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Feature selection has been studied by many researchers using information theory to select the most informative features. Up to now, however, little attention has been paid to the interactivity and complementarity between features and their relationships. In addition, most of the approaches do not cope well with fuzzy and uncertain data and are not adaptable to the distribution characteristics of data. Therefore, to make up for these two deficiencies, a novel interactive and complementary feature selection approach based on fuzzy multineighborhood rough set model (ICFS_FmNRS) is proposed. First, fuzzy multineighborhood granules are constructed to better adapt to the data distribution. Second, feature multicorrelations (i.e., relevancy, redundancy, interactivity, and complementarity) are considered and defined comprehensively using fuzzy multigranularity uncertainty measures. Next, the features with interactivity and complementarity are mined by the forward iterative selection strategy. Finally, compared with the benchmark approaches on several datasets, the experimental results show that ICFS_FmNRS effectively improves the classification performance of feature subsets while reducing the dimension of feature space.

Aiming at the problem of effectively selecting relevant features from heterogeneous data without decision, a novel feature selection approach is studied based on fuzzy mutual information in fuzzy rough set theory. First, the fuzzy relevance of each feature is defined by using fuzzy mutual information, and then the fuzzy conditional relevance is further given. Next, the fuzzy redundancy is defined by using the difference between the fuzzy relevance and the fuzzy conditional relevance. Thereby the evaluation index of the feature importance is obtained by using the idea of unsupervised minimum redundancy and maximum relevance. Finally, a fuzzy mutual information-based unsupervised feature selection (FMIUFS) algorithm is designed to select feature sequences. Extensive experiments are conducted on public datasets and six unsupervised feature selection algorithms are compared. The selected features are evaluated by classification, clustering, and outlier detection methods. Experimental results show that the proposed algorithm can select fewer heterogeneous features to maintain or improve the performance of learning algorithms.

Outlier detection is widely used in many fields, such as intrusion detection, credit card fraud detection, medical diagnosis, and so on. Existing outlier detection algorithms are mostly designed for dealing with numeric or categorical attributes. However, data usually exist in the form of mixed attributes in real-world applications. In this article, we propose a novel mixed attribute outlier detection method based on multigranulation relative entropy by employing the neighborhood rough set. First, the neighborhood system is constructed by optimizing the mixed distance metric and the radius of the statistical value. Second, the neighborhood entropy is introduced as an uncertainty measure of data. Furthermore, the three kinds of multigranulation relative entropy-based matrices are defined by three kinds of attribute sequences, and the multigranulation relative entropy-based outlier factor is integrated to indicate the outlier degree of every object. Based on the proposed outlier detection model, the corresponding algorithm is designed. Finally, the proposed algorithm is compared with other nine algorithms through experiments on public data. The experimental results show that the proposed technique is adaptive and effective.

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

BACKGROUND: The strawberry (Fragaria×annanasa Duch.) is a fresh fruit of its attractive colour, good flavor and enrichment of nutrients in the world. OBJECTIVE: This study analyzed the 3,885 strawberry research papers both article and review types from Food Science and Technology category. METHODS: The data were searched and extracted from Web of Science database, and were analyzed by bibliometric science and visualization tools. RESULTS: Papers mainly written in English (3,754, 96.628%), were from 12,695 authors, 94 countries/territories, 2,689 organizations and in 168 Journals and book series. The top five Journals were Journal of Agricultural and Food Chemistry (432, 11.12%), Food Chemistry (338, 8.7%), Postharvest Biology and Technology (245, 6.306%), Journal of the Science of Food and Agriculture (187, 4.813%) and Journal of Food Science (185, 4.762%), which each published more than 185 papers. The top five countries and regions were USA, Spain, Peoples R China, Italy and Brazil. The top five organizations were CSIC, ARS (USDA ARS), Univ Calif Davis, Univ Politecn Valencia and Zhejiang Univ. The top five authors were Battino Maurizio, Giampieri Francesca, Wang Shiow Y. (Wang, SY), Mezzetti Bruno and Carle Reinhold (Carle R), each published more than 23 papers. All keywords of the strawberry research from Food Science and Technology category were separated nine clusters for different research topics. CONCLUSIONS: The paper could provide a valuable guide for designing future studies, and is also useful for student identifying graduate schools and researchers selecting journals.

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

Cucumber (Cucumis sativus L.) is an economically important vegetable crop that is cultivated worldwide. The current study aimed to identify and analyze the 2030 articles and review article about cucumber research from the horticulture category of the VOS viewer Web of Science. Bibliometric data were analyzed by bibliometric science mapping and visualization tools. Articles mainly written in English (1884; 92.81%) were from 5630 authors, 80 countries or territories, and 1094 organizations; they were published in 46 journals and book series. The top five core journals are Scientia Horticulturae (337; 16.60%), HortScience (265; 13.05%), Journal of the American Society for Horticultural Science (239; 11.77%), European Journal of Plant Pathology (195; 9.61%), and Horticulture Journal (Journal of the Japanese Society for Horticultural Science) (157; 7.73%). These journals each published more than 157 articles. The top five countries and regions were the United States, People’s Republic of China, Japan, South Korea, and India. The top five organizations were the University of Wisconsin, North Carolina State University, U.S. Department of Agriculture–Agricultural Research Service, Michigan State University, and Nanjing Agricultural University. The top five authors are Todd C. Wehner (Wehner, TC), Jack E. Staub (Staub, JE), Yiqun Weng, R.L. Lower, and S. Tachibana; each published more than 24 articles. All keywords used for cucumber research in the horticulture category were separated into eight clusters for different research topics. Visualizations offer exploratory information regarding the current state in a scientific field or discipline as well as indicate possible developments in the future. This review could be a valuable guide for designing future studies.

Fuzzy information entropy based on fuzzy relation in fuzzy rough set theory is an important metric of uncertainty. However, the research of fuzzy information entropy for hybrid feature outlier detection has not been reported. On this basis, this paper constructs a hybrid feature outlier detection method based on fuzzy information entropy by using fuzzy approximate space with fuzzy similarity relation. Firstly, the adaptive fuzzy radius of standard deviation and hybrid fuzzy similarity are employed to construct the fuzzy approximate space, and the relative fuzzy entropy is defined based on the fuzzy information entropy. Then, two kinds of metrics are constructed to describe the outlier degree of object. Finally, the fuzzy entropy-based outlier factor is integrated to implement outlier detection, and the relevant fuzzy information entropy-based outlier detection algorithm (FIEOD) is designed. The FIEOD algorithm is compared with the main outlier detection algorithms on public data. The experimental results reveal that the proposed method has better effectiveness and adaptability.

BackgroundTo investigate the renal dysfunction in patients with hyperuricemia by employing a multiparametric MRI protocol, consisting of quantitative water molecule diffusion, microstructure, microscopic perfusion, and oxygenation measurements in kidneys.Materials and methodsA total of 48 patients with hyperuricemia (HU) and 22 age-matched healthy control subjects (HC) were enrolled in the study. For each participant, three different functional magnetic resonance imaging (fMRI) sequences were acquired and analyzed, including intravoxel incoherent motion imaging (IVIM), diffusion tensor imaging (DTI), and blood-oxygen-level-dependent MRI (BOLD). Thereafter, an independent two-samplet-test was applied to discover the significant differences of MRI indices between the hyperuricemia (HU) and HC groups, and the specific potential biomarkers between two subgroups of HU group (asymptomatic hyperuricemia group (AH) and gouty arthritis group (GA)). Further, multivariate logistic regression analyses were performed to classify the AH from the GA group using the MRI indices with significant between-group differences. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated to assess the performance of each MR index for differentiation between the AH and GA groups.ResultsTen parametric values of the HU group were significantly lower than those of the HC group among the 14 fMRI parameters (P *, andfvalues and medullary D and R2*values had significant differences between the AH and GA groups (P fvalues and medullary R2* value gave the best diagnostic efficacy, yielding an AUC, sensitivity, and specificity of 0.967 ± 0.022, 91.67%, and 95.83%, respectively.ConclusionsA multiparametric MR analysis plays an important role in the evaluation of renal dysfunction in hyperuricemia from multiple perspectives. It could be a promising method for noninvasive detection and identification of the early-stage renal damage induced by hyperuricemia.

Potato (Solanum tuberosum L.) has been recognized as the fourth largest crop after maize, wheat and rice and is a crop of importance in developing countries for ensuring human nutrition and food security. Based on the Web of Science, this study analysed 3943 article- and review-type papers of potato research from agronomy category during 2000 to 2021 and included 6 highly cited papers. The papers mainly written in English (96.88%) were from 11,479 authors, 120 countries/territories and 2719 organizations and published in 97 journals and one book series. The top 5 core journals were American Journal of Potato Research (949, 24.07%), Potato Research (437, 11.08%), European Journal of Plant Pathology (172, 4.36%), Plant Pathology (171, 4.34%) and Theoretical and Applied Genetics (142, 3.60%). The top 5 countries and regions were the USA, Canada, China, the Netherlands and Brazil. The top five organizations were USDA ARS, Agriculture and Agri-Food Canada, University of Wisconsin, Wageningen University and Research Centre and University of Idaho, each with more than 157 papers. The top 6 authors were C. R. Brown, R. G. Novy, J. B. Bamberg, R. G. F. Visser, K. G. Haynes and P. C. Struik, each publishing more than 43 papers. All keywords of the potato research from agronomy category were separated into seven clusters for different research topics. Visualizations offered exploratory information on the current state in a scientific field or discipline as well as indicating possible developments in the future. This work is useful for students identifying graduate schools and for researchers selecting journals.

Cotton is the main source of renewable fiber in the world and is primarily used for textile production. This study analyzed 3,856 papers of cotton research from Plant Sciences category during 1990 ...

Bibliometric analysis is a quantitative evaluation method for scientific research aimed at measuring knowledge expressed as scientific publications in a given field. Based on the Essential Science Indicators database, 1136 top papers on cultivated wheat (Triticum species) were researched from 2010 to 2020, including 1132 highly cited papers and 20 ‘hot’ papers. All papers written in English were from 5563 authors, 1668 organizations and 91 countries/territories, published in 317 journals and book series. The top five journals were Frontiers in Plant Science (50, 4.4%), Journal of Experimental Botany (38, 3.3%), New Phytologist (26, 2.3%), Bioresource Technology (25, 2.2%) and Field Crops Research (24, 2.1%), each publishing more than 24 papers. The five countries publishing the most papers were USA, People’s R China, Australia, England and Germany. The top five organizations were Chinese Academy of Science, Chinese Academy of Agricultural Science (CAAS), USDA Agricultural Research Service (ARS), CIMMYT, and CSIRO Agriculture and Food which each contributed more than 22 papers. Among authors, the top six were Rizwan, Muhammad; Ali, Shafaqat; Reynolds, Matthew; Gao, Caixia; Wang, Yanpeng; and Uauy, Cristobal, with each publishing more than eight papers. All keywords were separated into seven clusters representing different research topics. Visualizations offer exploratory information on current status in a scientific field or discipline as well as indicate possible future directions. This work will be useful for students in identifying graduate schools and researchers in selecting journals.

Vehicular social networks (VSNs) are considered as an emerging class of vehicular ad hoc networks (VANETs) with social attributes. In contrast to the traditional randomly distributed human social networks, vehicles normally only move along fixed paths. As such, information sharing and forwarding become challenging because of the high speed of vehicles, complicated propagation environment, and quickly changing network topologies. The social characteristics and human behavior features are used to improve the efficiency of information delivery among vehicles in VANETs. In this paper, we propose a dynamic periodic location encounter network (DPLEN) model that considering both time-varying and location-varying characteristics of vehicles. We calculate the line similarity for each encountered pair of vehicles based on the periodic time and location information of the encounter event, and analyze social attributes based on the network model, such as the Community structure, Betweenness Centrality and K-shell. We also use the similarity to design two routing protocols for unicast and multicast patterns. After testing the proposed model on empirically collected datasets of mobility traces, the results show that these two routing protocols are able to greatly improve the efficiency of information forwarding in the VSNs.

Lumbar spinal stenosis (LSS), which often occurs concurrently with degenerative spondylolisthesis (DS), is a common disease in the elderly population, affecting the quality of life of aged people significantly. Notwithstanding the frequently good effect of conservative therapy on LSS, a minority of the patients ultimately require surgery. Surgery for LSS aims to decompress the narrowed spinal canals with preservation of spinal stability. Traditional open surgery, either pure decompression or decompression with fusion, was considered effective for the treatment of LSS with or without DS. However, the long-term clinical outcomes of traditional open surgery are still unclear. Moreover, the disadvantages of conventional open surgery are extensive, examples including tissue injuries or secondary instability, with limited outcomes and significant reoperation rates. With the development and improvement of surgical tools, various minimally invasive spine surgery (MISS) methods, including indirect decompression techniques of interspinous process devices (IPDs) and direct decompression techniques such as microscopic spine surgery or endoscopic spine surgery (ESS), have been updated with enhancement. IPDs, such as Superion devices, were reported to behave with comparable physical function, disability, and symptoms outcomes to laminectomy decompression. As an emerging technique of MISS, ESS has beneficial hallmarks including minimal tissue injuries, reduced complication rates, and shortened recovery periods, thus gaining popularity in recent years. ESS can be classified in terms of endoscopic hallmarks and approaches. Predictably, with the continuous development and gradual maturity, MISS is expected to replace traditional open surgery widely in the surgical treatment of LSS associated with DS in the future.

It remains extremely challenging to build three-dimensional photonic crystals with complete photonic bandgaps by simple and experimentally realizable colloidal building blocks. Here, we demonstrate that particle softness can enhance both the self-assembly of pyrochlore- and perovskite-like lattice structures from simple deformable triblock Janus colloids and their photonic bandgap performances. Dynamics simulation results show that the region of stability of pyrochlore lattices can be greatly expanded by appropriately increasing softness, and the perovskite lattices are unexpectedly obtained at enough high softness. Photonic calculations show that the direct pyrochlore lattices formed from overlapping soft triblock Janus particles exhibit even larger photonic bandgaps than the ideal nonoverlapping pyrochlore lattice, and proper overlap arising from softness can also dramatically improve the photonic properties of the inverse pyrochlore and perovskite lattices. Our study offers a new and feasible self-assembly path toward three-dimensional photonic crystals with large and robust photonic bandgaps.

This study explores how a virtual reality (VR) design tool can enhance designers' cognitive action and creativity in the design process. Ten fashion designers participated in cognitive protocol res...

This study aimed to determine rates of hospitalization and in-hospital mortality in the first year following amyloidosis diagnosis with cardiac involvement using observational databases.Three admin...

Amyloid-β (Aβ) accumulation in the brain is a pivotal event in the pathogenesis of Alzheimer's disease (AD), and its clearance from the brain is impaired in sporadic AD. Previous studies suggest that approximately half of the Aβ produced in the brain is cleared by transport into the periphery. However, the mechanism and pathophysiological significance of peripheral Aβ clearance remain largely unknown. The kidney is thought to be responsible for Aβ clearance, but direct evidence is lacking. In this study, we investigated the impact of unilateral nephrectomy on the dynamic changes in Aβ in the blood and brain in both humans and animals and on behavioural deficits and AD pathologies in animals. Furthermore, the therapeutic effects of the diuretic furosemide on Aβ clearance via the kidney were assessed. We detected Aβ in the kidneys and urine of both humans and animals and found that the Aβ level in the blood of the renal artery was higher than that in the blood of the renal vein. Unilateral nephrectomy increased brain Aβ deposition; aggravated AD pathologies, including Tau hyperphosphorylation, glial activation, neuroinflammation, and neuronal loss; and aggravated cognitive deficits in APP/PS1 mice. In addition, chronic furosemide treatment reduced blood and brain Aβ levels and attenuated AD pathologies and cognitive deficits in APP/PS1 mice. Our findings demonstrate that the kidney physiologically clears Aβ from the blood, suggesting that facilitation of Aβ clearance via the kidney represents a novel potential therapeutic approach for AD.

Background Antithrombotic therapies are associated with an increased bleeding risk. Abnormal uterine bleeding data have been reported in clinical trials of patients with venous thromboembolism (VTE), but data are limited for patients with atrial fibrillation (AF). Objective Using real-world data from four US healthcare databases (October 2010 to December 2018), we compared the occurrence of severe uterine bleeding among women newly exposed to rivaroxaban, apixaban, dabigatran, and warfarin stratified by indication. Methods To reduce potential confounding, patients in comparative cohorts were matched on propensity scores. Treatment effect estimates were generated using Cox proportional hazard models for each indication, in each database, and only for pairwise comparisons that met a priori study diagnostics. If estimates were homogeneous (I2 < 40%), a meta-analysis across databases was performed and pooled hazard ratios reported. Results Data from 363,919 women newly exposed to a direct oral anticoagulant or warfarin with a prior diagnosis of AF (60.8%) or VTE (39.2%) were analyzed. Overall incidence of severe uterine bleeding was low in the populations exposed to direct oral anticoagulants, although relatively higher in the younger VTE population vs the AF population (unadjusted incidence rates: 2.8–33.7 vs 1.9–10.0 events/1000 person-years). In the propensity score-matched AF population, a suggestive, moderately increased risk of severe uterine bleeding was observed for rivaroxaban relative to warfarin [hazard ratios and 95% confidence intervals from 0.83 (0.27–2.48) to 2.84 (1.32–6.23) across databases with significant heterogeneity], apixaban [pooled hazard ratio 1.45 (0.91–2.28)], and dabigatran [2.12 (1.01–4.43)], which were sensitive to the time-at-risk period. In the propensity score-matched VTE population, a consistent increased risk of severe uterine bleeding was observed for rivaroxaban relative to warfarin [2.03 (1.19–3.27)] and apixaban [2.25 (1.45–3.41)], which were insensitive to the time-at-risk period. Conclusions For women who need antithrombotic therapy, personalized management strategies with careful evaluation of benefits and risks are required. ClinicalTrials.gov Registration NCT04394234; registered in May 2020. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-021-01060-4.

This paper presents the instructional design and development process for a fashion design education programme promoting creativity in a VR (Virtual Reality) environment. We designed the instruction...

Obstructive sleep apnea syndrome (OSAS) can lead to alterations in right ventricular (RV) performance and pulmonary vascular haemodynamics. Additionally, altitude-related hypoxia is associated with pulmonary vasoconstriction, and the effect of high-altitude on the pulmonary circulation in OSAS patients can be further altered. We sought to assess alterations in RV morphology and function in OSAS patients living at high altitude by way of 2-dimensional speckle tracking echocardiography (2D-STE), real-time 3- dimensional echocardiography (RT-3DE) and cardiac biomarkers. We also evaluate the impact of continuous positive airway pressure (CPAP) treatment on RV performance. Seventy-one patients with newly diagnosed OSAS and thirty-one controls were included in this study. All individuals were assessed for cardiac biomarkers as well as underwent 2D-STE and RT-3DE. Forty-five OSAS patients underwent CPAP therapy for at least 24 weeks and were studied before and after CPAP treatment. RT-3DE was used to measure RV volume, and calculate RV 3D ejection fraction (3D RVEF). Peak systolic strain was determined. Cardiac biomarkers, including C-reactive protein (CRP), N-terminal pro-B-type natriuretic peptide, and cardiac troponin T were also measured. Right atrium volume index, RV volume, RV volume index, systolic pulmonary artery pressure (sPAP), pulmonary vascular resistance (PVR) and level of serum CRP were significantly higher in OSAS group, while OSAS patients showed lower 3D RVEF and RV longitudinal strains. Compared to the patients with sPAP

To explore the value of combined diffusion tensor imaging (DTI) and blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) in detecting early renal alterations in patients with hyperuricemia. Seventy-one individuals were enrolled in this study and divided into three groups according to their serum uric acid (SUA) level and clinical symptoms: healthy controls (HC, n = 23), asymptomatic hyperuricemia (AH, n = 22) and gouty arthritis (GA, n = 26). All patients underwent both DTI and BOLD-MRI examination. Renal cortical and medullary ADC, FA and R2* values were calculated, respectively, and compared among the three groups. Correlations between ADC, FA and R2* with estimated glomerular filtration rate (eGFR) and SUA in hyperuricemia were evaluated, respectively. In the renal cortex, the ADC, FA and R2* values of the AH and GA groups were significantly lower than those of the HC groups (p

This study analyzed top papers published in the field of Library and Information Science (LIS) published between 2009 and 2019 and included in the Web of Science (WoS) subject category “Information Science & Library Science”. Data of the 501 top papers were extracted from the Essential Science Indicators (ESI) database comprising 499 highly cited papers and 16 hot papers in the field. The distributions of document type, language of publication, scientific output, and publication of journals are reported in this paper. The co-authorship network visualization of authors, organizations and countries, co-occurrence network visualization of all keywords are visualized using VOSviewer software. The 501 papers, all written in English language, were from 1,579 authors employed at 680 organizations based in 59 countries/territories. The papers were published in 40 journals in the field. The top 5 core journals ranked based on the impact factor (IF) were MIS Quarterly, Journal of the American Medical Informatics Association, International Journal of Information Management, Journal of the Association for Information Science and Technology, and Information Management. The top 5 organizations were University of Maryland (USA), University of Wolverhampton (UK), Vanderbilt University (USA), Indiana University (USA), and Wuhan University (China). Authors from the following countries contributed the most - USA, People’s Republic of China, England, Canada and Netherlands. Based on network map using VOSviewer, there were micro, meso and macro level collaborations based on common interests in a specific topics. Analysis of all keywords showed that the research were distributed into 6 clusters. This study concludes that one important characteristic of top papers is the journal reputation, therefore authors can choose their ideal journal with a high JIF and quartile to publish papers in the English language related to this research field.

3D printed carbon fiber reinforced composites (CFRP) have shown great potential in lightweight application. Here, we report a prepreg carbon fiber reinforced polyamide composite by fused filament fabrication 3D printing process. The influence of layer thickness and carbon fiber layers on mechanical properties of 3D printed parts was well studied. With the incorporation of prepreg carbon fibers, the value of tension and flexural strengths of 3D printed CFRP parts could achieve 2.7 and 13.6 times compared to neat polyamide, respectively. Result illustrates that with the prepreg process the carbon fiber have good interface bonding strength with neat polyimide. This work could also be used for more 3D printing composite systems.

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

It is traditionally believed that cerebral amyloid-beta (Aβ) deposits are derived from the brain itself in Alzheimer's disease (AD). Peripheral cells such as blood cells also produce Aβ. The role of peripherally produced Aβ in the pathogenesis of AD remains unknown. In this study, we established a bone marrow transplantation model to investigate the contribution of blood cell-produced Aβ to AD pathogenesis. We found that bone marrow cells (BMCs) transplanted from APPswe/PS1dE9 transgenic mice into wild-type (Wt) mice at 3 months of age continuously expressed human Aβ in the blood, and caused AD phenotypes including Aβ plaques, cerebral amyloid angiopathy (CAA), tau hyperphosphorylation, neuronal degeneration, neuroinflammation, and behavioral deficits in the Wt recipient mice at 12 months after transplantation. Bone marrow reconstitution in APPswe/PS1dE9 mice with Wt-BMCs at 3 months of age reduced blood Aβ levels, and alleviated brain Aβ burden, neuronal degeneration, neuroinflammation, and behavioral deficits in the AD model mice at 12 months after transplantation. Our study demonstrated that blood cell-produced Aβ plays a significant role in AD pathogenesis, and the elimination of peripheral production of Aβ can decrease brain Aβ deposition and represents a novel therapeutic approach for AD.

Objective: Observational evidence suggests that patients with type 2 diabetes mellitus (T2DM) are at increased risk for acute pancreatitis (AP) versus those without T2DM. A small number of AP events were reported in clinical trials of the sodium glucose co-transporter 2 inhibitor canagliflozin, though no imbalances were observed between treatment groups. This observational study evaluated risk of AP among new users of canagliflozin compared with new users of six classes of other antihyperglycemic agents (AHAs). Methods: Three US claims databases were analyzed based on a prespecified protocol approved by the European Medicines Agency. Propensity score adjustment controlled for imbalances in baseline covariates. Cox regression models estimated the hazard ratio of AP with canagliflozin compared with other AHAs using on-treatment (primary) and intent-to-treat approaches. Sensitivity analyses assessed robustness of findings. Results: Across the three databases, there were between 12,023–80,986 new users of canagliflozin; the unadjusted incidence rates of AP (per 1000 person-years) were between 1.5–2.2 for canagliflozin and 1.1–6.6 for other AHAs. The risk of AP was generally similar for new users of canagliflozin compared with new users of glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, sulfonylureas, thiazolidinediones, insulin, and other AHAs, with no consistent between-treatment differences observed across databases. Intent-to-treat and sensitivity analysis findings were qualitatively consistent with on-treatment findings. Conclusions: In this large observational study, incidence rates of AP in patients with T2DM treated with canagliflozin or other AHAs were generally similar, with no evidence suggesting that canagliflozin is associated with increased risk of AP compared with other AHAs.

This study was designed to develop a computer-aided diagnosis (CAD) system based on a convolutional neural network (CNN) to diagnose patients with pituitary tumors. We included adult patients clinically diagnosed with pituitary adenoma (pituitary adenoma group), or adult individuals without pituitary adenoma (control group). After pre-processing, all the MRI data were randomly divided into training or testing datasets in a ratio of 8:2 to create or evaluate the CNN model. Multiple CNNs with the same structure were applied for different types of MR images respectively, and a comprehensive diagnosis was performed based on the classification results of different types of MR images using an equal-weighted majority voting strategy. Finally, we assessed the diagnostic performance of the CAD system by accuracy, sensitivity, specificity, positive predictive value, and F1 score. We enrolled 149 participants with 796 MR images and adopted the data augmentation technology to create 7960 new images. The proposed CAD method showed remarkable diagnostic performance with an overall accuracy of 91.02%, sensitivity of 92.27%, specificity of 75.70%, positive predictive value of 93.45%, and F1-score of 92.67% in separate MRI type. In the comprehensive diagnosis, the CAD achieved better performance with accuracy, sensitivity, and specificity of 96.97%, 94.44%, and 100%, respectively. The CAD system could accurately diagnose patients with pituitary tumors based on MR images. Further, we will improve this CAD system by augmenting the amount of dataset and evaluate its performance by external dataset.

Background: Diabetic retinopathy is a common microvascular complication of diabetes mellitus. Abnormal energy metabolism in microvascular endothelium is involved in the progression of diabetic retinopathy. Bile Acid G-Protein-Coupled Membrane Receptor (TGR5) has emerged as a novel regulator of metabolic disorders. However, the role of TGR5 in diabetes mellitus-induced microvascular dysfunction in retinas is largely unknown. Methods: ELISA was used for analyzing bile acid profiles in diabetic rat retinas and retinal microvascular endothelial cells (RMECs) cultured in high glucose medium. The effects of TGR5 agonist on streptozotocin-induced diabetic retinopathy were evaluated by HE staining, TUNEL staining, retinal trypsin digestion and vascular permeability assay. A pharmacological inhibitor of RhoA was used to study the role of TGR5 on the regulation of Rho/Rho-associated coiled-coil containing protein kinase (ROCK) and western blot, immunofluorescence and siRNA silencing were performed to study the related signaling pathways. Findings: A decrease in bile acids was observed during DR progression in the diabetic rat retinas and RMECs cultured in high glucose medium. The TGR5 agonist obviously ameliorated diabetes-induced retinal microvascular dysfunction in vivo, and inhibited the effect of TNF-α on endothelial cell proliferation, migration, and permeability in vitro. On the contrary, knockdown of TGR5 by siRNA aggravated TNF-α-induced actin polymerization and endothelial permeability. Mechanistically, the effects of TGR5 on the improvement of endothelial function was due to its regulatory role on the ROCK signaling pathway. An inhibitor of RhoA significantly reversed the loss of tight junction protein under TNF-α stimulation. Interpretation: Our findings suggest that insufficient bile acid signaling plays an important pathogenic role in the development of DR. Up-regulation or activation of TGR5 may inhibit RhoA/ROCK-dependent actin remodeling and represent an important therapeutic intervention for DR. Funding Statement: This project was supported by the Natural Science Foundation of China (81770941, 81800845), Nanjing Medical University Science and Technology Development Fund (NMUB2018363) and Natural Science Foundation of Jiangsu Province (BK20190149, BK20180170). Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: All animal experiments were performed according to the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health, and the procedures were approved by the Animal Care and Use Committee of Nanjing Medical University.

Aims: This study aimed to investigate the clinical value of induction chemotherapy (IC) with docetaxel, 5-fluorouracil plus nedaplatin followed by concurrent chemoradiotherapy (CCRT) with nedaplatin for locoregional advanced nasopharyngeal carcinoma (NPC). Materials and Methods: In total, 269 patients diagnosed with locoregional advanced NPC between June 2012 and June 2017 were retrospectively included and divided into two groups: IC (docetaxel plus nedaplatin and 5-fluorouracil) followed by nedaplatin-based CCRT (TNF + N group, n = 146) and IC (docetaxel plus cisplatin and 5-fluorouracil) followed by cisplatin-based CCRT (TPF + P group, n = 123). The Kaplan-Meier method and Cox proportional hazards model were applied to analyse survival and prognosis. After propensity score-matched (PSM), 113 patients remained in each group. Toxicities were compared between the two groups using the Chi-square test or Fisher's exact test. Results: The overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS) rates of the TNF + N and TPF + P groups were 90.7% vs. 92.3% (P = 0.315), 78.9% vs. 79.4% (P = 0.715), 82.4% vs. 85.1% (P = 0.441) and 96.1% vs. 93.3% (P = 0.414), respectively, with no significant difference in 3-year survival outcome between the two groups, and this outcome was confirmed after using PSM analyses. In the PSM cohort, a significant higher frequency of grade 3/4 vomiting was observed in the TPF + P group compared to the TNF + N group (22.1% vs. 0%, P = 0.000). However, 15.9% of patients in the TNF + N group had grade 3/4 thrombocytopenia in comparison with 6.2% in the TPF + P group (P = 0.020). Conclusions: The TNF regimen followed by CCRT with nedaplatin is an alternative treatment strategy to the standard TPF regimen followed by CCRT with cisplatin for patients with locoregional advanced NPC.

Introduction: The adjuvant treatment of patients with resected lung adenocarcinoma (LUAD) remains unstandardized. We analyzed the survival outcomes of these patients based on EGFR mutation status and adjuvant chemotherapy treatment. Methods: This noninterventional real-world study (ICAN) enrolled Chinese patients with resected stages I to III LUAD from April 8, 2010, to December 31, 2010. Tumor EGFR mutation status and 3-year disease-free survival (DFS) were determined. The extension phase provided long-term follow-up with overall survival (OS) as the primary end point. Secondary end points included DFS and prognostic factors of survival. Survival outcomes based on adjuvant chemotherapy treatment, EGFR mutation status, and postoperative stage were analyzed post hoc. Results: Among 568 patients in the ICAN cohort, 472 continued to the extension phase and remained eligible. The 3-year DFS rate was 58.8%. In the extension cohort, 260 patients (55.1%) had EGFR-mutant disease and 207 (43.9%) received adjuvant chemotherapy. At a median follow-up of 109.0 (95% confidence interval [CI]: 106.6–111.4) months, median OS and DFS were 103.3 (95% CI: 101.7–104.9) and 67.4 (95% CI: 49.7–85.2) months, respectively. The 5-year OS and DFS rates were 68.9% (95% CI: 64.3–73.6) and 52.9% (95% CI: 48.2–57.7), respectively. EGFR wild-type disease was a significant independent predictor of worse OS (HR = 1.24, 95% CI: 1.07–1.44, p= 0.004) based on the Cox regression analysis of common factors. Post hoc subgroup analysis revealed that survival outcomes were not significantly different with adjuvant chemotherapy regardless of EGFR mutation status across all postoperative stages. Conclusions: EGFR mutations are common in operable LUAD, and recurrence and mortality after resection were considerable. Adjuvant chemotherapy did not improve survival outcomes, regardless of EGFR mutation status and postoperative stage.

Background Thromboprophylaxis extended after hospital discharge in medically ill patients currently is not recommended by practice guidelines because of uncertainty about the benefit for preventing major or fatal thromboembolic events, and the risk of bleeding. Methods and Results We assessed the benefit and risk of thromboprophylaxis with rivaroxaban 10 mg once daily extended for 25 to 45 days after hospitalization for preventing major thromboembolism in medically ill patients using the pooled data in 16 496 patients from 2 randomized trials, MARINER (Medically Ill Patient Assessment of Rivaroxaban Versus Placebo in Reducing Post‐Discharge Venous Thrombo‐Embolism Risk) and MAGELLAN (Multicenter, randomized, parallel‐group efficacy and safety study for the prevention of venous thromboembolism in hospitalized medically ill patients comparing rivaroxaban with enoxaparin). The data from the MARINER trial were pooled with the data from the MAGELLAN trial in patients who were free of thrombotic or bleeding events up to the last dose of enoxaparin/placebo and who continued in the outpatient phase of thromboprophylaxis. The composite outcome of major thromboembolic events (symptomatic deep vein thrombosis, nonfatal pulmonary embolism, myocardial infarction, and nonhemorrhagic stroke) and all‐cause mortality was used to assess benefit and was compared with the risk of the composite of fatal and critical site bleeding. The incidence of the composite efficacy outcome was 1.80% (148 of 8222 patients) in the rivaroxaban group, compared with 2.31% (191 of 8274 patients in the placebo group) (HR, 0.78 [95% CI, 0.63–0.97], P =0.024). Fatal or critical site bleeding events were infrequent and occurred in P =0.214). Conclusions The results suggest a benefit for reducing major thromboembolic outcomes (number needed to treat: 197), with a favorable trade‐off to fatal or critical site bleeding (number needed to harm: 2045). Registration URL: https://www.clinicaltrials.gov ; Unique identifiers: NCT00571649 and NCT02111564.

Background: Bronchiectasis is a chronic inflammation of the bronchi with recurrent infections and hemoptysis. The MAGELLAN study compared oral rivaroxaban, 10 mg once daily (QD), for 35 ± 4 days with subcutaneous enoxaparin 40 mg QD for 10 ± 4 days followed by placebo for 25 ± 4 days to prevent venous thromboembolism in patients hospitalized with an acute medical illness. MAGELLAN included a subset of patients with bronchiectasis. In a post hoc analysis, we evaluated the incidence and severity of pulmonary bleeding in patients with bronchiectasis who were hospitalized for an acute medical illness. This analysis included MAGELLAN patients diagnosed with bronchiectasis at baseline. Patients were evaluated by treatment group for International Society on Thrombosis and Haemostasis major bleeding, non-major clinically relevant (NMCR) bleeding, and the composite of the 2 (ie, clinically relevant bleeding). Results: Medically ill patients with bronchiectasis were randomized to rivaroxaban (n = 60) or enoxaparin/placebo (n = 61). There were 2 fatal pulmonary bleeds and 1 fatal gastrointestinal bleed in the rivaroxaban arm and no fatal or major bleeding in the enoxaparin/placebo arm. The incidence of major bleeding was 5% in the rivaroxaban arm. One NMCR bleed occurred in the rivaroxaban arm and 2 NMCR bleeds occurred in the enoxaparin/placebo arm. The incidence of clinically relevant bleeding was 6.7% versus 3.3% in the rivaroxaban and enoxaparin/placebo groups, respectively (relative risk = 2.06 [95% confidence interval: 0.351-12.046]). Conclusion: In-patients hospitalized with bronchiectasis and an acute medical illness, clinically relevant bleeding, including fatal pulmonary hemorrhage, occurs more frequently with extended rivaroxaban thromboprophylaxis than with enoxaparin followed by placebo.

Background The morbidity of rifampicin/multidrug-resistant tuberculous meningitis (RR/MDR-TBM) has shown an increasing trend globally. Its mortality rate is significantly higher than that of non-rifampicin/multidrug-resistant tuberculous meningitis (NRR/MDR-TBM). This article aimed to explore risk factors related to RR/MDR-TBM, and compare therapeutic effects of linezolid (LZD)- and non-linezolid-containing regimen for RR/MDR-TB patients in Shenzhen city. Furthermore, we aimed to find a better therapy for pathogen-negative TBM with RR/MDR-TBM related risk factors. Methods We conducted a retrospective study enrolling 137 hospitalized cases with confirmed TBM from June 2014 to March 2020. All patients were divided into RR/MDR-TBM group (12 cases) and NRR/MDR-TBM group (125 cases) based on GeneXpert MTB/RIF and (or) phenotypic drug susceptibility test results using cerebral spinal fluid (CSF). The risk factors related to RR/MDR-TBM were investigated through comparing clinical and examination features between the two groups. The mortality rate of RR/MDR-TBM patients treated with different regimens was analyzed to compare their respective therapeutic effects. A difference of P Results Most patients (111/137, 81%) were from southern or southwestern China, and a large proportion (72/137, 52.55%) belonged to migrant workers. 12 cases were RR/MDR-TBM (12/137, 8.8%) while 125 cases were NRR/MDR-TBM (125/137, 91.2%). The proportion of patients having prior TB treatment history in the RR/MDR-TBM group was significantly higher than that of the NRR/MDR-TBM group (6/12 vs. 12/125, 50% vs. 10.5%, P P = 0.045). Conclusions The main related risk factor of RR/MDR-TBM is the history of anti-tuberculosis treatment. Linezolid-containing regimen appears to lower mortality rate of RR/MDR-TBM significantly in our study. We think Linezolid should be evaluated prospectively in the treatment of RR/MDR-TBM.

Background The current study investigated the performance of intravoxel incoherent motion diffusion (IVIM) technology in monitoring early renal injury in streptozotocin rats. Methods Forty-eight Sprague-Dawley (SD) rats were divided into a control group and a diabetic mellitus (DM) group. Six rats in each group were randomly selected for MR scans at four different time points (0, 4, 8, and 12 weeks). The IVIM-derived parameters (D, D*, f and ADC values) of the renal cortex (CO), outer and inner stripe of the outer medulla (OS, IS), and internal medulla (IM) were acquired. Changes in each IVIM-derived parameter over time were analyzed, and differences between the two groups at each point were assessed. The associations between the IVIM parameters and IV collagen expression, urine volume (UV), blood urea nitrogen (BUN), and serum creatinine (Scr) were investigated. Results The D and D* values of CO and the ADC values of CO, OS, IS and IM displayed significantly different trends between the two groups over time (Pr=0.527, P=0.033; r=0.617, P=0.005), between the ADC value of IM and BUN (r=0.557, P=0.019) and between the f value of IM and BUN (r=0.527, P=0.033). No correlation was found between IVIM parameters and IV collagen expression and Scr. Conclusions IVIM is a potential sensitive and noninvasive technology for the simultaneous assessment of early renal cortical and medullary injuries induced by diabetes.

Hyperphosphorylated tau is an important pathological agent in Alzheimer’s disease (AD). Tau effluxes from the brain to the blood could potentially stimulate the production of naturally occurring antibodies (NAbs). We aimed to investigate whether NAbs to tau (NAbs-tau) was generated in human blood and to figure out the alteration of plasma NAbs-tau level in AD patients. About 192 AD patients and 192 age-matched and non-demented controls (NC) were enrolled in the present study. Immunofluorescence staining and western blot assays were used to confirm the existence of NAbs-tau in human blood. The plasma level of NAbs-tau in NC and AD group was analyzed by ELISA. Immunofluorescence staining and western blot assays confirmed the existence of NAbs-tau in human blood. However, no significant difference in the plasma level of NAbs-tau was observed between NC and AD group. Furthermore, the plasma level of NAbs-tau had no significant correlation with MMSE scores. The present study confirmed that NAbs-tau exists in human blood but does not differ in level between the NC and AD group. Plasma NAbs-tau is not a reliable biomarker for AD. Refereed/Peer-reviewed

Respiratory viruses, such as severe acute respiratory syndrome coronavirus (SARS-CoV)-1, SARS-CoV-2, influenza A viruses, and respiratory syncytial virus, pose a serious threat to society. Based on the guiding principles of “holism” and “syndrome differentiation and treatment”, traditional Chinese medicine (TCM) has unique advantages in the treatment of respiratory virus diseases owing to the synergistic effect of multiple components and targets, which prevents drug resistance from arising. According to TCM theory, there are two main strategies in antiviral treatments, namely “dispelling evil” and “fu zheng”. Dispelling evil corresponds to the direct inhibition of virus growth and fu zheng corresponds to immune regulation, inflammation control, and tissue protection in the host. In this review, current progress in using TCMs against respiratory viruses is summarized according to modern biological theories. The prospects for developing TCMs against respiratory viruses is discussed to provide a reference for the research and development of innovative TCMs with multiple components, multiple targets, and low toxicity.

Background The role of α1 adrenergic receptors (α1-ARs) signaling pathway in the pathogenesis of Alzheimer’s disease (AD) has rarely been investigated. Clarifying pathophysiological functions of α1-ARs in the AD brain is helpful for better understanding the pathogenesis and screening novel therapeutic target of AD. Methods This study included 2 arms of in vivo investigations: 1) 6-month-old female APPswe/PS1 mice were intravenously treated with AAV-PHP.eB-shRNA (ARs)-GFP or AAV-PHP.eB-GFP for 3 months. 2) 3-month-old female APPswe/PS1 mice were daily treated with 0.5 mg/kg terazosin or equal saline for 6 months. SH-SY5Y cell lines bearing human Amyloid precurssor protein were treated with terazosin or saline for investigating possible mechanisms. Results α1-ARs knockdown mice exhibited improved behavioral performances than control mice. α1-ARs knockdown mice had significantly lower brain amyloid burden, as reflected by soluble Aβ species, compact and total plaques, than control mice. The α1-ARs inhibitor terazosin substantially reduced Aβ deposition, attenuated downstream pathologies including Tau hyperphosphorylation, glial activation, neuronal loss, synaptic dysfunction, and rescued behavioral deficits of APPswe/PS1 mice. In vitro investigation demonstrated that α1-ARs inhibition down-regulated BACE1 expression, and promoted ser9 phosphorylation of GSK-3β, thus reduced Aβ production. Conclusions This study indicates that inhibition of α1-ARs signaling pathway might represent a promising therapeutic strategy for AD.

A highly efficient and stable electrocatalyst with the novel heterostructure of Co-embedded and N-doped carbon nanotubes supported Mo2C nanoparticles (Mo2C/NCNTs@Co) is creatively constructed by adopting the one-step metal catalyzed carbonization-nitridation strategy. Systematic characterizations and density functional theory (DFT) calculations reveal the advanced structural and electronic properties of Mo2C/NCNTs@Co heterostructure, in which the Co-embedded and N-doped CNTs with tunable diameters present electron-donating effect and the work function is correspondingly regulated from 4.91 to 4.52 eV, and the size-controlled Mo2C nanoparticles exhibit Pt-like 4d electronic structure and the well matched work function (4.85 eV) with I-/I3- redox couples (4.90 eV). As a result, the conductive NCNTs@Co substrate with fine-tuned energy level alignment accelerates the electron transportation and the electron migration from NCNTs@Co to Mo2C, and the active Mo2C shows high affinity for I3- adsorption and high charge transfer ability for I3- reduction, which reach a decent synergetic catalytic effect in Mo2C/NCNTs@Co heterostructure. The DSSC with Mo2C/NCNTs@Co CE achieves a high photoelectric conversion efficiency of 8.82% and exceptional electrochemical stability with a residual efficiency of 7.95% after continuous illumination of 200 h, better than Pt-based cell. Moreover, the synergistic catalytic mechanism toward I3- reduction is comprehensively studied on the basis of structure-activity correlation and DFT calculations. The advanced heterostructure engineering and electronic modulation provide a new design principle to develop the efficient, stable, and economic hybrid catalysts in relevant electrocatalytic fields.

Aims and objectives To explore whether the risk of peripheral venous catheters failure remained constant throughout catheter use in adult patients. Background Peripheral venous catheters, widely used in adult patients, may have a critical threshold dwell time associated with increased risk of catheter failure. Design Prospective, observational study. We have complied with the STROBE checklist of items. Methods This study was conducted from July-October 2018 in Hunan, China. Data on patient factors, catheter factors and catheter failure events were collected. Poisson regression was used to assess the effect of catheter dwell time on catheter failure while adjusting for other variables. Results A total of 1,477 patients were included in the analysis. There were 854 cases (57.8%) of catheter failure. The median dwell time to catheter failure was 52 hr (interquartile range: 36-73 hr). The incidence rate of catheter failure significantly increased by 1.1%/h in the first 38 hr after catheter insertion. From 39-149 hr, the incidence rate significantly decreased, and at >149 hr, there was no significant change in the incidence rate. Meanwhile, factors such as vascular quality and infused drugs showed having an impact on catheter failure events. Conclusions The risk of catheter failure may not remain constant throughout the dwell time. The results suggest that nurses should assess the insertion site frequently in the first 38 hr. Relevance to clinical practice The significant increase in the risk of catheter failure per hour may warrant close and frequent inspection of insertion site during the first 38 hr.

BACKGROUND Bortezomib is a first-line drug approved for patients with multiple myeloma (MM) and has significantly increased their overall survival. However, bortezomib-induced peripheral neuropathy (PN) remains a significant side effect that has led to its discontinuation in some patients. Guillain-Barré syndrome (GBS) is recognized as an immune-mediated PN characterized by the involvement of multiple nerve roots and peripheral nerves and albuminocytologic dissociation in cerebrospinal fluid (CSF) tests. Intravenous immunoglobulin (IVIG) and plasmapheresis are effective. CASE SUMMARY A 45-year-old man diagnosed with stage III MM (λ type) was treated with bortezomib and dexamethasone. Fourteen days after the second course, he complained of intense burning sensation in the lower limbs and hands, loss of tactile sensation, and pain in the distal area of both thighs and in the distal part of both wrist joints. Neurological examination revealed absence of knee and ankle reflexes. CSF examination revealed albuminocytologic dissociation. Nerve conduction studies indicated sensory nerve action potential amplitudes, conduction velocity decrease, and F wave latency prolongation. He was diagnosed as MM complicated with GBS. Subsequently, he was treated with high-dose IVIG (400 mg/kg/d for five days). His symptoms fully resolved without relapse at the 6-month follow-up. CONCLUSION Our case highlights the differential diagnosis and management of complications after bortezomib treatment in MM.

Purpose To compare the incidence of diabetic ketoacidosis (DKA) among patients with type 2 diabetes mellitus (T2DM) who were new users of sodium glucose co‐transporter 2 inhibitors (SGLT2i) versus other classes of antihyperglycemic agents (AHAs). Methods Patients were identified from four large US claims databases using broad (all T2DM patients) and narrow (intended to exclude patients with type 1 diabetes or secondary diabetes misclassified as T2DM) definitions of T2DM. New users of SGLT2i and seven groups of comparator AHAs were matched (1:1) on exposure propensity scores to adjust for imbalances in baseline covariates. Cox proportional hazards regression models, conditioned on propensity score‐matched pairs, were used to estimate hazard ratios (HRs) of DKA for new users of SGLT2i versus other AHAs. When I2

Objectives To investigate the pathogenicity of Klebsiella pneumoniae (KPN) possessing rmpA or the aerobactin gene in infected mice. Methods BALB/c mice were divided into four groups (n = 10 per group) and infected with: string test-positive and rmpA-positive or aerobactin-positive KPN (group 1), string test-negative but rmpA-positive KPN (group 2), string test-negative but aerobactin-positive KPN (group 3), or string test- and rmpA/aerobactin-negative KPN (group 4). Mouse survival time was compared among groups, and the infection of livers, spleens, lungs, and kidneys and KPN growth were assessed in infected mice. Results Compared with the negative group (group 4), the survival rates of mice infected with rmpA- or aerobactin-positive KPN (groups 1–3) were significantly lower, their multi-organ injuries were significantly more severe, and bacterial enumeration was significantly higher. Conclusions Despite being string test-negative, aerobactin- or rmpA-positive KPN still exhibit high virulence and anti-immune effect activity. Therefore, the combination of the string test and gene detection of aerobactin and rmpA will be helpful in screening hypervirulent KPN.

Objective: To assess long-term healthcare costs related to ischemic stroke and systemic embolism (stroke/SE) and major bleeding (MB) events in patients with non-valvular atrial fibrillation...

Objective: The endothelial glycocalyx (eGC) is a dynamic and multicomponent layer of macromolecules found at the surface of vascular endothelium, which is largely underappreciated. It has recently been recognized that eGC is a major regulator of endothelial function and may have therapeutic value in organ injuries. This study aimed to explore the role of the eGC in various pathologic and physiologic conditions, by reviewing the basic research findings pertaining to the detection of the eGC and its clinical significance. We also explored different pharmacologic agents used to protect and rebuild the eGC. Data sources: An in-depth search was performed in the PubMed database, focusing on research published after 2003 with keywords including eGC, permeability, glycocalyx and injuries, and glycocalyx protection. Study selection: Several authoritative reviews and original studies were identified and reviewed to summarize the characteristics of the eGC under physiologic and pathologic conditions as well as the detection and protection of the eGC. Results: The eGC degradation is closely associated with pathophysiologic changes such as vascular permeability, edema formation, mechanotransduction, and clotting cascade, together with neutrophil and platelet adhesion in diverse injury and disease states including inflammation (sepsis and trauma), ischemia-reperfusion injury, shock, hypervolemia, hypertension, hyperglycemia, and high Na+ as well as diabetes and atherosclerosis. Therapeutic strategies for protecting and rebuilding the eGC should be explored through experimental test and clinical verifications. Conclusions: Disturbance of the eGC usually occurs at early stages of various clinical pathophysiologies which can be partly prevented and reversed by protecting and restoring the eGC. The eGC seems to be a promising diagnostic biomarker and therapeutic target in clinical settings. Key words: Endothelial glycocalyx; Permeability; Injuries; Glycocalyx protection

ChinaPurpose: To compare the diagnostic efficiency of 68Gallium labelled prostate-specific membrane antigen positron emission tomography (68Ga-PSMA PET) and magnetic resonance imaging (MRI) for staging the lymph node metastases (LNMs) in the prostate cancer. Materials and Methods: A broad search of scientific databases including PubMed, EMBASE, Web of Science, Cochrane Database, and Chinese Biomedicine Literature Database (updated prior to November 1st, 2018) was conducted systematically by two reviewers. In this paper, we evaluated the methodological quality of each included article independently and performed a systematic review and meta-analysis to reveal the summary of the diagnostic performance of 68Ga-PSMA PET and MRI in properly identifying LNMs of intermediate- and/or high-risk prostate cancer.Results: Thirteen eligible articles comprising 1,597 patients were included. For LNMs detection, the pooled sensitivity and specificity of 68Ga-PSMA PET were 0.65 (95% confidence interval [CI]: 0.49–0.79) and 0.94 (95% CI: 0.88–0.97), respectively, while the corresponding values of MRI were 0.41 (95% CI: 0.26–0.57) and 0.92 (95% CI: 0.86–0.95). The area under the symmetric receiver-operating characteristic (SROC) curve for 68Ga-PSMA PET and MRI were 0.92 and 0.83, respectively. Conclusions: In intermediate- or high-risk pre-treatment prostate cancer, 68Ga-PSMA PET had a higher sensitivity and a slightly different specificity in probing the LNMs when comparing with MRI. Moreover, the area under the SROC curve indicated that 68Ga-PSMA PET was a more effective weapon for predicting the LNMs prior to radical surgery.

Suture and autologous nerve transplantation are the primary therapeutic measures for completely severed nerves. However, imbalances in the microenvironment and adhesion of surrounding tissues can affect the quality of nerve regeneration and repair. Previous studies have shown that human amniotic membrane can promote the healing of a variety of tissues. In this study, the right common peroneal nerve underwent a 5-mm transection in rats. Epineural nerve repair was performed using 10/0 non-absorbable surgical suture. The repair site was wrapped with a two-layer amniotic membrane with α-cyanoacrylate rapid medical adhesive after suture. Hindlimb motor function was assessed using footprint analysis. Conduction velocity of the common peroneal nerve was calculated by neural electrical stimulation. The retrograde axoplasmic transport of the common peroneal nerve was observed using fast blue BB salt retrograde fluorescent staining. Hematoxylin-eosin staining was used to detect the pathological changes of the common peroneal nerve sputum. The mRNA expression of axon regeneration-related neurotrophic factors and inhibitors was measured using real-time polymerase chain reaction. The results showed that the amniotic membrane significantly improved the function of the injured nerve; the toe spread function rapidly recovered, the nerve conduction velocity was restored, and the number of fast blue BB salt particles were increased in the spinal cord. The amniotic membrane also increased the recovery rate of the tibialis anterior muscle and improved the tissue structure of the muscle. Meanwhile, mRNA expression of nerve growth factor, growth associated protein-43, collapsin response mediator protein-2, and brain-derived neurotrophic factor recovered to near-normal levels, while Lingo-1 mRNA expression decreased significantly in spinal cord tissues. mRNA expression of glial-derived neurotrophic factor did not change significantly. Changes in mRNA levels were more significant in amniotic-membrane-wrapping-treated rats compared with model and nerve sutured rats. These results demonstrate that fresh amniotic membrane wrapping can promote the functional recovery of sutured common peroneal nerve via regulation of expression levels of neurotrophic factors and inhibitors associated with axonal regeneration. The study was approved by the Committee on Animal Research and Ethics at the Affiliate Hospital of Zunyi Medical University, China (approval No. 112) on December 1, 2017.

Background Ischemic post-conditioning (IPO) is a strategy in reducing myocardial ischemic-reperfusion (I/R) injury, but its specific molecular mechanism is incompletely understood. Deletions or mutations in the DJ-1 gene are directly linked to the cardiovascular system. DJ-1 plays a critical role in regulating mitochondrial homeostasis in response to stress through translocation of DJ-1 from the cytoplasm into the nucleus. Meanwhile, how the DJ-1 is removed in myocardial I/R injury and regulating apoptosis is needed to further verified. Given the discovery mentioned above, we hypothesize that DJ-1 translocate to mitochondria recover IPO induced cardioprotection in STZ-induced diabetic rats. To evaluate our hypothesis, we overexpressed the DJ-1 protein under high glucose condition, subjected IPO or not. And then measure the expression of DJ-1 in mitochondria and cytoplasm after myocardial I/R. Results We found that DJ-1 translocated to mitochondria combined with Bcl-xL was reduced cardiomyocyte injury and apoptosis in diabetic myocardial I/R heart. Additionally, the binding of DJ-1 and Bcl-xL is dependent on the oxidative state of DJ-1(oxidation of DJ-1 at Cys-106 is important for its protective effect). Conclusions If our hypothesis is correct, promote DJ-1 mitochondrial transfer may be critical with respect to restoring myocardial responsiveness to IPO in diabetes.

Background Numerous studies have shown that major depressive disorder (MDD) is characterized by a range of impairments in emotional and cognitive functions that are closely related to abnormalities in brain structure and function. Cognitive behavioral therapy (CBT) can be used as treatment for mild to moderate MDD, which can assist with ameliorating the symptoms. Previous studies have assumed that the internal fluctuations throughout the entire scan are static. However, it has recently been suggested that the brain connectivity is dynamic and relative to continuous rhythmic activity. The effect of dynamic changes in CBT on MDD patients is unknown. Methods Nineteen first-episode, unmedicated MDD patients and twenty-two healthy controls (HC) participated in the study. The patients received early CBT treatment once a week for 6 weeks. Symptom examinations and magnetic resonance imaging (MRI) scans were performed pre and post treatment. Degree centrality (DC) was used to investigate the whole-brain connectivity differences between patients with MDD and healthy controls, and sliding window correlation analysis was applied to investigate the dynamic changes of functional connectivity among MDD patients treated with CBT. The variance of dynamic functional connectivity (dFC) was calculated to evaluate the temporal variability along the time. Results Patients with MDD showed abnormal DC in dorsolateral prefrontal cortex (dlPFC), insula and postcentral gyrus. Correlation analysis revealed that degree centrality of dlPFC was negatively correlated with the course of disease in patients with MDD. Results of dynamic functional connectivity showed that, compared to HC, MDD patients-remained excessively stable in dlPFC and precuneus connectivity, which is associated with emotional cognitive symptoms. After CBT, patients showed increased dFC variability in dlPFC and precuneus (p Conclusion DLPFC plays an important role in pathophysiological mechanism of MDD. CBT helped patients suppress redundant thoughts and negative self-focus. As a connecting node, dlPFC participates in the mechanism of action of CBT.