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Federated learning allows a large number of resource-constrained clients to train a globally-shared model together without sharing local data. These clients usually have only a few classes (categories) of data for training, where the data distribution is non-iid (not independent identically distributed). In this paper, we put forward the concept of category privacy for the first time to indicate which classes of data a client has, which is an important but ignored privacy goal in the federated learning with non-iid data. Although secure aggregation protocols are designed for federated learning to protect the input privacy of clients, we perform the first systematic study on category inference attack and demonstrate that these protocols cannot fully protect category privacy. We design a differential selection strategy and two de-noising approaches to achieve the attack goal successfully. In our evaluation, we apply the attack to non-iid federated learning settings with various datasets. On MNIST, CIFAR-10, AG\_news, and DBPedia datasets, our attack achieves >90% accuracy measured in F1-score in most cases. We further consider a possible detection method and propose two strategies to make the attack more inconspicuous.

Mobile Edge Computing (MEC) infrastructure raises security concerns when the shared resources involve sensitive and private data of users. This paper proposes a novel blockchain-based key management scheme for MEC that is essential for ensuring secure group communication among the devices. In the proposed scheme, when a mobile device joins a subnetwork, it first generates lightweight key pairs, and broadcasts its public key to neighbouring peer users. The blockchain miner in the subnetwork packs all the public key of mobile devices into a block that will be sent to other users. This enables the mobile device to communicate with its peers in the subnetwork by encrypting the data with the public key stored in the blockchain. When the mobile device moves to another subnetwork, all the mobile devices of the new subnetwork can quickly verify its identity by checking its record in the local or higher hierarchy subnetwork blockchain. Theoretical security analysis shows that the proposed scheme can defend against the 51% attack and malicious entities in the blockchain network. Moreover, the backward and forward secrecy is also preserved. Experimental results demonstrate that the proposed scheme outperforms two baselines in terms of computation, communication and storage.

Studying the deep learning-based molecular representation has great significance on predicting molecular property, promoted the development of drug screening and new drug discovery, and improving human well-being for avoiding illnesses. It is essential to learn the characterization of drug for various downstream tasks, such as molecular property prediction. In particular, the 3D structure features of molecules play an important role in biochemical function and activity prediction. The 3D characteristics of molecules largely determine the properties of the drug and the binding characteristics of the target. However, most current methods merely rely on 1D or 2D properties while ignoring the 3D topological structure, thereby degrading the performance of molecular inferring. In this paper, we propose 3DMol-Net to enhance the molecular representation, considering both the topology and rotation invariance (RI) of the 3D molecular structure. Specifically, we construct a molecular graph with soft relations related to the spatial arrangement of the 3D coordinates to learn 3D topology of arbitrary graph structure and employ an adaptive graph convolutional network to predict molecular properties and biochemical activities. Comparing with current graph-based methods, 3DMol-Net demonstrates superior performance in terms of both regression and classification tasks. Further verification of RI and visualization also show better robustness and representation capacity of our model.

Networks that constantly transmit information and change structure are becoming increasingly prevalent. However, traditional privacy models are designed to protect static information, such as records in a database or a person's profile information, which seldom changes. This conflict between static models and dynamic environments is dramatically hindering the effectiveness and efficiency of privacy preservation in today's dynamic world. Hence, in this paper, we formally define the concept of dynamic privacy, present two novel perspectives, privacy propagation and accumulation, on the way private information can spread through dynamic cyberspace, and develop associated theories and mechanisms for preserving privacy in advanced complex networks, such as social networking sites where data are constantly being released, shared, and exchanged.

Homomorphic encryption (HE) schemes, such as fully homomorphic encryption (FHE), support a number of useful computations on ciphertext in a broad range of applications, such as e-voting, private information retrieval, cloud security, and privacy protection. While FHE schemes do not require any interaction during computation, the key limitations are large ciphertext expansion and inefficiency. Thus, to overcome these limitations, we develop a novel cryptographic tool, MAS-Encryption (MASE), to support real-value input and secure computation on the multiply-add structure. The multiply-add structures exist in many important protocols, such as classifiers and outsourced protocols, and we will explain how MASE can be used to protect the privacy of these protocols, using two case study examples. Specifically, the first case study example is the privacy-preserving Naive Bayes classifier that can achieve minimal Bayes risk, and the other example is the privacy-preserving support vector machine. We prove that the constructed classifiers are secure and evaluate their performance using real-world datasets. Experiments show that our proposed MASE scheme and MASE based classifiers are efficient, in the sense that we achieve an optimal tradeoff between computation efficiency and communication interactions. Thus, we avoid the inefficiency of FHE based paradigm.

To achieve efficiently search and update on outsourced encrypted data, dynamic searchable symmetric encryption~(DSSE) was proposed by just leaking some well-defined leakages. Though small, many recent works show that an attacker can exploit these leakages to undermine the security of existing DSSE schemes. In particular, an attacker can exploit even seemingly harmless size pattern to perform severe attacks. Many exiting schemes resort to oblivious RAM~(ORAM) to hide search/access pattern; however, even such powerful cryptographic primitive cannot protect size pattern leakage. In this paper, we first show that size pattern can lead to more information leakages, which is not well studied or protected by existing schemes. We then extend the existing privacy notion for DSSE to capture the size pattern leakage, achieving a strong forward and backward privacy definition. Following the definition, we propose a new DSSE scheme Eurus. Eurus can eliminate search/access pattern by relying on a multi-server ORAM scheme, meanwhile reducing size pattern with reasonable efficiency. We show that Eurus can reduce leakage significantly with better efficiency, compared with state-of-the-art leakage reduction schemes.

Subscription-based services, where broadcasting companies make profits by providing subscription programs to users, have become a popular application of wireless broadcast systems. Driving by business interests and data security, companies usually encrypt content of programs with session keys, then only authorized users can access the contents of their subscribed programs, respectively. It is challenging to flexibly distribute and update the session key, we are therefore motivated to propose an identity-based many-to-many subscription scheme (IMS) with efficient key management. The IMS scheme possesses three novel advantages: Firstly, it provides a whole set of subscription flow, from the selection of programs of interest to the generation and updating of keys. Secondly, it supports program updating and all subscription behaviors. Thirdly, it employs a signature and authentication mechanism to stipulate that only authorized users can access the programs ciphertext. The theoretical analysis demonstrates that the proposed scheme is secure against Chosen-Ciphertext Attacks (CCA) under the k-bilinear Diffie-Hellman exponent (BDHE) problem, and has a decent performance in storage and computational overhead. The experimental analysis shows the total time cost of the proposed scheme is reduced more than 75.02% compared against the popular peer schemes under the condition of 2500 users.

Order-preserving encryption (OPE) is a cryptographic primitive that preserves the order of plaintexts. In the past few years, many OPE schemes have been studied to solve the problem of executing range queries in encrypted databases. However, OPE allows certain information to be leaked (for example, the order of ciphertext), so it is vulnerable to many attacks. Subsequently, order-revealing encryption (ORE), as a generalization of order-preserving encryption, breaks through the limitation of the numeric order of OPE plaintext. It implements ciphertext comparison for any specific form of plaintext through a publicly computable comparison function. In this work, we aim to design the new ORE scheme which reduces the leakage and preserves the practicality in terms of ciphertext length and encryption time. We first propose the hybrid model named HybridORE. Then, we propose an improved scheme named EncodeORE which achieves acceptable security and appropriate ciphertext length. They both explore the encode strategy of encoding plaintext into different parts and apply suitable ORE algorithms to each part according to its security characteristics to reduce leakage. Compared with the typical schemes in large domain, they have less leakage. The experiment shows that the proposed EncodeORE is very practical.

Purpose To investigate the influence of anterior chamber depth (ACD) on the accuracy of the Kane, EVO 2.0, Barrett Universal II (BU II), Olsen, SRK/T, and Haigis formulas in patients with elongated eyes. Design Retrospective case series study. Methods A total of 106 patients (106 eyes) diagnosed with high myopia (axial length ≥26 mm) were enrolled and divided into 3 subgroups according to preoperative ACD. Mean refractive error (ME), mean absolute refractive error (MAE), median absolute refractive error (MedAE), and proportions of eyes within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D were calculated. Results In all patients, the MedAE was lowest for the Kane formula (0.28 D), followed by the BU II (0.34 D). In the shallow ACD subgroup, EVO 2.0 formula produced the lowest MedAE (0.22 D), and the highest proportion of eyes within ±0.25 D (58%); the BU II (0.23 D, 50%) and Kane (0.25 D, 50%) formulas produced similar proportions. In the deep ACD group, the MedAEs of the Haigis and SRK/T formulas (0.68 D and 0.50 D, respectively) were significantly higher than those of the EVO 2.0 (0.37 D), Kane (0.30 D), BU II (0.43 D), and Olsen (0.34 D) formulas (P Conclusions Overall, the Kane and EVO 2.0 formulas had the highest accuracy. EVO 2.0 and BU II formulas are recommended for patients with shallow ACD; the Kane formula is recommended for patients with deep ACD (especially patients with extremely elongated eyes). The SRK/T and Haigis formulas should be avoided as much as possible.

Recently, applying deep learning to no-reference image quality assessment (NR-IQA) has received significant attention. Especially in the last five years, an increasing interest has been drawn to the studies of rank learning since it can help mitigate the problem of small IQA datasets. However, on one hand, existing rank learning is not suitable for the authentically distorted images due to the lack of generated rank samples. On the other hand, the output of existing rank loss functions is uncontrollable, resulting in reduced performance. Motivated by these two limitations, we propose a novel rank learning based NR-IQA method, termed controllable list-wise ranking IQA (CLRIQA) in this paper. To be specific, we first present an imaging-heuristic approach, in which the over- and under-exposure is formulated as an inverse of the Weber-Fechner law, and fusion strategy and compression are adopted, to simulate the authentic distortion and generate the rank image samples. These samples are label-free yet associated with quality ranking information. Then we design a controllable list-wise ranking (CLR) loss function by setting an upper and lower bound of rank range and introducing an adaptive margin to tune rank interval. Finally, both the generated rank samples and proposed CLR are used to pre-train a convolutional neural network. Moreover, to obtain a more accurate prediction model, we take advantage of the IQA datasets to fine-tune the pre-trained network further. Various experiments are conducted on the IQA benchmark datasets, and experimental results demonstrate the effectiveness of the proposed CLRIQA method. The source code and network model can be downloaded at the following web address: https://github.com/GZHU-Image-Lab/CLRIQA.

Aging is frequently accompanied by various types of physiological deterioration, which increases the risk of human pathologies. Global public health efforts to increase human lifespan has been increasingly focusing on lowering the risk of incidences of aging-related disease, such as diabetes, neurodegenerative diseases, cardiovascular disease and cancers. Dietary interventions is a promising approach to maintain human health during aging. Lactoferrin (LF) is known for its physiologically pleiotropic properties. Anti-aging interventions of LF have proven to be safe and effective for various pharmacological activities such as antioxidants, anti-cellular senescence, anti-inflammation, and anti-carcinogenic. As well as the pivotal role of LF on the modulating of major signaling pathways that influence longevity of organisms. Thus, LF is expected to be able to attenuate the process of aging and greatly ameliorate its effects.

The visual-semantic gap between the visual space (visual features) and semantic space (semantic attributes) is one of the main problems in the Generalized Zero-Shot Learning (GZSL) task. The essence of this problem is that the structure of manifolds in these two spaces is inconsistent, which makes it difficult to learn embeddings that unify visual features and semantic attributes for similarity measurement. In this work, we tackle this problem by proposing a multi-modal aggregated posterior aligning neural network based on Wasserstein Auto-encoders (WAE) which learns a shared latent space for visual features and semantic attributes. The key to our approach is that the aggregated posterior distribution of the latent representations encoded from visual features of each class is encouraged to be aligned with a Gaussian distribution predicted by the corresponding semantic attribute in the latent space. On one hand, requiring the latent manifolds of visual features and semantic attributes to be consistent preserves the inter-class association between seen and unseen classes. On the other hand, the aggregated posterior of each class is directly defined as a Gaussian in the latent space, which provides a reliable way to synthesize latent features for training classification models. Using the AWA1, AWA2, CUB, aPY, FLO, and SUN benchmark datasets, we extensively conducted comparative evaluations to demonstrate the advantages of our method over state-of-the-art approaches.

Since big data becomes a main impetus to the next generation of IT industry, data privacy has received considerable attention in recent years. To deal with the privacy challenges, differential privacy has been widely discussed and related private mechanisms are proposed as privacy-enhancing techniques. However, with today's differential privacy techniques, it is difficult to generate a sanitized dataset that can suit every machine learning task. In order to adapt to various tasks and budgets, different kinds of privacy mechanisms have to be implemented, which inevitably incur enormous costs for computation and interaction. To this end, in this paper, we propose two novel schemes for outsourcing differential privacy. The first scheme efficiently achieves outsourcing differential privacy by using our preprocessing method and secure building blocks. To support the queries from multiple evaluators, we give the second scheme that employs a trusted execution environment to aggregately implement privacy mechanisms on multiple queries. During data publishing, our proposed schemes allow providers to go off-line after uploading their datasets, so that they achieve a low communication cost which is one of the critical requirements for a practical system. Finally, we report an experimental evaluation on UCI datasets, which confirms the effectiveness of our schemes.

Data deduplication technique has been widely adopted by commercial cloud storage providers, which is important in coping with the explosive growth of data. To further protect the security of users' sensitive data in the outsourced storage mode, many secure data deduplication schemes have been designed and applied in various scenarios. Among these schemes, secure and efficient re-encryption for encrypted data deduplication attracted the attention of many scholars, and many solutions have been designed to support dynamic ownership management. In this paper, we focus on the re-encryption deduplication storage system and show that the recently designed lightweight rekeying-aware encrypted deduplication scheme is vulnerable to the stub-reserved attack. Furthermore, we propose a secure data deduplication scheme with efficient re-encryption based on the convergent all-or-nothing-transform (CAONT) and randomly sampled bits from the Bloom filter. Due to the property of hash function, our scheme can resist the stub-reserved attack and guarantee the data privacy of data owners' sensitive data. Moreover, instead of re-encrypting the entire package, data owners are only required to re-encrypt a small part of it through the CAONT, thereby effectively reducing the computation overhead. Finally, security analysis and experimental results show that our scheme is secure and efficient in re-encryption.

In arthroscopic shoulder surgery, general anesthesia (GA) is the common method of anesthesia. Recently, the combined usage of interscalene brachial plexus block with general anesthesia (ISB/GA) was reported to have a lower incidence of adverse side effects than GA alone. However, to date, no study has compared stress and inflammatory responses between these two methods. Since stress and inflammatory responses are critical on intraoperative management and postoperative recovery, we integrated the laboratory and clinical methods and compared the stress and inflammatory factors, such as epinephrine, norepinephrine, glucose, lactate, inflammatory factors tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6), as well as the clinical outcomes to determine whether ISB/GA provides an advantage on stress and inflammatory inhibition. Data showed that ISB/GA resulted in significantly lower epinephrine, norepinephrine, and glucose levels perioperatively. Six hours after operation, the TNF-α and IL-6 levels were also significantly lower in the ISB/GA group. ISB/GA patients had lower blood pressure, a more stable heart rate, lower visual analog scale score, and less opioid consumption during and after surgery. Our results indicate that ISB/GA is a better choice for arthroscopic shoulder surgery, owing to less stress and inflammatory responses during and after operation, which provides better clinical outcomes. Therefore, we recommend ISB/GA as a preferred anesthesia method for arthroscopic shoulder surgery.

The 2011 Great East Japan Earthquake impacted many business enterprises in the tsunami affected Tohoku region. While the number of disaster related bankruptcies has been increasing in the tsunami-affected areas since 2011, one small shopping district in Natori city, Miyagi, has managed to make an early recovery from the disaster. The Yuriage Port Morning Market (YPMM), which is operated by the Yuriage Port Morning Market Cooperative (YPMMC), managed to resume business operations in its original location just two years and two months after the disaster, and the YPMM now attracts more visitors than it did before the disaster. The present study was designed to explore factors that had helped the YPMMC bring the YPMM back on track after the disaster. Results derived from interview and questionnaire surveys revealed that new business model creation and adaptation, social capital, and leadership seemed to have played significant roles in the early recovery of the YPMM. Although these factors might not have been the only factors contributing to the YPMM’s early recovery, they should have made the difference between the YPMM and other shopping districts that had failed to resume its business operations after the disaster.

The primitive of verifiable database (VDB) can enable a resource-limited client to securely outsource an encrypted database to an untrusted cloud server and the client could efficiently retrieve and update the data at will. Meanwhile, the client can undoubtedly detect any misbehavior by the server if the database has been tampered with. We argue that most of the existing VDB schemes can only support the updating operation of replacement, rather than other common updating operations such as insertion and deletion . Recently, the first publicly verifiable VDB schemes that supports all updating operations was proposed based on the idea of hierarchical vector commitment. However, one disadvantage of the proposed VDB scheme is that the computation and storage complexity increases linearly when the client continually inserts data records in the same index of the database. As a result, it remains an open problem how to construct an efficient (and publicly verifiable) VDB scheme that can support all updating operations regardless of the manner of insertion. In this paper, we first introduce a new primitive called committed invertible Bloom filter (CIBF) and utilize it to propose a new publicly verifiable VDB scheme that can support all kinds of updating operations. Additionally, the proposed construction is efficient regardless of the manner of updating operations and thus provides an affirmative answer to the above open problem.

As one of the conventional methods of lung cancer detection, computed tomography (CT) usually requires the use of contrast agents to enhance the imaging effect. Conventional iodine contrast agents have poor signal-to-noise ratio and are prone to adverse reactions. It is necessary to find more effective and safe contrast agents for CT scans. The gold nanoparticles with secondary electron effect and photoelectric absorption effect can prolong the display time of the patient’s blood circulation after being injected into the patient’s body, which makes the nanocontrast agent a research hotspot in the field of CT imaging. In this study, ultrasmall gold nanoclusters with a diameter of about 5 nm were used as the contrast agent in CT scans. It was found that CT scans based on nanocontrast agents can obtain high-quality lung cancer imaging images, and the patient has no obvious adverse reactions. When observing the CT image, it was found that the stage of lung cancer patients can be clearly distinguished through the CT scan image. When analyzing the consistency of CT imaging and pathological classification, the Kappa value was 0.810, indicating that the two have a high degree of consistency. Therefore, this study believes that the imaging characteristics of primary lung tumors based on nanocontrast agents are highly correlated with their pathological types.

Voltage stability is one of the critical factors for the stable operation of DC microgrids (MG). For the communication free DC MG, the DC voltage is more vulnerable due to the DC voltage deviation caused by the droop characteristics. When facing the transient power fluctuation caused by multiple electric vehicles (EVs) connected to the grid, PV shedding, etc., the DC bus will have a large voltage sag. The voltage quality degradation will bring adverse effects to the DC MG. However, most energy storage systems like battery energy storage systems (BESS) are not suitable for suppressing transient large power fluctuation. In this paper, the SMES is introduced to a DC MG to form a power regulation system. A voltage-based segmented (VBS) control is designed for the SMES-based power regulation system to suppress transient large power fluctuation in the DC MG. The voltage deviation caused by power distribution can be tolerant by VBS controlled SMES. Meanwhile, the dynamic recovery capability of the DC voltage is improved. The control method of SMES is independent of other devices in DC MGs, hence it is not dependent on communication. The control strategy of the SMES is further verified by simulation results.

PURPOSE: To compare the accuracy of the Barrett Universal II, Emmetropia Verifying Optical (EVO), Haigis, Kane, and SRK/T formulas for intraocular lens power calculation in patients with high axial myopia. METHODS: In this retrospective study, 175 eyes (175 patients) that underwent uneventful cataract surgery were enrolled. According to the axial length (AL), the eyes were divided into long AL (26 ⩽ AL < 28 mm), super long AL (28 ⩽ AL < 30 mm), and extremely long AL (⩾ 30 mm). The mean absolute prediction errors (MAE) 3 months postoperatively and the percentage of eyes within different prediction error were compared, followed by subgroup analysis. RESULTS: The MAE and percentage of eyes within ±0.50 diopters (D) of the five formulas were as follows: Barrett Universal II (0.342, 74.9%), EVO 2.0 (0.314, 82.3%), Haigis (0.336, 74.9%), Kane (0.318, 78.9%), and SRK/T (0.398, 69.7%) ( P = .552 and .071, respectively). Although no significant difference was found among the five formulas in the super and extremely long AL groups ( P = .792 and .227, respectively), the EVO 2.0 formula achieved the highest accuracy (88.9%, 72 of 81) in the long AL group ( P = .049). Moreover, the accuracy of the EVO 2.0 and Haigis formulas was stable, regardless of AL. The SRK/T formula showed a negative trend in the long and super long AL groups, whereas the Barrett Universal II, Kane, and SRK/T formulas showed positive trends in the extremely long AL group. CONCLUSIONS: Overall, the EVO 2.0 and Kane formulas achieved better results in patients with high axial myopia, whereas the other three formulas showed slightly poor outcomes. [ J Refract Surg . 2021;37(11):754–758.]

Each pixel can be classified in the image by the semantic segmentation. The segmentation detection results of pixel level can be got which are similar to the contour of the target object. However, the results of semantic segmentation trained by Fully convolutional networks often lead to the loss of detail information. This paper proposes a CRF-FCN model based on CRF optimization. Firstly, the original image is detected based on feature pyramid networks, and the target area information is extracted, which is used to train the high-order potential function of CRF. Then, the high-order CRF is used as the back-end of the complete convolution network to optimize the semantic image segmentation. The algorithm comparison experiment shows that our algorithm makes the target details more obvious, and improves the accuracy and efficiency of semantic segmentation.

The improved high-performance polymer cement mortar (PCM) and glass fiber reinforced plastic (GFRP) system reinforcement was used in the research to strengthen and repair the masonry structure, so as to improve its bond stress, anchoring force, and integral performance without changing the original structure and further study the shear performance of masonry structure strengthened by the combination of the two. The optimum ratio of improved high-performance PCM was determined by analyzing the bend-press ratio of PCM test block. Improved high-performance PCM and GFRP were combined to strengthen the damaged masonry wall, and a five-piece masonry wall composed of “improved high-performance PCM+ with or without GFRP+ different original wall failure modes before reinforcement” was designed. Through diagonal loading shear test, the shear strength, vertical displacement, horizontal relative displacement, and failure models of masonry walls were obtained, and the effects of five different reinforcement methods and different materials on shear strength, stiffness, ductility, and failure modes of masonry walls were studied. The results show that compared with the unreinforced original wall, the shear strength of the masonry wall reinforced with the improved O4PCM is 43.5% higher, and its stiffness is also greatly improved, but the failure mode is still brittle failure; the shear strength of masonry walls strengthened by O4PCM and GFRP is 6.5% higher than that of masonry walls strengthened by O4PCM alone, and the stiffness is also increased. Its failure mode changes from brittle failure to ductile failure; with a failure mode of ductile failure, the shear strength of masonry walls strengthened by P4PCM and GFRP and that strengthened by P6PCM and GFRP are 4.8% and 12.7% higher than that strengthened by O4PCM and GFRP, respectively, and the stiffness is also increased compared with that strengthened by O4PCM and GFRP. After experimental comparison, it is the best scheme to strengthen masonry wall with improved P6PCM and GFRP.

AimsThe aim of this study is to provide a detailed description of cases combining bridging patch repair with artificial ligament “internal brace” reinforcement to treat irreparable massive rotator cuff tears, and report the preliminary results.MethodsThis is a retrospective review of patients with irreparable massive rotator cuff tears undergoing fascia lata autograft bridging repair with artificial ligament “internal brace” reinforcement technique between January 2017 and May 2018. Inclusion criteria were: patients treated arthroscopically for an incompletely reparable massive rotator cuff tear (dimension > 5 cm or two tendons fully torn), stage 0 to 4 supraspinatus fatty degeneration on MRI according to the Goutallier grading system, and an intact or reparable infraspinatus and/or subscapularis tendon of radiological classification Hamada 0 to 4. The surgical technique comprised two components: first, superior capsular reconstruction using an artificial ligament as an “internal brace” protective device for a fascia lata patch. The second was fascia lata autograft bridging repair for the torn supraspinatus. In all, 26 patients with a mean age 63.4 years (SD 6.2) were included.ResultsAll patients underwent more than two years of follow-up (mean 33.5 months (24 to 45)). All clinical scores were also improved at two-year follow-up (mean visual analogue scale 0.7 (SD 0.5) vs 6.1 (SD 1.2); p < 0.001; mean American Shoulder and Elbow Surgeons score 93.5 (SD 5.3) vs 42.5 (SD 10.8); p < 0.001; mean University of California, Los Angeles score, 31.7 (SD 3.7) vs 12.0 (SD 3.1); p < 0.001; and mean Constant-Murley score 88.7 (SD 3.5) vs 43.3 (SD 10.9); p < 0.001), and 24 of 26 fascia lata grafts were fully healed on MRI (92%). One patient had haematoma formation at the harvesting side of the fascia lata at two days postoperatively.ConclusionThe fascia lata autograft bridging repair combined with artificial ligament internal brace reinforcement technique achieved good functional outcomes, with a high rate of graft healing at two-year follow-up. Although the short-term results are promising, further studies with a greater number of patients would provide clearer results. Cite this article: Bone Joint J 2021;103-B(10):1619–1626.

Objective: Coronavirus disease 2019 (COVID-19) was associated with a higher risk of arrhythmia in infected patients. However, there are no reports about the effect of the ongoing pandemic on arrhythmias in the non-infected population. We measured the arrhythmia burden in a non-infected population with cardiac implantable devices. Methods: The arrhythmia burden during the COVID-19 pandemic was compared to a 6-month interval in the pre-COVID-19 period. The COVID-19 pandemic was divided into high-risk (17 January 2020 to 16 March 2020) and low-risk periods (17 March 2020 to 17 July 2020) according to whether there were locally infected patients. Arrhythmia burdens were compared among the pre-COVID-19, high-risk, and low-risk periods. Results: A total of 219 patients with 1859 episodes were included. We observed a larger proportion of patients with atrial fibrillation (AF) during the COVID-19 pandemic (38.36% vs 26.03%, p = 0.006). There was not significantly more ventricular arrhythmia during the COVID period than the pre-COVID-19 period (p > 0.05). During the high-risk period, daily frequency of non-sustained ventricular tachycardia (NSVT) (0.0172, 0.0475 vs 0.0109, 0.0164, p < 0.05), atrial tachycardia (AT) (0.0345, 0.0518 vs 0.0164, 0.0219 p < 0.05) and AF (0.0345, 0.0432 vs 0.0164, 0.0186, p < 0.05) and daily duration of NSVT (0.1982, 0.2845 vs 0.0538, 0.1640 p < 0.05) were higher and longer than those in the pre-COVID-19 period. Regression modeling showed that the impact of COVID-19 pandemic lead to an increased onset of AF (odds ratio 2.465; p < 0.01). Patients with paroxysmal AF who had undergone a previous radiofrequency ablation had a lower burden of AF (incidence 21.43% vs 55.00%, P = 0.049, daily frequency 0.0000, 0.0027 vs 0.0000, 241.7978, P = 0.020) during the pandemic. Conclusion: The COVID-19 pandemic contributed to a higher burden of arrhythmias in non-infected patients. Patients would experience a lower burden of AF following radiofrequency ablation treatment, and this effect persisted during the pandemic.

To compare the clinical outcomes of external fixator + elastic stable intramedullary nail (EF+ESIN) vs. external fixator (EF) in the treatment for open tibial shaft fracture in overweight adolescents.Patients of open tibial shaft fractures younger than 14 years old with body weight over 50 Kg treated with EF + ESIN or EF at our institute from 2010 to 2018 were reviewed. Patients with Gustilo Type III open fractures, pathological fractures, previous fracture or instrumentation in the operative leg were excluded. Baseline information and clinical data were collected from the hospital database and during out-patient visits.Forty-six patients, including 27 males and 19 females, were included in the EF group, whereas 35 patients, including 18 males and 17 females, were included in the EF + ESIN group (p = 0.527). The incidence of superficial infection was higher in the EF group (26/46, 56.5%) than the EF + ESIN group (12/35, 34.3%), p 0.001. The frontal and sagittal angulation was higher in the EF group (p 0.001), but the degrees in both groups were within the acceptable range. The union time was longer in the EF group (68.0 ± 12.7, d) than the EF + ESIN group (61.9 ± 11.9), p 0.001. The retaining of EF (11.9 ± 3.2, w) was longer in the EF group than the EF +ESIN group (5.7 ± 1.2, w), p 0.001.EF+ESIN is a safe and alternative choice for selected overweight adolescents with open tibial shaft fracture.

Cong Wang,1,&ast; Wen-lin Xu,1,&ast; Guan-wu Li,2 Cong Fu,1 Jin-jin Li,1 Jing Wang,1 Xin-yu Chen,3 Zhen Liu,1 Yun-fei Chen1 1Department of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 3Acupuncture and Tuina Academy, Beijing University of Chinese Medicine Dongfang College, Hebei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yun-fei Chen; Zhen LiuDepartment of Acupuncture and Moxibustion, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No. 110 Ganhe Road, Hongkou District, Shanghai, 200437, People’s Republic of ChinaTel/Fax +86-21-65162628Email icyf1968@163.com; liuzhen8918@163.comStudy Objectives: To evaluate the efficacy and safety of acupuncture at HT 7 (Shenmen) and KI 7 (Fuliu) on sleep and comorbid symptoms for chronic insomnia.Methods and Design: A randomized, single-blind, parallel and sham-controlled trial consisted of an acupuncture group (n = 41) and a sham acupuncture group (n = 41). Setting: a tertiary hospital of integrated Chinese and Western medicine. Participants: 82 subjects with chronic insomnia based on the International Classification of Sleep Disorders, Third Edition (ICSD-3). Interventions: a 10-session acupuncture treatment at bilateral HT 7 and KI 7 or sham acupoints with shallow needling was performed over 3 weeks. Measurements: the Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI) were evaluated at baseline, posttreatment, and at two follow-ups as the primary outcome measures. Polysomnography (PSG) on two consecutive nights, the Beck anxiety inventory (BAI), the Beck depression inventory (BDI) fatigue severity scale (FSS) and the Epworth sleepiness scale (ESS) were evaluated at baseline and posttreatment as the secondary outcome measures.Results: After the treatments, PSQI scores decreased by 5.04 in the acupuncture group and 2.92 in the sham acupuncture group. ISI scores decreased by 7.65 in the acupuncture group and 5.05 in the sham acupuncture group. The between-group differences in the primary outcome measures posttreatment were statistically significant. However, no differences were found between the two groups during the two follow-ups. Regarding the PSG data, there were significantly lower levels of sleep onset latency (SOL), a lower percentage of sleep stage N1 and a higher percentage of sleep stage N3 in the acupuncture group than in the sham acupuncture group. After treatment, there were lower levels of comorbid symptoms (BAI, BDI, FSS and ESS) in both groups. However, no significant differences were observed between the groups.Conclusion: Acupuncture at HT 7 and KI 7 is an effective and safe nonpharmacologic intervention option for chronic insomnia.Clinical Trial Registration: The study was registered at the Chinese Clinical Trial Registry, registration ID: ChiCTR1900023787, China.Keywords: acupuncture, chronic insomnia, sleep and comorbid symptoms, randomized clinical trial

AIM: To examine the relationship between age-related cataracts (ARC) and comorbid hypertension and diabetes. METHODS: We analyzed the administrative records of 6,467 patients aged 50 years and older admitted to the ophthalmological department of a tertiary hospital from January 1st, 2011 to May 20th, 2017. With either eye considered, an ARC (n=3,343) was defined as the presence of lens opacity or previous cataract surgery without evidence of trauma, congenital anomalies or using certain medications. Patients admitted to the same department during the same period due to ocular traumas without clinical evidence of cataracts (n=379) were recruited as the cataract-free controls. Unconditional logistic regressions were obtained the odds ratio (OR) of hypertension and diabetes among ARC patients adjusted for age, sex and health care accessibility. RESULTS: Hypertension was diagnosed in 29.54% of men with any type of cataracts, in 30.12% of men with an ARC, and 10.82% of men of cataract-free controls. Diabetes was diagnosed in 16.64% of men with any type of cataracts, in 16.48% of men with ARC and 4.22% of men of cataract-free controls. Similar patterns were observed among women. After adjusting for age, sex, and health care accessibility, hypertension was weakly [OR=1.83 (95%CI: 1.23, 2.74)] and diabetes was strongly [3.38 (1.86, 6.15)] associated with ARCs. The adjusted OR of comorbid hypertension and diabetes among adults with ARC was 18.20 (4.38, 75.59). CONCLUSION: Hypertension and diabetes were independently associated with ARC. Hypertension and diabetes, if co-existing, multiplicatively strengthened the association with ARC.

Nociceptin opioid peptide (NOP) receptor modulates pain transmission and is considered a prospective target for pain management. Under acute pain conditions in rodents, however, no definitive conclusions about effects of systemically intervening NOP receptors on nociception, classical opioid-induced antinociception, tolerance and physical dependence have been drawn. Given that opioid analgesia has sex differences, and females experience greater pain and consume more opioids, clarifying these issues in females will help develop novel analgesics. To clarify the role of NOP receptors on the pharmacological profiles of µ-opioid receptor agonists, in this study, a selective agonist (SCH221510) and antagonist (SB612111) of the NOP receptor were subcutaneously administered in female mice in multiple animal models. In hot-plate test, neither SCH221510 (3 and 10 mg/kg, sc) nor SB612111 (10 mg/kg, sc) produced significant antinociception. SCH221510 (3 mg/kg, sc) attenuated but SB612111 (10 mg/kg, sc) enhanced morphine-induced antinociception, with rightward and leftward shift of morphine dose-response curves, respectively. SCH221510 (3 mg/kg, sc) combined with morphine (10 mg/kg, sc) accelerated the development of morphine antinociceptive tolerance. Conversely, SB612111 (10 mg/kg, sc) delayed morphine tolerance development. Neither SCH221510 (3 mg/kg, sc) nor SB612111 (10 mg/kg, sc) statistically significantly altered the development of morphine-induced physical dependence. Therefore, systemic activation of NOP receptors attenuated morphine antinociception to acute thermal stimuli, facilitated morphine-induced antinociceptive tolerance but did not robustly alter physical dependence in female mice. Systemic blockade of NOP receptors produced opposite actions. These findings demonstrate that N/OFQ-NOP receptor system plays diverse roles in modulating pharmacological profiles of µ-opioid receptor agonists.

Objectives Cephalic arch stenosis (CAS) is a common cause that leads to the failure of hemodialysis arteriovenous fistulas (AVFs). Patients with CAS are primarily treated with fluoroscopy-guided angioplasty. Here, seven patients with de novo cephalic arch stenosis who underwent office-based UG-PTA were. Methods Retrospectively analyzed the total of 321 patients with AVF dysfunction in the nephrology departmnet between July 2017 and October 2018. Among them, seven patients with de novo CAS were included in this study and followed up every 2 months for more than a year. Results No significant complications were seen from the operations, and the primary patency rates at 6 and 12 months were found to be 100% and 42.8%, respectively. Conclusions The office-based UG-PTA is probably safe, effective, and feasible in the management of CAS and can be used as a substitute for fluoroscopy-guided PTA.

In a proxy re-signature scheme, a semi-trusted proxy can convert Alice's (also called as delegatee's) signature into Bob's (also called as delegator's) signature on the same message. However, the proxy itself cannot produce any signatures on behalf of either Alice or Bob. There exists some unidirectional one-use and multi-use (a message can be re-signed a polynomial number of times) proxy re-signature schemes. In some scenarios of big data, it is required to design unidirectional infinite-use (a message can be re-signed infinite number of times) proxy re-signature schemes. In this paper, we propose the first unidirectional infinite-use proxy re-signature scheme and identity-based unidirectional infinite-use proxy re-signature scheme with private re-signature keys based on lattice and prove that they are secure in the random oracle model.

Cardiac fibroma is a rare disease, and surgical resection generally remains the treatment of choice for these tumors in children. However, open surgery for some patients has to be rejected due to high risk. Here, we report a case of somewhat successful radiofrequency ablation of a huge left ventricular fibroma in a 3-year-old asymptomatic child. At the 3-month follow-up, the child was clinically well. Our case highlights that radiofrequency ablation may be used as an alternative treatment for the cardiac tumors, which are unsuitable for cardiac operation.

In 3D IC integration, a critical demand of interfacial joints in high-end devices is ultra-fine pitch, below 2 μm. The pitch cannot be fabricated by using solder joints because of its low melting point. Microelectronic industry prefers a solid state process, but the processing temperature cannot be too high, preferable near 250 °C. Thus, Cu-to-Cu direct bonding has attracted much attention. We have bonded the highly (111)-oriented Cu microbumps to highly (111)-oriented Cu films as well as to randomly-oriented Cu films for comparison, at temperatures from 200 to 350 °C. We examined the microstructures of bonded interfaces and conducted shear tests to evaluate the mechanical strength of the Cu joints. The bonded interfaces for the (111) Cu microbumps to (111) Cu films had fewer voids than those bonded to randomly oriented Cu films. In addition, the bonding strength of the latter is much less than the former. We propose that the fast surface diffusivity on the (111) surfaces play a critical role on surface creep, which increases the bonding strength of the Cu joint. A surface creep model and its creep rate are presented, and a comparison to the experimental data has been made; the agreement is reasonable.

Neuroimaging is crucial in moyamoya disease (MMD) for neurosurgeons, during pre-surgical planning and intraoperative navigation not only to maximize the success rate of surgery, but also to minimize postsurgical neurological deficits in patients. This is a review of recent literatures which updates the clinical use of imaging methods in the morphological and hemodynamic assessment of surgical revascularization in patients with MMD. We aimed to assist surgeons in assessing the status of moyamoya vessels, selecting bypass arteries, and monitoring postoperative cerebral perfusion through the latest imaging technology.

The interoperability between the vehicle assembly and ground assembly of wireless charging systems has been specified in international standards. SAE J2954 first proposed an interoperability evaluation method based on interface impedance. However, the impedance measurement is challenging at high frequency since the phase difference between the voltage and current is not easy to measure accurately, especially when it is close to 90°. Small errors in phase angle measurement are amplified in impedance calculation due to the sine/cosine function. This letter proposes an impedance measurement method using the power decomposition algorithm. By decomposing the input power into two orthogonal components, the impedance angle can be calculated without directly measuring the phase difference between the voltage and current. Thus, the measurement results of the impedance angle do not introduce errors. With the proposal, the high-cost probe or complex high-precision phase difference measurement circuit is not needed. The experimental results show that the conventional method's maximum relative error reaches 80%, making interoperability hard to determine. Reversely, with the proposed method, the relative error of impedance measurement is reduced to less than 10%.

Microsurgical reconstruction of extremity defects with free flaps has been carried out for many years. The aim of this retrospective study is to characterize free flap surgery on children of 1 to 7 years old by evaluating a series of 20 cases of free flap surgeries that have been performed in pediatric patients.From February 2014 to January 2018, 20 patients, 10 boys and 10 girls aged from 1 to 7 years (average, 4.6 years), were engaged in this study. Several types of free flaps were used, including anterolateral thigh flaps (ALT), inferior ulnar collateral artery flap, latissimus dorsi flap, medial plantar flap, fibular osteocutaneous flap and hallux toenail flap. After operations, follow-up period was at least for 2 years and the average follow-up period was 48.5 months. The long-term outcomes were estimated by questionnaires derived from the American Academy of Orthopaedic Surgeons Pediatric Outcomes Data Collection Instrument (PODCI).A total of 21free-flap reconstructions were performed on 20patients, including 15 ALT, 3 composite flaps, and 3 other cutaneous flaps. The size of the tissue flap ranged from 1.5 to 280 cm2 (average, 74.1cm2). The diameter of the anastomosed artery of the flap ranged from 0.7 to 1.2 mm. Among the 21 flaps, 20 survived and the success rate was about 95 %. Contour adaption was achieved in all flaps. Fifteen children received a secondary operation for debulking or functional improvement. Secondary deformity was present in 3 children, among which ankle joint valgus was seen in two children and a flexion deformity of injured toe occurred in one child. The mean global functioning score of PODCI was 94 (ranging from 81 to 98, maximum 100).The success rate of free-flap surgery in pediatric patients was comparable to that achieved in adults. Post-operative caring for pediatric patients was easier than expected. For pediatric patients, the final outcomes were not varied remarkably from different types of free tissue transfer.Von Februar 2014 bis Januar 2018 nahmen 20 Patienten, 10 Jungen und 10 Mädchen im Alter von 1 bis 7 Jahren (Durchschnittsalter 4,6 Jahre), an dieser Studie teil. Es wurden mehrere Arten von freien Lappenplastiken verwendet, darunter anterolaterale Oberschenkellappen (ALT), Lappen der A. collateralis ulnaris inferior, des M. latissimus dorsi und der A. plantaris medialis sowie osteokutane Fibulalappen und Lappen des Großzehnnagels. Nach den Operationen wurden die Patienten über einen Mindestzeitraum von 2 Jahren nachbeobachtet, wobei der durchschnittliche Nachbeobachtungszeitraum bei 38,5 Monaten lag. Die Langzeitergebnisse wurden anhand von Fragebögen in Anlehnung an das Pediatric Outcomes Data Collection Instrument (PODCI) der American Academy of Orthopaedic Surgeons beurteilt.Insgesamt wurden 21 Rekonstruktionen mittels freier Lappenplastiken bei 20 Patienten durchgeführt, darunter 15 ALT, 3 zusammengesetzte Lappen und 3 andere kutane Lappenplastiken. Die Größe der Gewebelappen lag zwischen 1,5 und 280 cmDie Erfolgsrate chirurgischer Eingriffe mit freien Lappenplastiken bei pädiatrischen Patienten war mit der von Erwachsenen vergleichbar. Die postoperative Versorgung der pädiatrischen Patienten gestaltete sich einfacher als erwartet. Bei pädiatrischen Patienten unterschieden sich die Endergebnisse der verschiedenen Arten von freiem Gewebetransfer nicht nennenswert voneinander.

Shukui Qin,1 Rui-Hua Xu,2 Lin Shen,3 Jianming Xu,4 Yuxian Bai,5 Lei Yang,6 Yanhong Deng,7 Zhen-dong Chen,8 Haijun Zhong,9 Hongming Pan,10 Weijian Guo,11 Yongqian Shu,12 Ying Yuan,13 Jianfeng Zhou,14 Nong Xu,15 Tianshu Liu,16 Dong Ma,17 Changping Wu,18 Ying Cheng,19 Donghui Chen,20 Wei Li,21 Sanyuan Sun,22 Zhuang Yu,23 Peiguo Cao,24 Haihui Chen,25 Jiejun Wang,26 Shubin Wang,27 Hongbing Wang,28 Ning Wang,29 Bin Zhang,29 Qiang Zhang,29 Weiguo Su,30 Xiaojun Guo,30 Jin Li31 1Cancer Center, Jinling Hospital, Nanjing, People’s Republic of China; 2Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, People’s Republic of China; 3Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China; 4Department of Medical Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 5Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China; 6Department of Medical Oncology, Nantong Cancer Hospital, Nantong, People’s Republic of China; 7Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 8Department of Medical Oncology, The Second Hospital of Anhui Medical University, Hefei, People’s Republic of China; 9Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, People’s Republic of China; 10Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 11Department of Medical Oncology, Shanghai Medical College, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China; 12Department of Medical Oncology, Jiangsu Provincial Hospital, Nanjing, People’s Republic of China; 13Department of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 14Department of Medical Oncology, Peking Union Medical College Hospital, Beijing, People’s Republic of China; 15Department of Medical Oncology, The First Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, People’s Republic of China; 16Department of Medical Oncology, Fudan University Zhongshan Hospital, Shanghai Medical College, Shanghai, People’s Republic of China; 17Department of Medical Oncology, Guangdong Provincial People’s Hospital, Guangzhou, People’s Republic of China; 18Department of Medical Oncology, The First People’s Hospital of Changzhou, Changzhou, People’s Republic of China; 19Department of Medical Oncology, Jilin Province Cancer Hospital, Changchun, People’s Republic of China; 20Department of Medical Oncology, Shanghai Jiaotong University Affiliated First People’s Hospital, Shanghai, People’s Republic of China; 21Department of Medical Oncology, The First Hospital of Jilin University, Changchun, People’s Republic of China; 22Department of Medical Oncology, Xuzhou Central Hospital, Xuzhou, People’s Republic of China; 23Department of Medical Oncology, The Affiliated Hospital of Medical College Qingdao University, Qingdao, People’s Republic of China; 24Department of Medical Oncology, The Third Xiangya Hospital of Central South University, Changsha, People’s Republic of China; 25Department of Medical Oncology, Liuzhou Worker’s Hospital, Liuzhou, People’s Republic of China; 26Department of Medical Oncology, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai, People’s Republic of China; 27Department of Medical Oncology, Peking University Shenzhen Hospital, Beijing University, Shenzhen, People’s Republic of China; 28Department of Medical Oncology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou Medical College, Xuzhou, People’s Republic of China; 29Eli Lilly and Company, Shanghai, People’s Republic of China; 30Hutchison MediPharma Limited, Shanghai, People’s Republic of China; 31Department of Medical Oncology, Tongji University Shanghai East Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Jin LiDepartment of Medical Oncology, Tongji University Shanghai East Hospital, Shanghai, People’s Republic of ChinaTel +8613761222111Email lijin@csco.org.cnObjective: The aim of the present subgroup analysis of the FRESCO trial is to determine the efficacy and hepatotoxicity of fruquintinib in Chinese patients with metastatic CRC with liver metastasis (CRLM) who were receiving third-line or posterior-line therapy.Methods: Overall survival (OS) and progression-free survival (PFS) were evaluated by Kaplan–Meier method. Hazard ratio (HR) was estimated through Cox proportional hazards model. Hepatotoxicity was coded using the standardized MedDRA queries of hepatic failure, fibrosis, cirrhosis, and other liver injury-related conditions and graded using the Common Terminology Criteria Adverse Events grades. The efficacy of fruquintinib in patients with CRLM was evaluated in various subgroups.Results: A total of 287 (69.0%) patients with metastatic CRC had liver metastasis (LM, fruquintinib: 185 and placebo: 102). Median OS in patients with CRLM was significantly prolonged with fruquintinib compared with placebo (8.61 months vs 5.98 months; HR=0.59, 95% CI, 0.45– 0.77, P< 0.001). In patients with CRLM, the incremental median PFS for patients in the fruquintinib-treated group was significantly higher than in the placebo group (median PFS: 3.71 vs.1.84 months; HR=0.22, 95% CI: 0.17– 0.30; P< 0.001). Compared with placebo, significant improvements in OS were observed with fruquintinib in LM patients regardless of lung metastasis, prior target therapy, and K-RAS status. In patients with CRLM, treatment-emergent hepatotoxicities of any grade occurred in 7 (3.8%) patients in the fruquintinib group vs 2 (2.0%) in the placebo group.Conclusion: Fruquintinib demonstrated a statistically significant increase in OS and PFS as compared with placebo in Chinese patients with CRLM. The hepatotoxicity of fruquintinib was less reported, and comparable with placebo in patients with CRLM.ClinicalTrials.gov Identifier: NCT02314819.Keywords: colorectal cancer, FRESCO trial, fruquintinib, liver metastasis

Dissipative Kerr solitons (DKS)s offer an integrated platform for broad spectrum coverage, which is suitable for the high sensitivity spectroscopy. However, the large linespacing of the soliton comb limits the spectroscopy detection resolution. We overcome this limitation by modulating the soliton comb lines through an external EOM with a tunable RF source. By locking the pump laser to a reference cavity, the linewidth of the pump laser was compressed from $1.13\:\mathrm{MHz}$ to $72\:\mathrm{kHz}$, leading to the silimar linewidth of comb lines and showing a frequency resolution of hundreds of $kHz$. Based on the scanned microcomb, we measured the absorption spectra of a gas cell and the high-Q optical modes in the microcavity, with a fast scanning speed of $\mathrm{16\,\,\mathrm{GHz/\mu s}}$. The scanning comb allows the spectroscopy measurement to cover the whole comb mode spectrum over THz bandwidth. Our setup holds great potential for simple, robust spectroscopy measurement.

For adolescents with severely displaced proximal humeral fracture (PHF), surgery is a good choice yielding excellent outcomes, and Kirchner wire (KW) is a cost-effective choice for fixation. Purpose of this study is to compare the clinical outcomes of external fixator (EF) and KW for the treatment of PHF in adolescents.Patients of PHF operated at our institute, from January 2008 to January 2016, were reviewed retrospectively. Demographic data, including sex, age at the time of surgery, operated side, and hardware choice, were collected from the hospital database. Preoperative radiographs were reviewed and classified according to Neer-Horwitz classification. Shoulder function was evaluated at the last follow-up using the American Shoulder and Elbow Surgeons (ASES) score. Complications, including infection, malunion, nonunion, stiffness of the shoulder joint, and failure of fixation were also recorded.Thirty-five patients, including 23 males and 12 females, were included in the EF group, whereas 40 patients, including 25 males and 15 females, were included in the KW group (P = 0.867). The average age of patients in the EF group was 13.3 ± 1.7 years, and that of KW was 13.6 ± 1.8 years (P = 0.409). Patients in both groups were followed-up for at least 12 months. The operative time in the EF group (42.4 ± 11.2 min) was significantly shorter than those in the KW group (54 ± 13.6 min) (P0.001). The frequency of fluoroscopy in the EF group (12 ± 2.4 times) was significantly less than those in the KW group (17 ± 2.8 times (P0.001). The rate of open reduction was significantly higher in KW (35%) group than those in the EF group (0%) (P0.001). There was no case of nonunion and malunion in both groups.External fixator is superior to Kirschner wire in the treatment of proximal humeral fractures in adolescents with shorter operative time and lower rate of open reduction with comparable clinical outcomes.

Opioid use disorder is a worldwide societal problem and public health burden. Strategies for treating opioid use disorder can be divided into those that target the opioid receptor system and those that target non-opioid receptor systems, including the dopamine and glutamate receptor systems. Currently, the clinical drugs used to treat opioid use disorder include the opioid receptor agonists methadone and buprenorphine, which are limited by their abuse liability, and the opioid receptor antagonist naltrexone, which is limited by poor compliance. Therefore, the development of effective medications with lower abuse liability and better potential for compliance is urgently needed. Based on recent advances in the understanding of the neurobiological mechanisms underlying opioid use disorder, potential treatment strategies and targets have emerged. This review focuses on the progress made in identifying potential targets and developing medications to treat opioid use disorder, including progress made by our laboratory, and provides insights for future medication development.

Background Kidney transplantation is one of the most effective ways to treat end-stage kidney disease. However, 5000 renal transplant recipients start or restart dialysis because of chronic allograft nephropathy (CAN) every year in the United States. Detecting changes in the stiffness of transplanted kidneys can help diagnose transplanted kidney disease. Purpose To explore changes in the stiffness of transplanted kidneys after renal transplantation using shear wave elastography (SWE). Material and Methods This study conducted consecutive follow-up observations on 10 patients after kidney transplantation. SWE examination was performed in the first week, second week, first month, second month, third month, fourth month, fifth month, and sixth month after surgery. This study also analyzed the graft stiffness of 86 patients with stable renal function recovery one month after surgery. Results The results show that there is a change in the stiffness of the transplanted kidney over time after renal transplantation. It decreases rapidly within one month after renal transplantation and tends to be stable after one month. The mean renal cortical and pyramidal stiffness of patients with stable renal function were 28.48 ± 4.27 kPa and 21.97 ± 3.90 kPa, respectively. Conclusion Consecutive stiffness measurement of transplanted kidneys is an effective method for monitoring the function of transplanted kidneys. According to the change in transplanted kidney stiffness, we can designate a more scientific review plan to determine the functional status of the transplanted kidney.

In the feature matching of some Vehicular Ad Hoc Network (VANET) technologies, users’ privacy disclosure issue has seriously threatened personal safety and caused considerable economic loss. In this paper, we proposed Oblivious Transfer (OT) protocol and Private Set Intersection (PSI) protocol to protect the users’ privacy in the situation of VANET’s feature matching. In our schema, an efficient $k$ -out-of- $n$ OT protocol is constructed. Then, this OT protocol is adopted to give a PSI protocol with equality test. Based on the PSI protocol, the two parties of VANET can obtain the intersection of their characteristic sets and any information outside such intersection is unavailable. Accordingly, internal attacker fails to get any useful information from the two parties in the feature matching, and the two parties cannot obtain extra data of each other. Moreover, to reduce the computational cost of the OT protocol, the non-communicative algebraic structure–group ring $Z_{q}[S_{m}]$ is employed. In addition, we analyzed that the proposed scheme does not use complex calculations and can resist against the current quantum attacks.

Graphite carbon nitride (g-C3N4), a two-dimensional polymer semiconductor material, has good semiconductor properties, suitable electronic energy band structure, excellent physical and chemical stability. It is widely used in the field of energy and materials science such as photoelectric conversion. In this paper, the progress of g-C3N4 in dye sensitized solar cells (DSSC) and perovskite solar cells (PSC) was reviewed. As a new semiconductor material, g-C3N4 has the advantages of simple preparation, abundant amino and Lewis basic groups. Therefore, on the basis of excellent structure of g-C3N4, its electronic and optical properties are utilized to further expand its application in the field of photoelectric conversion.

Background Tuberculosis (TB) is one of the top 10 causes of death in the world. Since Directly Observed Therapy (DOT) as a core strategy for the global TB control are not applicable to all types of TB patients, and self-management of TB patients (SMTP) as a patient-centered supervision type is a supplement to DOT and can improve TB case management. However, the factors related to SMTP are complex and need more study. This study aimed at identifying the determinants of SMTP and examining the direct/indirect effects of these determinants. Methods The purposive sampling technique was used to select study sites and participants were recruited from the study sites by the consecutive sampling method. The PRECEDE model was used as the framework to analyze the determinants of SMTP. The responses of TB patients were acquired via a questionnaire survey for data collection. A Pearson correlation analysis was used to define the relationship between the predisposing, enabling, reinforcing factors with SMTP behaviors. A regression-based path analysis was used to determine the action paths of the predisposing, enabling, and reinforcing factors on SMTP behaviors. Results The predisposing (TB knowledge), enabling [health education and healthcare workers (HCWs) support], reinforcing factors (family support) had significant positive correlations with SMTP behaviors (P P Conclusions This study revealed the effects and action path of TB knowledge, health education, HCWs support, and family support on SMTP behaviors via a path analysis. Assessing patient’s needs for SMTP along with promoting effective TB health education and providing firm support from HCWs and family members are potential strategies to promote SMTP behaviors. Graphic abstract

To investigate the feasibility of quantitative intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) analyses in the upper abdominal organs by simultaneous multislice diffusion-weighted imaging (SMS-DWI).In this prospective study, a total of 32 participants underwent conventional DWI (C-DWI) and SMS-DWI sequences with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) in the upper abdomen with multiple b-values (0, 10, 20, 50, 80, 100, 150, 200, 500, 800, 1000, 1500, and 2000 seconds/mm2) on a 3 T system (MAGNETOM Prisma; Siemens Healthcare, Erlangen, Germany). Image quality and quantitatively measurements of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), mean kurtosis (MK), and mean apparent diffusivity (MD) for the liver, pancreas, kidney cortex and medulla, spleen, and erector spine muscle were compared between the 3 sequences.The acquisition times for C-DWI, SMS2-DWI, and SMS3-DWI were 10 minutes 57 seconds, 5 minutes 9 seconds, and 3 minutes 54 seconds. For image quality parameters, C-DWI and SMS2-DWI yielded better results than SMS3-DWI (P0.05). SMS2-DWI had equivalent IVIM and DKI parameters compared with that of C-DWI (P0.05). No statistically significant differences in the ADC, D, f, and MD values between the 3 sequences (P0.05) were observed. The D* and MK values of the liver (P = 0.005 and P = 0.012) and pancreas (P = 0.019) between SMS3-DWI and C-DWI were significantly different.SMS2-DWI can substantially reduce the scan time while maintaining equivalent IVIM and DKI parameters in the abdominal organs compared with C-DWI.

Background Regional anesthesia and analgesia reduce the stress response to surgery and decrease the need for volatile anesthesia and opioids, thereby preserving cancer-specific immune defenses. This study therefore tested the primary hypothesis that combining epidural anesthesia–analgesia with general anesthesia improves recurrence-free survival after lung cancer surgery. Methods Adults scheduled for video-assisted thoracoscopic lung cancer resections were randomized 1:1 to general anesthesia and intravenous opioid analgesia or combined epidural–general anesthesia and epidural analgesia. The primary outcome was recurrence-free survival (time from surgery to the earliest date of recurrence/metastasis or all-cause death). Secondary outcomes included overall survival (time from surgery to all-cause death) and cancer-specific survival (time from surgery to cancer-specific death). Long-term outcome assessors were blinded to treatment. Results Between May 2015 and November 2017, 400 patients were enrolled and randomized to general anesthesia alone (n = 200) or combined epidural–general anesthesia (n = 200). All were included in the analysis. The median follow-up duration was 32 months (interquartile range, 24 to 48). Recurrence-free survival was similar in each group, with 54 events (27%) with general anesthesia alone versus 48 events (24%) with combined epidural–general anesthesia (adjusted hazard ratio, 0.90; 95% CI, 0.60 to 1.35; P = 0.608). Overall survival was also similar with 25 events (13%) versus 31 (16%; adjusted hazard ratio, 1.12; 95% CI, 0.64 to 1.96; P = 0.697). There was also no significant difference in cancer-specific survival with 24 events (12%) versus 29 (15%; adjusted hazard ratio, 1.08; 95% CI, 0.61 to 1.91; P = 0.802). Patients assigned to combined epidural–general had more intraoperative hypotension: 94 patients (47%) versus 121 (61%; relative risk, 1.29; 95% CI, 1.07 to 1.55; P = 0.007). Conclusions Epidural anesthesia–analgesia for major lung cancer surgery did not improve recurrence-free, overall, or cancer-specific survival compared with general anesthesia alone, although the CI included both substantial benefit and harm. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Coronavirus disease 2019 (COVID-19) is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with typical respiratory symptoms. SARS-CoV-2 invades not only the respiratory system, but also other organs expressing the cell surface receptor angiotensin converting enzyme 2. In particular, the digestive system is a susceptible target of SARS-CoV-2. Gastrointestinal symptoms of COVID-19 include anorexia, nausea, vomiting, diarrhea, abdominal pain, and liver damage. Patients with digestive damage have a greater chance of progressing to severe or critical illness, a poorer prognosis, and a higher risk of death. This paper aims to summarize the digestive system symptoms of COVID-19 and discuss fecal-oral contagion of SARS-CoV-2. It also describes the characteristics of inflammatory bowel disease patients with SARS-CoV-2 infection and discusses precautions for preventing SARS-CoV-2 infection during gastrointestinal endoscopy procedures. Improved attention to digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients may aid health care providers in the process of clinical diagnosis, treatment, and epidemic prevention and control.

Background Treatment options for refractory metastatic colorectal cancer (mCRC) were limited. Anlotinib is a novel multitarget tyrosine kinase inhibitor. ALTER0703 study was conducted to assess efficacy and safety of anlotinib for patients with refractory mCRC. Materials and Methods This was a multicenter, double-blinded, placebo-controlled, randomized phase III trial involving 33 hospitals in China. Patients had taken at least two lines of therapies were 2:1 randomized to receive oral anlotinib (12 mg/day; days 1–14; 21 days per cycle) or placebo, plus best supportive care. Randomization was stratified by previous VEGF-targeting treatments and time from diagnosis to metastases. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), quality of life (QoL), and safety. Results A total of 419 patients (anlotinib: 282; placebo: 137) were treated from December 2014 to August 2016. The median PFS was improved in anlotinib group (4.1 months; 95% confidence interval [CI], 3.4–4.5) over placebo group (1.5 months; 95% CI, 1.4–1.5), with a hazard ratio (HR) of 0.34 (95% CI, 0.27–0.43; p < .0001). However, median OS was similar between two groups (8.6 months; 95% CI, 7.8–9.7 vs. 7.2 months; 95% CI, 6.2–8.8; HR, 1.02; p = .870). Improvements of ORR and DCR were observed in anlotinib over placebo. The most common grade ≥ 3 anlotinib related adverse events were hypertension (20.92%), increased γ-GT (7.09%), and hand-foot skin reaction (6.38%). Conclusion Anlotinib was tolerated in Chinese patients with refractory mCRC. Although OS did not reach significant difference, anlotinib still provided clinical benefits by substantially prolonged PFS in these patients. Implications for Practice In this randomized clinical trial that included 419 patients with refractory metastatic colorectal cancer, substantial prolonged in progression-free survival was noted in patients who received anlotinib compared with those given placebo. Improvements on objective response rate and disease control rate was also observed in anlotinib group. However, overall survival was similar between the two groups. In a word, in third-line or above treatment of Chinese patients with refractory metastatic colorectal cancer, anlotinib provided clinical benefit by significantly prolonged progression-free survival.

Background Experimental and observational research suggests that combined epidural–general anesthesia may improve long-term survival after cancer surgery by reducing anesthetic and opioid consumption and by blunting surgery-related inflammation. This study therefore tested the primary hypothesis that combined epidural–general anesthesia improves long-term survival in elderly patients. Methods This article presents a long-term follow-up of patients enrolled in a previous trial conducted at five hospitals. Patients aged 60 to 90 yr and scheduled for major noncardiac thoracic and abdominal surgeries were randomly assigned to either combined epidural–general anesthesia with postoperative epidural analgesia or general anesthesia alone with postoperative intravenous analgesia. The primary outcome was overall postoperative survival. Secondary outcomes included cancer-specific, recurrence-free, and event-free survival. Results Among 1,802 patients who were enrolled and randomized in the underlying trial, 1,712 were included in the long-term analysis; 92% had surgery for cancer. The median follow-up duration was 66 months (interquartile range, 61 to 80). Among patients assigned to combined epidural–general anesthesia, 355 of 853 (42%) died compared with 326 of 859 (38%) deaths in patients assigned to general anesthesia alone: adjusted hazard ratio, 1.07; 95% CI, 0.92 to 1.24; P = 0.408. Cancer-specific survival was similar with combined epidural–general anesthesia (327 of 853 [38%]) and general anesthesia alone (292 of 859 [34%]): adjusted hazard ratio, 1.09; 95% CI, 0.93 to 1.28; P = 0.290. Recurrence-free survival was 401 of 853 [47%] for patients who had combined epidural–general anesthesia versus 389 of 859 [45%] with general anesthesia alone: adjusted hazard ratio, 0.97; 95% CI, 0.84 to 1.12; P = 0.692. Event-free survival was 466 of 853 [55%] in patients who had combined epidural–general anesthesia versus 450 of 859 [52%] for general anesthesia alone: adjusted hazard ratio, 0.99; 95% CI, 0.86 to 1.12; P = 0.815. Conclusions In elderly patients having major thoracic and abdominal surgery, combined epidural–general anesthesia with epidural analgesia did not improve overall or cancer-specific long-term mortality. Nor did epidural analgesia improve recurrence-free survival. Either approach can therefore reasonably be selected based on patient and clinician preference. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New