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In recent years, Service Oriented Architecture (SOA) has been increasingly adopted to develop distributed applications in the context of the Internet. To develop reliable SOA-based applications, an important issue is how to ensure the quality of web services. In this paper, we propose a dynamic random testing (DRT) technique for web services, which is an improvement over the widely-practiced random testing (RT) and partition testing (PT). We examine key issues when adapting DRT to the context of SOA, including a framework, guidelines for parameter settings, and a prototype for such an adaptation. Empirical studies are reported where DRT is used to test three real-life web services, and mutation analysis is employed to measure the effectiveness. Our experimental results show that, compared with the three baseline techniques, RT, Adaptive Testing (AT) and Random Partition Testing (RPT), DRT demonstrates higher fault-detection effectiveness with a lower test case selection overhead. Furthermore, the theoretical guidelines of parameter setting for DRT are confirmed to be effective. The proposed DRT and the prototype provide an effective and efficient approach for testing web services. IEEE

Calcium sulfate (CaSO4) has been verified as a promising oxygen carrier (OC) in the chemical looping combustion (CLC) for its high oxygen capacity, abundant reserve and low cost, but its low reactivity and deleterious sulfur species emission from the side reactions of CaSO4 should be well considered for its wide application in CLC. In order to promote the reactivity of CaSO4 and increase its potential to inhibit the gaseous sulfur emission, a CeO2-enhanced CaSO4 OC mixed OC of core-shell structure was prepared using the combined template synthesis method. Reaction characteristics of the prepared CaSO4-CeO2 mixed OC with a typical lignite was first conducted and systematically investigated, and an improved reactivity of the prepared CaSO4-CeO2 mixed OC was demonstrated than its single component CaSO4 or CeO2 due to the fast transfer and exchange of oxygen from the CaSO4 substrate to coal via the doped CeO2. Furthermore, the solid products formed from the mixed CaSO4-CeO2 OC with the selected coal were collected and analyzed. Especially, evolution and redistribution of the sulfur species of different forms were focused. At the latter reaction stage of YN reaction with the CaSO4-CeO2 mixed OC, the SO2 emitted from the side reactions of CaSO4 was greatly diminished and the doped CeO2 was proven effective to directionally fix the SO2 released to turn into different solid sulfur compounds, which were determined as Ce2O2S, Ce2S3 and Ce2(SO4)3·5H2O and formed through the different pathways. In addition, good regeneration of the reduced CaSO4-CeO2 mixed OC could be reached in spite of the unavoidable interaction between the included minerals in coal and the reduced mixed OC. Overall, the combined template method-made CaSO4-CeO2 mixed OC reported herein was not only endowed with enhanced reactivity for coal conversion, but also owned the potential to directionally fix the gaseous sulfur emission, which is quite applicable as OC for simultaneous decarbonatization and desulfurization in the real CLC process.

The replacement of small cations with bulkier organic cations containing long alkyl chains or benzene rings to form a thin two-dimensional (2D) perovskite passivation layer on three-dimensional (3D) perovskite (2D/3D) has become a promising strategy for improving both the efficiency and stability of perovskite solar cells (PSCs). The 2D layer defines the interfacial chemistry and physics at the 2D/3D bilayer and endows the 2D/3D structure with better chemical and thermal stability. Herein, 2D/3D (CF3-PEA)2FA0.85MA0.15Pb2I7/FA0.85MA0.15PbI3 planar heterojunction perovskite was produced using a facile interfacial ion exchange process. The 2D (CF3-PEA)2FA0.85MA0.15Pb2I7 capping layer can not only passivate the FA0.85MA0.15PbI3 film but also act as super-hydrophobic layer to inhibit water diffusion and significantly enhance the stability. The 2D capping layer can also establish a unique graded band structure at the perovskite/Spiro-OMeTAD interface and lead to p-type doping for Spiro-OMeTAD layer which is beneficial for efficient charge transport. Optimized PSCs based on this 2D/3D heterojunction yield a champion power conversion efficiency (PCE) of 23.1% and improved stability. The device maintains 84% output for 2400 h aging under ambient environmental conditions without encapsulation, and maintains 81% for 200 h under illumination with encapsulation. This work will inspire the design of more fluorinated 2D perovskite interfaces for advanced photovoltaics and beyond.

Hepatocellular carcinoma (HCC) is the most common high malignancy with insidious onset, invasive fast-growing, high recurrence rate and fatality. YTH domain family plays essential roles in development of HCC. However, the biological function of YTH domain family in HCC have not been clarified. Here, through evaluating the expression profiles of YTH domain family, we found that upregulated YTHDF1 might be more significant and valuable in development and progression of HCC. There was a strong correlation between YTHDC1, YTHDF1 and YTHDF2 and pathological stage of HCC patients. Kaplan-Meier plotter revealed that HCC patients with high level of YTHDF1 and YTHDF2 were highly related to a shorter overall survival time, and low level of YTHDF1 (p = 0.0017) has an important association with a longer progression-free survival time. Genetic alterations using cBioPortal revealed that the alteration rates of YTHDF3 were the highest. We also found that the functions of YTH domain family were linked to several cancer-associated pathways, including peptidyl-serine modification, peptidyl-tyrosine modification and negative regulation of cellular component movement. TIMER database indicated that the YTH domain family had a strong relationship with the infiltration of six types of immune cells (macrophages, neutrophils, CD8+ T-cells, B-cells, CD4+ T-cells and dendritic cells). Next, Ualcan databases revealed that the global methylation levels of YTHDC1 was higher in HCC patients, while YTHDF2 was lower in HCC patients. In conclusion, our findings will enhance the understanding of YTH domain family in HCC pathology, and provide novel insights into YTH-targeted therapy for HCC patients.

BACKGROUND Although endoscopic sphincterotomy (EST) has a positive therapeutic effect on biliary-type sphincter of Oddi dysfunction (SOD), some patients still have little relief after EST, which implies that other functional abdominal pain may also be present with biliary-type SOD and interfere with the diagnosis and treatment of it. AIM To retrospectively assess EST as a treatment for biliary-type SOD and analyze the importance of functional gastrointestinal disorder (FGID) in guiding endoscopic treatment of SOD. METHODS Clinical data of 79 patients with biliary-type SOD (type I and type II) treated with EST at Affiliated Hospital of Guizhou Medical University from January 2014 to January 2019 were retrospectively collected to evaluate the clinical therapeutic effect of EST. The significance of relationship between FGID and biliary-type SOD was analyzed. RESULTS Seventy-nine patients with biliary-type SOD received EST, including 29 type 1 patients and 50 type 2 patients. The verbal rating scale-5 (VRS-5) scores before EST were all 3 or 4 points, and the scores decreased after EST; the difference was statistically significant (P < 0.05). After EST, the serum indexes of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and total bilirubin in biliary-type SOD were significantly lower than before (P < 0.05). After EST, 67 (84.8%) and 8 (10.1%) of the 79 patients with biliary-type SOD had obviously effective (VRS-5 = 0 points) and effective treatment (VRS-5 = 1-2 points), with an overall effectiveness rate of 94.9% (75/79). There was no difference in VRS-5 scores between biliary-type SOD patients with or without FGID before EST (P > 0.05). Of 12 biliary-type SOD (with FGID) patients, 11 had abdominal pain after EST; of 67 biliary-type SOD (without FGID) patients, 0 had abdominal pain after EST. The difference was statistically significant (P

Zeyu Zhang,1 Xiangyuan Qiu,1 Yuanliang Yan,2 Qiujiu Liang,2 Yuan Cai,3 Bi Peng,3 Zhijie Xu,3,4 Fada Xia1 1Department of Thyroid Surgery, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 3Department of Pathology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 4National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaCorrespondence: Zhijie XuDepartment of Pathology, Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaEmail xzj1322007@csu.edu.cnFada XiaDepartment of Thyroid Surgery, Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaEmail xiafada@csu.edu.cnBackground: Ferroptosis is the latest-discovered, iron-dependent form of regulated cell death. It has been increasingly recognized that ferroptosis-related genes participate in oncogenesis and development of cancers, including breast cancer (BRCA). Thus, It is important to explore the biofunctions of ferroptosis-related genes in BRCA.Methods: Transcriptome microarray datasets (GSE22358, GSE9014 and GSE8977, GSE2990 and GSE2034) and TCGA-BRCA were retrieved for analyses. And a variety of computational tools were used to identify the roles and associated biological functions in BRCA.Results: Two ferroptosis-related genes (AKR1C1 and AKR1C3) were significantly expressed in GSE22358, GSE9014 and GSE8977. Higher expression of AKR1C1 was related with favorable prognosis. TCGA-BRCA further confirmed the expression of AKR1C1 and the prognostic value of AKR1C1. Co-expression analyses showed the most enriched GO term and KEGG pathways were termination of DNA-templated transcription and Fanconi anemia pathway. Subsequently, immunological analyses showed AKR1C1 was significantly associated with various immune infiltration cells; among these, dendritic cells, neutrophils, macrophages were the top three infiltrating cells. Furthermore, AKR1C1 was also associated with multiple immunostimulatory molecules and chemokines, including PD-1, PD-L1, CTLA4, B7-H3, VSIR, IL-6, BTLA, CXCL2, and CCR7. These results indicated the potential roles of AKR1C1 in the immune reaction during the pathogenesis of breast cancer.Conclusion: This study firstly demonstrated that ferroptosis-related gene, AKR1C1, could be associated with immune microenvironment, thereby influencing the development and prognosis of patient with breast cancer.Keywords: breast cancer, AKR1C1, ferroptosis, immune microenvironment, immune infiltration

In a non-emulative precast shear wall structures, joints are the key to influence the overall mechanical performance under seismic actions. While wet joints are widely used in the precast reinforced concrete shear wall structure, they present problems such as collision of steel bars, inconsistency of the post-casting area and importantly, they cannot achieve the best potential of precast concrete structures. Hence, this paper proposes a new dry joint, which is a bolted C-shaped steel plate for the horizontal joint of precast shear walls. Four identical sub-assembly precast shear wall panels bolted with four distinct configurations of steel plates (plain, X-stiffeners, horizontal slots and vertical slots) were tested under reversed cyclic loading. It was discovered that the bolted steel plate with horizontal slots could improve the ductility and energy dissipation of the joint. Numerical models were calibrated by benchmarking with the experimental results. Through a systematic parametric study on the number and spacing of slots, thickness of steel plates and number of bolts, the results indicated that the number of bolts is the critical parameter that will affect initial stiffness, peak strength capacity and ductility of the proposed joint.

Background Endoscopic thyroidectomy is widely performed as it does not result in neck scar. However, there is a paucity of reports pertaining to completely endoscopic lateral neck dissection (LND). In this study, we introduce our step-wise approach for performing endoscopic selective LND via the chest–breast approach. We refer to this approach as Qin’s seven steps. Methods The Qin’s seven steps are: (1) establishment of working space range; (2) dissection of lymph nodes between the SCM and the sternohyoid muscle (level IV) and exposure of omohyoid; (3) dissection of lymph nodes at level IV; (4) dissection of lymph nodes at level III; (5) dissection of lymph nodes at carotid triangle (level III); (6) exposure of accessory nerve and dissection of lymph nodes at level II a; (7) dissection of lymph nodes at level II b. We reviewed the clinical data of 35 patients with papillary thyroid cancer (PTC) who were operated using the Qin’s seven steps. Results All 35 patients successfully underwent LND; bilateral LND was performed in 5 patients. The mean tumor size was 1.8 ± 1.0 cm; seven patients had multiple lesions. The mean number of retrieved lymph nodes in level II, III and IV were 8.8 ± 5.6, 6.1 ± 4.0 and 9.3 ± 5.1, respectively. As for complications, there were 3 cases of accessory nerve injury and 1 case of hypoglossal nerve injury. Internal jugular vein injury, cervical plexus injury and lymphatic leakage occurred in 2, 7, and 1 patients, respectively. Conclusion The Qin’s seven steps for performing endoscopic selective LND could be safely used in PTC patients with lateral lymph node metastasis. Satisfactory results were achieved in the short-term follow-up period. We recommend the use of Qin’s seven steps for PTC patients who are not desirous of neck scar.

Background This study aimed to evaluate the feasibility and safety of the trans-oral endoscopic thyroidectomy vestibular approach (TOETVA) with neuroprotection techniques for the surgical management of papillary thyroid carcinoma (PTC). Methods Patients with PTC who underwent TOETVA between December 2016 and July 2020 were included in this study, and their relevant clinical characteristics, operational details, and surgical outcomes were reviewed and extracted from their medical records for further analysis. Results A total of 75 patients successfully underwent TOETVA with zero conversions. Unilateral lobectomy with isthmectomy and total thyroidectomy were completed for 58 and 17 patients, respectively, all using our unique neuroprotective procedure and ipsilateral central neck dissection (CND). The mean number of retrieved lymph nodes versus positive lymph nodes was 6.8 ± 3.7 vs. 1.5 ± 2.3. Postoperative complications included three cases of transient superior laryngeal nerve (SLN) palsy (4.0%), five cases of transient recurrent laryngeal nerve (RLN) palsy (6.7%), 14 cases of transient hypoparathyroidism (18.7%), two cases of numb chin (2.7%) and two cases of flap perforation (2.7%). The follow-up period for patients with PTC lasted for 15.6 ± 10.9 months, during which no other complications or tumor recurrence were observed. Conclusion TOETVA can be safely performed for patients with PTC with satisfactory results during the short-term follow-up period. Our neuroprotection techniques can be integrated into TOETVA, which is worth recommending for PTC patients who desire better cosmetic surgical outcomes.

Aims Despite considerable therapeutic advances, there is still a dearth of evidence on the molecular determinants of cardiac hypertrophy that culminate in heart failure. Neuraminidases are a family of enzymes that catalyze the cleavage of terminal sialic acids from glycoproteins or glycolipids. This study sought to characterize the role of neuraminidases in pathological cardiac hypertrophy and identify pharmacological inhibitors targeting mammalian neuraminidases. Methods and results Neuraminidase 1 (NEU1) was highly expressed in hypertrophic hearts of mice and rats, and this elevation was confirmed in patients with hypertrophic cardiomyopathy (n = 7) compared with healthy controls (n = 7). The increased NEU1 was mainly localized in cardiomyocytes by co-localization with cardiac troponin T. Cardiomyocyte-specific NEU1 deficiency alleviated hypertrophic phenotypes in response to transverse aortic constriction or isoproterenol hydrochloride infusion, while NEU1 overexpression exacerbated the development of cardiac hypertrophy. Mechanistically, co-immunoprecipitation coupled with mass spectrometry, chromatin immunoprecipitation, and luciferase assays demonstrated that NEU1 translocated into the nucleus and interacted with GATA4, leading to Foetal gene (Nppa and Nppb) expression. Virtual screening and experimental validation identified a novel compound C-09 from millions of compounds that showed favourable binding affinity to human NEU1 (KD = 0.38 μM) and effectively prevented the development of cardiac remodelling in cellular and animal models. Interestingly, anti-influenza drugs zanamivir and oseltamivir effectively inhibited mammalian NEU1 and showed new indications of cardio-protection. Conclusions This work identifies NEU1 as a critical driver of cardiac hypertrophy and inhibition of NEU1 opens up an entirely new field of treatment for cardiovascular diseases.

Objective The aim of this study was to find out the relationship between serum biomarkers and cerebral collateral status in acute ischemic stroke with cerebral large artery atherosclerosis. Methods We enrolled patients with ischemic stroke due to large artery atherosclerosis within 7 days of symptom onset, age 18-80 years, from August 2016 to December 2017. Twelve biomarkers representing different pathophysiological mechanisms were tested after admission. Whole-brain perfusion combined with multiphase computed tomography angiography was performed to assess cerebral collateral structure and function. Results Fifty-two patients completed the test of candidate biomarkers and recruited in this study. The mean age was 55.0 (11.1) years, 42 (80.8%) patients were male, 20 (38.5%) had poor collateral, 36 (69.2%) patients had anterior circulation stenosis or occlusion. Compared with poor collateral group, the level of MMP-9 (135,475.00 pg/ml vs. 103,612.00 pg/ml, p = 0.040) and PGF (5.75 pg/ml vs. 3.46 pg/ml, p = 0.046) was significantly higher in good collateral group. The adjusted OR (95%CI) of MMP-9 and PGF were 5.533 (1.10-27.74, p = 0.038), 7.73 (1.41-42.39, p = 0.018), respectively. sTie-2 level had a positive correlation with proportion of Tmax 4-6 (r = 0.302, p = 0.033) and HMW-KGN had negative correlation with proportion of Tmax 6-8 (r = -0.338, p = 0.02). After adjustment, the correlation of sTie-2 level and proportion of Tmax 4-6 was statistically significant (p = 0.003), and correlation of HMW-KGN and Tmax6-8 was not statistically significant (p = 0.056). Discussion Serum PGF and MMP-9 levels may correlate with collateral status based on MP-CTA in acute ischemic stroke patients with cerebral large artery atherosclerosis. Higher PGF and MMP-9 concentration associated with good collateral status.

Chronic diabetic wounds affect the quality of life of patients, resulting in significant social and economic burdens on both individuals and the health care system. Although treatment methods for chronic diabetic wounds have been explored, there remains a lack of effective treatment strategies; therefore, alternative strategies must be explored. Recently, the abnormal expression of non-coding RNA in diabetic wounds has received widespread attention since it is an important factor in the development of diabetic wounds. This article reviews the regulatory role of three common non-coding RNAs (microRNA [miRNA], long non-coding RNA [lncRNA], and circular RNA [circRNA]) in diabetic wounds and discusses the diagnosis, treatment potential, and challenges of non-coding RNA in diabetic wounds. This article provides insights into new strategies for diabetic wound diagnosis and treatment at the genetic and molecular levels., Graphical abstract, This manuscript systematically reviews the regulatory effects of non-coding RNA on diabetic wound healing. The topic is novel, rich in content, and clear in logic. It will be helpful for non-coding RNA treatment of diabetic wounds and provides a theoretical basis for clinical application of the non-coding RNA.

As the main substance in some traditional Chinese medicines, cucurbitacins have been used to treat hepatitis for decades in China. Currently, the use of cucurbitacins against cancer and other diseases has achieved towering popularity among researchers worldwide, as detailed in this review with summarized tables. Numerous studies have reported the potential tumor-killing activities of cucurbitacins in multiple aspects of human malignancies. Continuous research on its anticancer activity mechanisms also brings a glimmer of light to the treatment of patients with lung cancer. In line with the promising roles of cucurbitacins against cancer, through various molecular signaling pathways, it is justifiable to propose the use of cucurbitacins as a potential mainline chemotherapy before the onset and after the diagnosis of lung cancers. Here, this article mainly summarized the findings about the biological functions and underlying mechanisms of cucurbitacins on lung cancer pathogenesis and treatment. In addition, we also discussed the safety and efficacy of their application for further research and even clinical practice.

Background and Purpose: Intraluminal thrombus (ILT) is an emerging imaging marker in acute ischemic stroke. We aimed to investigate the association of ILT with outcomes of acute large vessel occlusion (LVO) patients receiving endovascular treatment. Methods: Acute LVO stroke patients who underwent endovascular treatment within 24 hours, in a prospective, nationwide registry were enrolled. Pretreatment digital subtraction angiography was reviewed for the presence of ILT. The primary outcome was 90-day functional dependence (modified Rankin Scale scores, 3–6). Secondary outcomes included 24-hour LVO, 90-day death, and symptomatic intracranial hemorrhage. Results: Among 711 patients enrolled, 75 (10.5%) with ILT were less likely to have 90-day functional dependence compared with those without ILT (adjusted odds ratio, 0.53 [95% CI, 0.31–0.90]; P =0.021). The same trend was found among those with successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b–3; P =0.008) but not in those without successful reperfusion ( P =0.107). Presence of ILT was also independently associated with a lower rate of 24-hour LVO (adjusted odds ratio 0.34 [95% CI, 0.13–0.89]; P =0.028). However, those with or without ILT had similar risks of symptomatic intracranial hemorrhage and 90-day death. Conclusions: Among acute LVO patients receiving endovascular treatment, pretreatment ILT-positive patients may have a better 90-day functional outcome (versus ILT-negative) but similar risk of death and symptomatic intracranial hemorrhage. The possibly favorable effect of ILT patients remained in those with successful reperfusion. Registration: URL: http://www.chictr.org.cn ; Unique identifier: ChiCTR1900022154.

Electronic control systems are becoming more and more complicated, which makes it difficult to test them sufficiently only through experiments. Simulation is an efficient way in the development and testing of complex electronic systems, but the simulation results are always doubtful by people due to the lack of credible simulation platforms and assessment methods. This paper proposes a credible simulation platform based on real-time FPGA-based hardware-in-the-loop (HIL) simulation, and then an assessment method is proposed to quantitatively assess its simulation credibility. By using the FPGA to simulate all sensor chips, the simulation platform can ensure that the tested electronic system maintains the same hardware and software operating environment in both simulations and experiments, which makes it possible to perform the same tests in the simulation platform and the real experiment to compare and analyze the simulation errors. Then, the testing methods and assessment indices are proposed to assess the simulation platform from various perspectives, such as performance, time-domain response, and frequency-domain response. These indices are all normalized to the same scale (from 0 to 1) and mapped to a uniform assessment criterion, which makes it convenient to compare and synthesize different assessment indices. Finally, an overall assessment index is proposed by combining all assessment indices obtained from different tests to assess the simulation credibility of the whole simulation platform. The simulation platform and the proposed assessment method are applied to a multicopter system, where the effectiveness and practicability are verified by simulations and experiments., Comment: 8 pages, 10 figures

Purpose This present study aims to investigate the relationship between laboratory parameters on admission and prognosis of coronavirus disease 2019 (COVID-19) in maintenance hemodialysis patients, as well as providing a theoretical basis for clinical evaluation of prognosis and corresponding intervention measures. Methods Retrospective analysis was performed on the clinical data of 47 maintenance hemodialysis patients who infected with COVID-19 and admitted to our hospital. According to their clinical outcome, these patients were divided into a survival group (n = 38) and a fatality group (n = 9). Information on the general condition and laboratory parameters of the patients were collected. Laboratory parameters were compared between different groups. The area under the curve (AUC) was used to evaluate the prognosis of COVID-19 in maintenance hemodialysis patients. Results Statistically significant differences were observed in age, white blood cell count, neutrophil count, albumin, C-reactive protein (CRP), procalcitonin, and lactate dehydrogenase (LDH) on admission (P

Flue gas desulphurized slag was collected as the raw material and purified using the multiple steps of sour purification procedures, which was further prepared as CaSO4 oxygen carrier (OC). Reaction characteristics of the purified desulphurized slag OC with the selected lignite as well as release of the different gaseous sulfur species from the CaSO4 side reactions were investigated in a lab-scale fixed bed reactor. Several main influencing factors, including reaction temperature, OC excess number ϕ and the cycle numbers, were focused. The experimental results indicated that the purified CaSO4 OC was of high reactivity and promising to be applied in the coal-fueled chemical looping combustion process as OC. Furthermore, according to the pros and cons of the three influencing factors on the carbon conversion versus the gaseous sulfur release, the optimized reaction conditions were determined as 900°C and the OC excess number around 1.0. Finally, under this optimized reaction condition, the effect of the cycle numbers was evaluated and found that the continuous release of gaseous sulfur from the CaSO4 side reactions deteriorated the reactivity of the purified CaSO4 OC and its reaction stability was diminished with the five cycles.

BackgroundThere is a lack of evidence in support of any prophylactic measure to prevent secondary lower extremity lymphedema after radical hysterectomy among patients with cervical cancer. This study aimed to determine the effectiveness of modified complex decongestive physiotherapy in reducing the risk of secondary lower extremity lymphedema after radical surgery.MethodsA randomized single-blind clinical trial was conducted in 120 patients with cervical cancer who underwent laparoscopic radical hysterectomy with pelvic lymphadenectomy between January 2016 and April 2017 in the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Participants were randomly assigned to a modified complex decongestive physiotherapy intervention group (n=60) or control group (n=60). The intervention group received a modified complex decongestive physiotherapy program, which included manual lymph drainage, compression hosiery, regular exercise, and health education. The control group only received a health education program. The main outcome was the incidence of secondary lower extremity lymphedema.ResultsA total of 117 patients with cervical cancer completed a 1-year follow-up. Twenty-eight (23.9%) patients developed secondary lower extremity lymphedema (20 (34.5%) patients in the control group and 8 (13.6%) in the intervention group). The incidence of secondary lower extremity lymphedema was significantly higher in the control group than in the intervention group (p=0.008; OR 0.30 (95% CI 0.12 to 0.75). The median percentage of excess volume was significantly less in the intervention group (2.1%, IQR 0.5–3.4%) than in the control group (2.96%, IQR 1.1–4.98%); (p=0.042). The mean (SD) onset time of lymphedema was 8 (2.00) months vs 4.6 (2.82) months in the intervention and control groups, respectively (p=0.004).ConclusionsThis randomized trial showed that modified complex decongestive physiotherapy is effective for preventing lower extremity lymphedema in patients with cervical cancer after laparoscopic radical hysterectomy with pelvic lymphadenectomy.

Software reliability assessment is a key step that determines whether the software can be delivered for the use or not. Because only limited testing resources are allowed for software reliability assessment, this paper proposes a software cybernetics perspective that introduces feedback and self-adaptive control to guide the software testing process in the software reliability assessment. Also, an adaptive testing strategy based on gradient descent is proposed for software reliability assessment. The theoretical and experimental results show that reliability assessment methods based on software cybernetics can achieve highly precise and stable software-reliability-assessment results using restricted testing resources.

The population genetic structure of domestic animals and the protection of genetic resources are major issues of concern in the field of global biology. In this study, the mtDNA D -loop sequences of 1163 Chinese indigenous cattle (Bos taurus and Bos indicus) were used to analyze their maternal origin and population genetic structure and to prioritize conservation evaluations based on a population genetic evaluation model. The results revealed three maternal origins or domestication events among Chinese indigenous cattle and the occurrence of secondary expansions but also the phenomenon of gene penetration. The population genetic evaluation model results showed that the genetic diversity of Huangpi cattle (HHP), Mountainous cattle (CMO), Bashan cattle (SBS) and Guanling cattle (GGL)populations was highest and that the Zaosheng cattle (GZN), Qinchuan cattle (SQB) and Pingliang cattle (GPL) populations contributed most to the richness of Chinese indigenous cattle genetic resources, indicating that these populations should be protected first. Our research provides a scientific basis and effective evaluation methods for the protection of genetic resources of indigenous livestock varieties.

Alantolactone (ALT) is a natural compound extracted from Chinese traditional medicine Inula helenium L. with therapeutic potential in the treatment of various diseases. Recently, in vitro and in vivo studies have indicated cytotoxic effects of ALT on various cancers, including liver cancer, colorectal cancer, breast cancer, etc. The inhibitory effects of ALT depend on several cancer-associated signaling pathways and abnormal regulatory factors in cancer cells. Moreover, emerging studies have reported several promising strategies to enhance the oral bioavailability of ALT, such as combining ALT with other herbs and using ALT-entrapped nanostructured carriers. In this review, studies on the anti-tumor roles of ALT are mainly summarized, and the underlying molecular mechanisms of ALT exerting anticancer effects on cells investigated in animal-based studies are also discussed.

IntroductionGestational diabetes mellitus (GDM) is a common pregnancy-related complication that can seriously endanger the health of the mother and child. Studies have reported that offspring have varying sensitivities to high blood sugar in utero based on their sex. However, the underlying pathogenesis of metabolic diseases is still largely unknown. Therefore, this study aims to study the metabolic influence and mechanism of gestational diabetes on male and female offspring, which is beneficial in preventing or reducing the possibility of metabolic diseases among the offspring of mothers with GDM through long-term medical monitoring.MethodsResearch samples meeting the experimental ideas were evaluated and selected from GEO database. After sample pretreatment, enrichment analysis was performed using R software to further enrich the differentially expressed genes (DEGs), and further research on the biological processes and molecular pathways related to these genes was conducted through GO analysis and KEGG analysis. Following this, a protein–protein interaction (PPI) network of the DEGs in the STRING database was constructed and then refined using Cytoscape software. The CytoHubba software was then used to screen out the top 10 hub genes. At last, Gene set enrichment analysis (GSEA) was performed using GSEA software (v. 4.0) to further understand the molecular mechanism of the disease.ResultsA total of 718 different genes were selected from GSE150621, including 454 and 264 genes with up-regulated and down-regulated expressions, which were statistically significant. Based on the data from the STRING database, the top 10 genes with the highest degree of connectivity, including OAS1, OAS2, OAS3, RSAD2, MX1, IFIT1, IFIT2, IFIT3, XAF1, and ISG15, were selected. The relative expression levels of IFIT1, OSA1, and ISG15 are relevant to the prognosis of GDM patients and the potential occurrence of some metabolic diseases in their offspring.ConclusionsThe accumulation of OAS1, IFIT1, and ISG15 genes suggests that a chronic inflammatory response is a requisite part of the GDM process. However, this is not clearly related to the metabolic mechanisms of different gender offspring of mothers with GDM; therefore, this is subject to further research.

Xinxin Ren,1 Xiang Wang,2 Bi Peng,3 Qiuju Liang,2 Yuan Cai,3 Kewa Gao,3 Yongbin Hu,3 Zhijie Xu,3,4 Yuanliang Yan2 1Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 3Department of Pathology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 4National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaCorrespondence: Yuanliang YanDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People’s Republic of ChinaEmail yanyuanliang@csu.edu.cnPurpose: To explore the molecular profiles of transcriptional enhanced associate domain (TEAD) family in ovarian serous carcinoma (OSC).Methods: In this study, we use bioinformatics methods including GEPIA, GE-mini, Oncomine 3.0, Kaplan–Meier plotter, cBioPortal, WebGestalt, TIMER2.0 and DiseaseMeth2.0, and in vitro experimental RT-PCR to assess the expression profiles and prognostic significance of TEAD family in OSC.Results: According to the bioinformatics analysis, TEAD family was abnormally expressed in OSC. In terms of prognosis, Kaplan–Meier plotter indicated that OSC patients with high level of TEAD4 showed poor overall survival (OS), progression-free survival (PFS) and post progression survival (PPS). TEAD family also had significantly diagnostic values for OSC patients. Tumor Immune Estimation Resource (TIMER) algorithm indicated that TEAD family was significantly associated with different types of infiltrating immune cells, including B cells, macrophages, dendritic cells, neutrophils, CD8+ T cells and CD4+ T cells. Gene set enrichment analysis of TEAD family-associated coexpression genes was further explored. In in vitro experiments, the RT-PCR results showed the upregulated TEAD2/4 in OSC tissues and cells (A2780 and TOV112D). Moreover, decreased expression of TEAD2 could induce the ferroptosis through increasing the ROS accumulation.Conclusion: Thus, TEAD family correlated with the diagnosis, prognosis and immune infiltration in OSC. These results could provide comprehensive understanding of TEAD family in the diagnosis and prognosis of OSC patients.Keywords: TEAD family, Hippo pathway, ovarian serous carcinoma, expression profiles, prognosis, immune infiltration

BackgroundGlioblastoma (GBM) is the most common primary intracranial tumor and originates from the small pool of adult neural stem and progenitor cells (NSPCs). According to the World Health Organization (WHO) classification of brain tumors, gliomas are classified into grades I–IV, and GBM is defined as the highest grade (IV). GBM can be disseminated by cerebrospinal fluid (CSF), but extracranial metastasis is rare. Additionally, the pathway and mechanism involved remain unclear.Case PresentationWe report a rare case of left temporal lobe GBM with multiple bone metastases and soft tissue metastasis. This 49-year-old right-handed man who was diagnosed with GBM underwent surgery on May 9, 2017, followed by radiochemotherapy in June 2017. On August 13, 2019, local relapse was found. Then, the patient received a second surgery but not radiochemotherapy. In November 2019, the patient was reported to be suffering from low back pain for nearly 1 month. On December 6, 2019, magnetic resonance imaging (MRI) of the thoracolumbar vertebrae and abdominal computed tomography (CT) confirmed metastases on the ninth posterior rib on the right, the third anterior rib on the left, and the T7 and T10 vertebrae and their appendages. CT-guided rib space-occupying puncture biopsy was performed, and GBM was identified by pathology.ConclusionWe should pay attention to extracranial metastasis of GBM. Timely detection and early treatment improve overall quality of patients’ life. The extracranial metastasis in this patient may have occurred through the spinal nerve root or intercostal nerve. Further clinical observations are required to clarify the pathway and mechanism involved.

Background: Alterations of mitogen-activated protein kinase kinase 1 (MEK1) are commonly associated with tumorigenesis, and MEK1 is thought to be a suitable targeted therapy for various cancers. However, abnormal MEK1 alterations and their relevant clinical implications are unknown. Our research comprehensively analyzed the MEK1 alteration spectrum and provided novel insight for targeted therapies. Methods: There were 7694 samples covering 32 types of cancer from The Cancer Genome Atlas (TCGA) database. They were used to conduct an integrative analysis of MEK1 expression, alterations, functional impacts and clinical significance. Results: There was a dramatic difference in the alteration frequency and distribution and clinical implications in 32 types of cancer from the TCGA. Skin cutaneous melanoma (SKCM) has the most alterations and has therapeutic targets located in the protein kinase domain, and the growing expression of SKCM is positively related to patient prognosis. MEK1 expression in lung adenocarcinoma (LUAD), kidney renal papillary cell carcinoma (KIRP), esophageal carcinoma (ESCA) and liver hepatocellular carcinoma (LIHC) is decreased, which is associated with better prognosis, while MEK1 expression in thymoma (THYM), stomach adenocarcinoma (STAD), kidney renal clear cell carcinoma (KIRC), testicular germ cell tumors (TGCTs) and head and neck squamous cell carcinoma (HNSC) is increased, which is associated with better prognosis. Mesothelioma (MESO) has the second highest alterations but has no therapy targets. Conclusion: This study provided a great and detailed interpretation of MEK1 expression, alterations and clinical implications in 32 types of cancer and reminded us to fill the gap in MEK1 research from a new perspective. Keywords: MEK1, gene mutation, gene alteration, outcome, pan-cancer

ADA is a popular programming language that was named after Lady Ada Lovelace (1815-1852) and recommended by Department of Defense, USA, for development of large scale safety-critical software systems. In this Fast Abstract, ADA is reinterpreted as Autonomous, Dependable and Affordable. It is argued that future software systems should be ADA. A few affordable techniques are briefly described to highlight how to make software systems ADA.

Coronavirus disease 2019 (COVID-19), which is triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, continues to threaten global public health. Developing a vaccine that only requires single immunization but provides long-term protection for the prevention and control of COVID-19 is important. Here, we developed an adeno-associated virus (AAV)-based vaccine expressing a stable receptor-binding domain (SRBD) protein. The vaccine requires only a single shot but provides effective neutralizing antibodies (NAbs) over 598 days in rhesus macaques (Macaca mulatta). Importantly, our results showed that the NAbs were kept in high level and long lasting against authentic wild-type SARS-CoV-2, Beta, Delta and Omicron variants using plaque reduction neutralization test. Of note, although we detected pre-existing AAV2/9 antibodies before immunization, the vaccine still induced high and effective NAbs against COVID-19 in rhesus macaques. AAV-SRBD immune serum also efficiently inhibited the binding of ACE2 with RBD in the SARS-CoV-2 B.1.1.7 (Alpha), B.1.351 (Beta), P.1/P.2 (Gamma), B.1.617.2 (Delta), B.1.617.1/3(Kappa), and C.37 (Lambda) variants. Thus, these data suggest that the vaccine has great potential to prevent the spread of SARS-CoV-2.

Background As China’s aging trend intensifies and the proportion of empty nests increases, the health-related quality of life of the elderly is the focus of social attention. Previous studies focused on the quality of life of the elderly, rather than empty nesters, and lacked the discussion of the mechanism of influencing factors. Thus, this study aimed to explore the influencing factors of the quality of life (QOL) and interaction mechanisms among empty nesters in Shanxi Province, China, so as to provide practical reference for improving the QOL of empty nesters. Methods A total of 4901 empty nesters in Shanxi Province, China, were selected using multi-stage random cluster sampling method in this cross-sectional study. The quality of life was assessed with the Short Form 36 Health Survey (SF-36). Multiple linear regression analysis (stepwise) was performed to examine the factor associated with QOL. Structural equation model (SEM) approach was conducted to test the direct and indirect association between QOL influencing factors with QOL. Results The average QOL score of empty nesters was 63.34 (SD = 17.23). The multiple linear regression revealed that gender, age, education, monthly income, drinking status, exercise frequency, physical examination frequency, attention to daily nutritional health, relationship with a spouse and relationship with children were significant predictors of the empty nester’s QOL (P R2 = 0.128). SEM showed that behavioral lifestyle had a direct effect on QOL (β = 0.446, P β = 0.288, P β = 0.115, P Conclusion Behavioral lifestyle was the strongest influencing factor in the quality of life among empty nesters, followed by socio-economic status and family relationships. Thus, maintaining a healthy behavioral lifestyle was important to improve the QOL of the empty nesters. Our findings provide a concrete and strong reference for the formulation of targeted intervention strategies.

Henoch-Schonlein purpura nephritis (HSPN) is a common glomerulonephritis secondary to Henoch-Schonlein purpura (HSP) that affects systemic metabolism. Currently, there is a rarity of biomarkers to predict the progression of HSPN. This work sought to screen metabolic markers to predict the progression of HSPN via serum-urine matched metabolomics. A total of 90 HSPN patients were enrolled, including 46 HSPN (+) patients with severe kidney damage (persistent proteinuria >0.3 g/day) and 44 HSPN (–) patients without obvious symptoms (proteinuria < 0.3 g/day). Untargeted metabolomics was determined by liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-Q/TOF-MS). A total of 38 and 50 differential metabolites were, respectively, identified in serum and urine from the comparison between HSPN (+) and HSPN (–) patients. Altered metabolic pathways in HSPN (+) mainly included glycerophospholipid metabolism, pyruvate metabolism, and citrate cycle. A panel of choline and cis-vaccenic acid gave areas under the curve of 92.69% in serum and 72.43% in urine for differential diagnosis between HSPN (+) and HSPN (–). In addition, the two metabolites showed a significant association with clinical indices of HSPN. These results suggest that serum-urine matched metabolomics comprehensively characterized the metabolic differences between HSPN (+) and HSPN (–), and choline and cis-vaccenic acid could serve as biomarkers to predict HSPN progression.

Dynamically tunable ultra-narrowband perfect absorbers are important to next-generation active photonic devices. A composite structure of a graphene pair and a microcavity with Bragg mirrors are proposed for this purpose. Based on the electrically controllable doping of graphene and critical coupling of the incident light, the microcavity–graphene composite structure achieves peak absorptance higher than 99.5%, a relative peak width ( Δ λ / λ 0 ) smaller than 1.1%, and a modulation depth larger than 92.0% throughout the visible-to-mid-infrared range, surpassing other structures in comprehensive performance. By changing the number of the dielectric pairs in the Bragg mirrors, the device can become an amplitude or a spectral modulator. The results are based on the optical constants from experiment data, including the surface conductivity of graphene with relatively low mobility, so they are more useful in practical situations.

Intracranial atherosclerotic stenosis (ICAS) is one of most common causes of stroke; it has the highest rate of recurrence compared with other aetiologies.1 ICAS is especially more prevalent among the Asians.2 The results of the Chinese Intracranial Atherosclerosis Study indicated that the prevalence of symptomatic ICAS (sICAS) is as high as 46%.1 The 1-year stroke recurrence rate with sICAS is reported to be 12.2% and 15%.3 4 We understand, the following pathological reasons could account for the high recurrence rate in sICAS. First, patients with ICAS are prone to encounter hypoperfusion haemodynamics, especially under poor collateral conditions.5 Studies on the association of blood pressure (BP) control in the acute stage and clinical outcomes are contradictory, supporting this hypothesis.6 Second, plaques in stenotic arteries are usually highly vulnerable (due to large lipid cores, thin fibrous caps and intraplaque haemorrhage).7 These plaques are prone to rupture into downstream arteries, leading to embolic stroke in the territory of the responsible artery.5 Furthermore, these patients are often comorbid with heightened risk factors strongly correlated with stroke recurrence, including hypertension, metabolic disorders, dyslipidaemia.8 Therefore, there is an urgent need to standardise assessment and management of sICAS. The treatment of sICAS nowadays primarily focuses on secondary prevention to reduce stroke recurrence. Therapeutic methods include antiplatelet therapy, interventional therapy and control of risk factors.9 Two milestone trials, the Warfarin Aspirin Symptomatic Intracranial Disease (WASID)3 Trial and the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS)4 Trial aim to provide an updated strategy for clinical practice. The WASID Trial, with a double-blind, multicentre, randomised control clinical trial design, aimed to evaluate the efficacy and safety of warfarin over aspirin among patients with 50%–99% degree of ICAS. Aspirin proved to be equally efficient …

A particularly good software testing strategy is to achieve the underlying testing goal while solving the problems of tradeoffs between testing effectiveness and efficiency. To improve the fault detection effectiveness of software testing, the principle of feedback control theory was adopted, which motivated the proposal of dynamic random testing (DRT). The main idea behind DRT is using the testing results to guide the test case selection to increase the selection probabilities of the subdomains with higher fault detection rates. Previous works show that DRT strategy can achieve better effectiveness than random testing strategy and random partition testing strategy, and has significantly lower computational costs than adaptive testing strategy. However, the essential factors that affect the performance of DRT, i.e., adjusting parameters, initial profile, and test case classification have not been thoroughly investigated. Besides, some experimental assumptions are inconsistent with real scenarios. Therefore, this paper gives a series of investigations on DRT with a set of practical subject programs. More specifically, the effectiveness and efficiency of DRT are presented, and the extended experiments on DRT with relevant factors are conducted. The results indicate that the effectiveness of DRT is robust to different initial profiles and affected noticeably by the adjusting parameter settings and test case classification methods.

Price determinants of Airbnb listings is still in its infancy and Asian markets are underexplored. Based on existing literature, this article examines the impacts of five groups of explanatory variables on Airbnb price in Hong Kong: listing attributes, host attributes, rental policies, listing reputation, and listing location. Hedonic price regression highlights that: (a) compared with previous studies, the effect of room type on Airbnb price is exceptionally high in Hong Kong, due to the "the luxury of spaciousness" in this overpopulated city; (b) contradictory to previous findings, hosts' listings count have a negative effect on Airbnb listing price in Hong Kong, which can be explained by external (Hong Kong's fiercely competitive environment for multilisting Airbnb hosts) and internal (multilisting hosts' trade-off between booking opportunity and listing price) factors; (c) in Hong Kong, only low-end Airbnb rentals benefit from locational factors, indicating the heterogeneous effects of location on Airbnb pricing. These findings shed new light from previous studies and the authors provide possible explanations from theoretical and practical perspectives.

The Android operating system (OS) is a sophisticated man-made system and is the dominant OS in the current smartphone market. Due to the accumulation of errors in the system internal state and the incremental consumption of resources, such as the Dalvik heap memory of software applications and the physical memory, software aging is observed frequently and recognized as a chronic problem of Android smartphones. To mitigate this problem, we propose a two-level software rejuvenation, with the two levels referring to software applications and the OS, in this paper. Based on this strategy, a Markov regenerative process model is constructed to evaluate the steady-state availability and to optimize the time required to trigger rejuvenation for Android smartphones. The parameters of the model, such as the degradation rate and failure rate of software applications and the Android OS, are obtained via our testing platform. Experiments on two real Android applications show that the availability of an Android smartphone increases by 10.81% and 10.18% for the two subjects in our experiments, respectively. An empirical study comparing our two-level strategy with one-level strategies (single application-level and system-level rejuvenation) further verifies the effectiveness of our approach.

Background Kawasaki disease (KD) is the most common acute coronary vasculitis disease to occur in children. Its incidence has been attributed to the combined effects of infection, genetics, and immunity. Although the etiopathogenesis of KD remains unknown, we have performed a survey of global genetic DNA methylation status and transcripts expression in KD patients in order to determine their contribution to the pathogenesis of KD. Methods We recruited 148 participants for this case-control study. The chip studies consisted of 18 KD patients that were analyzed both before undergoing intravenous immunoglobulin (IVIG) treatment and at least 3 weeks afterward, as well as 36 non-KD control subjects, using Illumina HumanMethylation450 BeadChip and Affymetrix GeneChip® Human Transcriptome Array 2.0. We then carried out real-time quantitative PCR on a separate cohort of 94 subjects for validation. Results According to our microarray study, CD177, a neutrophil surface molecule, appeared to be significantly upregulated in KD patients when compared to controls with epigenetic hypomethylation. After patients received IVIG treatment, CD177 mRNA levels decreased significantly. PCR validation indicated that the CD177 expression is consistent with the Transcriptome Array 2.0 results. Furthermore, the area under the curve values of CD177 between KD patients and controls is 0.937. We also observed significantly higher CD177 levels in typical KD than in incomplete presentation or KD with IVIG resistance. Conclusion In this study, we have demonstrated the epigenetic hypomethylation and increased expression of CD177 during the acute stage of KD. Furthermore, a higher expression of CD177 in KD patients with typical presentation was associated with IVIG resistance.

Random testing and partition testing are two major families of software testing techniques. They have been compared both theoretically and empirically in numerous studies for decades, and it has been widely acknowledged that they have their own advantages and disadvantages and that their innate characteristics are fairly complementary to each other. Some work has been conducted to develop advanced testing techniques through the integration of random testing and partition testing, attempting to preserve the advantages of both while minimizing their disadvantages. In this paper, we propose a new testing approach, adaptive partition testing , where test cases are randomly selected from some partition whose probability of being selected is adaptively adjusted along the testing process. We particularly develop two algorithms, Markov-chain based adaptive partition testing and reward-punishment based adaptive partition testing , to implement the proposed approach. The former algorithm makes use of Markov matrix to dynamically adjust the probability of a partition to be selected for conducting tests; while the latter is based on a reward and punishment mechanism. We conduct empirical studies to evaluate the performance of the proposed algorithms using ten faulty versions of three large-scale open source programs. Our experimental results show that, compared with two baseline techniques, namely random partition testing (RPT) and dynamic random testing (DRT), our algorithms deliver higher fault-detection effectiveness with lower test case selection overhead. It is demonstrated that the proposed adaptive partition testing is an effective testing approach, taking advantages of both random testing and partition testing.

Service-based systems resource allocation in cloud computing is a key method of meeting service requests because service request workloads and resource demands change over time. When coping with dynamic fluctuating service requests and resource demands, adaptive resource allocation to ensure the quality of service (QoS) with the lowest resource consumption becomes challenging. In cloud computing, services share the same resource pool and compete for critical resources, such as CPU and memory resources. Because services need arbitrary resource combinations, focusing on a single resource may lead to excessive or deficient resource allocations or even service request failures. Due to the shared nature of cloud computing, QoS may be impacted by interference with co-hosted services. In this paper, we propose an adaptive control approach for resource allocation that adaptively reacts to dynamic request workloads and resource demands. The multivariable control is adopted to allocate multiple resources for multiple services according to the dynamic fluctuating requests and considers the interference between co-hosted services, thereby ensuring QoS even if the resource pool is insufficient. The comparative experiments show that the proposed approach can meet service requests and can improve resource utilization regardless of whether the resource pool is sufficient.

Outcomes of furazolidone- and amoxicillin-based quadruple therapy for Helicobacter pylori infection and predictors of failed eradication

Purpose: Renal denervation (RD) has been demonstrated to be an effective approach to reduce blood pressure for those with resistant hypertension. Yet, we aimed to explore the effect and possible mechanism of RD on blood-pressure response to hemorrhagic shock in spontaneously hypertensive rats. Methods: A total of 48 male spontaneously hypertensive rats were randomized to three groups: study group, sham-operation group and control group. RD was achieved by cutting off renal nerves and swabbing phenol on it. Ten weeks after RD, 8 rats in each group were sacrificed to collect the kidney and heart tissues. The remaining rats were subjected to an operation to induce hemorrhagic shock which would lead to 40% loss of total blood volume, and observed for 120 min. The serum concentration of norepinephrine was measured before and three weeks after RD. Results: The blood-pressure and norepinephrine levels were reduced significantly after RD (p 0.05). Additionally, the beta-1 adrenergic receptor (β1-AR) in the study group was significantly higher than those in the other two groups (p

sBackgroundIn China, more and more older people have encountered a situation called “empty nest.” Meanwhile, the health status of empty-nest older adults is an increasing public health concern. This research aims to examine the effectiveness of Self-Mutual-Group (SMG) model in improving quality of life of the empty-nest older adults to provide a scientific evidence for improving their health.MethodsA prospective intervention study was conducted among empty-nest older adults in Taiyuan, Shanxi. Multi-stage stratified random cluster sampling was employed to selected participants. A total of 396 empty nesters were enrolled as participants, of which 204 and 192 were in the intervention and control group, respectively. The intervention group received a seven-month SMG-based intervention. A participant’s quality of life was measured at the baseline and seven months after using the Short Form 36-Item Health Survey (SF-36).ResultsNo significant difference was found between the intervention and control groups in terms of participant characteristics at baseline (P > 0.05). After the intervention, participants’ scores on Mental Component Summary (MCS), Physical Component Summary (PCS), role emotional (RE), vitality (VT), social function (SF), mental health (MH) and general health (GH) increased significantly in the intervention group. Additionally, these scores differed significantly from those in the control group (P ConclusionThis study showed that the SMG-based health management is effective in improving quality of life among empty-nest older adults after seven months.Trial registrationStudy on the ‘SMG’ Health Management Model Based on Community Organization Theory among empty-nest older adults (ChiCTR1800015884). Registration date: 26-04-2018. Retrospectively registered.

Islet transplantation (IT) is considered the most effective endocrine replacement therapy for diabetes mellitus (DM). Studies have demonstrated that IT can repair testicular structural injury caused by inflammatory and oxidative stress in a diabetic rat model. However, highly effective exogenous antioxidant and anti-inflammatory drugs can achieve this effect. Testicular interstitial fibrosis caused by long-term hyperglycemia is however difficult to reverse or recover. Thus far, there are no effective drugs that prevent or relieve testicular interstitial fibrosis. Therefore, it is necessary to explore the potential benefit of IT on testicular interstitial fibrosis induced by DM and its underlying molecular mechanisms. In the present study, Wistar rats were used to establish a DM model by intraperitoneal injection of streptozotocin. The diabetic models then underwent IT or received insulin treatment after 12 weeks. IT was more effective than insulin treatment in ameliorating diabetic-induced testicular interstitial fibrosis, Leydig cells apoptosis, testosterone deficiency and poor sperm motility. IT and insulin treatment both significantly inhibited the upregulation of TGF-β1 and phosphorylated Smad2 in DM, with IT being more effective than insulin. The present study's findings proved that IT effectively protects diabetic-induced testicular interstitial fibrosis probably by inhibiting the TGF-β1/Smad2 signaling pathway, which offers hope in male patients with DM complicating with testicular interstitial fibrosis.

Background To investigate whether collateral status could modify the associations between post‐thrombectomy blood pressure (BP) measures and outcomes. Methods and Results Patients with anterior‐circulation large‐vessel‐occlusion successfully recanalized in a multicenter endovascular thrombectomy registry were enrolled. Pretreatment collateral status was graded and dichotomized (good/poor) in angiography. Maximum, minimum, and mean systolic BP (SBP) and BP variability (assessed by the SD, coefficient of variation) during the initial 24 hours after endovascular thrombectomy were obtained. The primary outcome was unfavorable 90‐day outcome (modified Rankin Scale score 3–6). Secondary outcomes included symptomatic intracranial hemorrhage and 90‐day mortality. Adjusted odds ratios (aOR) of BP parameters over the outcomes were obtained in all patients and in patients with good/poor collaterals. Among 596 patients (mean age 66 years; 59.9% males), 302 (50.7%) patients had unfavorable 90‐day outcome. In multivariable analyses, higher mean SBP (aOR, 1.59 per 10 mm Hg increment; 95% CI, 1.26–2.02; P 140 mm Hg (versus ≤120 mm Hg; aOR, 4.27; 95% CI, 1.66–10.97; P =0.002), and higher SBP SD (aOR, 1.08 per 1‐SD increment; 95% CI, 1.01–1.16; P =0.02) were respectively associated with unfavorable 90‐day outcome in patients with poor collateral but not in those with good collateral. A marginal interaction between SBP coefficient of variation tertiles and collaterals on 90‐day functional outcome ( P for interaction, 0.09) was observed. A significant interaction between SBP coefficient of variation tertiles and collaterals on 90‐day mortality ( P for interaction, 0.03) was observed. Conclusions Higher postprocedural BP is associated with 90‐day unfavorable outcomes after successful endovascular thrombectomy in patients with poor collateral. Registration URL: https://www.chictr.org.cn ; Unique identifier: ChiCTR1900022154.

The purpose of this study aimed to (1) identify the relationship between the fibula and the talus of the anterior talofibular ligament (ATFL); (2) collect detailed anatomical data and provide anatomical basis for ATFL anatomical reconstruction. We selected 27 ankle specimens of adult cadavers (9 left feet and 18 right feet in 11 males and 16 females; mean age 41.6 years) with the exception of ankle deformities, fractures, underdevelopment and degenerative diseases. In these 27 specimens,15 cases of ATFL were divided into two bundles and 12 cases of ATFL were single bundles. The average ATFL length was 20.31 ± 3.12mm. The center of the ATFL in 11 specimens was located in the calcaneofibular ligament (CFL) foot print area. The long axis of the fibula side stop point was 8.83±1.82 mm, and the short axis was 3.12±0.49 mm. The distance from the center of the ATFL fibula attachment area to the tip of the fibula was 14.22±2.87 mm, and the distance from the center of the CFL is 5.57±1.80mm. The distance from the center of the ATFL talar attachment area to the tibiotalar articular surface was (9.74±2.12) mm, and the distance from the anterior external cartilage surface of the talus was (4.87±1.82) mm. The angle between ATFL and the long axis of the fibula is 78°±12°. Our results suggest that in ATFL reconstruction, the anatomical attachment points around the ATFL or the angle between ATFL and the long axis of the fibula both can be used for bone canal positioning.

Background. Since the first diagnosed case of infection with the novel coronavirus (SARS-CoV-2), there has been a rapid spread of the disease with an increasing number of cases confirmed every day, as well as a rising death toll. An association has been reported between acute kidney injury (AKI) and mortality in patients infected with SARS-CoV-2. Therefore, our study was conducted to explore possible risk factors of AKI as well as whether AKI was a risk factor for worse outcome, especially mortality among patients with coronavirus disease (COVID-19). Methods. We included all hospital admissions with confirmed or clinically diagnosed COVID-19 from January 29 to February 25, 2020. We collected demographic and epidemiological information, past medical history, symptoms, laboratory tests, treatments, and outcome data from electronic medical records. A total of 492 patients with diagnosed or clinically diagnosed COVID-19 were included in this study. Results. The prevalence rate of AKI was 7.32%. Among the factors associated with AKI, males versus females (aOR 2.73), chronic kidney disease (aOR 42.2), hypertension (aOR 2.82), increased leucocytes (aOR 6.08), and diuretic use (aOR 7.89) were identified as independent risk factors for AKI among patients infected by SARS-CoV-2. There was a significant difference in hospital fees and death in patients with and without AKI ( p < 0.05 ). The mortality rate in patients with AKI was 63.9%. Conclusions. AKI was widespread among patients with COVID-19. The risk factors of AKI in COVID-19 patients included sex, chronic kidney disease, hypertension, infection, and diuretic use. AKI may be associated with a worse outcome, especially mortality in COVID-19 patients.

Objectives: This study aims to investigate whether the machine learning algorithms could provide an optimal early mortality prediction method compared with other scoring systems for patients with cerebral hemorrhage in intensive care units in clinical practice.Methods: Between 2008 and 2012, from Intensive Care III (MIMIC-III) database, all cerebral hemorrhage patients monitored with the MetaVision system and admitted to intensive care units were enrolled in this study. The calibration, discrimination, and risk classification of predicted hospital mortality based on machine learning algorithms were assessed. The primary outcome was hospital mortality. Model performance was assessed with accuracy and receiver operating characteristic curve analysis.Results: Of 760 cerebral hemorrhage patients enrolled from MIMIC database [mean age, 68.2 years (SD, ±15.5)], 383 (50.4%) patients died in hospital, and 377 (49.6%) patients survived. The area under the receiver operating characteristic curve (AUC) of six machine learning algorithms was 0.600 (nearest neighbors), 0.617 (decision tree), 0.655 (neural net), 0.671(AdaBoost), 0.819 (random forest), and 0.725 (gcForest). The AUC was 0.423 for Acute Physiology and Chronic Health Evaluation II score. The random forest had the highest specificity and accuracy, as well as the greatest AUC, showing the best ability to predict in-hospital mortality.Conclusions: Compared with conventional scoring system and the other five machine learning algorithms in this study, random forest algorithm had better performance in predicting in-hospital mortality for cerebral hemorrhage patients in intensive care units, and thus further research should be conducted on random forest algorithm.

It is very important for completing spectrum data in the wireless communication system. The traditional completion method mainly considered the missing completion operation of sparse data. To solve this problem, we proposed an efficient algorithm based on generative adversarial network (GAN), which can automatically mine the relationship of the data and complete the missing data accurately. The proposed method uses the sensing spectrum waterfall as the input sample of the network structure. We adopt a pre-classification module and generation module based on GAN to generate incomplete spectrum data in multiple jamming patterns. Simulation results show that the proposed algorithm can effectively complete the missing data, and its performance is better than that of the data completion algorithm without a clssifier.

Background: Kawasaki disease (KD) is the most common form of febrile coronary vasculitis disease to occur in children. Early diagnosis and proper therapy can prevent the complication of coronary artery lesions (CAL). The main pathogenesis of KD is an inflammatory process related to the host's genetic characteristics. In innate human immunity, the interaction of leukocytes and glycoprotein plays an important role against microbes. The purpose of our study was to understand the role of leukocytes' glycoprotein genes during the acute phase of KD.Materials and Methods: We enrolled a total of 97 subjects from a medical center. Of those, 24 subjects were healthy controls, and 24 subjects were fever controls; the other 49 subjects were KD patients who had had blood samples taken both before and after IVIG treatment. We collected the total RNA from leukocytes and performed a quantitative polymerase chain reaction for the HP, GRP84, and CLEC4D genes in real time.Results: Compared with both the healthy and fever controls, the upregulation of HP, GRP84, and CLEC4D genes was significant in peripheral leukocytes during acute-phase KD. The transcriptional level of these respective genes not only demonstrated a positive correlation with each other, but were also effective predictors for KD (all auROC >0.87) according to the ROC curve analysis. The hyper-expression of these three genes was significantly associated with IVIG resistance, but not CAL formation.Conclusions: Our study demonstrates that the expression of HP, GRP84, and CLEC4D genes of leukocytes play an important role in the pathogenesis and primary IVIG response during the acute inflammatory process of KD.

This paper investigates the problem of wireless transmitter identification in the presence of malicious attacker based on radio frequency (RF) fingerprint. A robust wireless transmitter identification scheme is proposed using Generative Adversarial Networks (GAN). First, to build unique RF fingerprint of different wireless transmitter, in-phase (I) and quadrature (Q) imbalance model is introduced. Then, a classifier which consists of multiple discriminators is proposed to detect attacker and classify trusted transmitters based on RF fingerprint. Every discriminator is trained in adversarial learning framework and serves as one binary classifier to verify RF fingerprint. Wasserstein GAN with gradient penalty (WGAN-GP) is modified to train the discriminator. Finally, a simulation dataset is generated to validate the proposed approach. Experimental results reveal that the approach achieves 99.98% accuracy for detecting attacker and an average accuracy of 97.36% for classifying trusted transmitters.

Background Double lumen tube (DLT) and Univent are two commonly used lung isolation devices that often require bronchoscopy assistance. In order to facilitate blind placement for situations where bronchoscopy was unavailable, the cricoid displacing maneuver (CDM) was adopted. This study was designed to explore whether the CDM could improve the successful blind placement rate in left lung isolation esophageal surgeries. Methods 120 ASA 1-3 patients who received left lung isolation esophageal surgeries from October 2014 to February 2016 and October 2018 to January 2020 were enrolled in this single-centered prospective assessorblinded randomized controlled trial. After anesthesia induction, patients were intubated either with DLT or Univent by applying the CDM, and the position of devices was checked by bronchoscopy. After turning into the right decubitus position, the devices were pulled back to the trachea, and placement was conducted once again. Successful placement rate for the first attempt, time needed for initial placement, malposition and reposition times by bronchoscopy during surgery, bronchus injury score, rank of lung isolation and postoperative anesthesia-related complications were recorded. Results At supine position, the successful placement rates for the first attempt of DLT-CDM, DLTcontrol, Univent-CDM and Univent-Control were 100%, 76.7%, 96.7% and 66.7% respectively (DLT: P=0.016; Univent: P=0.003) while at right decubitus position were 86.7%, 66.7%, 93.3% and 66.7% (DLT: P=0.067; Univent: P=0.010). There was no significant difference in the time needed for successful intubation and no severe complications. Conclusions The current study provided evidence that the CDM is an effective and safe blind endobronchial placement technique for left DLT and Univent. We suggest that CDM could be applied to the endobronchial placement of left DLT and Univent.