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Abstract Acute kidney injury (AKI) is a severe complication of coronavirus disease (COVID-19) that negatively affects its outcome. Concern had been raised about the potential effect of renin–angiotensin–aldosterone system (RAAS) blockades on renal outcomes in COVID-19 patients. However, the association between RAAS blockade use and incident AKI in COVID-19 patients has not been fully understood. We investigated the association between RAAS blockade exposure and COVID-19-related AKI in hospitalized patients through meta-analysis. Electronic databases were searched up to 24th December 2020. Summary estimates of pooled odds ratio (OR) of COVID-19-related AKI depending on RAAS blockade exposure were obtained through random-effects model. The random-effect meta-analysis on fourteen studies (17,876 patients) showed that RAAS blockade use was significantly associated with increased risk of incident AKI in hospitalized COVID-19 patients (OR 1.68; 95% confidence interval 1.19–2.36). Additional analysis showed that the association of RAAS blockade use on COVID-19-related AKI remains significant even after stratification by drug class and AKI severity. RAAS blockade use is significantly associated with the incident AKI in hospitalized COVID-19 patients. Therefore, careful monitoring of renal complications is recommended for COVID-19 patients with recent RAAS blockade use due to the potential risk of AKI.

Background: The number of heart transplantations (HTx) is increasing annually. Due to advances in medical and surgical support, the outcomes of HTx are also improving. Extracorporeal circulatory life support (ECLS) provides patients with decompensated heart failure a chance to undergo HTx. A medical approach involving collaboration among experienced experts in different fields should improve the outcomes and prognosis of ECLSbridged HTx. Methods: From December 2003 to December 2018, 1,465 patients received ECLS at Samsung Medical Center. We excluded patients who had not undergone HTx or underwent repeated transplantations. Patients younger than 18 years were excluded. We also excluded patients who received an implantable durable left ventricular assist device before HTx. In total, 91 patients were included in this study. A multidisciplinary team approach began in March 2013 at our hospital. We divided the patients into 2 groups depending on whether they were treated before or after implementation of the team approach. Results: The 30-day mortality rate was significantly higher in the pre-ECLS team group than in the post-ECLS team group (n=5, 18.5% vs. n=2, 3.1%; p=0.023). The 1-year survival rate was better in the post-ECLS team group than in the pre-ECLS team group (n=57, 89.1% vs. n=19, 70.4%; p=0.023). Conclusion: We found that implementing a multidisciplinary team approach improved the outcomes of ECLS-bridged HTx. Team-based care should be adapted at HTx centers that perform high-risk HTx.

Abstract Background Little is known regarding the effect of cardiopulmonary bypass (CPB) reoxygenation on cardiac function following tetralogy of Fallot repair. We hypothesized that hyperoxic reoxygenation would be more strongly associated with myocardial dysfunction in children with tetralogy of Fallot. Methods We investigated the association of perfusate oxygenation (PpO2) associated with myocardial dysfunction among children aged 6–72 months who underwent complete repair of tetralogy of Fallot in 2012–2018. Patients were divided into two groups: lower PpO2 group (≤ 250 mmHg) and higher PpO2 (> 250 mmHg) group based on the highest value of PpO2 during aortic occlusion. The odd ratio (ORs) and 95% confidence intervals (CIs) were estimated by logistic regression models. Results This study included 163 patients perfused with lower PpO2 and 213 with higher PpO2, with median age at surgery 23.3 (interquartile range [IQR] 12.5–39.4) months, 164 female (43.6%), and median body mass index 15.59 (IQR 14.3–16.9) kg/m2. After adjustment for baseline, clinical and procedural variables, patients with higher PpO2 were associated with higher risk of myocardial dysfunction than those with lower PpO2 (OR 1.770; 95% CI 1.040–3.012, P = 0.035). Higher PpO2, lower SpO2, lower pulmonary annular Z-score, and longer CPB time were independent risk factors for myocardial dysfunction. Conclusions Association exists between higher PpO2 and myocardial dysfunction risk in patients with tetralogy of Fallot, highlighting the modulation of reoxygenation during aortic occlusion to reduce cardiovascular damage following tetralogy of Fallot repair. Trial registration Clinical Trials. gov number NCT03568357. June 26, 2018

BackgroundNon-structural protein 1 (NS1), one of the viral proteins of influenza A viruses (IAVs), plays a crucial role in evading host antiviral immune response. It is known that the IAV NS1 protein regulates the antiviral genes response mainly through several different molecular mechanisms in cytoplasm. Current evidence suggests that NS1 represses the transcription of IFNB1 gene by inhibiting the recruitment of Pol II to its exons and promoters in infected cells. However, IAV NS1 whether can utilize a common mechanism to antagonize antiviral response by interacting with cellular DNA and immune-related transcription factors in the nucleus, is not yet clear.MethodsChromatin immunoprecipitation and sequencing (ChIP-seq) was used to determine genome-wide transcriptional DNA-binding sites for NS1 and NF-κB in viral infection. Next, we used ChIP-reChIP, luciferase reporter assay and secreted embryonic alkaline phosphatase (SEAP) assay to provide information on the dynamic binding of NS1 and NF-κB to chromatin. RNA sequencing (RNA-seq) transcriptomic analyses were used to explore the critical role of NS1 and NF-κB in IAV infection as well as the detailed processes governing host antiviral response.ResultsHerein, NS1 was found to co-localize with NF-κB using ChIP-seq. ChIP-reChIP and luciferase reporter assay confirmed the co-localization of NS1 and NF-κB at type III IFN genes, such as IFNL1, IFNL2, and IFNL3. We discovered that NS1 disturbed binding manners of NF-κB to inhibit IFNL1 expression. NS1 hijacked NF-κB from a typical IFNL1 promoter to the exon-intron region of IFNL1 and decreased the enrichment of RNA polymerase II and H3K27ac, a chromatin accessibility marker, in the promoter region of IFNL1 during IAV infection, consequently reducing IFNL1 gene expression. NS1 deletion enhanced the enrichment of RNA polymerase II at the IFNL1 promoter and promoted its expression.ConclusionOverall, NS1 hijacked NF-κB to prevent its interaction with the IFNL1 promoter and restricted the open chromatin architecture of the promoter, thereby abating antiviral gene expression.

Anxiety-like symptoms are common symptoms of methamphetamine (METH) users, especially in the acute withdrawal period, which is an important factor for the high relapse rate during METH acute withdrawal. Exercise has been demonstrated to relieve anxiety-like symptoms during METH withdrawal, but the underlying mechanisms of this anti-anxiety effect are still unclear. Activated microglia and abnormal neuroinflammation play an important role in the pathogenesis of anxiety-like symptoms after METH withdrawal. Moreover, peripheral immune factors were also significantly associated with anxiety symptoms. However, the effects of treadmill exercise on microglial function and neuroinflammation in the striatum and hippocampus during acute METH withdrawal have not been reported. In the current study, we found severe peripheral immune dysfunction in METH users during acute withdrawal, which may in part contribute to anxiety symptoms during METH acute withdrawal. We also showed that 2 weeks of METH exposure induced anxiety-like symptoms in the acute withdrawal period. Additionally, METH exposure resulted in increased microglial activation and proinflammatory cytokines released in the mouse striatum and hippocampus during acute withdrawal. We next evaluated the effects of treadmill exercise in countering anxiety-like symptoms induced by METH acute withdrawal. The results showed that anxiety-like symptoms induced by acute METH withdrawal were attenuated by coadministration of treadmill exercise. In addition, treadmill exercise counteracted METH-induced microglial activation in the mouse striatum and various subregions of the hippocampus. Furthermore, treadmill exercise also reversed the increase in proinflammatory cytokines induced by acute METH withdrawal in the mouse striatum, hippocampus and serum. Our findings suggest that the anti-anxiety effect of treadmill exercise may be mediated by reducing microglial activation and regulating central and peripheral inflammatory responses.

Objective To identify factors and assess to what extent they impact the magnitude of the treatment effect of acupuncture therapies across therapeutic areas.Data source Medline, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc, between 2015 and 2019.Study selection The inclusion criteria were trials with a total number of randomised patients larger than 100, at least one patient-important outcome and one of two sets of comparisons.Data analysis The potential independent variables were identified by reviewing relevant literature and consulting with experts. We conducted meta-regression analyses with standardised mean difference (SMD) as effect estimate for the dependent variable. The analyses included univariable meta-regression and multivariable meta-regression using a three-level robust mixed model.Results 1304 effect estimates from 584 acupuncture randomised controlled trials (RCTs) were analysed. The multivariable analyses contained 15 independent variables . In the multivariable analysis, the following produced larger treatment effects of large magnitude (>0.4): quality of life (difference of adjusted SMDs 0.51, 95% CI 0.24 to 0.77), or pain (0.48, 95% CI 0.27 to 0.69), or function (0.41, 95% CI 0.21 to 0.61) vs major events. The following produced larger treatment effects of moderate magnitude (0.2–0.4): single-centred vs multicentred RCTs (0.38, 95% CI 0.10 to 0.66); penetration acupuncture vs non-penetration types of acupuncture (0.34, 95% CI 0.15 to 0.53); non-pain symptoms vs major events (0.32, 95% CI 0.12 to 0.52). The following produced larger treatment effects of small magnitude (

OBJECTIVES The aim of this study was to explore factors affecting attitudes toward coronavirus disease 2019 (COVID-19) vaccination, including socio-demographic characteristics and mental health status during the pandemic. METHODS This study analyzed responses from 1,768 participants who were originally included in a community cohort study and responded to 3 online surveys related to COVID-19 (March 2020 to March 2021). The k-means method was used to cluster trust in and intention to receive COVID-19 vaccination. Baseline (2013-2018) socio-demographic characteristics, physical health status, and depressive symptoms were analyzed as exposure variables, and current mental health status was included in the analyses. RESULTS Almost half of all participants were classified into the moderate trust and high intention cluster (n=838, 47.4%); those with high trust and high intention accounted only for 16.9%. They tended to be older, had high-income levels, and engaged in regular physical activity at baseline (p

Various management systems are being broadly employed to minimize crop yield loss resulting from abiotic and biotic stresses. Here we introduce a Bacillus zanthoxyli HS1 strain as a potent candidate for managing manifold stresses on vegetable plants. Considering 16S rDNA sequence and biochemical characteristics, the strain is closely related to B. zanthoxyli. The B. zanthoxyli HS1's soil-drench confers disease resistance on tomato and paprika plants against infection with Ralstonia solanacearum and Phytophthora capsici, respectively. Root and shoot growths are also increased in B. zanthoxyli HS1-treated cabbage, cucumber, and tomato plants, compared with those in mock-treated plants, after application of high salinity solution. Moreover, the pretreatment of B. zanthoxyli HS1 on cabbage plants inhibits the degradation of chloroplast pigments caused by high salinity stresses, whereas the inhibitory effect is not observed in cucumber plants. These findings suggest that B. zanthoxyli HS1 stain inhibits disease development and confers tolerance to salinity stress on vegetable plants.

The dynamic on-resistance increase during power switching is one of the challenges of GaN-based HEMTs (high-electron-mobility transistors) for power electronic applications. Both the surface traps and buffer traps reduce channel carriers, resulting in decreased operating current during power switching. In this work, we propose a source metal trench toward the buffer region to alleviate channel carriers’ trapping in the buffer region. We compare the dynamic behaviors of the HEMTs with the source trench fabricated within and out of the mesa region. The results indicate less dynamic on-resistance increase at higher drain and gate stress voltages of the device with source trench in the mesa, as compared with the device with source trench fabricated away from mesa, or the one without a trench. We further develop physical models, including multiple current-conducting paths, reduction of buffer traps through source trench, and the re-distribution of the electric field profile, to explain the phenomenon.

Abstract Background The 2018 classification of periodontal disease characterizes the disease with a multidimensional staging and grading system. The purpose of this multicenter study was to examine variations in periodontitis classification among dental practitioners with different postgraduate educational backgrounds at the University of Maryland School of Dentistry and the Loma Linda University School of Dentistry using the 2018 classification. Methods This cross-sectional observational study included two cohorts: dental practitioners with periodontal backgrounds (n1 = 31) and those with other educational backgrounds (n2 = 33). The survey instrument contained three periodontitis cases presented with the guideline of the 2018 classification and a questionnaire including closed and open-ended questions. The participants were asked to review each case and to fill out the questionnaire independently. Fisher’s exact test was conducted to examine the differences in responses between the two cohorts. Polychoric correlations were calculated to examine the relation between the level of familiarity with the 2018 classification and the accuracy of the classification. Results The distribution of item responses was significantly different between the two cohorts regarding only one item, grading for Case 1 (p = 0.01). No significant differences in accuracy between the two cohorts were observed except for two items, grading in Case 1 (p = 0.03) and staging in Case 3 (p = 0.04). There were no significant differences in risk factor identification for each case among the two cohorts (p = 1.00, Case 1; p = 0.22, Case 2). Staging in Case 3 ( $$\widehat{\rho }$$ ρ ^ = 0.52) and risk factor identification in Case 2 ( $$\widehat{\rho }$$ ρ ^ = 0.32) were significantly correlated with familiarity with the 2018 classification. Conclusion A fair level of agreement in periodontitis classification was observed among dental practitioners with different educational backgrounds when the 2018 classification was used. The periodontal cohort showed better agreement levels and partially better accuracy. Risk factor identification for periodontal disease was difficult regardless of the educational background.

SARS-CoV-2 has spread rapidly, causing deaths worldwide. In this study, we evaluated the performance of the BD MAX Open System module for identifying viral pathogens, including SARS-CoV-2, in nasopharyngeal specimens from individuals with symptoms of upper respiratory tract infection. We developed and validated a rapid total nucleic acid extraction method based on real-time reverse transcription-polymerase chain reaction (RT-PCR) for the reliable, high-throughput simultaneous detection of common cold viral pathogens using the BD MAX Platform. The system was evaluated using 205 nasopharyngeal swab clinical samples. For assessment of the limit of detection (LoD), we used SARS-CoV-2, influenza A/B, and respiratory syncytial virus (RSV) RNA standards. The BD MAX dual multiplex real-time RT-PCR panel demonstrated a sensitivity comparable to that of the World Health Organization-recommended SARS-CoV-2 assay with an LoD of 50 copies/PCR. The LoD of influenza A/B and RSV was 100–200 copies/PCR. The overall percent agreement between the BD MAX panel and laboratory-developed RT-PCR test on 55 SARS-CoV-2-positive clinical samples was 100%. Among the 55 positive cases of COVID-19 analysed, no coinfection was detected. The BD MAX rapid multiplex PCR provides a highly sensitive, robust, and accurate assay for the rapid detection of SARS-CoV-2, influenza A/B, and RSV.

Abstract Although extracorporeal membrane oxygenation (ECMO) is increasingly utilized, only a limited level of experience has been reported in postpartum cardiopulmonary failure. Ten critically ill postpartum patients who received ECMO were included between January 2010 and December 2018 in this retrospective observational study. The main indication for ECMO support was peripartum cardiomyopathy (n = 5), followed by postpartum hemorrhage (n = 2). Nine patients initially received veno-arterial ECMO, and one patient received veno-venous ECMO. Major bleeding occurred in six patients. The median number of units of red blood cells (RBC) transfused during ECMO was 14.5 units (interquartile range 6.8–37.8 units), and most RBC transfusions occurred on the first day of ECMO. The survival-to-discharge rate was 80%. Compared to the survival outcomes in female patients of similar age who received ECMO, the survival outcomes were significantly better in the study population (56% versus 80%, P = 0.0004). Despite the high risk of major bleeding, ECMO for patients with postpartum cardiac or respiratory failure showed excellent survival outcomes. ECMO is feasible in these patients and can be carried out with good outcomes in an experienced centre.

Soil water deficit and salt stress are major limiting factors of plant growth and agricultural productivity. The primary root is the first organ to perceive the stress signals for drought and salt stress. In this study, maize plant subjected to drought, salt and combined stresses displayed a significantly reduced primary root length relative to the control plants. GC-MS was used to determine changes in the metabolites of the primary root of maize in response to salt, drought and combined stresses. A total of 86 metabolites were measured, including 29 amino acids and amines, 21 organic acids, four fatty acids, six phosphoric acids, 10 sugars, 10 polyols, and six others. Among these, 53 metabolites with a significant change under different stresses were identified in the primary root, and the content of most metabolites showed down-accumulation. A total of four and 18 metabolites showed significant up- and down-accumulation to all three treatments, respectively. The levels of several compatible solutes, including sugars and polyols, were increased to help maintain the osmotic balance. The levels of metabolites involved in the TCA cycle, including citric acid, ketoglutaric acid, fumaric acid, and malic acid, were reduced in the primary root. The contents of metabolites in the shikimate pathway, such as quinic acid and shikimic acid, were significantly decreased. This study reveals the complex metabolic responses of the primary root to combined drought and salt stresses and extends our understanding of the mechanisms involved in root responses to abiotic tolerance in maize.

Abstract Background Writing is a useful learning activity that promotes higher-order thinking, but there are limited studies that prove its effectiveness. In previous research, researchers tested the effect of summary writing on students’ comprehension and found no significant difference from that of re-studying texts. The purpose of this study, therefore, is to expand previous findings and investigate the effect of two types of writing tasks on medical students’ academic performance, specifically in the transfer of knowledge. Methods An experiment was conducted with 139 medical students from Seoul National University College of Medicine. They were randomly assigned to three study conditions: self-study (SS), expository writing (EW), and argumentative writing (AW) group. Each group studied the given material by the method they were assigned, and they were tested on their comprehension and transfer of knowledge using rote-memory type items and transfer type items respectively. Results The results showed that the two writing groups displayed better performance than the SS group in transfer type items, while there was no difference in scores between the EW and AW group. However, the three groups showed no significant difference in their scores for rote-memory type items. Also, there was a positive correlation between the writing scores and transfer type item scores in the AW group. Conclusions This study provides empirical evidence for writing to be adopted in medical education for greater educational benefits. Our findings indicate that writing can enhance learning and higher-order thinking, which are critical for medical students.

Background/Aims Sequential monotherapy is recommended for anthracycline-and taxane-resistant metastatic breast cancer (MBC), but combination chemotherapy is considered in patients with visceral crisis. Cisplatin-doublet chemotherapy is a combination regimen for MBC, but prolonged treatment is challenging because of toxicity. We analyzed the role of single-agent maintenance chemotherapy after cisplatin-doublet chemotherapy for MBC. Methods From January 2011 to December 2017, 96 anthracycline- and taxane-resistant MBC patients were retrospectively reviewed, and 49 patients with a sustained clinical benefit during the initial 6 cycles of cisplatin-doublet chemotherapy were enrolled for study. Patients were treated with gemcitabine-cisplatin (gemcitabine, 1,250 mg/m2, intravenously [IV], days 1 to 8; cisplatin 60 mg/m2, IV, day 1) or capecitabine-cisplatin (capecitabine 2,500 mg/m2, orally, days 1 to 14; cisplatin 60 mg/m2, IV, day 1) during the induction period. After 6 cycles, 16 patients were switched to single-maintenance treatment (gemcitabine or capecitabine) and the doublet regimen was continued in 24 patients. Survival outcomes (progression-free survival [PFS] and overall survival [OS]) were analyzed. Results Among the 49 patients who showed a clinical benefit during cisplatin-doublet therapy, 24 were maintained on the doublet regimen, 16 were switched to single-maintenance treatment, and chemotherapy was suspended until disease progression in nine patients. The single-maintenance chemotherapy group showed superior survival than the chemotherapy holiday and doublet regimen groups (median PFS 15.43 months vs. 8.37 and 10.67 months, respectively, p = 0.008; median OS 43.67 months vs. 22.17 and 22.33 months, respectively, p = 0.014). Conclusions Patients showing a clinical benefit during 6 cisplatin-doublet chemotherapy cycles may have a sustained survival benefit from single-maintenance chemotherapy.

Background: In recent years, health monitoring systems (HMS) have aroused great interest due to their broad prospects in preventive medicine. As an important component of HMS, flexible force sensors (FFS) with high flexibility and stretch-ability can monitor vital health parameters and detect physical movements. Aim of Review: In this review, the novel materials, the advanced additive manufacturing technologies, the selective sensing mechanisms and typical applications in both wearable and implantable HMS are discussed. Key Scientific Concepts and important findings of Review: We recognized that the next generation of the FFS will have higher sensitivity, wider linear range as well as better durability, self-power supplied and multifunctional integrated. In conclusion, the FFS will provide powerful socioeconomic benefits and improve people's quality of life in the future.

VARP is bound to endosomes and functions as a protein:protein interaction platform. Here, the authors present the NMR structure of the complex between the retromer subunit VPS29 and a VARP Zn-fingernail microdomain that is structurally distinct from Zn-fingers and further show that mutations, which abolish VPS29:VARP binding, inhibit trafficking from endosomes to the cell surface.

A 59-year-old man presented for possible durable ventricular assist device (VAD) implan-tation. He had previously been diagnosed with congenitally corrected transposition of the great arteries, a ventricular septal defect, an atrial septal defect, pulmonary valve stenosis, and aortic valve regurgitation. In the previous 22 years, he had undergone palliative cardi-ac surgery 3 times. VAD implantation as a bridge to transplantation was planned. Owing to severe adhesions, mesocardia, a left ascending aorta, and moderate aortic regurgitation, we performed VAD implantation and aortic valve closure via a dual left thoracotomy and partial sternotomy.

Flower-like nickel phyllosilicate (Ni-PS) was synthesized via the mild hydrothermal method. The generated Ni-PS containing ferric (Fe@Ni-PS) was then characterized and introduced into epoxy resins (EP) to prepare EP composites. The thermal stability and flame retardant properties of the EP composites were investigated. With the incorporation of 4.0 wt% Fe@Ni-PS, the LOI value of EP composite increased to 28.9 ± 0.2 % with an enhancement of 18.4 % comparing to pure EP. Furthermore, it extinguished after ignition for 12.0 s, and passed the V-1 rating in UL-94 test, while pure EP kept vigorous burning. Cone calorimetry test showed that EP composite had low the peak of heat release rate (pHRR) and total heat release (THR) of 810.9 kW/m2 and 99.9 MJ/m2 with a reduction of 20.1 % and 4.7 % compared to those of pure EP, respectively. Thermogravimetric analysis test indicated that with the addition of Fe@Ni-PS, although the initial decomposition temperature of EP composite shifted to the lower temperature, the maximum weight loss rate was obviously decreased. The research provides a viable approach to strengthening fire safety of EP composites.

Abstract It has been well established that quantum mechanics (QM) violates Bell inequalities (BI), which are consequences of local realism (LR). Remarkably QM also violates Leggett inequalities (LI), which are consequences of a class of nonlocal realism called crypto-nonlocal realism (CNR). Both LR and CNR assume that measurement outcomes are determined by preexisting objective properties, as well as hidden variables (HV) not considered in QM. We extend CNR and LI to include the case that the measurement settings are not externally fixed, but determined by HV. We derive a new version of LI, which is then shown to be violated by entangled $$B_d$$ B d mesons, if charge–conjugation–parity (CP) symmetry is indirectly violated, as indeed established. The experimental result is quantitatively estimated by using the indirect CP violation parameters, and the maximum of a suitably defined relative violation is about $$2.7\%$$ 2.7 % . Our work implies that particle physics violates CNR. Our LI can also be tested in other systems such as photon polarizations.

To study the treatment problem of the roof watering of the roadway during the ditch driving of the shallow coal seam, the topography and geological conditions at the ditch of the 4-2 coal centralized auxiliary transport roadway in Zhangjiamao Coal Mine are analyzed. Based on the hydrogeological exploration hole and roof exploration hole, the cause of the roadway outflow is analyzed. The water source of the roadway watering is the weathered bedrock water, and the channel is the anchor hole. The idea of water stoppage by grouting is put forward to plug anchor cable hole, and the roof water treatment project is designed. The result proves that the method of directly blocking the anchor cable hole, and the cement slurry, cement-water glass double-liquid slurry and urea-formaldehyde resin chemical slurry are successively injected, the method can effectively block the large-scale roof watering of the ditch roadway.

Abstract Gauge theory is the framework of the Standard Model of particle physics and is also important in condensed matter physics. As its major non-perturbative approach, lattice gauge theory is traditionally implemented using Monte Carlo simulation, consequently it usually suffers such problems as the Fermion sign problem and the lack of real-time dynamics. Hopefully they can be avoided by using quantum simulation, which simulates quantum systems by using controllable true quantum processes. The field of quantum simulation is under rapid development. Here we present a circuit-based digital scheme of quantum simulation of quantum ℤ2 lattice gauge theory in 2 + 1 and 3 + 1 dimensions, using quantum adiabatic algorithms implemented in terms of universal quantum gates. Our algorithm generalizes the Trotter and symmetric decompositions to the case that the Hamiltonian varies at each step in the decomposition. Furthermore, we carry through a complete demonstration of this scheme in classical GPU simulator, and obtain key features of quantum ℤ2 lattice gauge theory, including quantum phase transitions, topological properties, gauge invariance and duality. Hereby dubbed pseudoquantum simulation, classical demonstration of quantum simulation in state-of-art fast computers not only facilitates the development of schemes and algorithms of real quantum simulation, but also represents a new approach of practical computation.

Craniopharyngioma is an uncommon intracranial tumor that primarily occurs in the sella turcica. Giant cystic craniopharyngioma is rare in general and extremely rare in adults. We report a rare case of giant cystic craniopharyngioma in the anterior pontine cisterna and suprasellar cisterna. A 27-year-old man presented with double vision, and craniocerebral MRI revealed cystic masses in the anterior pontine cisterna and suprasellar cisterna. The masses were removed surgically and diagnosed as large cystic craniopharyngiomas by pathology and MRI. Giant cystic craniopharyngioma is rare in adults. Through this case report, we hope to increase awareness of this disease among various clinicians, including radiologists.

Abstract Corneal chemical burns can lead to blindness following serious complications. As most of these complications are caused by failure of reepithelization during the acute phase, treatment at this stage is critical. Although there have been some studies on corneal injury recovery using adipose tissue-derived stem cells (ADSCs), none has reported the effect of topical cell-free conditioned culture media (CM) derived from ADSCs on corneal epithelial regeneration. Here, the best conditions for CM were selected and used for in vitro and in vivo experiments. Corneal burn in rats was induced using 100% alcohol. The chosen CM was administered to corneal burn rats (CM-treated [CT] group) four times a day for three days and this group was compared with the normal control and corneal burn (CB) groups. Biomicroscopic fluorescence images and the actual physical corneas were taken over time and used for analysis. mRNA levels of hepatocyte growth factor and epidermal growth factor (EGF) were significantly increased, whereas those of vascular endothelial growth factor, interleukin (IL)-1β, IL-6, IL-10, and matrix metalloproteinase-9 were significantly decreased in the CT group compared with those in the CB group. The numbers of proliferating cell nuclear antigen- and zonular occludens-1-positive cells in the CT group were significantly higher than those in the CB group. The macrophage-infiltrating corneas in the CT group expressed significantly more of the M2 marker arginase than corneas in the CB group. Optimal CM (× 0.5 concentration) treatment significantly accelerated the migration of corneal epithelial cells and induced upregulation of the expression of IL-6, EGF, and C-X-C chemokine receptor type 4 mRNAs. Overall, in this study, topical administration of cell-free CM promoted regeneration of the corneal epithelium after induction of chemical burns.

Background: Advanced light-chain (AL) amyloidosis is associated with poor prognosis, with a 5-year survival rate of

Objective To compare the teaching quality between traditional and SOP (standard operation procedure)-based orthopedic teaching rounds. Methods Postgraduates and clinical postdoctors who were enrolled into orthopedic standardized training in 2017 and 2018 grade were included in this study. Thirty postgraduates and 20 clinical post doctors were in each group, with traditional or SOP-based teaching rounds were used respectively. The two groups were evaluated subjectively and objectively. Results The subjective and Objective evaluation scores of SOP-based teaching rounds were significantly higher than those of the traditional teaching group (P＜0.01,P＜0.05). Conclusions SOP-based method significantly improves the quality of teaching rounds.

Fused deposition modelling (FDM) is a commonly used 3D printing technology. The development of FDM materials was essential for the product quality of FDM. In this work, a series of polycaprolactone (PCL)-based composites for low-temperature FDM were developed. By melt blending technique, different ratios of starch were added into PCL to improve the performances of FDM, and the printability, tensile strength, rheological properties, crystallization behaviors and biological performances of the composites were studied. The PCL/starch composite had the best performance in FDM process with the starch ratio of 9 ph at 80–90 °C. The melting strength and solidification rate of PCL/starch composites were improved. The starch also increased the crystallization temperature, degree of crystallinity and crystallization rate of PCL/starch composites, while had no negative effects on the tensile strength of PCL. Due to the low printing temperature, various kinds of bioactive components were added into PCL/starch composites for preparation of antibacterial and biocompatible materials for FDM. The present work provides a new method to develop novel low-temperature FDM materials with various functions.

Here we present a rare case of pulmonary arterial thrombosis associated with a ductus arteriosus aneurysm that caused severe pulmonary stenosis. A 5-day-old newborn was admitted to our hospital for the evaluation of an intracardiac mass-like lesion found after the detection of a cardiac murmur. Echocardiography and heart computed tomography revealed a mass-like lesion measuring 8.1 mm in diameter across the distal main pulmonary artery to the proximal left pulmonary artery resulting in localized severe stenosis of the left pulmonary artery. Left pulmonary artery angioplasty for surgical resection of the thrombus revealed that the mass was adherent to the proximal part of the left pulmonary artery anterior wall and extended to the ductus arteriosus. Histological examination of the mass showed an old thrombus with dystrophic calcification. Five months after surgery, follow-up echocardiography showed that the left pulmonary artery peak pressure gradient had decreased but the proximal left pulmonary artery stenosis remained. Cardiac catheterization and balloon angioplasty suc cessfully relieved the pulmonary stenosis.

Abstract Purpose Humans are required to respond to a vehicle’s request to take-over anytime even when they are not responsible for monitoring driving environments in automated driving, e.g., a SAE level-3 vehicle. Thus, a safe and effective delivery of a take-over request from an automated vehicle to a human is critical for the successful commercialization of automated vehicles. Methods In the current study, a set of human-in-the-loop experiments was conducted to compare diverse warning combinations by applying visual, auditory, and haptic modalities under systematically classified take-over request scenarios in conditionally automated driving. Forty-one volunteers consisting of 16 females and 25 males participated in the study. Vehicle and human data on response to take-over request were collected in two take-over scenarios, i.e., a disabled vehicle on the road ahead and a highway exit. Results Visual-auditory-haptic modal combination showed the best performance in both human behavioral and physiological data and visual-auditory warning in vehicle data. Visual-auditory-haptic warning combination showed the best performance when considering all performance indices. Meanwhile, visual-only warning, which is considered as a basic modality in manual driving, performed the worst in the conditionally automated driving situation. Conclusions These findings imply that the warning design in automated vehicles must be clearly differentiated from that of conventional manual driving vehicles. Future work shall include a follow-up experiment to verify the study results and compare more diverse multimodal combinations.

Abstract. Background:. Patients carrying the HongKongαα (HKαα) allele and -α3.7/αααanti-4.2 could be misdiagnosed as -α3.7/αα by the current conventional thalassemia detection methods, leading to inaccurate genetic counseling and an incorrect prenatal diagnosis. This study was aimed to accurately analyze the genotypes of HKαα carriers and -α3.7/αααanti-4.2. Methods:. Samples were collected in our hospital from July 2017 to October 2019. Twenty-four common types of Chinese thalassemia were screened by gap-polymerase chain reaction (Gap-PCR) and reverse dot blot (RDB). Anti-4.2 multiplex-PCR was used to confirm carriers of the αααanti-4.2 duplication with -α3.7 deletion. Two-round nested PCR and multiplex ligation-dependent probe amplification (MLPA) were applied to accurately identify and confirm their genotypes. For data analysis, we used descriptive statistics and Fisher's exact tests. Results:. Two thousand five hundred and forty-four cases were identified as thalassemia in 5488 peripheral blood samples. The results showed that α, β, and αβ compound thalassemia were identified in 1190 (46.78%), 1286 (50.55%), and 68 (2.67%) cases, respectively. A total of 227 samples from thalassemia patients were identified as -α3.7/αα by Gap-PCR, and the genotypes of two samples were uncertain. There was a difference between Gap-PCR and combined groups (Gap-PCR combined with nested PCR and MLPA) in detecting HKαα (P

Background/Aims Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been recently discovered and validated as sensitive biomarkers that can predict stage 2 or 3 acute kidney injury (AKI) development in high-risk patients. We aimed to assess whether these biomarkers could predict adverse outcomes and renal recovery in established AKI patients. Methods This was a single-center study prospectively enrolling 124 patients diagnosed with AKI. TIMP-2, IGFBP7, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule 1 (KIM-1) levels were measured at the time of diagnosis and the predictive performance of short-term outcomes and renal recovery was assessed. Results Patients were divided into 4 quartiles according to the initial urinary TIMP-2/IGFBP7 levels. Stage 3 AKI (odds ratio [OR], 17.86), classified by the Kidney Disease Improving Global Outcomes (KDIGO), as well as the third and fourth quartiles of TIMP-2/IGFBP7 (OR, 5.75 and 44.98, respectively), were found to be independent predictors of renal replacement therapy at the time of AKI diagnosis. In addition, KDIGO stage 3 AKI (OR, 2.468) or the third of fourth quartiles of urinary TIMP-2/IGFBP7 (OR, 1.896 and 3.622, respectively) were also found to be useful in predicting nonrecovery of renal function. In a separate analysis of patients with renal recovery at discharge, initial urinary TIMP-2/IGFBP7 or urinary IGFBP7 at discharge could also predict new-onset or progressive chronic kidney disease (CKD). Conclusions In AKI patients, urine TIMP-2/IGFBP7 could serve as a biomarker for predicting adverse outcomes, renal recovery, or the development and progression of CKD.

Background/Purpose: A swine-origin influenza A/H1N1 virus (termed A/H1N1pdm) caused a pandemic in 2009 and has continuously circulated in the human population. To investigate its possible ecological effects on circulating influenza strains, the seasonal patterns of influenza viruses and the respective age distribution of infected patients were studies. Methods: The data obtained from national influenza surveillance systems in Taiwan from July 2009 to June 2018 were analyzed. Results: The A/H1N1pdm and A/H3N2 strains usually caused a higher ratio of severe to mild cases than influenza B. New variants of A/H1N1pdm and A/H3N2 emerged accompanied by a large epidemic peak. However, the new influenza B variants intended to circulate for several seasons before causing a large epidemic. The major group of outpatients affected by A/H1N1pdm were aged 13–23 years in the pandemic wave, and the age range of infected individuals gradually shifted to 24–49 and 0–6 years across seasons; A/H1N1pdm-infected inpatients were aged 24–49 years in 2009–2011, and the age range gradually switched to older groups aged 50–65 and >65 years. Individuals aged 0–6 or 24–49 years accounted for the majority of A/H3N2-infected outpatients across seasons, whereas most of the inpatients affected by A/H3N2 were aged >65 years. Conclusion: Understanding the effects of new variants and changes in dominant circulating viral strains on the age distribution of the affected human population, disease severity and epidemic levels is useful for the establishment of fine-tuned strategies for further improvement of influenza control. Keywords: Affected age groups, Epidemic, Influenza virus

BackgroundThis study aimed to investigate how social networks are associated with cognitive function in the middle-aged and elderly Korean population.MethodsA total of 7,704 individuals over the age of 50 were included from the baseline recruitment of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort from the years 2013 to 2018. Egocentric social network characteristics including network size, intimacy, and frequency of face-to-face meetings were measured as exposures, and the Korean version of Mini-Mental State Examination (K-MMSE) score was measured to reflect general cognitive function as an outcome. We also stratified the analysis by income level into tertiles, with income caps of 42,000 thousand won and 72,000 thousand won. A general linear regression model was used, adjusting for age, gender, socioeconomic factors, lifestyle factors, depressive symptoms, and study settings.ResultsSocial network properties were positively associated with cognitive function in both men and women. However, the specific estimates varied according to gender and income level. In men, frequency was most significantly associated with cognitive function (standardized β = 0.093, p-value

BackgroundType-Token Ratio (TTR), given its relatively simple hand computation, is one of the few LSA measures calculated by clinicians in everyday practice. However, it has significant well-documented shortcomings; these include instability as a function of sample size, and absence of clear developmental profiles over early childhood. A variety of alternative measures of lexical diversity have been proposed; some, such as Number of Different Words/100 (NDW) can also be computed by hand. However, others, such as Vocabulary Diversity (VocD) and the Moving Average Type Token Ratio (MATTR) rely on complex resampling algorithms that cannot be conducted by hand. To date, no large-scale study of all four measures has evaluated how well any capture typical developmental trends over early childhood, or whether any reliably distinguish typical from atypical profiles of expressive child language ability.Materials and MethodsWe conducted linear and non-linear regression analyses for TTR, NDW, VocD, and MATTR scores for samples taken from 946 corpora from typically developing preschool children (ages 2–6 years), engaged in adult-child toy play, from the Child Language Data Exchange System (CHILDES). These were contrasted with 504 samples from children known to have delayed expressive language skills (total n = 1,454 samples). We also conducted a separate sub-analysis which examined possible contextual effects of sampling environment on lexical diversity.ResultsOnly VocD showed significantly different mean scores between the typically -developing children and delayed developing children group. Using TTR would actually misdiagnose typical children and miss children with known language impairment. However, computation of VocD as a function of toy interactions was significant and emerges as a further caution in use of lexical diversity as a valid proxy index of children’s expressive vocabulary skill.DiscussionThis large scale statistical comparison of computer-implemented algorithms for expressive lexical profiles in young children with traditional, hand-calculated measures showed that only VocD met criteria for evidence-based use in LSA. However, VocD was impacted by sample elicitation context, suggesting that non-linguistic factors, such as engagement with elicitation props, contaminate estimates of spoken lexical skill in young children. Implications and suggested directions are discussed.

Processes in the food industry that use large amounts of water have been an important cause of waterborne disease outbreaks, as they expose individuals to risks for waterborne disease transmission. Developing technologies to ensure the hygiene and safety of food-processing steps is an urgent concern from an economic perspective. Furthermore, economic benefits can be derived if the processed water can be reused under microbiologically safe conditions. Among the major manufacturing processes in the kimchi industry, the brining process for salted kimchi cabbages requires a considerable amount of brine (approximately 2,000–2,500 l/1,000 kg of raw cabbage). The aim of this study was to establish virucidal conditions with ultraviolet-C light-emitting diodes (UVC LEDs) that can ensure the microbiological safety of brine water samples with various turbidities for reuse after disinfection. For quantitative analysis, first of all, magnetic bead separation (MBS) technique was used to capture and recover the human norovirus (HuNoV) virus particles; propidium monoazide (PMA) combined with RT-qPCR (PMA-RT-qPCR) was subsequently used to selectively detect infectious norovirus. Overall, as the turbidity of the brine water samples increased, the reduction in the HuNoV genogroup II genotype 4 (HuNoV GII.4) levels by UVC LED disinfection decreased. The derived inactivation rate constant (kinac) and inactivation curves (calculated using the log-linear model) were studied as a function of turbidity based on the exponential one-phase inactivation kinetics of HuNoV. Using an impeller system set at 100 rotations/min (rpm) with an eight-nephelometric turbidity unit (NTU) sample (the lowest turbidity studied), the kinact based on the levels of viral genomic RNA concentrations was approximately 2.15-fold higher than that observed without rotation (0 rpm). Moreover, the kinact increased 1.69-fold with a 56-NTU sample (the highest turbidity studied) when the impeller system was set at 100 rpm. UVC LED treatment decreased the HuNoV GII.4 population more effectively in conjunction with the impeller system (100 rpm) than without the impeller system. Our novel findings and model provide fundamental and scientific data that may help reuse brine water and ensure its microbiological safety through disinfection. Our study highlights the benefits of UVC LED treatment in successfully eliminating waterborne viruses in a prompt, resistance-reducing, and energy-efficient approach at the laboratory scale, which lays the foundation for future plant-scale studies of UVC LED-disinfection systems.

Anomaly detection algorithms have been proved to be useful in the search of new physics beyond the Standard Model. However, a prerequisite for using an anomaly detection algorithm is that the signal to be sought is indeed anomalous. This does not always hold true, for example when interference between new physics and the Standard Model becomes important. In this case, the search of new physics is no longer an anomaly detection. To overcome this difficulty, we propose a nested anomaly detection algorithm, which appears to be useful in the study of neutral triple gauge couplings at the CEPC, the ILC and the FCC-ee. Our approach inherits the advantages of the anomaly detection algorithm been nested, while at the same time, it is no longer an anomaly detection algorithm. As a complement to anomaly detection algorithms, it can achieve better results on problems that are no longer anomaly detection.

The ascomycete Colletotrichum gloeosporioides is a causal agent of anthracnose on crops and trees and causes enormous economic losses in the world. Protein kinases have been implicated in the regulation of growth and development, and responses to extracellular stimuli. However, the mechanism of the protein kinases regulating phytopathogenic fungal-specific processes is largely unclear. In the study, a serine/threonine CgSat4 was identified in C. gloeosporioides. The CgSat4 was localized in the cytoplasm. Targeted gene deletion showed that CgSat4 was essential for vegetative growth, sporulation, and full virulence. CgSat4 is involved in K+ uptake by regulating the localization and expression of the potassium transporter CgTrk1. CgSat4 is required for the cation stress resistance by altering the phosphorylation of CgHog1. Our study provides insights into potassium acquisition and the pathogenesis of C. gloeosporioides.

Colletotrichum gloeosporioides, a significant fungal pathogen of crops and trees, causes large economic losses worldwide. However, its pathogenic mechanism remains totally unclear. In this study, four Ena ATPases (Exitus natru-type adenosine triphosphatases), homology of yeast Ena proteins, were identified in C. gloeosporioides. Gene deletion mutants of ΔCgena1, ΔCgena2, ΔCgena3, and ΔCgena4 were obtained through the method of gene replacement. First, a subcellular localization pattern indicated that CgEna1 and CgEna4 were localized in the plasma membrane, while the CgEna2 and CgEna3 were distributed in the endoparasitic reticulum. Next, it was found that CgEna1 and CgEna4 were required for sodium accumulation in C. gloeosporioides. CgEna3 was required for extracellular ion stress of sodium and potassium. CgEna1 and CgEna3 were involved in conidial germination, appressorium formation, invasive hyphal development, and full virulence. The mutant of ΔCgena4 was more sensitive to the conditions of high concentrations of ion and the alkaline. Together, these results indicated that CgEna ATPase proteins have distinct roles in sodium accumulation, stress resistance, and full virulence in C. gloeosporioides.