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In the era of cloud computing, massive quantities of data are encrypted and uploaded to the cloud to realize a variety of applications and services while protecting user confidentiality. Accordingly, the formulation of methods for efficiently searching encrypted data has become a critical problem. Public-key encryption with keyword search is an efficient solution that allows the data owner to generate encrypted keywords for a given document while also allowing the data user to generate the corresponding trapdoor for searching. Huang and Li proposed a public-key authenticated encryption with keyword search (PAEKS) scheme to resist keyword guessing attacks, where the data owner not only encrypts keywords but also authenticates them. However, existing PAEKS-related schemes carry a tradeoff between efficiency, storage cost, and security. In this article, we introduce a novel framework called identity-certifying authority-aided identity-based searchable encryption, which has the advantage of reducing storage space while remaining the efficiency and security. We formally define the system model and desired security requirements to represent attacks in a real scenario. In addition, we propose a provably secure scheme based on the gap bilinear Diffie–Hellman assumption and experimentally evaluate our scheme in terms of its performance and theoretical features against its state-of-the-art counterparts.

The emerging 4D printing techniques open new horizons for fabricating self-actuated deformable objects by combing strength of 3D printing and stimuli-responsive shape memory materials. This work focuses on designing self-actuated deformable solids for 4D printing such that a solid can be programmed into a temporary shape and later recovers to its original shape after heating. To avoid a high material cost, we choose a dual-material strategy that mixes an expensive thermo-responsive shape memory polymer (SMP) material with a common elastic material, % for fabricating objects, which however leads to undesired deformation at the shape programming stage. We model this shape programming process as two elastic models with different parameters linked by a median shape based on customizing a constitutive model of thermo-responsive SMPs. Taking this material modeling as a foundation, we formulate our design problem as a nonconvex optimization to find the distribution of SMP materials over the whole object as well as the median shape, and develop an efficient and parallelizable method to solve it. We show that our proposed approach is able to design self-actuated deformable objects that cannot be achieved by state of the art approaches, and demonstrate their usefulness with three example applications.

This paper addresses the problem of instance-level 6DoF object pose estimation} from a single RGB image. Many recent works have shown that a two-stage approach, which first detects keypoints and then solves a Perspective-n-Point (PnP) problem for pose estimation, achieves remarkable performance. However, most of these methods only localize a set of sparse keypoints by regressing their image coordinates or heatmaps, which are sensitive to occlusion and truncation. Instead, we introduce a Pixel-wise Voting Network (PVNet) to regress pixel-wise vectors pointing to the keypoints and use these vectors to vote for keypoint locations. This creates a flexible representation for localizing occluded or truncated keypoints. Another important feature of this representation is that it provides uncertainties of keypoint locations that can be further leveraged by the PnP solver. Experiments show that the proposed approach outperforms the state of the art on the LINEMOD, Occluded LINEMOD, YCB-Video, and Tless datasets, while being efficient for real-time pose estimation. We further create a Truncated LINEMOD dataset to validate the robustness of our approach against truncation. The code is available at https://github.com/zju3dv/pvnet.

With the development of Internet-of-Things (IoT), we witness the explosive growth in the number of devices with sensing, computing, and communication capabilities, along with a large amount of raw data generated at the network edge. Mobile (multi-access) edge computing (MEC), acquiring and processing data at network edge (like base station (BS)) via wireless links, has emerged as a promising technique for real-time applications. In this paper, we consider the scenario that multiple devices sense then offload data to an edge server/BS, and the offloading throughput maximization problems are studied by joint radio-and-computation resource allocation, based on time-division multiple access (TDMA) and non-orthogonal multiple access (NOMA) multiuser computation offloading. Particularly, we take the sequence of TDMA-based multiuser transmission/offloading into account. The studied problems are NP-hard and non-convex. A set of low-complexity algorithms are designed based on decomposition approach and exploration of valuable insights of problems. They are either optimal or can achieve close-to-optimal performance as shown by simulation. The comprehensive simulation results show that the sequence optimized TDMA scheme achieves better throughput performance than the NOMA scheme, while the NOMA scheme is better under the assumptions of time-sharing strategy and the identical sensing capability of the devices., Comment: To appear in IEEE Transactions on Wireless Communications

Background: Smoking participates in pathogenesis of lung cancer. Long non-coding RNAs (lncRNAs) play some specific roles during development of lung cancers. Objective: To investigate effects of smoking on lncRNA alterations in lung cancer. Methods: There are 522 lung adenocarcinoma (LUAD) and 504 lung squamous cell carcinoma (LUSC) participants. Clinical and lncRNA genetic data were downloaded from The Cancer Genome Atlas (TCGA) database. LncRNA alterations were analyzed in lung cancer patients. Smoking category and packs were evaluated. Correlations between smoking and LncRNA alterations were analyzed. Kaplan-Meier analysis was performed to determine overall survival and disease free survival. Results: There are more non-smokers in LUSC than in LUAD. In both LUAD and LUSC, smoking could increase total mutation counts and fraction of copy number alterations. Smoking index positively correlated with total mutations in LUAD, but not in LUSC. Smoking could trigger lncRNA alterations both in LUAD and LUSC. Smoking regulated different lncRNA between male and female. EXOC3-AS1 and LINC00603 alterations were positively correlated with smoking index in male LUAD smokers. In female LUAD smokers, smoking index was positively correlated with SNHG15, TP53TG1 and LINC01600 and negatively with LINC00609 and PTCSC3. In both male and female LUSC patients, smoking increased or decreased several lncRNA alterations. DGCR5 alteration increased in male LUSC than in female LUSC patients. In female LUSC patients, LOH12CR2 alteration was positively correlated with smoking index. Conclusions: Smoking promoted LUAD and LUSC development by affecting different lncRNA alterations in different genders.

Silicosis is a leading cause of occupational disease-related morbidity and mortality worldwide, but the molecular basis underlying its development remains unclear. An accumulating body of evidence supports gasdermin D (GSDMD)-mediated pyroptosis as a key component in the development of various pulmonary diseases. However, there is little experimental evidence connecting silicosis and GSDMD-driven pyroptosis. In this work, we investigated the role of GSDMD-mediated pyroptosis in silicosis. Single-cell RNA sequencing of healthy and silicosis human and murine lung tissues indicated that GSDMD-induced pyroptosis in macrophages was relevant to silicosis progression. Through microscopy we then observed morphological alterations of pyroptosis in macrophages treated with silica. Measurement of interleukin-1β release, lactic dehydrogenase activity, and real-time propidium iodide staining further revealed that silica induced pyroptosis of macrophages. Additionally, we verified that both canonical (caspase-1-mediated) and non-canonical (caspase-4/5/11-mediated) signaling pathways mediated silica-induced pyroptosis activation, in vivo and in vitro. Notably, Gsdmd knockout mice exhibited dramatically alleviated silicosis phenotypes, which highlighted the pivotal role of pyroptosis in this disease. Taken together, our results demonstrated that macrophages underwent GSDMD-dependent pyroptosis in silicosis and inhibition of this process could serve as a viable clinical strategy for mitigating silicosis.

Identity‐based encryption (IBE), introduced by Shamir, eliminates the need for public‐key infrastructure. The sender can simply encrypt a message by using the recipient's identity (such as email or IP address) without needing to look up the public key. In particular, when ciphertexts of an IBE do not reveal recipient's identity, this scheme is known as an anonymous IBE scheme. Recently, Blazy et al. (ARES '19) analysed the trade‐off between public safety and unconditional privacy in anonymous IBE and introduced a new notion that incorporates traceability into anonymous IBE, called anonymous IBE with traceable identities (AIBET). However, their construction is based on the discrete logarithm assumption, which is insecure in the quantum era. In this paper, we first formalize the consistency of tracing key of the AIBET scheme to ensure that a ciphertext cannot be traced with the use of wrong tracing keys. Subsequently, we present a generic formulation concept that can be used to transform structure‐specific lattice‐based anonymous IBE schemes into an AIBET. Finally, we apply this concept to Katsumata and Yamada's compact anonymous IBE scheme (Asiacrypt '16) to obtain the first quantum‐resistant AIBET scheme that is adaptively secure under the ring learning with errors assumption without random oracle.

BackgroundPatients undergoing surgery for early stage non-small cell lung cancer (NSCLC) may be at high risk for postoperative mortality. Access to stereotactic body radiation therapy (SBRT) may facilitate more appropriate patient selection for surgery.Research questionIs postoperative mortality associated with early stage NSCLC lower at facilities with higher use of SBRT?Study design and methodsPatients with early stage NSCLC reported to the National Cancer Database between 2004 and 2015 were included. Use of SBRT was defined by each facility's SBRT experience (in years) and SBRT to surgery volume ratios. Multivariate logistic regression was used to test for the associations between SBRT use and postoperative mortality.ResultsThe study cohort consisted of 202,542 patients who underwent surgical resection of cT1-T2N0M0 NSCLC tumors. The 90-day postoperative mortality rate declined during the study period from 4.6%to 2.6%(P< .001), the proportion of facilities that used SBRT increased from 4.6%to 77.5%(P< .001), and the proportion of patients treated with SBRT increased from 0.7%to 15.4%(P< .001). On multivariate analysis, lower 90-day postoperative mortality rates were observed at facilities with > 6 years of SBRT experience (OR, 0.84; 95% CI, 0.76-0.94; P= .003) and SBRT to surgery volume ratios of more than 17%(OR, 0.85; 95% CI, 0.79-0.92; P< .001). Ninety-day mortality also was associated with surgical volume, region, year, age, sex, and race, among other covariates. Interaction testing between these covariates showed negative results.InterpretationPatients who underwent resection for early stage NSCLC at facilities with higher SBRT use showed lower rates of postoperative mortality. These findings suggest that the availability and use of SBRT may improve the selection of patients for surgery who are predicted to be at high risk of postoperative mortality.

Background : Full dose cabozantinib for metastatic renal cell carcinoma (mRCC) is 60mg, but adverse events (AEs) may require dose reductions. Limited data exist comparing efficacy among cabozantinib doses. We compared AEs and clinical outcomes in mRCC patients treated with full versus reduced starting cabozantinib dose. Methods : We performed a retrospective analysis of 87 mRCC patients treated with cabozantinib at Winship Cancer Institute from 2016-2019. Overall survival (OS), progression-free survival (PFS), and objective response (OR) rate measured clinical outcomes. AEs were collected from clinic notes and the most common were hypertension, mucositis/hand-foot skin reaction (HFSR), or gastrointestinal toxicity. Univariate analysis (UVA) between starting doses and AEs with clinical outcomes was performed using logistic regression model. Multivariable analysis (MVA) was also performed using Cox proportional hazard model. Results : Most patients were male (71%) with clear-cell RCC (72%). The majority were IMDC intermediate (58%) or poor (35%) risk. One third received first-line cabozantinib and 64% had ≥3 baseline metastatic sites. Most patients (68%) required dose reduction from 60mg or started at reduced dose without escalation. Reduced dose patients were more likely to have ≥3 distant metastatic sites (70% vs 58%) and ≥ 2 prior lines of systemic therapy (50% vs 40%) compared to full dose patients. UVA revealed a trend towards shorter OS (HR: 1.78, p=0.095), PFS (HR: 1.50, p=0.107), and lower chance of OR (HR:0.42, p=0.149) among reduced dose patients. This trend did not hold in MVA (OS HR: 1.20, p=0.636; PFS HR: 1.23, p=0.4662). Mucositis/HFSR and hypertension were significantly associated with improved outcomes in UVA. Conclusions : Although we found a trend favoring full dose cabozantinib, this is likely due to worse baseline disease characteristics among patients starting on a reduced dose. Hypertension and mucositis/HFSR may be associated with improved outcomes. Larger studies are warranted to validate these findings.

Abstract:: As a common systemically muscular-skeleton disorder of aging, osteoporosisis is characterized by the uninterrupted deconstruction in osseous microarchitecture. Osteoporosis can consequently lead to a significantly high risk of osteoporotic fractures, such as osteoporotic vertebral compressive fractures [OVCF] in the spine and osteoporotic femoral neck fractures in the hip joint, which can significantly increase the numbers of mortality and morbidity in elderly people, especially in postmenopausal women. In addition, vitamin K has been demonstrated to play a key role in inhibiting osteoporotic fractures among postmenopausal women, but its long-term benefits, potential harms, and side effects of the combination between vitamin K and other anti-osteoporosis medicines, such as bisphosphonates or teriparatide still remain to be extensively studied.Therefore, the present study aimed to systematically reviewed previously published literature on the role of vitamin K in the treatment of osteoporosis.We currently, via multiple query strategies, searched the relevant literature in Cochrane and PubMed from January 2010 to December 2019. Subsequently, we conducted the systematic review according to the standard guideline of Preferred Reporting Item for Systematic Reviews and Meta-Analyses [PRISMA]. Finally, ten relevant studies met our current criteria for inclusion; subsequently, we followed the PRISMA guideline, then systematically reviewed each study by categorizing the data sources and analytical approaches in each study, while setting up variables and defining each study's outcomes.

Trigeminal neuralgia (TN) is a disease characterized by recurring, short-lived, electric shock-like pain experienced on one side of the face. Microvascular decompression (MVD) is one of the most effective surgical interventions for resolving TN caused by neurovascular compression. This study aimed to determine the predictive and prognostic factors of surgical outcomes.This retrospective cohort study enrolled patients diagnosed with TN who underwent MVD at our hospital during 2013-2019. The demographic information, pain character, peri-operative Barrow Neurological Institute (BNI) scale, medication, operative finding were recorded. And the outcome was Outcomes were divided into drug-free and drug-dependent group. Predisposing factors for each outcome were analyzed by one-way analysis of variance, followed by a Mann-Whitney U test or Kruskal-Wallis test.A total of 104 consecutive patients received MVD to treat TN, and 88 patients were enrolled in this study. The overall postoperative drug-free outcome was 72.7%. A significant difference in drug-free outcomes was observed for patients with typical TN (80.8%) compared with patients with atypical TN (33.33%, p = 0001). When severe venous compression was encountered during MVD, the drug-free outcome fell to 50% (10/20, p = 0.009). The Mann-Whitney U test indicated typical TN as a positive predictive factor of a drug-free outcome, whereas severe venous compression was a negative predictive factor. The patients with preoperative BNI score of 4 had better improvement than others (p = 0.045). Age, onset duration, and arterial loop had no specific difference in this study.In our study, atypical TN and severe venous compression were associated with poor outcomes. Regrouping atypical TN into precise diagnosis represents an immediate priority according to our result. The preoperative BNI score could be used as an effective predictive tool for the outcome of MVD surgery.

Neoadjuvant chemotherapy (NAC) is increasingly used for operable breast cancer (BC). Appropriate radiation therapy (RT) fields (ie, whole breast [WB] ± regional nodal irradiation [RNI]) in patients who were clinically node positive (cN1) but convert to pathologically node negative (ypN0) after NAC are unknown and the subject of the accruing NSABP B-51 trial. We sought to compare outcomes between WB RT with or without RNI following breast conservation and sentinel lymph node biopsy (SLNB) alone in cN1, ypN0 women following NAC.We identified all BC patients with cN1, ypN0 who underwent NAC followed by lumpectomy and SLNB between 2006 and 2015 in the National Cancer Database. RNI utilization was evaluated using Cochran-Armitage test. Overall survival between WB RT alone versus WB + RNI was compared using Kaplan-Meier with and without propensity score-based weighted adjustment and multivariable (MVA) Cox proportional hazards.From 2006 to 2015, RNI use increased from 48.13% to 62.13% (Pfor trend.001). The 10-year survival for WB alone versus WB + RNI was 83.6% and 79.5%, respectively (P= .14). On MVA analysis, the addition of RNI compared to WB alone was not associated with a survival benefit (WB vs. WB + RNI: hazard ratio 0.80, 95% confidence interval, 0.58-1.11, P= .19). Results were unchanged after propensity score-based adjustment.For women with cN1 BC who convert to ypN0 following NAC and breast conserving surgery with SLNB alone, more extensive RNI may not provide a long-term survival benefit. Prospective validation via the NSABP B-51 trial will be essential.

Owing to the intense carrier recombination and limited optical absorption, the as‐fabricated CsPbBr3 visible light photodetectors (PDs) are far from practical application. In this work, we have demonstrated performance‐improved metal‐semiconductor‐metal (MSM) structured CsPbBr3 visible light PDs realized by the decoration of sputtered Au nanoparticles (NPs). It showed that the Au NPs on the CsPbBr3 exhibited synergistic benefits including improving the photogenerated charge carriers’ lifetime and enhancing the optical absorption of the CsPbBr3, both of which are fundamental factors for the performance‐improved PDs. Electrical characterizations showed that localized Schottky junctions formed at the Au NPs/CsPbBr3 interface. In addition, optical investigations showed that effective resonant coupling occurred between the localized surface plasmon resonance effects of Au NPs and excitons in the CsPbBr3. As a result, the on‐off switching of the Au‐decorated CsPbBr3 photodetector increased by 13 times compared with that of the pristine one. Meanwhile, the peak photo sensitivity of the CsPbBr3 photodetector was increased from 0.088 to 0.61 A W‐1 after the decoration of Au NPs. It is believed that the results shown in this work will provide pathways for fabricating high‐performance CsPbBr3 PDs and other similar devices in the future.

With the rapid development of the influencer marketing industry in recent years, the cooperation between brands and micro-influencers on marketing has achieved much attention. As a key sub-task of influencer marketing, micro-influencer recommendation is gaining momentum. However, in influencer marketing campaigns, it is not enough to only consider marketing effectiveness. Towards this end, we propose a concept-based micro-influencer ranking framework, to address the problems of marketing effectiveness and self-development needs for the task of micro-influencer recommendation. Marketing effectiveness is improved by concept-based social media account representation and a micro-influencer ranking function. We conduct social media account representation from the perspective of historical activities and marketing direction. And two adaptive learned metrics, endorsement effect score and micro-influencer influence score, are defined to learn the micro-influencer ranking function. To meet self-development needs, we design a bi-directional concept attention mechanism to focus on brands and micro-influencers marketing direction over social media concepts. Interpretable concept-based parameters are utilized to help brands and micro-influencers make marketing decisions. Extensive experiments conducted on a real-world dataset demonstrate the advantage of our proposed method compared with the state-of-the-art methods.

Switchable dielectric materials are attracting tremendous interest due to their low cost of manufacture, environment protection and structural flexibility. However, most of them have a single function. Here, we report one switchable dielectric material with high phase transition temperature based on 4-Ethylmorpholine. [4-Ethylmorpholine]2MnCl4 with the phase transition temperature of 425 K. What is more interesting is that this compound also has photoluminescence characteristic. Owing to the excellent switchable dielectric transition and efficacious Photoluminescence, this work may extend the application of switchable dielectric materials in the field of luminescence and multifunctional devices.

Background Whether the characteristics and outcome of secondary acute promyelocytic leukemia (s-APL) are similar to de no APL (dn-APL) remains unknown. Patients and Methods Using the SEER database, we identified 3877 patients with APL diagnosed from 2000 to 2014, including 465 s-APL and 3412 dn-APL. Results Compared with dn-APL, s-APL werecharacterized by older median age, and a higher early mortality rate. Multivariate Cox model showed s-APL, older age, earlier year of diagnosis, and male gender were independently associated with worse survival. Notably, s-APL had a significantly inferior survival regardless of gender, race, marital status, and year of diagnosis. However, the difference between the 2 cohorts was only evident in younger patients (≤ 65 years) but was lost in older patients (> 65 years). Additionally, the majority of index cancer type was breast and prostate in female and male s-APL, respectively. Latency Conclusions Inferior survival of s-APL points to the need for treatment improvement.

In this paper, general logic cell and module designs in basic digital signal processing (DSP), for transparent, flexible chips and wearable electronics are presented. Modified Circuits from ratioed logic and pass transistor logic styles are modified and proposed, based on n-type-only indium tin oxide (ITO) stabilized ZnO thin-film transistors (TFTs) process. Elaborations on logic circuits with purely n-type TFT transistors were carried out to extend the logic swing of circuit outputs and accelerate the signal propagation in complex logic functions with simplified pull-up/pull-down or passive networks. To implement logic complexes on multiple OR-of-ANDs functions with better performance, tailored active controlled ratioed logic style is adopted with faster speed and smaller area by simplifying the transistor networks properly. All the circuits were fabricated on transparent glass plate. The featured 2-input/3-input XOR gate, 4-1 MUX and D flip flop (DFF) can operate with maximum featured delays of 2-6 μs at 5 V power supply, with comparatively over 50% less delays and areas than other state-of-art works. The featured 4-bit adder performs maximum 16.41 μs delay at 5 V in measurement. A 4-bit multiplier is also presented based on the adder and DFF. These proposed TFT circuits exhibited smaller area with relatively moderate-high performance in comparison, which were promising building blocks for transparent flexible DSP electronics with low-speed requirements.

Background: This article assessed the relationship between waist circumference (WC) and cardiorespiratory fitness (CRF) of children and adolescents aged 7–18 years. Methods: Using a stratified cluster random sampling method, 92,574 children and adolescents (47,364 males and 45,210 females) were extracted. CRF was measured by performance in the 20 m shuttle run test (20mSRT) and the subsequent estimation of maximal oxygen consumption (V˙O2max) using the Léger equations. Participants were divided into five groups of WC percentiles and three groups of CRF percentiles by the Lambda Mu Sigma (LMS). The correlation between WC and CRF was examined by one-way ANOVA and curvilinear regression analysis. Results: WC increased with age, while V˙O2max showed an age-related decline. Controlling for gender, urban, and rural factors, for children and adolescents aged 10–12, 13–15, and 16–18 years, the V˙O2max Z-score of the normal WC group was significantly higher than the very low WC group (P

The TianQin-1 satellite, which was launched on 20 December 2019 into a Sun-synchronous orbit with an altitude of 628 km, is the first technology demonstration satellite for the TianQin project. A micro-electro-mechanical system (MEMS) global positioning system (GPS) receiver is installed on the satellite for precise orbit determination (POD). In addition to the conventional nadir-pointing mode, a specific Sun-pointing mode was used by the satellite owing to the limitation of system resources. The in-flight performance of the MEMS GPS receiver was assessed. The average numbers of available satellites for dual-frequency navigation in the nadir-pointing and Sun-pointing modes are 7 and 5, respectively. The qualities of the P2 code and carrier phase observations are basically equal for both modes. The average root mean square of the multipath errors for C1 observations in the Sun-pointing mode is 0.29 m, slightly larger than that in the nadir-pointing mode. In the Sun-pointing mode, the body of the TianQin-1 satellite rotates around the Sun-pointing axis, which may provide favourable geometric conditions for the estimation of the antenna phase center offset (PCO) corrections in the X, Y, and Z directions. Its feasibility is demonstrated using the simulated data. The GPS measurements of TianQin-1 are then used to estimate the PCO corrections in all three directions while in the Sun-pointing mode and in the Z direction while in the nadir-pointing mode. Satellite laser ranging validation shows that the orbit accuracy of TianQin-1 is approximately 5.90 cm in the nadir-pointing mode. In the Sun-pointing mode, the three-dimensional position difference of 5-h overlap decreased from 8.87 cm to 8.73 cm when the antenna PCO corrections were used in the POD.

Objective This study was designed to establish and validate promising and reliable nomograms for predicting the survival of angiosarcoma (AS) patients. Methods The Surveillance, Epidemiology, and End Results database was queried to collect the clinical information of 785 AS patients between 2004 and 2015. Data were split into a training cohort (n = 549) and a validation cohort (n = 236) without any preference. Univariate Cox and multivariate Cox regression analyses were performed to analyze the clinical parameters. Independent prognostic factors were then identified. Two nomograms were constructed to predict overall survival (OS) and cancer‐specific survival (CSS) at 3 and 5 years. Finally, the models were evaluated using concordance indices (C‐indices), calibration plots, and decision curve analysis (DCA). Results Based on the inclusion and exclusion criteria, 785 individuals were included in this analysis. Univariate and multivariate Cox regression analyses revealed that age, tumor size, and stage were prognostic factors independently associated with the OS of AS. Tumor site, tumor size, and stage were associated with the CSS of AS. Based on the statistical results and clinical significance of variables, nomograms were built. The nomograms for OS and CSS had C‐indices of 0.666 and 0.654, respectively. The calibration curves showed good agreement between the predictive values and the actual values. DCA also indicated that the nomograms were clinically useful. Conclusion We established nomograms with good predictive ability that could provide clinicians with better predictions about the clinical outcomes of AS patients., We constructed new and reliable nomograms with the clinical information obtained from the Surveillance, Epidemiology, and End Results database. Internal and external validation results suggested that our models had good prediction effects.

This paper is the first in the two-part series quantitatively modelling human grasp functionality and understanding the way human grasp objects. The aim is to investigate the thumb movement behavior influenced by object shapes, sizes, and relative positions. Ten subjects were requested to grasp six objects ( 3 shapes × 2 sizes ) in 27 different relative positions ( 3 X deviation × 3 Y deviation × 3 Z deviation ). Thumb postures were investigated to each specific joint. The relative position ( X , Y , and Z deviation) significantly affects thumb opposition rotation (Rot) and flexion (interphalangeal (IP) and metacarpo-phalangeal (MCP)), while the object property (object shape and size) significantly affects thumb abduction/adduction (ABD) motion. Based on the F value, the Y deviation has the primary effects on thumb motion. When the Y deviation changing from proximal to distal, thumb opposition rotation (Rot) and flexion (IP and MCP joint) angles were increased and decreased, respectively. For principal component analysis (PCA) results, thumb grasp behavior can be accurately reconstructed by first two principal components (PCs) which variance explanation ratio reached 93.8% and described by the inverse and homodromous coordination movement between thumb opposition and IP flexion. This paper provides a more comprehensive understanding of thumb grasp behavior. The postural synergies can reproduce the anthropomorphic motion, reduce the robot hardware, and control dimensionality. All of these provide a more accurate and general basis for the design and control of the bionic thumb and novel wearable assistant robot, thumb function assessment, and rehabilitation.

The clinical presentation of primary hyperparathyroidism (PHPT) differs between patients from developed and developing countries. In China, the clinical pattern has changed over the past few decades. Our aim was to elucidate general changes in the clinical characteristics of PHPT from 2010 to 2021. We enrolled 343 patients with PHPT at the Qilu Hospital of Shandong University, Jinan, China, from January 2010 to May 2021, including both surgical and non-surgical patients. Patients were divided into two subgroups, 2010–2016 (group A, n = 152) and 2017–2021 (group B, n = 191), based on the time span. We compared clinical manifestations and laboratory result data between these two groups. The mean patient age was 52.59 ± 13.55 years, and the male-to-female ratio was 1:2.54. Of the 343 patients, 183 (53.35%) had symptomatic PHPT; bone pain, urolithiasis, and fatigue were the most common symptoms. Post-operative pathology showed that 96.20% of the patients had parathyroid adenoma, whereas 2.41% had parathyroid carcinoma. Great changes occurred between 2010 and 2021; the percentage of patients with asymptomatic PHPT (aPHPT) increased from 36.18% in group A to 54.97% in group B. Moreover, patients in group B showed significantly lower serum calcium, alkaline phosphatase, parathyroid hormone, and urinary phosphate levels but higher serum 25-hydroxyvitamin D levels than those in group A. Clinical presentations in group B were also milder. In conclusion, the clinical characteristics of Chinese PHPT patients changed dramatically from 2010 to 2021, with asymptomatic PHPT (aPHPT becoming the predominant type over the last 3 years.

A 12-GHz transformer feedback Class-F2,3 voltage-controlled oscillator (VCO) using noise circulating is proposed in this letter. Transformer feedback is utilized in the proposed VCO to achieve Class-F2,3 resonant impedance control at the VCO output and tail current transistor input. Also, the noise contribution of the tail current transistor is further reduced by partially circulating its noise into itself. The proposed VCO is fabricated in 40-nm CMOS process with 0.04-mm2 core area. Experimental results show that the frequency tuning range of the VCO is 11.74–12.63 GHz. The VCO achieves phase noise of −120.2 dBc/Hz at 1-MHz offset frequency at 12 GHz with figure of merit (FoM) of 190.5 dBc/Hz and FoM $_{T}$ of 187.8 dBc/Hz, and consumes 13.23 mW from a 1.1-V supply.

Objective To evaluate the clinicoradiologic characteristics of hemorrhagic meningiomas (HMs) that are missed or misdiagnosed on radiologic imaging studies. Methods Clinical and radiologic data from 6 patients with HM who were initially misdiagnosed were collected and recorded respectively. In addition, we performed a literature review for misdiagnosed HM and summarized the results. Results Five of the 6 patients with misdiagnosed HM were female, and 1 was male. Both computed tomography (CT) and magnetic resonance imaging were performed in 4 patients, and CT alone was performed in 2. On CT, the HM was heterogeneously hyperdense in 5 patients and isodense in 1 patient. In all 4 patients who underwent magnetic resonance imaging, the HM was mixed iso- and hypointense on T1-weighted imaging and heterogeneously hyperintense on T2-weighted imaging. Marked heterogeneous contrast enhancement was observed in 2 patients, strong rim enhancement in 1, and peripheral enhancement in 1. The dural tail sign was seen in only 1 patient. The initial radiologic misdiagnoses were subdural hematoma (n = 1), malignant glioma (n = 1), ruptured arterial aneurysm (n = 1), metastasis (n = 2), and uncertain (n = 1). In the literature review, 22 cases of HM diagnostic error were collected. The main misdiagnoses were subdural hematoma (27.3%), traumatic hematoma (13.6%), vascular anomaly (13.6%), malignant glioma (4.5%), and metastasis (4.5%). Conclusions Our study showed that in patients with HM with inadequate imaging evaluation, a small tumor associated with massive hematoma and atypical imaging features was more likely to be misdiagnosed.

Primary Sjogren's syndrome (pSS) is an autoimmune exocrinopathy characterized by dryness symptoms. This review briefly describes recent advances in the targeted therapies for pSS. Biologics evaluated for pSS treatment mainly include B cell-depleting agents, inhibitors of B cell activation, and agents that target co-signaling molecules or proinflammatory cytokines. Small molecule inhibitors that target signaling pathways have also been evaluated. However, current evidence for the efficacy of targeted therapies in pSS is still sparse. Although ianalumab (an anti-B cell-activating factor [BAFF]-receptor antibody) and iscalimab (an anti-CD40 antibody) are promising biologics for pSS, their efficacy still needs to be evaluated in larger clinical trials. For other biologics, clinical trials have found no differences versus placebo in the change from baseline in European League Against Rheumatism Sjogren's Syndrome Disease Activity Index (ESSDAI) score and fatigue score. Possible causes of the disappointing outcomes mainly include the inefficacy of those evaluated biologics in treating pSS, the high heterogeneous nature of pSS, irreversible exocrine glandular failure at advanced disease stages, inappropriate recruitment strategy in clinical trials, and outcome measures. Early diagnosis and glandular function-centered outcome measures may help to improve the current situation in the systemic therapy of pSS.

Background: Portal vein velocity (PVV) has shown a reasonable correlation with the presence of portal hypertension in patients with cirrhosis. This study aims to evaluate the value of PVV for diagnosing clinically significant portal hypertension (CSPH) and predicting the risk of variceal hemorrhage (VH) in patients with hepatitis B virus (HBV)-related cirrhosis. Material and Methods: A cohort of 166 consecutive adult patients with HBV-related cirrhosis was recruited in this retrospective study from two high-volume liver centers in China between April 2015 and April 2017. The performance of PVV and other non-invasive parameters for diagnosing CSPH and predicting the risk of VH was studied. Results: PVV demonstrated the best performance for diagnosing CSPH (defined as an HVPG ≥10 mmHg) in patients with HBV-related cirrhosis among the included non-invasive predictors with the area under the receiver operating characteristic curve (AUC), specificity, and sensitivity of 0.745, 50%, and 93.5%, respectively. Other non-invasive markers, including APRI, AAR, LS, FIB-4, and diameter of the portal vein, did not show sufficient performance with the AUCs of 0.565, 0.560, 0.544, 0.529, and 0.474, respectively. With regard to predicting the risk of VH (defined as an HVPG ≥12 mmHg), PPV also exhibited a moderate performance with an AUC of 0.762, which was superior to that of the aforementioned markers. By using two cutoff values of PVV to rule-out (11.65 cm/s) and rule-in (20.20 cm/s) CSPH, 30 (33.7%) patients showed definite results categories, with 23 (76.7%) patients were well classified and 7 (23.3%) were misclassified. Fifty-nine (66.3%) patients were with indeterminate results. By using PVV values of 13.10 cm/s and 21.40 cm/s to rule-out and rule-in HVPG ≥ 12mmHg, 34 (38.2%) patients has definite results, among whom 26 (76.5%) were well classified and 8 (23.5%) were misclassified. And 55 (61.8%) patients required further evaluation. Conclusion: PPV is insufficient to serve as a non-invasive parameter for identifying CSPH and predicting the risk of VH in patients with HBV-related cirrhosis.

Microrobots can expand our abilities to access remote, confined, and enclosed spaces. Their potential applications inside our body are obvious, e.g., to diagnose diseases, deliver medicine, and monitor treatment efficacy. However, critical requirements exist in relation to their operations in gastrointestinal environments, including resistance to strong gastric acid, responsivity to a narrow proton variation window, and locomotion in confined cavities with hierarchical terrains. Here, we report a proton-activatable microrobot to enable real-time, repeated, and site-selective pH sensing and monitoring in physiological relevant environments. This is achieved by stratifying a hydrogel disk to combine a range of functional nanomaterials, including proton-responsive molecular switches, upconversion nanoparticles, and near-infrared (NIR) emitters. By leveraging the 3D magnetic gradient fields and the anisotropic composition, the microrobot can be steered to locomote as a gyrating "Euler's disk", i.e., aslant relative to the surface and along its low-friction outer circumference, exhibiting a high motility of up to 60 body lengths/s. The enhanced magnetomotility can boost the pH-sensing kinetics by 2-fold. The fluorescence of the molecular switch can respond to pH variations with over 600-fold enhancement when the pH decreases from 8 to 1, and the integration of upconversion nanoparticles further allows both the efficient sensitization of NIR light through deep tissue and energy transfer to activate the pH probes. Moreover, the embedded down-shifting NIR emitters provide sufficient contrast for imaging of a single microrobot inside a live mouse. This work suggests great potential in developing multifunctional microrobots to perform generic site-selective tasks in vivo.

Postoperative pulmonary complications (PPCs) are the most common complications following minimally invasive esophagectomy (MIE) and can be associated with adverse outcomes. This study aims to construct a nomogram based on clinical factors to predict PPCs and investigate related early outcomes. Clinical data of 969 consecutive patients receiving MIE were retrospectively collected. Univariate and multivariate analysis were performed to select independent predictors. Using independent predictors to develop a nomogram and using a bootstrap-resampling approach to conduct internal verification. Early outcomes of PPCs were analyzed. The incidence of PPCs following MIE was 39.6% (384 out of 969). In multivariate analysis, older age (Odds ratio (OR) 1.034, P

Tumor necrosis factor-α (TNF-α) inhibitors are the main types of biological conventional synthetic disease-modifying antirheumatic drugs and have efficacy in treating ankylosing spondylitis (AS) which is not sensitive for nonsteroidal anti-inflammatory drug. However, the impact of TNF-α inhibitors on immune cells in patients with AS is still clearly undefined, and the impact of immune cells on treatment response is also largely elusive. This study is aimed at evaluating the longitudinal changes of circulating immune cells after anti-TNF-α therapy and their associations with treatment response in AS patients. Thirty-five AS patients receiving the treatment of anti-TNF-α therapy were included into this prospective observational study. The frequencies of immune cells including Th1, Th2, Th17, regulatory T cell (Treg), T follicular helper cell (Tfh), and regulatory B cell (Breg) in the peripheral blood were measured by flow cytometry at baseline and 4 time points after therapy. The difference in the circulating immune cells between responders and nonresponders was compared. This study suggested that anti-TNF-α therapy could significantly reduce circulating proinflammatory immune cells such as Th17 and Tfh, but significantly increased the percentages of circulating Treg and Breg. Moreover, circulating Breg may be a promising predictor of response to anti-TNF-α therapy in AS patients.

Heterostructure devices based on two-dimensional materials have been under intensive study due to their intriguing electrical and optical properties. One key factor in understanding these devices is their nanometer-scale band profiles, which is challenging to obtain in devices. Here, we use a technique named contact-mode scanning tunneling spectroscopy to directly visualize the band profiles of MoS2/WSe2 heterostructure devices at different gate voltages with nanometer resolution. The long-held view of a conventional p-n junction in the MoS2/WSe2 heterostructure is reexamined. Due to strong inter- and intralayer charge transfer, the MoS2 layer in contact with WSe2 is found to convert from n-type to p-type, and a series of gate-tunable p-n and p-p+ junctions are developed in the devices. Highly conductive edges are also discovered which could strongly affect the device properties.

Purpose: To determine (i) the relationship between candidate biomarkers of the antiproliferative (Ki67) response to letrozole and palbociclib alone and combined in ER+/HER2− breast cancer; and (ii) the pharmacodynamic effect of the agents on the biomarkers. Experimental Design: 307 postmenopausal women with ER+/HER2− primary breast cancer were randomly assigned to neoadjuvant treatment with letrozole for 14 weeks; letrozole for 2 weeks, then letrozole+palbociclib to 14 weeks; palbociclib for 2 weeks, then letrozole+palbociclib to 14 weeks; or letrozole+palbociclib for 14 weeks. Biopsies were taken at baseline, 2 and 14 weeks and surgery at varying times after stopping palbociclib. Immunohistochemical analyses were conducted for Ki67, c-PARP, ER, PgR, RB1, CCNE1, and CCND1. Results: Higher baselines ER and PgR were significantly associated with a greater chance of complete cell-cycle arrest (CCCA: Ki67 Conclusions: High CCNE1 levels were confirmed as a biomarker of resistance to letrozole+palbociclib. Ki67 recovery within 3–9 days of discontinuing palbociclib indicates incomplete suppression of proliferation during the “off” week of its schedule.

Background Acute renal artery thrombosis is a relatively rare disease. Early diagnosis and emergent treatment can prevent the loss of renal function and the development of hypertension. Case summary We report a patient with acute renal artery thrombosis who presented to our hospital with acute-onset right flank pain and was treated by percutaneous mechanical thrombectomy using the Rotarex device. After 2 mo, right kidney function had recovered slightly. Conclusion Renal artery thrombosis may lead to loss of renal function and the development of hypertension. Rotarex mechanical thrombectomy may be a viable treatment option for rapid recanalization of the renal artery in patients with renal artery thrombosis.

Objective To evaluate the relationship between the accessibility of automatic external defibrillators (AEDs) and the survival rate of patients who have out-of-hospital cardiac arrest (OHCA). Methods The systematic review was conducted according to the Cochrane Handbook of Systematic Reviews. We searched the Chinese and English literature databases from 2009 to 2019. Study selection and data collection were conducted by three reviewers. One-month survival rates of OHCA with different AEDs accessibility were estimated using meta-analysis. Results Overall 16 studies with 55,537 participants were included. The overall one-month survival rate for OHCA was 27.4%. The one-month survival rate was 35.2% for people receiving AEDs within 5 min, 36.6% between 5 min to 10 min, and 28.4% for longer than 10 min. By distance between the location of the AEDs and the location of the cardiac arrest, the one-month survival rate was 37.1% for those ≤100 m, 22.0% for 100 m-200 m, and 12.8% for >200 m, respectively. The one-month survival rate was 39.3% in schools, sports venues and airports compared with 23.5% in other sites. The number of AEDs allocation was positively correlated, while the time and distance were negatively correlated with the one-month survival rate adjusted for other factors, but they were all non-significant correlations. Conclusion The improvement of accessibility of AEDs may increase the survival rate of OHCA and the survival rate may be higher in playgrounds, airports, and schools equipped with AEDs. However, the strength of evidence was limited by the considerably heterogeneity of included studies. Verification of these findings in further studies is warranted.

Epilepsy, which is caused by abnormal neuronal firing in the brain, is a common neurological disease and affects motor and cognitive functions. Excessive levels of glutamate and insufficient levels of inhibitory GABA are involved in its pathophysiology. Valproic acid (Val), a GABAergic agonist, is one of the first-line antiepileptic drugs, but it shows many adverse side effects at the clinical dose. Clavulanic acid (CA), a β-lactamase inhibitor, has been demonstrated to increase glutamate transporter-1 expression. This study evaluated the effects of CA and Val in an epilepsy rat model. Male Wistar rats received intraperitoneal injections of pentylenetetrazol (PTZ, 35 mg/kg, every other day, IP, for 13 days) to induce kindling epilepsy. After four times of PTZ injection, rats received daily treatment with CA (1 or 10 mg/kg, IP), Val (50 or 100 mg/kg, IP), or the combination of CA (1 mg/kg) and Val (50 mg/kg) for 7 consecutive days. Motor, learning, and memory functions were measured. Rats with PTZ-induced kindling exhibited seizures, motor dysfunction, cognitive impairment, and cell loss and reduction of neurogenesis in the hippocampus. Neither 1 mg/kg CA nor 50 mg/kg Val treatment was effective in alleviating behavioral and neuronal deficits. However, treatment with 10 mg/kg CA, 100 mg/kg Val, and the combination of 1 mg/kg CA and 50 mg/kg Val improved these behavioral and neuronal deficits. Particularly, the combination of CA and Val showed synergistic effects on seizure suppression, suggesting the potential for treating epilepsy and related neuronal damage and motor and cognitive deficits.

Perpendicular magnetic anisotropy (PMA) is a determining factor for the realization of nonvolatile information storage devices with high efficiency and thermal stability. In this work, a new spin gapless semiconductor Mn2.25Co0.75Ga0.5Sn0.5 Heusler alloy with an inter-spin zero gap was first designed theoretically. The Mn2.25Co0.75Ga0.5Sn0.5 bulk was prepared successfully in experiment. The effects of interfacial termination, oxidation, and film thickness on the magnetic anisotropy of Mn2.25Co0.75Ga0.5Sn0.5/MgO (MCGS/MgO) heterostructures are investigated systematically by first-principles calculations. The results show that all the Mn(A)Mn(C)GaSn-, Mn(A)Mn(C)CoGaSn-, Mn(B)GaSnI-, and Mn(B)GaSnII-terminated MCGS/MgO heterostructures (called as AC1, AC2, BD1, and BD2 models, respectively) present PMA, which mainly derives from the interfacial and surficial MCGS layers. Furthermore, the PMA of MCGS/MgO heterostructures can be preserved in a large range of interfacial oxidization (up to ±50%). With MCGS thickness increasing from 5 to 16 monolayers, the PMA of MCGS/MgO heterostructures with an AC-type surface decreases significantly. However, the PMA of BD-type surface models is relatively robust to the thickness of the MCGS layer, and the magnetic anisotropy always points to the out-of-plane direction. Therefore, MCGS Heusler alloy is a new promising spin gapless semiconductor candidate for spintronics applications. The robust and tunable PMA in MCGS/MgO heterostructures offers the possibility for developing nonvolatile data memory devices.

Light-emitting diodes (LEDs) based on metal halide perovskite quantum dots (QDs) have achieved impressive external quantum efficiencies; however, the lack of surface protection of QDs, combined with efficiency droop, decreases device operating lifetime at brightnesses of interest. The epitaxial incorporation of QDs within a semiconducting shell provides surface passivation and exciton confinement. Achieving this goal in the case of perovskite QDs remains an unsolved challenge in view of the materials' chemical instability. Here, we report perovskite QDs that remain stable in a thin layer of precursor solution of perovskite, and we use strained QDs as nucleation centers to drive the homogeneous crystallization of a perovskite matrix. Type-I band alignment ensures that the QDs are charge acceptors and radiative emitters. The new materials show suppressed Auger bi-excition recombination and bright luminescence at high excitation (600 W cm-2), whereas control materials exhibit severe bleaching. Primary red LEDs based on the new materials show an external quantum efficiency of 18%, and these retain high performance to brightnesses exceeding 4700 cd m-2. The new materials enable LEDs having an operating half-life of 2400 h at an initial luminance of 100 cd m-2, representing a 100-fold enhancement relative to the best primary red perovskite LEDs.

We evaluated the safety and immunogenicity of four doses of 20 or 60 ��g, and the immunogenicity and compliance of the short-term vaccination regimen (0, 1, and 2 months) among patients receiving MMT. We conducted a randomized controlled trial among 303 patients receiving MMT who were randomized to receive 3 or 4 doses of 20 or 60 ��g of recombinant hepatitis B vaccine. At month 7, the seroconversion rates in both IM20 �� 4 and IM60 �� 4 groups were numerically higher than the IM20 �� 3 group (P > 0.05). The high-level responses and geometric mean concentration (GMC) of anti-HBs in both IM20 �� 4 and IM60 �� 4 groups were significantly higher than the IM20 �� 3 group (P 0.05). The completion rate of the short-term high-strength vaccination group was significantly higher than the standard vaccination group (P 0.05), with similar immunogenicity (P > 0.05). Both the high-strength and standard-strength four-dose hepatitis B vaccine regimens could improve the immune response for patients receiving MMT. The high-strength short-term vaccination regimen could improve compliance and attain comparable immunogenicity with the standard vaccination regimen. The high-strength short-term vaccination regimen is recommended and the fourth dose is encouraged for this population considering the compliance and immunogenicity. ClinicalTrials.gov (NCT03962816)

A wideband dual-polarized multidipole antenna for base station applications is proposed. It consists of a pair of large square-shaped loop dipoles and a pair of small rectangle loop dipoles as radiation elements. A pair of small rectangle loop dipoles is fed by T-shaped feed structure which is in the large square-shaped loop dipoles radiating arm so that the antenna generates an additional resonance and obtains a wider bandwidth. The proposed antenna was fabricated and measured, and the results show that the antenna achieves a wide impedance bandwidth of 63.7 % with VSWR

Objective. To explore the efficacy of Internet-based chronic disease management model combined with the modified therapy of Bushenyiliu decoction in treating patients with type 2 diabetes mellitus (T2DM) and prostate cancer and its effect on disease control rate (DCR). Methods. 120 patients with T2DM and prostate cancer admitted to the Affiliated Hospital of Yangzhou University, Yangzhou First People’s Hospital, from February 2019 to February 2020, were retrospectively analyzed and equally divided into the experimental group and the control group according to their admission order. Conventional treatment combined with the modified therapy of Bushenyiliu decoction was performed on all patients for 3 months, and the Internet-based chronic disease management model was adopted for patients in the experimental group additionally, so as to compare their short-term effect, survival time, disease progression, blood glucose indicators, immune function indicators, and type 2 Diabetes Self-Care Scale (2-DSCS) scores. Results. Compared with the control group, the experimental group obtained significantly higher DCR and objective remission rate (ORR) ( P < 0.05 ), higher survival time and disease progression ( P < 0.001 ), better blood glucose indicators and immune function indicators ( P < 0.001 ), and higher 2-DSCS scores ( P < 0.001 ) after treatment. Conclusion. Combining the Internet-based chronic disease management model with the modified therapy of Bushenyiliu decoction can effectively enhance the self-care ability of patients with T2DM and prostate cancer, improve their blood glucose level, promote their body immunity, and comprehensively optimize the cancer control effect, which should be promoted in practice.

Previous cross-sectional studies have demonstrated the high prevalence of depression and comorbidity in knee osteoarthritis (KOA), and KOA or its impact on lifestyle was seen as a potential trigger factor of depression and comorbidity. However, the exact onset and progression pattern of depression and comorbidity in KOA was still unknown.Group-based trajectory modeling (GBTM) analysis was conducted in the 2833 subjects selected from the osteoarthritis initiative (OAI) database. Eight-year trajectories were determined and described. Baseline characteristics were investigated in multi-variable regression to detect the risk factors of the unfavored trajectory.Stable trajectory (70.4%) and worsening trajectory (29.6%) were identified in comorbidity. The risk factors for the worsening trajectory membership were the obesity (OR = 1.47 CI = [1.20, 1.79], P 0.001), older age (OR = 1.74, CI = [1.41, 2.16], P 0.001), and smoke (OR = 1.30, CI = [1.08, 1.57], P 0.01) at baseline. Stable trajectory (52.0%), slow-worsening trajectory (40.5%), and fast-worsening trajectory (7.5%) were identified in depression symptoms. The risk factors for the fast-worsening trajectory membership were female (OR = 1.51 CI = [1.03, 2.20], P 0.05), lower income (OR = 1.52, CI = [1.01, 2.27], P 0.05), and smoke (OR = 1.30, CI = [1.08, 1.57], P 0.01) at baseline.A significant amount of KOA subjects tends to develop depression symptoms and comorbidity. Managing related risk factors, like weight loss or smoking cessation, might have considerable significance in preventing or delaying depression symptoms and comorbidity in KOA. Key Points • The first study investigating the trajectory of comorbidity progression in KOA. • Approximately 7.5% of KOA patients tend to develop depression symptoms quite rapidly, and 30% of KOA patients tend to develop comorbidity • Risk factors of worsening trajectories were identified: obesity, older age, smoking, female, and lower income.

Objective Recurrent cervical cancer is hard to treat when occurring in a previous radiated area and unresectable or distant metastasis. We present three such cases who achieved complete remission (CR) after chemoradiotherapy and pembrolizumab. Case Report Case 1 was diagnosed with cervical adenocarcinoma, stage IVB. She obtained CR after concurrent chemoradiotherapy (CCRT) and post-CCRT adjuvant chemotherapy and bevacizumab. Recurrence at previous irradiated sacral bone was controlled with pembrolizumab and CCRT using proton therapy (PT). Case 2 was diagnosed with stage IVB squamous cell carcinoma. First recurrence occurred at inguinal lymph node (LN). Secondary recurrence occurred at paraaortic LN ten years later. PT with chemotherapy and pembrolizumab achieved CR. Case 3 had a small cell carcinoma (stage IVB) with bone metastasis. She had CR to CCRT with etoposide-cisplatin. Liver metastasis was salvaged with CCRT and pembrolizumab. Conclusion CCRT with pembrolizumab is potentially curative for recurrent cervical cancer conventionally amenable for palliation.

An extremely low-loss and high-speed millimeter-wave (mm-wave) interconnect based on hollow dielectric waveguide (HDW) is demonstrated. Though HDW is renowned for its distinguishably low-loss transmission among all dielectric-based competitors, it is criticized for the difficulty of smooth power transition from HDW to planar backplane systems. This article presents a novel approach for planar transition from tubular HDW to printed circuit board (PCB). The proposed transition circuit is composed of a dipole-antenna-like power coupler, a matching metal adapter, and a tapered horn. The experimental result shows only 0.68-dB transition loss at 58 GHz, which is the best value compared to other approaches in the literature. In addition, thorough analysis and modeling for the proposed technique are obtained. It implies the opportunity to apply this approach for applications in higher frequency by scaling. The 16 quadrature amplitude modulation (16QAM) communication over the proposed 1-m interconnect is demonstrated with a maximum data rate of 34 Gb/s. This technique provides an extremely low-loss and structurally stable solution for HDW-based interconnect and transition, which is expected to be applied for 5G/6G high-throughput communication in the near future.

Purpose Low-velocity penetrating brain injury (LVPBI) caused by foreign bodies can pose life-threatening emergencies. Their complexity and lack of validated classification data have prevented standardization of clinical management. We aimed to compare the trans-base and trans-vault phenotypes of LVPBI to help provide guidance for clinical decision-making of such injury type. Methods A retrospective study on LVPBI patients managed at our institution from November 2013 to March 2020 was conducted. We included LVPBI patients admitted for the first time for surgery, and excluded those with multiple injuries, gunshot wounds, pregnancy, severe blunt head trauma, etc. Patients were categorized into trans-base and trans-vault LVPBI groups based on the penetration pathway. Discharged patients were followed up by outpatient visit or telephone. The data were entered into the Electronic Medical Record system by clinicians, and subsequently derived by researchers. The demography and injury characteristics, treatment protocols, complications, and outcomes were analyzed and compared between the two groups. A t-test was used for analysis of normally distributed data, and a Mann-Whitney U test for non-parametric data. A generalized linear model was further established to determine whether the factors length of stay and performance scale score were influenced by each factor. Results A total of 27 LVPBI patients were included in this analysis, comprised of 13 (48.1%) trans-base cases and 14 (51.9%) trans-vault cases. Statistical analyses suggested that trans-base LVPBI was correlated with deeper wounds; while the trans-vault phenotype was correlated with injury by metal foreign bodies. There was no difference in Glasgow Coma Scale score and the risk of intracranial hemorrhage between the two groups. Surgical approaches in the trans-base LVPBI group included subfrontal (n = 5, 38.5%), subtemporal (n = 5, 38.5%), lateral fissure (n = 2, 15.4%), and distal lateral (n = 1, 7.7%). All patients in the trans-vault group underwent a brain convex approach using the foreign body as reference (n = 14, 100%). Moreover, the two groups differed in application prerequisites for intracranial pressure monitoring and vessel-related treatment. Trans-base LVPBI was associated with higher rates of cranial nerve and major vessel injuries; in contrast, trans-vault LVPBI was associated with lower functional outcome scores. Conclusion Our findings suggest that trans-base and trans-vault LVPBIs differ in terms of characteristics, treatment, and outcomes. Further understanding of these differences may help guide clinical decisions and contribute to a better management of LVPBIs.

Contrast-induced encephalopathy (CIE) is a rare complication of angiography. According to our knowledge, the majority of CIE reports is imaging observations and rarely includes results of cerebrospinal fluid (CSF) tests. Furthermore, among the cases reporting the data for CSF testing, most of the results were normal. Here, we report a case of CIE presenting with significantly elevated levels of CSF protein. We found that the course of improvement in brain imaging findings was not consistent with the severity of clinical manifestations. The diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) sequences were normal. Considering the lack of convenient direct indicators to observe blood-brain barrier (BBB) function, changes in the levels of CSF protein may be related to BBB permeability and recovery and may serve as a potential prognostic marker.

Background Several immune checkpoint inhibitors (ICIs) are approved for the treatment of advanced urothelial carcinoma (UC). There are limited biomarkers for ICI-treated patients with UC. We investigated the association between body composition and clinical outcomes in ICI-treated UC patients. Materials and Methods We conducted a retrospective analysis of 70 ICI-treated patients with advanced UC at Winship Cancer Institute from 2015 to 2020. Baseline computed tomography images within 2 months of ICI initiation were collected at mid-L3 and muscle and fat compartments (subcutaneous, intermuscular, and visceral) were segmented using SliceOMatic v5.0 (TomoVision, Magog, Canada). A prognostic body composition risk score (high: 0–1, intermediate: 2–3, or low-risk: 4) was created based on the β coefficient from the multivariate Cox model (MVA) following best-subset variable selection. Our body composition risk score was skeletal muscle index (SMI) + 2 × attenuated skeletal muscle (SM) mean + visceral fat index (VFI). Concordance statistics (C-statistics) were used to quantify the discriminatory magnitude of the predictive model. Results Most patients (70%) were men and the majority received ICIs in the second- (46%) or third-line (21%) setting. High-risk patients had significantly shorter overall survival (OS; hazard ratio [HR], 6.72; p Conclusion Body composition variables such as SMI, SM mean, and VFI may be prognostic and predictive of clinical outcomes in ICI-treated patients with UC. Larger, prospective studies are warranted to validate this hypothesis-generating data. Implications for Practice This study developed a prognostic body composition risk scoring system using radiographic biomarkers for patients with bladder cancer treated with immunotherapy. The study found that the high-risk patients had significantly worse clinical outcomes. Notably, the study's model was better at predicting outcomes than body mass index. Importantly, these results suggest that radiographic measures of body composition should be considered for inclusion in updated prognostic models for patients with urothelial carcinoma treated with immunotherapy. These findings are useful for practicing oncologists in the academic or community setting, particularly given that baseline imaging is routine for patients starting on treatment with immunotherapy.

Objective We focus on providing the first comprehensive national dataset on the incidence, injury aetiology and mortality of TSCI in China. Methods A multi-stage stratified cluster sampling method was used. We included TSCI cases from all hospitals in three regions, nine provinces and 27 cities in China via search of electronic medical records and retrospectively analysed the characteristics of TSCI in China from 2009 to 2018. We estimated the incidence of TSCI in the total population and subgroups. Results There were 5954 actual cases in 2009, corresponding to a total estimated TSCI incidence of 45.1 cases per million population (95% CI, 44.0–46.3). There were 10,074 actual cases in 2018, corresponding to a total estimated TSCI incidence of 66.5 cases per million population (95% CI, 65.2–67.8) (P P Conclusions The TSCI incidence increased significantly from 2009 to 2018. The incidence in the elderly populations was consistently high and continues to increase over time. The mortality of TSCI patients in hospitals is relatively low and continues to decrease each year, but elderly individuals remain at a high risk of hospital death.

In order to improve the intelligent effect of English performance rating, this paper analyzes the English performance rating process and builds the corresponding algorithm model based on the wisdom of teaching ideas, and it combines BP spatial network technology with spatial sampling and spatial statistical algorithms to construct the system kernel algorithm. Moreover, this paper extracts students’ English answers through text recognition and compares them with the standard library. Among them, objective questions are mainly scored directly through standard answer comparison, and subjective questions compare student scores with standard answers. In addition, this paper uses a needs analysis to construct the framework of the entire English performance rating system and evaluates the practical effect of the system constructed in the paper through experimental research. According to statistical research data, the English performance rating system in this paper is known to have certain effects.