cerebral artery, the posterior communicating arteries, and Aco in CoW was 100%, 99.2%, 94%, and 69%, respectively. Artificial intelligence (AI) can be considered as an adjunct tool for detecting the CoW, particularly related to reducing workload and improving the accuracy of the visual evaluation. The study will serve as a basis for the following research to determine an individual’s risk of stroke with the aid of AI.

International audience; Two-dimensional (2D) hybrid organic inorganic perovskite (HOIP) semiconductors have attracted widespread attention as a platform of next-generation optoelectronic devices benefiting from their naturally occurring and tunable multiple quantum-well-like (QW-like) structures, which enable a wide range of physical properties. Determining the intrinsic optical/electronic properties of 2D HOIPs is extremely important for further utility in photonic and optoelectronic devices. Here, we obtain the optical dielectric functions, complex refractive indices, and complex optical conductivities of both Ruddlesden–Popper (RP) and Dion–Jacobson (DJ) phases of 2D HOIPs, as a function of the perovskite QW thickness via spectroscopic ellipsometry over a broad energy range of 0.73–3.34 eV. We identify a series of feature peaks in the dielectric functions, and we explain the evolution of ground-state exciton peak with unit-cell thickness and changing excitonic confinement. We observe extraordinary values of optical extinction and electric loss tangents at the primary excitonic resonances and provide their detailed comparison with other known excitonic materials. Our study is expected to lay the foundation for understanding optical properties of pure-phase 2D HOIPs, which are critical and imperative for the accurate modelling of their photonic and optoelectronic devices.

Nowadays, autonomous vehicle is an active research area, especially after the emergence of machine vision tasks with deep learning. In such a visual navigation system for autonomous vehicle, the controller captures images and predicts information so that the autonomous vehicle can safely navigate. In this paper, we first introduced small and medium-sized obstacles that were intentionally or unintentionally left on the road, which can pose hazards for both autonomous and human driving situations. Then, we discuss Markov random field (MRF) model by fusing three potentials (gradient potential, curvature prior potential, and depth variance potential) to segment the obstacles and non-obstacles into the hazardous environment. Since the segment of obstacles is done by MRF model, we can predict the information to safely navigate the autonomous vehicle form hazardous environment on the roadway by DNN model. We found that our proposed method can segment the obstacles accuracy from the blended background road and improve the navigation skills of the autonomous vehicle.

Adenoid cystic carcinoma of the salivary gland (SACC) is a rare malignant tumors of the head and neck region, but it is one of the most common malignant tumors that are prone to perineural invasion (PNI) of the head and neck. The prognosis of patients with SACC is strongly associated with the presence of perineural spread (PNS). Although many contributing factors have been reported, the mechanisms underlying the preferential destruction of the blood-nerve barrier (BNB) by tumors and the infiltration of the tumor microenvironment by nerve fibers in SACC, have received little research attention. This review summarizes the current knowledge concerning the characteristics of SACC in relation to the PNI, and then highlights the interplay between components of the tumor microenvironment and perineural niche, as well as their contributions to the PNI. Finally, we provide new insights into the possible mechanisms underlying the pathogenesis of PNI, with particular emphasis on the role of extracellular vesicles that may serve as an attractive entry point in future studies.

The aim of this study was to explore the value of transcutaneous laryngeal ultrasonography in the diagnosis of vocal fold polyps. From December 2016 to June 2019, 87 patients with vocal fold polyps diagnosed pathologically in the Otolaryngology Head and Neck Surgery Department of the Second Affiliated Hospital of Xi'an Jiaotong University were enrolled and examined by electronic laryngoscopy and percutaneous laryngeal ultrasound on the same day before operation. To observe the effect of calcification length as a percentage of thyroid cartilage at the glottic level on vocal fold display, the characteristics of ultrasound images of vocal fold polyps and the value of transcutaneous laryngeal ultrasonography in the diagnosis of vocal fold polyps were assessed. Among 87 patients, the calcification rate of thyroid cartilage at the glottic level was 33.3%. The differences in calcification rate and percentage of calcification length between males and females were statistically significant. The rate of detection of vocal folds decreased gradually with an increase in calcification length percentage. Imaging features of vocal fold polyps were hypo-echoic with a clear boundary and regular shape. The detection rates for circular and non-circular polyps were 92.0% and 70.6%. Ultrasound was more likely to detect circular than non-circular polyps; however, the difference was not significant. Transcutaneous laryngeal ultrasonography can identify the morphology and location of vocal fold polyps and is non-invasive and highly accurate. Therefore, it has the potential to be an effective supplement to laryngoscopy for initial screening and post-operative review of vocal fold polyps.

Traditional energy planning methods are mostly related to newly-built area. However, in most already-built regions, the existing district energy systems (DESs) need to be ameliorated due to insufficient capacity and low efficiency. This paper investigates the methodology of expansion planning, which can offer planners a viable way to expand existing DESs. The term “expansion” aims to increase the supply capacity of the energy forms, e.g., steam, hot water and electricity, which cannot be accessed from national or urban energy supply network, and meanwhile increase energy utilization efficiency and cut CO2 emission. Three parts of the methodology, including problem analysis in current DESs, demand side analysis and the existing DES expansion, are introduced in this paper. New concepts of load structure and evaluation system of the whole district are proposed in this methodology. A case analysis of Ningbo Hi-Tech District, China is conducted to shed light on the application of this method.

Background/Aims: To explore the potential role of qiliqiangxin (QLQX) A traditional Chinese medicine and the involvement of angiotensin II receptor type 1 (AGTR1) and transient receptor potential vanilloid 1 (TRPV1) in diabetic mouse cardiac function. Methods: Intragastric QLQX was administered for 5 weeks after streptozotocin (STZ) treatment. Additionally, Intraperitoneal injections of angiotensin II (Ang II) or intragastric losartan (Los) were administered to assess the activities of AGTR1 and TRPV1. Two-dimensional echocardiography and tissue histopathology were used to assess cardiac function Western blot was used to detect the autophagic biomarkers Such as light chain 3 P62 and lysosomal-associated membrane protein 2 And transmission electron microscopy was used to count the number of autophagosomes. Results: Decreased expression of TRPV1 and autophagic hallmarks and reduced numbers of autophagolysosomes as well as increased expression of angiotensin converting enzyme 1 and AGTR1 were observed in diabetic hearts. Blocking AGTR1 with Los mimicked the QLQX-mediated improvements in cardiac function Alleviated myocardial fibrosis and enabled autophagy Whereas Ang II abolished the beneficial effects of QLQX in wild type diabetic mice but not in TRPV1-/- diabetic mice. Conclusions: QLQX may improve diabetic cardiac function by regulating AGTR1/ TRPV1-mediated autophagy in STZ-induced diabetic mice.

Deep learning has made remarkable progress in the field of image classification and object detection. Nevertheless, in the autonomous driving research, the real-time lane line detection and lane offset estimation in complex traffic scenes have always been challenging and difficult tasks. Traditional detection methods need manual adjustment of parameters, they face many problems and difficulties and are still highly susceptible to interference caused by obstructing objects, illumination changes, and pavement wear. It is still challenging to design a robust lane detection and lane offset estimation algorithm. In this paper, we propose a convolutional neural network for lane offset estimation and lane line detection in a complex road environment, which transforms the problems of lane line detection into the instance’s segmentation. In response to a change in the method of lane processing, the network will form its example to each line. The global scale perception optimization mechanism is designed to solve the issue, especially where the lane line width is gradually narrowing at the vanishing point of the lane. At the same time, to realize multi-tasking processing and improve performance, and end-to-end lane offset estimation network is used in addition to the lane line detection network.

AimsWe investigated the clinical and prognostic relevance of the mutational status of driver genes with allele burden and endogenous erythroid colony (EEC) growth in 203 Taiwanese patients with primary myelofibrosis (PMF).MethodsPyrosequencing was used to detect JAK2V617F mutational status and measure allele burden, while MPL (exon 10) mutations were analysed by PCR assay and then by direct sequencing. CALR exon 9 mutations were first screened for length changes by GeneScan followed by sequencing. The allele burden of the mutated CALR gene was measured by pyrosequencing. The EEC assay was conducted using a serum-free culture system.ResultsThe frequencies of the three driver mutations and triple-negative status were similarly distributed between pre-PMF and overt PMF patients, except that pre-PMF patients had a higher incidence of CALR type 2/type-2 like mutations and a lower JAK2V617F allele burden. EEC growth and CALR mutations conferred favourable overall survival (OS). A lower JAK2V617F allele burden and grade 3 bone marrow fibrosis were associated with shorter OS and decreased leukaemia-free survival (LFS). Type 2/type 2-like CAL mutations were associated with better LFS compared with type1/type 1-like mutations. Patients with triple-negative mutation status had significantly worse OS and LFS. The allele burden of CALR mutations remained unchanged, while some JAK2V617F mutations showed clonal expansion in patients during secondary acute myeloid leukaemia transformation.ConclusionsOur study showed that EEC growth, a higher JAK2V617F allele burden and CALR mutations, especially type 2, were independent predictors for better outcomes in PMF. The allele burden of CALR mutations remained stable, but the allele burden of JAK2V617Fmutations was variable during leukaemia transformation.

Heating, ventilation and air conditioning (HVAC) systems contribute to a major portion of energy consumption in buildings. Real-time optimal control is an efficient tool to improve the HVAC system efficiency. The formulation of the optimal control strategy is, however, challenging due to the lack of quantitative approaches and unified control format. Many previous studies use domain knowledge or experts’ interpretations to develop the optimal control strategy, which is qualitative, time-consuming and labor-intensive. This study proposes a data-mining-powered event-driven optimal control (EDOC) for improving HVAC operation efficiency. The main contributions are: (1) Provide a standard EDOC format to represent HVAC optimal control strategy; (2) Enable the automatic and quantitative formulation of optimal control strategies with minimal expert involvement. The random forest algorithm is adopted to discover event-driven relationships in the operation data. The effectiveness of the proposed approach is demonstrated through simulations. On average, the formulated EDOC strategy increases the energy saving by 0.9%–4.6% compared with a traditional time-driven optimal control. Meanwhile, events can be customized and can adapt to system renovations. The formulated EDOC is easy to use and can be easily understood by engineers and operators, which can be used to guide the optimal control of building HVAC systems.

Aiming at the fact that tower bolts are easily affected by factors such as occlusion during the identification process, an improved FasterR-CNN bolt identification method is proposed. In this method, in view of the small size of the detection target and the low resolution of the image, a residual network is added to the traditional FasterR-CNN to improve the efficiency of image recognition. Finally, the above scheme was proved through verification. The result shows that the above method is feasible.

BACKGROUND This study assessed an innovative tracer-based magnetic resonance imaging (MRI) system to visualize the dynamic transportation of tracers in regions of deep brain extracellular space (ECS) and to measure transportation ability and ECS structure. MATERIAL AND METHODS Gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) was the chosen tracer and was injected into the caudate nucleus and thalamus. Real-time dynamic transportation of Gd-DTPA in ECS was observed and the results were verified by laser scanning confocal microscopy. Using Transwell assay across the blood-brain barrier, a modified diffusion equation was further simplified. Effective diffusion coefficient D* and tortuosity λ were calculated. Immunohistochemical staining and Western blot analysis were used to investigate the extracellular matrix contributing to ECS structure. RESULTS Tracers injected into the caudate nucleus were transported to the ipsilateral frontal and temporal cortices away from the injection points, while both of them injected into the thalamus were only distributed on site. Although the caudate nucleus was closely adjacent to the thalamus, tracer transportation between partitions was not observed. In addition, D* and the λ showed statistically significant differences between partitions. ECS was shown to be a physiologically partitioned system, and its division is characterized by the unique distribution territory and transportation ability of substances located in it. Versican and Tenascin R are possible contributors to the tortuosity of ECS. CONCLUSIONS Tracer-based MRI will improve our understanding of the brain microenvironment, improve the techniques for local delivery of drugs, and highlight brain tissue engineering fields in the future.

ZnO-based ultraviolet (UV) light-emitting diodes (LEDs) are attractive for potential applications. In the study, ZnO-based UV LEDs were numerically investigated to determine the effects of the different step graded Mg compositions in multiple quantum barriers (QBs) on their electrical and optical properties. With the increase of Mg composition for QBs from n-side to p-side, the maximum internal quantum efficiency of various LEDs increase from 32.6% to 91.9%. These improvements can be explained in terms of the modified energy band structures which improve hole injection from p-side to the active region and change the carrier-concentration distributions in multiple quantum wells, then lead to an improvement of radiative recombination rates. One can expect that by the elaborate design of device structure, the performance of ZnO-based LEDs can be further improved.

The present study investigated the application of the T1ρ and T2 relaxation mapping magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in the evaluation of intervertebral disc degeneration (IDD). A total of 93 asymptomatic subjects were imaged with T1ρ and T2 mapping, as well as DWI. Pfirrmann grading was performed and correlation analysis was conducted for T1ρ, T2 and DWI results with the grading results and age. Pfirrmann grading indicated 69 cases of grade I, 240 cases of grade II, 101 cases of grade III, 43 cases of grade IV and 12 cases of grade V. MRI showed that the T1ρ values of the nucleus pulposi at L4/5 and L5/S1 were significantly reduced (P

Introduction: Perianal abscess may develop during neutropenia periods in patients with acute myeloid leukemia (AML). The standard of care for perianal abscess in AML is unclear. Methods: We retrospectively collected patient data in our institute from 2009 to 2012. Results: Two hundred ninety-two patients with AML were analyzed. In total, 1,051 chemotherapy sessions were administered. Twenty-three patients experienced perianal abscess. Patients with perianal abscess were younger than those without (44 vs. 60 years, p < 0.0001). Perianal abscess developed in various phases of treatment and in the stem cell transplantation period. Twelve recurrences developed in 6 patients. Patients with a prior perianal abscess have a 10-fold risk of developing a subsequent abscess following further chemotherapy. The microbiology profile revealed that most pathogens were derived from the intestinal tracts, which was similar to the findings of previous studies. The 28-day mortality was 14.3% and the direct cause of death was not perianal abscess in any case. Surgical interventions had no impact on recurrence or survival. Conclusion: In patients with AML, perianal abscess results from gastrointestinal tract pathogens. Many patients do not require surgical interventions. The mortality is low but recurrence is common following subsequent chemotherapies. Therefore, awareness of recurrence is important for the timely management of perianal abscess in AML.

The universe can be utilized as a sink for heat pumping by means of passive radiative cooling (PRC). This approach is an age-old cooling practice that has had a renaissance with increasing numbers of research papers over the past two decades. This paper reviews the trends of this technique, as well as advancements in recent years, with an attempt being made to analyze the cooling magnitude and developmental prospects for both diurnal and nocturnal periods. The models and calculations for computing the performances of passive radiative cooling systems are discussed along with the designs and fabrication factors that influence a system's performance. Optimizing strategies that maximize the net cooling power are also presented. The various system configurations that are available to date are summarized to demonstrate the building integration forms of PRC systems. The cooling potentials of different systems are assessed by simulations, and it is shown that the daytime cooling energy density is rather modest, even under the most favorable conditions. The barriers that likely exist to widespread application as well as the scopes for further improvements of PRC are also provided. It is noted that the commercialization of PRC systems is primarily limited by coating material constraints and technique reliability. The advent of a new type of material will be a critical solution to the prevalence of PRC.

The association of Pneumocystis jirovecii pneumonia (PJP) and acute myeloid leukaemia (AML) is not clearly defined. In our experience of 291 patients with AML, 20 (14 males and 6 females, median age 56) developed PJP (incidence 6.8%). Thirteen patients (65%) survived until discharge from hospital. We conclude that PJP is not uncommon among patients with AML. In clinical care of AML, awareness of PJP should be heightened and prophylaxis should be considered.

Summary Chronic lymphocytic leukaemia (CLL) is the most common leukaemia in Western countries but very rare in Asia. Peripheral blood or bone marrow mononuclear cells obtained at initial diagnosis from 194 patients with CLL were analysed to determine the ethnic difference in genetic abnormalities. Mutated IGHV was detected in 71·2% of Taiwanese CLL and IGHV3‐23 was the most frequently used gene. Stereotyped BCR was present in 18·3% with subset 8 being the most frequent. All cases with subset 8 belonged to IGHV 4‐39 and were exclusively associated with un‐mutated IGHV and poor outcome. Mutation frequencies of SF3B1 (9·7%), NOTCH1 (8·6%), BIRC3 (1·1%), ATM (16·9%) or TP53 (8·1%), and frequencies of cytogenetic abnormalities including trisomy 12 (18·6%), del(17p) (10·4%), del(13q) (43·7%) and IGH translocation (10·1%) were comparable to those reported from Western countries, except del(11q) (6·9%) which was lower in our patients. Patients with un‐mutated IGHV, subset 8, disrupted TP53, trisomy 12, and SF3B1 mutations had a worse outcome compared to patients without these mutations. In conclusion, IGHV3‐23 usage, stereotyped subset 8 and lower frequency of del(11q) show an ethnicity‐dependent association in Taiwanese CLL patients.

Multimode waveguide bend is one of the key components for realizing high-density mode-division multiplexing systems on chip. However, the reported multimode waveguide bends are either large, bandwidth-limited or fabrication-complicated, which hinders their applications in future high-density multimode photonic circuits. Here we propose a compact multimode waveguide bend supporting four TE modes simply by shape-optimizing with transformation optics. The shape of the waveguide is optimized in the virtual space with gradient distribution of the refractive index, so that the scattering loss and intermode cross talk are well suppressed. After conformal mapping back into the physical space, a compact (effective radius of 17 μm) multimode bending waveguide is obtained. Simulations show that the proposed multimode waveguide bend has little loss ( < 0.1 dB ) and low cross talk ( < − 20 dB ) throughout an ultrabroad wavelength range of 1.16–1.66 μm. We also fabricated the shape-optimized multimode bending waveguide on a silicon-on-insulator wafer. At 1550 nm wavelength, the measured excess losses for the four lowest-order TE modes are less than 0.6 dB, and the intermode cross talks are all below − 17 dB . Our study paves the way for realizing high-density and large-scale multimode integrated optical circuits for optical interconnect.

The focusing apodized subwavelength grating coupler (F-ASGC) has advantages of high coupling efficiency, small footprint and simple fabrication process, which make it a popular component for chip-scale coupling and testing of integrated optical circuit. However, the design of F-ASGC based on effective medium theory lacks accuracy, causing the drawbacks of peak wavelength deviation and performance degradation. In this work, we propose a deterministic design method of F-ASGC. Our grating coupler is formed by assembling various subwavelength grating units according to their complex effective indexes. The complex effective indexes of these grating units are accurately obtained by the weak form calculation. Then combining with transformation optics, we strictly analyze the F-ASGC for the first time. The simulation results show that the deterministically designed F-ASGC has high coupling efficiency of -2.51 dB, 3 dB bandwidth of 51 nm, and accurate central wavelength of 1553.1 nm. And we also fabricated it on the commercial SOI wafer. The measured maximum efficiency is -3.10 dB, the 3 dB bandwidth is 55 nm, and the central wavelength is 1551.5 nm.

We retrospectively analyzed 87 patients with angioimmunoblastic T cell lymphoma (AITL) in Taiwan. The median age was 68 (range 18-89) years. Of these patients, 74 % was at an advanced stage. The most common extra-nodal site involved was bone marrow (36 %). Of these patients, 77 % were International Prognostic Index (IPI)1 and 79 % had a prognostic index for peripheral T-cell lymphoma (PIT)1. Of 75 patients who received systemic chemotherapy, the complete remission rate was 60 %, the relapse rate was 47 %, and the 2-year progression-free survival rate was 37.4 %. The 2-year overall survival (OS) rate for all patients was 51.9 %. By multivariate analysis, bone marrow involvement (P 0.001) and ECOG1 (P = 0.007) were independent adverse factors for OS. A simplified prognostic index efficiently stratified patients into the following three groups: 2-year OS rates 79.8 % (0 factor), 28.3 % (1 factor), and 10.2 % (2 factors) by using bone marrow involvement and ECOG1 (P 0.001). In conclusion, AITL patients were older and had poorer prognosis in Taiwan. Bone marrow involvement, EOCG1, IPI1 and PIT1 had adverse impact on OS. The usefulness of this simplified prognostic index needs further validation.

Nano transparent conducting titanium-zinc oxide (Ti-ZnO) thin films were prepared on glass substrates by radio frequency (RF) magnetron sputtering technique. The deposited films are characterized by X-ray diffraction (XRD), four-probe meter and UV-visible spectrophotometer. The effects of Ti-doping content on the structural, optical and electrical properties of the films are investigated. The XRD results show that the obtained films are polycrystalline with a hexagonal wurtzite structure and preferentially oriented in the (002) crystallographic direction. The structural and optoelectronic characteristics of the deposited films are subjected to the Ti-doping content. The Ti-ZnO sample fabricated with the Ti-doping content of 3% (weight percentage) possesses the best crystallinity and optoelectronic performance, with the highest degree of preferred (002) orientation of 99.87%, the largest crystallite size of 83.2 nm, the minimum lattice strain of 6.263×10-4, the highest average visible transmittance of 88.8%, the lowest resistivity of 1.18×10-3 Ω·cm and the maximum figure of merit (FOM) of 7.08×103 Ω-1·cm-1. Furthermore, the optical bandgaps of the films are evaluated by extrapolation method and observed to be an increasing tendency with the increase of the Ti-doping content.

Slow light in square-lattice chalcogenide photonic-crystal (PC) holey fibers with uniform longitude geometry are proposed and theoretically investigated. By using the planewave-expansion method, a largest normalized complete 2-D photonic bandgap (CPBG) width of about 7.4% is found in an optimized connected-rod square-lattice chalcogenide PC, and the CPBG remains open with a refractive-index contrast as low as 2.48:1. We then consider the PCs as cladding layers to form holey fibers, and group indices up to several hundreds are predicted.

Ultraviolet (UV) light-emitting diodes (LEDs) based on zinc oxide (ZnO) materials have been the subject of many investigations because of their potential applications. In this study, ZnO/MgZnO multiple-quantum-well UV LEDs with graded-composition barriers were developed and numerically analyzed. The simulation results demonstrate that an optimized LED with a Mg composition graded from 24% to 2% in each triangular barrier exhibits the highest internal quantum efficiency (IQE) (88.0%) at 200 A/cm2, showing a 31.3% increase compared with the conventional LED with square barriers. This enhancement is attributed to the modified energy band structures that improve the symmetry in carrier transportation and increase the radiative recombination rate in each ZnO quantum well, thus enhancing the IQE of the device. Additionally, the different band-offset ratios of the MgZnO/ZnO and InGaN/GaN heterojunctions, which lead to the different carrier transport and electroluminescence properties of the ZnO- and GaN-based LEDs, were discussed here, providing researchers new insights into device design of ZnO-based LEDs.

Objective Previous studies have shown that patients with obstructive sleep apnea syndrome (OSAS) may have various vestibular abnormalities, and these mainly present as subclinical lesions. In this study, we attempted to combine ocular vestibular-evoked myogenic potentials (VEMPs) and cervical (VEMPs) to investigate vestibular dysfunction in patients with OSAS. Methods Thirty-eight patients with severe OSAS and 42 healthy controls were enrolled and divided into two groups according to results of polysomnography. All parameters of VEMP graphs were analyzed. Results The response rate of ocular VEMPs was significantly lower in patients with severe OSAS (85.5%) than in controls (96.4%). The mean n1 latency of patients with severe OSAS (10.6 ± 1.0 months) was significantly longer than that of controls (10.2 ± 1.1 months). With regard to cervical VEMP, p1-n1 amplitudes were significantly different between the groups. Other VEMP parameters were not significantly different between the groups. Conclusions VEMPs can potentially be used to evaluate vestibular system lesions at the early stage of OSAS, including not only the vestibular nerve, but also the otolith organs involved.

To obtain efficient and stable light trapping, angle rotation is introduced to form rotated square pillar array grating (SPAG) solar cells. Compared with the unpatterned stack slab and the optimized uniform SPAG cells, the maximum short-circuit current ( J sc) of the optimized rotated SPAG is increased by 78.54% and 3.21%, respectively. Moreover, besides the fact that the low-incidence angular sensitivity of J sc could be maintained, J sc of the optimized rotated SPAG will always be larger than that of the optimized uniform SPAG at any incident angle. Furthermore, when the structural parameters of the subsquare pillar slightly deviate from the optimum, the absorption only deceases slightly as well, which indicates both a high structural tolerance and a stable absorption performance. In addition, our results show not only that the proposed rotated SPAG is promising to make light trapping efficient and stable but also that introducing rotation disorders is promising for other high-absorption pseudounordered surface structures.

Giant panda (Ailuropoda melanoleuca) is an iconic species of conservation. However, long-term monitoring of wild giant pandas has been a challenge, largely due to the lack of appropriate method for the identification of target panda individuals. Although there are some traditional methods, such as distance-bamboo stem fragments methods, molecular biological method, and manual visual identification, they all have some limitations that can restrict their application. Therefore, it is urgent to explore a reliable and efficient approach to identify giant panda individuals. Here, we applied the deep learning technology and developed a novel face-identification model based on convolutional neural network to identify giant panda individuals. The model was able to identify 95% of giant panda individuals in the validation dataset. In all simulated field situations where the quality of photo data was degraded, the model still accurately identified more than 90% of panda individuals. The identification accuracy of our model is robust to brightness, small rotation, and cleanness of photos, although large rotation angle (>20°) of photos has significant influence on the identification accuracy of the model (P

We propose and experimentally demonstrate a silicon based ultra-compact and low loss higher order mode bandpass filter (HMF), which was inversely designed by a direct-binary search topology optimization algorithm. The proposed HMF is a directional coupler with optimally positioned etched circular air holes in the coupling region which footprint is only 1.8 × 3 μm2. The experimental results show that the HMF has low insertion loss of

Several hemispherical optical receivers based on angle diversity technology are optimized to achieve better reception for multiple-input multiple-output (MIMO) visible light communication (VLC) system with an improved inter-symbol interference (ISI) model. The optimal parameters are obtained via analyzing the performances under different diversity dimensions, spatial distances between adjacent photodiodes (PDs) and inclination angles. The simulation results reveal that under the condition of optical angle diversity receiver (OADR) with 4 PDs, the optimal spatial distance between adjacent PDs is 0.1 m and the inclination angle is 5 0 ∘ , respectively. Compared with common plane model of 4 PDs, the average SNR has increased by 15.2%. It is no doubt that the OADR is a kind of promising alternative for indoor visible light communications.

Objectives We aimed to define the clinical features, outcome, and prognostic factors for extranodal NK/T-cell lymphoma (ENKTL) patients in Taiwan. Methods We retrospectively reviewed 101 ENKTL patients diagnosed between February 1998 and October 2015. Results The median age of 101 patients was 52 years old (range 22-85); 76.2% of patients were Ann Arbor stage I/II disease. The 5-year progression-free survival (PFS) and overall survival (OS) were 49.9% and 54.8%, respectively. Patients with log[EBV-DNA] ≥ 3.8 and bone marrow hemophagocytosis at diagnosis had inferior PFS and OS. Most stage I/II patients received combined chemoradiotherapy with anthracycline-containing regimen, with overall response rate of 96.7%, complete response rate 86.9%, 5-year PFS 65%, and OS 72%. The relapse rate was 29.3% with a short median disease-free survival of 6.2 months. In advanced stage patients, overall response rate was only 13.6%, with median PFS 2.3 months, and OS 4.8 months. Age ≥ 60 (HR 3.773, 95% CI 1.733-8.215, P = 0.001) and stage III/IV (HR 7.785, 95% CI 2.312-26.213, P = 0.001) were unfavorable prognostic factors for PFS and OS by multivariate analyses. Conclusions Age ≥ 60 and stage III/IV are independent poor prognostic factors for PFS and OS. Early-stage ENKTL patients had good response to combined chemoradiotherapy with anthracycline-containing regimen but with a high relapse rate and short disease-free survival. Anthracycline-containing regimen in advanced stage had poor response and dismal outcome.

Objectives Different experiment approaches have demonstrated that children with obstructive sleep apnea (OSA) exhibit neurocognitive and behavioral deficits. This review summarized the potential biomarkers of OSA-associated neurocognitive impairment in children. Methods A scoping review of studies on children with OSA that evaluated the potential value of different markers in identifying neurocognitive impairment was undertaken. Additionally, the biomarkers were categorized according to the different research methods, including brain imaging studies, serological indicators and urine markers. Results Majority of the studies that evaluated blood biomarkers, plasma insulin growth factor-1 (IGF-1) and Alzheimer's disease (AD)-related biomarkers appeared to exhibit a favorable profile, and could discriminate between OSA children with or without neurocognitive impairments. Brain imaging studies and urinary neurotransmitters could also be helpful for screening OSA cognitive morbidity in children. Conclusion Due to limited research methods available in children, the cognitive susceptibility of children with OSA has been rarely studied. The main reason for this may be the limited research methods in children. Numerous study populations of children and complex psychological tests are required, which involve major labor and costs.Multi-center prospective studies are needed to identify suitable biomarkers for the timely prediction and effective intervention to prevent neurocognitive impairment in children with OSA and to explore further opportunities in this arena.

Objective For immune thrombocytopenia (ITP), efficacy of frontline steroids is well established. However, clinical data comparing various treatment options for refractory or relapsed ITP are limited. We aimed to investigate the outcome of frontline steroid treatment for ITP patients and compare common second-line modalities in a single institute in Taiwan. Methods We collected the complete outpatient list over a 6-month period. Patients were identified from the list, and medical records were reviewed to capture the data retrospectively. The diagnosis of ITP was made by excluding other etiologies. Results Among 665 patients with thrombocytopenia, the diagnosis of ITP was made in 375. Two hundred and fifty-seven patients (51 males, median age 45.5) received treatment. Response to steroids was evaluable for 184 patients. Complete response (CR) was achieved in 120 (65.2%) and partial response in 43 (23.3%). In 21 (11.4%) patients, ITP was refractory to steroids. Among those with CR, 76 (63%) patients relapsed in a median of 9.5 months. After relapse or steroid failure, 57 (49%) received azathioprine treatment and 38 (32%) underwent splenectomy. Response rate was 71.4% (38.1% CR) for azathioprine and 91.4% (77.1% CR) for splenectomy. Rituximab was effective in 8 of 10 patients. Conclusion Steroids are effective frontline treatment for ITP, but relapse is common. Both azathioprine and splenectomy are effective treatment after steroid failure. Rituximab appears to a reasonable second-line treatment option in our limited experience.

In the original manuscript, the maximum short-circuit current in Fig. 2 and the description of angular stability for polarization in Fig. 6 are found incorrect owing to negligence. The incorrect maximum integrated absorption also led to errors appeared in Fig. 3 and Fig. 4(d), in which the mistake value was used to plot. In this erratum, all of those mistakes have been corrected. Moreover, both higher Fourier expansion order and the resolution of frequency are adopted in the recalculation to make sure the updated results to be reliable. The updated data presented still support the main conclusions drawn in the previous manuscript.