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Nowadays, increasing business applications running in the cloud are embracing the microservice architecture. This paper presents the challenges and implications of diagnosing root causes of anomalies in large-scale microservice architecture using real incidents in IBM Bluemix. We propose ServiceRank, a novel framework for anomaly detection and root cause identification in the microservice architecture to tackle these challenges. ServiceRank introduces an anomaly detector followed by a root cause analysis module, which detects the suspected abnormal service without pre-defined thresholds. To generalize our approach, we design a dynamic causal relationship extraction approach to construct impact graphs for root cause investigation according to specific anomalies. To eliminate cloud design-patterns' impact on anomaly diagnosis, we propose a mechanism called correlation calibration in ServiceRank and present a calibration algorithm for the circuit breaker - a typical protection pattern in the microservice architecture. Finally, we design a heuristic investigation algorithm based on the second-order random walk to identify the anomaly's root cause. Experimental results in a simulated environment and the IBM Bluemix platform show that ServiceRank outperforms selected approaches in accuracy and offers fast identification of root cause service when an anomaly occurs. Moreover, we can deploy ServiceRank rapidly and easily in various systems without any pre-defined knowledge.

Bone Marrow Mesenchymal Stem Cells (BMSCs), multidirectional cells with self-renewal capacity, can differentiate into many cell types and play essential roles in tissue healing and regenerative medicine. Cell experiments and in vivo research in animal models have shown that BMSCs can repair degenerative discs by promoting cell proliferation and expressing Extracellular Matrix (ECM) components, such as type II collagen and protein-polysaccharides. Delaying or reversing the Intervertebral Disc Degeneration (IDD) process at an etiological level may be an effective strategy. However, despite increasingly in-depth research, some deficiencies in cell transplantation timing and strategy remain, preventing the clinical application of cell transplantation. Exosomes exhibit the characteristics of the mother cells from which they are secreted and can inhibit Nucleus Pulposus Cell (NPC) apoptosis and delay IDD through intercellular communication. Furthermore, the use of exosomes effectively avoids problems associated with cell transplantation, such as immune rejection. This manuscript introduces almost all of the BMSCs and exosomes derived from BMSCs (BMSCs-Exos) described in the IDD literature. Many challenges regarding the use of cell transplantation and therapeutic exosome intervention for IDD remain to be overcome.

Non-orthogonal multiple access (NOMA)-based cognitive heterogeneous multi-homing networks is a very important scenario in the future wireless networks. In this work, we formulate a joint video packet assignment, power control and user scheduling problem as a mixed integer non-linear programming (MINLP) to maximize the total video transmission quality for cognitive multi-homing heterogeneous NOMA networks, which is subject to the maximum accessed number of secondary users at each subchannel, video encoding characteristics, maximum interference power constraint and total available power constraint. For the joint video packet assignment, power control and user scheduling problem, we divide it into a video packet assignment subproblem, a power control subproblem and a secondary user scheduling subproblem for cognitive multi-homing heterogeneous NOMA networks. Firstly, the secondary user scheduling algorithm is proposed using the greedy method. Then, we utilize successive convex approximation (SCA) method to transform the power control subproblem into a convex programming problem, and an approximated optimal power control algorithm is proposed with the dual decomposition method. Finally, a heuristic video packet assignment algorithm is designed, which utilizes the auction theory. Numerical simulation results demonstrate that the proposed algorithms not only improve the video transmission quality, but also enhance the total throughput of cognitive multi-homing heterogeneous NOMA networks.

Purpose: The present study investigated the association between Systematic COronary Risk Evaluation (SCORE)-estimated cardiovascular risk and carotid stiffening in a middle-aged population using ultrafast pulse wave velocity (ufPWV).Methods: This study enrolled 683 participants without known cardiovascular disease or diabetes mellitus who underwent ufPWV measurements. Clinical interviews, physical examinations, laboratory findings, carotid intima-media thickness (cIMT), pulse wave velocity (PWV) at the beginning of systole (PWV-BS), and PWV at the end of systole (PWV-ES) were assessed. Each participant underwent an assessment of SCORE risk based on major cardiovascular risk factors (CVRFs), including age, sex, smoking, systolic blood pressure (SBP), and total cholesterol (TC). Crude and adjusted odds ratios (ORs) with 95% confidence intervals and ordinal logistic regression were used. Overall CVRFs were adjusted to assess ORs.Results: cIMT and carotid stiffening in PWV-BS and PWV-ES were significantly different between sex subgroups (all P0.05).Conclusion: Carotid stiffening quantified by ufPWV is linked to SCORE categories, and elevated PWV-ES may aid in cardiovascular risk stratification.

Internet of Things (IoT) connects physical, cyber and human spaces. Event-based system is one of the cornerstones to help IoT achieve real-time monitoring, context-awareness and intelligent control. In the era of big data, the huge amount and high complexity of event inference rule pose a great challenge to traditional event-based system in its efficiency, especially resources-constrained IoT edge systems. This paper proposes a high-efficiency joint event inference model for real-time contextawareness and decision-making in IoT edge systems. We define different kinds of redundancy relations between event inference models and propose a description mechanism, named event containing graph, to support multi-pattern optimization. Three operations on single-pattern event inference models, Merge, Failure and Output are defined respectively. The joint inference model is established by merging sharing patterns, constructing failure transitions and conditional output to eliminate inter-model redundancies. Experimental results prove that the joint model consumes less computational resources and provides higher performance than other benchmarks. It also verifies and proves that joint model has better optimization effect when processing large number of complex events. Especially in edge computing environment, joint inference model improves the real-time performance and significantly reduces the energy consumption in data transmission from edges to data center.

In this paper, we study a cloud security service market, which is composed of cloud users and cloud security service vendors (CSSVs). The CSSVs work as the insurers for selling the cloud security plan, which is consisted of cloud security service and cloud-insurance. The users in the cloud platform can purchase the cloud security plan from the CSSVs to secure their cloud service. If the cloud service is attacked and loss happens, the users will receive the claim from the CSSVs. To reduce the probability of paying claim, the CSSV has an incentive to invest in improving its cloud security service. To meet these requirements, we propose a two-stage Stackelberg game. In the first stage, the CSSVs jointly set the price charging the users and determine the security investment to improve their offered cloud security service. In the second stage, the users decide on the amount of the cloud security plan to purchase based on the prices of the cloud security plan and the perceived cyber breach probability of the cloud security service. The existence and uniqueness of the equilibrium of the Stackelberg game are proven analytically. Extensive simulations have been conducted to evaluate the performance of the Stackelberg game.

This paper presents a multi-metric and self-adaptive root cause diagnosis framework, named MS-Rank. MS-Rank decomposes the task into four phases: impact graph construction, random walk diagnosis, result precision evaluation, metrics weight update. Initially, we introduce the concept of implicit metrics and propose a composite impact graph construction algorithm, using multiple types of metrics to discover causal relationships between services. Afterwards, we propose a diagnostic algorithm in which forward, selfward and backward transitions are designed to heuristically identify the root cause services. In addition, we establish a self-adaptive mechanism to update the confidence of different metrics dynamically according to their diagnostic precision. Lastly, we develop a prototype system and integrate MS-Rank into real production system - IBM Cloud. Experimental results show that MS-Rank has a high diagnostic precision and its performance outperforms several selected benchmarks. Through multiple rounds of diagnosis, MS-Rank can optimize itself effectively. MS-Rank can be rapidly deployed in various microservice-based systems and applications, requiring no predefined knowledge. MS-Rank also allows us to introduce expert experiences into its framework to improve the diagnostic efficiency and precision.

In this work, we investigated leaching of lanthanide and yttrium (REY) from a Central Appalachian coal and its ashes obtained at 550–950 °C with the main purpose of understanding the impact of ashing temperature on REY leachability in water, ammonium sulfate, and hydrochloric acid. It is found that the coal contains a negligible amount of water-soluble REY, less than 1% ion-exchangeable REY, and about 28% of HCl-soluble REY. Ashing leads to dramatic changes in REY leachability in both ammonium sulfate and hydrochloric acid solutions, which is believed to be related to transformation and redistribution of organically-associated REY in coal during the ashing process. Ashing temperature significantly affects REY leaching from coal ashes; higher ashing temperature results in lower REY leachability in both solutions. Clay minerals may play a significant role in changing the leachability of REY after ashing. In addition, the results also suggest that the organic matter in the coal is relatively enriched in heavy REY.

Liver cirrhosis is an established high-risk factor for HCC and the majority of patients diagnosed with HCC have cirrhosis. However, HCC also arises in non-cirrhotic livers in approximately 20 %of all cases. HCC in non-cirrhotic patients is often clinically silent and surveillance is usually not recommended. HCC is often diagnosed at an advanced stage in these patients. Current information about HCC in patients with non-cirrhotic liver is limited. Here we review the current knowledge on epidemiology, clinical features and imaging features of those patiens.

Objective To investigate the clinicopathologic characteristics and outcome of bilateral breast cancer (BBC) in the Chinese population. Methods : A retrospective study was conducted on 7797 cases with primary breast cancer diagnosed between 2016 and 2020, including 7618 cases of unilateral breast cancer (UBC) and 179 cases of BBC. Among the latter, there were 108 cases of synchronous BBC (SBBC) and 71 cases of metachronous BBC (MBBC). We compared the clinicopathological characteristics and outcomes among these groups. Results : In the present study, the incidence of SBBC and MBBC are 1.39% and 0.91% among the general population, respectively. In comparison of UBC and BBC, SBBC and MBBC, there are significant differences in the common clinicopathological characteristics, such as pathologic stage, hormone receptor (HR) status and molecular type. Additionally, differences in the pathologic stage and the type of surgery in the first and second tumors are observed in both SBBC and MBBC. In respect of the surgical treatment of BBC, 49.72% of the patients chose mastectomy. The 3-year disease free survival (DFS) for SBBC and MBBC are 94.4% and 96.9%, respectively. There is no difference in the overall survival (OS) and DFS between SBBC and MBBC. The histological grade and type of surgery on tumors of both sides are important influencing factors of DFS in the BBC patients. Conclusion : There are statistical differences in the clinicopathological characteristics and outcomes between SBBC and MBBC among the Chinese population. Therefore, the treatment of BBC patients should be individualized.

A simple decoupling method between two closely-located dual-polarized slot antennas is proposed in this communication. Based on substrate integrated waveguide (SIW), the dual-polarized antenna is realized using cross-shaped slot and U-shaped feed line, and two identical elements are closely located in edge-to-edge space of only 0.031λ0 to form the multiple-input-multiple-output (MIMO) array, where λ0 is the free-space wavelength at the center operating frequency. Wideband characteristics, high dual-polarized isolation, and low envelope correlation coefficient (ECC) are realized by introducing a superstrate with gradient relative permittivity (GRP) above the array. The GRP is obtained using drilling hole arrays on low-cost FR-4 materials. To validate the proposed design, the antenna array is fabricated and measured. The measured result shows that 13 dB and 16 dB isolation enhancements are provided for two orthogonally polarized fields, simultaneously. Moreover, the measured operating bandwidth is from 8 GHz to 10.35 GHz (about 25.6%, the isolation is more than 20 dB), and the ECC between two antennas is less than -52 dB for E1-pol and -62.4 dB for E2-pol over entire operating band. The proposed method has the potential to be used in MIMO wireless systems.

Car-following models have been widely applied and made remarkable achievements in traffic engineering. However, the traffic micro-simulation accuracy of car-following models in a platoon level, especially during traffic oscillations, still needs to be enhanced. Rather than using traditional individual car-following models, we proposed a new trajectory generation approach to generate platoon level trajectories given the first leading vehicle's trajectory. In this article, we discussed the temporal and spatial error propagation issue for the traditional approach by a car following block diagram representation. Based on the analysis, we pointed out that error comes from the training method and the model structure. In order to fix that, we adopt two improvements on the basis of the traditional LSTM-based car-following model. We utilized a scheduled sampling technique during the training process to solve the error propagation in the temporal dimension. Furthermore, we developed a unidirectional interconnected LSTM model structure to extract trajectories features from the perspective of the platoon. As indicated by the systematic empirical experiments, the proposed novel structure could efficiently reduce the temporal-spatial error propagation. Compared with the traditional LSTM-based car-following model, the proposed model has almost 40% less error. The findings will benefit the design and analysis of micro-simulation for platoon-level car-following models.

Text‐based CAPTCHAs have been widely deployed by many popular websites, and many have been attacked. However, most previous cracks were based on classification algorithms that typically rely on a series of preprocessing operations or on many training samples, thus making such attacks complicated and costly. In this study, a simple, generic, fast and end‐to‐end attack based on advanced object detection technologies is introduced. The proposed attack combines a feature extraction module, a character location and recognition module and a coordinate matching module. The experiments show that the attack can break a wide range of real‐world text CAPTCHAs deployed by the 50 most popular websites on Alexa.com and that the method achieves a high attack accuracy with only 2000 samples at an attack speed of less than 0.10 s. The attack was also evaluated on four click‐based CAPTCHAs that cannot be attacked in the end‐to‐end manner used by previous attacks, and the results demonstrated that within one step, the proposed approach achieves high success rates on both click‐based CAPTCHAs and schemes based on large‐scale character sets, such as Chinese character sets.

Fine-grained vehicle categorization has evolved into a significant subject of study due to its importance in the Intelligent Transportation System. A highly accurate and real-time vehicle categorization system will help to support many applications not only in the security aspect but also many walks of life. In this paper, facing the growing importance of this study, we present an image dataset named Frontal-103 to promote the development of the vision-based research on the vehicle, and particularly for the task of fine-grained vehicle categorization. This paper provides a detailed analysis of Frontal-103 in its current state: 1,759 fine-grained vehicle models in 103 vehicle makes and 65,433 web-nature images in total. Apart from the specific viewpoint and vehicle hierarchy, Frontal-103 is superior to the other state-of-the-art vehicle image datasets not only in the scale and diversity but also the accuracy and fine-grained level. We further discuss the peculiar challenges and issues lies in the task of fine-grained vehicle categorization and illustrate the usefulness of our dataset in addressing those problems. We hope Frontal-103 will be beneficial to the vision-based vehicle analysis and contribute to the computer vision community.

Background: Multiple endocrine neoplasia type 2A (MEN 2A) is mainly caused by germline RET codon C634 mutation and is characterized by Medullary Thyroid Carcinoma (MTC), pheochromocytoma (PHEO), and hyperparathyroidism (HPTH). The early diagnosis and initial normative treatment are helpful for the long-term outcome of MEN2A. Methods: Three index cases and their 29 relatives from three families with MEN2A were included in this study. Genetic screening was performed on all participants. Demographic, clinical profiles, tumor histopathologic features, and follow-up records were systematically analyzed. Results: In total, RET C634Y mutation was identified in 10 individuals (10/32, 31.3%). Among them, 5 presented with MTC symptoms, whereas the other 5 did not show apparent clinical manifestation, and all were subjected to thyroidectomy with varying neck dissection. Compared to individuals in the former, the latter benefited greatly from RET screening with significantly younger age at diagnosis of MTC and surgery (18.1 ± 13.8 years vs. 39.0 ± 14.1 years, P =0.045), and lessaggressive MTC behavior (size: 0.74 vs. 2.82 cm, P =0.026; LN+/resected: 20.0% vs. 100.0%, P =0.048) and also lower recurrence rate of MTC (20.0% vs. 100.0%, P =0.048). The PHEO was identified in 6 of the 10 carriers (60.0%), and all had undergone adrenal-sparing surgery. During the 10 years of follow-up, one (16.7%) developed recurrence of PHEO. Conclusion: Integrated RET screening, serum calcitonin, and plasma metanephrine/ normetanephrine levels can facilitate the early diagnosis and standardized MTC/PHEO surgery to improve the prognosis of MEN2A. Laparoscopic adrenal-sparing surgery prior to the bilateral total thyroidectomy is a preferred surgical approach for PHEO.

Aumolertinib (formerly almonertinib; HS-10296) is a novel third-generation EGFR tyrosine kinase inhibitor (TKI) with revealed activity against EGFR-sensitizing mutations and EGFR T790M mutation.Patients with locally advanced or metastatic NSCLC who developed an EGFR T790M mutation after progression on first- or second-generation EGFR TKI therapy were enrolled in this registrational phase 2 trial of aumolertinib at 110 mg orally once daily (NCT02981108). The primary end point was objective response rate (ORR) by independent central review.A total of 244 patients with EGFR T790M-positive NSCLC were enrolled. The ORR by independent central review was 68.9% (95% confidence interval [CI]: 62.6-74.6). The disease control rate was 93.4% (95% CI: 89.6-96.2). The median duration of response was 15.1 months (95% CI: 12.5-16.6). The median progression-free survival was 12.4 months (95% CI: 9.7-15.0). Among 23 patients with assessable central nervous system (CNS) metastases, the CNS-ORR and CNS-disease control rate were 60.9% (95% CI: 38.5-80.3) and 91.3% (95% CI: 72.0-98.9), respectively. The median CNS-duration of response was 12.5 months (95% CI: 5.6-not reached). Treatment-related adverse events of more than or equal to grade 3 occurred in 16.4% of the patients, with the most common being increased blood creatine phosphokinase level (7%) and increased alanine aminotransferase level (1.2%). The relative dose density of aumolertinib was 99.2% in this study.Aumolertinib is an effective and well-tolerated third-generation EGFR TKI for patients with EGFR T790M-positive advanced NSCLC after disease progression on first- and second-generation EGFR TKI therapy. On the basis of these findings, aumolertinib was approved in the People's Republic of China for patients positive for EGFR T790M NSCLC.

PURPOSE: The aim of this study was to evaluate the efficacy, safety and costs of ultrasound guided percutaneous radiofrequency ablation (RFA) versus open thyroidectomy for treating low-risk papillary thyroid microcarcinoma (PTMC) by using propensity score matching (PSM). PATIENTS AND METHODS: 157 patients who underwent RFA and 206 patients who underwent surgery for low-risk PTMC were included in the study. The patients were followed up at 1, 3, 6, 12 months after treatment, and every half year thereafter. A 1:1 PSM method was applied to balance the pretreatment data of the two groups. In the matched group (133 patients for each), the operative time, length of hospital stay, hospitalization expenses, cosmetic results, complications were assessed and compared between two groups. RESULTS: At last follow-up, 39 tumors (29.3%) in the RFA group completely disappeared. Between the well-matched groups, no local recurrence, lymph node metastasis or distant metastases were detected in either group during the follow-up period. After matching, the operation time and hospitalization time in RFA group were shorter than those in surgery group (both P

Due to the power interaction between the phase-shifted dual active bridges (PSDABs) and series resonant dual active bridges (SRDABs) in the hybrid modular dc Transformer (HMDCT), it is difficulty to optimize current stress based on the transferred power. An extended-state-observer based model predictive control (ESO-MPC) strategy with the extended phase shift (EPS) is proposed to optimize the current stress of the PSDABs in the HMDCT. The MPC is employed to calculate the optimal transferred power of the PSDABs. Moreover, a first-order ESO is introduced to observe the uncertain output current of the PSDABs. Based on the calculated transferred power, the optimal phase-shifted duty ratios of each PSDAB under EPS, which achieves optimal current stress, are obtained by the Lagrange multiplier method. Because of the ESO-MPC strategy, it enables to achieve the current sensorless control of the HMDCT. Simulations on a four-cell 3kV/500V HMDCT and the extensive experiments of a downscale laboratory platform, using DSP OMPL138 -EZW + FPGA XC7A75T as the core controller, validate the feasibility of the proposed control strategy.

In this letter, a circularly polarized (CP) metal-tolerant tag antenna with long reading distance (RD) is proposed for the ultra-high frequency (UHF) radio-frequency identification (RFID) systems. In order to realize CP radiation and high gain, a cross slot is etched on top patch to provide two orthogonal polarizations, whereas the meandered strip on central copper layer is used to obtain 90o phase difference between adjacent ports. An equivalent circuit model (ECM) is established to better understand the operating mechanism and impedance characteristic. A prototype mounted on a 200 mm 200 mm metal plate has been manufactured and measured to verify the design, and shows an impedance bandwidth of 8 MHz (918-926 MHz) and axial ratio bandwidth of 1.3 MHz (921.6-922.9 MHz). Also, a maximum gain of 2 dBi at 922 MHz and a maximum RD of about 22.4 m have been demonstrated.

Publisher Summary With image enhancement, the visibility of selected features in an image can be improved, but the inherent information content cannot be increased. The design of a good image enhancement algorithm should consider the specific features of interest in the microscopic image and the imaging process itself. The image enhancement algorithms can be classified into two categories: spatial domain methods and transform domain methods. The spatial domain methods include operations carried out on a whole image or on a local region selected on the basis of image statistics. Techniques that belong to this category include histogram equalization, image averaging, sharpening of important features such as edges or contours, and nonlinear filtering. The transform domain enhancement methods manipulate image information in transform domains, such as Fourier and wavelet transforms. Often, interesting image information cannot be separated out in the spatial domain but can be isolated in the transform domain. For example, one can amplify certain coefficients in the Fourier domain and then recover the image in the spatial domain to highlight interesting image content. The wavelet transform is another powerful tool that has been developed in recent years and used for image enhancement.

Osteoporosis is a systemic metabolic bone disease with an increasing incidence rate. Chinese medicinal herbs have a long history of treating bone diseases. Polysaccharides are an important category of phytochemicals in Chinese medicinal herbs, and their health benefits have increased the interest of the public. Numerous studies have indicated that polysaccharides exhibit anti-osteoporosis effects by balancing bone resorption and bone formation, but the detailed effects and mechanism have not been systematically summarized. We performed a comprehensive review of the literature to consolidate studies for the period 2000–2021 by conducting electronic searches on the PubMed, CNKI, VIP, and Wanfang databases. In total, polysaccharides from 19 kinds of Chinese medicinal herbs in 54 studies have shown bone homeostasis protective properties. In vivo and in vitro experiments have demonstrated that polysaccharides present properties in the treatment of postmenopausal osteoporosis, senile osteoporosis, and glucocorticoid-induced secondary osteoporosis, especially postmenopausal osteoporosis. Moreover, a number of signalling pathways, such as the Wnt/β-catenin signalling pathway, BMP/SMAD/RUNX2 signalling pathway, OPG/RANKL/RANK signalling pathway, apoptosis pathway, and transcription factors, are regulated by polysaccharides and participate in improving bone homeostasis. This review will provide a better understanding of the anti-osteoporotic effects of polysaccharides and the concomitant modulations of signalling pathways.

Background The kinase MST4 limits inflammatory responses through direct phosphorylation of the adaptor TRAF6. TRAF6 interacts with NLRP3 to promote the activation of NLRP3 inflammasome. However, the role of MST4 in neuroinflammation after intracerebral hemorrhage (ICH) and how it interacts with NLRP3 inflammasome remain unclear. Methods Mice were administered MST4 AAV four weeks before collagenase-induced ICH. ICH mice received either hesperadin (MST4 selective inhibitor), or MCC950 (NLRP3 inflammasome selective inhibitor). Neurological deficits and brain water content were assessed. Western blot and immunofluorescence were performed to evaluate the proteins content and localization in MST4/NLRP3 signaling pathway. Results The expression of endogenous MST4 and NLRP3 was increased after ICH compared to sham group. MST4 and NLRP3 were respectively colocalized in microglia. Upregulation of MST4 gene inhibited the activation of NLRP3 inflammasome, the release of IL-1β and TNF-α, and significantly improved brain edema and neurological deficits. Hesperadin pretreatment inhibited the expression of MST4 and increased the expression of NLRP3 inflammasome-mediated proteins, which aggravated neurological deficits and cerebral edema. MCC950 markedly alleviated neurological deficits and brain edema but had no effect on the expression of MST4 protein. Conclusions MST4 alleviates inflammatory progression and brain injury in ICH mice possibly by inhibiting NLRP3 inflammasome activation.

The transoral endoscopic thyroidectomy vestibular approach has been demonstrated to have similar surgical outcomes as open thyroidectomy for selected papillary thyroid carcinomas. This study aimed to evaluate and compare the surgical outcomes and safety of the transoral endoscopic thyroidectomy vestibular approach with those of open thyroidectomy in the treatment of papillary thyroid carcinoma with a diameter between1 cm and ≤3.5cm.We retrospectively reviewed all patients who had papillary thyroid carcinoma that was between1 cm and ≤3.5 cm in diameter and who had undergone the transoral endoscopic thyroidectomy vestibular approach (n = 96) or an open thyroidectomy (n = 425) from January 2017 to June 2020. We then performed 1:1 propensity score matching, yielding 78 matched pairs. Afterward, surgical outcomes and follow-up data were compared between the 2 matched groups.Compared with the matched open thyroidectomy group, the papillary thyroid carcinoma group had a significantly longer operative time (P.001), more blood loss (P.05), higher postoperative white blood cell count (P.05), higher C-reactive protein (P.001), more total drainage volume (P.001), increased surgical cost (P.05), better cosmetic satisfaction (P.001), lower scar self-consciousness (P.001), and better quality of life (P.001). We observed no significant differences in the incidence of other outcomes, including the number of retrieved lymph nodes and metastatic central lymph nodes, the rate of intraoperative recurrent laryngeal nerve signal weakened and parathyroid autotransplantation, visual analog scale scores for pain, drainage duration, postoperative hospital stay, rate of complications, and oncologic completeness. We observed no conversion to open thyroidectomy and no intraoperative capsular disruption in the transoral endoscopic thyroidectomy vestibular approach group. There was 1 case of persistent nodal disease in the transoral endoscopic thyroidectomy vestibular approach group. No recurrence was observed in the 2 groups during the follow-up period.The transoral endoscopic thyroidectomy vestibular approach is feasible in selected patients with papillary thyroid carcinoma, not only because it is cosmetically advantageous but also because it is surgical and oncologically safe and may be an optional surgical method for treating papillary thyroid carcinomas having a diameter between1 cm and ≤3.5 cm.

Background Acute mesenteric ischemia is a common surgical emergency. Restoration of blood flow is a critical objective of treating this pathology. However, many patients suffer from ischemia-reperfusion (I/R) injuries at the time of revascularization, requiring prolonged hospitalizations. B-1a cells are a subtype of B lymphocytes with roles in regulating inflammation and tissue injury by spontaneous release of natural IgM and IL-10. We hypothesized that treatment with B-1a cells protects mice from intestinal I/R. Methods Mesenteric ischemia was induced in mice by placing a vascular clip on the superior mesenteric artery for 60 minutes. At the time of reperfusion, B-1a cells or PBS control were instilled into the peritoneal cavity (PerC) of mice. PerC lavage, blood, intestine, and lungs were collected 4 h after reperfusion. Serum organ injury and inflammatory markers such as ALT, AST, LDH, lactate, IL-6, as well as lung and gut histology and myeloperoxidase (MPO) were assessed. Results In intestinal I/R, B-1a cell frequency and number in the PerC were significantly decreased compared to sham-operated mice. There was an increase in the serum levels of ALT, AST, LDH, lactate, and IL-6 when comparing the vehicle group with the sham group. These increases were significantly reduced in the B-1a cell treated group. B-1a cell treatment significantly decreased the intestine and lung injury scores as well as MPO content, compared to vehicle treated mice. B-1a cell treatment resulted in a reduction of apoptotic cells in these tissues. Serum IgM levels were decreased in intestinal I/R, while treatment with B-1a cells significantly increased their levels towards normal levels. Conclusions B-1a cell treatment at the time of mesenteric reperfusion ameliorates end organ damage and reduces systemic inflammation through the improvement of serum IgM levels. Preserving B-1a cells pool could serve as a novel therapeutic avenue in intestinal I/R injury.

Background Nontuberculous mycobacterial pulmonary disease (NTM-PD) is an uncommon mycobacterial infection characterized by worsening lung function and increased health care resource utilization; however, the overall risk for hospitalization among patients with NTM-PD remains unclear. Research Question What is the hospitalization risk among older adults with NTM-PD? Study Design and Methods A retrospective, nested, case-control study was conducted by using the Medicare claims database. Cases were defined as patients with ≥ 2 NTM-PD claims ≥ 30 days apart between January 1, 2007, and December 31, 2015. The study included individuals aged ≥ 65 years with ≥ 12 months of continuous enrollment in both Parts A and B before the first NTM-PD diagnosis. Cases were matched 1:2 to Medicare beneficiaries without NTM-PD (control subjects) according to age and sex. Hospitalizations following the first NTM-PD claim were compared between case and control subjects by using univariate and multivariate analyses. Results A total of 35,444 case subjects and 65,467 matched control subjects (mean age, 76.6 years; 70% female; ≥ 87% White) were identified. Baseline comorbidities, particularly pulmonary comorbidities, were more common in case subjects than in control subjects (81.1% vs 17.7% for COPD; 44.6% vs 0.6% for bronchiectasis). All-cause hospitalization was observed in 65.7% of case subjects and 44.9% of control subjects. Unadjusted annual hospitalization rates were significantly (P < .05) greater among case subjects than control subjects. Case subjects also had a significantly shorter time to hospitalization than control subjects. The increased burden due to hospitalization was reflected in multivariate analysis adjusting for baseline comorbidities. All-cause hospitalization in patients with NTM-PD relative to control subjects was 1.2 times more likely (relative risk, 1.23; 95% CI, 1.21-1.25; P < .0001) with a 46% greater hazard (hazard ratio, 1.46; 95% CI, 1.43-1.50; P < .0001). Interpretation Patients with NTM-PD were significantly more likely to be hospitalized, had greater annualized hospitalization rates, and had shorter time to hospitalization than age- and sex-matched control subjects without NTM-PD. These findings highlight the significantly increased burden of hospitalizations among patients with NTM-PD., Graphical Abstract

Background and Purpose: This study tests whether patients with unruptured intracranial aneurysm who underwent stent placement benefitted from platelet function monitoring–guided adjustment of antiplatelet therapy. Methods: We conducted a randomized, open-label, parallel group, assessor-blinded trial. Patients with unruptured intracranial aneurysm who underwent stent placement were assigned in a 1:1 ratio to receive either drug adjustment (patients who had high on-treatment platelet reactivity to antiplatelet therapy on the basis of platelet function monitoring [monitoring group]) or conventional therapy (without monitoring and drug adjustment [conventional group]). The second monitoring was performed 14 days after randomization in patients with drug adjustment. The primary outcome was the composite frequency of ischemic stroke, transient ischemic attack, stent thrombosis, urgent revascularization, and cerebrovascular death within 7 days after stent implantation. The safety outcome was the composite frequency of major, minor, or minimal bleeding within 1 month after stent implantation. Results: In total, 314 patients were included (n=157 per group). The primary combined outcome occurred in 19 patients (12.1%) in the conventional group and 8 patients (5.1%) in the monitoring group (hazard ratio, 0.39 [95% CI, 0.17–0.92]; P =0.03). Ischemic stroke occurred at a lower frequency in the monitoring group compared with that in the conventional group (4.5% versus 12.1%; hazard ratio, 0.34 [95% CI, 0.14–0.83]; P =0.01), which drove the overall primary combined outcome. The safety outcome occurred in the monitoring group (7.0%) and in the conventional group (1.9%; hazard ratio, 3.87 [95% CI, 1.06–14.14]; P =0.03). A significant difference was observed in the frequency of minor or minimal bleeding events between the two groups (monitoring group versus conventional group, 6.4% versus 1.3%; P =0.02) but not in the frequency of major bleeding events between the two groups. Conclusions: Platelet function monitoring–guided antiplatelet therapy reduces thromboembolic events in patients with unruptured intracranial aneurysm after stent placement, significantly enhancing minor or minimal bleeding events but not major bleeding events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03989557.

The current study sought to examine longitudinal changes of dysphagia in Parkinson’s disease, identify predictors of dysphagia aggravation and elucidate the influence of dysphagia on other symptoms in Parkinson’s disease patients. Forty-eight patients with Parkinson’s disease were enrolled. All patients underwent videofluoroscopic study of swallowing evaluation and a battery of neuropsychological assessments at baseline in 2014 and at follow-up in 2020. We used t-tests or Wilcoxon tests for comparative analysis between patients with/without dysphagia and comparative analysis of longitudinal data. We used Spearman’s correlation analysis to examine predictors of dysphagia aggravation, and the Wilcoxon test to compare neuropsychological aggravation between patients with/without dysphagia at baseline. Swallowing function, cognitive function, depression, anxiety, and quality of life were aggravated at follow-up. Dysphagia prevalence increased from 27.08 at baseline to 39.58% at follow-up. Spearman’s correlation results showed that dysphagia was more likely to become aggravated in male patients compared with female patients (P = 0.0049). Cognitive impairment at baseline was significantly related to dysphagia aggravation (P = 0.042). Patients with dysphagia at baseline exhibited a significantly greater increase in anxiety scores than patients without dysphagia at baseline (P = 0.021). The results revealed that male sex and cognitive impairment predicted worsening dysphagia in Parkinson’s disease patients, and suggested that dysphagia may have a negative impact on anxiety in Parkinson’s disease patients. The results highlight the importance of swallowing function screening and necessary instrumental checks, such as videofluoroscopic study of swallowing, in Parkinson’s disease patients.

Purpose: We assessed whether perioperative circulating tumor DNA (ctDNA) could be a biomarker for early detection of molecular residual disease (MRD) and prediction of postoperative relapse in resected non–small cell lung cancer (NSCLC). Experimental Design: Based on our prospective, multicenter cohort on dynamic monitoring of ctDNA in lung cancer surgery patients (LUNGCA), we enrolled 950 plasma samples obtained at three perioperative time points (before surgery, 3 days and 1 month after surgery) of 330 stage I–III NSCLC patients (LUNGCA-1), as a part of the LUNGCA cohort. Using a customized 769-gene panel, somatic mutations in tumor tissues and plasma samples were identified with next-generation sequencing and utilized for ctDNA-based MRD analysis. Results: Preoperative ctDNA positivity was associated with lower recurrence-free survival (RFS; HR = 4.2; P < 0.001). The presence of MRD (ctDNA positivity at postoperative 3 days and/or 1 month) was a strong predictor for disease relapse (HR = 11.1; P < 0.001). ctDNA-based MRD had a higher relative contribution to RFS prediction than all clinicopathologic variables such as the TNM stage. Furthermore, MRD-positive patients who received adjuvant therapies had improved RFS over those not receiving adjuvant therapy (HR = 0.3; P = 0.008), whereas MRD-negative patients receiving adjuvant therapies had lower RFS than their counterparts without adjuvant therapy (HR = 3.1; P < 0.001). After adjusting for clinicopathologic variables, whether receiving adjuvant therapies remained an independent factor for RFS in the MRD-positive population (P = 0.002) but not in the MRD-negative population (P = 0.283). Conclusions: Perioperative ctDNA analysis is effective in early detection of MRD and relapse risk stratification of NSCLC, and hence could benefit NSCLC patient management.

Significance: Sepsis is defined as a life-threatening organ dysfunction caused by dysregulated host response to infection. This leads to an uncontrolled inflammatory response at the onset of infection, followed by immunosuppression. The development of a specific treatment modality for sepsis is still challenging, reflecting our inadequate understanding of its pathophysiology. Understanding the mechanism and transition of the early hyperinflammation to late stage of immunosuppression in sepsis is critical for developing sepsis therapeutics. Recent Advances: Damage-associated molecular patterns (DAMPs) are intracellular molecules and released upon tissue injury and cell death in sepsis. DAMPs are recognized by pattern recognition receptors to initiate inflammatory cascades. DAMPs not only elicit an inflammatory response but also they subsequently induce immunosuppression, both are equally important for exacerbating sepsis. Recent advances on a new DAMP, extracellular cold-inducible RNA-binding protein for fueling inflammation and immunosuppression in sepsis, have added a new avenue into the dual functions of DAMPs in sepsis. Critical Issues: The molecular modification of DAMPs and their binding to pattern recognition receptors transit dynamically by the cellular environment in pathophysiologic conditions. Correlation between the dynamic changes of the impacts of DAMPs and the clinical outcomes in sepsis still lacks adequate understanding. Here, we focus on the impacts of DAMPs that cause inflammation as well as induce immunosuppression in sepsis. We further discuss the therapeutic potential by targeting DAMPs to attenuate inflammation and immunosuppression for mitigating sepsis. Future Directions: Uncovering pathways of the transition from inflammation to immunosuppression of DAMPs is a potential therapeutic avenue for mitigating sepsis.

The folate-mediated one-carbon metabolism pathway is thought to play an important role in the etiology of non-syndromic oral clefts (NSOFC), although none of the genes in this pathway has shown significant signals in genome-wide association studies (GWAS). Recent evidence indicated that enhanced understanding could be gained by aggregating multiple SNPs effect simultaneously into polygenic risk score (PRS) to assess its association with disease risks. This study is aimed to assess the association between the genetic effect of folate-mediated one-carbon metabolism pathway and NSOFC risks using PRS based on a case-parent trio design. A total of 297 SNPs mapped from 18 genes in the folate-mediated one-carbon metabolism pathway were aggregated from a GWAS of 2458 case-parent trios recruited from an international consortium. We found a PRS based on the folate-mediated one-carbon metabolism pathway was significant among all NSOFC trios (OR = 1.95, 95% CI: 1.66-2.28, p = 2.39 × 10-16 ), as well as two major subtypes, non-syndromic cleft lip with or without cleft palate (NSCL/P) trios (OR = 1.71, 95% CI: 1.50-1.96, p = 7.66 × 10-15 ) and non-syndromic cleft palate only (NSCPO) trios (OR = 1.51, 95% CI: 1.36-1.68, p = 2.1 × 10-14 ). Similar results were also observed in further subgroup analyses stratified into Asian and European trios. The averaged PRS of the folate-mediated one-carbon metabolism pathway varied between the NSOFC case group and its comparison group (p

BACKGROUND Recent studies have revealed that the nasal microbiota in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) is profoundly altered and is correlated with systemic inflammation. However, little is known regarding whether the microbiota can be utilized to predict nasal polyp recurrence. This study is aimed to determine whether altered nasal microbiota constituents could be used as biomarkers to predict CRSwNP recurrence. METHODS Nasal microbiota constituents were quantified and characterized using bacterial 16S ribosomal RNA gene sequencing. Selected features for least absolute shrinkage and selection operator regression-based predictors were the nasal microbiota community composition and CRSwNP patient clinical characteristics. The primary outcome was recurrence, which was determined post-admission. RESULTS By distinguishing recurrence-associated nasal microbiota taxa and exploiting the distinct nasal microbiota abundance between patients with recurrent and non-recurrent CRSwNP, we developed a predictive classifier for the diagnosis of nasal polyps' recurrence with 91.4% accuracy. CONCLUSIONS Key taxonomical features of the nasal microbiome could predict recurrence in CRSwNP patients. The nasal microbiome is an understudied source of clinical variation in CRSwNP and represents a novel therapeutic target for future prevention and treatment.

Objective Helicobacter pyloriinfection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-basedH. pyloriinfection control and management to reduce the related disease burden. Methods Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements. Results Experts discussed and modified the original 23 statements on family-basedH. pyloriinfection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1)H. pyloriinfection and transmission among family members, (2) prevention and management ofH. pyloriinfection in children and elderly people within households, and (3) strategies for prevention and management ofH. pyloriinfection for family members. In addition to the ‘test-and-treat’ and ‘screen-and-treat’ strategies, this consensus also introduced a novel third ‘family-basedH. pyloriinfection control and management’ strategy to prevent its intrafamilial transmission and development of related diseases. Conclusion H. pyloriis transmissible from person to person, and among family members. A family-basedH. pyloriprevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.

In this letter, an enhanced machine learning (ML) framework combining radial phase grating (RPG) and channel information has been proposed for underwater wireless optical orbital angular momentum (OAM) communications. The optical irradiance profile and diffraction pattern are simulated by the combination of split-step angular-spectrum propagation and Monte Carlo methods, then they were embedded by the convolution and fully connected layers. The transfer learning-based ML architectures are trained by the image features and the embedding channel information with fine-tuning. The impacts of oceanic turbulence, seawater types, and transmission distance are considered. Results show that the transfer learning-based OAM detectors could achieve the order-of-magnitude gain in the bit error rate. Besides, the proposed ML framework could combine with a variety of state-of-the-art methods and thus improve the system performance. This work indicates transfer learning-based ML frameworks have great potential in ML-based OAM communication systems.

Thin-walled pipes have been widely used in chemical facilities and propulsion structures, where the distortion problem induced by welding fabrication is common and prominent, deteriorating assembly accuracy and even reducing load-bearing capacity. External constraint has shown great capacity to control the residual stresses and welding deformation. The objective of this research is to investigate the effect of constraint on welding process in thin-walled 304 stainless steel pipes through experiments and numerical simulation. To include the clamping effect in the welding simulation, the external constraint was modeled as the additional heat dissipation and mechanical restraint. The seam welded pipes with and without constraints were both modeled for comparison purpose. Good agreement was obtained between numerical modelling and measurements in both pipes. The results show that the welding deformation and residual stresses are both obviously reduced under the effect of external constraint, which was found to work mainly in the cooling process by generating more tensile plastic strain so as to reduce the shrinkage force in both axial and hoop directions. The maximum distortion is observed on the middle section of constrained pipe and on the end sections in the unconstrained one, which is caused by the combined effect of bending direction on the circumference and shrinkage force in the axial direction according to the inherent strain analysis. Moreover, the analysis of welding deformation mode reveals that the inward bending induced by hoop constraint contributes to the dimensional accuracy of the pipe ends under axial shrinkage forces. Parametric simulation analysis of the external constraint strategy was performed, and the results showed that reducing the constraint distance was the most effective way to mitigate welding distortion in seam welded pipes.

Both road users and road administrators are keen to know traffic flow of fine-grained vehicle type. Successful prediction on the traffic flow of heavy, medium and small vehicle could contribute to the improvement of travel safety and efficiency. However, the classification on vehicle type is always not accurate enough using in practice. It could cost a lot to identify from the additional video cameras to cover the full-length of large-scale freeway with high-resolution to capture vehicles clearly. In this paper, empirical data are cleaned, normalized, compensated, filled, decoded and filtered with help of the fusion of vehicle detector data, remote microwave sensors data and toll collection data. The traffic flows of fine-grained heavy, medium and small vehicles are successfully reconstructed. Improved deep belief network (DBN) are then proposed to forecast traffic flow of different types of vehicles in 30-, 60- and 120-minutes time interval. Random-selected road segments on a ring way around a city are trained with data accumulated three months and predict data in the next month. According to prediction error analysis, the proposed method performs better in estimation and forecasting, with respect to the existing methods, especially for longer time prediction and heavy vehicle prediction. It would benefit traffic control to prevent freeway congestion escalation, protect the traffic infrastructure via heavy vehicle control, reduce the road risk, prompt quick emergency response and eventually contributes to more applications for intelligent transportation system (ITS).

BACKGROUND Medial displacement calcaneal osteotomy (MDCO) is frequently used for the surgical correction of flatfoot. This study aims to investigate the biomechanical effect of the different diagonal screw design on a novel-designed embedded calcaneal plate for MDCO using finite element analysis (FEA), mechanical test and digital image correlation (DIC) measurement. METHODS Four groups according to the varied implanted plate were set as control group (Group 1), non-diagonal screw (Group 2), one-diagonal screw (Group 3), and two-diagonal screws groups (Group 4). For FEA, A 450 N load was applied to on the anterior process of the calcaneus from top to bottom. Observational indices included the stress on the cortical and cancellous bone of the calcaneus surrounding the implant, the plate itself as well as screws, and the displacement of the overall structure. In addition, this study also used in vitro biomechanics test to investigate the stiffness of the structure after implantation, and used DIC to observe the displacement of the calcaneus structure after external force. RESULTS Under a simulated load in FEA, there are significant overall instability and high stress concentration on the calcaneal surrounding host bone and the plate/screws system, respectively, in group 2 compared with other groups. Regard to the mechanical testing with DIC system, significant increased rotation stability, maximum force and stiffness with the addition of diagonal screws. In comparison to Group 2, the increase of 112% and 157% in maximum force as well as 104% and 176% in stiffness were found in Group 3 and 4, respectively. CONCLUSION For reducing stress concentration and enhancing overall stability, more than one-diagonal screw design is recommended and two-diagonal screws design will be superior. This study provided biomechanical references for further calcaneal implants design to prevent clinical failure after MDCO.

Blood vessel dysfunction causes several retinal diseases, including diabetic retinopathy, familial exudative vitreoretinopathy, macular degeneration and choroidal neovascularization in pathological myopia. Vascular endothelial growth factor (VEGF)-neutralizing proteins provide benefits in most of those diseases, yet unsolved haemorrhage and frequent intraocular injections still bothered patients. Here, we identified endothelial CD146 as a new target for retinal diseases. CD146 expression was activated in two ocular pathological angiogenesis models, a laser-induced choroid neovascularization model and an oxygen-induced retinopathy model. The absence of CD146 impaired hypoxia-induced cell migration and angiogenesis both in cell lines and animal model. Preventive or therapeutic treatment with anti-CD146 antibody AA98 significantly inhibited hypoxia-induced aberrant retinal angiogenesis in two retinal disease models. Mechanistically, under hypoxia condition, CD146 was involved in the activation of NFκB, Erk and Akt signalling pathways, which are partially independent of VEGF. Consistently, anti-CD146 therapy combined with anti-VEGF therapy showed enhanced impairment effect of hypoxia-induced angiogenesis in vitro and in vivo. Given the critical role of abnormal angiogenesis in retinal and choroidal diseases, our results provide novel insights into combinatorial therapy for neovascular fundus diseases.

Research suggests that to eliminate undesirable effects of the scale layer, natural wool needs to be surface-modified before further application to textile manufacture, obtaining better properties ...

The discriminative optimization (DO) algorithm has been successful in three-dimensional LIDAR rigid point cloud registration. However, its feature descriptor is local, which may restrict the robust...

This paper compares different track model formulations for the simulation of dynamic vehicle–track interaction in switches and crossings (S&C, turnouts) in a multi-body simulation (MBS) environment. The investigations are an extension of the S&C simulation Benchmark with the addition of a finite element model of a 60E1-760-1:15 turnout. This model constitutes a common reference from which four different track formulations are derived: co-running, modal superposition, finite element incorporated into the MBS model and finite element coupled to MBS using a co-simulation approach. For the different track models, the difference in modelling technique, results, simulation time, and suitability for different simulation tasks is compared. A good agreement is found between the different track model formulations for wheel–rail contact forces and rail displacements. This study found a better agreement between co-running and structural track models compared to previous studies in the prediction of wheel–rail contact forces. This appears to be due to the increased complexity of co-running track model used in this study together with a tuning of the co-running track model to the reference model in a wider frequency range. For the reader interested to reproduce the results in this paper, the reference track model is available for download.

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

Deep-layer autoencoder (DAE) provides a powerful way for medical image analysis, while it remains a daunting challenge due to the limited samples but high dimension. In this paper, a DAE with sparse and graph Laplacian regularization, termed as GSDAE, is presented to identify significant differences of dynamic functional connectivity (dFC) between child and young adult groups. The proposed model incorporates prior knowledge into sparse learning, i.e., the intrinsic structural information defined by manifold in the data. In this way, the reconstruction ability of unsupervised DAE can be improved, which facilitates the extraction of most discriminative features of dFC changing with age. Results on the fMRI data from the Philadelphia Neurodevelopmental Cohort project reveal essential differences lying in the reoccurrence patterns of dFC and in the connectivity of resting state networks with increasing age, e.g., there exist different trajectories of connectivity patterns in brain functions: those associated with complex cognitive functions generally decreased, while those associated with basic visual or motor control functions usually enhanced. In addition, the brain circuitry moves from segregation to integration during brain development.

Purpose: The aim of this study was to retrospectively evaluate contrast-enhanced ultrasound (CEUS) findings in patients with peliosis hepatis (PH).Methods: A retrospective analysis was conducted of CEUS features in 24 patients with histopathologically confirmed PH (11 men and 13 women; mean age, 32.4±7.1 years; range, 28 to 41 years). All lesions were histologically proven, either by core needle biopsy (n=10) or by hepatic surgery (n=14).Results: The mean size was 36.8±12.4 mm (range, 10 to 80 mm). On B-mode ultrasonography (BMUS), all PH lesions were heterogeneously hypoechoic, with well-defined margins but irregular shapes. No mass effect was observed. During the arterial phase of CEUS, all lesions displayed mild heterogeneous hyperenhancement (83.3%, 20/24) or isoenhancement (16.7%, 4/24). Furthermore, 87.5% of the PH lesions showed mild washout after 1 minute in the portal venous phase (30-120 seconds) and mild washout in the late phase (>120 seconds).Conclusion: The lack of a mass effect on BMUS, mild heterogeneous arterial hyperenhancement, and washout in the very late portal venous phase (after 1 minute) on CEUS are characteristic of PH. Although it is a histological diagnosis, PH should be considered in the differential diagnosis when the clinical context does not favor a malignancy or infection.

An in-tool, on-wafer detectors’ array for monitoring deep ultraviolet (DUV) light is proposed and demonstrated in this work. The proposed electronic layer detectors array (ELDA) features FinFET CMOS compatibility and compact pixel structure. Its minimum pixel pitch can reach 0.7 $\mu \text{m}$ , enabling the realization of high spatial resolution array. Most importantly, the sensing results from DUV exposure can be stored in the in-pixel storage node for days without external power supply, providing offline electrical nondestructive measurement and readout.

In order to improve the accuracy of hail forecasting for mountainous and plateau areas in China, this study presents a novel fusion forecast model based on machine learning techniques. Specifically, known mechanisms of hail formation and two newly proposed elevation features calculated from radar data, sounding data, automatic station data, and terrain data, are firstly combined, from which a hail/short-duration heavy rainfall (SDHR) classification model based on the random forest (RF) algorithm is built up. Then, we construct a hail/SDHR probability identification (PI) model based on the Bayesian minimum error decision and principal component analysis methods. Finally, an “and” fusion strategy for coupling the RF and PI models is proposed. In addition to the mechanism features, the new elevation features improve the models’ performance significantly. Experimental results show that the fusion strategy is particularly notable for reducing the number of false alarms on the premise of ensuring the hit rate. A comparison with two classical hail indexes shows that our proposed algorithm has a higher forecasting accuracy for hail in mountainous and plateau areas. All 19 hail cases used for testing could be identified, and our algorithm is able to provide an early warning for 89.5% (17 cases) of hail cases, among which 52.6% (10 cases) receive an early warning of more than 42 minutes in advance. The PI model sheds new light on using Bayesian classification approaches for high-dimensional solutions.

BACKGROUND: The appropriate ventilation mode for one-lung ventilation (OLV) in infants undergoing video-assisted thoracoscopic surgery (VATS) remains controversial. Here we investigated the effect of ventilatory mode “pressure-controlled ventilation-volume guaranteed” (PCV-VG) on the airway pressures and oxygenation parameters by comparing it with volume-controlled ventilation (VCV). METHODS: We retrospectively analyzed the clinical data of infants aged 2 to 12 months who underwent extratracheal bronchial blockage for OLV in our center between January 2017 and August 2020. The infants were divided into two groups according to the OLV pattern: group G (n=30, receiving PCV-VG) and group V (n=28, receiving VCV). Mean arterial pressure (MAP), heart rate (HR), maximum inspiratory pressure (P(peak)), mean airway pressure (P(mean)), dynamic compliance (Cdyn), partial arterial pressure of oxygen (PaO(2)) was measured and compared between these two groups 10 min before OLV (T1), 30 min after the onset of OLV (T2) and 15 min after OLV (T3). The possible occurrence of hypoxemia and hypotension during OLV was monitored. RESULTS: Compared to group V, group G had significantly higher PaO(2)and C(dyn) (both P0.05). The incidence of hypoxemia was significantly higher in group V than in group G (P0.05). CONCLUSIONS: Mechanical ventilation using the PCV-VG mode is possible in infants when performing OLV during VATS. Compared to VCV, PCV-VG can offer lower P(peak) and P(mean), improve lung compliance, and achieve better oxygenation.

AIMS: Heart failure (HF) is common in both men and women, yet disease pathophysiology, presentation, and progression differ between sexes. Studies addressing whether biomarkers predict new onset HF sex-specifically are scarce. This study therefore aims to test the sex-specificity of 252 protein biomarkers for new-onset HF. METHODS AND RESULTS: A matched case-control design in patients selected from cohorts within the HOMAGE consortium was used. Cases (new-onset HF, n = 562) and controls (n = 780) were matched for cohort (PREDICTOR, HEALTH-ABC, & PROSPER), follow-up time (defined as time from entry to incident HF), and age. Incident HF was defined as first hospitalization for HF. Targeted plasma proteins (n = 252) were measured using Proximity Extension Assay technology from O-link. To look for sex differences for new onset HF, we adjusted for cohort, age, and baseline clinical parameters. At baseline, women had a biomarker profile reflecting activated metabolism and immune responses. However, none of the biomarkers had a significant interaction with sex in predicting new onset HF, but four biomarkers had a trend towards sex-specificity (P