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Globally, 80% of the world population use electricity as a prime energy source. Government and private organizations face many challenges in providing efficient power facilities to their customers due to over-population and exponential increase in electricity demands. Furthermore, the abrupt damages in transmission lines pose another big barrier in the form of reliable and safer power transmissions. These line damages become more severe when the transmission infrastructure spans thousands of kilometers. Mostly, it results in life loss (humans and cattle), destruction of homes and crops, over-costing, etc. To address these problems, a hybrid deep learning mechanism is proposed in this research work that can accurately identify the damages in the transmission lines. This model consists of convolution neural network (CNN) and support vector machine (SVM) where CNN is used for the classification damaged power-line images, while SVM for the identification and calculating the severity of damaged power-lines using statistical information. Applicability of the model is validated using UAVs and other performance metrics such as accuracy, precision, F-score, error-rate, simulation time, area under curve values, and True–False values. The proposed model outperformed by generating a high recognition rate of 95.57% for the identification of damaged power-lines. The implications of this research work include no humans and cattle life loss, no extra transmission lines management and checkup costs, no destruction of homes crops, etc.

Coal-based graphite has become the main material of emerging industries. The microstructure of coal-based graphite plays an important role in its applications in many fields. In this paper, the effect of carbon disulfide/N-methyl-2-pyrrolidone solvent mixture extraction on the microstructure of bituminous coal-based graphite was systematically studied through preliminary extraction coupled with high-temperature graphitization. The graphitization degree g (75.65%) of the coal residue-based graphite was significantly higher than that of the raw coal-based graphite. The crystallite size La of the coal residue-based graphite was reduced by 47.06% compared with the raw coal-based graphite. The ID/ IG value of the coal residue-based graphite is smaller than that of the raw coal-based graphite. The specific surface area (16.72 m2/g) and total pore volume (0.0567 m3/g) of the coal residue-based graphite are increased in varying degrees compared with the raw coal-based graphite. This study found a carbon source that can be used to prepare coal-based graphite with high graphitization degree. The results are expected to provide a theoretical basis for further clean and efficient utilization of the coal residue resources.

Estimated to comprise approximately 10% of lung cancer cases, multiple pulmonary lesions pose a diagnostic and therapeutic challenge in thoracic oncology. Distinction between multiple primary lung cancer (MPLC) and intrapulmonary metastasis (IPM) directly affects tumor staging and clinical management. In equivocal cases in which the lesions are histopathologically indistinguishable, targeted sequencing can provide key additional evidence for differential diagnosis. Herein, we describe an unusual patient who presented with seven lung lesions that consisted of primary tumors and metastatic lesions, each showing distinct clonality status based on histomolecular findings. Specifically, the 45-year-old female never-smoker underwent a surgery that removed one invasive lepidic predominant adenocarcinoma and five microinvasive adenocarcinomas. Next-generation sequencing revealed three of the lesions to carry a clonal driver mutation EGFR p.L858R, supporting an IMP diagnosis. EGFR p.L858R was not detected in two other surgical specimens, which instead harbored respective oncogenic BRAF p.G469A and an uncommon EGFR p.G779F. These results led to diagnosis of the two lesions as primary tumors of lineages different from that of the metastases. The patient had achieved a recurrence-free survival of 21 months as of the latest follow-up. In this rare case that presented with evidence of both MPLC and IPM, targeted sequencing proved valuable in facilitating the diagnostic workup.

It is unclear that the changes and migration of coal-derived minerals on the graphitization process of coal. The Taixi anthracite is the study sample of the changes and migration mechanisms of coal-derived minerals during graphitization. Raw coal and different temperature-treated products were collected and analyzed by X-ray diffraction (XRD) to reflect the variation trends of the crystal structure and functional groups with temperature. To analyze the microstructure and mineral composition of the samples in experimental and industrial ultrahigh-temperature graphitization furnaces, a series of experiments were performed using X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy–energy-dispersive X-ray spectroscopy (SEM–EDS). The results showed that temperature played a crucial role in the changes and migration of minerals during the graphitization of anthracite. As the temperature rose, cracks appeared from the surface to the inside of anthracite and minerals gradually changed and migrated from the inside of the anthracite to the cracks in the form of gas or liquid. At ultrahigh temperatures, only a small amount of silicon remains in the system as a catalyst, and most of the elements escaped in the form of oxides.

The Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) pandemic has challenged public health systems worldwide. Therefore, large-scale testing capacity is extremely important diagnosis and exclusion diagnosis. However, fixed laboratories are limited or far away from remote areas. Fortunately, MBS-Lab is characterized by high mobility and rapid on-site detection of SARS-CoV-2 nucleic acid. MBS-Lab was first used in northern Australia during a melioidosis outbreak in 1997. The MBS-Lab and a well-trained diagnostic team were dispatched to Dongchang District, Tonghua City, Jilin Province, China to assist the SARS-CoV-2 virus screening and diagnosis on January 17, 2021. Altogether, 93,952 oropharyngeal swabs samples were collected and tested among the high-risk groups and the general population in Dongchang District. Two single samples were identified as positive in the second turn screening. In the second turn screening, 3 mixed samples (10 in 1) were identified as positive; 10 mixed samples were identified as positive in the third turn screening. By resampling again, one and four cases were identified as positive, respectively. The positive cases were properly isolated and treated in hospital and avoided to visit family members, friends, colleagues and any other persons. Through this way of large-scale screening, human-human spread of SARS-CoV-2 can be effectively avoided. In addition, all staff members strictly executed multiple safety precautions and reduce exposure risks. In the end, none of the staffs was infected with SARS-CoV-2 virus or other pathogens. As an emergency facility for infectious disease control, the MBS-Lab satisfies the requirements of ports and other remote areas far from fixed laboratories and supplements the capabilities of fixed laboratories.

There is an increasing concern for data privacy when people outsource their data to remote cloud storage servers. To secure outsourced data, cloud users are suggested to employ cryptographic encryption to specify access policies such that only users meeting the policies can access the data. After the application of an encryption, however, users are difficult to modify their access policies since the policies were already formulated by the encryption. To address such problem, the authors propose a new approach referred to as re-definable access control (RDAC). The RDAC utilises identity-based encryption (IBE) and attribute-based encryption (ABE) to secure outsourced data and allows users to choose either to achieve access control according to their capability and requirements. Moreover, the RDAC allows users to change simple access policies into fine-grained access policies by converting IBE encrypted files into ABE encrypted ones, without leaking the underlying data. Surprisingly, the access policy conversion does not require the users to perform any costly computation, nor the storage servers to be disturbed. The authors prove the security of RDAC under a rigorous definition, and empirically show that the introduction of the conversion incurs almost no costs to the outsourcing and access procedures.

Periodontitis, a chronic progressive inflammation caused by plaque biofilm, is the main cause of tooth loss in adults. For certain refractory periodontitis cases, it is difficult to achieve a good curative effect using the existing periodontal treatment approaches, which may be due to periodontal pathogenic mechanism in the affected periodontal tissue that the host cannot resist and eliminate. Various pieces of evidence collectively revealed that most studies are focusing on phages in periodontal disease. Several studies have reported periodontitis treatment using phage therapy, highlighting its features including specificity, rapid propagation, and effectiveness on bacteriophage biofilms. In this study, we focus on these reports, aiming to lay the foundation for improved periodontal treatment approaches.

In order to better protect the tourist satisfaction, this paper studies the optimization of rural tourism route intelligent recommendation method, through the collection of rural tourism landscape information, reasonable planning feasible route, and comprehensive consideration of traffic, geology, weather and other factors to select the optimal route, and realize the reasonable recommendation of tourism route. Finally, the experiments show that the proposed method has higher effectiveness and practicability in the practical application process, and fully meets the research requirements.

Smart grid is an emerging power system capable of providing appropriate electricity generation and distribution adjustments in the two-way communication mode. However, privacy preservation is a critical issue in the power request system since malicious adversaries could obtain users’ daily schedule through power transmission channel. Blind signature is an effective method of hiding users’ private information. In this paper, we propose an untraceable blind signature scheme under the reputable modification digital signature algorithm (MDSA). Moreover, we put forward an improved credential-based power request system architecture integrated with the proposed blind signature. In addition, we prove our blind signature’s blindness and unforgeability under the assumption of Elliptic Curve Discrete Logarithm Problem (ECDLP). Meanwhile, we analyze privacy preservation, unforgeability, untraceability, and verifiability of the proposed scheme. Computational cost analysis demonstrates that our scheme has better efficiency compared with other two blind signatures.

Bovine mastitis, an inflammatory disease that occurs frequently in early lactation or the dry period, is primarily caused by bacterial infections. There is growing evidence that Aerococcus viridans (A. viridans) is becoming an important cause of bovine mastitis. The treatment of bovine mastitis is primarily based on antibiotics, which not only leads to a large economic burden but also the development of antibiotic resistance. On the other hand, bacteriophages present a promising alternative treatment strategy. The object of this study was to evaluate the potential of a previously isolated A. viridans phage vB_AviM_AVP (AVP) as an anti-mastitis agent in an experimental A. viridans-induced murine mastitis model. A. viridans N14 was isolated from the milk of clinical bovine mastitis and used to establish a mastitis model in mice. We demonstrated that administration of phage AVP significantly reduced colony formation by A. viridans and alleviated damage to breast tissue. In addition, reduced inflammation was indicated by decreased levels of inflammatory cytokines (TNF-α, IL-1β, and IL-6) and myeloperoxidase (MPO) activity in the phage-treated group compared to those in the phosphate buffered saline (PBS)-treated group. To the best of our knowledge, this report is the first to show the potential use of phages as a treatment for A. viridans-induced mastitis.

With the rapid development of cloud computing, various network attack methods are becoming more advanced, and the attack speed is getting faster. Traditional security protection solutions can no longer adapt to new network attacks, bringing significant challenges to security protection in virtualized network environments such as cloud computing. Based on these problems, this paper proposes a dynamic calling mechanism of security functions for software-defined security based on software-defined network technology. This mechanism defined the strategies of dynamically scheduling of virtual security service nodes in the virtualized network environment. The strategies describe the network’s data flow and virtual security devices by extending the attribute-based access control policy model. It can dynamically construct the mapping relationship between network flow and virtual security devices according to users’ security requirements, thus forming a personalized security service chain for specific network flows. This mechanism can protect the “north-south” network flow at the IoT edge agent according to the user security business requirements.

With the rapid development of e-commerce, the rural e-commerce also has gained great progress. The scale of the county logistics is also broadened. However, as the end of the logistics service chain directly linked with the customer, the “last kilometer” distribution strategy has become a bottleneck in the development of the county logistics. By analyzing the present situation and existed problems of the county logistics distribution, this paper explores main factors working on rural e-commerce distribution, and based on which it proposes “the last kilometer” distribution strategy of the county logistics.

Staphylococcus aureus (S. aureus) is a common and dangerous pathogen that causes various infectious diseases. Skin damage, such as burn wounds, are at high risk of Staphylococcus aureus colonization and infection, which increases morbidity and mortality. The phage lysin LysGH15 exhibits highly efficient lytic activity against methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) strains. Apigenin (api) significantly decreases haemolysis of rabbit erythrocytes caused by S. aureus and shows anti-inflammatory function. LysGH15 and api were added to Aquaphor to form an LysGH15-api-Aquaphor (LAA) ointment. The LAA ointment simultaneously exhibited bactericidal activity against S. aureus and inhibited haemolysis. In an LAA-treated mouse model of an MRSA-infected skin wound, the mean bacterial colony count decreased to approximately 102 CFU/mg at 18 h after treatment (and the bacteria became undetectable at 96 h), whereas the mean count in untreated mice was approximately 105 CFU/mg of tissue. The LAA ointment also reduced the levels of pro-inflammatory cytokines (TNF-α, IL-1β, and IFN-γ) and accelerated wound healing in the mouse model. These data demonstrate the potential efficacy of a combination of LysGH15 and api for use as a topical antimicrobial agent against S. aureus.

Chronic hepatitis delta virus infection (CHD) is a condition arising from super-infection of hepatitis B virus (HBV)-infected patients, resulting in a more rapid advance in liver pathology and hepatocellular carcinoma than is observed for HBV mono-infection. Although hepatitis delta virus (HDV) is structurally simple, its life cycle involves the complex participation of host enzymes, HBV-derived surface antigen (HBsAg), and HDV-auto-ribozyme and hepatitis delta antigen (HDAg) activities. Unsatisfactory clinical trial results with interferon-based therapies are motivating researchers to adjust and redirect the approach to CHD drug development. This new effort will likely require additional structural and functional studies of the viral and cellular/host components involved in the HDV replication cycle. This review highlights recent work aimed at new drug interventions for CHD, with interpretation of key pre-clinical- and clinical trial outcomes and a discussion of promising new technological approaches to antiviral drug design.

As yet, very few vaccine candidates with activity in animals against Mycobacterium tuberculosis infection have been tested as therapeutic postexposure vaccines. We recently described two pools of mycobacterial proteins with this activity, and here we describe further studies in which four of these proteins (Rv1738, Rv2032, Rv3130, and Rv3841) were generated as a fusion polypeptide and then delivered in a novel yeast-based platform (Tarmogen) which itself has immunostimulatory properties, including activation of Toll-like receptors. This platform can deliver antigens into both the class I and class II antigen presentation pathways and stimulate strong Th1 and Th17 responses. In mice this fusion vaccine, designated GI-19007, was immunogenic and elicited strong gamma interferon (IFN-γ) and interleukin-17 (IL-17) responses; despite this, they displayed minimal prophylactic activity in mice that were subsequently infected with a virulent clinical strain. In contrast, in a therapeutic model in the guinea pig, GI-19007 significantly reduced the lung bacterial load and reduced lung pathology, particularly in terms of secondary lesion development, while significantly improving survival in one-third of these animals. In further studies in which guinea pigs were vaccinated with BCG before challenge, therapeutic vaccination with GI-19007 initially improved survival versus that of animals given BCG alone, although this protective effect was gradually lost at around 400 days after challenge. Given its apparent ability to substantially limit bacterial dissemination within and from the lungs, GI-19007 potentially can be used to limit lung damage as well as facilitating chemotherapeutic regimens in infected individuals.

Distal tibiofibular syndesmosis (DTS) has wide anatomic variability in depth of incisura fibularis and shape of tibial tubercles. We designed a 3-year prospective cohort study of 300 young physical training soldiers in an Army Physical Fitness School. Ankle computed tomography (CT) scans showed that 56% of the incisura fibularis were a “C” shape, 25% were a “1” shape, and 19% were a “Г” shape. Furthermore, we invited a randomly selected subcohort of 6 participants in each shape of DTS to undergo a three-dimensional (3D) laser scanning. The “1” shape group showed widest displacement range of the DTS in the y-axis, along with the range of motion (ROM) on the position more than 20° of the ankle dorsiflexion, inversion and eversion. During the 3-year study period, 23 participants experienced recurrent lateral ankle sprains. 7 cases of the incisura fibularis were “C” shape, 13 cases were “1” shape, and 3 cases were “Г” shape. The “1” shape showed highest risk among the three shapes in incident recurrent lateral ankle sprains. We propose that it is possible to classify shapes of DTS according to the shapes of incisura fibularis, and people with “1” shape may have more risk of recurrent lateral ankle sprains.

Purpose: Enzalutamide, a second-generation androgen antagonist, was approved by the U.S. Food and Drug Administration (FDA) for castration-resistant prostate cancer (CRPC) treatment. Immunotherapy has been shown to be a promising strategy for prostate cancer. This study was performed to provide data to support the combination of enzalutamide and immunotherapy for CRPC treatment. Experimental Design: Male C57BL/6 or TRAMP (transgenic adenocarcinoma of the mouse prostate) prostate cancer model mice were exposed to enzalutamide and/or a therapeutic vaccine targeting Twist, an antigen involved in epithelial-to-mesenchymal transition and metastasis. The physiologic and immunologic effects of enzalutamide were characterized. The generation of Twist-specific immunity by Twist-vaccine was assessed. Finally, the combination of enzalutamide and Twist-vaccine to improve TRAMP mice overall survival was evaluated. Results: Enzalutamide mediated immunogenic modulation in TRAMP-C2 cells. In vivo, enzalutamide mediated reduced genitourinary tissue weight, enlargement of the thymus, and increased levels of T-cell excision circles. Because no changes were seen in T-cell function, as determined by CD4+ T-cell proliferation and regulatory T cell (Treg) functional assays, enzalutamide was determined to be immune inert. Enzalutamide did not diminish the ability of Twist-vaccine to generate Twist-specific immunity. Twist was confirmed as a valid tumor antigen in TRAMP mice by immunohistochemistry. The combination of enzalutamide and Twist-vaccine resulted in significantly increased overall survival of TRAMP mice compared with other treatment groups (27.5 vs. 10.3 weeks). Notably, the effectiveness of the combination therapy increased with disease stage, i.e., the greatest survival benefit was seen in mice with advanced-stage prostate tumors. Conclusions: These data support the combination of enzalutamide and immunotherapy as a promising treatment strategy for CRPC. Clin Cancer Res; 19(22); 6205–18. ©2013 AACR.

To the editor, We read the article by Chen et al. [2] with great interest. In this randomised controlled trial, the authors concluded that closed reduction followed by surgical fragment excision for Pipkin type 1 fractures is better than closed reduction alone. However, we have several concerns regarding the treatment methods and their outcome evaluation in this study. Before discussing the article by Chen et al., we briefly describe the current strategy for Pipkin fracture-dislocation management focusing mainly on type 1 fracture [1]. The philosophy of Epstein in the management of femoral-head fracture is no longer accepted. Epstein believed that closed reduction was contraindicated for fracture dislocation of the hip when open reduction is planned later. In contrast, current management strategy consists of urgent closed reduction under sedation, preferably within six hours of injury, to minimise chances of avascular necrosis, irrespective of future surgical plans [1, 4]. A proper evaluation of the radiographs before reduction is necessary to exclude hairline or undisplaced femoral-neck fracture. Again, the reduction manoeuvre should be as gentle as possible to avoid iatrogenic complications. All hips after reduction should be assessed with radiographs and computed tomographic (CT) scan (2-mm slice) to assess joint congruency. If the joint is congruent and stable, conservative management with traction should be continued for at least six weeks. Subsequent mobilisation depends on fracture healing on radiographs. Failure to achieve closed reduction, fracture gap ≥2 mm and presence of intra-articular fragments or debris are indications for surgical intervention. Ultimately, the aim of treatment is anatomical reduction of the fracture to restore articular congruency [1, 4]. If we consider these treatment philosophies, the article in question seems to be lacking in many aspects. First of all, it is difficult to randomise such studies. In their article, the authors randomly selected patients and assigned them to either the conservative or the surgical group. A patient assigned to the conservative group may need surgical intervention if a congruous joint is not achieved. In such a situation, randomisation will not be possible. The authors were fortunate that they could achieve acceptable closed reduction in all cases in the conservative group. The authors found no significant difference between groups in relation to age, sex and time between injuries to reduction; even the postoperative protocol was the same in both groups. Thus, no extra benefit in terms of early mobilisation in the postoperative period was gained by the surgical group despite surgical excision of the fragment. We could not understand why surgical patients were immobilised for such a long time (12 weeks) after fragment excision (it is not a fixation). Three-week immobilisation should have been sufficient to allow soft-tissue healing. After a similar time of follow-up, a significantly better outcome was observed in the surgically treated group. In the conservative group, one patient had excellent, three had good, two had fair and two had poor outcomes according to the Thompson and Epstein score and the Merle d’Aubigne and Postel score. In the surgical group, five were excellent, two were good, one was fair and none was graded as poor. The authors noticed avascular necrosis (AVN) in two cases (both had poor outcome) and heterotopic ossification (HO) in one case in the conservative group. On the other hand, four cases in the surgical group developed HO. As per the literature, the poor outcome of Pipkin fracture dislocation is largely dependent on complications [3]. We were not able to understand why AVN was attributed to the “conservative management plan”. It could, in fact, be because of the initial severity of trauma and hip dislocation, unless a vigorous closed reduction was attempted and had compromised vascularity [1, 3, 4]. It is true that the surgical approach may cause AVN, which may contribute to poor outcome in surgically treated patients [3]. Can the authors confirm that the four cases of HO in the surgical group were not attributable to surgical intervention? Again, can they confirm the AVN in the conservative group is because of the conservative management plan? If not, then we are certain that the surgical group definitely had some complication because of surgery. On the other hand, perhaps the complications seen in the conservative group were not due to treatment plan but rather to the severity of initial injury. If we exclude the two AVN patients from the conservative group, four (67%) of the remaining six patients had excellent to good outcome. With these figures, we do not believe that the surgical group would show a significantly better outcome on statistical analysis. Kloen et al. [4] specifically mentioned that closed anatomical reduction in Pipkin I and II is the best treatment option. If this cannot be obtained (as determined on postreduction CT), osteosynthesis is likely to lead to a better result than is excision. As per the literature, closed reduction leads to excellent/good results for Pipkin I and II fractures in about 75% of cases, open reduction and internal fixation (ORIF) yields similar results in 64% of cases and fragment excision gives good/excellent results in only 50% of cases. Our experience after treating over 100 cases of Pipkin fracture dislocation is not apparently different from that mentioned in the literature. We noted equivalent or even better outcome in conservatively treated patients with Pipkin fracture-dislocation compared to surgical patients (excision or osteosynthesis). Epstein advocated fragment excision, stating that up to one third of the non-weight-bearing portion of the femoral head can be excised without compromising the function. However, maintaining joint congruity is a prerequisite for a good outcome, which is reinforced by the more recent literature [1, 3, 4]. We believe that the article by Chen et al. needs greater clarification before their philosophy regarding Pipkin fracture-dislocation management is accepted over the long standing trends of management. Randomisation is not the strength of their article for reasons discussed above. Rather, the small series, with lack of scientific explanation for better outcome in surgically treated patients, is definitely its shortcoming. The authors discussed Henle’s [3] perception in treating such injury and mentioned that closed reduction is very difficult in Pipkin fracture dislocation. Henle could achieve only one proper closed reduction in his series of 12 cases. The remaining cases needed surgical intervention for reduction. Surprisingly, that was not the case in Chen et al.’s article, in which it was reported that they could achieve good reduction in all 16 cases. Biomechanical cadaveric studies indicate that excision of a small part (

Soft tissue defects of the pretibial area and the foot are among the most common complications in patients with lower extremity injuries and remain a challenge for surgeons. This study examined the clinical effects of repairing pretibial and foot soft tissue defects with a medial crural fasciocutaneous flap. Twenty-three injury cases with soft tissue defects in the middle/lower parts of the tibia and ankle/heel were treated. Of these, 8 injuries were in the lower pretibial region, 11 injuries were in the heel, and 4 injuries were in the dorsalis pedis. The dimensions of the soft tissue defects ranged from 7 cm × 5 cm to 18 cm × 10 cm. The crural fasciocutaneous flap was used for wound repair in all cases. The skin harvest dimensions ranged from 12 cm × 6 cm to 23 cm × 12 cm, and the width of the reverse flap pedicle was greater than 4 cm. The patients were followed up for 6 to 27 months postsurgery. All flaps survived and appeared healthy, and leg function was satisfactorily recovered. Five patients suffered from distal flap necrosis and 2 patients suffered from effusion. The area of the crural fasciocutaneous flap harvest appeared to have a good blood supply, and the procedure was easy to perform without injuries to the main vasculature. In conclusion, the medial crural fasciocutaneous flap is a safe and effective clinical intervention for the reconstruction of soft tissue defects of the pretibial area and foot.

Cognitive radio networks (CRNs) are expected to improve spectrum utilization significantly by allowing secondary users (SUs) to opportunistically access the licensed spectrum of primary users (PUs). In a CRN scenario consisting of multiple heterogeneously integrated CRNs, the SUs with multiple interfaces may have to conduct spectrum handoff to target subchannels. Jointly considering the interruption delay and the transmission performance of the handoff SUs on target subchannels, the subchannel selection and resource allocation optimization problem which maximizes the energy efficiency of all the interrupted SUs under the quality of service (QoS) constraints is formulated and solved through applying iterative algorithm and Lagrange dual method. Numerical results demonstrate the efficiency of the proposed scheme.

Cognitive radio networks (CRNs) are expected to improve spectrum utilization significantly by allowing secondary users (SUs) to opportunistically access licensed spectrum without affecting the normal communications of primary users (PUs). In a CRN scenario consisting of multiple heterogeneously integrated CRNs, the SUs with multiple interfaces may have to conduct network and spectrum selection for continuous data transmission. In this paper, a spectrum selection scheme is proposed which minimizes the total transmission delay of interrupted SUs in a heterogeneous CRN under the quality of service (QoS) constraints. Applying M/G/1 queue model, the waiting delay of SUs is calculated. Jointly considering the heterogeneous characteristics of CRNs, the transmission performance of target channels and the properties of queue model, the total transmission delay of SUs is formulated, and the candidate channel with the minimum total transmission delay is selected as the target channel. Numerical results demonstrate the efficiency of the proposed scheme.

Chronic hepatitis B infection (CHB) is characterized by sub-optimal T cell responses to viral antigens. A therapeutic vaccine capable of restoring these immune responses could potentially improve HBsAg seroconversion rates in the setting of direct acting antiviral therapies. A yeast-based immunotherapy (Tarmogen) platform was used to make a vaccine candidate expressing hepatitis B virus (HBV) X, surface (S), and Core antigens (X-S-Core). Murine and human immunogenicity models were used to evaluate the type and magnitude of HBV-Ag specific T cell responses elicited by the vaccine. C57BL/6J, BALB/c, and HLA-A*0201 transgenic mice immunized with yeast expressing X-S-Core showed T cell responses to X, S and Core when evaluated by lymphocyte proliferation assay, ELISpot, intracellular cytokine staining (ICS), or tumor challenge assays. Both CD4+ and CD8+ T cell responses were observed. Human T cells transduced with HBc18–27 and HBs183–91 specific T cell receptors (TCRs) produced interferon gamma (IFNγ following incubation with X-S-Core-pulsed dendritic cells (DCs). Furthermore, stimulation of peripheral blood mononuclear cells (PBMCs) isolated from CHB patients or from HBV vaccine recipients with autologous DCs pulsed with X-S-Core or a related product (S-Core) resulted in pronounced expansions of HBV Ag-specific T cells possessing a cytolytic phenotype. These data indicate that X-S-Core-expressing yeast elicit functional adaptive immune responses and supports the ongoing evaluation of this therapeutic vaccine in patients with CHB to enhance the induction of HBV-specific T cell responses.

Closed intramedullary nailing is a classical therapeutic approach for floating knee injuries. An appropriate positioning is critical for a successful surgery. However, there is a lack of an ideal auxiliary device to facilitate the implantation of intramedullary nail. The authors developed a simple lower limb outrigger frame (SLLOF), which is made of nylon, to facilitate the nail implementation process. The SLLOF could be radiolucent and autoclavable. A total of 31 patients with floating knee injury underwent the closed intramedullary nailing assisted by SLLOF. The average operative duration was 91.0min, and all tibial and femur fractures reached bony union. The SLLOF could assist well insertion of intramedullary nail for the treatment of floating knee injuries, with the advantages of simple operation, less manpower, easy imaging access but less radiation exposure, and more cost-effectiveness.

With the rapid development of urbanization, the importance of city power grids safety has been gradually recognized. Given a full consideration for the characteristics of city power grids, we design a complete set of risk evaluation index system based on probability theory by employing risk theory and analytic hierarchy process (AHP) in power system online static security risk assessment. Further, we have developed city grid online risk assessment software, and have provided a clear description of some key technologies of implementation and calculation process after installation. Finally, the test result shows the functionality and applicability of our software.

The objective of the present study was to evaluate the clinical, radiological, and functional outcomes of a subscapularis transthoracic surgical approach and a posterolateral surgical approach with debridement, bone graft fusion, and internal fixation for the treatment of upper thoracic tuberculosis.There is currently debate over the best surgical approach for the treatment of upper thoracic tuberculosis. Traditionally, the subscapularis transthoracic approach has been preferred; however, the posterolateral approach has gained popularity in the past few years.A prospective, consecutive cohort of 43 upper thoracic tuberculosis patients with a mean age of 39 years (range: 20-52 years) was followed up for a minimum of 12 months (range: 12-60 months). Patients were randomly divided into 2 groups. Group A (n = 21) was treated by the subscapularis transthoracic approach and group B (n = 22) was treated by the posterolateral approach. All cases were evaluated for clinical, radiological, and functional outcomes. Intraoperative blood loss, operative duration, intraoperative and postoperative complications, hospital stay, the cure rate, fusion time, and the Frankel scale were used for clinical and functional evaluation, whereas the kyphosis angle was used for radiological evaluation.Grafted bones were fused by 10 months in all cases. There was no statistically significant difference between groups before surgery in terms of gender, age, segmental tuberculosis, erythrocyte sedimentation rate (ESR), Frankel scale, or Cobb's angle (P > 0.05). The average operative duration for Group B was lower than that of Group A. There were no significant differences in intraoperative blood loss, intraoperative and postoperative complications, hospital stay, grafted bone fusion time, or cure rate between groups (P > 0.05). The Cobb's angle correction rate for group B (68.5%) was significantly better than that of group A (30.9%). The neurological score showed significant postoperative improvement in both groups, with no significant difference between the groups.The subscapularis transthoracic approach and the posterolateral approach with debridement, bone graft fusion, and internal fixation are both sufficient and satisfactory for the surgical treatment of upper thoracic tuberculosis. However, the posterolateral approach is superior to the subscapularis transthoracic approach in terms of surgical trauma, operative time, and kyphosis correction.

Background: While mutations in the ras gene and corresponding product are known to be etiologic in a number of human cancers, efforts to block the mutated protein have been largely unsuccessful leading to its characterization as “undruggable.” We have taken an alternative approach involving generation of T cell responses to the mutated protein. GI-4000 is a series of proprietary immunotherapeutics designed to target cells with activating ras mutations using heat-killed Saccharomyces cerevisiae yeast (named Tarmogens: Targeted Molecular Immunogens) genetically engineered to express Ras G12 and Q61 mutations. Tarmogens activate antigen-specific T cell-mediated immune responses that kill target cells expressing a number of cancer antigens including mutated Ras. Activating mutations in ras occur in > 90% of pancreas cancer cases and >20% cases of NSCLC. GI-4000 has been evaluated in phase 2 trials in both these indications. GI-4000 has demonstrated: i) protection in a murine model of lung cancer (1), ii) in the pancreas trial, improvements in median RFS and OS vs placebo in subjects with a favorable proteomic signature (2), iii) also in the pancreas trial, 3 month improvement in median OS (p=NS) in R1 subjects, with 5 month improvement for immune responders (2), iv) improved OS in subjects with NSCLC treated with GI-4000 compared to case matched controls: HR=0.577, p=NS. In addition, Tarmogens specific for other oncologic targets decreased human regulatory T cells (Tregs) in vitro with a reciprocal increase in effector T cells (3). Here we discuss immunologic outcomes in R0 subjects enrolled in the pancreas cancer trial. Methods: In the pancreas cancer study 176 subjects with Ras mutant+ adenocarcinoma of the pancreas post resection were randomized 1:1 to GI-4000/gemcitabine or placebo/gemcitabine (stratified by resection status: R0/R1). Three weekly injections of GI-4000 or placebo were followed by 6 cycles of gemcitabine 1000 mg/m2 iv (day 1, 8, 15, then every 28 days). Monthly GI-4000 or placebo were administered on gemcitabine off-weeks and continued monthly until disease recurrence, intolerable toxicity or death. R0 subjects (n=102) with adequate blood samples available from timepoints throughout the study were assayed for immune response by interferon-γ (IFNγ) ELISpot assay using Ras peptide pools containing the G12 mutation present in the subject's tumor and a mismatched peptide set identical to the mutation-specific set except at G12. Frequencies of Tregs at baseline and pre-gemcitabine were measured by flow cytometry (n=76). Results: In contrast to the R1 group, there was no increase in Ras mutation-specific IFNγ responses in the R0 GI-4000 group compared to placebo: 16/52 (30.8%) vs 22/50 (44.0%) based on pre-specified criteria. However, naive Tregs (CD4+/CD45RA+/Foxp3low) in the GI-4000 treated group were significantly decreased compared to placebo: 11/42 (26.2%) vs 3/34 (8.8%) subjects had a >2-fold decrease in this fraction (p=0.048 Fisher's exact test). IFNγ responses and OS were strikingly influenced by G12 mutation and associations of specific Ras mutations with outcome will be discussed. Conclusions: GI-4000 decreases frequencies of Tregs, which could be an important attribute for an immunotherapeutic in the treatment of cancer. GI-4000 also generates mutation-specific immune responses and appears to have clinical activity in pancreas cancer and NSCLC. Immune targeting of the activating mutation may be a promising approach to Ras mutated cancers. References: 1. Lu Y., et al. Cancer Research 64: 5084-88, 2004. 2. Richards D.A., et al. ESMO, Vienna, Austria, Sept 2012. 3. Cereda V., et al. Vaccine 29: 4992-99, 2011. Citation Format: Claire Coeshott, Tom Holmes, Alicia Mattson, Tom King, Zhimin Guo, Allen Cohn, Timothy C. Rodell. Immune responses to mutated Ras - development of a yeast-based immunotherapeutic. [abstract]. In: Proceedings of the AACR Special Conference on RAS Oncogenes: From Biology to Therapy; Feb 24-27, 2014; Lake Buena Vista, FL. Philadelphia (PA): AACR; Mol Cancer Res 2014;12(12 Suppl):Abstract nr A28. doi: 10.1158/1557-3125.RASONC14-A28

Closed intramedullary nailing is a classical therapeutic approach for floating knee injuries. An appropriate positioning is critical for a successful surgery. However, there is a lack of an ideal auxiliary device to facilitate the implantation of intramedullary nail. The authors developed a simple lower limb outrigger frame (SLLOF), which is made of nylon, to facilitate the nail implantation process. The SLLOF could be radiolucent and autoclavable. A total of 31 patients with floating knee injury underwent the closed intramedullary nailing assisted by SLLOF. The average operative duration was 91.0 min, and all tibial and femur fractures reached bony union. The SLLOF could assist well insertion of intramedullary nail for the treatment of floating knee injuries, with the advantages of simple operation, less manpower, easy imaging access but less radiation exposure, and more cost-effectiveness.

458 Background: Saccharomyces cerevisiae (yeast) has been genetically modified to express CEA protein and employed as a heat-killed immune-stimulating, vector-based vaccine. Preclinical studies have shown that yeast CEA vaccine can induce a strong CEA-specific T-cell immune response (IR) and anti-tumor activity. Methods: Patients (Pts) were enrolled in this phase I trial at 3 dose levels: 4, 16, and 40 yeast units (each unit =107 yeast particles). The vaccine was administered equally at 4 sites subcutaneously in bilateral inguinal and anterior chest wall regions. Vaccine was administered at 2 week intervals for 3 months, then monthly. Eligible pts were required to have a serum CEA > 5 ng/ml or > 20% CEA+ positive tumor block and no autoimmune history. An expansion cohort of 10 pts was enrolled to focus on IR. Pts had re-staging scans at 3 months, then bimonthly. Peripheral blood was collected for analysis of IR including the Effector/Regulatory T-cell ratio, ELISPOT assay, changes in the myeloid-derived suppressor cells (MDSC) and natural killer cells (NK). Results: 25 pts with progressive metastatic CEA-expressing carcinoma were enrolled; 22 had colorectal adenocarcinoma. Vaccine was well tolerated with no dose limiting toxicities. The most common adverse event was grade 1/2 injection site reaction. Overall, 7 patients had stabilization or declines in serum CEA after treatment. Of them, 5 pts (3 with colorectal cancer) had stable disease beyond 3 months and 1 is still on-going (14 +, 8, 8, 4.5 and 4 months). No anti-CEA antibodies were detected. Post vs. pre-vaccination: a) five out of 9 evaluable pts showed evidence by ELISPOT of CEA-specific T-cell IRs b) 8/16 pts had increased and 8/16 pts had decreased CD4 Effector/Treg ratio and c) 6/13 pts had increased and 2/13pts had decreased NK frequency. Conclusions: Saccharomyces cerevisiae-CEA demonstrated an acceptable safety profile. Although this is an advanced disease population of pts which is not ideal for immune-based therapy, CEA serum stabilizations and CEA-specific IRs were seen in some pts. Randomized studies are required to determine the clinical benefit of this vaccine in a more appropriate patient population for vaccine therapy.

2604 Background: Saccharomyces cerevisiae (yeast) were engineered to express human CEA protein and administered as a heat killed, whole yeast therapeutic vaccine. Preclinical studies have shown that these modified yeast can induce a strong immune response to CEA as well as antitumor responses in a CEA-transgenic host. Methods: Patients (pts) were enrolled in this classic phase I design at 3 dose levels: 4, 16, and 40 yeast units (each unit =107 yeast particles). The vaccine was administered in equal doses at 4 sites subcutaneously in bilateral inguinal and anterior chest wall regions. Vaccine was administered at 2 week intervals for 3 months, then monthly. Eligible patients were required to have a serum CEA > 5 ng/ml or >20% CEA+ positive tumor block, ECOG PS 0-2, and no autoimmune history. An expansion cohort of 10 ECOG PS 0-1 pts was enrolled to focus primarily on immune response at the 40 yeast unit dose. Pts had re-staging scans at 3 months, then bimonthly. Peripheral blood was collected for analysis ...