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Elliptical elements are essential optical surfaces for modifying optical systems. For polishing the whole elliptical surface using doughnut-shaped MCF polishing tool with variable tilt angle, an experimental investigation was conducted in this work. Firstly, a flat workpiece was polished to determine the polishing feasibility. It was found that the middle portion of the polishing tool had optimal ability to remove materials, and the surface roughness Sa at the material removal peak was changed from 134 nm to 17.5 nm within 50 min of polishing. A smoother surface could be obtained using MCF2 slurry and MCF3 slurry, but the use of MCF1 slurry resulted in a rough surface. Then, the effects of working gap h, revolution speed of MCF polishing tool and polishing time on the polishing results were tested to study the polishing characteristics. Sa 9.6 nm and glossiness 278 Gu were obtained, and form error improved from 2.3 μm to 1.3 μm. Finally, the MCF polishing tool was dried to observe the microstructure of the MCF polishing tool after polishing. Abrasive particles were distributed evenly after polishing. It was seen that the abrasive particles were grabbed by the ferric clusters, and the α-celluloses were interleaved between the clusters.

MAX phase materials, exhibiting excellent antioxidation, corrosion resistance and high electrical and optical conductivity, attract much attention. The nonlinear optical properties of the MAX phase Ti2AlC was demonstrated by measuring the saturable absorption of Ti2AlC- polyvinyl (PVA) film. The modulation depth of the Ti2AlC-PVA film is calculated to be 2.21%. Stable Q-switched and mode-locked pulses train were achieved in Erbium-doped fiber ring cavity by using Ti2AlC-PVA film as a saturable absorber. The maximum single pulse energy of the Q-switched laser was 92.8 nJ, and the pulse width of the mode-locked laser was 680 fs. This study shows the great potential of MAX phase materials for ultrashort laser pulses generation and provides some valuable design guidelines for the preparation of SAs based on MAX phase materials.

BackgroundPituitary adenoma is one of the most common central nervous system tumors. The diagnosis and treatment of pituitary adenoma remain very difficult. Misdiagnosis and recurrence often occur, and experienced neurosurgeons are in serious shortage. A knowledge graph can help interns quickly understand the medical knowledge related to pituitary tumor. ObjectiveThe aim of this study was to develop a data fusion method suitable for medical data using data of pituitary adenomas integrated from different sources. The overall goal was to construct a knowledge graph for pituitary adenoma (KGPA) to be used for knowledge discovery. MethodsA complete framework suitable for the construction of a medical knowledge graph was developed, which was used to build the KGPA. The schema of the KGPA was manually constructed. Information of pituitary adenoma was automatically extracted from Chinese electronic medical records (CEMRs) and medical websites through a conditional random field model and newly designed web wrappers. An entity fusion method is proposed based on the head-and-tail entity fusion model to fuse the data from heterogeneous sources. ResultsData were extracted from 300 CEMRs of pituitary adenoma and 4 health portals. Entity fusion was carried out using the proposed data fusion model. The F1 scores of the head and tail entity fusions were 97.32% and 98.57%, respectively. Triples from the constructed KGPA were selected for evaluation, demonstrating 95.4% accuracy. ConclusionsThis paper introduces an approach to fuse triples extracted from heterogeneous data sources, which can be used to build a knowledge graph. The evaluation results showed that the data in the KGPA are of high quality. The constructed KGPA can help physicians in clinical practice.

ObjectiveThe purpose of this study was to verify that hypothalamus-pituitary dysfunction is one of the risk factors for postoperative central nervous system infections (PCNSIs).MethodWe performed a retrospective analysis of all patients with sellar region lesions who underwent surgery between January 2016 and November 2019 at Peking Union Medical College Hospital. In total, 44 age− and sex-matched controls were enrolled. Univariate and multivariate analyses were performed to identify risk factors for PCNSIs.ResultWe enrolled 88 patients, 44 of whom had PCNSIs. Surgical approach (TCS) (P

This article reviewed dataset collected from an array of 12 coastal Integrated Marine Observing System (IMOS) moorings off the southwest coast of Western Australia (WA) during 2009-2020, at depths ranging from 47 m to 500 m. The dataset includes temperatures and salinities collected with Seabird SBE37 and SBE39 sensors and Water Quality Monitor (WQM). Velocities were collected by Teledyne RDI Acoustic Doppler Current Profilers (ADCP) and Nortek ADCPs. Here, a daily gridded in-situ subsurface temperature, salinity and ocean currents, and their average annual cycles are presented. Monthly data are also included. This integrated dataset provides an overview of data availability and allows users to have a quick access to the mooring data, without the need of manipulating over one thousand files individually. This unique dataset offers an invaluable baseline perspective on physical water column properties and temporal variability in WA coastal waters. The data can be used to characterise subsurface features of extreme events such as marine heat waves, marine cold-spells, and to detect long-term change signals along WA coast, influenced by the Leeuwin Current and the wind-driven Capes Current.

BackgroundThere are no established accurate models that use machine learning (ML) methods to preoperatively predict immediate remission after transsphenoidal surgery (TSS) in patients diagnosed with histology-positive Cushing’s disease (CD).PurposeOur current study aims to devise and assess an ML-based model to preoperatively predict immediate remission after TSS in patients with CD.MethodsA total of 1,045 participants with CD who received TSS at Peking Union Medical College Hospital in a 20-year period (between February 2000 and September 2019) were enrolled in the present study. In total nine ML classifiers were applied to construct models for the preoperative prediction of immediate remission with preoperative factors. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the performance of the models. The performance of each ML-based model was evaluated in terms of AUC.ResultsThe overall immediate remission rate was 73.3% (766/1045). First operation (p

Extreme events have long been underestimated in the extent to which they shape the surface of our planet, our environment, its ecological integrity, and the sustainability of human society. Extreme events are by definition rarely observed, of significant impact and, as a result of their spatiotemporal range, not always easily predicted. Extremes may be short-term catastrophic events such as tsunamis, or long-term evolving events such as those linked to climate change; both modify the environment, producing irreversible changes or regime shifts. Whatever the driver that triggers the extreme event, the damages are often due to a combination of several processes and their impacts can affect large areas with secondary events (domino effect), whose effects in turn may persist well beyond the duration of the trigger event itself. Early studies of extreme events were limited to opportunistic approaches: observations were made within the context of naturally occurring events with high societal impact. Given that climate change is now moving us out of a relatively static climate regime during the development of human civilization, extreme events are now a function of underlying climate shifts overlain by catastrophic processes. Their impacts are often due to synergistic factors, all relevant in understanding process dynamics; therefore, an integrated methodology has become essential to enhance the reliability of new assessments and to develop strategies to mitigate societal impacts. Here we summarize the current state of extreme event monitoring in the marine system, highlighting the advantages of a multidisciplinary approach using Research Infrastructures for providing the temporal and spatial resolution required to monitor Earth processes and enhance assessment of associated impacts.

PurposeDyslipidemia has been frequently reported and associated with increased cardiovascular risk in patients with Cushing’s disease (CD). Few studies are available regarding the relationships between lipid abnormalities and other preoperative metabolic comorbidities in CD, and the data on alterations of the lipid profile after surgery is quite variable. We aimed to investigate the associations between hyperlipidemia and other baseline metabolic and hormonal parameters and the impact of surgical remission on lipid metabolism in patients with CD.MethodsThis retrospective study included 104 patients diagnosed with CD. Baseline hormonal and metabolic parameters were compared between the hyperlipidemia (HLP) group and non-hyperlipidemia (NLP) group, and their relationships with hyperlipidemia at diagnosis were evaluated. Alterations in lipid profiles after surgical remission of CD were evaluated in 65 patients with available follow-up data.ResultsUpon baseline, logistic regression analysis showed that impaired glucose metabolism (IGM) (OR=4.68, 95%CI:1.38–15.91) and morning cortisol levels (per 10 μg/dl change) (OR=1.81, 95%CI:1.11–2.95) are both independent risk factors of preoperative occurrence of hyperlipidemia in patients with CD. The baseline triglyceride (TG) level was positively correlated with systolic blood pressure (SBP) (r=0.297, p=0.003). Lipid abnormalities had improvement but may persist after surgical remission, and the persisted hyperlipidemia is associated with higher baseline total cholesterol (TC) levels (r=0.505, p=0.033).ConclusionsPersistence of post-surgery hyperlipidemia is associated with severe baseline lipid abnormalities. Surgical remission with concomitant control of impaired glucose metabolism at diagnosis may have significant implications for controlling hyperlipidemia and reducing cardiovascular risk in CD.

Breast cancer is the most common malignancy in women worldwide, and is responsible for more than half a million deaths each year. The appropriate therapy depends on the evaluation of the expression of various biomarkers, such as the human epidermal growth factor receptor 2 (HER2) transmembrane protein, through specialized techniques, such as immunohistochemistry or in situ hybridization. In this work, we present the HER2 on hematoxylin and eosin (HEROHE) challenge, a parallel event of the 16th European Congress on Digital Pathology, which aimed to predict the HER2 status in breast cancer based only on hematoxylin–eosin-stained tissue samples, thus avoiding specialized techniques. The challenge consisted of a large, annotated, whole-slide images dataset (509), specifically collected for the challenge. Models for predicting HER2 status were presented by 21 teams worldwide. The best-performing models are presented by detailing the network architectures and key parameters. Methods are compared and approaches, core methodologies, and software choices contrasted. Different evaluation metrics are discussed, as well as the performance of the presented models for each of these metrics. Potential differences in ranking that would result from different choices of evaluation metrics highlight the need for careful consideration at the time of their selection, as the results show that some metrics may misrepresent the true potential of a model to solve the problem for which it was developed. The HEROHE dataset remains publicly available to promote advances in the field of computational pathology.

During 1982–2021, the highest sea surface temperature (SST) variability over the North Pacific was in the Kuroshio-Oyashio Extension (KOE) region, with more intense marine heatwaves (MHWs), especially during summertime. In this study, we explored the evolution and driving factors of the strongest summer MHWs based on their cumulative intensity using satellite observations and reanalyzed model results. Strong summer MHWs in 1999, 2008, 2012, and 2016 were initiated and peaked around summer. The more recent summer MHW events in 2018, 2020, and 2021 appeared to be associated with intermittent MHW events in the previous winter that extended to boreal summer. Based on a mixed layer temperature budget analysis from March to their peaks in summer, MHWs in 1999, 2008, 2012, and 2016 were primarily driven by the air-sea heat flux anomalies, with anomalous shortwave radiation due to reduced cloud cover being the dominant factor. Summer MHWs in 2018, 2020, and 2021 were mainly contributed by the ocean memory of winter warming. The northward shift of the Kuroshio Extension axis, the northward intrusion of the anticyclonic eddies, and the decadal warming trend may contribute to the positive sea surface height anomalies and increased upper ocean heat content in the KOE to increase winter SST and precondition the summer MHWs. Understanding MHW variability and the underlying mechanisms will help manage the marine ecosystem of the KOE region, as well as predict climate change impacts.

In this study, ultra-high molecular weight polyethylene (UHMWPE) fibers reinforced rigid polyurethane (RPU) composites were prepared with the goal of improving strength and toughness. The satisfactory mechanical properties of the composites were mainly contributed to the copper-polydopamine composite coating. Polydopamine on the surface of UHMWPE fibers could react with polyurethane to form chemical bonds, leading to the improvement of material strength. Moreover, the deposited metal layer provided more paths for crack propagation in the composites, thus improved the toughness of the material. Compared with pure RPU, the tensile, interlaminar shear, and impact strength of polydopamine (PDA)-cooper (Cu) UHMWPE fibers/RPU composites were increased by 97.8%, 35.85%, and 2456.9%, respectively.

Abstract Capacitive deionization (CDI) is an emerging desalination technology for effective removal of ionic species from aqueous solutions. Compared to conventional CDI, which is based on carbon electrodes and struggles with high salinity streams due to a limited salt removal capacity by ion electrosorption and excessive co‐ion expulsion, the emerging Faradaic electrodes provide unique opportunities to upgrade the CDI performance, i.e., achieving much higher salt removal capacities and energy‐efficient desalination for high salinity streams, due to the Faradaic reaction for ion capture. This article presents a comprehensive overview on the current developments of Faradaic electrode materials for CDI. Here, the fundamentals of Faradaic electrode‐based CDI are first introduced in detail, including novel CDI cell architectures, key CDI performance metrics, ion capture mechanisms, and the design principles of Faradaic electrode materials. Three main categories of Faradaic electrode materials are summarized and discussed regarding their crystal structure, physicochemical characteristics, and desalination performance. In particular, the ion capture mechanisms in Faradaic electrode materials are highlighted to obtain a better understanding of the CDI process. Moreover, novel tailored applications, including selective ion removal and contaminant removal, are specifically introduced. Finally, the remaining challenges and research directions are also outlined to provide guidelines for future research.

Summary: Extreme fast charge (10 min to reach 80% state of charge) is one of the key limiting parameters preventing the widespread adoption of battery-based electric vehicles into the transportation sector. Many recent simulations and experimental-based studies have been recently published in this area with a specific focus on why extreme fast charge is challenging. These studies identified that cathode particle cracking and electrolyte transport limitation are the key barriers that have caused the well-known safety and stability problems. Interestingly, there have been very few studies that have demonstrated significant improvements toward a 10-min charge under high energy density conditions. Several strategies pertaining to electrolyte modifications (concentrated electrolyte and low viscosity additives) along with adaptive fast charging are highlighted and suggested.

Purpose: Silent corticotroph adenoma (SCA) is clinically non-functional pituitary adenoma with expression of corticotropin or Tpit. To further understand the characteristics of this rare type of SCA transforming to a functional SCA, we retrospectively reviewed SCAs that converted to typical Cushing's syndrome at a tertiary medical center and the relevant literature.Methods: Patients were identified based on the diagnosis of pituitary adenoma without symptoms of hypercortisolism at the initial visit with positive Immunohistochemical (IHC) staining for corticotropin or Tpit after surgery and subsequent transformation to functional SCAs during the follow-up period from March 1990 to January 2020 at Peking Union Medical College Hospital and in the literature. The characteristics of the clinical manifestations, biochemical results, imaging findings, pathology findings and outcome were analyzed.Results: Altogether, 16 patients were included in the study with an average age of 42.0 ± 12.48 (18–65) years at the first visit. Females were slightly predominant (F:M = 1.3:1). The median time of conversion from the nonfunctional to the functional type was 30 (13.0, 68.3) months. Once a functional SCA developed, the adrenocorticotropic hormone (ACTH) level and 24-h urine free cortisol were increased 3.8- (2.6, 12.9) and 5.3- (2.6, 19.3) fold, respectively, above the normal range. Approximately 50% of the patients had macrocystic changes on pituitary MRI. All 16 patients experienced 1–5 surgeries with a median of 2.5 (2.0, 4.0) surgeries. The proportion of patients with Ki-67 ≥ 3% increased from 22.2% (2/9) at the beginning to 50% (7/14) at the time of functional SCA diagnosis. Thirteen patients received radiotherapy, and 4 patients (30.8%) achieved remission. Four patients with refractory functional SCAs received temozolomide treatment with the normalization of cortisol in 4 cases and reduced tumor volume in 3 cases.Conclusion: In this study, all cases that transformed to functional SCAs were macroadenomas. Hypercortisolism was more severe in functional SCA patients. The tumors tended to have frequent recurrence and were highly invasive. Temozolomide could be a promising treatment for refractory functional SCA cases. Long-term follow-up is needed for nonfunctional SCAs since some cases have the potential to transform to clinical Cushing's syndrome.

Background: Some patients with acromegaly do not reach the remission standard in the short term after surgery but achieve remission without additional postoperative treatment during long-term follow-up; this phenomenon is defined as postoperative delayed remission (DR). DR may complicate the interpretation of surgical outcomes in patients with acromegaly and interfere with decision-making regarding postoperative adjuvant therapy.Objective: We aimed to develop and validate machine learning (ML) models for predicting DR in acromegaly patients who have not achieved remission within 6 months of surgery.Methods: We enrolled 306 acromegaly patients and randomly divided them into training and test datasets. We used the recursive feature elimination (RFE) algorithm to select features and applied six ML algorithms to construct DR prediction models. The performance of these ML models was validated using receiver operating characteristics analysis. We used permutation importance, SHapley Additive exPlanations (SHAP), and local interpretable model–agnostic explanation (LIME) algorithms to determine the importance of the selected features and interpret the ML models.Results: Fifty-five (17.97%) acromegaly patients met the criteria for DR, and five features (post-1w rGH, post-1w nGH, post-6m rGH, post-6m IGF-1, and post-6m nGH) were significantly associated with DR in both the training and the test datasets. After the RFE feature selection, the XGboost model, which comprised the 15 important features, had the greatest discriminatory ability (area under the curve = 0.8349, sensitivity = 0.8889, Youden's index = 0.6842). The XGboost model showed good discrimination ability and provided significantly better estimates of DR of patients with acromegaly compared with using only the Knosp grade. The results obtained from permutation importance, SHAP, and LIME algorithms showed that post-6m IGF-1 is the most important feature in XGboost algorithm prediction and showed the reliability and the clinical practicability of the XGboost model in DR prediction.Conclusions: ML-based models can serve as an effective non-invasive approach to predicting DR and could aid in determining individual treatment and follow-up strategies for acromegaly patients who have not achieved remission within 6 months of surgery.

Purpose: Cushing's disease (CD) is one of the most severe endocrine disorders and primarily affects women of reproductive age. The peripartum period has been observed to be a common time to develop CD. This study aims to retrospectively analyze the clinical characteristics of CD potentially associated with pregnancy and to evaluate relevant pregnancy outcomes.Methods: Patients who underwent surgery from January 2010 to May 2019 at Peking Union Medical College Hospital (PUMCH) with biochemically and pathologically confirmed CD were retrospectively analyzed. Pregnancy-associated CD was defined as CD onset during gestation or within 12 months after delivery or abortion. Data including demographics, biochemical tests, magnetic resonance imaging (MRI) findings, and disease outcomes were obtained from all patients by reviewing their medical records. Information regarding pregnancy was collected through a supplementary online questionnaire.Results: In a series of female patients (n = 70) of reproductive age with childbearing desire, 27.1% (n = 19) met the criteria for pregnancy-associated CD. The timing of diagnosis of pregnancy-associated CD was 2.7 ± 3.4 years after symptom onset, and the overall remission rate for these women was 89.5%. Three patients with pregnancy-associated CD developed hypertension during pregnancy, two of whom had new-onset hypertension at 16 weeks of gestation and one of whom had a complication of severe diabetes. The rates of spontaneous abortion and preterm birth among the women with pregnancy-associated CD were 26.3 and 28.6%, respectively. The proportions of all low-birth-weight (LBW) newborns (p = 0.002) and term LBW newborns (p = 0.033) were significantly higher in the pregnancy-associated CD group than in the non-pregnancy-associated CD group.Conclusions: In this study, a total of 27.1% of women of reproductive age with CD had pregnancy-associated CD, which might be induced by the hormonal milieu of pregnancy. An increased risk of having a LBW newborn was observed among mothers with pregnancy-associated CD. A high degree of clinical suspicion for CD may be warranted in the peripartum period. Patients with symptoms suspicious for CD throughout pregnancy and after childbirth, such as early-onset hypertension, severe hyperglycemia, and persistent weight gain, should be carefully diagnosed and closely monitored by clinicians.

Abstract An ocean downscaling model product, forced under the Representative Concentration Pathway 8.5 future climate change scenario, has been used to understand the ocean heat balance of the Indian Ocean in a warming climate. Toward the end of the 21th century, the model simulates a significant reduction of Indonesian throughflow (ITF) transport, which reduces the Pacific to Indian Ocean heat transport by 0.20 PW, whereas across 32°S in the Southern Indian Ocean (SIO), the southward heat transport is reduced by 0.28 PW, mainly contributed from the weakening western boundary current, the Agulhas Current (0.21 PW). The projected weakening of the Agulhas Current is to compensate for the reduction of the ITF transport, with additional contribution from the spin‐down of the SIO subtropical gyre. Thus, being amplified by the ocean circulation changes in the SIO, the projected Indian Ocean warming trend will be faster than the direct air‐sea heat flux input.

Modulation of the magnetic anisotropy by the electric field in epitaxial Fe3O4/PMN–PT multiferroic heterostructure is studied, which shows that the coercive field of Fe3O4 thin films can be decreased from 368 to 113 Oe by applying an electric field in PMN–PT [011] direction. Meanwhile, most shift of ferromagnetic resonance (FMR) field Hr ( $ \Delta {H_{{\rm r},[01\bar{1}]}} $ ) can reach up to −483 Oe by applying an external electric field. The giant shift of Hr from 251 to 9681 Oe is obtained as the sample rotated from θ = 90° (H // $ [{01\bar{1}} ] $ to θ = 0° (H // [100]) when the electric field was applied in Fe3O4/PMN–PT heterostructure.

Interfacial magnetism at transition-metal oxide interfaces is of tremendous interest. The emergence of ferromagnetism and a matrix-dependent charge transfer between Co and Mn ions in the interdiffusion region of compressively strained LaMnO3–LaCoO3 superlattices (SLs) were studied. The SLs exhibit considerable ferromagnetism, which is negligible in both constituents. This is explained by the matrix-dependent charge transfer between Co and Mn ions. That is, the valence state of diffused Co ions into LaMnO3 shifts from 3+ to 2+ by adopting one electron from Mn3+, inducing the same amount of Mn4+, while the Mn ions that diffuses into LaCoO3 remains Mn3+.

Marine heatwaves are climatic extremes with devastating and long-term impacts on marine ecosystems, fisheries and aquaculture. Here the authors use a range of ocean temperature observations to identify significant increases in marine heatwaves over the past century.

Abstract Background Diabetic patients have a higher risk factor for colorectal cancer (CRC) metastasis. Stearoyl-CoA desaturase 1 (SCD1), the main enzyme responsible for producing monounsaturated fatty acids(MUFA) from saturated fatty acids, is frequently deregulated in both diabetes and CRC. The function and mechanism of SCD1 in metastasis of CRC and its relevance to glucose remains largely unknown. Methods SCD1 expression levels were analyzed in human CRC tissues and the Cancer Browser database (https://genome-cancer.ucsc.edu/). CRC cell lines stably transfected with SCD1 shRNAs or vector were established to investigate the role of SCD1 in modulating migration and invasion of CRC cells. A glucose concentration gradient was set to investigate regulation of SCD1 in CRC relevant to diabetic conditions. Results The clinical data analysis showed high expression of SCD1 in CRC tissues with a negative correlation with the prognosis of CRC. In vitro experiments revealed that SCD1 increased CRC progression through promoting epithelial–mesenchymal transition (EMT). Lipidomic analysis demonstrated that SCD1 increased MUFA levels and MUFA administration could rescue migration and invasion defect of CRC cells induced by SCD1 knockdown. Furthermore, SCD1-mediated progression of CRC was promoted by carbohydrate response-element binding protein (ChREBP) in response to high glucose. Mechanistically, hyperglycemia-SCD1-MUFA induced CRC cell migration and invasion by regulating PTEN. Conclusions Our findings show that SCD1 promotes metastasis of CRC cells through MUFA production and suppressing PTEN in response to glucose, which may be a novel mechanism for diabetes-induced CRC metastasis.

Despite considerable achievement in the past few decades, medical system still faces critical challenges in China, including uneven distribution of medical resources, discrepancy in disease management, limited continuing education and insufficient research platform, which restrict the further improvement of healthcare in China. The 5th-generation mobile network (5G) has the characteristics of high speed and low latency. Taking the advantage of top-level design and leading technology, 5G may facilitate thee ffective settlement of the above mentioned problems and promote the development of healthcare system in China. DOI: 10.3969/j.issn.1672-6731.2019.09.002

Rapid restratification of the ocean surface boundary layer in the Indonesian-Australian Basin was captured in austral spring 2018, under the conditions of low wind speed and clear sky during the suppressed phase of Madden–Julian Oscillations (MJOs). Despite sunny days, strong diurnal variations of sea surface temperature (SST) were not observed until the wind speed became extremely low, because the decreasing wind speed modulated the latent heat flux. Combined with the horizontal advection of ocean current, the reduced upward heat loss inhibited the nighttime convective mixing and facilitated the restratification of the subsurface ocean layers. The surface mixed layer was thus shoaled up to 40 m in two days. The restratified upper ocean then sustained high SSTs by trapping heat near the sea surface until the onset of the MJO convection. This restratification process might be initialized under the atmospheric downwelling conditions during the suppressed phase of MJOs. The resulted high SSTs may affect the development and trajectories of MJOs, by enhancing air-sea heat and moisture fluxes as the winds pick up. Simulating this detailed interaction between the near-surface ocean and atmospheric features of MJOs remains a challenge, but with sufficient vertical resolution and realistic initial conditions, several features of the observations can be well captured.

Objective The goal of this study was to investigate the effects of dietary standard ileal digestible (SID) valine:lysine ratios on performance, intestinal morphology, amino acids of liver and muscle, plasma indices and mRNA expression of branched-chain amino acid (BCAA) metabolism enzymes. Methods A total of 144 crossbred pigs (Duroc×Landrace×Large White) weaned at 28±4 days of age (8.79±0.02 kg body weight) were randomly allotted to 1 of 4 diets formulated to provide SID valine:lysine ratios of 50%, 60%, 70%, or 80%. Each diet was fed to 6 pens of pigs with 6 pigs per pen (3 gilts and 3 barrows) for 28 days. Results Average daily gain increased quadratically (p

Abstract The Indonesian Throughflow (ITF) is an important component of the upper cell of the global overturning circulation that provides a low-latitude pathway for warm, fresh waters from the Pacific to enter the Indian Ocean. Variability and changes of the ITF have significant impacts on Indo-Pacific oceanography and global climate. In this paper, the observed features of the ITF and its interannual to decadal variability are reviewed, and processes that influence the centennial change of the ITF under the influence of the global warming are discussed. The ITF flows across a region that comprises the intersection of two ocean waveguides—those of the equatorial Pacific and equatorial Indian Ocean. The ITF geostrophic transport is stronger during La Niñas and weaker during El Niños due to the influences through the Pacific waveguide. The Indian Ocean wind variability associated with the Indian Ocean Dipole (IOD) in many years offsets the Pacific ENSO influences on the ITF geostrophic transport during the developing and mature phases of El Niño and La Niña through the Indian Ocean waveguide, due to the co-varying IOD variability with ENSO. Decadal and multi-decadal changes of the geostrophic ITF transport have been revealed: there was a weakening change from the mid-1970s climate regime shift followed by a strengthening trend of about 1Sv every 10 year during 1984–2013. These decadal changes are mostly due to the ITF responses to decadal variations of the trade winds in the Pacific. Thus, Godfrey’s Island Rule, as well as other ITF proxies, appears to be able to quantify decadal variations of the ITF. Climate models project a weakening trend of the ITF under the global warming. Both climate models and downscaled ocean model show that this ITF weakening is not directly associated with the changes of the trade winds in the Pacific into the future, and the reduction of deep upwelling in the Pacific basin is mainly responsible for the ITF weakening. There is a need to amend the Island Rule to take into account the contributions from the overturning circulation which the current ITF proxies fail to capture. The implication of a weakened ITF on the Indo-Pacific Ocean circulation still needs to be assessed.

Growth hormone (GH)-secreting pituitary adenoma is a chronic disease characterized by excess levels of GH and insulin-like growth factor 1 (IGF-1). Based on our clinical experience and observations, we identified discordant GH and IGF-1 levels after surgery. The risk factors for this phenomenon are unclear, and individualized cure, control criteria, and management after surgery should be considered. Purpose: This study aims to investigate the factors affecting the discordant GH and IGF-1 levels after pituitary surgery in acromegalic patients. Methods: We retrospectively analyzed 146 patients diagnosed with acromegaly caused by GH-secreting pituitary adenoma who had undergone trans-sphenoidal adenectomy (TSA) at Peking Union Medical College Hospital in 2013. Medical histories were obtained for all patients. Hormone levels, biochemical measurements of liver and renal function, and tumor size were recorded before and 3 months after surgery. Results: Among the GH-cured patients who had normal GH levels after TSA, 39.2% (20 of 51) had elevated IGF-1. Acromegalic patients with elevated IGF-1 and normal GH levels after TSA had a significantly higher mean body mass index and percentage of upper limit of normal range IGF-1 than the cured patients (p 25.0 kg/m2 and a percentage of upper limit of normal range IGF-1 higher than 141.5 before TSA might predict the occurrence of hormone-level discordance after surgery. Conclusion: Body mass index and percentage of upper limit of normal range IGF-1 before TSA might constitute prognostic risk factors for discordance in IGF-1 and GH levels in acromegaly. Additional attention should be devoted to potential risk factors for this phenomenon, and methods for modifying the cure and control criteria for acromegaly should be developed.

The Medium-Earth-Orbit SAR (MEOSAR) is one of the potential spaceborne SAR of next-generation owing to its excellent performance. Ionospheric effects analysis is one of the critical techniques for the development of MEOSAR. The spatio-temporal variability of the ionosphere is analyzed using the measured ionosphere data. The factors and the mechanism of ionospheric effects on MEOSAR are studied based on the spatio-temporal variability of the ionosphere and the characteristics of MEOSAR such as long synthetic aperture time, wide swath, and high orbit. The results reveal that there are many differences in the ionospheric effects between MEOSAR and LEOSAR.

Abstract Episodic anomalously warm sea surface temperature (SST) extremes, or marine heatwaves (MHWs), amplify ocean warming effects and may lead to severe impacts on marine ecosystems. MHW-induced coral bleaching events have been observed frequently in recent decades in the southeast Indian Ocean (SEIO), a region traditionally regarded to have resilience to global warming. In this study, we assess the contribution of El Niño-Southern Oscillation (ENSO) to MHWs across the mostly understudied reefs in the SEIO. We find that in extended summer months, the MHWs at tropical and subtropical reefs (divided at ~20°S) are driven by opposite ENSO polarities: MHWs are more likely to occur at the tropical reefs during eastern Pacific El Niño, driven by enhanced solar radiation and weaker Australian Monsoon, some likely alleviated by positive Indian Ocean Dipole events, and at the subtropical reefs during central Pacific La Niña, mainly caused by increased horizontal heat transport, and in some cases reinforced by local air-sea interactions. Madden-Julian Oscillations (MJO) also modulate the MHW occurrences. Projected future increases in ENSO and MJO intensity with greenhouse warming will enhance thermal stress across the SEIO. Implementing forecasting systems of MHWs can be used to anticipate future coral bleaching patterns and prepare management responses.

Purpose. To identify the characteristics of the physical and mental health status of patients with pituitary adenomas, explore the postoperative reversibility of impaired health status, and assess the impact of clinical characteristics, hormone levels, anxiety, depression, and disease stigma on health status. Methods. We prospectively enrolled 147 and 138 patients with nonfunctioning and secretory pituitary adenomas, respectively. Health status was evaluated in 8 domains using the 36-item Short-Form Health Survey before and 3 months after transsphenoidal surgery. The Self-Rating Anxiety Scale, the Self-Rating Depression Scale, and the Stigma Scale for Chronic Illness were used to assess the psychological status. Results. Compared with the healthy population reference values, general physical and mental health, social functioning, and role limitations due to physical and psychological health problems were all found to be significantly impaired in the adenoma patients. Health status was worse in patients with adrenocorticotropic hormone- (ACTH-) secreting and growth hormone- (GH-) secreting adenomas than in patients with nonfunctioning adenomas. Among the patients, 11.6% had anxiety and 30.9% had depression. Higher scores for anxiety, depression, and disease stigma; older age; higher body mass index; and tumor recurrence were independent risk factors for health status impairment in at least one domain. Physical function impairment and role limitations caused by physical health problems became worse after surgery, whereas the mental component of health status remained the same. Conclusion. Health status was impaired in patients with pituitary adenomas, especially secretory adenomas. Physical function and role limitations were worse 3 months after surgery than before surgery. Mental problems, old age, obesity, and tumor recurrence reduced health status.

Purpose: Abnormal glucose metabolism is one of the most frequent acromegaly complications. Improvement of glucose metabolism can be observed only in half of acromegaly patients after surgery. We aimed to investigate the risk factors for determining abnormal glucose metabolism before surgery in patients with acromegaly, and to explore the predictors of improved preoperative glucose intolerance after surgery.Methods: We retrospectively reviewed 64 patients who received transsphenoidal surgery for acromegaly. Growth hormone (GH), insulin-like growth factor-1 (IGF-1) and glucose metabolism were assessed before, immediately after, and 3 months after surgery. Glucose metabolic parameters included glycosylated hemoglobin (HbA1c), plasma glucose (PG), C-peptide (CP), insulin (INS), and the indices of β-cell function, insulin sensitivity, and insulin resistance (IR).Results: Preoperatively, 18 patients (28.1%) had diabetes (DM), 34 (53.1%) had prediabetes (PreDM), and 12 (18.8%) had normal glucose tolerance (NGT). All the indices of pancreatic β-cell function were significantly lower in patients with DM than those with PreDM and NGT (all P < 0.005). IGF-1 was significantly positively correlated with insulin sensitivity and IR (P < 0.05), while GH was not. Postoperatively, glucose tolerance was improved in 71.2% of patients (37/52) with preoperative glucose intolerance. Insulin sensitivity was increased, while β-cell function and IR were decreased in most patients after surgery, regardless of whether their acromegaly achieved remission. A multivariate logistic regression analysis revealed that preoperative fasting C-peptide (FCP, OR = 2.639, P = 0.022), disposition index (DI, OR = 1.397, P = 0.043) and Predictor-2 (OR = 0.578, P = 0.035) were determined to be the predictors for improved glucose tolerance status after surgery. Afterwards, through Receiver operating characteristic (ROC) analyses, FCP >2.445 ng/ml was the best independent predictor, with an 86.6% PPV (positive predictive value) and a 74.5% NPV (negative predictive value).Conclusions: Preoperative high FCP is a promising postsurgical predictor of improved glucose tolerance in patients with acromegaly. Oral glucose tolerance testing (OGTT) and HbA1c should be monitored regularly after surgery, and diabetes management should be adjusted based on the patient's latest glucose tolerance status.

Objective: Epidermal growth factor receptor (EGFR) has been found to localize in several human neoplasms and has been shown to have a significant correlation with adenomaigenesis and patient prognosis. EGFR is also overexpressed in pituitary corticotroph adenomas. However, its clinical significance and relationship with tumor behavior, especially tumor recurrence status, remain obscure. The purpose of the present study was to identify the expression patterns of EGFR and its downstream signaling pathway molecules in pituitary corticotroph adenomas and to investigate the association of EGFR with clinicopathological characteristics and tumor recurrence.Methods: Fifty-two sporadic pituitary adenoma specimens and six normal pituitary glands were collected. The expression levels of EGFR and its downstream signaling molecules in each sample were evaluated and quantified using immunohistochemistry and Western blot. The relationships of EGFR expression with clinicopathological characteristics and tumor recurrence status were analyzed.Results: EGFR was overexpressed in 55.8% of the pituitary corticotroph adenomas and in 1 of 6 of the normal adenohypophysial tissues. The expression degree was significantly higher in pituitary corticotroph adenomas than in normal adenohypophysial tissues. In EGFR-overexpressing adenomas, the downstream pathway phosphorylated Erk (p-Erk) was also significantly activated. Moreover, the expression levels of EGFR were positively correlated with the adrenocorticotropic hormone (ACTH) and cortisol levels but were not correlated with age, sex or symptom duration. The expression levels of EGFR, phosphorylated EGFR (p-EGFR) and p-Erk were significantly up-regulated in the recurrent adenoma group compared with those in the non-recurrent adenoma group (all p < 0.05). The expression levels of EGFR were strongly correlated with the recurrence-free interval (p = 0.005, CC = −0.31).Conclusion: The expression levels of EGFR and its downstream pathway components were significantly increased in pituitary corticotroph adenomas compared to the levels in normal adenohypophysial tissues. EGFR expression levels were positively associated with the ACTH and cortisol levels and with tumor recurrence status. Pituitary corticotroph adenomas with high EGFR expression levels were correlated with an increased recurrence rate and a decreased recurrence-free interval. EGFR could be used as a promising biomarker for predicting pituitary corticotroph tumor recurrence.

Background: Prediction of radiotherapeutic response before radiotherapy could help determine individual treatment strategies for patients with acromegaly.Objective: To develop and validate a machine-learning-based multiparametric MRI radiomics model to non-invasively predict radiotherapeutic response in patients with acromegaly.Methods: This retrospective study included 57 acromegaly patients who underwent postoperative radiotherapy between January 2008 and January 2016. Manual lesion segmentation and radiomics analysis were performed on each pituitary adenoma, and 1561 radiomics features were extracted from each sequence. A radiomics signature was built with a support vector machine using leave-one-out cross-validation for feature selection. Multivariable logistic regression analysis was used to select appropriate clinicopathological features to construct a clinical model, which was then combined with the radiomics signature to construct a radiomics model. The performance of this radiomic model was assessed using receiver operating characteristics (ROC) analysis and its calibration, discriminating ability, clinical usefulness.Results: At 3-years after radiotherapy, 25 patients had achieved remission and 32 patients had not. The clinical model incorporating seven clinical features had an area under the ROC (AUC) of 0.86 for predicting radiotherapeutic response, and performed better than any single clinical feature. The radiomics signature constructed with six radiomics features had a significantly higher AUC of 0.92. The radiomics model showed good discrimination abilities and calibration, with an AUC of 0.96. Decision curve analysis confirmed the clinical utility of the radiomics model.Conclusion: Using pre-radiotherapy clinical and MRI data, we developed a radiomics model with favorable performance for individualized non-invasive prediction of radiotherapeutic response, which may help in identifying acromegaly patients who are likely to benefit from radiotherapy.

The extreme Western Australia 2011 marine heatwave had a lasting effect on the marine ecosystem and after 7 years, only parts of the ecosystem have showed good signs of recovery. After the heatwave, scallop fisheries in the Abrolhos Is. and Shark Bay were closed for 3-5 years, while the Shark Bay crab fishery was closed for 18 months; these fisheries at the center of the heatwave have shown some improvement due to better protection of spawning stock and improved environmental conditions. Also at the center of the heatwave, Roe’s abalone suffered a catastrophic mortality and has not recovered as spawning stock remains very low. The Perth abalone stock which was outside the peak heatwave area had a major stock reduction but remained opened with reduced catches. The heatwave had a marked indirect effect on brown tiger prawns in Exmouth Gulf due to loss of seagrass habitat. The heatwave also resulted in a decline in western king prawn recruitment in Exmouth Gulf, to the north of heatwave center, but an improved recruitment in the cooler waters of Shark Bay. Western rock lobsters near the heatwave peak also appear to have been indirectly affected and have not recovered. Factors influencing the recovery rate from the heatwave appeared to be: species near their upper temperature range and/or sensitive to warming temperatures; spatial overlap between the warming event and species distribution; whether spawning stock was affected to the point of recruitment impairment; life-cycle duration of invertebrate (or habitat) species affected; and management intervention. This study provides a framework for managing the consequences of heatwaves on fisheries by highlighting the value of early identification of the event and its effect on fisheries and having flexible harvest strategies for early management intervention. This is particularly important as long-term increases in water temperatures will increase the frequency of marine heatwave events and the fisheries stocks would have less time for recovery.

Ocean boundary current systems are key components of the climate system, are home to highly productive ecosystems, and have numerous societal impacts. Establishment of a global network of boundary current observing systems is a critical part of ongoing development of the Global Ocean Observing System. The characteristics of boundary current systems are reviewed, focusing on scientific and societal motivations for sustained observing. Techniques currently used to observe boundary current systems are reviewed, followed by a census of the current state of boundary current observing systems globally. The next steps in the development of boundary current observing systems are considered, leading to several specific recommendations.

The Indonesian seas play a fundamental role in the coupled ocean and climate system with the Indonesian Throughflow (ITF) providing the only tropical pathway connecting the global oceans. Pacific warm pool waters passing through the Indonesian seas are cooled and freshened by strong air-sea fluxes and mixing from internal tides to form a unique water mass that can be tracked across the Indian Ocean basin and beyond. The Indonesian seas lie at the climatological center of the atmospheric deep convection associated with the ascending branch of the Walker Circulation. Regional SST variations cause changes in the surface winds that can shift the center of atmospheric deep convection, subsequently altering the precipitation and ocean circulation patterns within the entire Indo-Pacific region. Recent multi-decadal changes in the wind and buoyancy forcing over the tropical Indo-Pacific have directly affected the vertical profile, strength, and the heat and freshwater transports of the ITF. These changes influence the large-scale sea level, SST, precipitation and wind patterns. Observing long-term changes in mass, heat and freshwater within the Indonesian seas is central to understanding the variability and predictability of the global coupled climate system. Although substantial progress has been made over the past decade in measuring and modeling the physical and biogeochemical variability within the Indonesian seas, large uncertainties remain. A comprehensive strategy is needed for measuring the temporal and spatial scales of variability that govern the various water mass transport streams of the ITF, its connection with the circulation and heat and freshwater inventories and associated air-sea fluxes of the regional and global oceans. This white paper puts forward the design of an observational array using multi-platforms combined with high-resolution models aimed at increasing our quantitative understanding of water mass transformation rates and advection within the Indonesian seas and their impacts on the air-sea climate system.

Background: Prediction of tumor consistency before surgery is of vital importance to determine individualized therapeutic schemes for patients with acromegaly. The present study was performed to noninvasively predict tumor consistency based on magnetic resonance imaging and radiomics analysis.Methods: In total, 158 patients with acromegaly were randomized into the primary cohort (n = 100) and validation cohort (n = 58). The consistency of the tumor was classified as soft or firm according to the neurosurgeon's evaluation. The critical radiomics features were determined using the elastic net feature selection algorithm, and the radiomics signature was constructed. The most valuable clinical characteristics were then selected based on the multivariable logistic regression analysis. Next, a radiomics model was developed using the radiomics signature and clinical characteristics, and 30 patients with acromegaly were recruited for multicenter validation of the radiomics model. The model's performance was evaluated based on the receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), accuracy, and other associated classification measures. Its calibration, discriminating capacity, and clinical usefulness were also evaluated.Results: The radiomics signature established according to four radiomics features screened in the primary cohort exhibited excellent discriminatory capacity in the validation cohort. The radiomics model, which incorporated both the radiomics signature and Knosp grade, displayed favorable discriminatory capacity and calibration, and the AUC was 0.83 (95% confidence interval, 0.81–0.85) and 0.81 (95% confidence interval, 0.78–0.83) in the primary and validation cohorts, respectively. Furthermore, compared with the clinical characteristics, the as-constructed radiomics model is more effective in prediction of the tumor consistency in patients with acromegaly. Moreover, the multicenter validation and decision curve analysis suggested that the radiomics model was clinically useful.Conclusions: This radiomics model can assist neurosurgeons in predicting tumor consistency in patients with acromegaly before surgery and facilitates the determination of individualized therapeutic schemes.

The mode-1 semidiurnal internal tides that emanate from multiple sources in the Sulu-Sulawesi Seas are investigated using multi-satellite altimeter data from 1993–2020. A practical plane-wave analysis method is used to separately extract multiple coherent internal tides, with the nontidal noise in the internal tide field further removed by a two-dimensional (2-D) spatial band-pass filter. The complex radiation pathways and interference patterns of the internal tides are revealed, showing a spatial contrast between the Sulu Sea and the Sulawesi Sea. The mode-1 semidiurnal internal tides in the Sulawesi Sea are effectively generated from both the Sulu and Sangihe Island chains, forming a spatially inhomogeneous interference pattern in the deep basin. A cylindrical internal tidal wave pattern from the Sibutu passage is confirmed for the first time, which modulates the interference pattern. The interference field can be reproduced by a line source model. A weak reflected internal tidal beam off the Sulawesi slope is revealed. In contrast, the Sulu Island chain is the sole energetic internal tide source in the Sulu Sea, thus featuring a relatively consistent wave and energy flux field in the basin. These energetic semidiurnal internal tidal beams contribute to the frequent occurrence of internal solitary waves (ISWs) in the study area. On the basis of the 28-year consistent satellite measurements, the northward semidiurnal tidal energy flux from the Sulu Island chain is 0.46 GW, about 25% of the southward energy flux. For M2, the altimetric estimated energy fluxes from the Sulu Island chain are about 80% of those from numerical simulations. The total semidiurnal tidal energy flux from the Sulu and Sangihe Island chains into the Sulawesi Sea is about 2.7 GW.