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Additional file 4: Table S3. Dunn index comparison with concatenation, COCA, SNF and ANF in six different cancer data set.

Additional file 6: Fig. S1. Parameter selection for RWRF and RWRNF. a P values for log-rank test varies with parameter γ. b Dunn values varies with parameter γ.

Additional file 2: Table S1. Dunn index comparison before and after the fusion in six different cancer data set.

Background Scarring alopecia in systemic lupus erythematosus (SLE) patients caused reduced life quality and prolonged disease course. This case-control study aims to survey the prevalence of scarring alopecia during the disease course of SLE and evaluate the risk factors for scarring alopecia in Chinese SLE patients. Methods SLE patients in Chinese SLE treatment and Research group (CSTAR) were recruited. Scarring alopecia was defined according to SLICC/ACR-DI which was collected during follow-up visits or via self-reported questionnaires. We collected demographic characteristics, common comorbidities, autoantibody profiles, disease activity status, major organ involvements, and treatment strategies of these patients at registry. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for scarring alopecia. Results We recruited 4792 SLE patients, and 374 (7.80%) patients had scarring alopecia. Mucocutaneous lesions (OR 2.062, p p p = 0.029) were risk factors for scarring alopecia, while renal (OR 0.714, p = 0.028) and cardio-respiratory involvements (OR 0.347, p = 0.044), and immunosuppressant treatment (OR 0.675, p Conclusions The prevalence of scarring alopecia in SLE patients is 7.80%. Active treatment strategies should be adopted to prevent scarring alopecia occurring.

Additional file 8: Fig. S3. Anti-noise ability of RWRF and RWRNF. NMI between cluster labels obtained by spectral clustering of the RWRF (and RWRNF) fused similarity matrix and the simulated ground truth varies with parameter standard deviation of Gaussian noise (a), parameter α of Gamma noise (b) and parameter β of Gamma noise (c).

Additional file 9: Fig. S4. Artificial multi-omics datasets that verifies the anti-noise ability of RWRF and RWRNF. a The heatmaps of the generated methylation data, gene expression data and protein expression data. b, c The similarity heatmaps (after network clustering) of the methylation data, gene expression data and protein expression data. d The similarity heatmap (after network clustering) of the integrated network by using RWRF. e The similarity heatmap (after network clustering) of the integrated network by using RWRNF. The heatmaps of the methylation data, gene expression data and protein expression data are plotted by using “InterSIM” R package.

Objective To investigate the protective efficacies and potent mechanisms of combination therapy with semaglutide and rosiglitazone (RSG) on the high-glucose incubated human ARPE-19 cells and diabetic retinopathy (DR) model rats. Main methods The CCK-8 methods were used to evaluate the protective effects of semaglutide and RSG alone or combination on the cell viability of high-glucose treated ARPE-19 cells. After the DR rat model was established, the effects of combined treatment on general indexes, retinal morphological changes, retinal Muller cells as well as PI3K/Akt/MTOR related factors of DR model rats were investigated. Results The CCK-8 assay showed obviously enhanced protective efficacies of combination therapy with semaglutide and RSG on the ARPE-19 with oxidative stress induced by high-glucose with combination index all below 1.5 demonstrating obvious synergistic effects. Combined incubation could also effectively decrease the expression of inflammatory factors, including TNF-α, IL-1β, IL-6, and the increase of ROS content in ARPE cell culture supernatant induced by high-glucose. Combined use of the antioxidant, PI3K/Akt and mTOR inhibitors, we further demonstrated that combined incubation of semaglutide and RSG could effectively by reduce high glucose-induced inflammatory injury inhibiting ROS/PI3K/Akt/mTOR signaling. Furthermore, chronic combination treatment effectively improved the histopathological characteristics and down-regulated the GFAP expression in Muller cells as well as PI3K/Akt/MTOR signaling pathway-related factors in retina which was better than any monomer treatment group. Conclusions Combined semaglutide with RSG exhibited synergistically protective efficacies on retinal cells by decreasing the GFAP expression, inhibiting oxidative stress and PI3K/Akt/MTOR signaling-transduction in DR model rats.

Background: Scarring alopecia in systemic lupus erythematosus (SLE) patients caused reduced life quality and prolonged disease course. This case control study aims to survey the prevalence of scarring alopecia during the disease course of SLE and evaluate the risk factors for scarring alopecia in Chinese SLE patients. Methods: SLE patients in Chinese SLE treatment and Research group (CSTAR) were recruited. Scarring alopecia was defined according to SLICC/ACR-DI which was collected during follow-up visits or via self-reported questionnaires. We collected demographic characteristics, common comorbidities, autoantibody profiles, disease activity status, major organ involvements and treatment strategies of these patients at registry. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for scarring alopecia. Results: We recruited 4792 SLE patients, and 374 (7.80%) patients had scarring alopecia. Mucocutaneous lesions (OR 2.062, pConclusions: The prevalence of scarring alopecia in SLE patients is 7.80%. Active treatment strategies should be adopted to prevent scarring alopecia occurring.

Objectives Pulmonary arterial hypertension is a life-threatening complication of systemic lupus erythematosus. However, there is no algorithm to identify those at high risk. We aimed to develop a prediction model for pulmonary arterial hypertension in lupus patients that provides individualized risk estimates. Methods A multicenter, longitudinal cohort study was undertaken from January 2003 to January 2020. The study collected data on 3,624 consecutively evaluated patients diagnosed with lupus. The diagnosis of pulmonary arterial hypertension was confirmed by right heart catheterization. Cox proportional hazards regression and least absolute shrinkage and selection operator were used to fit the model. Model discrimination, calibration, and decision curve analysis were assessed for validation. Results Ninety-two lupus patients developed pulmonary arterial hypertension (2.54%) at a median follow-up of 4.84 years (interquartile range, 2.42-8.84). The final prediction model included five clinical variables (acute/subacute cutaneous lupus, arthritis, renal disorder, thrombocytopenia, and interstitial lung disease) and three autoantibodies (anti-RNP, anti-Ro/SSA and anti-La/SSB). A 10-year pulmonary arterial hypertension probability-predictive nomogram was established. The model was internally validated by C statistic (0.78), the Brier score (0.03), and a satisfactory calibration curve. According to the net benefit and predicted probability thresholds, we recommend annual screening in high-risk (> 4.62 %) lupus patients. Conclusion We developed a risk stratification model using routine clinical assessments. This new tool may effectively predict the future risk of pulmonary arterial hypertension in patients with systemic lupus erythematosus.

BACKGROUND: Left heart involvement might be a differential factor in the physiopathology and prognosis of severe tricuspid regurgitation (TR) following cardiac surgery. We aimed to compare the outcomes of isolated tricuspid valve surgery (ITVS) after congenital versus left heart-disease surgery. METHODS: We retrospectively studied and followed up 58 patients who underwent ITVS for TR following cardiac surgery in our center from January 2012 to December 2017. According to the different etiologies of TR, the participants were divided into one group of TR following surgery for congenital heart diseases (CHD) (pCHD group, n=24), and another group of TR following surgery for left heart disease (pVHD group, n=34). RESULTS: Compared to the pCHD group, the pVHD group presented with a more advanced age (P

Gold nanoparticles (AuNPs) have attracted considerable interest in suppressing tumor cell migration, while small extracellular vesicles (sEVs) play an essential role in tumor metastasis by shaping the tumor microenvironment. Understanding how AuNPs alter sEV attributes is critical in antitumor medication design. In this study, mouse embryonic stem cells (mESCs) were treated with three sizes of AuNPs (i.e. 5 nm AuNPs, 20 nm AuNPs, and 80 nm AuNPs) to obtain sEVs (i.e. sEV-5, sEV-20, and sEV-80), which were characterized from the biophysical and proteomic aspects. When compared with the control (sEV-ctrl), sEV-5 possessed relatively higher rigidity, and a differentially expressed protein profile. It attenuated 4T1 tumor cell proliferation and migration through inhibiting cofilin expression and extracellular regulated protein kinase (Erk) phosphorylation, which was opposite to the effect induced by sEV-ctrl. In contrast, sEV-20 and sEV-80 had negligible effects. This study revealed for the first time that AuNP-5 exposure changed the biophysical properties and cellular functions of mESC-derived sEVs, providing a promising strategy for designing AuNP-based antitumor medication.

Using Chinese Simmental cattle semitendinosus, psoas major, and longissimus thoracis samples, we assessed muscle fiber characteristics and postmortem quality. The type I, IIA, and IIB fiber diameters were greater in semitendinosus and longissimus thoracis relative to psoas major, with psoas major, semitendinosus, and longissimus thoracis having the highest respective percentages of type I, IIB, and IIA fibers. Psoas major had the highest R 248 and R 250 values and lowest R 258 values at 1‐ and 6‐hr postmortem. Psoas major had the lowest Warner–Bratzler shear force (WBSF), hardness, and chewiness values. The trends of WBSF, hardness, and chewiness changes decreased with increasing aging time. Semitendinosus had higher changes in WBSF than psoas major, and the number % type I fibers was correlated negatively with % changes of WBSF. Therefore, muscles with a high proportion of type IIB fibers and a low proportion of type I had lower tenderness and higher tenderization rate. Further research should be done to seek the optimal composition of muscle fiber type in order to improve beef quality, as muscle fiber type has opposite effect of tenderness background and tenderization rate., Muscle fiber characteristics and postmortem quality of longissimus thoracis (LT), psoas major (PM), and semitendinosus (ST) from Chinese Simmental cattle were studied. Results showed that muscles with a high proportion of type IIB fibers and a low proportion of type I had lower tenderness and higher tenderization rate.

This paper proposes an impact-increment-based hybrid (IIHybrid) reliability assessment approach for power transmission systems. The proposed approach integrates the advantages of impact-increment-based state enumeration method (IISE) and impact-increment-based Monte Carlo simulation (IIMC) to improve computational efficiency and accuracy. The IISE can efficiently assess the impacts of low-order contingencies. The accuracy is, however, sacrificed as high-order contingencies are usually neglected. The IIMC is more suitable for large-scale contingency spaces compared with IISE, although the calculation process is time-consuming. In this paper, the proposed IIHybrid can take advantage of their strengths while avoiding their shortcomings. The IISE and the IIMC are applied to lower and higher contingency spaces respectively. The high-order contingencies elimination technique proposed in our previous studies is still applicable to the IIHybrid. Besides, efficiency can be controlled by modifying the preset parameters to adapt to various scenarios. Case studies are performed on the IEEE 118-bus test system and PEGASE System. The results show that the proposed approach is more efficient and practicable than traditional methods.

An air–gap hollow fiber membrane contactor (AHFMC) has been proposed and applied for fluid heating in the HVAC applications. The water and the liquid desiccant (solution) streams flow inside the neighboring hollow fiber membranes in a cross-flow arrangement. The solution is heated due to the absorption and mixing heats by absorbing the water vapor from the water stream. A mathematical model of the coupled heat and mass transports in the AHFMC is established by converting it into a parallel-plate one. The optimal design of the AHFMC is studied by using the multi-objective particle swarm optimization (MOPSO) algorithm to obtain the maximum thermal performance and minimum total annual cost together with the coupled heat and mass transfer model. A set of multiple optimum solutions, which are named as “Pareto optimal solutions”, are then obtained. Influences of geometric variables of the contactor length, width, height, fiber outer diameter and fiber distances in different directions on the heating performance and total annual cost are studied. The optimally geometrical parameters of the AHFMC are obtained using the MOPSO algorithm. These results are useful for the design of the AHFMC based on the desired temperature lift, the contactor constraint, and the available investment in the real applications.

As one of attractive technology of energy conservation, combined cooling, heating and power (CCHP) system has brought about widespread attention. However, the variability of users demand has limited the application of CCHP system. To ensure stable and efficient operation, the compressed air energy storage is considered to be integrated with CCHP system. A grid-connected CCHP system with compressed air energy storage (CAES) and hybrid refrigeration is proposed in this paper. The power from grid is stored in CAES at off-peak time and released at on-peak time. The hybrid refrigeration system including LiBr absorption chiller and electric compression refrigerator provides cooling load to users. A multi-objective assessment and optimization synthetically considering energy, economy and environment are presented. The multi-objective indicator used as objective function to optimize each component capacity of the proposed CCHP system. A sensitive analysis of key parameters and performance comparison with conventional CCHP system have been carried out. The results shows that when the capacity of gas turbine is 691 kW, the comprehensive performance of the proposed CCHP system is the optimal performance. The power price, natural gas price, compression ratio and turbine inlet temperature of CAES have great influence on the performance of the proposed CCHP system. Meanwhile, the multi-objective indicator’s value of the proposed CCHP system is more than conventional CCHP system 4.85%.

Six Sigma is a systematic methodology aiming at operational excellence. Under the general umbrella of Six Sigma, DMAIC and Design for Six Sigma are usually be implemented to improve product and process quality. Facing quality bottlenecks in traditional improvement projects, tools in Design for Six Sigma is an efficient way to achieve better results. In this paper, to meet the high-quality requirement of key clients, a telecom service system improvement project is illustrated by redesigning troubleshooting and service delivery processes in company Shanghai Telecom Co. Ltd. (ST) with the aid of some Design for Six Sigma tools. Company ST improved its service system performance and obtained significant economic benefits from this project implementation. Four key factors that affect the success of Design for Six Sigma tools application in improvement projects are discussed at last.

With the potential continuous application of mono- or few-layered black phosphorus (BP) in electronic, photonic, therapeutic, and environmental fields, the possible side effects of BP on aquatic organisms after release into natural water are of great concern. We investigated the potential toxicity of BP on the unicellular organism, Tetrahymena thermophila. After the exposure for 8 h at 10 μg/mL, the reproduction of T. thermophila significantly decreased by 46.3%. Severe cell membrane and cilium damage were observed by scanning electron microscopy (SEM) upon treatment with BP. Based on bright-field microscopy and three-dimensional Raman imaging, we investigated the cellular uptake and translocation of BP within T. thermophila. It was observed that the engulfment of BP by T. thermophila was oral apparatus dependent, through which intracellular BP was then transported to the posterior end of T. thermophila by food vacuole packaging. Our study also revealed that BP induced the increase of intracellular reactive oxidant species and formed oxidative stress-dependent toxicity to T. thermophila. Our findings paved a way for better understanding the BP toxicityon aquatic organisms and its potential ecological risks.

As an energy comprehensive utilization technology, combined cooling, heating and power (CCHP) system has received much attention in many countries. Due to the variability of users demand, the CCHP system is often running at off-design condition. CCHP system integrated with energy storage system is an efficient method to improve the off-design performance of CCHP system. A novel CCHP system with trigenerative compressed air energy storage (T-CAES) is proposed in the paper, which can meet various forms energy demand of users. A comprehensive thermodynamic model of the system has been set up, and the thermodynamic performance analysis has been done. Furthermore, a sensitivity analysis is conducted by the key parameters effected on performance of CCHP system integrated with T-CAES. The comparison of thermodynamic and economic analysis between the novel CCHP system and conventional CCHP system are carried out in application of office building. The primary energy rate of novel CCHP system is 85.57%, the primary energy saving ratio of novel CCHP system is 26.87%, and the total cost saving ratio of novel CCHP system is 30.55%. The result shows that the performance of the CCHP system integrated with T-CAES is superior to conventional CCHP system.

This article addresses the tough problem of effectively utilizing the low-grade residual heat of jacket-cooling water (JCW) from an internal combustion engine in combined cooling, heating, and power (CCHP) systems. An experimental platform was set up for this purpose, in which the JCW was used as a heat source to drive a LiCl liquid absorption dehumidifier (LAD). The thermodynamic model of the LAD in a CCHP system was established to correlate heat- and mass-transfer of the LAD with the output power of the engine, and the performance of the system was analyzed. An experiment and modelling study showed that increasing the output power of the engine resulted in increases in both the JCW temperature and the LAD dehumidifying capacity, leading to lower relative humidity of the outlet air. A thermodynamic performance comparison of the CCHP system with and without a LAD was performed, and the thermodynamic performance of the CCHP system with the LAD was superior to a conventional CCHP system without it.

Nanohybrids have greatly promoted the application of nanomaterials in real world problems, since they not only present the individual advanced properties of each material, but can also realize the amplification of the functions of the combined materials. Here, we assembled up-conversion nanoparticles NaYF4,Yb/Er@NaYF4 (UCNPs) and MnFe2O4 (MF) into a multi-functional nanohybrid through direct coordination using polyacrylic acid (PAA) as the surficial bridging linker. Afterwards, the photosensitizer molecules Rose Bengal (RB) and PEG-COOH were covalently grafted onto the nanohybrid. UCNPs effectively stimulated RB by means of fluorescence resonance energy transfer effects to convert O2 to 1O2. Meanwhile, the MF NPs worked as a Fenton catalyst to continuously generate O2 by decomposing H2O2 in the H2O2 over-expression tumor micro-environment. Thus, a comprehensive therapeutic system was successfully constructed, which can efficiently perform photodynamic therapy (PDT) of hypoxic tumors under the excitation of a 980 nm laser. This work explored a new method for the assembly of nanohybrids using heterogeneous nanomaterials by coordination with bridging ligands between NPs and provided a versatile PDT candidate for hypoxic tumors.

A numerical model that calculates the collisional interactions between the lithium atoms from a lithium pellet and the background plasmas has been upgraded. The ion density ( N i ), electron temperature ( T e ), ion temperature ( T i ) and parallel ion velocity ( V ∥ , i ) are used to characterize the background plasmas. The lithium atom density ( N L i a ) and parallel velocity ( V ∥ , a ) of lithium atoms evolve with time. For each lithium ion, the density ( N L i n + ), temperature ( T L i n + ) and parallel velocity ( V ∥ , L i n + ) are self-consistently calculated. A C-mod lower single null equilibrium is used to generate the grid for the BOUT++ simulation. The lithium atoms can be fully ionized to L i 3 + in ∼2 μs. The rapid radial and poloidal expansion of the lithium ions are found in the simulation. After the collision interaction process, the electron temperature rapidly decreases at the pellet location; then, it rapidly poloidally expands, and the temperature at the pellet location starts to recover. The electron pressure increases at the pellet location despite the decrease in electron temperature because of the extra electrons from the lithium ionization. The ion pressure profile decreases in the pellet location due to the decrease in ion temperature.

Synthetic phenolic antioxidants (SPAs) are closely correlated with human life due to their extensive usages, and increasing concerns have been raised on their biosafety. The previous controversial findings caused continuous debates on their potential endocrine disrupting effects. In the present study, four commonly used SPAs, including butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), tert-butyl hydroquinone (TBHQ) and 2,2′-methylenebis(6-tert-butyl-4-methylphenol) (AO2246), were investigated for their estrogenic effects, and the results from in vitro screening assays showed SPAs themselves had negligible estrogen receptor binding affinities. Nevertheless, significant increase in E2 secretion was observed in H295R cells treated with SPAs, especially for BHA. The transcriptional levels of steroidogenic enzymes, including StAR, 3βHSD, CYP11B1, and CYP11B2 were up-regulated via the mediation of protein kinase A (PKA) signaling pathway. In vivo experiment confirmed that waterborne exposure to BH...

Contaminants of emerging concern are continuously increasing, which makes it important to develop high throughput screening techniques for the evaluation of their potential biological effects, especially endocrine disrupting effects, which would directly influence the population dynamics in environment. A novel competitive binding assay based on enzyme fragmentation complementation technology was established to screen the binding affinities of emerging chemicals for estrogen receptor (ER) α or β isoforms. Exogenous compounds could compete with the fragment (ED-ES) of genetically engineered β-galactosidase enzyme (β-gal) for the binding to ERα or β, thus quantitatively altering the formation of enzymatically active β-gal and the hydrolysis of luminescent substrate. According to the monitoring of luminescence curves and the optimization of ERα or β concentrations, it was found that luminescent signals were sustainably emitted for 9h, and 40nM ERα or β in the system would lead to the most sensitive luminescence response. Using 17β-estrodiol (E2) and genistein as the representative estrogenic hormones, their binding affinities for ERα and β were evaluated. The results were consistent with those determined by traditional methods, which confirmed the reliability of this competitive binding assay based on β-gal. Four polyfluorinated iodine alkanes (PFIs) with specific structural characteristics in iodine substitution and carbon chain length were screened, and the results showed diverse binding affinities and different preferences of these chemicals to ERα or β isoforms. The binding affinities of PFIs for ERα were consistent with the result from MVLN transcriptional reporter assay. Overall, the competitive binding assay presented in this study provided a promising alternative to high throughput screening of emerging chemicals with estrogenic effects, which would be important in explanation of their potential toxicological effects and human exposure risks.

The densities of six diluents with molality of 0.0199 to 0.5070 mol·kg−1 were measured at atmospheric pressure from 293.15 to 328.15 K. The studied ionic liquids (ILs) include 1-ethyl-3-methylimidazolium bis[(trifluoromethyl)sulfonyl]imide ([Emim][NTf2]), 1-butyl-3-methylimidazolium bis[(trifluoromethyl)sulfonyl]imide ([Bmim][NTf2]), and 1-butyl-2,3-dimethylimidazolium bis[(trifluoromethyl)sulfonyl]imide ([Bmmim][NTf2]). The solvents include diethylene glycol dimethyl ether (DEGDME) and tetraethylene glycol dimethyl ether (TEGDME). The measured densities were applied for calculation of V Ð Φ / m 3 Â · m o l - 1 (apparent molar volume) from 293.15 K to 328.15 K. The influence of the introduction of methylene (–CH2-), methyl (–CH3) groups, and the structure of solvents on the density, apparent molar volume were discussed in depth. Redlich-Rosenfeld-Meyer (RRM) equation was used to fit V Ð Φ / m 3 Â · m o l - 1 dependence on the molality of the six studied diluent solutions. Two parameter of V Ð Φ o / m 3 Â · m o l - 1 (infinite dilution apparent molar volume) and E Ð Φ 0 / m 3 Â · m o l - 1 Â · K - 1 (limiting apparent molar expansibility) were also been fitted and discussed based on the RRM equation and polynomial equation, respectively. Besides, the interactions of ion-ion and ion–solvent were discussed according to the fitted parameters. The structure making or breaking were also discussed for IL in solvent.

The density of two functionalized ionic liquids (FILs) 1-methoxyethyl-3-methylimidazolium bis[(trifluoromethyl)sulfonyl]imide ([MOEmim][NTf2] and 1-methoxyethyl-2,3-dimethylimidazolium bis[(trifluoromethyl)sulfonyl]imide [MOEmmim][NTf2]) have been measured with ether solvents proprylene glycol monomethyl ether (PEGMME), diethylene glycol dimethyl ether (DEGDME), tetraethylene glycol dimethyl ether (TEGDME) at diluted concentration range. The determined temperature range is from 293.15 to 328.15 K at atmospheric pressure. The measured densities are used for the calculation of apparent molar volumes, Vϕ/m3·mol−1, at the temperature range. The effects of the ether ( O ) and methyl ( CH3) introduction on imidazolium cation are discussed for the density and apparent molar volume in deeply. The Redlich-Rosenfeld-Meyer (RRM) equation was used for the fitting of apparent molar volumes, Vϕ/m3·mol−1, for the six studied dilute solutions. The infinite dilution apparent molar volumes, Vϕ/m3·mol−1, and limiting apparent molar expansibility, E Φ 0 / c m 3 · m o l - 1 · K - 1 , have been obtained and discussed from the RRM equation and polynomial equation. The thermal expansion coefficients, α/K−1, have also been calculated and discussed from density for the studied dilute solutions in the temperature range.

Thoracic ossification of the ligamentum flavum (TOLF) is a unique disease with ectopic ossification, and is a major cause of thoracic spinal stenosis and myelopathy. However, the underlying etiology remains largely unknown. In this study, the ligamentum flavum was systematically analyzed in TOLF patients by using comprehensive iTRAQ labeled quantitative proteomics. Among 1285 detected proteins, there were 282 proteins identified to be differentially expressed. The Gene Ontology (GO) analysis regarding functional annotation of proteins consists of the following three aspects: the biological process, the molecular function, and the cellular components. The function clustering analysis revealed that ten of the above proteins are related to inflammation, such as tumor necrosis factor (TNF). This finding was subsequently validated by ELISA, which indicated that serum TNF-α of TOLF patients was significantly higher compared with the control group. To address the effect of TNF-α on ossification-related gene expression, we purified and cultured primary cells from thoracic ligamentum flavum of patients with TOLF. TNF-α was then used to stimulate cells. RNA was isolated and analyzed by RT-PCR. Our results showed that TNF-α was able to induce the expressions of osteoblast-specific transcription factor Osterix (Osx) in ligamentum flavum cells, suggesting that it can promote osteoblast differentiation. In addition, as the Osx downstream osteoblast genes OCN and ALP were also activated by TNF-α. This is the first proteomic study to identify inflammation factors such as TNF-α involved in ossified ligamentum flavum in TOLF, which may contribute to a better understanding of the cause of TOLF.

The extensive use of telematics system in the new generation of automobiles contributed to the rising trend of using automobiles as a channel to provide remote service. Yet the measurement of telematics service quality (TeleServQ) is not well established. This paper aims to identify the dimensions of TeleServQ. In-depth interviews are used to investigate the initial items in measuring telematics service. Conceptual framework of TeleServQ scale is proposed based on items sorting. Then the multidimensional scale is refined and validated with questionnaire survey. As a result, six dimensions including efficiency, system reliability, information quality, security, customisation and call centre service are identified. Some of the dimensions are consistent with the literature related to technology-based services, and others are specific in telematics context. Among six dimensions, efficiency and system reliability have the strongest relationship with customer satisfaction and loyalty intention. The scale demons...

In the last decade, the use of magnesium and its alloys as biodegradable implant materials has become increasingly accepted. However, surface modification of these materials to control the degradation rate in the early stages of healing and improve their biocompatibility is crucial to the successful implementation of magnesium alloy implants in medicine. Cell adhesion and proliferation at the implant surface is a vital factor for successful integration of a biomaterial within the body. Cells accomplish this task by binding to ligands such as the arginine-glycine-aspartic acid peptide sequence (RGD) commonly found on adhesive proteins present in the extracellular matrix. In this paper, we report a biomimetic surface modification strategy involving deposition of a mixed organosilane layer on Mg AZ31 followed by covalent immobilization of RGD peptides through a heterobifunctional cross-linker molecule. Our results indicate that with optimized deposition conditions uniform organosilane coatings were successfully deposited on the Mg AZ31 substrate. Furthermore, we have demonstrated that the surface density of immobilized RGD can be varied by depositing organosilane layers from solutions containing two different organosilanes in specified ratios. Increases in cell adhesion and cell proliferation were observed on the surface modified substrates., Graphical abstract Image 1, Highlights • A simple method for preparing organosilane coatings with variable RGD surface density was developed. • Surface modification resulted in improved cell adhesion compared to bare Mg. • Cell proliferation at the mixed organosilane coated magnesium alloy surface was strongly affected by the RGD surface density.

The robust desirability membership functions are constructed.We present the robust fuzzy programming approach.Proposed algorithm is used to deal with MRO problems.Comparisons are given to further illustrate the developed method. In this paper, considering the uncertainty associated with the fitted response surface models and the satisfaction degrees of the response values with respect to the given targets, we construct the robust membership functions of the responses in three cases and explain their practical meanings. We translate the feasible regions of multiple responses optimization (MRO) problems into -level sets and incorporate the model uncertainty with the confidence intervals simultaneously to ensure the robustness of the feasible regions. Then we develop the robust fuzzy programming (RFP) approach to solve the multiple responses optimization (MRO) problems. The key advantage of the presented method is that it takes account of the location effect, dispersion effect and model uncertainty of the multiple responses simultaneously and thus can ensure the robustness of the solution. An example from literatures is illustrated to show the practicality and effectiveness of the proposed algorithm. Finally some comparisons and discussions are given to further illustrate the developed approach.

Based on the local thermal equilibrium theory in porous media, a two-dimensional numerical model is developed to investigate the heat storage and heat release processes of a molten-salt thermocline in a porous packed-bed tank. The numerical model is validated by comparing the simulation results with the experimental data. The performance of the heat storage system is analyzed using the thermocline thickness and the heat storage efficiency with a focus on energy balance. The results show that stable thermocline layers can form during heat storage or heat release processes. Because of the existence of the thermocline and replaced porous fillers, the heat storage efficiency in a porous packed-bed tank is slightly lower than that of pure molten-salt thermocline heat storage. The volumetric heat capacity of porous media is a key factor in heat storage performance. Improving the performance of the porous filler and setting the condition of a reasonably low flow rate, it can enable optimization control of the thermocline evolution in heat storage/release processes and improve the thermal efficiency of the heat storage system, which reveals directions for further research.

To evaluate the radiological and clinical outcomes of the corrective surgery for patients with moderate to severe focal kyphosis in thoracolumbar spine. Fifty-seven patients with moderate to severe focal kyphosis of the thoracolumbar spine underwent apical segmental resection osteotomy with dual axial rotation correction at our hospital. There were 30 male and 27 female patients. The mean age was 34.3 years. The kyphosis level radiographs were obtained from each patient before surgery, immediately after surgery and at follow-up. Local kyphosis and scoliosis Cobb angles were measured. Full-spine standing radiographs were obtained before surgery and at follow-up, and the spine sagittal and coronal balance were evaluated. The height of patients, the Frankel grading system for neurological functions, the Oswestry disability index for life quality, the visual analogue score for back pain and the patient satisfactory index for satisfaction to surgery were applied before surgery and at follow-up. The radiological and clinical outcomes were further analyzed in different sub-groups of patients according to etiology, severity of kyphosis, age, level of kyphosis apex, Frankel grade before surgery, and complications. The average follow-up time of patients was 46.1 months. The average kyphosis angle reduced from 94.6° before surgery to 31.0° immediately after surgery, and remained at 34.4° at follow-up. The sagittal balance of the spine, height of patients, Frankel grading, Oswestry disability index and visual analogue score were improved. The patient satisfactory index (PSI) showed a satisfied rate of 91.2%. The correction rate was significantly higher in patients with kyphosis angle less than 95° and age less than 35 years. The clinical improvement rate was significantly higher in patient with kyphosis apex at lower thoracic spine or thoracolumbar segment, Frankel grade E before surgery and no complication group. The incidence of intra-operative and early stage complications was 38.6%, and the incidence of instrumentation failure was 10.5%. The most severe complication was transient spinal cord injury, and the incidence was 7.0%. All complications got good relief after appropriate intervention. Apical segmental resection osteotomy with dual axial rotation correction is an effective procedure to treat moderate to severe focal kyphosis, the prevention of serious neurological complications is fundamental to achieve the ideal clinical results.

Thoracic spinal stenosis (TSS) is a rare disease secondary to multiple pathological changes that differ in prevalence and clinical characteristics. The epidemiological characteristics of these pathologies are largely unknown due to the limited case samples and regional differences. Therefore, a systematic review was conducted to elucidate the prevalence and clinical characteristics of TSS. Case series and case reports on the ossification of the posterior longitudinal ligaments (OPLL), ossification of the ligamentum flavum (OLF) and thoracic disk herniation (TDH) were screened from PubMed, Embase and Web of Science databases and systematically reviewed. Epidemiological, demographic and segmental distribution data were extracted and analyzed. A total of 129 studies including 1935 subjects were selected, of which 361 (18.7%) were diagnosed with OPLL, 804 (41.5%) with OLF, 143 (7.4%) with OPLL + OLF and 627 (32.4%) with TDH. Most reports were from China, Japan and USA. Thoracic OPLL occurred mostly at the middle-thoracic spine (43.4%), while OLF predominately occurred at the lower-thoracic spine (63.1%). TDH was mainly localized in the middle (46.0%) and lower-thoracic (50.3%) spine. Thirty-two studies involving 524 patients described tandem spinal stenosis, of which 52.1% had accompanying cervical diseases and 35.9% lumbar diseases. There are significant differences in the age, sex and segment distribution characteristics of different pathologies leading to TSS. Tandem spinal stenosis is not uncommon and should be considered when diagnosing TSS. Our findings provide new insights into the prevalence and clinical characteristics of TSS and can help reduce misdiagnosis.

The phosphorescence lifetime approach based on the room temperature phosphorescence (RTP) property has received considerable attention in recent years due to its excellent performance in the precise measurement of oxygen. Herein, a smart nanoprobe, Gd[PC]@ZIF-8, was designed and assembled by homogenously encapsulating a rare-earth complex phosphor Gd[(Pyr)4cyclen] (Pyr = pyrenol) into a zeolitic imidazolate framework (ZIF-8). Because of the restriction of the metal-organic framework (MOF) matrix and host-guest interactions, the nanoprobe Gd[PC]@ZIF-8 exhibited highly enhanced RTP properties, including intensity, quantum yield, and elongated decay lifetime. It displayed an outstanding linear relationship between the phosphorescence decay lifetime, intensity and oxygen concentration, which can be applied in the field of oxygen sensing. Moreover, the complex Gd[(Pyr)4cyclen] in the nanoprobe Gd[PC]@ZIF-8 served as a favorable photosensitizer that resulted in the simultaneous conversion of sufficient oxygen molecules into single state oxygen (1O2) under irradiation during the phosphorescence quenching process, which is conducive to photodynamic therapy (PDT). Thus, the design of the smart nanoprobe Gd[PC]@ZIF-8 in this study provides an ingenious strategy of utilizing a MOF as a matrix to enhance the RTP properties of phosphors for synchronous oxygen sensing and PDT.

As a means of detecting and assisting maintenance of power equipment, on-line condition monitoring(CM) has been widely used in power generation, transmission, substation, distribution, consumption and other fields in the past few decades. This paper reviews current on-line condition monitoring techniques and development trends of condition monitoring. In the context of ‘Ubiquitous Internet of things’, on-line condition monitoring is surely a promising way towards reliable protection of electrical equipment. However, in spite of obvious progress and undoubted benefits, the on-line condition monitoring system has also experienced a large number of practical problems in the application process such as generally low data availability and reliability. Furthermore, statistics on relative standards show a dramatic blank in international standards of on-line condition monitoring. Therefore, there is an urgent need that the international standards for condition monitoring should be set up as soon as possible. Corresponding areas for further research are also presented such as uncertainty evaluation, error modeling and evaluation system based on sequential control. It is intended that this review will provide the basis for future developments of safe and reliable on-line condition monitoring system.

Background Pedicle subtraction osteotomy (PSO) and vertebral column decancellation (VCD) are frequently used methods for correction of thoracolumbar kyphosis resulting from ankylosing spondylitis (AS). However, there are limited reports performed to evaluate the difference of loss of correction and the effectiveness of PSO and VCD techniques in patients with thoracolumbar kyphosis secondary to AS. Objective To retrospectively estimate the effectiveness of correction and loss of correction of PSO and VCD techniques in patients with thoracolumbar kyphosis secondary to AS. Methods We performed a retrospective review of 61 consecutive AS kyphosis patients undergoing PSO or VCD surgery from March 2012 to April 2015. The patients were divided into PSO group (n = 25) and VCD group (n = 36) according to the types of osteotomies. Measurement of the radiographic parameters was performed and the change was analyzed. Results Mean loss of correction in the global kyphosis was 2.31° in the PSO group and 2.29° in VCD group at the last follow-up, respectively, with no significant difference. Progressive junctional kyphosis occurred in both groups. VCD obtained a significantly larger correction than PSO while sharing a similar incidence of complications. No serious complications were observed in the two groups. Conclusion The PSO osteotomy and VCD osteotomy are both safe and effective methods in treating thoracolumbar kyphosis secondary to AS. Mild loss of correction mainly occurred in the global kyphosis in both techniques with no significant difference.

Our study aimed to investigate the role of long non-coding RNAs (lncRNA) TP73-AS1 in retinoblastoma (Rb). In the present study, we found that TP73-AS1 was up-regulated, while miR-139–3p was down-regulated in Rb. TP73-AS1 and miR-139-3p were inversely correlated in Rb tissues. In cells of Rb cell lines, overexpression of miR-139-3p failed to affect TP73-AS1, while TP73-AS1 overexpression caused the down-regulated miR-139-3p. TP73-AS1 overexpression caused promoted proliferation of Rb cells but showed no significant effects on cell migration and invasion. miR-139-3p overexpression played an opposite role and attenuated the effects of TP73-AS1 overexpression. Therefore, lncRNA TP73-AS1 may down-regulate miR-139-3p to promote Rb cell proliferation.

Our study aimed to investigate the role of long non-coding RNAs (lncRNA) TP73-AS1 in retinoblastoma (Rb). In the present study, we found that TP73-AS1 was up-regulated, while miR-139–3p was down-regulated in Rb. TP73-AS1 and miR-139-3p were inversely correlated in Rb tissues. In cells of Rb cell lines, overexpression of miR-139-3p failed to affect TP73-AS1, while TP73-AS1 overexpression caused the down-regulated miR-139-3p. TP73-AS1 overexpression caused promoted proliferation of Rb cells but showed no significant effects on cell migration and invasion. miR-139-3p overexpression played an opposite role and attenuated the effects of TP73-AS1 overexpression. Therefore, lncRNA TP73-AS1 may down-regulate miR-139-3p to promote Rb cell proliferation.

Background: Pterygium, a common eye disease with high postoperative recurrence, lacks effective therapeutic strategies. Therefore, it’s urgent to identify specific targets to develop rationally targeted molecular drugs for the pterygial therapy. Methods: The cell proliferation and motility were studied in both the primary human pterygial fibroblasts (hPFs) and an ex vivo pterygium model. hPFs transfected with the pCMV3-PDGFRB plasmid, PDGFRB siRNA and CRISPR/Cas9 system were used to determine the role of PDGFR-β in pterygial fibroblasts functions. Western blotting, immunohistochemistry and immunofluorescence were performed to evaluate the expression of the key proteins. Results: PDGFR-β expression in the pterygial stroma and primary hPFs was significantly higher than that in the conjunctiva and human conjunctival fibroblasts. PDGF-BB promoted the proliferation, migration and invasion of hPFs, which can be significantly suppressed by sunitinib via inhibition of the PDGFR-β/extracellular signal-regulated kinase (ERK) pathway. In the ex vivo model, the knockout of PDGFRB and sunitinib treatment blocked the proliferation and motility of fibroblasts in the pterygial stroma via the suppression of PDGFR-β/ERK pathway. Conclusion: This study demonstrates that PDGFR-β may be a potential therapeutic target for pterygium, and inhibition of PDGFR-β by sunitinib is a promising and effective approach for pterygium treatment.

Butylated hydroxyanisole (BHA) isomers, as the widely used anthropogenic antioxidants in food, have been revealed to induce endocrine disrupting effects, while the mechanism how BHA isomers regulate the lipogenic differentiation remains to be elucidated. Using 3T3-L1 differentiation model, the effects of BHA isomers, including 2-tert-butyl-4-hydroxyanisole (2-BHA), 3-tert-butyl-4-hydroxyanisole (3-BHA) and their mixture (BHA), on adipogenesis were tested. The results showed that 3-BHA and BHA promoted adipocyte differentiation and enhanced the cellular lipid accumulation through the regulation of the transcriptional and protein levels of the adipogenetic biomarkers, while 2-BHA had no effect. The effective window for 3-BHA induced lipogenesis was the first four days during 3T3-L1 differentiation. BHA isomers showed no binding affinities for peroxisome proliferator activated receptor γ (PPARγ). Instead, the upstream of PPARγ signaling pathway, i.e. the phosphorylation of cAMP-response element binding protein (CREB), upregulation of CAAT/enhancer-binding proteins β (C/EBPβ) and elevated cell proliferation during postconfluent mitosis stage were induced by 3-BHA exposure. Altogether, this study revealed the adipogenic effect of 3-BHA through interference with the upstream events of the PPARγ signaling pathway. The authorized usage of BHA as food additives and its occurrence in human sera can potentially contribute to the incidence of obesity, which is of high concern.

The current work presents a detailed energy and exergy analysis of an iso-octane/n-butanol blend-fueled spark-ignition (SI) engine to investigate exergy loss mechanisms and understand how the exergy destruction changes with different iso-octane/n-butanol blend fuels. Energy and exergy analysis was applied to a quasi-dimensional two-zone SI engine model, including Wiebe function to model the actual combustion process based on fuel types and operating conditions. Results were obtained for an SI engine at 3000 rpm by changing spark timing, volume fraction of n-butanol, and load. When sweeping spark timing, it was found that the location of maximum first and second-law efficiency appear at around −31 °CA ATDC for iso-octane, BU10, BU20 and BU30, and approximately −28 °CA ATDC for n-butanol. Increasing butanol fraction in the blends increases the percentage of total irreversibility in total availability at either MBT or constant spark timing, while has slight influence on availability transferred by heat transfer. At the MBT spark timing and WOT condition, the first-law efficiency increases slightly with increase of n-butanol, while the second-law efficiency for blended fuel decreases slightly. However, with decreasing engine load, the percentages of total irreversibility and availability transferred by heat transfer increase, the first and second-law efficiencies both decrease.

The positive effect of low-magnitude, high‑frequency (LMHF) vibration on implant osseointegration has been demonstrated; however, the underlying cellular and molecular mechanisms remain unknown. The aim of this study was to explore the effect of LMHF vibration on the adhesion and the osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) cultured on hydroxyapatite (HA)-coated surfaces in an in vitro model as well as to elucidate the molecular mechanism responsible for the effects of LMHF vibration on osteogenesis. LMHF vibration resulted in the increased expression of fibronectin, which was measured by immunostaining and RT-qPCR. Stimulation of BMSCs by LMHF vibration resulted in the rearrangement of the actin cytoskeleton with more prominent F-actin. Moreover, the expression of β1 integrin, vinculin and paxillin was notably increased following LMHF stimulation. Scanning electron microscope observations revealed that there were higher cell numbers and more extracellular matrix attached to the HA-coated surface in the LMHF group. Alkaline phosphatase activity as well as the expression of osteogenic-specific genes, namely Runx2, osterix, collagen I and osteocalcin, were significantly elevated in the LMHF group. In addition, the protein expression of Wnt10B, β-catenin, Runx2 and osterix was increased following exposure to LMHF vibration. Taken together, the findings of this study indicate that LMHF vibration promotes the adhesion and the osteogenic differentiation of BMSCs on HA-coated surfaces in vitro, and LMHF vibration may directly induce osteogenesis by activating the Wnt/β‑catenin signaling pathway. These data suggest that LMHF vibration enhances the osseointegration of bone to a HA-coated implant, and provide a scientific foundation for improving bone-implant osseointegration through the application of LMHF vibration.

Sickle cell patients often require monthly transfusions with normal blood to treat the many complications of the disease. In this therapy, the clinician lowers the amount of hemoglobin S (HbS) containing red blood cells (RBCs) by transfusing normal blood units containing hemoglobin A (HbA). We have developed a point-of-care (POC) quantitative immunoassay for HbS to serve as a diagnostic aid for clinicians providing this life-saving treatment. The test consists of a small-footprint reader and cartridges that quantify the percentage of HbS in a small volume of patient blood. The test reports % HbS values in the range from 5 to 86% that highly correlate (slope 1.03, R(2) = 0.97) with currently used central laboratory HPLC systems. The test also shows a 1% limit of blank, 2% limit of detection, and 5% limit of quantitation. The test was also shown to encounter minimal effects from potential interferences. This cost-effective, POC HbS quantitative approach will allow for real-time transfusion monitoring in sickle cell treatment settings and therefore improve workflow and allow clinicians to quickly make informed therapeutic decisions.

Four novel symmetrical donor–acceptor–donor (D–A–D) type boron dipyrromethene (BODIPY) based dyes, namely BDP1 – 4 , featuring an electron-withdrawing BODIPY motif as the central core, and several types of electron-donating segments, including thiophene, bithiophene, fluorene and carbazole, flanked at its 2,6-positions as terminal groups were synthesized and characterized. All of these BDPs exhibit panchromatic absorption covering the wavelength range 300–900 nm with high extinction coefficients (0.78 × 10 5 to 1.22 × 10 5 cm −1 M −1 ) and relatively lower HOMO energy levels from −5.17 to −5.48 eV. Furthermore, BDP1 – 4 show good thermal stabilities, excellent film-forming abilities and low fluorescent quantum yields. BDP2 flanking with bithiophene units demonstrates superior charge transport property and favorable nanoscale morphology relative to BDP1 , BDP3 and BDP4 . The power conversion efficiency (PCE) values of the organic solar cells (OSCs) based on the BDPs /PC 61 BM (1:0.5, w/w) are 1.49% for BDP1 , 2.15% for BDP2 , 1.06% for BDP3 and 1.56% for BDP4 , respectively.

The potential effects of intermittent parathyroid hormone (1–34) [PTH (1–34)] administration on bone formation have previously been investigated. A number of studies have suggested that the cyclic adenosine monophosphate/protein kinase A (cAMP/PKA) pathway is associated with PTH-induced osteogenic differentiation. However, the precise signaling pathways and molecular mechanism by which PTH (1–34) induces the osteogenic differentiation of bone mesenchymal stromal cells (BMSCs) remain elusive. The purpose of the present study was to investigate the mechanism underlying the effect of intermittent PTH (1–34) application on the proliferation and osteogenic differentiation of BMSCs. BMSCs were randomly divided into four groups, as follows: Osteogenic medium (control group); osteogenic medium and intermittent PTH (1–34); osteogenic medium and intermittent PTH (1–34) plus the adenylyl cyclase activator forskolin; and osteogenic medium and intermittent PTH (1–34) plus the PKA inhibitor H-89. A cell proliferation assay revealed that PTH (1–34) stimulates BMSC proliferation via the cAMP/PKA pathway. Furthermore, reverse transcription-quantitative polymerase chain reaction, alkaline phosphatase activity testing and cell examination using Alizarin Red S staining demonstrated that PTH (1–34) administration promotes osteogenic differentiation and mineralization, mediated by the cAMP/PKA pathway. Crucially, the results of western blot analyses suggested that PTH (1–34) treatment and, to a greater degree, PTH (1–34) plus forskolin treatment caused an increase in phosphorylated cAMP response element binding protein (p-CREB) expression, but the effect of PTH on p-CREB expression was blocked by H-89. In conclusion, the current study demonstrated that intermittent PTH (1–34) administration regulates downstream proteins, particularly p-CREB, in the cAMP/PKA signaling pathway, to enhance the proliferation, osteogenic differentiation and mineralization of BMSCs.

Objective This study aims to evaluate the survival of patients with systemic lupus erythematosus (SLE)-associated pulmonary arterial hypertension (PAH) by a systematic review and meta-analysis. Methods Studies were searched from MEDLINE (OVID), EMBASE, Cochrane Central Register of Controlled Trial and Scopus databases, and were selected according to the inclusion and exclusion criteria. Two independent reviewers extracted data from selected studies. Quality assessments were also performed using the Newcastle-Ottawa Scale. All pooled analyses were conducted both for random-effects model and fixed-effects model. Subgroup analysis and sensitivity analysis were conducted to investigate the origins of heterogeneity. Publication bias was evaluated using Begg’s funnel plots and Egger’s test. Results Six studies encompassing 323 patients with SLE-associated PAH were included in the meta-analysis. The pooled 1-, 3- and 5-year survival rates were 88% (95% CI, 0.80–0.93), 81% (95% CI, 0.67–0.90) and 68% (95% CI, 0.52–0.80), respectively. No significant publication bias was shown. WHO Functional class (Fc) III/IV was found to be an independent prognostic factor of mortality. Higher mean pulmonary arterial pressure (mPAP), higher pulmonary vascular resistance (PVR), lower six minutes walking distance (6MWD), higher brain natriuretic peptide (BNP) and higher N-terminal proBNP (NT-proBNP) level were also related to poor survival. Conclusion The long-term survival of patients with SLE-associated PAH is poor, which is worth paying greater clinical and academic attention. This study suggested that early diagnosis and management are recommended in patients with SLE-associated PAH for a better outcome of survival.

As one of the widely used anthropogenic food additives, 3-tert-butyl-4-hydroxyanisole (3-BHA) has been found to perturb adipogenesis in vitro and induce lipid accumulation in some strains of oleaginous microalgae. The impact of this chemical on adipocyte development and lipid metabolism in mammals remains to be elucidated. In this study, we performed 18-week oral administration of 3-BHA to male C57BL/6J mice with normal diet (ND) or high-fat diet (HFD) and investigated its impacts on adipogenesis and lipid accumulation in vivo. The results indicated that long-term exposure to 3-BHA impacted the mouse body weight gain, white adipose tissue accumulation, and plasma lipids through transcriptional regulation of adipogenesis, lipid metabolism, and adipocyte endocrine function, while glucose metabolism and insulin sensitivity remained unaffected. HFD-fed mice responded to 3-BHA stimulation differently from ND-fed animals, suggesting potential risks for the human burden of 3-BHA in lean and obese subjects. The findings herein validate 3-BHA as an environmental obesogen, and more caution is recommended for its authorized use as a food antioxidant against lipid rancidity.

Purpose We report the efficacy of a modified heterodigital neurovascular island flap innervated by the dorsal branch of the proper digital nerve and the proper digital nerve, for repairing either pulp or volar defects in the fingers. Method We repaired 14 digits of 14 patients who had a complex defect involving soft tissue and digital nerve in the pulp or volar surface of the digit using the modified heterodigital neurovascular island flap. Cases were divided into 2 groups: a pulp defect group including 5 thumbs and 1 little finger; and a volar defect group with a digital nerve defect, involving one thumb, 3 index and 3 middle fingers, and one ring finger. At the recipient site, nerve stumps of the PDNs in the pulp defect group were coapted with the proximal ends of the dorsal branch of the PDN and the proper digital nerve in the flap. The distal and proximal ends of the PDN in the flap were intercalated into the defect of the PDN in volar defect group, and the proximal end of dorsal branch of PDN in the flap was also coapted to the proximal end of the proper digital nerve of the recipient finger. At the donor site, the defect of the proper digital nerve was repaired with nerve graft harvested from the proximal portion of the dorsal branch of the same proper digital nerve, and a full-thickness skin graft covered the donor site. Results All flaps and the skin grafts of the donor site survived completely. At the final follow-up, 9 of 14 flaps had a static 2-point discrimination result below the normal threshold ( Conclusions The modified heterodigital neurovascular island flap is a useful and reliable treatment option for a digital pulp or volar defect, especially when the digital nerve defect requires repair. Type of study/level of evidence Therapeutic IV.