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Mobile Deep Learning (MDL) has emerged as a privacy-preserving learning paradigm for mobile devices. This paradigm offers unique features such as privacy preservation, continual learning and low-latency inference to the building of personal mobile sensing applications. However, squeezing Deep Learning to mobile devices is extremely challenging due to resource constraint. Traditional Deep Neural Networks (DNNs) are usually over-parametered, hence incurring huge resource overhead for on-device learning. In this paper, we present a novel on-device deep learning framework named MDLdroidLite that transforms traditional DNNs into resource-efficient model structures for on-device learning. To minimize resource overhead, we propose a novel Release-and-Inhibit Control (RIC) approach based on Model Predictive Control theory to efficiently grow DNNs from tiny to backbone. We also design a gate-based fast adaptation mechanism for channel-level knowledge transformation to quickly adapt new-born neurons with existing neurons, enabling safe parameter adaptation and fast convergence for on-device training. Our evaluations show that MDLdroidLite boosts on-device training on various PMS datasets with 28x to 50x less model parameters, 4x to 10x less floating number operations than the state-of-the-art model structures while keeping the same accuracy level.

To monitor the degradation status of units and prevent unexpected failures in engineering systems, health index (HI)-based data fusion technologies have been rapidly developed by combining multiple sensor signals, which are helpful to understand the degradation processes of units and predict their remaining useful lifetime (RUL). Although promising, existing HI-based data fusion models for degradation modeling are still limited due to the restrictive assumptions made during the fusion or the degradation modeling processes, e.g., assuming the fusion model as a linear or kernel-based function from multiple sensor signals, or modeling the degradation process by a preselected basis function. Such assumptions are often invalid in industrial practice and may fail to accurately characterize the complicated relationships between multiple sensor signals and the underlying degradation process. To address the issue, this article proposes a generic indirect deep learning method that constructs an HI by combining multiple sensor signals to better characterize the degradation process. In particular, our innovative idea is to seamlessly integrate a deep neural network (DNN) and a long short term memory (LSTM) model to construct the HI by fusing multiple sensor signals and characterize the degradation process, which can be applied to the degradation modeling of various engineering systems. Domain knowledge including the concept of failure threshold and monotonicity of the degradation process is also considered to enhance the interpretability of the proposed method. For parameter estimation, we develop an indirect gradient descent (IGD) algorithm to train the proposed method. Simulation studies and a case study on the degradation of aircraft gas turbine engines are presented to validate the performance of the proposed method.

In the last decade, a number of severe urban power outages have been caused by extreme natural disasters, e.g., hurricanes, snowstorms and earthquakes, which highlights the need for rethinking current planning principles of urban energy systems and expanding the classical reliability-oriented view. In addition to being reliable to low-impact and high-probability outages, power system should also have high level of resilience to withstand high-impact and low-probability (HILP) events. Compared with power system, multi-energy systems (MESs) have advantages in improving resilience through energy shifting across multiple energy sectors, a variety of generalized energy storage resources and thermal inertia of heat/cooling loads. This paper proposes a resilience-oriented planning method to determine optimal configuration of distribution level MES, e.g., urban energy supply systems, considering comprehensive impacts from supply, network and demand sides in MES. Impacts of energy shifting at supply side, pipe storage at network side and thermal inertia at demand side are described in the same linear modeling framework using energy hub (EH) model. Generalized energy storage resources including centralized and distributed energy storage devices, pipe network storage and building heat capacity are all modeled into centralized energy storage to facilitate an efficient configuration planning of MES.

The rectangular profile conductor with a large cross-section requires less slot space and has better heat dissipation ability than the traditional round profile one. But its application in automotive propulsion electric machines is thwarted by high ac winding losses and temperature rise under high-speed operations. This paper proposes a novel stator winding topology with hybrid strands based on the ac losses' distribution characteristics and the theoretical relationship between the eddy current suppressing ability and the geometric parameters. The new winding can effectively reduce the ac loss and the peak temperature in the winding at high-speed operation. Meanwhile, it can maintain a high filling rate. Therefore, the machines maximum rotating speed and power density can be effectively improved. In experimental validation, a winding sample with this new topology is manufactured and compared with the conventional one formed by rectangular wires. It shows the proposed method can reduce the winding ac loss by up to 12% and the temperature rise by 10%~21%. It is validated to have considerable industrial potential in the future development of automotive motors.

Power grids are vulnerable to extreme events that may cause the failure of multiple components and lead to severe power outages. It is of practical importance to design effective restoration strategies to enhance the power grid resilience. In this brief, we consider different time scales of various restoration methods and propose an integrated strategy to maximize the total amount of electricity supplied to the loads in the recovery process. The strategy properly combines the slow restoration method of component repair and the fast restoration method of optimal power dispatch. The Q-learning algorithm is used to generate the sequential order of repairing damaged components and update the network topology. Linear optimization is used to obtain the largest amount of power supply on given network topology. Simulation results show that our proposed method can coordinate the available resources and manpower to effectively restore the power grid after extreme events.

Facial expression recognition (FER) is a challenging task due to the large appearance variations and the lack of sufficient training data. Conventional deep approaches either learn a good representation through deep models or synthesize images automatically to enlarge the training set. In this paper, we perform both tasks jointly and propose an end-to-end deep model for simultaneous facial expression recognition and facial image synthesis. The proposed model is based on Generative Adversarial Network (GAN) and enjoys several merits. First, the facial image synthesis and facial expression recognition tasks can boost their performance for each other via the unified model. Second, paired images are not required in our facial image synthesis network, which makes the proposed model much more general and flexible. Meanwhile, the generated facial images largely expand the training set and ease the overfitting problem in our FER task. Third, different expressions are encoded in a disentangled manner in a latent space, which enables us to synthesize facial images with arbitrary expressions by exchanging certain parts of their latent identity features. Quantitative and qualitative evaluations on both controlled and in-the-wild FER benchmarks (Multi-PIE, MMI, and RAF-DB) demonstrate the effectiveness of our proposed method on both facial image synthesis and facial expression recognition task.

Due to high storage and calculation efficiency, hash-based methods have been widely used in image retrieval systems. Unsupervised deep hashing methods can learn the binary representations of images effectively without any annotations. The strategy of constraining hash code in the previous unsupervised methods may not fully utilize the structural information in semantic similarity. To address this problem, we propose a new strategy based on contrastive learning to capture high-level semantic similarity among features and preserve it in generated hash codes. In addition, we employ a novel framework to handle hash codes with different lengths simultaneously which is more time-saving in generating hash codes than existing methods. Extensive experiments on MIRFlickr, NUS-WIDE, and COCO benchmark datasets show that our method makes great improvement on the performance of unsupervised image retrieval.

Inflammation or trauma occurring on one side of the body can cause pathological pain on the contralateral noninjured side in a phenomenon called mirror-image pain (MIP). Although some potential mechanisms involved in MIP have been reported, including those involving the immune system and glial cells as well as neural mechanisms, the molecular mechanisms are not well understood. In this study, we aimed to understand the molecular mechanisms in MIP using quantitative proteomics and whole-cell patch clamp recordings. Behavioral test results showed that complete Freund's adjuvant could induce MIP in the mice. The results of isobaric tags for relative and absolute quantification (iTRAQ) quantitative proteomics showed that 108 proteins were dysregulated, and these proteins may represent potential targets. Furthermore, bioinformatics analysis was applied to explore the potential molecular mechanisms during MIP after complete Freund's adjuvant (CFA) treatment. Parallel reaction monitoring (PRM) results showed that PKCδ and seven other dysregulated proteins were related to MIP after CFA treatment. Patch clamp recording results showed that CFA treatment could increase intrinsic excitability and spontaneous firing in spinal cord neurons during MIP. In summary, we found that CFA could induce MIP. The results of proteomic research on the spinal cord after CFA treatment could provide new insight into the molecular mechanisms of MIP. Moreover, the neuronal activity of spinal cord neurons was upregulated during MIP after CFA treatment. In summary, the results of the spinal cord proteomic profile provide a potential molecular mechanism for understanding MIP.

Developing efficient adsorbents for CO2 separation is the key step of CO2 sequestration which has found many applications including carbon capture from flue gas and natural gas purification. Although many adsorbents have been reported in the past decades, the development of efficient adsorbent with both high separation selectivity and excellent capacity is technically challenging due to the trade-off effect between adsorption capacity and selectivity. In this work, we report the CO2 separation performance of a microporous MOF which comprise of nano-cages and ultra-high density of dual-side open metal sites. Adsorption results reveal a prominent CO2 uptake and outstanding separation selectivity for CO2/N2 and CO2/CH4. Furthermore, this MOF also exhibit preferable adsorption of C2~C3 light hydrocarbons over CH4. Simulation studies reveal that the dual-side open metal sites are the preferable adsorption sites for CO2, C2H4 and C3H6. Therefore, the outstanding separation performance can be attributed to the combined effects of nano-cages and high density of open metal sites.

Systematic and dynamic humoral immune reconstitution is little-known for patients with relapsed/refractory (R/R) multiple myeloma (MM) who received anti–B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapy. We investigated the kinetics of B-cell, normal plasma cell, and immunoglobulin recovery in 40 patients who achieved ongoing response after anti-BCMA CAR T-cell therapy. All patients developed B-cell aplasia and the median duration of B-cell aplasia was 70 days (range, 23-270). The B-cell count reached its nadir on median day 7 and returned to baseline level on median day 97. BCMA+ cells in bone marrow turned undetectable on median day 28 (13-159) in 94.87% (37 of 39) of patients. Normal plasma cells in bone marrow were first redetected on median day 212. All patients developed a significant decrease in serum IgG, IgA, and IgM on median day 60. At year 1, recovery of serum IgG, IgM, and IgA was observed in 53.33% (8 of 15; non-IgG MM), 73.08% (19 of 26; non-IgM MM), and 23.81% (5 of 21;non-IgA MM) of the patients, respectively. Median time to IgG, IgM, and IgA recovery were days 386, 254, and not reached during follow-up, respectively. Virus-specific IgG levels decreased with loss of protection. Twenty-three of 40 (57.5%) patients had a total of 44 infection events. There were no infection-related deaths. These results reveal a 7-month aplasia of bone marrow normal plasma cells and longer period of hypogammaglobulinemia, suggesting a profound and lasting humoral immune deficiency after anti-BCMA CAR T-cell therapy, especially for IgA.

Background Systemic inflammation and cachexia are associated with adverse clinical outcomes in elderly patients with cancer. The Geriatric Nutritional Risk Index (GNRI) is a simple and useful tool to assess these conditions, but its predictive ability for elderly patients with cancer cachexia (EPCC) is unknown. Methods This multicentre cohort study included 746 EPCC with an average age of 72.00 ± 5.24 years, of whom 489 (65.5%) were male. The patients were divided into two groups (high GNRI group ≥91.959 vs. low GNRI group

Background Although systemic inflammation is an important feature of the cancer cachexia, studies on the association between systemic inflammation and prognostic of cancer cachexia are limited. The objective of this study is to evaluate whether the neutrophil‐to‐lymphocyte ratio (NLR) is associated with outcome and quality of life for patients with cancer cachexia and investigated any interaction between NLR and the clinical parameters. Methods This is a multicentre cohort study of 2612 cancer patients suffering from cachexia diagnosed between June 2012 and December 2019. The main parameters measured were overall survival (OS) time and all‐cause mortality. The association between NLR and all‐cause mortality was evaluated using hazard ratios (HRs) and the restricted cubic spline model with a two‐sided P‐value. Optimal stratification was used to solve threshold points. We also evaluated the cross‐classification of NLR for each variable of survival. Results Of the 2612 participants diagnosed with cancer cachexia, 1533 (58.7%) were male, and the mean (SD) age was 58.7 (11.7) years. Over a median follow‐up of 4.5 years, we observed 1189 deaths. The overall mortality rate for patients with cancer cachexia during the first 12 months was 30.2% (95%CI: 28.4%–32.0%), resulting in a rate of 226.07 events per 1000 patient‐years. An increase in NLR had an inverted L‐shaped dose–response association with all‐cause mortality. The optimal cut‐off point for NLR as a predictor of mortality in cancer patients with cachexia was 3.5. An NLR of 3.5 or greater could independently predict OS (HR, 1.51, 95%CI: 1.33–1.71). These associations were consistent across subtypes of cancer. Several potential effect modifiers were identified including gender, BMI, tumour type, KPS score and albumin in content. Increasing NLRs were independently associated with a worsening in the majority of EORTC QLQ‐C30 domains. Elevated baseline NLR was associated with low response and poor survival in patients treated with immunotherapy. Conclusions The baseline NLR status was found to be a significant negative prognostic biomarker for patients with cachexia; this effect was independent of other known prognostic factors.

Acute lung injury (ALI) is a sudden onset systemic inflammatory response. ALI causes severe morbidity and death and currently no effective pharmacological therapies exist. Natural products represent an excellent resource for discovering new drugs. Screening anti-inflammatory compounds from the natural product bank may offer viable candidates for molecular-based therapies for ALI. In this study, 165 natural compounds were screened for anti-inflammatory activity in lipopolysaccharide (LPS)-challenged macrophages. Among the screened compounds, flavokawain B (FKB) significantly reduced LPS-induced pro-inflammatory IL-6 secretion in macrophages. FKB also reduced the formation of LPS/TLR4/MD2 complex by competitively binding to MD2, suppressing downstream MAPK and NF-κB signaling activation. Finally, FKB treatment of mice reduced LPS-induced lung injury, systemic and local inflammatory cytokine production, and macrophage infiltration in lungs. These protective activities manifested as increased survival in the ALI model, and reduced mortality upon bacterial infection. In summary, we demonstrate that the natural product FKB protects against LPS-induced lung injury and sepsis by interacting with MD2 and inhibiting inflammatory responses. FKB may potentially serve as a therapeutic option for the treatment of ALI.

Although we have numerous publications about the effect of fractional CO2 laser therapy for burn scars, quantitative data about its efficacy and safety are sparse. The purpose of this meta-analysis was to assess the efficacy and safety of fractional CO2 laser therapy for the treatment of burn scars. Pertinent studies were identified by a search of PubMed, Embase and Web of Science up to 20 September 2020. Weighted mean difference (WMD) was conducted to combine the results, and a random-effect model was used to pool the results. Publication bias was estimated using Begg and Egger’s regression asymmetry test. Twenty articles were included. Our pooled results suggested that fractional CO2 laser therapy significantly improved the Vancouver Scar Scale (VSS) score (WMD = −3.24, 95%CI: −4.30, −2.18; P

Massive ultra-reliable and low latency communications (mURLLC) has emerged as new and dominating 6G-standard services to support statistical quality-of-services (QoS) provisioning for delay-sensitive data transmissions. To measure the freshness of updated information, age of information (AoI) has recently formed as the new dimension of QoS metric. Since status updates usually consist of a small number of information bits but warrant ultra-low latency, integrating AoI with finite blocklength coding (FBC) creates an alternative promising solution for mURLLC. On the other hand, to solve the massive connectivity issues imposed by mURLLC, unmanned aerial vehicle (UAV) has been developed to significantly enhance the line-of-sight (LOS) coverage while guaranteeing various QoS requirements. However, how to efficiently integrate the above new techniques for statistical delay and error-rate bounded QoS provisioning in UAV systems has been neither well understood nor thoroughly studied. To overcome these challenges, we propose FBC based statistical delay and error-rate bounded QoS provisioning schemes which leverage AoI as a key QoS provisioning technique for mURLLC over UAV mobile networks. First, we develop FBC based UAV system models. Second, we build up AoI-metric based modeling frameworks to upper-bound peak AoI violation probability using FBC. Third, we formulate and solve FBC based peak AoI violation probability minimization problem. Forth, we jointly optimize peak AoI violation probability and $\epsilon $ -effective capacity and characterize their tradeoffs. Finally, our simulations validate and evaluate our developed schemes.

The uncertain nature of renewable energy resources (RERs) and fast demand response lead to recurring voltage violations in the power systems, which causes frequent transformer tap shifting and capacitor switching. Therefore, this paper resorts to the static var compensators (SVCs) to manage the bus voltages based on the multi-agent deep reinforcement learning (MA-DRL) algorithm. The proposed scheme includes several system agents and SVC agents to collaboratively adjust the injected reactive power to restrict the bus voltages within the normal range. All the agents are trained centrally and executed separately, which requires minimum communication cost. The IEEE 14-bus system, IEEE 300-bus system, and China 157-node urban power grid are used to verify the effectiveness of the proposed method.

Background Clinical studies have suggested that there is a significant correlation between left ventricular (LV) false tendon and premature ventricular complexes (PVCs). Objective This study aimed to investigate the electrophysiological characteristics and the outcome of radiofrequency catheter ablation (RFCA) for this category of PVCs. Methods From a total of 2284 patients with idiopathic PVCs who underwent catheter ablation at 6 institutions in China, intracardiac echocardiography (ICE) was used during the procedure in 346 cases; 10 patients (2.9%) with PVCs associated with false tendon were retrospectively reviewed and enrolled in the present study. Activation mapping and pace mapping were performed to localize the origin of PVCs. ICE was used in all patients. If the false tendon was directly visualized and identified, we attempted to identify the distinct relationship with the PVC origin. Results The PVCs were successfully eliminated by ablation in all patients. The target sites were confirmed to be related to false tendon. The origin of PVCs was located at the attachment of the false tendon to the papillary muscle, LV septum, or LV apex. At the target site, high-frequency Purkinje potentials were observed preceding local ventricular activation in 7 patients. Conclusion LV false tendon can be associated with PVCs, which can be cured by RFCA. An ICE-guided electroanatomical approach should be considered to improve the safety and feasibility of this procedure.

A variety of studies have demonstrated the role of lipocalin 2 (LCN2) in both diabetes and neurological disorders. Nevertheless, the relationship between LCN2 and diabetic peripheral neuropathy (DPN) needs to be elucidated in humans. Therefore, this study aimed to investigate the association of LCN2 with DPN in type 2 diabetes (T2D). A total of 207 participants with T2D and 40 participants with normal glucose tolerance (NGT) were included in this study. All participants were classified into DPN group and non-DPN (NDPN) group based on the Toronto Clinical Neuropathy Scoring (TCNS). Demographic and biochemical parameters were measured. Serum LCN2 levels were determined using an ELISA technique. Serum LCN2 levels in NGT group were lower than those in either DPN group (P = 0.000) or NDPN group (P = 0.043), while serum LCN2 levels in DPN group were higher than NDPN group (P = 0.001). Moreover, serum LCN2 levels positively correlated to TCNS scores, which reflects neuropathy severity (r = 0.438, P = 0.000). Multivariate stepwise regression analysis showed that BMI, triglycerides, and diastolic pressure were independently associated with serum LCN2 in DPN. Additionally, logistic regression analysis demonstrated that LCN2 (odds ratio (OR) = 1.009) and diabetes duration (OR = 1.058) were independently associated with the occurrence of DPN in T2D. Our report reveals the association of serum LCN2 with DPN in T2D. LCN2 might be used to evaluate DPN severity and serve a role in the pathogenesis of DPN.

Background and aims Childhood overweight and obesity are lifetime risk factors for cardiovascular disease but the relationship between dynamic body mass index (BMI) change and cardiovascular structure and function in early childhood remains unclear. Methods and results This cohort study consisted 525 participants with 6 distinct representative growth patterns to examine the associations between BMI growth patterns and subsequent cardiovascular structure and function at age 4. BMIs were obtained at birth, 2 and 4 years old. Cardiovascular assessments were performed, including blood pressure (BP), cardiac geometric parameters, left ventricular (LV) function, speckle-tracking, integrated backscatter analysis and carotid intima-media thickness. Compared to the stable normal BMI pattern, children with the stable overweight (OW) pattern had significantly greater LV anatomic parameters in fully adjusted models. Children with the catch-up (CU) pattern revealed a uniform trend and had poorer strain. LV diameters and integrated backscatter signals were larger for those with BMI gain and lose pattern. Children with BMI lose pattern showed improved tendency involving LV mass index and BP. Both OW and CU patterns were associated with high systolic BP [odds ratio (95% CI): OW: 3.67 (1.08, 12.47); CU: 4.24 (1.75, 10.28)]. Compared to static BMI measurements at birth, 2 and 4 years old, dynamic BMI growth patterns were more predictive of cardiovascular structure and function at 4. Conclusions Children with overweight-related BMI growth patterns in early childhood experienced undesirable cardiovascular functional or structural changes as early as 4 years old, indicating that early intervention is needed and potentially beneficial.

BACKGROUND Spinal cord injury (SCI) refers to the interruption of the tracts inside the spinal cord caused by various factors. The repair of damaged axons has always been a difficult point in clinical treatment and neuroscience research. The treatment of SCI with Buyang huanwu decoction (BYHWD), a well-known recipe for invigorating Qi (a vital force forming part of any living entity in traditional Chinese culture) and promoting blood circulation, shows a good effect. METHODS The rubrospinal tract (RST) transection model in rats was established in this study and rats were administrated with low (BL), medium (BM), or high (BH) doses of BYHWD. RESULTS Compared with the SCI group, BL, BM moderately, and BH significantly improved the motor function of forelimbs and increased the number of red nucleus neurons in SCI rats. As for the possible molecular mechanism, BL, BM moderately, and BH significantly increased mTOR whereas decreased Beclin-1 and LC3 in the red nucleus. CONCLUSION In conclusion, low, medium, and high doses of BYHWD could promote neural recovery in SCI rats through improving motor function and neuron survival in the red nucleus. The neuroprotective effects of BYHWD might be associated with affecting the mTOR signaling pathway and autophagy.

Objective To investigate the correlation between computed tomography (CT) values and bone mineral density (BMD) in elderly Chinese patients with proximal humeral fractures. Methods This was a single‐center retrospective study involving 166 elderly patients with proximal humeral fractures between January and June 2015 in our hospital. Following the inclusion and exclusion criteria, 89 patients were finally enrolled in this study. The spiral CT scanning was performed on these patients, and the CT images were obtained by using MIMICS software. The CT values in axial, coronal, and sagittal images of healthy proximal humeri were measured using a circular region of interest (ROI) by Image J. The bone mineral density (BMD) of the lumbar spine and femoral neck was measured using dual‐energy X‐ray absorptiometry (DXA). Spearman rank correlation methods were used for analysis of the association between the proximal humerus average CT value (CTMean) and the lumbar spine as well as femoral neck BMD in patients with proximal humeral fractures, or osteoporotic patients. Results Among the included 89 patients, there were 26 males and 63 females, 69% and 84% of whom were diagnosed with osteoporosis, respectively. The lumbar spine and femoral neck BMD and the CTMean of the proximal humerus were higher in males than females with proximal humeral fractures (P, Our study explored computed tomography values in bone mineral density of aged patients with proximal humeral fractures. The study tried to introduce a more objective method to assess proximal humeral bone quality and to provide valuable reference data for preoperative planning.

Background: Changes in platelet count (PLT) are strongly associated with patient survival and may be clinically indicative of certain underlying diseases. However, there were few studies on the prognosis of patients with cancer cachexia. Objective: The purpose of this study was to investigate the relationship between PLT and 1-year survival in patients with cancer cachexia. Methods: We performed a nested case-control study of data from a multicenter clinical study of cancer. There were 252 patients with cancer cachexia whose survival time was less than or equal to 1 year and 252 patients with cancer cachexia whose survival time was more than 1 year meeting the inclusion criteria. The mortality risk and the adjusted risk were estimated by logistic regression and displayed as odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: PLT was negatively correlated with 1-year overall survival (OS) of patients with cancer cachexia (increased per standard deviation (SD): OR = 1.29; 95% CI: 1.05-1.60; P = 0.018). The higher the PLT, the lower the OS of patients. When classified by dichotomy (D1 < 296×109/L, D2 ≥ 296×109/L), OS of patients in the D2 group was worse (OR = 2.18; 95% CI: 1.38-3.47; P = 0.001). When classified by quartile (Q1- Q3 < 305×109/L, Q4 ≥ 305×109/L), OS of patients in the Q4 group was poorer (OR = 1.82; 95% CI: 1.14-2.94; P = 0.013). In addition, patients with a low PLT (< 296×109/L) and either a high total bilirubin (TBIL) (≥ 17.1 µmol/L) or a smoking history had poor 1-year survival. Based on our primary cohort study, we conducted a survival analysis of 3130 patients with cancer cachexia and found that OS was better in patients with low PLT (< 296×109/L). Conclusion: PLT was negatively correlated with 1-year overall survival of patients with cancer cachexia.

BACKGROUND This study investigated the advantages and disadvantages of contrast media administration by gravity drip and manual push injection during cholangiography. METHODS A total of 100 patients who presented to the Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University, for a cholangiography between June 2019 to June 2020 were enrolled in this study. Patients were randomly divided into 2 treatment groups. One group of patients with manual injection of contrast (the N group, n=50), received the contrast agent via the traditional manual injection method whereby the doctor injects 50 mL of prepared contrast agent into the right side of the patient while continuously observing the effects on the bile duct. The other group of patients with gravity drip administration of contrast media (the O group, n=50), received the contrast agent via gravity drip at a rate of 80 drops per minute, and both clinicians and radiologists monitored the entire cholangiography process from a safe distance. Patients were followed up and angiographic satisfaction was assessed after two weeks. RESULTS All 100 patients completed cholangiography without allergic reaction to the contrast medium. In the traditional injection group (N group), nine patients experienced upper abdominal discomfort with nausea, abdominal pain, chills, high fever, and other symptoms, and residual gallstones were observed in 12 patients. In patients in the gravity drip group (O group), four patients felt upper abdominal discomfort accompanied by nausea, abdominal pain, chills, high fever, and other symptoms, with residual gallstones detected in six patients. CONCLUSIONS Patients who underwent gravity drip cholangiography had significantly reduced adverse reactions compared to patients who underwent traditional manual infusion cholangiography. Furthermore, gravity drip cholangiography resulted in clearer images and reduced X-ray exposure for medical staff. Thus, increased implementation of gravity drip cholangiography in the clinical setting should be considered. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1800018202.

BACKGROUND In mainland China, HPV vaccines have been available to the public. However, only a few related studies among health care providers, as the key information providers, were reported although public concerns on HPV vaccines still exist. In this study, we aim to assess the knowledge of HPV, its vaccines, and attitudes toward HPV vaccines among the three most important groups of health care providers in Western China. METHOD This was a cross-sectional questionnaire-based study. Health care providers including obstetrician-gynecologists (OB-GYNs), pediatricians, and immunization service providers in Western China were investigated regarding their knowledge of HPV and its vaccines and their attitudes toward HPV vaccines. RESULTS Of 1079 health care providers completing the survey, 1015 (94.1%) knew HPV infection is the primary cause of cervical cancer. However, lower knowledge levels of other HPV-related diseases were also found (43.2%). About three-quarters (74.1%) of practitioners interviewed would be willing to recommend HPV vaccination, which was found to be lower among the OB-GYNs (69.6%) and the pediatricians (73.2%). "Lack of relevant knowledge," "concerns on safety and efficacy" and price were the three most important concerns surrounding HPV vaccination. CONCLUSION The interviewed practitioners did not have adequate knowledge of HPV and its vaccines in depth. Education interventions are highly recommended to the health care providers, especially for OB-GYNs and pediatricians, to increase the coverage of HPV vaccination among the population. For the currently high price of vaccines, a future co-sharing mechanism between the government, the providers, and the individuals might be a solution.

Purpose Seizure originates from different pathological substrate; however, the same pathologies may have distinct mechanisms underlying seizure generation. We aimed to improve the understanding of such mechanisms in patients with temporal lobe epilepsy (TLE) by investigating the stereoelectroencephalography (SEEG) ictal onset patterns (IOPs). Methods We analyzed data from a cohort of 19 consecutive patients explored by SEEG and had 1–3-year seizure-freedom following temporal lobe resection. Results Six IOPs were identified. They were low voltage fast activity (LVFA) (36.5%), rhythmic spikes or spike-waves at low frequency and with high amplitude (34.1%), runs of spikes (10.6%), rhythmic sharp waves (8.2%), low frequency high amplitude repetitive spiking (LFRS) (7.1%), and delta activity (3.5%). All six patterns were found in patients with mesial temporal onset and only two patterns were found in patients with temporal neocortical onset. The most prevalent patterns for patients with mesial temporal onset were rhythmic spikes or spike-waves, followed by LVFA with a mean discharge rate 74 Hz. For patients with temporal neocortical onset, the most prevalent IOP pattern was LVFA with a mean discharge rate 35 Hz, followed by runs of spikes. Compared with Lateral TLE (LTLE), the duration between the onset of the IOPs to the onset of the symptom was longer for patients with MTLE (Mesial TLE) (MTLE:55.7 ± 50.6 s vs LTLE:19.5 ± 16.4 s). Conclusion Multiple IOPs underlie seizure generation in patients with TLE. However, the mesial and lateral temporal lobes share distinct IOPs.

Backgrounds Hand grip strength (HGS) is one of diagnose criteria factors of sarcopenia and is associated with the survival of patients with cancer. However, few studies have addressed the association of HGS and 1 year mortality of patients with cancer cachexia. Methods This cohort study included 8466 patients with malignant solid tumour from 40 clinical centres throughout China. Cachexia was diagnosed using the 2011 International cancer cachexia consensus. The hazard ratio (HR) of all cancer cachexia mortality was calculated using Cox proportional hazard regression models. Kaplan–Meier curves were generated to evaluate the association between HGS and the 1 year mortality of patients with cancer cachexia. The interaction analysis was used to explore the combined effect of low HGS and other factors on the overall survival of patients with cancer cachexia. Results Among all participants, 1434 (16.9%) patients with cancer were diagnosed with cachexia according to the 2011 International cancer cachexia consensus with a mean (SD) age of 57.75 (12.97) years, among which there were 871 (60.7%) male patients. The HGS optimal cut‐off points of male and female patients were 19.87 and 14.3 kg, respectively. Patients with cancer cachexia had lower HGS than those patients without cachexia (P

Despite the known association between muscle mass/function and malnutrition-related mortality in upper gastrointestinal (UGI) cancer, no comprehensive study to determine the impact of muscle mass-dominant nutritional status on cancer prognosis has been conducted. The present study aimed to investigate the prognostic significance of integrated muscle mass and function in UGI cancer.Between July 2013 and March 2018, we enrolled 2546 cancer patients with risks of malnutrition (Nutrition Risk Screening 2002, ≥3 points) from a multicenter cohort study and split 527 patients with primary UGI cancer into an internal validation group. We prospectively performed instant nutritional assessment and recorded all general clinical characteristics of the participants, such as weight loss, body mass index, anthropometric measurements of muscle mass and function, dietary intake conditions, and disease burden and/or inflammation status based on the validated tools. Prognostic analyses were performed with post-assessment overall survival (OS).According to the entire set, UGI cancer was identified as the dominant risk factor for disease burden and inflammation criteria (hazard ratio (HR), 2.08, 95% confidence interval (Cl), 1.81-2.39, P 0.001). Integrated muscle mass/function analysis with validated cutoff values showed that hand grip strength/weight followed by triceps skinfold thickness and maximum calf circumference are the most potent predictors. Univariate and multivariate analyses revealed that reduced muscle mass/function (74.8%) and dietary intake (66.2%) independently affect OS of patients with UGI cancer. Significant associations were found between the reduced muscle mass/reduced dietary intake and the shortest OS (HR, 4.48; 95% Cl, 3.07-6.53; P 0.001). Appending subgroups of muscle mass/function and dietary intake to the pre-existing risk model increased the efficiency of the time-dependent receiver operating characteristic curve analysis for OS in UGI cancer, particularly within 2 years of instant nutritional assessment.Impaired muscle mass/function adversely affects the near-term prognosis in patients with UGI cancer. Along with a comprehensive evaluation of dietary intake conditions, the timely nutritional assessment might be useful for risk stratification of UGI cancers with potential for enteral and parenteral nutrition interventions.ChiCTR1800020329.

Introduction A new scale, named the Clinical Assessment Scale for Autoimmune Encephalitis (CASE), has recently been developed for rating the severity of autoimmune encephalitis (AE) with a high level of clinimetric properties. In this study, our primary objective was to validate the performance of CASE through a multicenter study in China. Methods Between July 2014 and December 2019, 143 consecutive patients with definite neuronal surface antibody-associated AE from three tertiary hospitals were enrolled in the study. We validated the reliability, internal consistency, and validity of CASE. We further compared CASE with the modified Rankin scale (mRS) among different subtypes of AE in terms of its sensitivity to disease dynamics. Statistical analyses were performed using GraphPad Prism and R software. Results Our analyses showed that CASE had good inter- and intraobserver reliability (intra-class correlation coefficient 0.96/0.98) and internal consistency (Cronbach α = 0.847) at disease onset. The scores of CASE and mRS remained well correlated in patients at admission and at discharge (both r = 0.80, p

Dysregulated long non-coding RNAs (lncRNAs) have been shown to contribute to the pathogenesis of ischemic stroke. However, the potential role of lncRNAs in post-stroke microglial activation remains largely unknown. Here, we uncovered that lncRNA-U90926 was significantly increased in microglia exposed to ischemia/reperfusion both in vivo and in vitro. In addition, adenovirus-associated virus (AAV)-mediated microglial U90926 silencing alleviated neurological deficits and reduced infarct volume in experimental stroke mice. Microglial U90926 knockdown could reduce the infiltration of neutrophils into ischemic lesion site, which might be attributed to the downregulation of C-X-C motif ligand 2 (CXCL2). Mechanistically, U90926 directly bound to malate dehydrogenase 2 (MDH2) and competitively inhibited the binding of MDH2 to the CXCL2 3' untranslated region (UTR), thus protecting against MDH2-mediated decay of CXCL2 mRNA. Taken together, our study demonstrated that microglial U90926 aggravated ischemic brain injury via facilitating neutrophil infiltration, suggesting that U90926 might be a potential biomarker and therapeutic target for ischemic stroke.

Inflammatory bowel diseases (IBDs) are chronic and recurrent diseases that often occur in young people and place a heavy burden on public health in both developed and developing countries. Melatonin has been confirmed to be useful in various diseases, including Alzheimer’s disease, liver injuries and diseases, and cancers, while its role in IBDs remains unclear. To uncover the function of melatonin in IBDs, three intestinal models, including Caco-2 cells, 3D intestinal organoids and intestinal explants, were used. It was found that different concentrations of melatonin could significantly inhibit the expression levels of NFκB and its downstream cytokines, including IL6 and IL8 in Caco-2 cells (*P

Uromodulin, also named Tamm Horsfall protein, have been associated with renal function and sodium homeostasis regulation. The authors sought to examine the effects of salt intake on plasma and urinary uromodulin levels and the association of its genetic variants with salt sensitivity in Chinese adults. Eighty patients from our natural population cohort were maintained sequentially either on a usual diet for 3 days, a low‐salt diet (3.0 g) for 7 days, and a high‐salt diet (18.0 g) for an additional 7 days. In addition, the authors studied 514 patients of the Baoji Salt‐Sensitive Study, recruited from 124 families who received the same salt intake intervention, and investigated the association of genetic variations in uromodulin gene with salt sensitivity. Plasma uromodulin levels were significantly lower on a high‐salt diet than on a baseline diet (28.3 ± 4.5 vs. 54.9 ± 8.8 ng/ml). Daily urinary excretions of uromodulin were significantly decreased on a high‐salt diet than on a low‐salt diet (28.7 ± 6.7 vs. 157.2 ± 21.7 ng/ml). SNPs rs7193058 and rs4997081 were associated with the diastolic blood pressure (DBP), mean arterial pressure (MAP) responses to the high‐salt diet. In addition, several SNPs in the uromodulin gene were significantly associated with pulse pressure (PP) response to the low‐salt intervention. This study shows that dietary salt intake affects plasma and urinary uromodulin levels and that uromodulin may play a role in the pathophysiological process of salt sensitivity in the Chinese populations.

Vagus nerve stimulation (VNS) and anterior thalamic deep brain stimulation (ANT-DBS) have both been used for treatments of drug-resistant epilepsy (DRE). However, there is no comparative study on the effectiveness of two methods from one single center. 17 patients with DRE who underwent VNS therapy and 18 patients who underwent DBS were enrolled. A retrospective study was performed starting from baseline before operation extending to 12 months after operation. The seizure types, duration of epilepsy, age at implantation, failed numbers of antiepileptic drugs (AEDs) before operation, history of craniotomy, stimulation parameters and response rate were described. The analysis of liner regression on the age of onset, duration of epilepsy, numbers of AEDs, and the seizure reduction at 12 months after operation was applied. The mean seizure reduction in patients with DBS at 3, 6, 9 and 12 months after the operation was 57.22%, 61.61%, 63.94% and 65.28%, and that in cases with VNS was 36.06%, 39.94%, 45.24% and 48.35%, respectively. At 1 year after the operation, the patients with older operation age, focal seizures and older age of onset responded better to VNS; and those older operation age, focal generalized seizures, history of craniotomy and longer duration of disease responded better to DBS. The efficiency of ANT-DBS was higher than that of VNS at each follow up time point. Patients can choose the appropriate treatment according to the individual clinical characteristics.

Xi Zhang,1– 3 Jing-Hua Li,4 Qi Zhang,1,3 Qin-Qin Li,1,3 Kang-Ping Zhang,1,3 Meng Tang,1,3 Yi-Zhong Ge,1,3 Wei Li,5 Hong-Xia Xu,6 Zeng-Qing Guo,7 Han-Ping Shi1,3 1Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of China; 2Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, 071000, People’s Republic of China; 3Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People’s Republic of China; 4Department of Hepatobiliary Surgery, Affiliated Hospital of Hebei University, Baoding, 071000, People’s Republic of China; 5Cancer Center of the First Hospital of Jilin University, Changchun, 130021, People’s Republic of China; 6Department of Clinical Nutrition, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, 400042, People’s Republic of China; 7Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University, Fujian, 350014, People’s Republic of ChinaCorrespondence: Han-Ping ShiDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of ChinaTel +86-10-6392 6985Fax +86-10-6392 6325Email shihp@ccmu.edu.cnBackground: Overweight and obese patients with cancer present with chronic inflammation, dysfunctional antitumor immunity and malnutrition risk. Prognostic nutritional index (PNI) is a promising indicator for predicting inflammatory, immunological and nutritional states; however, its prognostic value in overweight and obese patients with cancer has not been explored. Therefore, the aim of the current study was to explore the prognostic value of PNI levels in overweight and obese patients with cancer.Methods: The current large-scale retrospective cohort multicenter study included 3532 patients. Time-dependent receiver operating characteristic (ROC) curve analysis was used to determine the prediction accuracy of PNI levels for mortality of overweight and obese patients with cancer. Restricted cubic splines were used to model the association between PNI levels and mortality. Association between low PNI and overall survival rate was analyzed using the Kaplan–Meier method and Cox regression model.Results: Area under the curve (AUC) of the PNI for all-cause mortality was higher compared with that of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in overweight and obese patients with cancer. There was a significant inverse relationship between PNI levels and all-cause mortality (per SD increment-HR: 0.79; 95% CI: 0.74, 0.85; P< 0.001). Subgroup analysis showed that the risk for mortality significantly decreased with increase in PNI levels in patients at risk of malnutrition (per SD increment-HR: 0.67; 95% CI: 0.57, 0.78; P< 0.001) and elderly patients (per SD increment-HR: 0.74; 95% CI: 0.64, 0.84; P< 0.001). In addition, PNI levels showed an inverse association with mortality in patients without malnutrition risk (per SD increment-HR: 0.81; 95% CI: 0.75, 0.88; P< 0.001). Subgroup analysis based on tumor type showed that low PNI was an independent predictor of poor prognosis for patients with lung cancer, gastric cancer and hepatobiliary and pancreatic cancer.Conclusion: Low PNI levels are associated with an increased risk for all-cause mortality. PNI level is a potential effective inflammation-based prognostic tool for overweight and obese patients with cancer.Keywords: PNI, mortality, overweight or obese, prognosis, cancer patients

As a new and dominating type of time-sensitive traffic over 6G wireless networks, massive ultra-reliable and low latency communications (mURLLC) has attracted considerable research attention, while raising several new challenges, including massive connectivity, ultra-low latency, super-reliability, and high energy efficiency. Several promising 6G enablers, including statistical delay and error-rate bounded quality-of-service (QoS) provisioning, cell-free (CF) massive multi-input multi-output (m-MIMO), simultaneous wireless information and power transfer (SWIPT), etc., have been developed to support mURLLC. Specifically, CF m-MIMO can significantly enhance QoS performance of SWIPT by boosting data rate and energy efficiency. On the other hand, finite blocklength coding (FBC) has been proposed to support various massive access techniques while reducing access latency and guaranteeing stringent QoS. However, how to efficiently integrate SWIPT with CF m-MIMO using FBC for statistical delay and error-rate bounded QoS to support mURLLC has posed many new challenges not encountered before. To overcome these difficulties, in this paper we develop FBC based statistical delay and error-rate bounded QoS provisioning schemes over SWIPT-enabled CF m-MIMO 6G wireless networks. First, we establish SWIPT-enabled CF m-MIMO system models using FBC. Then, we optimize the tradeoffs between $\epsilon$ -effective capacity and harvested energy for our proposed statistical QoS provisioning. Finally, our simulated results validate and evaluate our developed schemes.

Xiao-Yue Liu,1– 4,&ast; Xi Zhang,1– 3,5,&ast; Guo-Tian Ruan,1– 3 Kang-Ping Zhang,1– 3 Meng Tang,1– 3 Qi Zhang,1– 3 Meng-Meng Song,1– 3 Xiao-Wei Zhang,1– 3 Yi-Zhong Ge,1– 3 Ming Yang,1– 3 Hong-Xia Xu,6 Chun-Hua Song,7 Han-Ping Shi1– 3 1Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of China; 2Department of Oncology, Capital Medical University, Beijing, 100038, People’s Republic of China; 3Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People’s Republic of China; 4School of Clinical Medicine, Hebei University, Baoding, 071000, People’s Republic of China; 5Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, 071000, People’s Republic of China; 6Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing, 400042, People’s Republic of China; 7Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Han-Ping ShiDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of ChinaEmail shihp@ccmu.edu.cnPurpose: Serum albumin can indicate the onset of cancer cachexia, provide information about a patient’s nutritional status, and serve as a biomarker for the prognosis of patients with cancer cachexia. However, the relationship between serum albumin levels and mortality in patients with cancer cachexia remains unclear. We aimed to examine the association of albumin and total protein with 1-year mortality in patients with cancer cachexia.Patients and Methods: We conducted a nested case–control study using data from a multicenter cancer clinical survey from 2013 to 2018. In total, 266 patients with cancer cachexia who survived for < 1 year and 266 patients who survived for ≥ 1 year were included in this study. The participants were matched by age, sex, tumor type, tumor stage, and hospital site. The crude and adjusted risks of 1-year survival were estimated using odds ratios (ORs) and 95% confidence intervals (95% CIs) using logistic regression, with or without adjustment for covariates.Results: Logistic regression analysis revealed a significantly negative linear association between albumin level and 1-year mortality in patients with cancer cachexia (p < 0.001). An L-shaped relationship existed between total protein and 1-year mortality, with a turning point at 70.4 g/L. When albumin was divided into quartiles, Q3 (OR: 0.40; 95% CI: 0.24, 0.68; p < 0.001) and Q4 (OR: 0.33; 95% CI: 0.19, 0.55; p < 0.001) were associated with higher 1-year survival than Q1 among patients with cancer cachexia. When total protein was divided into quartiles, Q2 (OR: 0.38; 95% CI: 0.23, 0.64; p < 0.001), Q3 (OR: 0.57; 95% CI: 0.33, 0.96; p = 0.035), and Q4 (OR: 0.43; 95% CI: 0.25, 0.72; p = 0.002) were associated with higher 1-year survival than Q1 among patients with cancer cachexia.Conclusion: Serum albumin and total protein may predict 1-year survival. Future clinical studies should lead to a more comprehensive understanding of the effects of serum protein levels in patients with cancer cachexia.Keywords: nutrition, survival, death, cachectic patients

To analyze the brain CT imaging data of children with cerebral palsy (CP), deep learning-based electronic computed tomography (CT) imaging information characteristics were used, thereby providing help for the rehabilitation analysis of children with CP and comorbid epilepsy. The brain CT imaging data of 73 children with CP were collected, who were outpatients or inpatients in our hospital. The images were randomly divided into two groups. One group was the artificial intelligence image group, and hybrid segmentation network (HSN) model was employed to analyze brain images to help the treatment. The other group was the control group, and original images were used to help diagnosis and treatment. The deep learning-based HSN was used to segment the CT image of the head of patients and was compared with other CNN methods. It was found that HSN had the highest Dice score (DSC) among all models. After treatment, six cases in the artificial intelligence image group returned to normal (20.7%), and the artificial intelligence image group was significantly higher than the control group (X2 = 335191, P < 0.001 ). The cerebral hemodynamic changes were obviously different in the two groups of children before and after treatment. The VP of the cerebral artery in the child was (139.68 ± 15.66) cm/s after treatment, which was significantly faster than (131.84 ± 15.93) cm/s before treatment, P < 0.05 . To sum up, the deep learning model can effectively segment the CP area, which can measure and assist the diagnosis of future clinical cases of children with CP. It can also improve medical efficiency and accurately identify the patient’s focus area, which had great application potential in helping to identify the rehabilitation training results of children with CP.

Earthquakes are vibrations induced by the rapid releases of large quantities of energy from the crustal movements. During seismic excitation, there are kinetic energy, damping energy, and strain energy acting on the tunnel structure. Based on the indexes of the total energy, releasable elastic strain energy, and dissipated energy, this paper proposes three energy evaluation criteria for the tunnel structure, which are applied to the optimization of the aseismic design of the cross-sectional shape and material property of the tunnel structure. It can be concluded that the peak values and accumulated values of elastic strain energy at the spandrel and arch springing are significantly larger than other positions, which indicates that the strengths of the spandrel and arch springing are the most influential factor for the seismic damage of the tunnel structure. Considering this factor, the width-to-height ratio of 1.33 and Poisson’s ratio of 0.3 are determined as the most optimal cross-sectional shape and material property, respectively. Furthermore, by analyzing the relationship between the internal energy and the input energy of the tunnel structure with seismic excitation and proposing an equation for the evaluation of the dynamic stability of tunnel structure, the stabilities of the tunnel structure with different PGAs are analyzed; it can be concluded that the larger the peak value of seismic wave acceleration, the longer the instable period and the greater the degree of dynamic instability. The derived equations can be used as references for the seismic analysis of the tunnel structure, and the conclusions of this paper can contribute to the aseismic design of tunnel lining.

Organic crystals, especially ultra-thin two-dimensional (2D) ones such as monolayer molecular crystals, are fragile and vulnerable to traditional vacuum deposition. Up to now, most of the methods reported for fabricating organic field-effect transistors (OFETs) with top-electrodes on the 2D molecular crystals are based on mechanical-transfer method. Nondestructive method for large scale in-situ electrode deposition is urgent. In this work, the silver mirror reaction (SMR) is introduced to construct top-contact electrodes on 2D organic crystalline thin films. OFETs based on bilayer crystalline films with solution-processed silver electrodes show comparable performance to devices with transferred gold electrodes. In addition to that, OFETs with SMR fabricated silver electrodes show lower contact resistance than the ones with evaporated silver electrodes. Furthermore, the temperature under which SMR electrodes annealed is relatively low (60 °C), making this approach applicable to varies of organic semiconductors, such as spin-coated polymer films, vacuum evaporated films, 2D and even monolayer crystalline films. Besides, OFETs with sub-micrometer channel width and 25 µm channel length are realized which might find practical application in the ultra-small pixel mini/micro-LEDs.

There has been a tendency to embed the theoretical thermal model of electric machines into vehicle thermal management systems to realize real-time temperature prediction and advanced cooling adjustment. The construction process of the high-precision analytical model is the most difficult part for engineering application. However, the electric machines used in electric vehicles usually work in a wide operation space, in which the alternating electromagnetic fields produce different heat production behavior in different operating states. Meanwhile, the major loss components and the main heat transfer paths are highly affected by the temperature variation. The traditional modeling methods usually ignore these effects and oversimplify the model, which will lead to obvious deviations. The main contribution of this article is to propose a theoretical modeling approach with high predicting accuracy in the whole operation space of the electric machines. The experimentally test shows the real-time predicting accuracy has been improved by nearly 60% in a standard test cycle. The computation cost when using the proposed thermal model in the thermal management system is also evaluated to ensure engineering application.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.

The role of autologous hematopoietic stem cell transplantation (auto-HSCT) following high-dose chemotherapy has been validated and accepted as a standard treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL). However, its clinical efficacy as frontline therapy remains to be elucidated. This study aimed to examine the feasibility of frontline auto-HSCT for newly diagnosed intermediate/high-risk DLBCL patients. We retrospectively reviewed the data of 223 patients treated with frontline auto-HSCT or chemotherapy alone (year 2008-2014) from four hospitals. The median follow-up time was 29.4 months. Between the two treatment arms among the intermediate/high-risk DLBCL patients, the 3-year overall survival (OS) and progression-free survival (PFS) rates of patients given frontline auto-HSCT were 87.6% and 81.9%, respectively, and the chemotherapy-alone group showed 3-year OS and PFS rates of 64.9% and 59.59%, respectively. Compared with the chemotherapy-alone group, the frontline auto-HSCT could eliminate the adverse impact of non-germinal center B-cell (GCB) type. In addition, in the frontline auto-HSCT group, patients who achieved complete response (CR) at auto-HSCT had a longer survival time than those who did not achieve CR. Our results suggested that frontline auto-HSCT could improve the prognosis of intermediate/high-risk DLBCL patients.

One of most important techniques for enabling the sixth-generation (6G) mobile wireless network lies in how to efficiently guarantee various stringent quality-of-service (QoS) performance-metrics to support the emerging massive Ultra-Reliable Low-Latency Communications (mURLLC) in 6G. Correspondingly, finite blocklength coding (FBC) has been developed as an effective technique to significantly improve various QoS indices for mURLLC through implementing short-packet communications. On the other hand, Terahertz (THz) band wireless nano-communications have been widely envisioned as a promising 6G technique to efficiently support utra-high data-rate (up to 1 Tbps). One of the major constraints over THz-band nano-networks is the severely limited energy that can be accessed by nano devices. Towards this end, various novel energy harvesting (EH) mechanisms have been proposed to remedy the energy scarcity problem. However, how to accurately characterize the relationships among THz wireless channels, energy consumption, and EH models for FBC based nano communications remains a challenging problem to support statistical delay and error-rate bounded QoS provisioning over FBC based 6G THz wireless nano-networks. To overcome these challenges, in this paper we propose optimal resource allocation policies to achieve the maximum $\epsilon $ -effective capacity in the THz band over FBC-EH-based nano-networks. Particularly, we establish nano-scale system models and characterize wireless channel models in the THz band using FBC. In order to support statistical delay and error-rate bounded QoS provisioning, we formulate and solve the $\epsilon $ -effective capacity maximization problem under several different EH constraints for our proposed schemes. Simulation results are included, which validate and evaluate our proposed schemes in the finite blocklength regime.

Lung cancer remains the most common cancer worldwide. Although significant advances in screening have been made and early diagnosis strategies and therapeutic regimens have been developed, the overall survival rate remains bleak. Curcumin is extracted from the rhizomes of turmeric and exhibits a wide range of biological activities. In lung cancer, evidence has shown that curcumin can markedly inhibit tumor growth, invasion and metastasis, overcome resistance to therapy, and even eliminate cancer stem cells (CSCs). Herein, the underlying molecular mechanisms of curcumin were summarized by distinct biological processes. To solve the limiting factors that curtail the clinical applications of curcumin, nanoformulations encapsulating curcumin were surveyed in detail. Nanoparticles, including liposomes, micelles, carbon nanotubes (CNTs), solid lipid nanoparticles (SLNs), nanosuspensions, and nanoemulsions, were explored as proper carriers of curcumin. Moreover, it was firmly verified that curcumin has the ability to sensitize lung cancer cells to chemotherapeutic drugs, such as cisplatin and docetaxel, and to various targeted therapies. Regarding the advantages and drawbacks of curcumin, we concluded that combination therapy based on nanoparticles would be the optimal approach to broaden the application of curcumin in the clinic in the near future.

Nowadays, it is necessary to explore effective biomarkers associated with tumor immune microenvironment (TIME) noninvasively. Here, we investigated whether the metabolic parameter from preoperative 2-[18F]FDG PET/CT could provide information related to TIME in patients with clear cell renal cell carcinoma (ccRCC). Ninety patients with newly diagnosed ccRCC who underwent 2-[18F]FDG PET/CT prior to surgery were retrospectively reviewed. The immunological features included tumor-infiltrating lymphocytes (TILs) density, programmed death-ligand 1 (PD-L1) expression, and tumor immune microenvironment types (TIMTs). TIMTs were classified as TIMT I (positive PD-L1 and high TILs), TIMT II (negative PD-L1 and low TILs), TIMT III (positive PD-L1 and low TILs), and TIMT IV (negative PD-L1 and high TILs). The relationship between maximum standardized uptake value (SUVmax) in the primary lesion from 2-[18F]FDG PET/CT and immunological features was analyzed. Cox proportional hazards analyses were performed to identify the prognostic factors for disease-free survival (DFS) after nephrectomy. Tumors with high TILs infiltration showed remarkable correlation with elevated SUVmax and aggressive clinicopathological characteristics, such as high World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade. PD-L1 expression on tumor cells was positively associated with WHO/ISUP grade and negatively correlated with body mass index (BMI). However, no correlation was observed between SUVmax and PD-L1 expression, regardless of its spatial tissue distribution. SUVmax of TIMT I and IV was higher than that of TIMT II, but there was remarkable difference merely between TIMT II and IV. In multivariate analysis, SUVmax (P = 0.022, HR 3.120, 95% CI 1.175–8.284) and WHO/ISUP grade (P = 0.046, HR 2.613, 95% CI 1.017–6.710) were the significant prognostic factors for DFS. Six cases (16.2%) with normal SUVmax showed disease progression, while 25 cases (71.4%) with elevated SUVmax experienced disease progression. Conversely, the immunological features held no prognostic value. Our findings demonstrated that 2-[18F]FDG PET/CT could provide metabolic information of TIME for ccRCC patients and develop image-guided therapeutic strategies accordingly. Patients with elevated preoperative SUVmax should be seriously considered, and perioperative immunotherapy might be beneficial for them.