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Aimed at improving the nonlinear integrated navigation solution performance of multiple low-cost sensors fusion, this paper presents a multilayer loosely-coupled, local-global, and step-optimized MF5DCKF (Multisensor Federated fifth-degree Cubature Kalman filter) state estimation algorithm for the small unmanned aerial vehicle (UAV). This method establishes a multilayer nonlinear integrated navigation model composed of the nonlinear attitude and heading reference system (AHRS) error model, strapdown inertial navigation system/global positioning system (SINS/GPS) error model, and strapdown inertial navigation system/barometer (SINS/BARO) error model to enhance the robustness and richness of the navigation module. Further, based on the above navigation models, a loosely-coupled error state fusion frame is designed to obtain the local convergent state vector. Simultaneously, a three-layer fifth-degree Cubature Kalman filter is proposed to improve the local state estimation accuracy. Subsequently, to optimize the estimated local state, this paper presents a novel distributed MF5DCKF scheme fusing the local state vector to calculate the global optimal state parameters in a step-optimized process. The experimental flight test results show that the proposed algorithm achieves a higher state solution accuracy and a better convergent performance compared with some conventional multisensor fusion algorithms. The new algorithm framework can provide applicability and reliability for the small UAV during the flight.

The Adaptive Data Rate (ADR) algorithm is used in LoRaWAN, allocating an appropriate transmission rate for terminal equipment to improve channel utilization and reduce power consumption. However, the standard ADR algorithm is only suitable for static terminal equipment. In addition, due to the complexity of the external environment, the selected data rate will not match the new environment and communication packets will be lost. Therefore, this paper proposed a novel and more effective ADR algorithm called New-Dynamic ADR (ND-ADR). The algorithm mainly solves two problems, i.e., the standard ADR algorithm cannot be applied to mobile terminal devices and the poor communication quality and high packet loss rate in harsh environments. In this study, we also developed FLoRaWAN (Frame for LoRaWAN), a simulation framework for the star network topology LoRaWAN in OPNET. Furthermore, we built an OKUMURA-HATA model and additionally introduced a noise factor β to simulate the loss of wireless communication in harsh environments. Finally, extensive simulation results showed that the number of data packets required by different end nodes for rate allocation was different. Compared with the standard ADR algorithm, even for mobile nodes in harsh environments, the ND-ADR algorithm reduced network energy consumption by about 13%, reduced network delay by about 18%, and increased effective throughput by about 15%. Therefore, the improved ND-ADR algorithm is more suitable for wireless communication of removable nodes in harsh environments. Its advantages are better awareness of link environment, faster data rate regulation, improved channel utilization, and further reduction of network energy consumption.

Background: MicroRNAs can regulates tumor metastasis either as an oncomiR or suppressor miRNA. Here, we investigate the role of miR-224 in lymphatic metastasis of non-small-cell lung cancer (NSCLC). Methods: The expression of miR-224 was demonstrated by a validation cohort of 156 lung cancer patients (77 cases with lymphatic metastasis) by q-PCR. In vitro and in vivo experiments were performed to study the malignant phenotype after upregulation and inhibition of miR-224 expression. Furthermore, the direct target genes of miR-224 were determined by a luciferase reporter assay. Results: miR-224 was identified as a high expression miRNA in the tumor tissues with lymphatic metastasis) with an area under the receiver operating characteristic curve (AUC) of 0.57. Forced expression of miR-224 in H1299 cells promoted not only the cell viability, plate clone formation, migration and invasion in vitro, but also tumor growth and lung metastasis in vivo. Consistently, inhibition of miR-224 suppressed the malignant characters both in vitro and in vivo. Molecular mechanism research suggested that miR-422a targeted the ANGPTL1 as a novel tumor suppressor.Conclusions: The present study demonstrates that miR-224 is a potential marker for the prediction of lymphatic metastasis of NSCLC. And application of miR-224 may help for prophylactic intervention of NSCLC in clinical practice.

The energy-conversion storage systems serve as crucial roles for solving the intermittent of sustainable energy. But, the materials in the battery systems mainly come from complex chemical process, accompanying with the inevitable serious pollutions and high energy-consumption. Natural mineral resources display various merits, such as unique architecture, adsorption capability and rich active sites, which have captured numerous attentions with remarkable advancements. Recently, the minerals compounds, containing 1D structure (halloysites, attapulgites, sepiolite), 2D structure (montmorillonite, vermiculite, molybdenite) and 3D structure (diatomite, pyrites), have been applied in plenty of fields. Aiming at their energy-storage applications, the significant utilizations in electrodes, separators, electrolyte and metal-protection were detailedly reviewed in lithium-ions battery, lithium-sulfur battery, solid-state battery and so on. However, it should be acknowledged that, the simple minerals hardly meet the demand of energy-storage systems, due to their inferior conductivity and less active substances. Thus, series of modified manners are applied for the evolution of phase (from silicate mineral to Si), the incorporating with carbon/polymer and the tailoring of surface traits, which were in-depth discussed as following. The work was expected to summarize the traits about mineral compounds from different architectures, whilst offering significant guidelines for exploring mineral-based materials in energy-storage systems.

OBJECTIVE The dynamic adaptive immune responses elicited by the inactivated virus vaccine, CoronaVac, remain elusive. METHODS In a prospective cohort of 100 SARS-CoV-2 naïve healthcare professionals who received two doses of CoronaVac, we analyzed SARS-CoV-2-specific humoral and cellular responses at four different timepoints, including before vaccination (T1), 2 weeks after the first dose (T2), 2 weeks after the booster dose (T3), and 8-10 weeks post the booster dose (T4). SARS-CoV-2-specific antibodies, serum neutralizing activities, peripheral B cells, CD4+ and CD8+ T cells, and their memory subsets were simultaneously measured in this cohort. RESULTS SARS-CoV-2 Spike-specific IgG responses reached the peak (geometric mean titer [GMT] 54827, 30969-97065) after two doses and rapidly declined (GMT 502, 212-1190) at T4, whereas suboptimal IgA responses were detected (GMT 5, 2-9). Spike-specific circulating B cells (0.60%, 0.46-0.73% of total B cells) and memory B cells (1.18%, 0.92-1.44% of total memory B cells) were effectively induced at T3 and sustained over time (0.33%, 0.23-0.43%; 0.87%, 0.05-1.67%, respectively). SARS-CoV-2-specific circulating CD4+ T cells (0.57%, 0.47-0.66%) and CD8+ T cells (1.29%, 1.04-1.54%) were detected at T3. At T4, 0.78% (0.43-1.20%) of memory CD4+ T cells and 0.68% (0.29-1.30%) of memory CD8+ T cells were identified as SARS-CoV-2 specific, while 0.62% (0.51-0.75%) of CD4+ T cells and 0.47% (0.38-0.58%) of CD8+ T cells were SARS-CoV-2 specific terminally differentiated effector memory cells. Furthermore, age and interval between doses affected the magnitude of CoronaVac induced immune responses. SARS-CoV-2 memory CD4+ T cells was strongly associated with both RBD-specific memory B cells (r=0.87, p, Graphical abstract Image 1

A radio frequency memory (RFM) based on microwave photonic mixing and digital RFM is proposed and demonstrated. By introducing the microwave photonic mixing, the operational frequency range is largely extended. Besides, the mixing spurs are effectively suppressed, which is important to guarantee the system efficiency and avoid generating significant feature for the jamming recognition. Meanwhile, by applying the digital RFM, flexible modulation and reconstruction are achieved. A proof-of-concept experiment is carried out. The wide working frequency range from C- to Ka- bands is achieved. The mixing spurs over the 0-40 GHz frequency range are experimentally suppressed. Radar imaging is successfully deceived. A radar waveform with a bandwidth of 500 MHz in the K band is successfully received and reconstructed. Two false targets are added. To the best of our knowledge, it is the first time that a photonics-assisted RFM is reported to have the functions of storage, flexible modulation, and reconstruction with wideband RF signals at a high frequency. The proposed scheme shows the great potential to be applied in electronic warfare, electronic environment simulation and testing, and so on.

In this article, we focus on addressing the nonlinear filtering problem with unknown measurement noise covariance and measurement outliers, which may be encountered in the application in strapdown inertial navigation system/global positioning system integrated navigation system. Although the existing methods, such as the adaptive Kalman filter, are widely used in the integrated navigation system, their estimation accuracy is poor, this paper proposes a variational Bayesian-based robust cubature Kalman filter to address this problem, which not only retains the adaptivity when the measurement noise is unknown but also exhibits robustness in the presence of measurement outliers, First, the variational Bayesian method is applied to the estimation of measurement noise, then the maximum correntropy criterion is introduced to replace the minimum mean square error criterion, which improves the robust performance of the filter. The numerical simulation demonstrates that the proposed filter outperforms the existing filters both in estimation accuracy and robustness, and the effectiveness of the proposed filter is verified on the integrated navigation system.

The analysis of trace DNA is a crucial component in forensic applications. Biological materials containing low-level DNA collected at crime scenes, such as fingerprints, can be valuable as evidence. Automatic detection of biological samples has been largely embraced in forensic applications to meet the increasing throughput requirements. However, the amount of DNA automatically retrieved from trace evidence often tends to be small and unstable, ultimately resulting in poor detection of DNA profiles. Thus, in this work, we introduced a robust DNA extraction and purification platform named Bionewtech® BN3200 (Bionewtech®, Shanghai, China) with the goal of constructing a rapid automatic detection system for trace DNA. The establishment of automatic detection system for trace DNA mainly encompassed two parts: assessing the sensitivity of automatic extraction platform and screening the optimal short tandem repeat (STR) typing kit. The sensitivity of Bionewtech® BN3200 platform based on Ultra-sensitive DNA Extraction kit was initially estimated, demonstrating that this extraction platform might contain large potential in the trace DNA extraction. For the amplification part, three sets of commercial multiplex STR typing kits were selected as candidates, and the amplified products were further genotyped on the Applied Biosystems 3500xl Genetic Analyzer. After comparation, SiFa™ 23 Plex Kit was determined as the most suitable amplification system for trace DNA. Eventually, the newly exploited trace DNA detection system was successfully implemented in the detection of fingerprints derived from glass surfaces with the five-seconds contact time. As a result, the DNA recovered from the fingerprints fluctuated approximately from 57.60 pg to 18.05 ng, in addition, over 70% of the total STR loci were detected in 75% of the fingerprint samples.

Three RF switches and a phase shifter are proposed using the conductive bridging random access memory (CBRAM) technique. The fabrication process is developed with the Nafion membrane on a high-resistivity silicon substrate. The equivalent circuit model is established for each memristive RF switch. The proposed switches and the phase shifter have been validated by the good agreement achieved among the simulated, measured, and modeled results. The experimental results show that the series planar switch has the ON-state insertion loss (IL) below 1.69 dB and the OFF-state isolation over 25 dB up to 10 GHz, with the actuation voltages of 6.1~7.8/-1.5~-2 V. The parallel metal-insulator-metal (MIM) switch has the small ON-state IL below 0.45 dB and the OFF-state isolation over 18.4 dB when biased with 0.8~3.7/-0.5~-0.9 V. The series MIM switch has the ON-state IL below 0.61 dB and the OFF-state isolation over 21.9 dB with 0.7~2.3/-0.5~-0.9 V. The series MIM switch shows a good comprehensive performance of low actuation voltage, good uniformity, low IL, moderate isolation, and independent control. The phase shifter is realized with four series MIM switches, which provides a phase shift of 45° ± 5° from 3.8 to 4.3 GHz with the in-band IL of 2.25 dB. Compared with the conventional RF switchable devices, the proposed devices have the advantages of nonvolatility and low power consumption. Without depending on the electron beam lithography process and high-temperature phase change, the proposed technique is promising for reconfigurable RF circuits with mass production and feasibility to various substrates.

A photonics-based system for simultaneous angle of arrival (AOA) and frequency measurement is proposed and demonstrated. In the proposed system, an acousto-optic modulator (AOM) based optical frequency shift loop (OFSL) is used to generate an optical frequency-stepped local oscillator (LO). After balanced in-phase and quadrature (I/Q) down-conversion with the frequency-stepped LO, the frequency to be measured is obtained. Thanks to the balanced I/Q down-conversion, the image frequencies and undesired frequency-mixing components can be suppressed, making the system have better adaptability to multiple-target scenarios. In addition, the AOA from different RF sources can also be estimated based on the Van CittertZernike theorem, even if the working bands of these targets overlap with each other. In the proof-of-concept experiment, the measurement of multiple targets with different frequencies is achieved by frequency detection with 0.179 MHz resolution. Moreover, incoherent microwave sources at the same frequency band can also be distinguished in the angular direction, achieving the capacity of simultaneous frequency and AOA measurement of multiple-target.

Chance-constrained economic dispatch (CCED) is widely used to cope with uncertainties brought by renewable energy sources. In CCED, security of power system is guaranteed by restricting risks under permitted level. As the penetration rate of renewable energy increases rapidly, the CCED model may be infeasible because of inadequate system reserve and/or transmission congestion under certain circumstances. Therefore, the curtailment of renewable energy is indispensable to guarantee security in some scenarios for power systems with high penetration of renewable energy. To address this crucial issue, this paper proposes a novel CCED model, where generation of conventional units and curtailment strategies of renewable energy are co-optimized to minimize total operational cost and restrict operational risks. An efficient solution method is developed to schedule generation and curtailment sequentially, in which tractable optimization models are formulated for each step. Numerical tests demonstrate that the proposed model can significantly reduce the probability of emergency control of curtailment compared with conventional CCED models. Furthermore, this solution method also outperforms scenario-based method with significantly improved computational efficiency and higher-quality solution.

Introduction: The main aim of this article was to study the retinal peripapillary and macular vascular structures in eyes with primary angle-closure suspects (PACS) using optical coherence tomography angiography (OCTA). Methods: In this cross-sectional study, control and PACS subjects were recruited from a community screening. Only one eye per subject was used for analysis. All participants underwent a questionnaire survey, physical and ophthalmic examinations, ocular biometry measurements, and OCTA. We compared basic demographics and vessel structure parameters between control and PACS eyes. Univariate and multivariate linear regression analyses were performed to investigate factors associated with vascular parameters in both groups. Results: Data from 254 subjects including 155 PACS and 99 controls were analyzed. In the peripapillary region, PACS eyes showed similar retina nerve fiber layer (RNFL) and vessel densities (VDs) including and excluding large vessels compared to control eyes. Compared to control eyes, all macular OCTA parameters showed significant differences in PACS eyes, including decreased superficial VD (p = 0.006) and deep VD (p = 0.004), larger fovea avascular zone (FAZ) area (p = 0.006), and longer FAZ perimeter (p = 0.004). Gender (p = 0.039), age (p < 0.001), and Garway-Heath superior hemisphere RNFL (p < 0.001) were risk factors influencing optic disc VD excluding large vessels. Axial length was the major factor affecting macula superficial and deep VDs (p = 0.004 and 0.001 respectively), while PACS was an independent factor associated with larger FAZ perimeter (p = 0.046). Conclusion: While PACS and control eyes have comparable RNFL and vascular structure around the optic nerve head, macular vascular structures are significantly different.

Background The treatment for intertrochanteric femoral fractures (IFF) among the elderly has been a controversial topic. Hemiarthroplasty (HA) and proximal femoral nail antirotation (PFNA) have their own advantages in the management of IFF. Hence, this study aims to compare and analyze differences in the effectiveness of both procedures on IFF among the elderly. Methods Overall, 99 patients (81.09 ± 8.29 years; 68 women) underwent HA or PFNA from January 2016 to May 2020. IFF were classified according to the Arbeitsgemeins für Osteosynthesefragen (AO) classification. The difference in underlying diseases, the American Society of Anesthesiologists (ASA) grade, Singh index, Harris scores, surgical time, intraoperative bleeding, postoperative blood test results, postoperative number of days to partially bearing weight, and survival outcomes were analyzed. Postoperative follow-ups were performed every 3 months. Results There was no significant difference in the AO classification, underlying diseases, ASA grade, Singh index, surgical time, and survival outcomes of the HA (45 patients) group and PFNA group (54 patients). The HA group was associated with earlier partial weight-bearing (HA: 4 [2 ~ 4.5] days, PFNA: 10 [8~14] days). It also had a higher total Harris score than the PFNA group at the 6-month follow-up visit (HA: 86.8 [81.90 ~ 90.23], PFNA: 83.48 [75.13 ~ 88.23]). Harris scores decreased more in patients aged ≥90 years in the PFNA group than in the HA group. The postoperative stress recovery rate in the HA group was faster based on postoperative blood test results. Conclusions PFNA and HA have good therapeutic effects in the treatment of IFF. The advantages of HA were reflected in short-term weight bearing, faster recovery from stress, and better joint function in the long term. This advantage is more obvious in the patient population aged over 90 years. Therefore, we suggest that surgeons should consider the benefit of HA in the treatment of IFF among the elderly. Trial registration Chinese Clinical Trial Registry, ChiCTR2000035814. Registered 17 August 2020, https://www.chictr.org.cn/showproj.aspx?proj=57083

Today, as social networks play an increasingly important role, people are more likely to use them to discuss hot topics. Thus, reposting behavior plays a crucial role in such networks for information diffusion. However, the existing models do not consider the impact of some important numerical features on the spread of tweets. In addition, the potential correlation of the user information in different groups and their tweets will also affect the effect of retweet prediction. Considering the above problems, in this article, we propose a novel deep multitask learning-based method, CH-Transformer, for retweet prediction. First, we extract numerical features to represent tweet information features and social features. Then, the numerical features are concatenated with textual features. After feature extraction, we obtain the feature embeddings and feed them into our model to achieve propagation prediction. Finally, we evaluate the proposed method using well-known evaluation measures. The experimental results demonstrate the effectiveness of our method.

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that currently has no cure. The aged population is growing globally, creating an urgent need for more promising therapies for this debilitating disease. Much effort has been made in recent decades, and the field is highly dynamic, with numerous trials. The main focus of these trials includes disease modification and symptomatic treatment. Some have shown beneficial outcomes, while others have shown no significant benefits. Here, we cover the outcome of recently published AD clinical trials, as well as the mechanism of action of these therapeutical agents, to re-think drug development strategies and directions for future studies.

Although epidermal growth factor receptor tyrosine kinase inhibitors (TKIs) show efficacy in lung adenocarcinoma (LUAD) patients, TKI resistance inevitably develops, limiting long-term results. Thus, there is an urgent need to address drug resistance in LUAD. Long non-coding RNA (lncRNA) HIF1A-AS2 could be a critical mediator in the progression of various tumor types. We examined the function of HIF1A-AS2 in modifying tumor aggravation and osimertinib resistance in lung adenocarcinoma. Using clinical samples, we showed that HIF1A-AS2 was upregulated in LUAD specimens, predicting poorer overall survival and disease-free survival. HIF1A-AS2 silencing inhibited the proliferation, migration, and tumorigenesis of LUAD cells and therapeutic efficacy of osimertinib against tumor cells in vitro and in vivo. RNA precipitation assays, western blotting, luciferase assays, and rescue experiments demonstrated that HIF1A-AS2 sponged microRNA-146b-5p (miR-146b-5p), promoting interleukin-6 (IL-6) expression, activating the IL-6/STAT3 pathway, and leading to LUAD progression. miR-146b-5p and IL-6 levels were correlated with the prognosis of LUAD patients. Our results indicated that HIF1A-AS2 functions as an oncogenic factor in adenocarcinoma cells by targeting the miR-146b-5p/IL-6/STAT3 axis and may be a prognostic indicator of survival. Moreover, it can be a potential therapeutic target to enhance the efficacy of osimertinib in LUAD patients., Graphical abstract, EGFR-TKIs have exhibited notable therapeutic efficacy in lung adenocarcinoma (LUAD) patients. However, TKIs resistance inevitably develops. The study indicates that HIF1A-AS2 functions as an oncogenic factor by targeting the miR-146b-5p/IL-6/STAT3 axis and may be a potential therapeutic target to enhance the efficacy of osimertinib in LUAD patients.

Crack-like defects frequently form in pipes exposed to aggressive environments or during welding fabrication. Appropriate strength matching factors should be determined for welding process evaluation based on the reliability aspect. In this paper, the current research status of codes and standards related to the strength requirement of weld metals in the pipeline industry were reviewed. The results showed that almost all standards considered the lower limit of pipe tensile strength as a requirement for weld strength evaluation for specimens of cross-weld test breaking at the weld position. This was contradictory to the original intention of even-match or over-match of pipeline girth weld. The Monte Carlo Method was then employed to investigate the evolution of girth weld strength matching factor and pipeline failure probability under different high-low misalignments, fracture toughnesses, and standard deviations of pipe strength distribution. The data revealed significantly reduced probability of pipe failure as the weld metal strength matching factor increased. At the same strength matching factor, the failure probability of pipe decreased as fracture toughness of girth weld. The failure probability of pipe also declined as the misalignment and standard deviation of pipe strength distribution diminished. Based on the requirement of certain target reliability and strain demand, a semi-empirical prediction model of critical strength matching factor was proposed for engineering applications. The analysis of parameter sensitivity showed the relative importance of several parameters on the critical strength matching factor of girth weld, including high-low misalignment, standard deviation of pipe material strength distribution, and fracture toughness.

AIM: To compare visual field defects using the Swedish Interactive Thresholding Algorithm (SITA) Fast strategy with SITA Faster strategy, a newly developed time-saving threshold visual field strategy. METHODS: Ninety-three participants (60 glaucoma patients and 33 normal controls) were enrolled. One eye from each participant was selected randomly for the study. SITA Fast and SITA Faster were performed using the 24-2 default mode for each test. The differences of visual field defects between the two strategies were compared using the test duration, false-positive response errors, mean deviation (MD), visual field index (VFI) and the numbers of depressed test points at the significant levels of P0.05). Correlation analysis showed a high correlation for MD (r=0.986, P

Few studies have examined the long-term prognosis of Chinese patients with intracerebral hemorrhage (ICH). This study assessed the clinical characteristics and predictors of vascular events occurring within 5 years after ICH. We included consecutive patients diagnosed with first-ever ICH between June 2013 and December 2014. Based on follow-up data (collected until December 2019), we used multivariable logistic regression to examine the clinical characteristics and long-term predictors of vascular events (including recurrent ICH, ischemic stroke, and acute coronary syndrome) in patients who survived more than 30 days after ICH. Across the 307 patients in our analysis, the 5-year mortality rate was 28.01%. Within 5 years after ICH, major vascular events were observed in 62 patients (17.82%, 95% CI 13.78–21.82%). We observed high incidence of recurrent ICH (8.91%) and ischemic stroke (10.06%), but low incidence of acute coronary syndrome (1.15%). Most cases of recurrent ICH (80.65%) occurred within 3 years after ICH. Age ≥56 years and history of ischemic stroke or transient ischemic attack (TIA) were identified as predictors of cardiovascular and cerebrovascular events. ICH survivors are at high risk of both cardiovascular and cerebrovascular events, especially older patients (≥56 years) and those who experienced ischemic stroke or TIA prior to their first ICH. Recurrent ICH is more likely to occur within the first three years after first ICH than at later times. Clinicians should monitor patients closely for adverse events, particularly during the first three years after initial ICH.

Polarization-sensitive photodetector based on low-dimensional semiconductor is a kind of special photoelectric device which can take advantage of the semiconductor’s anisotropy and convert it into an electrical signal. However, the polarization performance of the photodetector is limited by the challenges of the anisotropy of semiconductors. The design of alloy semiconductors with excellent anisotropy is one of the mainstream methods to improve the dichroic ratio of the polarization-sensitive photodetector. Here, we design the tunable alloying Sb–S–Se nanowires (NWs), which can be used in the research field of polarization-sensitive photodetectors because of their low symmetry crystal structure, suitable bandgap, and high mobility. It is demonstrated that the metal-semiconductor-metal polarization-sensitive photodetector based on Sb–S–Se NWs has great photoelectric properties and polarization performance in UV–Vis-near-infrared response (NIR) spectrum. Under the irradiation laser of the 532-nm, the photoresponsivity ( ${R}$ ) and detectivity ( ${D}$ *) of the Sb2(S1/3Se2/3)3 NW-based polarization-sensitive photodetector can reach 6.38 A/W and 1.63 $\times 10^{9}$ Jones. By investigating the polarization characteristics of the photodetector, the dichroic ratio of the photodetector can reach 3.8 at 532 nm. By regulating the proportion of each component in the alloy semiconductor, an effective method is provided for adjusting the photoresponse spectrum and optimizing the performance of the polarization-sensitive photodetector, which has a promising research prospect in the future.

Colon cancer is the third most common malignancy and the fourth most prevalent cause of death worldwide. Unfortunately, current cancer treatment approaches suffer from low specificity toward colon ...

Objective:We aimed to evaluate the association between coffee and/or tea consumption and breast cancer (BC) risk among premenopausal and postmenopausal women and to conduct a network meta-analysis.Design:Systematic review and network meta-analysis.Setting:We conducted a systematic review of electronic publications in the last 30 years to identify case–control studies or prospective cohort studies that evaluated the effects of coffee and tea intake.Results:Forty-five studies that included more than 3 323 288 participants were eligible for analysis. Network meta-analysis was performed to determine the effects of coffee and/or tea consumption on reducing BC risk in a dose-dependent manner and differences in coffee/tea type, menopause status, hormone receptor and the BMI in subgroup and meta-regression analyses. According to the first pairwise meta-analysis, low-dose coffee intake and high-dose tea intake may exhibit efficacy in preventing ER(estrogen receptor)− BC, particularly in postmenopausal women. Then, we performed another pairwise and network meta-analysis and determined that the recommended daily doses were 2–3 cups/d of coffee or ≥5 cups/d of tea, which contained a high concentration of caffeine, particularly in postmenopausal women.Conclusions:Coffee and tea consumption is not associated with a reduction in the overall BC risk in postmenopausal women and is associated with a potentially lower risk of ER− BC. And the highest recommended dose is 2–3 cups of coffee/d or ≥5 cups of tea/d. They are potentially useful dietary protectants for preventing BC.

Primary pulmonary lymphoma is a relatively rare extranodal lymphoma, and the incidence rate has increased in recent years. In the past, the disease mainly relied on surgery to obtain the pathological basis, so the clinical misdiagnosis rate was high. How to improve its early diagnosis and treatment has attracted much attention. By exploring the imaging manifestations of primary pulmonary lymphoma, we can further understand and improve the imaging diagnosis level of primary pulmonary lymphoma. This paper discusses the classification, imaging manifestations, diagnosis and identification of pulmonary lymphoma. The clinical data and imaging findings of primary pulmonary lymphoma diagnosed in a hospital were retrospectively summarized, and their imaging features were analyzed. We observe the clinicopathological characteristics and immunohistochemical phenotypes of multiple masses with cavitation type primary lung lymphoma, and analyze the virus and imaging characteristics of hybridization. The results of the study show that the CT (Computed Tomography) manifestations of primary lung lymphoma are diverse. The characteristics of cross-leaf distribution are more characteristic, and enhanced scanning lesions are usually mild to moderate. In the case of simultaneous masses and pneumonialike consolidation in the lungs, this disease needs to be considered.

Extramedullar plasmacytoma refers to the primary plasmacytoma (plasmacytoma is a group of diseases, including multiple myeloma, solitary plasmacytoma and extramedullary plasmacytoma), which is a rare soft tissue malignant tumor composed of plasmacytes, accounting for about 4% of all plasmacytomas. The imaging data of 6 cases of extramedullary plasmacytoma confirmed by pathology were analyzed retrospectively. Results among the 6 cases, the mass was located in the oropharynx in 1 case, in the nasal cavity in 2 cases, in the lung in 2 cases, and in the mediastinum in 1 case. CT revealed a soft, clear boundary, multiple density, and contrast scans from medium to medium. MRI showed that the T1 signal was equal or slightly longer, indicating that the T2 signal was equal or slightly longer, and the diffusion of DWI images was clearly limited and the signal separation was low in some lesions. Tumor necrosis was not evident, and enhanced enhancement was observed in contrast enhanced scanning. In other words, there is a specific image characteristic in extramedullary plasmacytoma, but because of its specificity, diagnostic biopsy is necessary for diagnosis. Preoperative CT and MRI examinations can remove lesions, adjacent tissues, and lymph node lesions. This is very important for early diagnosis, treatment and efficacy evaluation of the disease.

Mesenchymal stem cells (MSCs), a kind of multipotent stem cells with self-renewal ability and multi-differentiation ability, have become the "practical stem cells" for the treatment of diseases. MSCs have immunomodulatory properties and can be used to treat autoimmune diseases, such as systemic lupus erythematosus (SLE) and Crohn's disease. MSCs also can be used in cancer and aging. At present, many clinical experiments are using MSCs. MSCs can reduce the occurrence of inflammation and apoptosis of tissue cells, and promote the proliferation of endogenous tissue and organ cells, so as to achieve the effect of repairing tissue and organs. MSCs presumably also play an important role in Corona Virus Disease 2019 (COVID-19) infection.

BACKGROUND Anti-glutamic acid decarboxylase (GAD) antibody is known to cause several autoimmune-related situations. The most known relationship is that it may cause type I diabetes. In addition, it was also reported to result in several neurologic syndromes including stiff person syndrome, cerebellar ataxia, and autoimmune encephalitis. Decades ago, isolated epilepsy associated with anti-GAD antibody was first reported. Recently, the association between temporal lobe epilepsy and anti-GAD antibody has been discussed. Currently, with improvements in examination technique, many more autoimmune-related disorders can be diagnosed and treated easier than in the past. CASE SUMMARY A 44-year-old female Asian with a history of end-stage renal disease (without diabetes mellitus) under hemodialysis presented with diffuse abdominal pain. The initial diagnosis was peritonitis complicated with sepsis and paralytic ileus. Her peritonitis was treated and she recovered well, but seizure attack was noticed during hospitalization. The clinical impression was gelastic seizure with the presentation of frequent smiling, head turned to the right side, and eyes staring without focus; the duration was about 5–10 s. Temporal lobe epilepsy was recorded through electroencephalogram, and she was later diagnosed with anti-GAD65 antibody positive autoimmune encephalitis. Her seizure was treated initially with several anticonvulsants but with poor response. However, she showed excellent response to intravenous methylprednisolone pulse therapy. Her consciousness returned to normal, and no more seizures were recorded after 5 d of intravenous methylprednisolone treatment. CONCLUSION In any case presenting with new-onset epilepsy, in addition to performing routine brain imaging to exclude structural lesion and cerebrospinal fluid studies to exclude common etiologies of infection and inflammation, checking the autoimmune profile has to be considered. In the practice of modern medicine, autoimmune-related disorders are relatively treatable and should not be missed.

Myelofibrosis (myelofibrosis) is a deadly blood neoplasia with the worst prognosis among myeloproliferative neoplasms (MPN). The JAK2 inhibitors ruxolitinib and fedratinib have been approved for treatment of myelofibrosis, but they do not offer significant improvement of bone marrow fibrosis. CDK6 expression is significantly elevated in MPN/myelofibrosis hematopoietic progenitor cells. In this study, we investigated the efficacy of CDK4/6 inhibitor palbociclib alone or in combination with ruxolitinib in Jak2V617F and MPLW515L murine models of myelofibrosis. Treatment with palbociclib alone significantly reduced leukocytosis and splenomegaly and inhibited bone marrow fibrosis in Jak2V617F and MPLW515L mouse models of myelofibrosis. Combined treatment of palbociclib and ruxolitinib resulted in normalization of peripheral blood leukocyte counts, marked reduction of spleen size, and abrogation of bone marrow fibrosis in murine models of myelofibrosis. Palbociclib treatment also preferentially inhibited Jak2V617F mutant hematopoietic progenitors in mice. Mechanistically, treatment with palbociclib or depletion of CDK6 inhibited Aurora kinase, NF-κB, and TGFβ signaling pathways in Jak2V617F mutant hematopoietic cells and attenuated expression of fibrotic markers in the bone marrow. Overall, these data suggest that palbociclib in combination with ruxolitinib may have therapeutic potential for treatment of myelofibrosis and support the clinical investigation of this drug combination in patients with myelofibrosis. Significance: These findings demonstrate that CDK6 inhibitor palbociclib in combination with ruxolitinib ameliorates myelofibrosis, suggesting this drug combination could be an effective therapeutic strategy against this devastating blood disorder.

BACKGROUND: Organ/space surgical site infections (OSSI) after pancreaticoduodenectomy (PD) are not rare events. The role of diagnosis and treatment for pancreatic and biliary diseases with an endoscopic retrograde cholangio-pancreatography (ERCP) procedure is currently controversial. However, the ERCP procedure might play a role in surgical outcomes after PD. METHODS: We conducted a retrospective cohort study for patients who underwent PD in the First Affiliated Hospital with the Nanjing Medical University from 1st September 2012 to 31st January 2018. The relationship between ERCP exposure and OSSI after PD was analyzed by univariate and forward stepwise multivariate logistic regression model. RESULTS: Of the 1,365 patients who underwent PD, 136 developed OSSI (10.0%). We found that ERCP exposure before PD (EEBPD) was significantly associated with an increased incidence rate of post-operative pancreas fistula (POPF) [24.2% (23/95) vs. 14.9% (189/1,270), risk ratio (RR) =1.63, 95% confidence interval (CI), 1.11–2.38, P=0.015]. Hypertension, a higher level of preoperative low-density lipoprotein (LDL) and creatinine (Cr) were associated with elevated risks of post-operative OSSI [adjusted odds ratio (Adj-OR) (95% CI) were 1.59 (1.09–2.32), 1.70 (1.16–2.51), 1.99 (1.36–2.92)], whereas a preoperatively higher level of aspartate aminotransferase (AST) would decrease the risk [Adj-OR (95% CI), 0.62 (0.42–0.91)]. Remarkably, EEBPD would significantly increase and more than double the OSSI risk [Adj-OR (95% CI), 2.56 (1.46–4.47)] especially if it was within 14 days before surgery (Spearman =–0.698, P

Anomalies as misalignment, microcrack are inevitable for large diameter high strength steel pipelines. To ensure the strain capacity of mismatched welding joint with misalignments of D 1,422 mm X80 steel pipeline, a comprehensive study via wide plate experiments and finite element model simulations was conducted. The full-scale tensile experiment of a X80 pipe wide plate with weld joint was conducted. Strain distributions on the plate was derived by DIC technic. Trends of CMOD at the precrack in the weld joint with tensile strains monitored. A FE model was established to inverse the wide plate experiment and prove the accuracy of numerical model’s prediction results for crack driving forces. Using the same modeling method, a parametrical 3D numerical simulation model for X80 line pipe with cracks in automatic welding joints was established. The double V-shaped groove type welding joint was precisely considered in the geometric model. Difference of the stress-strain relationships of yielding-to-tensile ratio of the BM, softening rate of the HAZ and strength matching coefficient of WM were considered in the material model. A CTOD extracting program coded was employed. Parametric analysis was performed to investigate the effects of load conditions, strength matching coefficient of WM, yielding-to-tensile ratio of BM and softening rate of HAZ on the strain capacity with a critical fracture toughness adopted in pipeline industry. Based on the derived results, mismatched ratio requirements of D 1,422 mm X80 pipes were listed, which provides guidance for the welding parameter design and safety evaluation of automatic welding joints.

The existing recommender system provides personalized recommendation service for users in online shopping, entertainment, and other activities. In order to improve the probability of users accepting the system’s recommendation service, compared with the traditional recommender system, the interpretable recommender system will give the recommendation reasons and results at the same time. In this paper, an interpretable recommendation model based on XGBoost tree is proposed to obtain comprehensible and effective cross features from side information. The results are input into the embedded model based on attention mechanism to capture the invisible interaction among user IDs, item IDs and cross features. The captured interactions are used to predict the match score between the user and the recommended item. Cross-feature attention score is used to generate different recommendation reasons for different user-items.Experimental results show that the proposed algorithm can guarantee the quality of recommendation. The transparency and readability of the recommendation process has been improved by providing reference reasons. This method can help users better understand the recommendation behavior of the system and has certain enlightenment to help the recommender system become more personalized and intelligent.

Real‐time power dispatch can coordinate wind farms, automatic generation control units and non‐automatic generation control units. In real‐time power dispatch, the probable wind power forecast errors should be appropriately formulated to ensure system security with high probability and minimize operational cost. Previous studies and the authors' onsite tests show that Cauchy distribution effectively fits the “leptokurtic” feature of small‐timescale wind power forecast errors distributions. In this paper, a chance‐constrained real‐time dispatch model with the wind power forecast errors represented by multivariate Cauchy distribution is proposed. Since the Cauchy distribution is stable and has promising mathematical characteristics, the proposed chance‐constrained real‐time dispatch model can be analytically transformed to a convex optimization problem considering the dependence among wind farms’ outputs. Moreover, the proposed model incorporates an affine control strategy compatible with automatic generation control systems. This strategy makes the chance‐constrained real‐time dispatch adaptively take into account both the potential power ramping requirement and power variation on transmission lines caused by the generation adjustment to offset the wind power forecast errors in real‐time power dispatch stage. Numerical test results show that the proposed method is reliable and effective. Meanwhile it is very efficient and suitable for real‐time application.

The near-infrared (NIR) polarized photodetector has wide range of applications including the object identification. Wavelength of 1550 nm is the least loss band for transmission communication, and the study of photodetectors working at 1550 nm demonstrate special scientific and applied significances. GaSb has attracted tremendous attention in the field of photoelectric detection due to its suitbale band gap, high mobility, sensitivity, and good compatibility with modern microelectronics technology. In this work, a highly polarization-sensitive GaSb nanowire-based photodetectors under short-wave near-infrared photoelectric detection is achieved. The device has a good optical detection ability in the near-infrared band, and showed the responsivity up to 77.3 A/W with the external quantum efficiency of $6.18\times 10 ^{3}$ % (illumination intensity of 1.59 mW/mm2) under 1550 nm. Furthermore, obvious photocurrent anisotropy are investigated under the near-infrared band from 808 nm to 1550 nm. The largest dichroic ratio reaches 3.3 at 1550 nm. These results indicate that GaSb nanowire based photodetectors are not only promising candidates for NIR detection but also have promising potentials in polarization sensitive applications.

BACKGROUND: Here, we carried out an extensive meta-analysis to investigate the effectiveness of the use of axillary reverse mapping (ARM) during axillary lymph node dissection (ALND) in preventing breast cancer-related lymphedema (BCRL). METHODS: Database searches to identify relevant randomized controlled trials (RCTs) were performed of MEDLINE (PubMed), Web of Science, Embase, and the Cochrane Library. Eligible articles with a publication date from database establishment to December 2020 were retrieved by combining keywords including: “breast cancer”, “breast carcinoma”, “breast neoplasm”, “axillary reverse mapping”, “axillary lymph node dissection”, “lymphatic arm drainage”, and “lymphedema”. Independent data extraction was conducted, and Review Manager (version 5.3) was used for statistical analyses. RESULTS: Five eligible RCTs were included in the meta-analysis. A total of 37 patients suffered arm lymphedema (37/786, 4.71%) in the experimental group (ARM during ALND), compared with 164 arm lymphedemas (164/873, 18.79%) in the control group (ALND alone). The results showed that ARM during ALND was superior to ALND alone in reducing the incidence of BCRL [OR =0.20, 95% confidence intervals (CI): 0.13–0.29, P

For cancer therapy, drug delivery systems are often limited by insufficient drug loading capacity, which usually results in systemic toxicity and heavy metabolic burden to excrete the carriers. Her...

Animal choruses, such as those found in insects and frogs, are often intermittent. Thus females sampling males in the chorus might have to remember the location of the potential mates' calls during periods of silence. Although a number of studies have shown that frogs use and prefer multimodal mating signals, usually acoustic plus visual, it is not clear why they do so. Here we tested the hypothesis that preference for multimodal signals over unimodal signals might be due to multimodal signals instantiating longer memories than unimodal signals, particularly during the inter-chorus intervals. We tested this hypothesis in serrate-legged small treefrogs (Kurixalus odontotarsus) whose males produce advertisement calls accompanied by conspicuous vocal sac inflation. Females were tested with acoustic and acoustic + visual (video of inflating-deflating vocal sac) mating calls. We found that females prefer multimodal calls over unimodal, audio-only calls. Furthermore, multimodal calls are still preferred after a silent period of up to 30 seconds, a time that spans the average silent period of the chorus. This was not true of unimodal calls. Our results demonstrate that a multimodal signal can engage longer working memory than a unimodal signal, and thus female memory might favour the evolution of multimodal signals in males through sexual selection. Selection might also favor female preference for multimodal signals if longer memory facilitates mate searching and assessment. Our study does not allow us to elucidate the sequence of evolution of this trait and preference.

Recently, the combined use of FOLFIRINOX (leucovorin and fluorouracil plus irinotecan and oxaliplatin) and gemcitabine plus nab-paclitaxel has significantly improved the prognosis of patients with pancreatic cancer. However, there is still a high proportion of patients who develop metastatic pancreatic cancer in the course of chemotherapy or within a short period after chemotherapy. Previous reports have shown that chemotherapy-driven cytokine storms or the direct effects of certain chemotherapeutics on stromal and/or immune cells collectively change the microenvironment of the primary tumor, thus indirectly promoting metastasis. However, the mechanism underlying chemotherapy-induced metastasis in the course of chemotherapy, and afterwards, remains elusive in pancreatic cancer. In the present study, we aimed to determine the expression of CCL26 in the pancreatic cancer-associated fibroblasts (CAFs) after nab-paclitaxel treatment and to explore the role of CCL26 in the pancreatic adenocarcinoma (PDAC) invasion. Our results showed that nab-paclitaxel increased CCL26 mRNA and protein expression levels in a dose- and time-dependent manner. Subsequently, PDAC cell lines were treated with recombinant CCL26 for 48 h. The transwell migration assay showed that recombinant CCL26 enhanced the invasion of PDAC cells. Western blot analysis showed that the protein expression levels of phospho-(p-)PI3K, p-AKT, and p-mTOR were increased by CCL26 in PDAC cells. CCL26 expressions in 95 PDAC tissues and adjacent normal tissues were evaluated using reverse transcription-quantitative polymerase chain reaction and immunohistochemistry. CCL26 was found to be overexpressed in PDAC samples, and upregulated CCL26 expression was significantly associated with advanced perineural invasion, lymph node metastasis, and poor differentiation. In summary, our results showed that nab-paclitaxel increased the expression of CCL26 in CAFs, and CCL26 enhanced the invasive potential of pancreatic cancer cells by activating the PI3K/AKT/mTOR axis. Thus, CCL26 may be a potential prognostic biomarker for pancreatic cancer.

Background The efficacy of hemodialysis (HD) is closely associated with patient survival time and quality of life. The classical method (CLM) to calculate the urea clearance index (Kt/V) and urea reduction rate (URR) requires multiple blood tests. A novel method that may be used as a noninvasive alternative to CLM is required. Methods Based on the urea kinetic model, a new method, named the “assessment method” (ASM), was established to calculate blood urea nitrogen after HD, based on parameters obtained during HD. The consistency of the Kt/V and URR values between the ASM and CLM was evaluated in 41 patients from the China–Japan Friendship Hospital between September 2017 and December 2018. Results Forty-one patients (24 males and 17 females; mean age, 55.7 ± 14.2 years) undergoing regular HD in our hospital were randomly selected for this study. The blood flow rate was 244.5 ± 19.6 mL/min and the dialysate flow rate was 500 mL/min. We obtained Kt/V (CLM = 1.40 ± 0.06, ASM = 1.37 ± 0.07) and URR (CLM = 68.6 ± 6.4%, ASM = 67.7 ± 7.2%) values. Paired t-test indicated no significant differences between the ASM- and CLM-derived values. The intraclass correlation coefficients were 0.907 and 0.916 for Kt/V and URR, respectively. Similarly, Bland–Altman plots suggested good concordance between the 2 methods. Conclusions The Kt/V and URR values calculated using the ASM and CLM were in significant agreement, and both can be used to effectively assess the adequacy of HD in patients undergoing maintenance HD. The ASM is an effective, rapid, inexpensive, and noninvasive alternative to the CLM for obtaining Kt/V and URR values. The ASM has good potential for clinical application, particularly for patients in areas of low socioeconomic status.

Background The dietary nutritional status of the lactating mothers is related to maternal health and has a significant impact on the growth and development of infants through the secretion of breast milk. The food frequency questionnaire (FFQ) is the most cost-effective dietary assessment method that can help obtain information on the usual dietary pattern of participants. Until now, the FFQs have been used for different populations in China, but there are few FFQs available for the lactating mothers. We aimed to develop a semi-quantitative, 156-item FFQ for the Chinese lactating mothers, and evaluate its reproducibility and relative validity. Methods A total of 112 lactating mothers completed two FFQs and one 3-d dietary record (3DR). The first FFQ (FFQ1) was conducted during postpartum at 60–65 days and the second FFQ (FFQ2) during subsequent follow-up at 5 weeks. The 3DR was completed with portion sizes assessed using photographs taken by the respondent before and after eating (instant photography) 1 week after FFQ1. Results For reproducibility, the Spearman’s correlation coefficients for food ranged from 0.34 to 0.68, and for nutrients from 0.25 to 0.61. Meanwhile, the intra-class correlation coefficients for food ranged from 0.48 to 0.87, and for nutrients from 0.27 to 0.70. For relative validity, the Spearman’s correlation coefficients for food ranged from 0.32 to 0.56, and for nutrients from 0.23 to 0.72. The energy-adjusted coefficients for food ranged from 0.26 to 0.55, and for nutrients from 0.22 to 0.47. Moreover, the de-attenuation coefficients for food ranged from 0.34 to 0.67, and for nutrients from 0.28 to 0.77. The Bland-Altman plots also showed reasonably acceptable agreement between the two methods. Conclusions This FFQ is a reasonably reproducible and a relative valid tool for assessing dietary intake of the Chinese lactating mothers.

Aim A third-line chemotherapy regimen for metastatic colorectal cancer (mCRC) is not available in China. Studies have shown that raltitrexed or S-1 has no complete cross-resistance with fluorouracil (5-FU). In this phase II study, we prospectively analyzed the efficacy and safety of raltitrexed combined with S-1 (RS regimen) in the treatment of mCRC after the failure of conventional chemotherapy. Methods A total of 105 patients with mCRC with progression following treatment with 5-FU, oxaliplatin, and irinotecan were enrolled between November 2015 and May 2019. Patients received intravenous infusion of raltitrexed (3 mg/m2 from day 1 every 3 weeks) and oral S-1 (80-120 mg for 14 days every 3 weeks). Tumor evaluations were performed every two cycles according to the RECIST 1.1 guidelines. Results In the intention-to-treat patients, the objective response and disease control rates were 7.62% and 48.57%, respectively. The median progression-free survival and median overall survival were 2.5 and 8.0 months, respectively. Common adverse events included neutropenia, anemia, thrombocytopenia, and nausea, while neutropenia, anemia, thrombocytopenia nausea, diarrhea, skin eruption, and oral ulceration had grade 3 or higher adverse events. Subgroup analysis revealed that primary site or gene mutation status had little influence on the RS regimen efficacy, while the baseline albumin level, 5-FU administration in second-line therapy, and number of previous treatment regimens affected the efficacy. Conclusion The RS regimen demonstrated favorable effects in patients with mCRC following failure of standard chemotherapy, and could be a new choice for third-line treatment, and must be verified in future randomized clinical trials (Clinical trial: NCT02618356).

Xiaodong Fan,1,* Nian Zhao,2,3,* Zhen Yu,1 Haoda Yu,1 Bo Yin,1 Lifei Zou,1 Yinying Zhao,1 Xiufen Qian,1 Xiaoyan Sai,1 Chu Qin,1 Congli Fu,1 Caixia Hu,1 Tingting Di,1 Yue Yang,1 Yan Wu,1 Tao Bian1 1Departments of Pulmonary and Critical Care Medicine, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, 214023, People’s Republic of China; 2Departments of Pulmonary and Critical Care Medicine, The First People’s Hospital of Kunshan, Kunshan, Jiangsu, 215300, People’s Republic of China; 3The first medical college of Nanjing Medical University, NanJing, Jiangsu, 211166, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yan Wu; Tao BianDepartment of Pulmonary and Critical Care Medicine, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, 214023, People’s Republic of ChinaEmail wuyanyangting@163.com; biantaophd@126.comPurpose: Exhaled nitric oxide has been used as a marker of airway inflammation. The NO concentration in the central and peripheral airway/alveolar can be measured by a slow and fast exhalation flow rate to evaluate inflammation in different divisions within the respiratory tract. We hypothesized that FeNO200 (exhaled NO at a flow rate of 200mL/s) could be used as an evaluation tool for peripheral airway/alveolar inflammation and corticosteroid therapy in chronic obstructive pulmonary disease (COPD) patients.Methods: We recruited 171 subjects into the study: 73 healthy controls, 59 stable COPD patients, and 39 acute exacerbations of COPD (AECOPD) patients. Exhaled nitric oxide (FeNO50 (exhaled NO at a flow rate of 50mL/s)), FeNO200 and CaNO (peripheral concentration of NO/alveolar NO) and clinical variables including pulmonary function, COPD Assessment Test (CAT), C-reactive protein concentration (CRP) and circulating eosinophil count were measured among the recruited participants. FeNO50, FeNO200 and CaNO were repeatedly evaluated in 39 AECOPD patients after corticosteroid treatment.Results: FeNO200 was significantly higher in stable COPD and AECOPD patients than in healthy controls. Nevertheless, CaNO could not differentiate COPD from healthy controls. No correlation was found between circulating eosinophil counts or FEV1 and exhaled nitric oxide (FeNO50, FeNO200, CaNO) in COPD patients. For AECOPD patients, 64% of patients had eosinophil counts > 100 cells/μL; 59% of patients had FeNO200 > 10 ppb; only 31% of patients had FeNO50 > 25 ppb. Among AECOPD patients, the high FeNO50 and FeNO200 groups’ levels were significantly lower than their baseline levels, and significant improvements in CAT were seen in the two groups after corticosteroid treatment. These implied a good corticosteroid response in AECOPD patients with FeNO200> 10ppb.Conclusion: FeNO200 is a straightforward and feasible method to evaluate the peripheral NO concentration in COPD. FeNO200 can be a type 2 inflammation biomarker and a useful tool for predicting corticosteroid therapy in COPD.Keywords: exhaled nitric oxide, chronic obstruction pulmonary disease, corticosteroid, biomarker

A whole-body MRI (WB-MRI) including T1, short time inversion recovery (STIR), diffusion-weighted imaging (high b value) was applied in our center for the detection of bone metastasis in prostate cancer (PCa) patients. We intended to assess the diagnostic performance of this examination. 547 cases of PCa patients with higher risk of metastasis were referred to bone scintigraphy with SPECT/CT (BS + SPECT/CT) and whole-body MRI in Shanghai Changhai Hospital. Best valuable comparator (BVC) was applied for the final diagnosis of metastasis. A panel of radiologists interpreted the results. Decision curve analysis (DCA) and receiver operating characteristic curve (ROC) analysis were applied. Bone metastasis was diagnosed in 110 cases, and others were non-metastatic by BVC. The area under the receiver operating characteristic curve (AUC) was higher in WB-MRI (0.778) than BS + SPECT/CT (0.634, p

BACKGROUND Malignancy prediction remains important to preoperative diagnosis and postoperative follow-up in laryngeal neoplasm. AIM To evaluate the circulating immune population and develop a nomogram for prediction of malignancy in patients with laryngeal neoplasm. METHODS A primary cohort of 156 patients was divided into laryngeal benign lesion, premalignant lesion and malignant lesion groups. Peripheral blood from patients was measured by blood routine test and flow cytometry. A nomogram was developed and applied to a validation cohort containing 55 consecutive patients. RESULTS Age, gender and seven circulating immune parameters exhibited significant differences between laryngeal benign lesion and premalignant lesion. The nomogram incorporated predictors, including gender, age, smoke index, proportions of monocytes, CD8+ T cells, CD4+ T cells, B cells and CD4/CD8+ T cell ratio. It showed good discrimination between laryngeal premalignant lesion and malignant lesion, with a C-index of 0.844 for the primary cohort. Application of this nomogram in the validation cohort (C-index, 0.804) still had good discrimination and good calibration. Decision curve analysis revealed that the nomogram was clinically useful. CONCLUSION This novel nomogram, incorporating both clinical risk factors and circulating immune parameters, could be appropriately applied in preoperative individualized prediction of malignancy in patients with laryngeal neoplasm.

Background Accurate estimation of food portion sizes remains an important challenge in dietary data collection. The present study aimed to develop a food atlas with adequate visual reference to improve the accuracy of dietary surveys in China. Methods A food atlas for dietary surveys in China was developed using three visual reference systems, namely, regularly placed food portions, the two‐dimensional background coordinates and common objects known in daily life. The atlas was validated by estimating a meal before and after using the food atlas, and differences in weight estimation were compared using a paired t‐test. In total, 50 college students participated in the study. Results After determination of food varieties; design of the food display; purchase, processing, cooking and weighing of food; photographing food; post‐image processing and data processing, a total of 799 pictures of 303 types of food and two types of tableware were produced. The mean value of food weight estimated with the atlas was closer to the actual weight, and the variation range of these values was smaller and more stable than that estimated without the atlas. The differences estimated before and after using the atlas for all foods were significant (P, Accurate estimation of food portion sizes remains an important challenge in dietary data collection. We developed a food atlas for retrospective dietary surveys in China, which can be used to enable a better understanding of nutritional adequacy in the Chinese population.

Background: A considerable part of colorectal cancer (CRC) patients also have chronic hepatitis B (CHB), esp. in Asia. The effect of concomitant active CHB on the hazard of colorectal liver metastasis (CRLM) remains unclear. To evaluate the effect of concomitant active CHB on the risk of CRLM. Methods: The medical record of all newly diagnosed CRC patients who were hospitalized to the three hospitals between January 2010 to January 2016 were reviewed, the prevalence of synchronous CRLM (synCRLM) were retrospectively studied. Totally 7187 cases of newly diagnosed CRC, including 368 cases with concomitant CHB were recruited. The prevalence of synCRLM in HBsAg+/HBeAg+ patients was compared to that in HBsAg+/HBeAg- patients. Significant risk factors for synCRLM were analyzed by logistic regression analysis. Results: The overall prevalence of synCRLM was 8.72% (627/7187) and was significantly higher in HBsAg+ patients (43/368) than HBsAg- patients (576/6742) (11.68% vs. 8.54%, P=0.037; χ2 test).In 368 HBsAg+ patients, 365 patients also had HBeAg information. synCRLM was also more prevalent inHBsAg+/HBeAg+ patients (13/69) compared to HBsAg+/HBeAg- patients (30/296) (18.84% vs. 10.14%, P=0.043; χ 2 test). In univariate and multivariate logistic regression analysis, HBeAg positivity was the second strongest predictor of synCRLM (multivariate: OR, 2.622, P=0.020) after CEA. (univariate: OR, 2.920, P=0.001). Conclusions: HBeAg positivity is a clinical risk factor for CRLM that can be readily identified and addressed. Whether anti-CHB treatment can decrease the risk of CRLM worth carefully-designed prospective trials to define.

To improve the diagnostic efficiency of prostate cancer (PCa) and reduce unnecessary biopsies, we defined and analyzed the diagnostic efficiency of peripheral zone prostate-specific antigen (PSA) density (PZ-PSAD). Patients who underwent systematic 12-core prostate biopsies in Shanghai General Hospital (Shanghai, China) between January 2012 and January 2018 were retrospectively identified (n = 529). Another group of patients with benign prostatic hyperplasia (n = 100) were randomly preselected to obtain the PSA density of the non-PCa cohort (N-PSAD). Prostate volumes and transition zone volumes were measured using multiparameter magnetic resonance imaging (mpMRI) and were combined with PSA and N-PSAD to obtain the PZ-PSAD from a specific algorithm. Receiver operating characteristic (ROC) curve analysis was used to assess the PCa detection efficiency in patients stratified by PSA level, and the area under the ROC curve (AUC) of PZ-PSAD was higher than that of PSA, PSA density (PSAD), and transition zone PSA density (TZ-PSAD). PZ-PSAD could amend the diagnosis for more than half of the patients with inaccurate transrectal ultrasonography (TRUS) and mpMRI results. When TRUS and mpMRI findings were ambiguous to predict PCa (PIRADS score ≤3), PZ-PSAD could increase the positive rate of biopsy from 21.7% to 54.7%, and help 63.8% (150/235) of patients avoid unnecessary prostate biopsy. In patients whose PSA was 4.0-10.0 ng ml-1, 10.1-20.0 ng ml-1, and >20.0 ng ml-1, the ideal PZ-PSAD cut-off value for predicting clinically significant PCa was 0.019 ng ml-2, 0.297 ng ml-2, and 1.180 ng ml-2, respectively (sensitivity >90%). Compared with PSA, PSAD, and TZ-PSAD, the efficiency of PZ-PSAD for predicting PCa is the highest, leading to fewer missed diagnoses and unnecessary biopsies.

Type 2 diabetic mellitus (T2DM) is a complicated metabolic disorder that is now considered as a major global public health problem. Fucoidan exhibits diverse biological activities, especially prevention of metabolic diseases. In this regard, we herein aimed to reveal the beneficial effect of Sargassum fusiforme fucoidan (SFF) on high-fat diet (HFD) and streptozotocin (STZ) induced T2DM mice. We noted that on the one hand, SFF significantly decreased fasting blood glucose, diet and water intake, and hyperlipidemia, while on the other hand, it improved glucose tolerance. Furthermore, SFF reduced epididymal fat deposition, attenuated the pathological changes in heart and liver tissues, and decreased oxidative stress in diabetic mice. To explore the underlying mechanisms of these ameliorative effects, the gut microbiota was analyzed. Notably, SFF highly enriched benign microbes including Bacteroides, Faecalibacterium and Blautia, as well as increased levels of (R)-carnitine and choline in the colon of diabetic mice. This may be a potential mechanism for alleviating T2DM, thus implying the benefits of SFF as an adjuvant agent for T2DM treatment. Taken together, this study demonstrated a promising application of fucoidan as one of the adjuvant agents for the management of T2DM in the future.

The correlated renewable energy farms are usually aggregated as a cluster in economic dispatch to relieve computational burden. This strategy can also achieve better performance since the precision of predicting the power generation of a cluster can be higher than those of individual farms. This paper proposes an optimal decomposition method to allocate dispatch schedules among renewable energy farms (REFs) in the cluster under existing stochastic optimization framework. The proposed model takes advantage of probabilistic characteristics of renewable generation to minimize the curtailment and ensure the feasibility of dispatch schedule of the clusters. Approximated tractable formulation and efficient solution method are the proposed to solve the proposed model. Numerical tests show that the proposed method achieves the optimal decomposition of dispatch schedule among REFs and facilitates the utilization of renewable generation.