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BackgroundMyosteatosis is a well-established predictor of poor prognosis in many types of cancer, and a decreased Creatinine/Cystatin C ratio (CCR) is a known indicator of unfavorable outcomes in patients with metabolic disorders and cancer. Despite this knowledge, the significance of concurrent CCR and myosteatosis in predicting the prognosis of patients with cholangiocarcinoma (CCA) who undergo radical surgery remains uncertain.MethodData from 757 patients with cholangiocarcinoma who underwent the first radical resection in the Affiliated Hospital of Qingdao University from January 2017 to March 2022 were collected. According to the inclusion and exclusion criteria, 149 patients were finally included in the retrospective study cohort. Various clinicopathological, serological, and radiological data were collected at admission. Myosteatosis was evaluated using sliceOmatic software on computed tomography (CT) images. The study used receiver operating characteristic (ROC) curve analysis to determine the critical value of CCR, which predicts overall survival (OS) based on the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were employed to identify the risk factors associated with OS and RFS confidently.ResultsThe group identified as the myosteatosis cohort consisted of 79 patients with an average age of 64.3 ± 7.8 years. The ROC curve analysis revealed an optimal critical CCR value of 10.834. A low CCR ≤ 10.834 and myosteatosis were found to be associated with poor OS and RFS outcomes (P = 0.022; P = 0.017; P = 0.038; P = 0.030 respectively). Moreover, patients with myosteatosis and a CCR ≤ 10.834 had the worst OS and RFS outcomes (P = 0.035; P = 0.027).ConclusionAfter radical excision in CCA patients, the presence of myosteatosis and CCR had a negative correlation with prognosis. A more accurate prediction of OS and RFS was possible by combining CCR and myosteatosis, compared to CCR alone.

Abstract With continuous advancements in ancient‐book digitization and preservation research, the problems with the stitching of ancient‐book images have become increasingly prominent, as traditional feature‐mapping‐based methods cannot satisfactorily stitch non‐overlapping images. To realize the accurate stitching of the left and right pages of ancient‐book images, this paper proposes a method for ancient‐book image stitching to meet the requirements of their digitization in back‐wrapped binding and other binding forms. First, a dataset of the black text frames from ancient‐book images was established and then used to train a VGG16‐UNet network for the extraction of black text frames. Then, the Douglas–Peucker algorithm was used to fit the black text frames and filter outliers. Finally, a sliding matching algorithm based on the position information of black text frames was proposed for the rectification of misalignments. The results showed that the method achieved a satisfying stitching effect and had good robustness.

Endometrium is suspectable to severe injury due to recurrent abortion, curettage or intrauterine infection which could lead to pathological conditions and sabotage women's fertility. Promoting endometrium regeneration is the core of the treatments to uterine related infertility. Patients who received traditional treatments can only expect limited effects, thereby novel therapies are badly in need to promote endometrium regeneration. Here we generated a decellularized extracellular matrix (ECM) from porcine dermis, and composited adipose stem cell derived exosomes (ADSC-exos) on it (ECM@ADSC-exos). In vitro experiments proved that ECM@ADSC-exos exhibited good cytocompatibility and could improve cell proliferation, migration and angiogenesis. We also observed that, when implanted in the uterine cavity of a rat model of endometrium injury, ECM@ADSC-exos improved endometrium regeneration, enhanced local angiogenesis, promoted myometrium repair and finally preserved fertility. Our results proved that ECM@ADSC-exos could be a novel option for endometrium regeneration.

Abstract The commercial plywood is mainly made of high‐value wood veneer and formaldehyde‐based adhesives, which pose a major risk to human health and environmental protection. Here, we report an all‐natural plywood made of self‐adhesive bark veneer directly from hardy rubber trees (HRT) via delignification, epoxidation reaction and densification. The resulting bark veneer is demonstrated with sandwich structures featuring natural integration between cellulose and biopolymer Eucommia ulmoides gum (EUG). The intrinsic EUG act as a potential strong “self‐adhesive” and water‐proofing agent, leading to bark veneer with high hardness, excellent hydrophobicity, wear resistance, and low thermal conductivity. Furthermore, we can produce the self‐adhesive plywood on a large scale directly from HRT bark using this approach without any adhesives, endowing it with environmental friendliness, safety in use, and health benefits of human beings. Combining its efficient and low‐cost production, the bark veneer shows great promise in fabricating high‐performance and environmentally sustainable plywood.

In irregular repetition slotted ALOHA (IR-SA) systems, a population of devices transmits their packets to an access point (AP) within a frame of slots. The AP decodes these packets by iterative processing between intra- and inter-slot successive interference cancellations. The average normalized offered traffic, as a performance metric, represents the number of packets transmitted per slot when the packet loss rate approaches zero. Such asymptotic types of traffic as the belief propagation (BP) threshold, the maximum a posteriori (MAP) threshold, and the converse bound of IR-SA systems have been analyzed over various channel models. However, over fading channels, the MAP threshold and the converse bound have not yet been investigated. This paper derives an MAP threshold and a converse bound of the systems over Rayleigh block fading channels. The derivations are based on two extrinsic information transfer (EXIT) curves, which are associated with two iterative density evolution equations to analyze the BP threshold of the IR-SA systems. First, since an open decoding tunnel exists in an EXIT chart, the sum of the two areas below two EXIT curves is smaller than the area of the entire domain. This provides the traffic’s converse bound, which is tight. Second, a coincidence of the BP EXIT and MAP EXIT curves makes it possible to derive the traffic’s MAP threshold. Third, a density evolution for a spatially-coupled scheme is formulated and gives a BP decoding threshold of the traffic. Numerical results show that the spatially-coupled scheme achieves a threshold saturation effect where the BP threshold approaches the MAP threshold.

Abstract The importance of surface roughness with respect to the bulk properties of dielectric materials is often overlooked. Surface roughness or interfaces between different material layers often significantly affects the external properties of thin films. Surface roughness holds its commonalty and critical impact among many materials properties. This review summarises the recent work on the effect of surface roughness on the mechanical, thermal, physical, and dielectric properties of dielectric films. Appropriate roughness favours adhesion, filtration, biological fouling, tribological properties, and magnetic properties. Nevertheless, lower roughness generally benefits the dielectric properties of dielectric materials, with thicknesses ranging from a few nanometres to up to 50 μm. This review discusses surface roughness control and the techniques of measurement as well. It emphasises the importance and characterisation of sample surface roughness for a better understanding of the dielectric phenomenon, mechanisms, and electrical stress test setup for various dielectric films.

BackgroundHuman papillomavirus-positive (HPV+) cervical cancers are highly heterogeneous in clinical and molecular characteristics. Thus, an investigation into their heterogeneous immunological profiles is meaningful in providing both biological and clinical insights into this disease.MethodsBased on the enrichment of 29 immune signatures, we discovered immune subtypes of HPV+ cervical cancers by hierarchical clustering. To explore whether this subtyping method is reproducible, we analyzed three bulk and one single cell transcriptomic datasets. We also compared clinical and molecular characteristics between the immune subtypes.ResultsClustering analysis identified two immune subtypes of HPV+ cervical cancers: Immunity-H and Immunity-L, consistent in the four datasets. In comparisons with Immunity-L, Immunity-H displayed stronger immunity, more stromal contents, lower tumor purity, proliferation potential, intratumor heterogeneity and stemness, higher tumor mutation burden, more neoantigens, lower levels of copy number alterations, lower DNA repair activity, as well as better overall survival prognosis. Certain genes, such as MUC17, PCLO, and GOLGB1, showed significantly higher mutation rates in Immunity-L than in Immunity-H. 16 proteins were significantly upregulated in Immunity-H vs. Immunity-L, including Caspase-7, PREX1, Lck, C-Raf, PI3K-p85, Syk, 14-3-3_epsilon, STAT5-α, GATA3, Src_pY416, NDRG1_pT346, Notch1, PDK1_pS241, Bim, NF-kB-p65_pS536, and p53. Pathway analysis identified numerous immune-related pathways more highly enriched in Immunity-H vs. Immunity-L, including cytokine-cytokine receptor interaction, natural killer cell-mediated cytotoxicity, antigen processing and presentation, T/B cell receptor signaling, chemokine signaling, supporting the stronger antitumor immunity in Immunity-H vs. Immunity-L.ConclusionHPV+ cervical cancers are divided into two subgroups based on their immune signatures' enrichment. Both subgroups have markedly different tumor immunity, progression phenotypes, genomic features, and clinical outcomes. Our data offer novel perception in the tumor biology as well as clinical implications for HPV+ cervical cancer.

Abstract Designing high voltage (>3 V) and stable electrochemical supercapacitors with low self‐discharge is desirable for the applications in modern electronic devices. This work demonstrates a 4 V symmetric supercapacitor with stabilized cycling performance through atomic layer deposition (ALD) of alumina (Al2O3) on the surface of activated carbon (AC). The 20‐cycle ALD Al2O3 coated AC delivers 84 % capacitance retention after 1000 charge/discharge cycles under 4 V, contrary to the bare AC cells having only 48 % retention. The extended cycling life is associated with the thickened Stern layer and suppressed oxygen functional group. The self‐discharge data also show that the Al2O3 coating enables AC cells to maintain 53 % of charge retention after 12 h, which is more than twice higher than that of bare AC cells under the same test protocol of 4 V charging. The curve fitting analysis reveals that ALD coating induced slow self‐discharge dominated by ion diffusion mechanism, thus enhancing the AC surface energy.

Background Infection is an important risk factor for gestational diabetes mellitus (GDM), while infection of human cytomegalovirus (HCMV) with GDM remains unclear and rarely reported. This study aimed to investigate the association of HCMV infection and serum inflammatory factor levels in pregnancy with GDM. Methods This prospective study included pregnant women who attended at Affiliated Hospital of Qingdao Hospital and Zibo Maternal and Child Health Hospital between December 2018 and August 2020. HCMV specific IgM and serum levels of inflammatory factors, including TNF-α, IL-6, and IL-1β, were analyzed. Results A total of 5,316 pregnant women were included (415 with GDM (107 with HCMV+GDM+ and 308 with HCMV-GDM+) and 4901 GDM-free (759 with HCMV+GDM- and 4142 with HCMV-GDM-)). The prevalence of GDM was 7.81%. The rate of activation of HCMV was 16.29%. Specifically, 107 and 759 women in the GDM and control group exhibited HCMV infection, with positive rates of25.78% and 15.48%, respectively (P

Objective. Electrocardiogram (ECG) is an important diagnostic tool that has been the subject of much research in recent years. Owing to a lack of well-labeled ECG record databases, most of this work has focused on heartbeat arrhythmia detection based on ECG signal quality. Approach. A record quality filter was designed to judge ECG signal quality, and a random forest method, a multilayer perceptron, and a residual neural network (RESNET)-based convolutional neural network were implemented to provide baselines for ECG record classification according to three different principles. A new multimodel method was constructed by fusing the random forest and RESNET approaches. Main Results. Owing to its ability to combine discriminative human-crafted features with RESNET deep features, the proposed new method showed over 88% classification accuracy and yielded the best results in comparison with alternative methods. Significance. A new multimodel fusion method was presented for abnormal cardiovascular detection based on ECG data. The experimental results show that separable convolution and multiscale convolution are vital for ECG record classification and are effective for use with one-dimensional ECG sequences.

Objectives: To evaluate the safety and efficacy of conservative laparoscopic surgery for adnexal torsion and the feasibility of secondary operation. Methods: This is a retrospective study that consists of 17 patients with clinically diagnosed adnexal torsion who have a desire for pregnancy in the future. We performed conservative laparoscopic adnexal detorsion operations from January 2014 to June 2016 in Sir Run Run Shaw Hospital. The collected data, including age, onset time, maximum diameter of adnexal lesion, local blood flow signal, torsion degree, and recovery of local blood supply after detorsions, were analyzed. The blood flow of the lesion side, the antral follicles development, the basal endocrine hormone levels and the menstrual cycle were examined one-month and three-month post operation. Future fertility was investigated postoperatively. Results: All cases had no obvious clinical postoperative complications. There were no significant changes on menstrual cycle and ovarian function during the follow-up period. Conclusions: Adnexal torsion in young patients should be carefully treated and fertility reservation should be thoroughly considered. The decision to remove adnexa needs careful consideration. Conservative laparoscopic surgery is safe and does not increase the occurrence of serious complications. There is a higher possibility of a long delay between surgery and onset necrosis, but this is not always the case. Even if there is adnex thromboembolic infarction it does not result in serious complications such as pulmonary infarction. Conservative laparoscopic surgery can be performed first unless the clinician is certain it is already necrotic. We should do our best to reserve patients’ fertility as much as possible. If necessary, a secondary surgery can be performed. Keywords: Adnexal torsion, Laparoscopic conservative surgery, Fertility preservation

As a conventional electrode material of electric double-layer capacitors (EDLC), activated carbon (AC) still faces challenges to exhibit high capacitance. To address this problem, herein, we introduce a combined method of oxygen plasma and Al2O3 tomic layer deposition (ALD) on AC electrodes to reduce the impedance and improve the cycle stability of EDLC. The defect structure can be precisely designed by simply tuning the oxygen-plasma treatment time, thereby affecting the microstructures of AC electrode. Such a tactic permits the first-operated AC electrode with more defects and the ALD passivation of AC resulting in an outstanding rate performance for the device (40.6 F g–1 at 5 mA cm–2, 20.1 Fg–1 at 100 mA cm–2) and cycling stability (∼90% retention after 5,000 cycles). This benefit from the synergistic effect of defects from doped oxygen and stable aluminum oxide layer on the electrode surface. This work delivers a feasible strategy to construct a stable AC material with superior cycling performance for supercapacitor.

In the field of green environmental design, the design system of environmental art is a complex and multidimensional cross-domain fusion system, which can be regarded as a large task system. The development model that combines artificial intelligence (AI) technology and green environment design can not only integrate and analyze problems quickly and efficiently but also provide designers with new design ideas, gradually extending traditional environment design concepts, producing more diverse artistic creation methods, and shifting from a fixed application model to a more diversified artistic development. Therefore, on the basis of summarizing and analyzing previous research works, this paper expounded the research status and significance of green environment design, elaborated the development background, current status, and future challenges of AI technology, introduced the network topology and platform frame structures of green environment design under the AI background, constructed a technical framework of green environment design under the AI background, analyzed the methods and principles of program design and function development, proposed the application model of green environment design under the AI background, conducted design function model optimization and intelligent design process analysis, and finally discussed the evaluation indicators and hierarchical analysis of the green environment design under the AI background. The results show that the application mode of combining AI technology and green environment design can not only help designers break through traditional time and space barriers and use multidimensional thinking but also help designers have a new understanding of artistic design concept and give full play to the advantages of artificial intelligence in a green environment. The study results of this paper provide a reference for further research on the application mode of green environment design under the AI background.

In this article, we study the mural restoration work based on artificial intelligence-assisted multiscale trace generation. Firstly, we convert the fresco images to colour space to obtain the luminance and chromaticity component images; then we process each component image to enhance the edges of the exfoliated region using high and low hat operations; then we construct a multistructure morphological filter to smooth the noise of the image. Finally, the fused mask image is fused with the original mural to obtain the final calibration result. The fresco is converted to HSV colour space, and chromaticity, saturation, and luminance features are introduced; then the confidence term and data term are used to determine the priority of shedding boundary points; then a new block matching criterion is defined, and the best matching block is obtained to replace the block to be repaired based on the structural similarity between the block to be repaired and the matching block by global search; finally, the restoration result is converted to RGB colour space to obtain the final restoration result. An improved generative adversarial network structure is proposed to address the shortcomings of the existing network structure in mural defect restoration, and the effectiveness of the improved modules of the network is verified. Compared with the existing mural restoration algorithms on the test data experimentally verified, the peak signal-to-noise ratio (PSNR) score is improved by 4% and the structural similarity (SSIM) score is improved by 2%.

High voltage electric double layer capacitors with reliable cycling performance are in high demand for energy storage applications. In this research, studies of the process-structure-property relations of commercial activated carbon electrode modified with atomic layer deposition (ALD) have been performed in terms of coating of various oxide compounds. These investigations have yielded similar enhancements of cycling performance at high voltages (3.5 V) enabled by the ALD coating of oxides on activated carbon surfaces. The commonalities are the phenomenal increase in capacitance retention of coin cell supercapacitors after 1,000 charge/discharge cycles regardless of the electric nature of ALD deposited oxides. Minor differences in coating morphologies and uniformities were observed between the aluminum oxide, titanium oxide, and manganese-cobalt oxide. ALD coating of these oxides of about 20-growth cycle (1–2 nm in thickness) was found to effectively result in reliable cycling performance, lower impedance, and significantly low leakage current. The authors proposed a modified Gouy-Chapman-Stern model to explain the remarkable increase in operating voltage and cycling performance by the increased Stern layer thickness due to the ALD oxide coating. These results demonstrate that the ALD oxide coating has excellent potential for activated carbons for high operating voltage and energy density supercapacitor.

Infectious diseases are the second most important cause of human death worldwide; Staphylococcus aureus (S. aureus) is a very common human pathogenic microorganism that can trigger a variety of infectious diseases, such as skin and soft tissue infections, endocarditis, osteomyelitis, bacteremia, and lethal pneumonia. Moreover, according to the sensitivity to antibiotic drugs, S. aureus can be divided into methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA). In recent decades, due to the evolution of bacteria and the abuse of antibiotics, the drug resistance of S. aureus has gradually increased, the infection rate of MRSA has increased worldwide, and the clinical anti-infective treatment for MRSA has become more difficult. Accumulating evidence has demonstrated that the resistance mechanisms of S. aureus are very complex, especially for MRSA, which is resistant to many kinds of antibiotics. Therefore, understanding the drug resistance of MRSA in a timely manner and elucidating its drug resistance mechanism at the molecular level are of great significance for the treatment of S. aureus infection. A large number of researchers believe that analyzing the molecular characteristics of S. aureus can help provide a basis for designing effective prevention and treatment measures against hospital infections caused by S. aureus and further monitor the evolution of S. aureus. This paper reviews the research status of MSSA and MRSA, the detailed mechanisms of the intrinsic antibiotic resistance and the acquired antibiotic resistance, the advanced research on anti-MRSA antibiotics and novel therapeutic strategies for MRSA treatment.

Sparsely spread code division multiple access (SCDMA) is a non-orthogonal superposition coding scheme that allows concurrent communications between a base station and multiple users over a common channel. However, the detection performance of an SCDMA system is mainly determined by its signature matrix, which should be sparse to facilitate the belief propagation (BP) detection. On the other hand, to guarantee good maximum likelihood (ML) detection performance, the minimum Euclidean distance for the equivalent signal constellation after multi-user superposition should be maximized. In this paper, a code distance analysis is proposed for SCDMA systems with a finite number of users and spreading lengths. Based on this analysis, good signature matrices whose factor graphs have very few short cycles and possess large superposed signal constellation distances are designed. The proposed signature matrices have both good BP and ML detection performances. Moreover, their BP detection performances exactly converge to their ML detection performances with few iterations. It is worth pointing out that the proposed signature matrix design could be directly applied to the 5G non-orthogonal multiple access systems.