Search

BACKGROUND To analyze the venous thromboembolism (VTE) risk factors and prophylaxis of elderly patients in the intensive care unit (ICU). METHODS We retrospectively recruited 200 elderly patients with VTE and 234 non-VTE patients. VTE risk factors were got from data of all patients. The sensitivity and specificity of the Caprini scores and Padua scores were calculated. We use the receiver operating characteristic (ROC) curve and the area under the curve (AUC) to evaluate each score. RESULTS We found that male sex, sepsis, being bedridden (>72 hours), pneumonia, history of deep vein thrombosis (DVT), diabetes mellitus, coronary heart disease, heart failure, glucocorticoid treatment, PaO2, hemoglobin (Hb), prothrombin time (PT), and international normalized ratio (INR), D-dimer (D-D), mechanical ventilation, and continuous renal replacement therapy (CRRT) were significantly associated with VTE in elderly ICU patients (P

The lack of hydrogen (H2) transportation infrastructure restricts the development of the H2 industry. Owing to the high investment of building specific facilities, using existing natural gas (NG) pipelines to transport a blend of H2 and NG (H2NG) is a viable means of transportation and approach for large-scale long-time storage. However, variation in the thermo-physical properties of an H2NG blend will impact the performance of pipeline appliances. To address the gaps in H2 transmission via an NG system in the context of energy consumption, in the present paper, a one-dimensional pipeline model is proposed to predict the blended flow in a real existing pipeline (Shan–Jing I, China). The data of NG components were derived from real gas fields. Furthermore, the influence of H2 fractions on pipeline energy coefficient and the layout of pressurization stations are comprehensively analyzed. In addition, the case of intermediate gas injection is investigated, and the effects of injection positions are studied. This study serves as a useful reference for the design of an H2NG pipeline system. The present study reveals that with the increasing in H2 fraction, the distance between pressure stations increases. Furthermore, when the arrangement of original pressure stations is maintained, overpressure occur. Intermediate gas injection results in the inlet pressure of subsequent pressurization stations reducing. Using existing pipeline network to transport H2NG, it is necessary to make appropriate adjustment.

We propose a method to design a tensegrity joint, making its elastic deformation an accurate joint-like motion, such as a rotation around the designed rotational center. The tensegrity joint can be a revolute, universal, and ball joint through this method. Axis drift is presented as a design criterion to describe the rotational center’s deviation degree with respect to the compliance center since the rotational center is not fixed to one point for different positions of the tensegrity joint. The axis drift is designed to be in a prescribed range so that the tensegrity joint is approximately equivalent to a rigid joint. In other words, the tensegrity joint’s elastic response under external torque and force becomes precise rigid joint-like kinematics and can replace rigid joints to transfer motion, force, and energy. A large-size tensegrity rotational joint is developed to verify the joint equivalence experimentally. The experimental results show that the tensegrity joint achieved maximum dimensionless axis drift of less than 2%, which indicates an excellent joint equivalence. The tensegrity joints’ ability to replace rigid joints as modular joints to construct a hyper redundant serial structure is demonstrated using a tensegrity robotic arm. The proposed compliant tensegrity joint has notable benefits of tensegrity structure, such as high mechanical efficiency, modularity, and scalability. It can be extended to many robotic applications, such as large-size serial robotic arms and snake-like robots.

Heterogeneous information network (HIN) is a kind of large-scale network which contains different types of objects and complex links. It is distinguished from a homogenous network for its heterogeneity of objects represented as nodes and complexity of links, which also makes the object classification more difficult. A meta-path can denote the relationship between nodes in HINs, and the path information can be enriched by extracting jump-paths. Based on this idea, the problem of data sparseness can be alleviated effectively. As multiple meta-paths represent different semantics, we propose an active weight learning method for each type, which aims to maximize the weight of meta-path with strong correlation and lower the weight if the correlation is weak. The feature matrix based on the meta-path is constructed and the Random Forest classifier is trained to implement the node classification in HINs. The experimental results show that our method achieves better performance in the complex network by using the fewer labeled data. The active learning strategy is effective for identifying objects to label for training.

Aortic dissection (AD) is a life-threatening disease featured by the dissection of intimal layer and the formation of a blood-filled false lumen within the aortic wall. Recent studies revealed that the formation and progression of AD lesions is closely related to vascular inflammation and macrophage infiltration. However, the potential efficacy of anti-inflammatory therapy on the prevention and treatment of AD has not been extensively investigated. Herein, we proposed a biomimetic anti-inflammatory liposome (PM/TN-CCLP) co-loaded with curcumin and celecoxib (CC), modified with cell-penetrating TAT-NBD fusion peptide (TN), and further camouflaged by isolated macrophage plasma membrane (PM), as a potential nanotherapy for AD. In vitro results showed that PM/TN-CCLP exhibited low cytotoxicity and elevated cellular uptake by inflammatory macrophages, and prominently inhibited the transendothelial migration, inflammatory responses and ROS generation of macrophages. Moreover, the PM/TN-CCLP treatment significantly prevented the H2O2-induced smooth muscle cell apoptosis. In vivo experiments were performed on the acute and chronic AD mouse models, respectively. The results verified the elevated accumulation of PM-camouflaged liposome at the aorta lesions. Further, the anti-inflammatory liposomes, especially PM/TN-CCLP, could reduce the rupture rate of dissection, prevent the loss of elastic fibers, and reduce MMP-9 expression as well as macrophage infiltration in the aortic lesions. Notably, as compared with free drugs and TN-CCLP, the PM/TN-CCLP treatment displayed the longest survival period along with the minimal aortic injury on both acute and chronic AD mice. Taken together, the present study suggested that the macrophage-biomimetic anti-inflammatory nanotherapy would be a promising strategy for the prevention and therapy of aortic dissection.

Arsenic trioxide (ATO) is first-line drug for acute promyelocytic leukemia. Clinically, the continuously slow intravenous infusion is adopted to maintain effective blood concentration and reduce toxic effects, but it causes poor patient' compliance for a considerable infusion period. To overcome these disadvantages, we developed an oral ATO sustained-release preparation which was constructed via the ATO core pellets prepared by extrusion spheronization and followed by a coating membrane by fluid-bed technology. The prepared coated pellets displayed a round surface and uniform particle size. All

Nanomedicines such as liposomes have been widely exploited in the treatment of tumors, and are also involved in combination therapies to enhance anti-tumor efficacy and reduce side effects. However, few studies have systematically discussed the significance and optimized regimens for nanomedicine-based combination therapy. In this study, we used anti-inflammatory and anti-tumor liposomes for co-administration, and compared three regimens: intermittent, metronomic, or sequential administration (IA, MA, and SA). The anti-inflammatory liposome HA/TN-CCLP was constructed in our previous research, which co-loaded curcumin (CUR) and celecoxib (CXB), modified with TAT-NBD peptide (TN) and finally coated with hyaluronic acid (HA), thereby inhibiting NF-κB and STAT3 pathways in the treatment of metastatic breast cancer. Furthermore, doxorubicin liposomes with and without TN modification (namely TN-DOXLP and DOXLP) were constructed and administrated with HA/TN-CCLP. The anti-tumor and anti-metastasis efficacy of different regimens was investigated. Results showed that in vitro cytotoxicity of DOXLP and TN-DOXLP was significantly enhanced when combined with HA/TN-CCLP. In vivo experiments also revealed the superiority of three combination therapies in inhibiting tumor growth, prolonging the survival of tumor-bearing mice, inducing apoptosis, and reducing lung metastases. In particular, the combination therapy could reduce MDSCs (Gr-1+/CD11b+) and CSCs (CD44+/CD24+) infiltration, which are two important factors in tumor metastasis and recurrence. Among three regimens, sequential administration (SA) showed the best therapeutic outcome and was especially effective for the inhibition of CSCs. In general, the results demonstrated that combination therapy, particularly the sequential administration of anti-inflammatory and anti-tumor liposome, was superior to monotherapy in inhibiting the development and metastasis of inflammation-related tumors.

3D cancer cell models are suitable for drug evaluation because they more precisely mimic tissue architecture than 2D cultures. To study cytotoxicity of anticancer agents, the most sensitive CellTiter-Glo 3D assay is used. However, this is an end point assay, so it is not possible to consider the variance of the starting material amount in the final reading. It is difficult to maintain an even plating density of 3D organoids for cytotoxicity analysis. We present a simple, 3D bladder cancer culture that can be maintained, cryopreserved and used for molecular and drug response studies. We applied a simple modification of the drug response assay for 3D cultures by measuring the background signal with the CellTiter Blue assay before drug application.

Background Plasma coagulation Factor XII (FXII) plays a crucial role in contact activation, ultimately regulating both the kinin-kallikrein system and the intrinsic pathway of coagulation. A growing body of evidence suggests that inhibition of FXII can prevent thrombosis. Given FXII does not appear to modulate hemostasis, targeting FXII is a promising strategy for the prevention of pathological thrombus formation without the hemostatic risks typically associated with anticoagulants. To this end, a subcutaneously administered investigational RNAi therapeutic targeting liver F12 mRNA (ALN-F12) was developed. Aim To investigate the thrombo-protective and hemostatic effects of FXII reduction by ALN-F12 in rodent thrombosis and hemostasis models. Methods A single dose of ALN-F12 was subcutaneously administered to C57Bl/6 mice. After reaching steady state FXII reduction, the impact on thrombosis (ferric chloride arterial thrombosis and electrolytic injury induced venous thrombosis models) and hemostasis (saphenous vein injury and tail tip transection bleeding models) was evaluated. Result Administration of ALN-F12 resulted in dose-dependent reductions of both liver F12 mRNA and plasma FXII protein. In mice, ALN-F12 led to dose-dependent reductions in platelet and fibrin accumulation in the venous electrolytic-injury model and in the time to occlusion in the ferric chloride arterial thrombosis model. At 10 mg/kg ALN-F12, the top dose level evaluated, this resulted in >95% reduction of FXII and ~10 fold reduction in fibrin deposition. Finally, hemostasis models showed that >95% reduction of FXII had no impact on bleeding time or blood loss. Conclusion Our findings support that reduction of plasma Factor XII by ALN-F12 provided thrombo-protective effects with no increased bleeding risk in rodent models of thrombosis and hemostasis.

We propose and experimentally demonstrate an on-chip optical sensor based on a dual-passband microwave photonic filter (MPF) incorporating a silicon photonic integrated microdisk resonator (MDR). Two whispering gallery modes supported by the MDR that are experiencing different wavelength shifts are employed for simultaneous temperature and refractive index (RI) measurements. To increase the interrogation speed and resolution, the MDR is incorporated in an MPF to produce two microwave passbands. By applying a broadband linearly chirped microwave waveform to the MPF, two filtered microwave waveforms with their temporal locations or equivalently central frequencies corresponding to the wavelength shifts of the notches are generated. The measurement of the temporal locations or equivalently the central frequencies is performed at high speed and high resolution using a digital signal processor. To increase the signal-to-noise ratio of the filtered microwave waveforms, a noise reduction algorithm based on phase-only filtering is proposed and employed. The on-chip optical sensing system is experimentally demonstrated. The sensing system can provide high temperature and RI interrogation resolutions of 2.4 × 10−5 °C and 9.1 × 10−8 RIU at a high interrogation speed of 1 MHz.

An ultrafast high-sensitivity refractive index (RI) and temperature-sensing system based on an optoelectronic oscillator (OEO) is proposed and demonstrated in this paper. A Fabry-Perot fiber Bragg grating (FP-FBG), which combines a gap with two FBGs in a silica V-shaped slot and characterizes a narrow notch in the reflection spectrum, is incorporated in the OEO to implement a microwave photonic filter and perform oscillating frequency selection. A microwave signal is generated by the OEO, whose oscillating frequency is determined by the center frequency of the FP-FBG notch, which varies with the surrounding environments. The RI or the temperature change can be accordingly measured by monitoring the frequency shift of the microwave signal using an electrical spectrum analyzer or a digital signal processor. An experiment is performed to verify the proposal. An RI sensitivity of 413.8 MHz/0.001RIU and a temperature sensitivity of 2516 MHz/°C are successively demonstrated.

By incorporating a phase-shifted fiber Bragg grating (PS-FBG) inscribed in few-mode fiber (FMF) named FM-PS-FBG for the first time, a novel frequency-switchable optoelectronic oscillator (OEO) to perform simultaneous strain and temperature measurement is proposed and experimentally demonstrated. In the OEO loop, two switchable oscillation frequencies are determined by the reflected bands of FM-PS-FBG based on different mode couplings and corresponding notches. Due to the characteristics of modes, two OEO-generated microwave signals exhibit different strain and temperature sensitivities. Therefore, through monitoring the frequency shifts of microwave signals, the simultaneous strain and temperature sensing can be realized by the proposed OEO sensor with high-speed and high-resolution interrogation.

We propose a novel polarization-maintaining supermode fiber containing quasi-elliptically arranged high-index cores. Numerical simulation indicates that such a fiber could support up to 20 distinct modes with different polarization states and spatial orientations. At 1550 nm, all the 20 modes are separated from their adjacent modes with effective refractive differences beyond 10- 4 . We also investigate the influence of parameters on mode number and effective area of the proposed fiber. Wavelength-dependent performance is analyzed subsequently ranging from 1500 to 1630 nm. The proposed fiber could guide 20 modes with low dispersion over the entire C-band. This letter illustrates that the proposed fiber might be a promising candidate for mode division multiplexing to enhance optical transmission capacity.

A novel Erbium-doped fiber ring cavity laser sensor for refractive index (RI) measurement based on a special designed few-mode-singlemode-few-mode structure is proposed and experimentally demonstrated. The few-mode fiber is a home-made concentric ring core fiber (CRCF) which can only support two scalar modes. Thus a stable mode interference occurs which functions as a sensing head and band-pass filter to select the lasing wavelength simultaneously. A sensitivity of −45.429 nm/RIU is obtained in the range of 1.333–1.363. High optical signal to noise ratio (OSNR) of ∼45 dB and narrow 3-dB bandwidth of ∼0.1 nm indicate that the fiber ring laser sensing system has a high resolution and accuracy RI measurement.

A novel coreless-D-shape-coreless (CDC) fiber structure for liquid-level sensing is proposed and experimentally investigated. The D-shape fiber with cladding partially etched is sensitive to the ambient refractive index change and the CDC structure transmission dip wavelength shifts related to the length of D-shape fiber immersed in the liquid, so liquid level is measured by monitoring the dip wavelength. The sensitivities for three different liquids with the RIs of 1.333, 1.355, and 1.377 are 191.89, 208.11, and 213.80 pm/mm, respectively. The temperature influence is also studied. The sensor exhibits a low-temperature cross-sensitivity of −0.128 mm/°C. The proposed modal interferometer based on the D-shape fiber with high sensitivity, low cost, and easy fabrication is suitable to liquid-level sensing applications.

Highlights • Metastatic breast carcinoma rarely spreads to the Gastrointestinal Tract (GIT). • GIT breast carcinoma rarely has triple: ER, PR and HER2-neu negative histology. • We report a case of triple negative breast carcinoma that spread to the jejunum. • This is the first reported case in the U.S., Metastasis from breast carcinoma to the gastrointestinal tract (GIT) is very uncommon. To date, only a few cases have been described worldwide. Of those which do metastasize to the GIT, only estrogen receptor (ER), progesterone receptor (PR) and HER2-neu receptor positive cancers have been reported and none have been mentioned in the U.S. We report a case of a 70-year-old white female with history of triple negative lobular carcinoma eight years earlier who presented with solitary jejunal mass causing obstruction.

We proposed and demonstrated a novel few-mode concentric-ring core fiber (FM-CRCF) for axial micro-strain measurement with fiber ring laser based on few-mode-singlemode-few-mode fiber structure. The core area of CRCF consists of four concentric rings which refractive indices are 1.448, 1.441, 1.450, 1.441, respectively. LP 01 and LP 11 are two dominated propagating mode groups contributing in the CRCF. In this few-mode-singlemode-few-mode structure, two sections of CRCF act as the mode generator and coupler, respectively. The basis of sensing is the center single mode fiber. Moreover, this structure can be used as an optical band-pass filter. By using fiber ring cavity laser, the axial micro-strain sensing system has high intensity (∼20 dB), high optical signal to noise ratio (∼45 dB) and narrow 3 dB bandwidth (∼0.1 nm). In the axial micro-strain range from 0 to 1467 μ e , the lasing peak wavelength shifts from 1561.05 nm to 1559.9 nm with the experimentally sensitivity of ∼ 0.81 pm / μ e .

In this paper, an optimal and predictive multilevel control solution is developed to utilize data and capabilities provided by the Connected and Automated Vehicle (CAV) technologies to reduce fuel consumption for line-haul class 8 trucks. The longer horizon road grade and speed limit data combined with shorter horizon and time-varying traffic data on real-world driving scenarios is utilized in the developed integrated optimal control algorithms to further reduce fuel consumption with respect to a production baseline control with state-of-art Advanced Driver-Assistance Systems (ADAS) control features. Furthermore, integration of the developed control algorithms for the front vehicle automation in platoon with a rear truck is also studied. The results indicate that with the application of the developed control solutions for powertrain efficiency in both single truck automation or the automation of the front truck in platoon with a rear truck, the fuel consumption is significantly reduced over real-world driving scenarios with road grade, speed limit and traffic data. The proposed solution is implementable in real-time with the utilization of CAV technologies with the proposed multilevel control architecture.

Decorrelation-based OCTA is a widely used optical coherence tomography angiography method which utilizes OCT intensity information. However, cardiac and respiratory motions in animals are seriously degrade image quality. These kind of bulk motion is periodic, and its C-Scan (slow scan) direction component hinder motion correction because of scan position and OCT structure’s change. Some correction methods were proposed, but vasculature information will be lost when larger bulk motion occur. Here we demonstrate a correction method which uses stitch scan protocol in C-Scan direction, and sets a threshold to the maximum value of normalized cross-correlation among repeated B-Scan intensity signal to exclude false OCT B-scans. Result of In vivo imaging experiment for mice indicates that our method can reserve whole vasculature information and effectively improve image quality.

Contrast-Enhanced Digital Breast Tomosynthesis (CEDBT) provides quasi three-dimensional contrast enhancement of breast lesions and has been investigated for breast cancer detection and lesion assessment. The acquisition geometry of CEDBT may affect its ability to detect and assess contrast-enhanced lesions. In this study, we investigate the effects of angular range of CEDBT on lesion margin assessment. The CIRS BR3D phantom with iodine inserts was imaged for four angular ranges between 15 and 45 degrees with same total glandular dose using a prototype CEDBT system. The artifact spread functions of iodine objects with various sizes were measured. The detectability of iodine objects overlaid in the depth direction with different separation distances was evaluated using signal-difference-to-noise ratio. Clinical images of malignant lesions were acquired with 25 projections over approximately 50 degrees, and CEDBT for various angular ranges were generated using a subset or all of the projection images and were assessed for lesion margins. Our results show that increasing angular range of CEDBT improves the separation of overlapping iodine signals in phantom images, and the margins of malignant mass lesions are better identified. In conclusion, CEDBT with wide angular range may improve lesion characterizations, e.g. lesion size, morphology and location, and provide better performance than contrast enhanced digital mammography (CEDM) for applications such as guidance of biopsy and evaluation of treatment response.

Contrast-enhanced digital mammography (CEDM) reveals neovasculature of breast lesions in a two-dimensional contrast enhancement map. Contrast-enhanced digital breast tomosynthesis (CEDBT) provides contrast enhancement in three dimensions, which may improve lesion characterization and localization. We aim to compare CEDM and CEDBT for lesion assessment. Women with breast imaging-reporting and data system 4 or 5 suspicious breast lesion(s) were recruited in our study and were imaged with CEDM and CEDBT in succession under one breast compression. Two radiologists assessed CEDM and CEDBT with both images displayed side-by-side and compared (1) contrast enhancement of lesions and (2) lesion margin using a five-point scale ranging from [Formula: see text] (CEDM much better) to [Formula: see text] (CEDBT much better). Biopsy identified 19 malignant lesions with contrast enhancement. Our results show that CEDBT provides better lesion margins than CEDM with limited reduction in contrast enhancement. CEDBT delivers less radiation dose compared to CEDM + DBT. Synthetic CEDM can be generated from CEDBT data and provides lesion contrast enhancement comparable to CEDM. CEDBT has potential for clinical applications, such as treatment response monitoring and guidance for biopsy.

Due to the lockdown regulations worldwide during the COVID-19 pandemic, the global aviation industry has been severely hit. This study focuses on the volatility estimation of stock indexes in the Chinese Airport Shipping Set (ASS) at industry-enterprise levels and identifies possible business behavior that may cause fluctuating differences. Depending on the Generalized Autoregressive Conditional Heteroskedasticity (GARCH) model, text mining method and Word Cloud Views, results show that (1) the holistic volatility of Airport Shipping Set Index (ASSI) increases relative to the pre-COVID period, (2) volatility of airport stocks has crucial differences, while the volatility of shipping stocks is similar, (3) there are different responses to the pandemic between Shenzhen Airport and Shanghai Airport shown in their semiannual financial reports. Compared to the latter, the former had a more positive attitude and took various measures to mitigate risks, providing evidence of the volatility differences between firms.

Fiber ring laser sensor for curvature measurement based on a single-mode–no-core–single-mode structure is proposed and experimentally demonstrated. Compared with the conventional curvature system, the proposed laser sensor system has a high optical signal-to-noise ratio and a narrow 3-dB bandwidth, which enables the system to monitor the variation of micro-bending more distinctly. In the experiment, changes in peak wavelength show a blue shift when the curvature varies from 0.1225 to 0.4062 $\text{m}^{-1}$ . The sensitivity of the curvature is about −22.33 nm/ $\text{m}^{-1}$ in the range of 0.2121–0.3463 $\text{m}^{-1}$ . The response to the temperature of the fiber laser sensor is also discussed, where temperature sensitivity of 9.23 pm/°C within the range from 10 °C to 100 °C is obtained.

There is only one previously reported incident in the English literature of sarcoma ex pleomorphic adenoma of the parotid and there are only 8 cases of primary parotid leiomyosarcoma. In our case, a 79-year-old female patient presented to our care with left preauricular pain, swelling, and facial weakness. After CT imaging, she underwent left total parotidectomy. A spindle cell lesion was identified intraoperatively and the facial nerve was sacrificed. Subsequent analysis of the lesion yielded a diagnosis of leiomyosarcoma ex pleomorphic adenoma. After 30 fractions of radiation therapy, scans were negative for tumor. However, 18 months after first experiencing symptoms, she was found to have metastases to the brainstem and lung. When diagnosing sarcoma ex pleomorphic adenoma of the parotid gland, it is important to perform thorough immunohistochemical staining and exclude a previous history of sarcoma or other sources of metastases. Complete resection is critical due to the tumor’s local aggressiveness and metastatic potential. Although these tumors are not very responsive to chemotherapy or radiation, adjuvant treatment is commonly used when margins are unclear.

Genomic analysis of a patient's tumor is the cornerstone of precision oncology, but it does not address whether metastases should be treated differently. Here we tested whether comparative single-cell RNA sequencing (scRNA-seq) of a primary small intestinal neuroendocrine tumor to a matched liver metastasis could guide the treatment of a patient's metastatic disease. Following surgery, the patient was put on maintenance treatment with a somatostatin analog. However, the scRNA-seq analysis revealed that the neuroendocrine epithelial cells in the liver metastasis were less differentiated and expressed relatively little SSTR2, the predominant somatostatin receptor. There were also differences in the tumor microenvironments. RNA expression of vascular endothelial growth factors was higher in the primary tumor cells, reflected by an increased number of endothelial cells. Interestingly, vascular expression of the major VEGF receptors was considerably higher in the liver metastasis, indicating that the metastatic vasculature may be primed for expansion and susceptible to treatment with angiogenesis inhibitors. The patient eventually progressed on Sandostatin, and although consideration was given to adding an angiogenesis inhibitor to her regimen, her disease progression involved non-liver metastases that had not been characterized. Although in this specific case comparative scRNA-seq did not alter treatment, its potential to help guide therapy of metastatic disease was clearly demonstrated.

To create and validate patient-completed Caprini risk score (CRS) tools for Chinese people. We revised Chinese patient-completed CRS form according to previously published studies. We prospectively recruited 70 internal medical patients and 70 surgical patients. The average age of these patients was 54.26 ± 15.29 years, 54.29% of them were male and 80% of them had education beyond high school. The study compared: (1) patient-completed CRS and physician-completed CRS; (2) the final value of physician-completed CRS (physician-completed CRS + body mass index) and CRS in the electronic medical record (EMR) system. Patient-completed CRS was 3.71 ± 3.63, patients spent 3.60 ± 1.24 minutes, 57.14% patients were at high-highest risk; physician-completed CRS was 3.84 ± 3.63, physicians spent 2.11 ± 1.13 minutes, 59.28% patients were at high-highest risk; the final value of physician-completed CRS was 4.12 ± 3.62, 63.58% patients were at high-highest risk; CRS value in the EMR system was 4.07 ± 3.58, 65% patients were at high-highest risk. There were strong positive correlations ( P < .0001) between patient-completed CRS and physician-completed CRS ( r = 0.978, κ = 0.76) and between the final value of physician-completed CRS and CRS in EMR ( r = 0.994, κ = 0.97). This study successfully developed and validated a Chinese patient-completed CRS that we found can replace physician-completed CRS. This results in considerable time saving for physicians and this process should increase the percentage of patients having complete risk assessment when they are admitted to the hospital.

Contrast-Enhanced Digital Breast Tomosynthesis (CEDBT) provides a three-dimensional (3D) contrast-enhancement map with co-registered anatomical information from low-energy DBT. It combines the benefits from Contrast-Enhanced Digital Mammography (CEDM) and Digital Breast Tomosynthesis (DBT), and may improve breast cancer detection and assessment of lesion morphology. We investigate the efficacy of CEDBT in the assessment of lesion contrast enhancement and margin identification, and evaluate the dose efficiency. We generate synthetic CEDM images from CEDBT data, similar to synthesis of 2D mammograms from DBT data, which may facilitate overall lesion assessment without additional radiation dose. Preliminary results from a patient study show that CEDBT depicts lesion margins better compared to CEDM, while the contrast-enhancement level for in-plane slice is not as high as in CEDM. CEDBT delivers less radiation dose compared to CEDM + DBT. Synthetic CEDM is able to provide lesion contrast-enhancement level comparable to CEDM.

Solitary fibrous tumors are well described in the pleura, but rare extra-pleural neoplasms have been reported. We describe a patient with a solitary left renal fibrous tumor who after undergoing a nephrectomy, presented 8 years later with a contralateral metachronous solitary fibrous tumor. Malignant metastatic extra-pleural solitary fibrous tumors are extremely rare, and to our knowledge, this is the first case of contralateral recurrence of solitary renal fibrous tumor. The patient underwent a robotic assisted partial nephrectomy of the right renal mass. Both tumors showed overlapping histopathology.

Mesenchymal stem cells (MSCs), exhibiting tumor-tropic and migratory potential, can serve as cellular carriers to improve the effectiveness of anticancer agents. However, several challenges, such as the safety issue, the limited drug loading, the conservation of stemness and migration of MSCs, still remain in the MSC-based delivery system. In the present study, a novel nano-engineered MSC delivery system was established by loading doxorubicin (DOX)–polymer conjugates for the systemic treatment of pulmonary metastasis of breast cancer. For the first time, a dual drug-loaded mode, endocytosis and membrane-bound, was adopted to achieve the maximum amount of DOX conjugates in MSCs. The in vitro studies revealed the loaded MSCs possessed multifunctional properties, including preservation of the stemness and migration of MSCs, excellent stability of drug loading, acid sensitive drug release and obvious cytotoxicity against 4T1 cells. The in vivo studies confirmed that the loaded MSCs mainly located and long stayed in the lung where the foci of metastatic tumor situated. Importantly, loaded MSCs can significantly inhibit the tumor growth and prolong the life span of tumor-bearing mice in contrast with DOX and DOX-conjugate. The present loaded MSCs system suggested a promising strategy to solve several issues existed in cell-based delivery systems. Especially for the problem of low drug loading, the strategy, simultaneously loading nanodrug in cells’ internal and membrane, might be the most desirable method so far and could be developed as a generalizable manner for cell-mediated tumor-targeted therapy.

Melanoma, characterized by high mortality, rapid development and accompanied with angiogenesis is the most typical malignant tumor in skin cancer. Hence, the detection of blood vessels is of much significance. The early vascular network has small scale. If we remove the tumor early and biopsy it, it will increase the spread of the cancer cells and infection and bleeding. In this case, we presented a new angiography method. A high-resolution OCT system for noninvasive angiographic imaging of early skin melanoma — Swept Source Optical Coherence Tomography Angiography (SS-OCTA) is proposed. With a high lateral resolution of 10[Formula: see text][Formula: see text]m in vivo tomographic angiography, SS-OCTA is used to image and identify the morphology of the early tumor blood vessels. In addition, a control group experiment is conducted to observe the growth of melanoma in the process of rupture, malformation of micro-vessels. The results of the analysis and statistical test ([Formula: see text]) are statistically significant.

An on-chip two-step microwave frequency measurement method with high accuracy and an ultra-wide frequency measurement range is reported. A silicon photonic integrated micro-disk resonator (MDR) array is used to coarsely measure the signal frequency via an array of add-drop MDRs with smaller disk radii; then an MDR with a larger radius is used to finely measure the signal frequency, which is done by monitoring the optical powers of the optical signals from the through port and drop port of the MDRs. The proposed system features a very compact structure, ultra-wide frequency measurement range, and high frequency measurement accuracy, which is verified by a proof-of-concept experiment using two MDRs with radii of 6 and 10 μm. A frequency measurement of microwave signals from 1.6 to 40 GHz is implemented with a measurement error of less than 60 MHz. The stability of the system is also evaluated.

A real-time random grating sensor array for quasi-distributed sensing based on spectral-shaping and wavelength-to-time (SS-WTT) mapping and time-division multiplexing is proposed and experimentally demonstrated. The sensor array consists of multiple random gratings written in a single-mode fiber (SMF) at different physical locations. When the temperature or strain applied to a particular random grating is changed, the central wavelength of the reflection spectrum of the random grating will change, which is converted to the time domain as a time shift based on SS-WTT using a linearly chirped fiber Bragg grating. After detection at a photodetector, an electrical waveform with the time shift information encoded in the random waveform is obtained, which is further compressed by correlation to increase the time resolution. As a demonstration, a real-time quasi-distributed sensing system based on a two-random-grating array is implemented. The results show that the sensing resolutions for temperature and strain are 0.23°C and 2.5 μϵ, respectively, and the accuracies for temperature and strain are 0.11°C and 1.2 μϵ, respectively. Compared with a conventional quasi-distributed sensor, our proposed sensing system has key advantages, including real-time sensing, high-resolution interrogation, and large scalability.

Immunohistochemical analysis has been a key clinical tool that shows the protein expression of molecular markers. Expression of molecular markers in breast pathology has been used to distinguish breast cancers from benign lesions, classify subtypes of breast cancers, and determine therapeutic intervention. It is a relatively fast and efficient option in stratifying breast lesions to assist in both determining pathology diagnosis and offer strategies to the best course of clinical action. In this chapter, we discuss the use of immunohistochemistry testing for some of the key molecular markers involved in breast pathology that are crucial for classifying breast cancers and the guidelines for the interpretation of testing results that assist in clinical management.

Contrast-enhanced digital breast tomosynthesis CEDBT may improve contrast-enhanced lesion conspicuity and relative contrast quantification by improving three-dimensional visualization of lesion morphology, and reducing the integration of attenuation information along the axial direction. Improved visualization of patterns of contrast-enhancement and improved iodine quantification may help differentiate between malignant and benign enhancing lesions. The dependence of dual-energy contrast-enhanced lesion detectability on imaging chain design is investigated. Lesion detectability and relative iodine quantification is comparable for subtraction in either reconstruction or projection domains for both phantom and patient images. SART generally produces greater SDNR than FBP, and scatter correcting projections further improves SDNR.

Closure of diabetic dermal chronic wounds remains a clinical challenge. Implant-assisted healing is emerging as a potential class of therapy for dermal wound closure; this advancement has not been paralleled by the development in complementary diagnostic techniques to objectively monitor the wound-healing process in conjunction with assessing/monitoring of implant efficacy. Biopsies provide the most objective morphological assessments of wound healing; however, they not only perpetuate the wound presence but also increase the risk of infection. A noninvasive and high-resolution imaging technique is highly desirable to provide objective longitudinal diagnosis of implant-assisted wound healing. We investigated the feasibility of deploying optical coherence tomography (OCT) for noninvasive monitoring of the healing of full-thickness excisional dermal wounds implanted with a novel in situ gelable hydrogel composed of N-carboxyethyl chitosan, oxidized dextran, and hyaluronan, in both normal and db/db mice. The results showed that OCT was able to differentiate the morphological differences (e.g., thickness of dermis) between normal and diabetic mice as validated by their corresponding histological evaluations (p

To examine the utility and potential limitations of microelectromechanical systems-based spectral-domain cystoscopic optical coherence tomography (COCT) so as to improve the diagnosis of early bladder cancer.An optical coherence tomography catheter was integrated into the single instrument channel of a 22F cystoscope to permit white-light-guided COCT over a large field of view (4.6 mm wide and 2.1 mm deep per scan at 8 frames/s) and 10-microm resolution. Intraoperative COCT diagnosis was performed in 56 patients, with a total of 110 lesions examined and compared with biopsied histology.The overall sensitivity of COCT (94%) was significantly higher than cystoscopy (75%, P = .02) and voided cytology (59%, P = .005); the major enhancement over cystoscopy was for low-grade pTa-1 cancer and carcinoma in situ (P.018). The overall specificity of COCT (81%) was comparable to voided cytology (88.9%, P = .49), but significantly higher than cystoscopy (62.5%, P = .02).The microelectromechanical systems-based COCT, owing to its high resolution and detection sensitivity and large field of view, offers great potential for "optical biopsy" to enhance the diagnosis of nonpapillary bladder tumors and their recurrences and to guide bladder tumor resection.

This paper summarizes the recent technological development in our lab on cystoscopic optical coherence tomography (COCT) by integrating time-domain OCT (TDOCT) and spectral-domain OCT (SDOCT) with advanced MEMS-mirror technology for endoscopic laser scanning imaging. The COCT catheter can be integrated into the instrument channel of a commercial 22Fr rigid cystoscopic sheath for in vivo imaging of human bladder under the cystosocopic visual guidance; the axial/transverse resolutions of the COCT catheter are roughly 9 μm and 12 μm, respectively, and 2D COCT imaging can be performed with over 110dB dynamic range at 4–8 fps. To examine the utility and potential limitations of OCT for bladder cancer diagnosis, systemic ex vivo rat bladder carcinogenesis studies were performed to follow various morphological changes induced by tumor growth and in vivo porcine study was performed to examine the feasibility of COCT for in vivo imaging. Justified by promising results of the animal studies, preliminary clinical study was conducted on patients scheduled for operating-room cystoscopy for bladder cancers. Double-blind clinical results reveal that COCT can delineate detailed bladder architectures (e.g., urothelium, lamina propria, muscularis) at high resolution and detect bladder cancers based on enhanced urothelial heterogeneity as a result of excessive growing nature of bladder cancers. The diagnostic sensitivity and specificity can be enhanced to 92% and 85%, respectively. Results also suggest that due to reduced imaging depth of COCT in cancerous lesions, staging of bladder cancers may be limited to Ta or T1 for non-outgrowing cancerous lesions.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular proliferative disorder, which most commonly involves the skin of the head and neck regions. Noncutaneous localization of this pathology is unusual, and its primary localization in large arteries presenting as a pulsatile mass is extremely rare. We report here two cases of ALHE manifested as masses of the occipital and brachial artery. ALHE should be considered in the differential diagnosis of localized peripheral arterial masses in young patients.

We report a case of uterine perivascular epithelioid cell tumor (PEComa) with malignant histological features in a 59-year-old woman with tuberous sclerosis (TBS). The patient also had extrapulmonary lymphangioleiomyomatosis involving pelvic lymph nodes, myometrium, cervix, and ovary ("pecomatosis"). The uterine tumor measured 2.6 cm and had marked nuclear pleomorphism, necrosis, and 2 mitoses per 50 high-powered field, with an occasional atypical mitosis and infiltrative borders. The nonneoplastic myometrium, the cervical wall, and the hilum of the ovary had multiple clusters of bland-looking epithelioid clear cells that ranged from 1 to 5 mm (pecomatosis). The uterine tumor cells were positive for HMB-45 (90%), Melan-A (70%), smooth muscle actin (50%), and estrogen receptor (30%). Of the 16 pelvic lymph nodes excised, 3 were involved with lymphangioleiomyomatosis that was positive for HMB-45 and estrogen receptor. This is only the second reported PEComa associated with pecomatosis and the fourth PEComa described in a patient with TBS. The clinical significance of pecomatosis is still uncertain but seems to be seen only in patients with TBS.

This paper focuses on the control architecture and the enabling technologies for the Ethernet-supported Internet protocol-over-wavelength-division-multiplexing metropolitan area networks. We present the general architecture of an access node of such networks and propose solutions to facilitate the essential system functionalities. The aim is to render the flexible and high-capacity metropolitan network, which provides service provisioning improvement and resource utilization efficiency for the packet-dominated data traffic. Specifically, an enhanced address resolution protocol is proposed to reduce the call setup latency and the signaling overhead associated with the address probing procedure, a burst-based transmission mechanism is adopted to improve the network throughput and resource utilization efficiency, and a wavelength allocation algorithm is investigated to provide flexible bandwidth multiplexing with fairness and high scalability. Theoretical analysis and simulations are conducted to evaluate the performance of our algorithms, demonstrating that the proposed architecture and technologies deliver substantial transport performance improvement with efficient network resource utilization.

We propose a forward resource reservation (FRR) scheme to reduce the data burst delay at edge nodes in optical burst switching (OBS) systems. We also explore algorithms to implement the various intrinsic features of the FRR scheme. Linear predictive filter (LPF)-based methods are investigated and demonstrated to be effective for dynamic burst-length prediction. An aggressive resource reservation algorithm is proposed to deliver a significant performance improvement with controllable bandwidth cost. By reserving resources in an aggressive manner, an FRR system can reduce both the signaling retransmission probability and the bandwidth wastage as compared with a system without the aggressive reservation. An FRR-based QoS strategy is also proposed to achieve burst delay differentiation for different classes of traffic. Theoretical analysis and simulation results verify the feasibility of the proposed algorithms and show that our FRR scheme yields a significant delay reduction for time-critical traffic without incurring a deleterious bandwidth overhead.

TTP and HUS are two disorders with many similarities. Though their first descriptions appeared at different time in history, there has been a trend among physicians to consider them as the same clinical entity. However, in recent years new research findings on the pathophysiology of TTP and HUS have revealed some differences between the two disorders. In this paper, we will review the current approaches to the clinical and laboratory diagnosis of TTP and HUS, as well as therapeutic strategies. We will also summarize the recent advances in three areas in the study of the pathophysiology of TTP and HUS, namely the newly discovered von Willebrand factor multimer-cleaving protease, endothelial cell apoptosis induced by serum from patients with TTP and atypical HUS and the activation of complement system. Since distinguishing and differentiating between TTP and HUS may help to develop more effective therapies targeted at key steps of the disease development, we will discuss possible ways of reclassifying the TTP-HUS disorders. In the end, we also present our views on possible future development.

We present the results on clinical diagnosis of bladder cancer in vivo with MEMS-based endoscopic OCT and the methods to enhance the detection of carcinoma in situ by 3-D OCT using SV40T transgenic mouse model.