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Does enhanced regulatory transparency facilitate alignment of private and public enforcement? Utilizing the SEC's 2004 decision to publicly disclose its comment letters, we explore the actions of the SEC and shareholder litigants. We find the two parties converge more on enforcement targets after the public disclosure. The increased alignment is attributable to public scrutiny of SEC oversight enhancing regulator incentives and reducing regulatory capture, and to shareholder plaintiffs gaining information previously accessible only by regulators, enabling litigants to identify cases with “merit.” These findings suggest regulatory transparency enhances the complementarity of public and private enforcement, potentially improving enforcement outcomes.

Purpose: To establish recommended phase II dose (RP2D) in phase I and evaluate safety and efficacy of abivertinib in patients with EGFR Thr790Met point mutation (T790M)-positive(+) non–small cell lung cancer (NSCLC) with disease progression from prior EGFR inhibitors in phase II. Patients and Methods: This multicenter, open-label study included 367 adult Chinese patients. Abivertinib at doses of 50 mg twice a day to 350 mg twice a day was evaluated in phase I in continual 28-day cycles, and the RP2D of 300 mg twice a day was used in phase II in continual 21-day cycles. Primary endpoints include RP2D in phase I and objective response rate (ORR) at RP2D in phase II. Results: The RP2D of 300 mg twice a day for abivertinib was established based on pharmacokinetics, efficacy, and safety profiles across doses in phase I. In phase II, 227 patients received RP2D for a median treatment duration of 24.6 weeks (0.43–129). Among 209 response–evaluable patients, confirmed ORR was 52.2% [109/209; 95% confidence interval (CI): 45.2–59.1]. Disease control rate (DCR) was 88.0% (184/209; 95% CI: 82.9–92.1). The median duration of response (DoR) and progression-free survival (PFS) was 8.5 months (95% CI: 6.1–9.2) and 7.5 months (95% CI: 6.0–8.8), respectively. The median overall survival (OS) was 24.9 months [95% CI: 22.4–not reachable (NR)]. All (227/227) patients reported at least 1 adverse event (AE), with 96.9% (220/227) of treatment-related AEs. Treatment-related serious AEs were reported in 13.7% (31/227) of patients. Death was reported in 4.4% (10/227) of patients, and none was deemed as treatment-related. Conclusions: Abivertinib of 300 mg twice a day demonstrated favorable clinical efficacy with manageable side effects in patients with EGFR T790M+ NSCLC.

To explore effects of dexmedetomidine (Dex) on cognitive function and hippocampal neuronal apoptosis in rats anesthetized with sevoflurane (Sevo), and regulation of brain-derived neurotrophic factor (BDNF) and its downstream signaling. 30 Sprague-Dawley (SD) rats were randomly divided into control group inhaled 29% concentration oxygen), Sevo group (2 L/min oxygen flow +1.5% Sevo), Dex+Sevo group (after injection of 20 μg/kg Dex, treated with 2L/min oxygen flow+1.5% Sevo). Haematoxylin and eosin (HE) staining and Nissl’s staining were adopted to detect morphological and functional changes in hippocampus of rats. Apoptosis was detected by immunofluorescence, BDNF expression was detected by immunohistochemistry. Reverse transcription PCR (RT-PCR) was conducted to detect mRNA expression of key proteins in downstream signaling of BDNF. The results showed that Sevo induced apoptosis of hippocampus neurons, while Dex improved Sevo induced apoptosis. In contrast to the control, the positive expression of BDNF in hippocampus of Sevo group was notably decreased (P < 0.05), and that of Dex+Sevo group was notably higher in contrast to Sevo group (P < 0.05). Signaling pathways of MAPK, PI3K-Akt, and Ras were predicted by String software as the downstream pathways of BDNF. RT-PCR results showed that these 3 signaling pathways were involved in Dex improving Sevo-induced cognitive impairment and hippocampal neuron apoptosis. In conclusion, Dex could improve cognitive dysfunction and hippocampal neuron apoptosis in rats induced by Sevo, and the mechanism was related to upregulation of BDNF expression and activation of pathways of MAPK, PI3K-Akt, and Ras.

Perovskite solar cells (PSCs) are one of the most prominent photovoltaic technologies. However, PSCs still encounter great challenges of scaling up from laboratorial cells to industrial modules without serious performance loss while maintaining excellent long-term stability, owing to the resistive losses and extra instability factors that scale quadratically with the device area. Here, we manifest a concept of multifunctional interface modulation for highly efficient and stable perovskite solar modules (PSMs). The advisably designed multifunctional interface modulator GO/QD crosslinks the CsPbBr3 perovskite quantum dots (QDs) on the conductive graphene oxide (GO) surfaces, which significantly improve charge transport and energy band alignment at the perovskite/hole transporting layer interface to reduce the charge transport resistance while passivating the surface defects of the perovskite to inhibit carrier recombination resistive losses. Moreover, the GO/QD interlayer acts as a robust permeation barrier that modulates the undesirable interfacial ion and moisture diffusion. Consequently, we adopt a scalable vacuum flash-assisted solution processing (VASP) method to achieve a certified stabilized power output efficiency of 17.85% (lab-measured champion efficiency of 18.55%) for the mini-modules. The encapsulated PSMs achieve over 90% of their initial efficiency after continuous operation under 1 sun illumination and the damp heat test at 85 °C, respectively. This journal is, The authors acknowledge financial from the National Natural Science Foundation of China (21875081, 91733301, and 51972251), the Chinese National 1000-Talent-Plan program, the Foundation of State Key Laboratory of Coal Conversion (Grant No. J18-19-913), and the Frontier Project of the Application Foundation of Wuhan Science and Technology Plan Project (2020010601012202).

PURPOSE To determine differences in cycloplegic vs. non-cycloplegic refractive error and factors associated with these differences in Chinese school students. METHOD In this cross-sectional school-based study, refractive error was measured in school students using a NIDEK autorefractor before and after administration of 0.5% tropicamide. Spherical equivalent (SER) in diopters (D) was calculated as sphere plus half cylinder. SER differences before vs. after cycloplegia were evaluated using mean, standard deviation (SD), 95% limits of agreement. Univariable and multivariable regression models were used to determine factors associated with SER differences. RESULTS Among 3604 students, 3450 (95.7%) provided data for analysis. Mean age (SD) was 9.7 (3.6) years. The mean SER (SD) was -1.12 (1.97) D before cycloplegia, and -0.20 (2.19) D after cycloplegia, with a mean difference of 0.92 D (95% limits of agreement: -0.93 to 2.78 D). Among 196 eyes with non-cycloplegic SER -6.0 D or worse (e.g., met high myopia definition), 71.4% had cycloplegic SER -6.0 D or worse, and among 3607 eyes with non-cycloplegic SER -0.5 D or worse (e.g., met myopia definition), 62.1% eyes had cycloplegic SER -0.5 D or worse. Cycloplegic SER was more correlated with axial length than non-cycloplegic SER (Pearson r = 0.82 vs. 0.72, p

In practical applications, particularly in flexible manufacturing systems, there is a high level of uncertainty. A type-2 fuzzy logic system (T2FS) has several parameters and an enhanced ability to handle high levels of uncertainty. This article proposes an improved artificial immune system (IAIS) algorithm to solve a special case of the flexible job shop scheduling problem (FJSP), where the processing time of each job is a nonsymmetric triangular interval T2FS (IT2FS) value. First, a novel affinity calculation method considering the IT2FS values is developed. Then, four problem-specific initialization heuristics are designed to enhance both quality and diversity. To enhance the exploitation abilities, six local search approaches are conducted for the routing and scheduling vectors, respectively. Next, a simulated annealing method is embedded to accept antibodies with low affinity, which can enhance the exploration abilities of the algorithm. Moreover, a novel population diversity heuristic is presented to eliminate antibodies with high crowding values. Five efficient algorithms are selected for a detailed comparison, and the simulation results demonstrate that the proposed IAIS algorithm is effective for IT2FS FJSPs.

There is no specific drug for coronavirus disease 2019 (COVID-19). We aimed to investigate the possible clinical efficacy of moderate-dose vitamin C infusion among inpatients with severe COVID-19. Data of 397 adult patients with severe COVID-19 admitted to a designated clinical center of Wuhan Union Hospital (China) between February 13 and February 29, 2020, were collected. Besides standard therapies, patients were treated with vitamin C (2–4 g/day) or not. The primary outcome was all-cause death. Secondary outcome was clinical improvement of 2 points on a 6-point ordinal scale. About 70 participants were treated with intravenous vitamin C, and 327 did not receive it. No significant association was found between vitamin C use and death on inverse probability treatment weighting (IPTW) analysis (weighted hazard ratio [HR], 2.69; 95% confidence interval [CI], 0.91–7.89). Clinical improvement occurred in 74.3% (52/70) of patients in the vitamin C group and 95.1% (311/327) in the no vitamin C group. No significant difference was observed between the two groups on IPTW analysis (weighted HR, 0.76; 95% CI, 0.55–1.07). Our findings revealed that in patients with severe COVID-19, treatment with moderate dose of intravenous vitamin C had no significant benefit on reducing the risk of death and obtaining clinical improvement.

Introduction Acute-on-chronic liver failure (ACLF) patients are susceptible to invasive fungal infections. We evaluated the prognosis and antifungal options in ACLF patients with invasive pulmonary aspergillosis (IPA). Methods ACLF patients with IPA from 15 hospitals were retrospectively screened from 2011 to 2018, and 383 ACLF patients without lung infections were included from a prospective cohort (NCT02457637). Demographic, laboratory, clinical data, and 28-day outcomes were documented in the two cohorts. Results ACLF patients with probable IPA (n = 145) had greater 28-day mortality (33.6% vs. 15.7%, p

BACKGROUND Chronic liver diseases (CLD), including cirrhosis and non-cirrhotic liver diseases, are globally widespread and create a serious disease burden. Platelet count is a clinically accessible and affordable prognostic indicator of liver disease. We investigated the relationship between platelet count and 90-day prognosis in patients with acute-on-chronic liver diseases (AoCLD). METHODS A total of 3,970 patients with AoCLD from the Chinese Acute-on-Chronic Liver Failure (CATCH-LIFE) study, which included two prospective multi-center cohorts, were included in the study. We grouped the patients according to the platelet count and analyzed the 90-day adverse outcome (death or liver transplantation). RESULTS In the final analysis, 3,939 patients with AoCLD were included, of whom 2,802 had definite liver cirrhosis. The cumulative incidence of 90-day adverse outcomes in patients increased with the change of platelet group (log-rank P

PURPOSE To evaluate the diagnostic performance of LR-5 for diagnosing poorly differentiated hepatocellular carcinoma (p-HCC). To build a contrast-enhanced ultrasound (CEUS) signature for improving the differential diagnostic performance between p-HCC and intrahepatic cholangiocarcinoma (ICC). METHODS The B-mode ultrasound (BUS) and CEUS features of 60 p-HCCs and 56 ICCs were retrospectively analyzed. The CEUS LI-RADS category was assigned according to CEUS LI-RADS v2017. A diagnostic CEUS signature was built based on the independent significant features. An ultrasound (US) signature combining both BUS and CEUS features was also built. The diagnostic performances of the CEUS signature, US signature, and LR-5 were evaluated by receiver operating characteristic (ROC) analysis. RESULTS One (1.7%) p-HCC and 26 (46.4%) ICC patients presented cholangiectasis or cholangiolithiasis (P

A compact environmentally-stable mode-locked figure-9 fiber laser is reported in this paper. The laser cavity is composed of only two all-polarization-maintaining fiber components, which enjoys a concise and stable structure. As a result, vibration-immune stable fundamental single-pulse mode-locking operation can always be observed. The pulse repetition rate was measured to be 201.14 MHz which was much higher than the most of previous works. The output pulse was also measured to have a center wavelength/3-dB spectral bandwidth/radio frequency signal to noise ratio/pulse width of 1561.29 nm/20.97 nm/78 dB/510 fs, respectively. Besides, a temperature test in the range of 20 to 36 °C, together with a 12-h output performance test was explored. The measured evolutions of output power, repetition frequency, and spectrum showed the laser had excellent environmental stability, illustrating it as an easy-fabrication, environmentally-stable and compact ultrafast candidate for the scientific area of this kind.

Over the past few years, we have made great progress in image categorization based on convolutional neural networks (CNNs). These CNNs are always trained based on a large-scale image data set; however, people may only have limited training samples for training CNN in the real-world applications. To solve this problem, one intuition is augmenting training samples. In this article, we propose an algorithm called Lavagan ( La tent V ariables A ugmentation Method based on G enerative A dversarial N ets) to improve the performance of CNN with insufficient training samples. The proposed Lavagan method is mainly composed of two tasks. The first task is that we augment a number latent variables (LVs) from a set of adaptive and constrained LVs distributions. In the second task, we take the augmented LVs into the training procedure of the image classifier. By taking these two tasks into account, we propose a uniform objective function to incorporate the two tasks into the learning. We then put forward an alternative two-play minimization game to minimize this uniform loss function such that we can obtain the predictive classifier. Moreover, based on Hoeffding’s Inequality and Chernoff Bounding method, we analyze the feasibility and efficiency of the proposed Lavagan method, which manifests that the LV augmentation method is able to improve the performance of Lavagan with insufficient training samples. Finally, the experiment has shown that the proposed Lavagan method is able to deliver more accurate performance than the existing state-of-the-art methods.

Doping engineering of two-dimensional (2D) semiconductors is vital for expanding their device applications, but has been limited by the inhomogeneous distribution of doping atoms in such an ultrathin thickness. Here, we report the controlled doping of Sn heteroatoms into 2D MoS2 crystals through a single-step deposition method to improve the photodetection ability of MoS2 flakes, whereas the host lattice has been well reserved without the random aggregation of the introduced atoms. Atomic-resolution and spectroscopic characterizations provide direct evidence that Sn atoms have been substitutionally doped at Mo sites in the MoS2 lattice and the Sn dopant leads to an additional strain in the host lattice. The detection performance of Sn-doped MoS2 flakes exhibits an order of magnitude improvement (up to Rλ ≈ 29 A/W, EQE ≈ 7.8 × 103%, D* ≈ 1011 Jones@470 nm) as compared with that of pure MoS2 flakes, which is associated with electrons released from Sn atoms. Such a substitutional doping process in TMDs provides a potential platform to tune the on-demand properties of these 2D materials.

Blazed gratings are widely used in optical detection devices with the unique property of concentration of light energy to a desired diffraction order. However, traditional substrates for fabricating blazed gratings are easily damaged with the wear and tear in long-term usage under harsh conditions. Here, we propose the fabrication of blazed gratings on sapphire with high mechanical stability by femtosecond laser lithography combined with subsequent reactive ion etching (RIE). Various sapphire blazed gratings with periods from 2 μm to 10 μm and heights from 260 nm to 2 μm were realized to concentrate light energy (wavelengths of 405 nm, 532 nm and 633 nm) to different diffraction orders (1st, 2nd, and 3rd). The results provide great insights for the construction of micro-optical devices that have potential applications under harsh conditions.

With the rapid development of microgrid and large-scale grid-connected operation, the detection and location of short-circuit faults in microgrid has become a bottleneck. In this paper, a simulation model of short-circuit fault in low-voltage AC microgrid is built on PSCAD/EMTDC. The characteristics of current wavelet energy spectrum under various short-circuit fault states are studied and the early detection of faults is realized. Based on the relationship between the first peak value of fault current wavelet energy spectrum and the location of short-circuit points, a method for early detection and area location of short-circuit faults in microgrid is proposed. The simulation and experimental results show that this method can detect and locate the short-circuit fault area of microgrid quickly and accurately.

Prospective study. The main purpose of this study was to investigate whether the use of a tourniquet changes the blood coagulation state following primary total knee arthroplasty (TKA) by means of conventional coagulation tests and thromboelastography (TEG) analyses. A total of 154 patients who underwent primary unilateral TKA from January 2018 to October 2020 were enrolled. Seventy-nine patients were randomized into a tourniquet group, and 75 were randomized into a no-tourniquet group. Demographic data, surgical time, intra-operative blood loss, transfusion rate, and wound complications were collected. Complete blood count, conventional coagulation tests, and TEG were performed the day before surgery, one day after surgery, three days after surgery, and seven days after surgery. Lower extremity Doppler ultrasound was performed the day before surgery and seven days after surgery. The baseline characteristics of the patients were similar between the two groups. Hidden blood loss, transfusion rate, and wound complications were similar between the two groups, but the intra-operative blood loss of the tourniquet group was lower than that of the no-tourniquet group. The calculated total blood loss of the tourniquet group was higher than that of the no-tourniquet group. In terms of conventional coagulation tests and TEG, the tourniquet group had higher values of fibrin degradation products, D-dimer, maximum amplitude, and coagulation index (p

Objective At present, there are several guidelines for cancer complicated with VTE, but there is no specific recommendation for the treatment of lung cancer complicated with VTE. Whether is necessary to explore treatment and prevention of VTE in lung cancer. Background Venous thromboembolism (VTE) is a common complication of severe lung cancer that can entail many adverse effects for patients. The incidence of VTE is higher in patients with lung cancer than in those with other kinds of solid tumors, and it is especially high among patients with lung adenocarcinoma, at advanced tumor-node-metastasis (TNM)stages, or with a history of central venous catheter (CVC) or chemotherapy. However, the clinical symptoms of VTE in patients with lung cancer are not typical and cannot be detected easily, and the clinical prevention rate is low. In the acute phase of VTE in lung cancer, the Eastern Cooperative Oncology Group (ECOG) performance status score of patients typically ranges from 2 to 4 points, leaving end-stage maintenance therapy as the only treatment option. Methods Here, we analyze the existing literature and discuss the current status (including epidemiology, clinical manifestations, and risk factors), risk assessment tools, and the treatment and prevention of VTE in severe lung cancer. We focus particularly on the use of low-molecular-weight heparin and new oral anticoagulants (including in the management of thrombocytopenia after antitumor therapy) in lung cancer patients with VTE. Conclusions Large-scale prospective multicenter studies on the treatment and prevention of VTE in lung cancer are necessary.

Background: Secondary hypertension has emerged as a major public health problem in China. Early diagnosis and treatment can significantly improve the clinical outcomes. However, data on the current cause composition in China are seldom reported. Objective: To describe the trends in cause-related comorbidities in hospitalized patients with secondary hypertension in China from 2013 to 2016. Methods: This was a retrospective analysis based on the national Hospital Quality Monitoring System (HQMS) database, which collects information from the front pages of in-hospital medical records. Hospitalized patients with secondary hypertension from 746 tertiary hospitals that consistently uploaded data to the HQMS from 2013 to 2016 were enrolled. All diagnoses were identified using International Classification of Diseases version 10 (ICD-10) diagnostic codes. Descriptive analyses were used to determine the proportions of secondary hypertension causes and changing trends over 4 years. Result: The study collected data on 402 371 hospitalized patients with secondary hypertension from the HQMS during 2013–2016. Secondary hypertension caused by renal parenchymal disease ranked first and accounted for more than 50%. Obstructive sleep apnea syndrome (OSAS) followed closely with a rate of approximately 25%. Primary aldosteronism presented the highest proportion among all causes of endocrine hypertension. Regarding longitudinal changes over time, the rates of renal hypertension showed a significant downward trend from 2013 to 2016 (P

β-Carotene displays antioxidant and anti-inflammatory activities and prevents the development of cancer. Ulcerative colitis (UC) is a kind of inflammatory bowel disease that is accompanied by a certain risk of colon cancer. However, the role of β-carotene in the modulation of gut microbiota and UC improvement is unclear. In this research, the properties of β-carotene on anti-inflammatory and the composition of gut microbiota were evaluated in a rat model of UC induced by dextran sulfate sodium (DSS). The results revealed that β-carotene significantly (p < 0.05) decreased the severity of colitis in rats, as assessed using body weight (6.00 ± 1.73%), colon length (22.23 ± 0.53%), and disease activity index, and improved the structure of the colon damaged. Moreover, colonic levels of proinflammatory cytokines were significantly lower following β-carotene supplementation. β-Carotene intervention also lowered the expression levels of phosphorylated p65 (0.60 ± 0.02), p38 (0.57 ± 0.00), Erk (0.63 ± 0.04), and JNK (0.70 ± 0.00). The result of the relative abundance of gut microbiota showed that DSS administration significantly changed the microbial structure at the phylum and genus levels of rats. Furthermore, β-carotene treatment significantly increased the abundance of Faecalibacterium, the levels of which negatively correlated with the levels of inflammatory cytokines. Faecalibacterium may be a potential target in the alleviation of DSS-induced UC. β-Carotene can alleviate DSS-induced UC through the regulation of gut microbiota. This study provides a reference for the rational use of β-carotene in the treatment of UC. PRACTICAL APPLICATION: β-Carotene can relieve ulcerative colitis and regulate the gut microbiota; the nutritional intervention of β-carotene enhancing animal health.

Trends in blood lead levels in the same birth cohort (generation) are necessary to identify the lead load in the population. This analysis uses a nationally representative sample to investigate the trends in blood lead levels from 1999 to 2016 by birth cohort and to revisit the association between blood lead levels and age.Data from the 1996 to 2016 National Health and Nutrition Examination Surveys were used to describe the distribution of blood lead levels. Trends in blood lead levels were analyzed using joinpoint regression models. Association of blood lead levels with age was conducted with both cross-sectional and birth cohort analysis. Analyses were conducted in 2020.In total, 68,877 participants were included (weighted mean age=38.4 years, 50.6% female). From 1999 to 2016, the geometric mean of blood lead levels decreased from 1.68 µg/dL (95% CI=1.63, 1.74) to 0.82 µg/dL (95% CI=0.77, 0.87). The annual percentage change estimated by the joinpoint model was -4.26% (p0.05). The associations between blood lead levels and age were "U"-shaped by cross-sectional analysis, with higher risks for the lowest and highest ages. However, by birth cohort analysis the blood lead levels declined monotonically with age. The joinpoint analysis indicated the inflection point of age 13-17 years and statistically significant differences in decline slopes before and after this age.In this nationally representative study of the U.S. population, estimates of blood lead levels showed an overall decrease from 1999 to 2016. Blood lead levels are highest in childhood.

Quickly and conveniently identifying buildings in disaster areas plays an important role in disaster assessment. To achieve the technical requirements of flood disaster relief projects, this paper proposes a building extraction method for use with remote sensing images that combines traditional digital image processing methods and convolution neural networks. First, the threshold segmentation method is used to select and construct a training dataset. Then, a variety of preprocessing methods are used to enhance the selected dataset. Finally, the improved Mask R-CNN algorithm is used to detect buildings in the images. Experiments show that compared to the R-CNN algorithm, the proposed method improves detection accuracy and reduces the computational time.

Aims The beneficial effect of β-blocker on heart failure with reduced ejection fraction is well established. However, its effect on the 1-year outcome of heart failure with mid-range ejection fraction (HFmrEF) remains unclear. Methods and results We analysed the data of the patients with left ventricular ejection fraction (LVEF) between 40% and 49% in China Patient-centred Evaluative Assessment of Cardiac Events Prospective Heart Failure Study (China PEACE 5p-HF Study), in which patients hospitalized for heart failure from 52 Chinese hospitals were recruited from 2016 to 2018. Two primary outcomes were all-cause death and all-cause hospitalization. The associations between β-blocker use at discharge and outcomes were assessed by inverse probability of treatment weighting (IPTW)-weighted Cox regression analyses. To assess consistency, IPTW adjusting medications analyses, multivariable analyses and dose-effect analyses were performed. A total of 1035 HFmrEF patients were included in the analysis. The mean age was 65.5 ± 12.7 years and 377 (36.4%) were female. The median (interquartile range) of LVEF was 44% (42–47%). Six hundred and sixty-one (63.8%) were treated with β-blocker. Patients using β-blocker were younger with better cardiac function, and more likely to use renin–angiotensin system inhibitor and mineralocorticoid receptor antagonist. During the 1-year follow-up, death occurred in 84 (12.7%) treated and 85 (22.7%) untreated patients (P Conclusions Among patients with HFmrEF, β-blocker use was associated with lower risk of all-cause death, but not with lower risk of all-cause hospitalization.

Oral mucositis and taste dysfunction are frequently complained by patients with head and neck cancer receiving radiotherapy, challenging the clinical outcome of cancer treatment. Recent studies have indicated the protective role of Wnt/β-catenin signaling in radiation-induced oral mucositis (RIOM) and its pivotal role in the development and self-renewal of taste buds. The current study hypothesizes that lithium chloride (LiCl), a potent activator of the Wnt/β-catenin signaling pathway, can promote the postirradiation restoration of oral mucosa integrity and taste function. To validate this hypothesis, we established a RIOM mouse model and evaluated the treatment efficacy of LiCl on oral mucositis and taste dysfunction in comparison with keratinocyte growth factor (KGF), an agent approved by the US Food and Drug Administration for oral mucositis. The results showed that LiCl alleviated the weight loss and tongue ulceration of RIOM mice, promoted proliferation of basal epithelial cells, and inhibited epithelial-mesenchymal transition in tongue mucosa. More important, elevated taste bud renewal and dysgeusia recovery toward sweetness were observed in RIOM mice treated with LiCl as compared to those treated by KGF. Collectively, our data demonstrate that LiCl can mitigate oral mucositis and rescue taste alteration induced by irradiation, and activation of Wnt/β-catenin signaling may represent a promising therapy to improve the quality of life of patients receiving radiotherapy.

Coronavirus disease 2019 (COVID-19) has become a global pandemic and garnered international attention. The causative pathogen of COVID-19 is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel, highly contagious coronavirus. Numerous studies have reported that liver injury is quite common in patients with COVID-19. Hepatitis B has a worldwide distribution as well as in China. At present, hepatitis B virus (HBV) remains a leading cause of cirrhosis, liver failure, and hepatocellular carcinoma. Because both viruses challenge liver physiology, it raises questions as to how coinfection with HBV and SARS-CoV-2 affect disease progression and mortality. Is there an increased risk of COVID-19 in patients with HBV infection? In this review, we summarize the current reports of SARS-CoV-2 and HBV coinfection and elaborate the interaction of the two diseases. The emphasis was placed on evaluating the impact of HBV infection on disease severity and clinical outcomes in patients with COVID-19 and discussing the potential mechanism behind this effect.

We demonstrate a 1MBit array of 1-Transistor-8-Resistive RAM (1T8R) memory fabricated using a foundry logic technology. Using a gradual SET/RESET programming scheme, sixteen conductance levels are stored in each RRAM, achieving 1T8R array with 4 bits per RRAM. We report SET/RESET endurance of 100K cycles and 10-year retention at 110°C.

Objective: To retrospectively analyse the lung ultrasound images of 60 patients undergoing thoracoscopic partial pneumonectomy and compare the difference of bilateral lung ultrasound images. Results: B3 lines were predominant in ventilating side lung, B7 lines and atelectasis were predominant in operative side lung. Conclusion: Short-term lung injury after one-lung ventilation is mainly on the ventilation side, and the main manifestation is pulmonary edema.

Aims Current evidence about the effect of angiotensin receptor blocker (ARB) on the outcome of heart failure with mid‐range ejection fraction (HFmrEF) is lacking. We aim to assess the association between use of ARB and 1 year all‐cause mortality after hospitalization for HFmrEF. Methods and results We analysed the data of patients with ejection fraction of 40–49% in China Patient‐centred Evaluative Assessment of Cardiac Events Prospective Heart Failure Study; 4907 patients hospitalized for heart failure from 52 Chinese hospitals were enrolled from August 2016 to May 2018. Use of ARB was determined by prescriptions at discharge. Patients who died during hospitalization or were using angiotensin‐converting enzyme inhibitors at discharge were excluded. The association between the use of ARB and outcome was assessed using stabilized inverse probability of treatment weighting‐adjusted Kaplan–Meier and Cox regression analyses. A total of 701 patients with HFmrEF were included for analysis. The mean age was 66.4 ± 12.8 years, and 267 (38.1%) were female. Of them, 244 were treated (34.8%) with ARB. During the 1 year follow‐up period, patients treated with ARB had lower all‐cause mortality compared with untreated patients (11.5% vs. 21.9%, P = 0.0005). Inverse probability of treatment weighting‐adjusted Cox regression analysis showed that use of ARB was associated with significantly reduced all‐cause mortality (adjusted hazard ratio 0.44, 95% confidence interval 0.28–0.69, P = 0.0004). Conclusions Among patients hospitalized for HFmrEF, the use of ARB was associated with lower 1 year mortality after discharge.

Light field (LF) imaging has generated considerable interest owing to its ability to capture both spatial and angular information of light rays simultaneously. However, the extremely large volume of data associated with LF imaging poses challenges to both data storage and transmission. This study addresses this issue by proposing a view synthesis-based LF image compression method using a generative adversarial network (GAN). The primary basis of compression relies on the fact that adjacent sub-aperture images (SAIs) are highly correlated. Accordingly, only sparsely sampled SAIs are transmitted and the others are reconstructed at the decoder side. The proposed sparse SAI sampling method enhances the quality of reconstructed SAIs by considering a fair trade-off between the number of SAIs available for use as priors in the synthesis process and SAI redundancy. The quality of reconstructed SAIs is further enhanced by a GAN-based SAI synthesis method, where the synthesis procedure is broken into disparity estimation and un-sampled SAI estimation components, and the adversarial nature of the jointly trained generative and discriminative networks results in a more accurate generative model. Furthermore, more texture details can be preserved in the synthesized SAIs by adopting a loss function in the GAN model based on perceptual quality. Extensive experimental results demonstrate the superiority of the proposed method relative to several other state-of-the-art compression methods in terms of standard quality metrics and the perceptual quality of the synthetic SAIs at the decoder side.

Dysangiogenesis and chronic inflammation are two critical reasons for diabetic foot ulcers. Desferrioxamine (DFO) was used clinically in the treatment of diabetic foot ulcers by repeated injections because of its capacity to induce vascularization. Biocompatible carriers that release DFO slowly and facilitate healing simultaneously are preferable options to accelerate the healing of diabetic wounds. Here, DFO-laden silk nanofiber hydrogels that provided a sustained release of DFO for more than 40 days were used to treat diabetic wounds. The DFO-laden hydrogels stimulated the healing of diabetic wounds. In vitro cell studies revealed that the DFO-laden hydrogels modulated the migration and gene expression of endothelial cells, and they also tuned the inflammation behavior of macrophages. These results were confirmed in an in vivo diabetic wound model. The DFO-laden hydrogels alleviated dysangiogenesis and chronic inflammation in the diabetic wounds, resulting in a more rapid wound healing and increased collagen deposition. Both in vitro and in vivo studies suggested potential clinical applications of these DFO-laden hydrogels in the treatment of diabetic ulcers.

In this paper, we document 45 specific allegations related to audit deficiencies based on GAAS, as detailed in 141 AAERs and 153 securities class action lawsuits over the violation years 1978–2016. Next, we use these allegations to validate existing popular proxies of audit quality. Of all the audit quality proxies, we find that restatements consistently predict all of the top six most cited audit deficiencies. The ratio of audit fees to total fees and the presence of a city specialist auditor predict five of the most cited deficiencies. Overall, our results suggest that the predictive power of audit quality proxies depends on (i) the settings that researchers are interested in; and (ii) the specific audit deficiencies hypothesized to matter in the investigated setting. For instance, future studies related to auditor independence might consider using restatements and the ratio of audit fees to total fees as proxies of audit quality.

Because of the wealth of fascinating physical phenomena observed in topological insulators (TIs), their exciting properties have been intensively investigated for electronic and optoelectronic appl...

To observe the clinical efficacy of heat-sensitive moxibustion plus Western medicine in treating patients with diabetic peripheral neuropathy (DPN). A total of 70 patients with DPN were divided into an observation group and a control group by sealed envelope method combined with the random number table method, with 35 cases in each group. The control group was treated with routine medicine, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment in the control group. After 2 courses of treatment, the scores of Toronto clinical scoring system (TCSS) and vibration perception threshold (VPT) in both groups were observed, and the clinical efficacy was compared. During treatment, 3 cases dropped out in the control group and 4 cases in the observation group. After treatment, the total effective rate in the observation group was higher than that in the control group (P

A model-agnostic data enhancement (MADE) algorithm is proposed to comprehensively investigate the circular dichroism (CD) properties in the higher-order diffracted patterns of two-dimensional (2D) chiral metamaterials possessing different parameters. A remarkable feature of MADE algorithm is that it leverages substantially less data from a target problem and some training data from another already solved topic to generate a domain adaptation dataset, which is then used for model training at no expense of abundant computational resources. Specifically, nine differently shaped 2D chiral metamaterials with different unit period and one special sample containing multiple chiral parameters are both studied utilizing the MADE algorithm where three machine learning models (i.e, artificial neural network, random forest regression, support vector regression) are applied. The conventional rigorous coupled wave analysis approach is adopted to capture CD responses of these metamaterials and then assist the training of MADE, while the additional training data are obtained from our previous work. Significant evaluations regarding optical chirality in 2D metamaterials possessing various shape, unit period, width, bridge length, and separation length are performed in a fast, accurate, and data-friendly manner. The MADE framework introduced in this work is extremely important for the large-scale, efficient design of 2D diffractive metamaterials and more advanced photonic devices.

Background and aims Transarterial chemoembolization (TACE) is a standard locoregional therapy for patients with hepatocellular carcinoma (HCC) patients with a variable overall response in efficacy. We aimed to identify key molecular signatures and related pathways leading to HCC resistance to TACE, with the hope of developing effective approaches in preselecting patients with survival benefit from TACE. Approach and results Four independent HCC cohorts with 680 patients were used. MicroRNA (miRNA) transcriptome analysis in patients with HCC revealed a 41-miRNA signature related to HCC recurrence after adjuvant TACE, and miR-125b was the top reduced miRNA in patients with HCC recurrence. Consistently, patients with HCC with low miR-125b expression in tumor had significantly shorter time to recurrence following adjuvant TACE in two independent cohorts. Loss of miR-125b in HCC noticeably activated the hypoxia inducible factor 1 alpha subunit (HIF1α)/pAKT loop in vitro and in vivo. miR-125b directly attenuated HIF1α translation through binding to HIF1A internal ribosome entry site region and targeting YB-1, and blocked an autocrine HIF1α/platelet-derived growth factor β (PDGFβ)/pAKT/HIF1α loop of HIF1α translation by targeting the PDGFβ receptor. The miR-125b-loss/HIF1α axis induced the expression of CD24 and erythropoietin (EPO) and enriched a TACE-resistant CD24-positive cancer stem cell population. Consistently, patients with high CD24 or EPO in HCC had poor prognosis following adjuvant TACE therapy. Additionally, in patients with HCC having TACE as their first-line therapy, high EPO in blood before TACE was also noticeably related to poor response to TACE. Conclusions MiR-125b loss activated the HIF1α/pAKT loop, contributing to HCC resistance to TACE and the key nodes in this axis hold the potential in assisting patients with HCC to choose TACE therapy.

Introduction Sepsis is a complication in acute-on-chronic liver failure (ACLF) patients associated with high rates of mortality and morbidity. Early diagnosis of sepsis in ACLF patients can improve prognosis. This study aimed to explore potential effective biomarkers for the early diagnosis of sepsis in ACLF patients. Methods Ninety-four ACLF patients with sepsis were enrolled from 10 hospitals across China from January 2015 to June 2016 as well as 49 ACLF patients without infection from Xiangya Hospital. The first-day admission data and SOFA score and CLIF-SOFA score were collected. The differences of indicators between groups were compared with Kruskal-Wallis test. The receiver-operating characteristic (ROC) curve was analyzed to evaluate the diagnostic efficiency of the selected factors. Results Soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and presepsin were significantly higher in ACLF-sepsis patients compared with ACLF patients with no infection (P

Background Respiratory infections are a serious threat to human health. So, rapid detection of all respiratory pathogens can facilitate prompt treatment and prevent the deterioration of respiratory disease. Previously published primers and probes of the TaqMan array card (TAC) for respiratory pathogens are not sensitive to Chinese clinical specimens. This study aimed to develop and improve the TAC assay to detect 28 respiratory viral and bacterial pathogens in a Chinese population. Methods To improve the sensitivity, we redesigned the primers and probes, and labeled the probes with minor groove binders. The amplification efficiency, sensitivity, and specificity of the primers and probes were determined using target-gene containing standard plasmids. The detection performance of the TAC was evaluated on 754 clinical specimens and the results were compared with those from conventional methods. Results The performance of the TAC assay was evaluated using 754 clinical throat swab samples and the results were compared with those from gold-standard methods. The sensitivity and specificity were 95.4 and 96.6%, respectively. The lowest detection limit of the TAC was 10 to 100 copies/μL. Conclusions TAC is an efficient, accurate, and high-throughput approach to detecting multiple respiratory pathogens simultaneously and is a promising tool for the identification of pathogen outbreaks.

The exposure to airborne particles are of great concern in public health. The present study was aimed to clarify the effects of the breathing mode (nasal and oral inhalation) and exposure conditions on particle inhalation and deposition in human airway.A scanned upper airway embedded body model in an extended computational domain was constructed to perform numerical investigation into the inhalation and deposition of airborne particles.It was clarified that the inhalation of sub-micro and micro particles was of high efficiency and insensitive to the breathing mode, while super microparticles were much less inhalable, in particular under the nasal intake. Moreover, the relative variation of environmental wind speed and direction could significantly reshape the breathing zone as well as modify the critical inhalable area at far upstream. In addition, the breathing mode was found to be affective on the regional deposition of the microparticles, and increasing the proportion of nasal inhalation flowrate slightly enhanced the total deposition in the upper airway model.The breathing mode and exposure conditions significantly influence the particle inhalability and deposition pattern in human airway, which should be considered in the evaluation of health risk associated with airborne particle exposure.

Background DNA from many pathogens can be detected in saliva. However, the presence and quantity of Treponema pallidum DNA in patients with syphilis in saliva is unknown. Methods 234 patients with syphilis with different stages and 30 volunteers were enrolled. Paired saliva and plasma samples were collected from all participants. Consecutive saliva samples from 9 patients were collected every 4 hours following treatment. Treponema pallidum DNA in samples was determined by nested polymerase chain reaction (PCR) and droplet digital PCR targeting polA and Tpp47. Results Treponema pallidum DNA detection rates in saliva and plasma were 31.0% (9/29) and 51.7% (15/29) in primary syphilis (P = .11), 87.5% (63/72) and 61.1% (44/72) in secondary syphilis (P, There were high loads of Treponema pallidum DNA in saliva in patients with syphilis. In addition, the collection of saliva is noninvasive and convenient. Therefore, saliva may be a new specimen for syphilis diagnosis.

Image segmentation plays an important role in many fields such as computer vision, pattern recognition, machine learning and so on. In recent years, many variants of standard fuzzy C-means (FCM) algorithm have been proposed to explore how to remove noise and reduce uncertainty. In fact, there are uncertainty on the boundary between different patches in images. Considering that hesitant fuzzy set is a useful tool to deal with uncertainty, in this paper, we merge hesitant fuzzy set with fuzzy C-means algorithm, introduce a new kind of method of fuzzification and defuzzification of image and the distance measure between hesitant fuzzy elements of pixels, present a method to establish hesitant membership degree of hesitant fuzzy element, and propose hesitant fuzzy C-means (HFCM) algorithm. Finally, we compare our proposed HFCM algorithm with some existing fuzzy C-means (FCM) algorithms, and apply HFCM algorithm in natural image, BSDS dataset image, different size images and multi-attribute decision making. These numerical examples illustrate the validity and applicability of our proposed algorithm including its comprehensive performance, reducing running time and almost without loss of accuracy.

The security of smart devices is facing great challenges. This article presents a new hybrid cipher framework suitable for such devices. Using software/hardware (SW/HW) co-design method, an efficient encryption/decryption and digital signature scheme based on SM2, SM3, and SM4 algorithms is implemented. First, the framework is partitioned into software and hardware parts based on the analysis result of a pure software solution and the hardware overhead under the conditions of design constraints. Second, the flow of the whole scheme and embedded algorithms are realized by SW/HW co-design. Finally, an improved implementation of SM2/3/4 algorithms is proposed to achieve higher efficiency. In this implementation, some SW/HW modules are parallelized to reduce the running time and enhance the performance. The proposed design is safe and can resist simple power analysis (SPA) attacks. Especially, the AHB bus interface IP and software scheduling approach are adopted in data transfer and manipulation. The design is taped-out on a silicon chip with SMIC 110-nm technology process. The chip uses about 199K logic gates and 1-mm2 areas. The operating frequency of the design is 36 MHz and the chip consumes 23-mW power. The comparison with similar previous works shows our proposed design is more efficient with speed increasing of more than 10%.

Current studies have shown that long non‐coding RNAs (lncRNAs) may serve as prognostic biomarkers in multiple cancers. Therefore, we postulated that expression patterns of multiple lncRNAs combined into a single signature could improve clinicopathological risk stratification and prediction of overall survival rate for breast cancer patients. Two algorithms, Least Absolute Shrinkage and Selector Operation (LASSO) and Support Vector Machine‐Recursive Feature Elimination (SVM‐RFE), were used to select candidate lncRNAs. Univariate and multivariate Cox regression analyses were employed to construct a seven‐lncRNA signature for breast cancer. Stratified analysis revealed that the signature was significantly associated with multiple clinicopathological risk factors. For clinical use, we developed a nomogram model to predict overall survival and odds of death for breast cancer patients. Single‐sample gene set enrichment analysis (ssGSEA), CIBERSORT algorithm and ESTIMATE method were employed to assess the relative immune cell infiltrations of each sample. Differentially infiltration of immune cells and diverse tumour mutation burden (TMB) scores might give rise to the efficacy of lncRNA signature for predicting the overall survival of patients. Correlation analysis implied that LINC01215 was associated with multiple immune‐related signalling pathways. A seven‐lncRNA prognostic signature is a reliable tool to predict the prognosis of breast cancer patients.

Due to limited size and imperfect of the optical components in a spectrometer, aberration has inevitably been brought into two-dimensional multi-fiber spectrum image in LAMOST, which leads to obvious spacial variation of the point spread functions (PSFs). Consequently, if spatial variant PSFs are estimated directly , the huge storage and intensive computation requirements result in deconvolutional spectral extraction method become intractable. In this paper, we proposed a novel method to solve the problem of spatial variation PSF through image aberration correction. When CCD image aberration is corrected, PSF, the convolution kernel, can be approximated by one spatial invariant PSF only. Specifically, machine learning techniques are adopted to calibrate distorted spectral image, including Total Least Squares (TLS) algorithm, intelligent sampling method, multi-layer feed-forward neural networks. The calibration experiments on the LAMOST CCD images show that the calibration effect of proposed method is effectible. At the same time, the spectrum extraction results before and after calibration are compared, results show the characteristics of the extracted one-dimensional waveform are more close to an ideal optics system, and the PSF of the corrected object spectrum image estimated by the blind deconvolution method is nearly central symmetry, which indicates that our proposed method can significantly reduce the complexity of spectrum extraction and improve extraction accuracy., 10 pages, 14 figures

BackgroundIncidence, predictors, and prognostic impact of recurrent acute myocardial infarction (AMI) after initial AMI remain poorly understood. Data on recurrent AMI in China is unknown.MethodsUsing the China Patient-centred Evaluative Assessment of Cardiac Events (PEACE)-Prospective AMI Study, we studied 3387 patients admitted to 53 hospitals for AMI and discharged alive. The association of recurrent AMI with 1-year mortality was evaluated using time-dependent Cox regression. Recurrent AMI events were classified as early (1–30 days), late (31–180 days), and very late (181–365 days). Their impacts on 1-year mortality were estimated by Kaplan-Meier methodology and compared by the log-rank test. Multivariable modelling was used to identify factors associated with recurrent AMI.ResultsThe mean (SD) age was 60.7 (11.9) years and 783 (23.1%) were women. The observed 1-year recurrent AMI rate was 2.5% (95% CI 2.00 to 3.07) with 35.7% events occurring within the first 30 days. Recurrent AMI was associated with 1-year mortality with an adjusted HR of 25.42 (95% CI 15.27 to 42.34). Early recurrent AMI was associated with the highest 1-year mortality rate of 53.3% (log-rank p90 min/beats at initial admission, renal dysfunction, and not being prescribed any of guideline-based medications at discharge.ConclusionsOne-third of recurrent AMI events occurred early. Recurrent AMI is strongly associated with 1-year mortality, particularly if early. Heightened surveillance during this early period and improving prescription of recommended discharge medications may reduce recurrent AMI in China.

Introduction Dye pulsed light (DPL) was proven to be effective at treating erythematous and telangiectatic skin disorders. However, there are limited data on the efficacy of DPL treatment for erythematotelangiectatic rosacea (ETR), and researchers do not fully understand the factors that may affect the efficacy. Here, we performed a study to investigate the efficacy of DPL treatment for ETR and determine the factors affecting that efficacy. Methods Sixty-five patients with ETR underwent three treatment sessions with DPL at 4-week intervals and were followed up at 4 weeks after the last treatment session. Skin type, sex, age, lesion site, severity of erythema and telangiectasia, VISIA percentile ranking, clinical photographs and red area images were recorded at baseline. The post-treatment erythematous and telangiectatic scores and VISIA percentile rankings were recorded, and the effects of different personal and clinical factors on the efficacy were statistically analysed. Results The erythema and telangiectasia scores and VISIA percentile rankings showed significant improvement after the DPL procedures (p 0.05). With regard to telangiectasia, the treatment efficacy was greater for mild telangiectasia than for severe telangiectasia (odds ratio = 4.14, p 0.05). Conclusion DPL is not the optimal procedure for treating severe telangiectasia in patients with ETR, whereas the efficacy of the treatment for erythema was not affected by the severity of the condition.

In this paper, a novel distributed tracking method is proposed for the problem of manoeuvring target tracking in sensor networks. Firstly, an adaptive adjustment tracking model is established by extended state observer (ESO) theory. Then, the consensus-based square-root cubature Kalman filter (SCKF) algorithm is proposed in order to improve the global accuracy and stability. In addition, the integrated model could reduce the influence of measurement noise. Finally, simulation is performed to verify the effectiveness of the scheme, whereby comparison results show that the estimation accuracy of the method proposed is higher than that of the traditional ESO and SCKF.

Summary Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an epidemic in China and many other countries. Many infected clusters have been found within familial households, but the data about secondary transmission among household contacts is limited. Methods In this retrospective case series, we enrolled 85 patients infected with SARS-CoV-2 and their household members in Wuhan. Patients were confirmed infected with SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (RT-PCR) assays on throat swabs. Epidemiological, clinical and laboratory data of the household members were collected. Results There were 155 close contacts in total. 104 contacts received RT-PCR assays, with 47 (30%) positive cases and 57 (37%) negative cases. 51 (33%) cases did not received RT-PCR tests for they showed no symptoms of pneumonia during the 2 weeks of quarantine. The infection rate of close contacts was 38% for households with 1 contact, 50% for households with 2 contacts, and 31% for households with 3 contacts. Conclusions The rate of secondary transmission among household contacts of patients with SARS-CoV-2 infection was 30%. Our data provide insight into the rate of secondary transmission of SARS-CoV-2 in home.