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Background Theta burst stimulation (TBS), a patterned repetitive transcranial magnetic stimulation (rTMS) protocol with shorter simulation duration and lower stimulus intensity, could be a better protocol for individuals with autism spectrum disorder (ASD). Our study aimed to explore the impacts of intermittent TBS (iTBS) over the bilateral posterior superior temporal sulcus (pSTS) on intellectually able adults with ASD. Material and methods In this randomized, single-blinded, sham-controlled crossover trial, 13 adults with ASD completed iTBS for 5 consecutive days over the bilateral pSTS and inion (as a sham control) in a 16-weeks interval and in a randomly assigned order. The neuropsychological function was measured with the Wisconsin Card Sorting Test (WCST) for cognitive flexibility while the clinical outcomes were measured with both self-rate and parents-rate Autism Spectrum Quotient (AQ) before and after 5-day iTBS interventions. Results The results revealed significantly immediate effects of multi-session iTBS over the bilateral pSTS on parent-rate autistic symptoms in adults with ASD. The post-hoc analysis revealed the impacts of multi-session iTBS on cognitive flexibility were affected by baseline social-communicative impairment and baseline cognitive performance. Besides, the impacts of multi-session iTBS on clinical symptoms was affected by the concurrent psychotropic medication use and baseline autistic symptoms. Conclusions Given the caveat of the small sample size and discrepancy of multiple informants, this pilot study suggests the therapeutic potential of 5-day multi-session iTBS over the pSTS in adults with ASD. Individual factors modulating the response to rTMS should be explicitly considered in the future trial.

Background Atherosclerosis is a chronic inflammatory disease in which macrophage polarization plays an important role in contribution to atherosclerotic plaque formation and stability. Here we tested the effect of miR-92 regulation on the development of atherosclerosis beyond tumorigenesis and explored the potential mechanism. Methods and results In the present study, bone marrow derived macrophages (BMDMs), mouse peritoneal macrophages (MPMs), and human macrophages were used to test the expression of miR-92. Here we noticed miR-92 levels were enhanced in classic M1 macrophage but decreased in alternative M2 macrophage, respectively. In vitro, we demonstrated that macrophages transfected with miR-92 inhibitor attenuated proinflammatory cytokine secretion represented by polarized M1 markers but promoted anti-inflammatory state that was indicative of an M2 phenotype. Mechanistically, miR-92 was found to directly interact with KLF4 and we further identified a requirement role of KLF4 in mediating the effect of miR-92 silencing macrophage polarization. Concomitantly, miR-92 inhibition treated ApoE-/- mice promoted macrophage polarization toward alternative M2 macrophage, thus protecting against atherosclerotic plaque formation and preventing a vulnerable phenotype. Conclusion miR-92 inhibition promoted alternative macrophage activation and attenuated atherosclerosis regression partially regulated in a KLF4-dependent manner, which indicated that miR-92/KLF4 axis may serve as a promising strategy for prevention of atherosclerotic diseases.

BACKGROUND Many studies have investigated treatment-related sequelae in Hodgkin's lymphoma (HL) in high-prevalence areas, but very few have been conducted in low-prevalence areas, including Taiwan and Japan. MATERIALS AND METHODS We retrospectively reviewed 101 HL patients who had received mediastinal radiotherapy between January 1997 and April 2013. RESULTS Nine patients had cardiac events and nine patients developed second malignancies. Univariate analysis showed that bulkiness of disease was significantly associated with higher incidence of cardiac events (HR 7.70, 95% CI 1.60-38.00, p = 0.012). Disease stage and cumulative dose of radiotherapy were significantly correlated with incidence of radiation pneumonitis (HR 1.40, 95% CI 1.00-2.10, p = 0.043 and HR 1.10, 95% CI 1.00-1.20, p = 0.009, respectively). All cases of grade III-IV radiation pneumonitis happened in patients receiving a radiation dose higher than 35 Gy and developed within 4 months after radiotherapy. CONCLUSIONS Despite the similar incidence rates of treatment-related sequelae among HL survivors between areas with high and low prevalence of HL, cardiac events and second malignancies cannot be overlooked in HL survivors in low-prevalence areas.

Multi-agent technologies have been widely applied to many applications, such as in e-markets, cloud computing, service-oriented environments, etc. In real applications, service-oriented environments are open and dynamic, where loosely coupled agents interact to consume and provide services. How to accurately evaluate the potential performance (i.e., QoS) of service providers on the service requested by a service consumer in such open and dynamic environments is a challenging issue in both theory and practice. In this paper, an innovative approach is proposed to evaluate the QoS of service providers in service-oriented environments. The proposed approach first borrows the reference report mechanism from the certified reputation model, so as to efficiently collect reference reports (i.e., historical performance) of service providers in open and dynamic environments. Then, a tensor-based QoS model is proposed to construct multi-dimensional relationships between QoS evaluation factors and the QoS values of service providers based on the collected reference reports. The QoS evaluation factors include the type of services, the performance of service providers, the subjectivity of service consumers, the time slot of reference reports. Finally, a CANDECOMP/PARAFAC decomposition and gradient descent-based mechanism is used to evaluate the QoS values of service providers through completing the missing entry values in the constructed tensor. The uniform random simulation experiments indicate that the proposed approach can achieve efficient and accurate QoS evaluation in service-oriented environments with only limited collected reference reports, especially when some service providers do not have reference reports.

Objective To provide a general description of women with postpartum urinary incontinence (PPUI), and investigate the effect of different types of PPUI with varied severity on affected women's quality of life. Methods We performed a cross-sectional study in China that included 130 women with reported symptoms of PPUI. At the sixth to eighth week postpartum, we analyzed sociodemographic and clinical characteristics and compared women's quality of life (measured using the I-QOL and IIQ-7) by severity of PPUI (measured using the ICI-Q-SF), types of PPUI, stages of prolapse, and age. Results 81 of the (62.3%) participating women were classified as mild PPUI, 43 as (33.1%) moderate, and 6 as (4.6%) severe, with 80 of these (61.5%) were grouped into stress urinary incontinence (SUI). With the symptoms of PPUI becoming more severer the total I-QOL score decreased significantly, and the total IIQ-7 score increased. Women with MUI reported lower scores for I-QOL and behavioral impacts, and higher scores of IIQ-7 than those with SUI. Conclusions We found that more severe symptoms of UI and prolapse more negatively affected the quality of life of postpartum women, and women with MUI experienced a lower QOL.

Qinghuan Li,1,* Yi Liang,1,* Zeng Liu,2 Chuanyun Yu1 1Oncology Radiotherapy Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, 441021, People’s Republic of China; 2Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, 441021, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chuanyun Yu Tel/Fax +86-710-2813559Email yuchuanyunxy@163.comZeng Liu Email liu8901@126.comBackground: Head and neck squamous cell carcinoma (HNSCC) ranks the sixth most common cancer worldwide. This study aims to evaluate the associations of GWAS-identified HNSCC risk loci with progression, efficacy and toxicity of radiotherapy of HNSCC treated with radiotherapy.Methods: Six GWAS-identified risk loci were genotyped and evaluated. Multivariate logistic regression was used to determine the associations of these SNPs with progression, efficacy and toxicity of radiotherapy of HNSCC treated with radiotherapy.Results: We found that rs259919 was significantly associated with higher TNM stage (allele A vs G: OR=1.49; 95% CI: 1.09– 2.03; P=0.012), while rs3135001 was significantly associated with better efficacy of radiotherapy (allele T vs C: OR=1.80, 95% CIs=1.19– 2.73, P=0.005). Both SNP rs1265081 (allele A vs C: OR=1.41, 95% CIs=1.08– 1.86, P=0.012) and rs3135001 (allele T vs allele C: OR=0.53, 95% CIs=0.35– 0.79, P=0.002) were significantly associated with the occurrence of grade 3– 4 oral mucositis.Conclusion: We identified that three GWAS-identified HNSCC risk loci were significantly associated with progression, efficacy and toxicity of radiotherapy of HNSCC. Our findings strengthen the understanding of the essential role of genetic background in the progression and therapeutic effects of HNSCC.Keywords: progression, genetic, radiotherapy, HNSCC, efficacy, toxicity

Deep-ultraviolet (DUV) photodetection has garnered extensive research interest for its vital applications in many military and civil fields. In this work, we present the synthesis of a large-area two-dimensional (2D) PdTe2 multilayer, which can be directly transferred onto a GaN substrate to construct a vertical heterostructure for visible-blind DUV photodetection. Upon 265 nm light irradiation, the heterostructure displays a distinct photovoltaic behavior, enabling it to serve as a self-driven photodetector. The important photoresponse parameters, such as ${I}_{light}/{I}_{dark}$ ratio, responsivity, specific detectivity and DUV/visible (265 nm/450 nm) rejection ratio reach as high as 106, 168.5 mA/W, $5.3 \times 10^{12}$ Jones, and 104, respectively, at zero bias. The responsivity can be further enhanced to 254.6 mA/W by applying a small reverse bias of −1.0 V. In addition, the photodetector can function as a DUV light image sensor to reliably record an “H” pattern with a decent resolution. The present study paves a way for designing high-performance cost-effective DUV photodetectors towards practical optoelectronic applications.

Postoperative cognitive dysfunction (POCD; cognitive change associated with anesthesia and surgery) is one of the most serious long-term postoperative complications that occur in elderly patients. Dexmedetomidine (DEX) has been shown to be beneficial for improving outcomes of postoperative cognitive function. However, the exact mechanism underlying this role requires is yet to be found. The present study aims to determine the pathways involved in the protective effects of DEX against POCD in C57BL/6 J aged mice. DEX was administered after POCD modeling in C57BL/6 J aged mice. The cognitive function was evaluated after DEX treatment using novel object recognition, open field, and Y-maze tests. We also assessed its effects on neuron apoptosis and production of TNF-α and IL-1β in mouse brain tissues as well as expression levels of DNA damage-related proteins p53, p21, and γH2AX. Interactions between early growth response 1 (EGR1) and p53, microRNA (miR)-381, and EGR1 were identified by ChIP and luciferase reporter assays, and gain- and loss-of-function experiments were performed to confirm the involvement of their interaction in POCD. DEX administration attenuated hippocampal neuron apoptosis, neuroinflammation, DNA damage, and cognitive impairment in aged mice. miR-381 targeted EGR1 and disrupted its interaction with p53, leading to a decline in hippocampal neuron apoptosis, DNA damage, neuroinflammation, and cognitive impairment. Furthermore, DEX administration resulted in the enhancement of miR-381 expression and the subsequent inhibition of EGR1/p53 to protect against cognitive impairment in aged mice. Overall, these results indicate that DEX may have a potential neuroprotective effect against POCD via the miR-381/EGR1/p53 signaling, shedding light on the mechanisms involved in neuroprotection in POCD.

Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment and may progress to dementia. However, the brain functional mechanism of T2DM‐related dementia is still less understood. Recent resting‐state functional magnetic resonance imaging functional connectivity (FC) studies have proved its potential value in the study of T2DM with cognitive impairment (T2DM‐CI). However, they mainly used a mass‐univariate statistical analysis that was not suitable to reveal the altered FC “pattern” in T2DM‐CI, due to lower sensitivity. In this study, we proposed to use high‐order FC to reveal the abnormal connectomics pattern in T2DM‐CI with a multivariate, machine learning‐based strategy. We also investigated whether such patterns were different between T2DM‐CI and T2DM without cognitive impairment (T2DM‐noCI) to better understand T2DM‐induced cognitive impairment, on 23 T2DM‐CI and 27 T2DM‐noCI patients, as well as 50 healthy controls (HCs). We first built the large‐scale high‐order brain networks based on temporal synchronization of the dynamic FC time series among multiple brain region pairs and then used this information to classify the T2DM‐CI (as well as T2DM‐noCI) from the matched HC based on support vector machine. Our model achieved an accuracy of 79.17% in T2DM‐CI versus HC differentiation, but only 59.62% in T2DM‐noCI versus HC classification. We found abnormal high‐order FC patterns in T2DM‐CI compared to HC, which was different from that in T2DM‐noCI. Our study indicates that there could be widespread connectivity alterations underlying the T2DM‐induced cognitive impairment. The results help to better understand the changes in the central neural system due to T2DM., We used high‐order functional connectivity to reveal the abnormal connectomics pattern in T2DM with cognitive impairment with a multivariate, machine learning‐based strategy. We also investigated whether such patterns were different between T2DM with cognitive impairment and T2DM without cognitive impairment to better understand T2DM‐induced cognitive impairment. Our study is well suited for publication in Human Brain Mapping as we used this method is highly advanced and desirable for extensive applications in the future. Meanwhile, it is of great help for standardizing the methodology and boosting clinical applications of the functional imaging‐based machine learning with improved reproducibility, generalizability, and interpretability.

Post-traumatic stress disorder (PTSD) is a psychiatric disease that seriously affects brain function. Currently, selective serotonin reuptake inhibitors (SSRIs) are used to treat PTSD clinically but have decreased efficiency and increased side effects. In this study, nasal cannabidiol inclusion complex temperature-sensitive hydrogels (CBD TSGs) were prepared and evaluated to treat PTSD. Mice model of PTSD was established with conditional fear box. CBD TSGs could significantly improve the spontaneous behavior, exploratory spirit and alleviate tension in open field box, relieve anxiety and tension in elevated plus maze, and reduce the freezing time. Hematoxylin and eosin and c-FOS immunohistochemistry slides showed that the main injured brain areas in PTSD were the prefrontal cortex, amygdala, and hippocampus CA1. CBD TSGs could reduce the level of tumor necrosis factor-α caused by PTSD. Western blot analysis showed that CBD TSGs increased the expression of the 5-HT1A receptor. Intranasal administration of CBD TSGs was more efficient and had more obvious brain targeting effects than oral administration, as evidenced by the pharmacokinetics and brain tissue distribution of CBD TSGs. Overall, nasal CBD TSGs are safe and effective and have controlled release. There are a novel promising option for the clinical treatment of PTSD., Graphical abstract Nasal delivery of cannabidiol inclusion complex temperature-sensitive hydrogels could effectively target to brains for the treatment of mice with post-traumatic stress disorder (PTSD), which is a novel promising option for the clinical treatment of PTSD.Image 1

Pulse repetition frequency (PRF) is an essential parameter in synthetic aperture radar (SAR). However, a small PRF value will cause spectrum ambiguity and a large value will increase the computational complexity. In highly squinted SAR imaging with maneuvering platform, the traditional PRF design methods used are airborne and space borne. SAR systems perform with a low precision because of the complex geometric configuration and system deviations. In order to adapt to the maneuvering platform SAR system, a modified design method of PRF is proposed in this paper. First, the azimuth spectrum of echoes is analyzed by establishing the SAR geometry base on the single point equivalent squint (SPES) model. Subsequently, the calculation of azimuth bandwidth is transformed into an optimization problem, and the lower limit of PRF is obtained by the Golden Section Method. Besides, the criteria of spectrum unambiguity and time sequence constraints in PRF design is also discussed in detail. Simulation experiments demonstrate the feasibility and accuracy of the proposed method.

Introduction Metastasis is the primary cause of lung cancer-related death. Nevertheless, the underlying molecular mechanisms and evolutionary patterns of lung cancer metastases are still elusive. Methods We performed whole-exome sequencing for 40 primary tumors (PTs) and 61 metastases from 47 patients with lung cancer, of which 40 patients had paired PTs and metastases. The PT-metastasis genomic divergence, metastatic drivers, timing of metastatic dissemination, and evolutionary origins were analyzed using appropriate statistical tools and mathematical models. Results There were various degrees of genomic heterogeneity when comparing the paired primary and metastatic lesions or comparing metastases of different sites. Multiple metastasis-selected/enriched genetic alterations were found, such as MYC amplification, NKX2-1 amplification, RICTOR amplification, arm 20p gain, and arm 11p loss, and these results were were also featured in a meta-analysis cross-validated using an independent cohort from Memorial Sloan-Kettering Cancer Center database. To elucidate the metastatic seeding time, we applied a metastatic model and found 61.1% of the tumors were late dissemination, in which the metastatic seeding happened approximately 2.74 years before clinical detection. One exception was lymph node metastases whose dissemination time was relatively early. By analyzing the evolutionary origins, we reported that nonlymph node metastases were mainly seeded by the PT (87.5%) rather than the earlier colonized lymph node metastases. Conclusions Our results shed light on the molecular features that potentially drive lung cancer metastases. The distinct temporospatial pattern of disease progression revealed that lung cancer was susceptible to either late dissemination or indolent early lymph node metastases, leaving a potential time window to minimize metastases by early cancer detection.

To estimate the prevalence of primary immune thrombocytopenia (ITP) and describe ITP-associated healthcare resource utilization (HRU) among Texas Medicaid beneficiaries.A retrospective analysis using 2012-2015 Texas Medicaid claims data was conducted to estimate the annual prevalence of ITP. HRU was summarized for the 12-month period following initial ITP diagnosis. Logistic regression and generalized linear model were used to investigate predictors for all-cause and ITP-related HRU.The average annual prevalence of ITP was 17.0 per 100,000 persons; higher among females vs males (17.4 vs 13.6 per 100,000) and highest among adults aged ≥ 65 years (36.7 per 100,000). Among 325 patients included in the HRU analyses, 49.2% received ITP therapies. More than half of patients had at least one all-cause emergency department (ED) visit (70.5%) and/or hospitalization (56.0%). One-third (32.6%) experienced at least one ITP-related ED visit and 40.3% had at least one ITP-related hospitalization. Compared to adults aged 18-49 with ITP, children aged 0-4 (odds ratio [OR] = 3.65,There are 17 patients diagnosed with ITP for every 100,000 Texas Medicaid enrollees annually, with higher prevalence in females and the elderly. Children are more likely to experience hospitalizations and ED visits associated with ITP. ITP patients in Texas Medicaid utilize more healthcare resources compared to the general Medicaid population.

PurposeLeveraging the power of corporate social responsibility (CSR) is strategically important to corporations. Although various studies have explored the positive effects of CSR, few have been devoted to the investigation of CSR related to service employees from the internal marketing perspective. Therefore, this study fills this research gap by developing a conceptual model based on social influence theory to explain how internal CSR initiatives affect service employees' attitudes and behaviors.Design/methodology/approachThis study develops and empirically tests a theoretical model examining the impact of internal CSR initiatives (i.e. internal dissemination of and management support for CSR) on service employees' attitudes toward an organization (i.e. employee–company identification and value congruence), which ultimately enhance their organizational citizenship behaviors (OCBs) toward customers, other employees and the organization. Survey data from 271 frontline employees of service firms actively involved in CSR-related activities were examined with structural equation modeling.FindingsThe results suggest that perceived internal dissemination of and management support for CSR affect service employees' citizenship behaviors toward customers, other employees and the organization through the mediation of employee–company identification and value congruence.Practical implicationsInternal CSR initiatives are highly related to service employees' various OCBs that are beneficial to improving the service performance of firms. Therefore, it is imperative for companies to devote attention to internal marketing dissemination while promoting CSR. In addition, as managers' attitudes and behaviors trickle down to employees, service supervisors' support of CSR activities plays a significant role in forming employee perceptions of a firm's CSR dedication.Originality/valueThis study represents one of the first to view internal CSR initiatives as an effective internal marketing lever. Moreover, the relationship between internal CSR initiatives and service employees' OCBs – OCB toward customers, other employees and the organization – is proposed and tested with an empirical model, providing significant contributions.

Background Coronary artery calcification (CAC) is an independent risk factor of major adverse cardiovascular events; however, the impact of CAC on in-hospital death and adverse clinical outcomes in patients with coronavirus disease 2019 (COVID-19) remains unclear. Objective To explore the association between CAC and in-hospital mortality and adverse events in patients with COVID-19. Methods This multicenter retrospective cohort study enrolled 2067 laboratory-confirmed COVID-19 patients with definitive clinical outcomes (death or discharge) admitted from 22 tertiary hospitals in China between January 3, 2020 and April 2, 2020. Demographic, clinical, laboratory results, chest CT findings, and CAC on admission were collected. The primary outcome was in-hospital death and the secondary outcome was composed of in-hospital death, admission to intensive care unit (ICU), and requiring mechanical ventilation. Multivariable Cox regression analysis and Kaplan–Meier plots were used to explore the association between CAC and in-hospital death and adverse clinical outcomes. Results The mean age was 50 years (SD,16) and 1097 (53.1%) were male. A total of 177 patients showed high CAC level, and compared with patients with low CAC, these patients were older (mean age: 49 vs. 69 years, P

We examine financing outcomes for small businesses seeking to sell public securities in a setting characterized by high information asymmetry, weak requirements for auditor participation, and a complete absence of Big N auditors. Issuers that raise capital from small, unsophisticated investors through crowdfunding, under the Securities and Exchange Commission's Regulation Crowdfunding (RegCF), often need no auditor attestation or need only weak attestation in the form of reviews, not audits, of their financial statements. We find that auditor reviews are positively associated with both the probability of crowdfunding success and the total amount raised. Further, we compare outcomes for issuers that procure auditor reviews voluntarily and mandatorily, and document that issuers with voluntary reviews have better outcomes. We conjecture that for issuers that voluntarily procure reviews, the reviews serve as signals of high future prospects. Finally, the positive effect of reviews is concentrated in PCAOB-registered auditors. JEL Classifications: G18; M41; M42; M48.

As the wind power penetration increases, the frequency stability of the power system is deteriorating. Thus, it is expected that the wind power plants (WPPs) will be required to produce the inertial response during the short-term large-scale frequency disturbances. To study the effects of the inertial response of the WPP, the dynamic equivalent model (DEM) of the WPP should be able to emulate the inertial response of the actual WPP. Otherwise, the simulated system frequency would be different from the actual one. Therefore, the inertial response identification algorithm (IRIA) is proposed in this article. The IRIA is able to identify the gain of the inertial controller and the inertia constants of the WPP according to the actual system frequency and the active power output of the actual WPP. In this article, the actual WPP is represented by the detailed model. In order to prove the effectiveness of the IRIA, three cases with different gains of the inertial controller are studied. The simulation results demonstrate that the proposed IRIA allows the DEM of the WPP to generate similar response of the active power and lead to close response of the system frequency as the actual WPP does in three different scenarios.

Summary Background & aims To date, the prevalence of Gestational diabetes mellitus (GDM) in China was 17.5%. Given the substantial relevance of GDM for medium- and long-term health of both mother and offspring and the paucity of existing data on the link between maternal diet and glucose homeostasis during pregnancy in Asian population, additional studies are needed. To examine the relevance of dietary glycemic index (GI), glycemic load (GL) and fiber intake before and during pregnancy for the development of GDM and glucose homeostasis over the course of pregnancy. Methods Cox proportional hazards analysis and linear mixed effects regressions were performed on data from 9317 women for whom three food frequency questionnaires (pre-pregnancy, 1st and 2nd trimesters) and biochemical measures during pregnancy were available. Investigated outcome variables included GDM risk, fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), and homeostasis model assessment insulin resistance (HOMA-IR) in the 1st, 2nd and 3rd trimesters. Results Women in the highest tertile of dietary GI (or GL) before pregnancy, in the 1st, or the 2nd trimester respectively had a 12% (15%), 25% (23%) or 29% (25%) higher risk of developing GDM than those in the lowest tertile (all p for trend ≤ 0.02). Women with the highest dietary fiber intake before pregnancy, in the 1st or 2nd trimester had a 11%, 17% or 18% lower GDM risk (all p for trend ≤ 0.03). Moreover, increases in GI or GL and decreases in fiber intake over the course of pregnancy (1st to 3rd trimesters) were independently associated with adverse concurrent developments in FPG, HbA1C and HOMA-IR (p ≤ 0.03). Conclusions Our study indicates that dietary GI, GL and fiber intake before and during pregnancy affects glucose homeostasis of pregnant Chinese women.

Global production networks have become the most important organizational platforms for coordinating international production activities, and their evolution patterns profoundly affect value distribution across the world. In this study, we shall firstly carry out an in-depth quantitative research to analyze the patterns and evolution of global production networks, using a long time-sequenced multi-region input-output table and the network analysis approach. Then based on the method of value-added decomposition, we will develop an index system to measure the degree of participation of regions in global production networks. Finally, we will try to identify the factors affecting the degree of participation of countries in global production networks by constructing a regression model. The results show that from 1995 to 2015, the evolution of global production networks measured by input-output linkages experienced four stages: expansion, contraction, re-expansion, and re-contraction. In addition, the core communities of global production networks evolved from two major production communities (Europe and the Americas) to three pillars (Europe, Americas, and Asia) while more segmented communities are mainly affected by geographical proximity. The latter consists of European, North American, South American, African and Asian communities. The evolution of the global production network pattern primarily manifests as a process of cooperation strengthening or weakening among communities, based on changes in the external environment and the need for individual development strategies. Meanwhile, the United States, Germany, and the United Kingdom have consistently ranked among the top entities in global production networks, whereas China, Russia, and Southeast Asia have the fastest rises in ranking. In addition, government efficiency, resources endowment, infrastructure conditions and technology levels play important roles in the participation in global production networks.

Technical debt refers to the design, development, and implementation shortcuts taken by firms when deploying accounting information systems. Prior system-level studies have shown that such shortcuts decrease the reliability of systems and increase the long-term system maintenance obligations. On the one hand, technical debt may cause system disruptions that impair firm-level performance. On the other hand, incurring technical debt may aid firms to expedite their systems deployment and to implement idiosyncratic functionalities that may enhance performance. In this firm-level study, we examine the economic implications of technical debt accumulated by 26 firms in their customer relationship management (CRM) systems over an 11-year period. We find that firms operating in industries with higher “clockspeed” and higher competitive threats tend to accumulate more technical debt. After controlling for industry- and firm-level factors, our analysis reveals that technical debt embedded in the CRM systems negatively impacts firms’ performances, measured as gross profit scaled by beginning-of-year total assets (GROA). We estimate that a 10% increase in technical debt reduces GROA by 16% on average. The negative impact of technical debt on GROA increases over the lifecycle of the systems, which significantly reduces the long-term business value of those systems. Highly experienced information technology teams and the presence of a chief information officer in a firm’s top management team, however, serve to mitigate, at least partially, the negative impact of technical debt. We discuss the implications of these findings for research on the business value and governance of accounting information systems and performance evaluation. This paper was accepted by Shiva Rajgopal, accounting.

Solar-blind deep-ultraviolet (DUV) photodetectors based on Ga2O3 have attracted great attention due to their potential applications for many military and civil purposes. However, the development of device integration for optoelectronic system applications remains a huge challenge. Herein, we report a facile method for patterned-growth of high-quality β-Ga2O3 thin films, which are assembled into a photodetectors array comprising 8 × 8 device units. A representative detector exhibits outstanding photoresponse performance, in terms of an ultra-low dark current of ∼0.62 pA, a large Ilight/Idark ratio exceeding 104, a high responsivity of ∼0.72 A W−1 and a decent specific detectivity of ∼4.18 × 1011 Jones, upon 265 nm DUV illumination. What is more, the DUV/visible (250/400 nm) rejection ratio is as high as 103 with a sharp response cut-off wavelength at ∼280 nm. Further optoelectronic analysis reveals that the photodetectors array has good uniformity and repeatability, endowing it the capability to serve as a reliable DUV light image sensor with a decent spatial resolution. These results suggest that the proposed technique offers an effective avenue for patterned growth of β-Ga2O3 thin films for multifunctional DUV optoelectronic applications.

Yang Liu,1,* Feng-Jiao Zhang,2,* Xi-Xi Zhao,3,* Yuan Yang,4 Chun-Yi Liang,3 Li-Li Feng,5 Xiang-Bo Wan,5 Yi Ding,1 Yao-Wei Zhang1 1Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China; 2Shanghai Concord Medical Cancer Center, Shanghai, 200001, People’s Republic of China; 3Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China; 4Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China; 5Department of Radiation Oncology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, 510655, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yi Ding; Yao-Wei Zhang Tel +86 20-62786616Email dingyi197980@126.com; weiyaozhang2@163.comPurpose: Neoadjuvant chemoradiotherapy (nCRT) has become the standard treatment for locally advanced rectal cancer (LARC). However, the accuracy of traditional clinical indicators in predicting tumor response is poor. Recently, radiomics based on magnetic resonance imaging (MRI) has been regarded as a promising noninvasive assessment method. The present study was conducted to develop a model to predict the pathological response by analyzing the quantitative features of MRI and clinical risk factors, which might predict the therapeutic effects in patients with LARC as accurately as possible before treatment.Patients and Methods: A total of 82 patients with LARC were enrolled as the training cohort and internal validation cohort. The pre-CRT MRI after pretreatment was acquired to extract texture features, which was finally selected through the minimum redundancy maximum relevance (mRMR) algorithm. A support vector machine (SVM) was used as a classifier to classify different tumor responses. A joint radiomics model combined with clinical risk factors was then developed and evaluated by receiver operating characteristic (ROC) curves. External validation was performed with 107 patients from another center to evaluate the applicability of the model.Results: Twenty top image texture features were extracted from 6192 extracted-radiomic features. The radiomics model based on high-spatial-resolution T2-weighted imaging (HR-T2WI) and contrast-enhanced T1-weighted imaging (T1+C) demonstrated an area under the curve (AUC) of 0.8910 (0.8114– 0.9706) and 0.8938 (0.8084– 0.9792), respectively. The AUC value rose to 0.9371 (0.8751– 0.9997) and 0.9113 (0.8449– 0.9776), respectively, when the circumferential resection margin (CRM) and carbohydrate antigen 19-9 (CA19-9) levels were incorporated. Clinical usefulness was confirmed in an external validation cohort as well (AUC, 0.6413 and 0.6818).Conclusion: Our study indicated that the joint radiomics prediction model combined with clinical risk factors showed good predictive ability regarding the treatment response of tumors as accurately as possible before treatment.Keywords: rectal cancer, neoadjuvant chemoradiotherapy, magnetic resonance imaging, tumor response

A 60‐year‐old man was hospitalized because of numbness and weakness in the right upper limb. Magnetic resonance imaging revealed a large mass in the right upper lobe invading the right eighth cervical and first thoracic nerve root. Biopsy pathology confirmed primary lung adenocarcinoma with a clinical stage of cT4N0M0 IIIA, negative for anaplastic lymphoma kinase fusion gene and epidermal growth factor receptor mutations but positive for programmed death ligand 1 (3%). Neoadjuvant tislelizumab and chemotherapy were offered to this patient with Pancoast tumor, and tumor shrinkage of 71% was achieved. After the operation, surgical pathology indicated pathologic complete response (pCR). Circulating tumor cells testing was negative after the first adjuvant treatment. In this case, we provide real‐world evidence of encouraging pCR with neoadjuvant tislelizumab and chemotherapy for a patient with Pancoast tumor., • Neoadjuvant tislelizumab and chemotherapy was offered for a patient with Pancoast tumor (TNM stage, cT4N0M0 IIIA). • Surgical resection was successfully performed and a pCR was achieved.

Purpose Studies regarding the association between dietary fat intake and gestational diabetes mellitus (GDM) are limited and provide conflicting findings. Thus, the study aims to examine the association of dietary fat intake in the year preceding pregnancy and during pregnancy with the risk of GDM, taking the relevance of dietary protein intake on GDM into consideration. Methods A prospective study was conducted in 6299 singleton pregnancies, using the data from the Nutrition in Pregnancy and Growth in Southwest China (NPGSC). A validated food frequency questionnaire was used to assess dietary fat intake in the year preceding pregnancy and during the first and second trimesters of pregnancy. Logistic regression analysis was used to assess the prospective associations of dietary fat intake and the type and source of dietary fats in different time windows with GDM risk. Results Higher intake of total fat [OR (95% CI): 2.21 (1.19–4.20), P = 0.02] during 12–22 weeks of gestation was associated with higher GDM risk. However, adjustment for animal protein intake greatly attenuated this association [OR (95% CI): 1.81 (0.93, 3.64), P = 0.11]. Total fat intake neither in the year preceding pregnancy nor during the early pregnancy was associated with GDM risk. Moreover, insignificant associations were observed between intakes of vegetable fat, animal fat, cholesterol, saturated fatty acid, monounsaturated fatty acid and polyunsaturated fatty acid one year before pregnancy and during the first and second trimesters and GDM risk. Conclusion Our study indicated that dietary fat intake one year before pregnancy and across the two pregnancy trimesters preceding the diagnosis of GDM has no relevance on GDM risk among Chinese women, particularly those with normal BMI, low, or normal calorie intake.

Interleukin (IL)-17 and its related cytokines have been shown to be involved in myocardial fibrosis and irreversible ventricular remodelling, which have predictive values in the development of left ventricular diastolic dysfunction (LVDD). This study aimed to assess the correlation between IL-17 and LVDD, and investigate the prognostic value of IL-17 among patients with normal left ventricular ejection fraction (LVEF).A total of 120 patients with normal LVEF underwent left ventricular (LV) catheterisation for LV end-diastolic pressure (LVEDP) measurement and routine echocardiography. The follow-up period was 30 (18, 35) months.The levels of IL-17 and IL-6 from the systemic blood were significantly increased in non-heart failure (HF) patients with LVDD (p0.001). Receiver operating characteristic (ROC) revealed that the combination of IL-17 and IL-6 showed the highest diagnostic accuracy in predicting LVDD (AUC, 0.890; 95% CI, 0.835-0.945; p0.001), and the cut-off value was 41.5 pg/mL. On logistic regression analysis, the increment of the combination of IL-17 and IL-6 was an independent predictor for the prognosis of LVDD (odds ratio, 1.25; 95% CI, 1.01-1.12; p0.05). According to the cut-off value of the combination of IL-17 and IL-6, the patients with lower levels of IL-17 and IL-6 (41.5 pg/mL group) had a better prognosis. The increased levels of IL17 and IL-6 were significantly correlated with the levels of fibrotic parameters.Assessment of LVDD by measuring the combination of IL-17 and IL-6 might provide valuable prognostic significance for non-HF patients with LVDD.

Purpose: Although enzalutamide (ENZ) has been widely used to treat de novo or castration-resistant metastatic prostate cancer, resistance develops and disease progression is ultimately inevitable. There are currently no approved targeted drugs to specifically delay or overcome ENZ resistance. Experimental Design: We selected several ENZ-resistant cell lines that replicated clinical characteristics of the majority of patients with ENZ-resistant disease. A high-throughput pharmacologic screen was utilized to identify compounds with greater cytotoxic effect for ENZ-resistant cell lines, compared with parental ENZ-sensitive cells. We validated the potential hits in vitro and in vivo, and used knockdown and overexpression assays to study the dependencies in ENZ-resistant prostate cancer. Results: ABT199 (BCL-2 inhibitor) and IMD0354 (IKKB inhibitor) were identified as potent and selective inhibitors of cell viability in ENZ-resistant cell lines in vitro and in vivo which were further validated using loss-of-function assays of BCL-2 and IKKB. Notably, we observed that overexpression of BCL-2 and IKKB in ENZ-sensitive cell lines was sufficient for the emergence of ENZ resistance. In addition, we confirmed that BCL-2 or IKKB inhibitors suppressed the development of ENZ resistance in xenografts. However, validation of both BCL-2 and IKKB in matched castration-sensitive/resistant clinical samples showed that, concurrent with the development of ENZ/abiraterone resistance in patients, only the protein levels of IKKB were increased. Conclusions: Our findings identify BCL-2 and IKKB dependencies in clinically relevant ENZ-resistant prostate cancer cells in vitro and in vivo, but indicate that IKKB upregulation appears to have greater relevance to the progression of human castrate-resistant prostate cancer.

The diagnosis and treatment of massive hemoptysis remain challenging. We report a 28-year-old woman with refractory massive hemoptysis caused by a mediastinal hemangioma. Despite multiple bronchial artery embolizations and fiberoptic bronchoscopy treatments, effective control of the bleeding and clearing of the airway was not possible. Finally, with the support of venovenous extracorporeal membrane oxygenation, mediastinal hemangioma resection and right upper lobe sleeve resection were simultaneously performed. During the operation, many blood clots in the airway were removed. The airway bleeding was effectively controlled, and the patient recovered.

Peripheral inflammation and nerve injury usually accompany each other. However, whether inflammatory and neuropathic pain share similar mechanisms at all stages is unknown. TRPV1 and P2X3 are two major ion channels in dorsal root ganglia (DRGs) and are involved in chronic pain. Here, their function and expression in DRGs at different phases of the two types of pain were investigated. Both the paw withdrawal threshold (PWT) and paw withdrawal latency were decreased in rats injected with complete Freud's adjuvant (CFA). However, only the PWT was decreased in rats with spared nerve injury (SNI). CFA increased the magnitude of the TRPV1-mediated Ca2+ response but not the P2X3-mediated Ca2+ response 14 days after injection. Consistent with this result, the P2X3 expression level in CFA rats was increased only at 3 days after injection. SNI surgery increased the magnitudes of the TRPV1- and P2X3-mediated Ca2+ responses and upregulated both TRPV1 and P2X3 expression in lumbar DRGs. The distributions of TRPV1 and P2X3 in DRGs after modeling were observed, and TRPV1 was found to be highly expressed mainly in the L4-L5 DRGs in CFA rats and in the L5-L6 DRGs in SNI rats. P2X3 was highly expressed in the L4-L6 DRGs in CFA rats 3 days after injection but was only highly expressed in the L4 DRG 14 days after modeling. On the other hand, SNI promoted the P2X3 expression L4-L5 DRGs 3 days after surgery, but only L6 DRG 14 days after modeling. All the results indicate that P2X3 and TPRV1 are involved in inflammatory and neuropathic pain by different expression levels and distributions in the lumbar DRG in the chronic stage.

With the introduction of Materials Genome Initiative (MGI) in 2011, high-throughput material computation and material prediction have gradually become a hot topic in materials research. MGI has strong guiding significance and high practical application value as the deepening of the concept of environmental protection, low-consumption, faster, and high-throughput. MGI aims to convert the traditional “Trial Experiment” to “Computation to Experiment”, which has become the trend of materials research. There are two main ways to realize the MGI, the first one is the development of quantum chemical calculations and statistical mechanics, while the other one is the establishment of Quantitative Structure-Property Relationship (QSPR). Among them, the QSPR method has been widely used in recent years due to its excellent predictive properties. Combining data-driven and machine learning algorithms, the QSPR method has undergone major changes today, the most prominent of which is the change in the calculation method used in the QSPR method. Reasonable use of calculation methods in QSPR can greatly increase the speed of QSPR model formation and the accuracy of prediction, which is critical to predicting new materials. The calculation methods are the main factors that determine the accuracy and construction speed of the QSPR model. Choosing the best calculation method is very important to improve the prediction accuracy and calculation speed of the QSPR model. Therefore, this article first summarizes the QSPR model, briefly introduces the calculation steps of the QSPR method, focuses on the calculation methods of molecular descriptors and model optimization algorithms in QSPR, and analyzes the advantages and disadvantages of each method. Finally, this article summarizes the application trend of various calculation methods in QSPR in recent years, and concludes as follow: (1) There are many kinds of molecular descriptor calculation software, and most of the software calculation speed is quite fast. At the same time, the calculated number of molecular descriptors is pretty large, which can achieve better calculation results. However, each software still has its own limitations. Researchers can choose one or some software to calculate molecular descriptors according to their needs. (2) The preprocessing algorithms are mainly screening algorithms, including statistical methods, informatics methods, and biological methods. Evolutionary algorithms, which are developed by biological methods, are increasingly being used because of their excellent global screening capabilities. While the number of molecular descriptors obtained by calculation increase significantly, the global influence of molecular descriptors has been gradually emphasized. Therefore, in recent years, evolutionary algorithms have gradually become a popular choice for molecular descriptor screening. (3) The optimization methods mainly include machine learning algorithms, which can be classified into linear methods, nonlinear methods, and hybrid methods. The first two methods have their own advantages for linear methods can show directly the importance of each molecular descriptor and the nonlinear methods’ models are more accurate. In order to improve the efficiency of algorithm parameter calculation, in recent years, more and more global optimization algorithms have been introduced into machine learning algorithms as parameter optimization methods, which forms the third method—Hybrid optimization method.

Drug refractory epilepsy (RE) is believed to be associated with structural lesions, but some RE patients show no significant structural abnormalities (RE-no-SA) on conventional magnetic resonance imaging scans. Since most of the medically controlled epilepsy (MCE) patients also do not exhibit structural abnormalities, a reliable assessment needs to be developed to differentiate RE-no-SA patients and MCE patients to avoid misdiagnosis and inappropriate treatment. Using resting-state scalp electroencephalogram (EEG) datasets, we extracted the spatial pattern of network (SPN) features from the functional and effective EEG networks of both RE-no-SA patients and MCE patients. Compared to the performance of traditional resting-state EEG network properties, the SPN features exhibited remarkable superiority in classifying these two groups of epilepsy patients, and accuracy values of 90.00% and 80.00% were obtained for the SPN features of the functional and effective EEG networks, respectively. By further fusing the SPN features of functional and effective networks, we demonstrated that the highest accuracy value of 96.67% could be reached, with a sensitivity of 100% and specificity of 92.86%. Overall, these findings not only indicate that the fused functional and effective SPN features are promising as reliable measurements for distinguishing RE-no-SA patients and MCE patients but also may provide a new perspective to explore the complex neurophysiology of refractory epilepsy.

Two-dimensional layered (2D) materials are currently attracting intensive research interest for high-performance photodetection and other optoelectronic applications. However, the study of device integration for multifunctional optoelectronic applications is still at a nascent stage. Here, the assembly of a multilayered PtSe2/pyramid-Si heterostructure-based photodetector array consisting of 8 × 8 device units is demonstrated. Owing to the pronounced light confinement effect of the heterostructures, the devices present an prominent photovoltaic effect, which enables efficient self-driven photodetection in a broadband wavelength spectrum. The Ilight/Idark ratio, responsivity, external quantum efficiency (EQE) and specific detectivity can attain values as high as 5.51 × 106, 567 mA W−1, 87% and 1.26 × 1013 jones, respectively, upon 810 nm near-infrared (NIR) light illumination. What is more, benefiting from the large-scale homogeneous material growth technique, the photodetector array exhibits excellent uniformity and repeatability in photoresponse performance with negligible unit-to-unit variation. The above characteristics provide the photodetector array with the capability of recording a simple image produced by NIR illumination and monitoring a moving photonic signal, showing the great possibility for NIR image sensing and light trajectory tracking applications.

Multispectral photodetection has garnered enormous research interest and has always been challenging to date. Here, we present the realization of an electrically adjusted single-band/dual-band photodetector based on an inorganic lead-free halide Cs3Cu2I5/two-dimensional (2D) PdTe2 multilayer/Ge multiheterostructure. Owing to its unique optical property and distinct carrier transport behaviour, the device can be easily converted from a single-band photodetector operating in the near-infrared (NIR) region to a dual-band photodetector working in both deep-ultraviolet (DUV) and NIR regimes, upon applying a reverse bias voltage. Significantly, the device shows a peak responsivity of ∼694.1 mA W−1 at 1550 nm at zero bias, and maximum responsivity values of ∼744.2 mA W−1 and ∼712.5 mA W−1 at 265 nm and 1550 nm, respectively, at a small reverse bias. This characteristic also endows the photodetector with an excellent DUV/NIR dual-band optical imaging capability. This work will offer a new opportunity for designing high-performance photodetectors with multiple functionalities operating in complicated circumstances.

Hepatocellular carcinoma (HCC), is one of the most common malignancies worldwide, which is globally the third most common cause of cancer-related mortality. This study aims to identify new potential early-stage diagnostic and prognostic biomarker for HCC. The candidate gene SLC26A6 expression was analyzed based on the Oncomine and Tumor Immune Estimation Resource (TIMER) databases and verified forwards with Gene Expression Omnibus (GEO) datasets. The protein expression was retrieved from Human Protein Atlas (HPA) database. We also validated the diagnostic and prognostic value in HCC, and the relationship between SLC26A6 and clinicopathologic parameters were also accessed. The Gene Set Enrichment Analysis (GSEA) and Protein-Protein Interaction (PPI) network were constructed to analyze the SLC26A6-related pathway. These results reveal that SLC26A6 expression was elevated in HCC, and the diagnostic sensitivity of SLC26A6 was higher than α-fetoprotein (AFP). SLC26A6 expression was independent prognostic factor for HCC. SLC26A6 up-regulation was mainly associated with excision repair, DNA replication, etc. SLC26A6-related mR-NAs was enriched in PI3K-AKT signaling pathway, axon guidance, pathways in cancer, and so on. PPI network indicated that SLC26A6 was interacted with solute carrier members, ABC transporters and other ion transport molecule. We further analyzed three positively correlated microRNAs and 10 negatively correlated microRNAs, all of these were reported participating or inhibiting in cancer progression. This is the first study demonstrated that SLC26A6 is up-regulated in HCC and correlated with poor prognosis, which might be served as a diagnostic marker or prognostic biomarker for HCC.

Objectives Hypoxia is one of the characteristics of microenvironmental changes after orthognathic surgery for fractures. HIF-1α is a main regulator of the hypoxic response and plays a crucial role in bone formation, remodelling, and homeostasis. Osteoclasts participate in bone absorption and affect osteogenesis, and osteoclasts differentiate in a path from the oxygen-rich bone marrow to oxygen-deficient bone lesions. Thus, we aimed to study the key functions of HIF-1α in osteoclasts during mandibular healing after osteotomy. Materials and methods The function of HIF-1α in osteoclasts during fracture healing in osteoclast-specific HIF-1α-conditional-knockout mice was investigated in mandibular osteotomy. Primary osteoclasts were used to explore the expression of HIF-1α and cardiotrophin-1 (CT-1) at both the mRNA and protein levels. The ability of BMSCs co-cultured with conditioned media from osteoclast-specific HIF-1α-knockout primary osteoclasts was detected using osteoclast-mediated osteogenesis experiments. Results Hypoxia-inducible factor-1α increased osteoclastogenesis and bone resorption, and a delay in bone healing was found in osteoclast-specific HIF-1α-conditional-knockout mice compared with normal mice. HIF-1α-knockout primary osteoclasts inhibited bone resorption and CT-1 expression, and HIF-1α enhanced the osteoclast-mediated stimulation of BMSC differentiation by secreting CT-1. Conclusions Hypoxia-inducible factor-1α can play a key role in the physiology and pathogenesis of bone resorption by promoting osteoclastogenesis during fracture and influencing osteogenesis through CT-1 during bone healing.

Background: Whether electroacupuncture (EA) stimulation at different frequencies has a similar effect on spared nerve injury (SNI) as other neuropathic pain models, and how EA at different frequencies causes distinct analgesic effects on neuropathic pain is still not clear. Methods: Adult male Sprague-Dawley rats were randomly divided into sham SNI, SNI, 2 Hz, 100 Hz and sham EA groups. Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were measured. EA was performed once a day on days 1 to 14 after SNI. The expressions of transient receptor potential cation subfamily V member 1 (TRPV1) and peripheral purinergic P2X receptor 3 (P2X3) were determined by western blotting and immunofluorescence. TRPV1 siRNA and P2X3 siRNA were administered by intrathecal injection. TRPV1 or P2X3 agonists were combined with EA. Results: There were significant decreases in PWT, but no changes in PWL in the 14 days after SNI. EA using 2- or 100-Hz stimulation similarly increased PWT at every time point. The cytosol protein expression of P2X3 in the L4–L6 dorsal root ganglia (DRG) increased, but the expression of TRPV1 decreased in the SNI model. Both these effects were ameliorated by EA, with 2-Hz stimulation having a stronger effect than 100-Hz stimulation. Blocking either TRPV1 or P2X3 specific siRNAs attenuated the decreased PWT induced by SNI. Administration of either a TRPV1 or P2X3 agonist inhibited EA analgesia. Conclusion: 2- and 100-Hz EA similarly induced analgesic effects in SNI. This effect was related to up-regulation and down-regulation, respectively, of cytosol protein expression of P2X3 and TRPV1 in L4–L6 DRG, with 2 Hz having a better effect than 100 Hz.

Complex regional pain syndrome (CRPS) results in chronic and excruciating pain in patients. Conventional therapies lack effectiveness, rendering it one of the most difficult to treat neurological conditions.. Electroacupuncture (EA) is an effective alternative therapy for pain relief. Here, we investigated whether EA exerts analgesic effect on a rat model of CRPS type-I (CRPS-I) and related mechanisms. The rat chronic postischemic pain (CPIP) model was established to mimic CRPS-I. 100Hz EA exerted robust and persistent antiallodynic effect on CPIP model compared with 2 Hz EA or sham EA. EA markedly suppressed the overexpression of CXCL12/CXCR4 in spinal cord dorsal horn (SCDH) of CPIP model, leading to substantial decrease in neuronal and glial cell activities in SCDH. Pharmacological blocking CXCR4 mimicked EA-induced antiallodynic effect and related cellular events in SCDH, whereas exogenous CXCL12 abolished EA's effect. CXCR4 signaling resulted in ERK activation in SCDH, contributing to mechanical allodynia of CPIP model rats, whereas EA markedly reduced ERK activation. Therefore, we demonstrated that EA interferes with CXCL12/CXCR4 signaling in SCDH and downstream ERK pathway to exert robust antiallodynic effect on an animal model of CRPS-I. Our work suggests that EA may be a potential therapeutic option for CRPS-I in clinic. PERSPECTIVE: Our work identified that EA exerts robust antiallodynic effect on an animal model of CRPS-I, via mechanisms involving inhibition of CXCL12/CXCR4 signaling. EA further attenuates downstream neuronal and glial cell activation and ERK pathway in SCDH. This work suggests that EA may be a potential therapeutic option for CRPS-I management in clinic.

The methods based on the combination of word-level and character-level features can effectively boost performance on Chinese short text classification. A lot of works concatenate two-level features with little processing, which leads to losing feature information. In this work, we propose a novel framework called Mutual-Attention Convolutional Neural Networks, which integrates word and character-level features without losing too much feature information. We first generate two matrices with aligned information of two-level features by multiplying word and character features with a trainable matrix. Then, we stack them as a three-dimensional tensor. Finally, we generate the integrated features using a convolutional neural network. Extensive experiments on six public datasets demonstrate improved performance of our new framework over current methods.

Background and objectives Patients with femoral neck fractures often suffer severe pain. This randomized controlled clinical study compared the effect of femoral nerve block (FNB) and fascia iliaca compartment block (FICB) in this population. Patients and methods Forty-six patients were randomly assigned to one of the two groups: FNB group (femoral nerve block, n=23) or FICB group (fascia iliaca compartment block, n=23). Before positioning for spinal anesthesia, patients received FNB with 15 mL of 0.5% ropivacaine or FICB with 40 mL of 0.5% ropivacaine. Pain was evaluated using a visual analogue scale (VAS) at rest and during hip flexion after admission to the operation room; at 3, 5, 8, and 10 min after analgesia intervention; and during positioning for spinal anesthesia. Positioning was attempted after 10 min of analgesia intervention in each group. Time required to perform spinal anesthesia, quality of positioning, and patient satisfaction were documented. Results The VAS scores in the FNB group were significantly lower than those in FICB group at 3 and 5 min after analgesia intervention (P=0.000). However, there were no significant differences in VAS between groups at 8 or 10 min or during positioning. Conclusion FNB and FICB produce similar analgesic effects in patients with femoral neck fractures, but FNB has a more rapid onset of pain relief.

This research demonstrates a new methodology—stack casting, which combines fabric formwork and robotic assembly. In the following research, a robot placed a textile mold on top of a precast environment to erect a significant architectural object. Through this method the robotic casting process obtained further contextual information to create highly customized assemblies. The natural form-fit boundary of the fabric strengthened the identification between global and local systems. As the digital method met the natural form-finding process, an interactive tectonic was generated—calibrating itself for any composition and accommodating deviations in geometry. Driven by the correspondence between digital and physical, the technique extended the building method of a dry-fitted cast in situ wall. To build a full-scale prototype, robotic stack casting collaborated with other versatile methods to invent new set-up strategies, which link to both on-and off-site construction. This research is part of a bigger picture rising in soft robotics. By interpreting unique forming into the computational design, precise and imprecise fabrication were redefined in a playful phenomenon. In traditional robotic stacking, the robot bridges the digital and physical world but its lack of adaptivity causes problem when placing imprecise objects. In this research’s process, the use of inexact fabric molds fixed the tolerance and found centers of gravity through relative reactions. They adjusted to the unique personal properties of their surroundings and compensated for discrepancies in material. As an alternative to the application of sensor feedback for accommodating tolerance in material, the use of stack casting digital formwork instead adjusts and reshapes the non-ideal masonry from the real-time architectural context. This playful process opens the door to further imaginations from design to build.

Background Small supernumerary marker chromosomes (sSMCs), are additional abnormal chromosomes, which can’t be detected accurately by banding cytogenetic analysis. Abnormal phenotypes were observed in about 30% of SMC carriers. Duplication of chromosome 15 and related disorders, characterized by hypotonia motor delays, autism spectrum disorder (ASD), intellectual disability, and epilepsy including infantile spasms, might be account for 50% of the total sSMCs. Case presentation An 11-month-old infant with an sSMC found by banding cytogenetics was referred to our clinic because of developmental retardation and autism spectrum disorder. After several months of rehabilitation treatment, the progress of motor development was obvious, but the consciousness was still far from satisfied. High-resolution karyotype analysis, multiplex ligation-dependent probe amplification and copy number variation sequencing (CNV-Seq) were conducted to confirm the identity of the sSMC. A bisatellited dicentric sSMC was observed clearly in high-resolution karyotype analysis and a 10.16-Mb duplication of 15q11.1q13.2 (3.96 copies) together with a 1.84-Mb duplication of 15q13.2q13.3 (3 copies) was showed by CNV-Seq in the proband. It suggested that the molecular cytogenetic karyotype was 47,XY,+dic(15;15)(q13.2;q13.3). Furthermore, the clinical symptoms of the proband mostly fit 15q duplication related disorders which are characterized by hypotonia motor delays, autism spectrum disorder (ASD), and intellectual disability. Conclusion We reported for the first time using CNV-Seq to detect sSMCs and find a partial trisomy and tetrasomy of 15q11-q13 associated with developmental delay and autism spectrum disorder. Our report indicates that CNV-seq is a useful and economical way for diagnosis of dup15q and related disorders.

BackgroundModerate-to-severe postoperative pain following craniotomy has a high incidence in pediatric patients. Such pain may cause agitation, intracranial hypertension, epileptic seizures, and postoperative hematoma, which affect morbidity and mortality. Although scalp nerve block (SNB) achieves satisfactory pain relief except for suboccipital mid-craniotomy in adults and ropivacaine is widely used as a long-acting peripheral nerve block agent in children, there are few studies of SNB with ropivacaine in pediatric patients undergoing craniotomy. In addition, the neurosurgery operation time is relatively long, but the duration of action of SNB is limited. It is generally believed that postoperative SNB is better than preoperative SNB for postoperative analgesia. However, considering the concept of preemptive analgesia, we believe that preoperative SNB may achieve a longer postoperative analgesia effect than we expected.MethodsThis trial is a single-institution, prospective, randomized, controlled, double-blind study. A total of 180 children aged between 1 and 12 years who are undergoing elective craniotomy will be randomly allocated in a 1:1:1 ratio to three groups: group B (preoperative ropivacaine block group), group A (postoperative ropivacaine block group), and group N (nonblocking control group). This randomization will be stratified by age in two strata (1–6 years and 7–12 years). The primary outcome is the total consumption of sufentanil within 24 h after surgery. The secondary outcomes include assessment of pain scores, total consumption of sufentanil and emergency-remedy medicine consumption at observation points, the occurrence of postoperative complications, and the length of hospitalization after surgery.DiscussionThis study is designed to explore the effect and feasibility of SNB with ropivacaine for postoperative analgesia in pediatric patients undergoing craniotomy. Further aims are to compare the effects of preoperative and postoperative SNB on postoperative analgesia in order to identify whether there is a preemptive analgesic effect and determine the better time to implement SNB in pediatric patients during craniotomy.Trial registrationChinese Clinical Trial RegistryChiCTR1800017386. Registered on 27 July 2018.

In the era of advanced computer intelligence, Internet of Things (IoT) provides fantastic services to users. However, users are suffering a severe risk of private information inference, which is caused by the leakage of motion sensory data from IoT devices. Existing works of risk assessment of motion sensor based private information inference underestimates the risk because they ignore the possibility of using advanced Computational Intelligence techniques and the variety of languages with different input methods. In this paper, we assess the risk of motion sensor based private information inference by considering the variety of languages with different input methods, advanced Computational Intelligence techniques, and reinforcement learning of personal usage habits. We collect data from real users and run simulations to provide an authentic and up-to-date risk assessment. Based on the simulation result, we discuss the risky usage actions and possible defense strategies for the Internet of Things users.

Background Acute pain can transition to chronic pain, presenting a major clinical challenge. Electroacupuncture (EA) can partly prevent the transition from acute to chronic pain. However, little is known about the mechanisms underlying the effect of EA. This study investigated the effect of EA on pain transition and the activation of metabotropic glutamate receptor 5 (mGluR5)-protein kinase C epsilon (PKCe) signaling pathway in the dorsal root ganglia (DRG). Methods The hyperalgesic priming model was established by the sequential intraplantar injection of carrageenan (1%, 100 μL) and prostaglandin E2 (PGE2) into the left hind paw of rats. EA treatment (2/100 Hz, 30 min, once/day) was applied at bilateral Zusanli (ST36) and Kunlun (BL60) acupoints in rats. Von Frey filaments were used to investigate the mechanical withdrawal threshold (MWT) at different time points. The protein expression levels of mGluR5 and PKCe in the ipsilateral L4-L6 DRGs of rats were detected by Western blot. Some pharmacological experiments were performed to evaluate the relationship between mGluR5, PKCe and the MWT. It was also used to test the effects of EA on the expression levels of mGluR5 and PKCe and changes in the MWT. Results Sequential injection of carrageenan and PGE2 significantly decreased the MWT of rats and up-regulated the expression level of mGluR5 and PKCe in the ipsilateral L4-L6 DRGs. EA can reverse the hyperalgesic priming induced by sequential injection of carrageenan/PGE and down-regulate the protein expression of mGluR5 and PKCe. Glutamate injection instead of PGE2 can mimic the hyperalgesic priming model. Pharmacological blocking of mGluR5 with specific antagonist MTEP can prevent the hyperalgesic priming and inhibit the activation of PKCe in DRGs. Furthermore, EA also produced analgesic effect on the hyperalgesic priming rats induced by carrageenan/mGluR5 injection and inhibited the high expression of PKCe. Sham EA produced none analgesic and regulatory effect. Conclusion EA can regulate pain transition and it may relate with its inhibitory effect on the activation of mGluR5-PKCe signaling pathway in the DRGs.

To investigate the chest CT imaging characteristics and clinical manifestations of patients with COVID-19 pneumonia.This study included 150 patients with COVID-19 pneumonia diagnosed from January 10 to February 12, 2020 to analyze their clinical and CT imaging characteristics.The period between symptom onset and initial CT examination ranged from 1 to 8 days. There were 83 cases (55.33%) involving both lungs, 67 cases (44.67%) involving a single lung (left 25 cases and right 42 cases). There were 49 cases (32.67%) of single intrapulmonary lesion, 33 cases (22.00%) of multiple intrapulmonary lesions, 68 cases (44.00%) of diffused intrapulmonary lesions, 67 cases (44.67%) of subpleural lesions, 24 cases (16.00%) of lesions localizing along the bronchovascular bundles, and 59 cases (39.33%) with lesions in both locations. There were 18 cases (12.00%) exhibiting ground-glass nodules of 10 mm, 124 cases (82.67%) of patchy ground-glass opacities with or without consolidation, 8 cases (5.33%) of cord-like lesions, 6 cases (4.00%) of pleural effusion, and 2 cases (1.33%) of enlarged lymph nodes.The main manifestations of initial chest CT in COVID-19 pneumonia patients was ground-glass opacities, commonly involving single site in patients 35 years old and multiple sites and extensive area in patients 60 years old. The common lesion sites were the subpleural region and the posterior basal segments of the lower lobes, mostly showing thickening of the interlobular septum and mixed with consolidation.

Cloud computing offers a cost-effective and elastic computing paradigm that facilitates large scale data storage and analytics. By deploying virtualization technologies in the datacenter, cloud enables efficient resource management and isolation for various big data applications. Since the hotspots (i.e., overloaded machines) can degrade the performance of these applications, virtual machine migration has been utilized to perform load balancing in the datacenters to eliminate hotspots and guarantee Service Level Agreements (SLAs). However, the previous load balancing schemes make migration decisions based on deterministic resource demand estimation and workload characterization, without considering their stochastic properties. By studying real world traces, we show that the resource demand and workload of virtual machines are highly dynamic and bursty, which can cause these schemes to make inefficient migrations for load balancing. To address this problem, in this paper we propose a stochastic load balancing scheme which aims to provide probabilistic guarantee against the resource overloading with virtual machine migration, while minimizing the total migration overhead. Our scheme effectively addresses the prediction of the distribution of resource demand and the multidimensional resource requirements with stochastic characterization. Moreover, as opposed to the previous works that measure the migration cost without considering the network topology, our scheme explicitly takes into account the distance between the source physical machine and the destination physical machine for a virtual machine migration. The trace-driven experiments show that our scheme outperforms the previous schemes in terms of SLA violation and the migration cost.

PurposeKeeping both employees and customers highly engaged has become a critical issue for service firms, especially for high-contact and highly customized services. Therefore, it is essential to engage employees and customers during service interactions for better service outcomes. However, past research on employee and customer engagement has primarily focused on brands and organizations. Little research has concentrated on service interactions as the objects of engagement. To fill this research gap, this study aims to clarify and define service engagement behaviors (SEBs), identify various employee and customer SEBs and develop a model to investigate the relationships between these behaviors.Design/methodology/approachA theoretical framework was developed based on social contagion theory and service-dominant (S-D) logic to explore the effects of employee SEBs on customer SEBs through customer perceptions of relational energy and interaction cohesion. Dyadic survey data collected from 293 customer-employee pairs in various high-contact and highly customized service industries were examined through structural equation modeling.FindingsResults show that employee SEBs (service role involvement, customer orientation behavior and customer empowerment behavior) positively influence relational energy and interaction cohesion, which in turn affect customer SEBs (service exploration behavior and service coordination behavior).Originality/valueThis study represents pioneering research to conceptualize SEBs. Different from the extant literature on engagement, SEBs capture the proactive and collaborative engagement behaviors of employees and customers in service interactions. Various employee and customer SEBs were identified and an empirical model was proposed and tested to investigate the effect of employee SEBs on customer SEBs through relational energy and interaction cohesion.

Recently, many methods based on deep learning (DL) have been used for hyperspectral image (HSI) classification and achieved good performance. But such approaches often need numerous labelled traini...