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The present study focuses on investigating the low cycle fatigue (LCF) behavior and cyclic deformation mechanism of Ti–6Al–4V-0.55Fe alloy under strain and stress control. Based on the results of this alloy under strain amplitudes and the corresponding stress amplitudes, the effect of tension-compression asymmetry (TCA) on fatigue behavior and microstructure evolution was systematically discussed with transmission electron microscopy (TEM) and electron backscatter diffraction (EBSD). The results show that under strain control, TCA has little effect on LCF behavior due to the negligible compressive mean stress. And the deformation mechanism is mainly determined by planar slip. While under stress control, the accumulation of significant unidirectional ratcheting strain caused by TCA is observed, resulting in extra heterogeneous plastic deformation and more fatigue damage, responsible for the reduction in fatigue life. However, under low stress amplitude (≤690 MPa), no ratcheting behavior occurs due to the constant strain amplitude (0.56%), which reduces the driving force of crack nucleation and prolongs fatigue life, compared with that under low strain amplitude (0.6%).

Abstract Background To examine the relationship between neutrophil-to-lymphocyte ratio (NLR), age, and mortality rates after emergency surgery. Methods In this observational study, a total of 851 patients undergoing emergency surgery between January 2022 and January 2023 were retrospective examined. Using 30 and 180 days mortality data, NLR differences and receiver operating characteristic (ROC) curves were analyzed using a 65-year threshold. A multiple logistic regression model was constructed incorporating age and NLR. Finally, Kaplan–Meier curves were constructed for mortality. Results Among 851 patients, the 30 and 180 days mortality rates were 5.2% and 10.8%, respectively. Median NLR in 30 days was 5.6 (3.1 to 9.6) in survivors and 8.7 (4.6 to 13.4) in deceased patients (p

Atmospheric corrosion of Al–Cu–Li AA2195 alloys was investigated in constant relative humidity (RH) controlled by saturated salt solutions. Corrosion process was governed by RH, especially for the transformation of corrosion products and crack growth. The deceleration corrosion kinetics and maximum pit depth were found to be in accordance with the power laws. The corrosion products gradually transformed from γ-Al(OH)3 and γ-AlOOH into NaAlCO3(OH)2 and γ-Al(OH)3 affected by RH and exposure time. The localized formation of pitting, filiform and exfoliation corrosion was induced by the presence of Cu/Mg/Li-containing secondary precipitates, including T1(Al2CuLi), θ'(Al2Cu) and S'(Al2CuMg) phases. Secondary precipitates with lower potential were prone to triggering intergranular corrosion. The primary cracks penetrated into the internal matrix along large angular grain boundaires. Secondary cracks propagated along corrosion channels of the stress-concentrated triple grain boundaries with higher schimd factors, larger Kernel average misorientation and higher geometrically necessary dislocation densities. A crack propagation mechanism controlled by RH was proposed.

In this paper, nano-Ti-2Fe-0.1B alloys with different grain sizes were processed by high pressure torsion (HPT) deformation. The study examined the microstructural evolution of the Ti–2Fe-0.1B alloy during HPT and evaluated its mechanical properties through microhardness and tensile tests. The results of the microstructural observations revealed that the grain size of the Ti–2Fe-0.1B alloy progressively decreased from 3.14 μm in the as-annealed state to approximately 20 nm after 10 turns. In the initial state, the alloy consists of α-phase and β-phases, with a volume ratio of approximately 5:1. During the HPT process, transformations of α-phase and β-phase to ω-phase were observed. The primary reason for this is that the shear forces applied during the HPT process facilitated the phase transformation of the α-phase. Additionally, the presence of Fe element in the alloy altered the lattice compatibility between the grains of β-phase and ω-phase, thereby promoting the phase transformation of the β-phase, with the accumulated turns of HPT process, the fraction of ω-phase increased in the beginning gradually, then decreased, which reached to the maximum 80.8% in the 5 turns. This is higher than that of pure titanium and Ti–Fe alloys under the same conditions, because the proportion of the ω-phase increases with the increase in Fe content. Studies of mechanical properties demonstrated that HPT can substantially enhance the hardness of Ti–2Fe-0.1B alloys to as high as 483 HV, and the tensile strength of the Ti–2Fe-0.1B alloy was observed to increase from 725 MPa to 1568 MPa after 5 turns, which is much higher than Ti–6Al–4V subjected to the identical processing conditions. It can be ascribed to the exist of mass ω-phase as well as finer grain size in nanocrystalline Ti–2Fe-0.1B alloy.

Abstract The aim of this study was to investigate the fertility of "Huajin 6" and the effect of exogenous methyl jasmonate on its fertility. In this study, "Huajin 6", "Huajin 6" treated with methyl jasmonate and "Damaohua" were used as the research objects, the stamen phenotypes and the shape of pollen grains were observed, pollen viability and stigma receptivity were measured. The results showed that the pistil structure and function were normal, and although the stamen anthers did not dehisce, they were still capable of producing pollen with a certain amount of vigor. Methyl jasmonate could promote the opening of the flowers of "Huajin 6" and improve the development of pollen grains to a certain extent, but it could not promote anthers dehiscence of "Huajin 6". This study can provide theoretical guidance for the cultivation of new honeysuckle varieties using "Huajin 6".

Abstract Background Whether patients with cT1 − 2N1M0 breast cancer can benefit from postoperative radiotherapy (RT) after receiving neoadjuvant chemotherapy (NAC) has been controversial. Therefore, the purpose of this study was to explore whether postoperative RT can benefit this group of patients in terms of survival. Methods We used Surveillance, Epidemiology, and End Results (SEER) data to conduct a retrospective review of women with cT1 − 2N1M0 breast cancer diagnosed between 20 and 80 years of age who received NAC between 2010 and 2015. Our study compared the impact of postoperative RT on overall survival (OS) and cancer-specific survival (CSS) in breast cancer patients using propensity score matching (PSM) and performed subgroup analysis. Results This study finally included 1092 cT1 − 2N1M0 breast cancer patients. Regardless of the patient’s PSM status, postoperative RT was significantly associated with OS of cT1- 2N1M0 breast cancer patients who received NAC. Specifically, the 10-year OS rate was 78.7% before PSM matching, compared with 71.1% in patients who did not receive postoperative RT, and the difference was more significant after PSM matching, which was 83.1% and 71.1% respectively. However, postoperative RT did not significantly benefit CSS in patients with cT1 − 2N1M0 breast cancer who received NAC. The 10-year CSS rate was 81.4% VS 76.2% (P = 0.085) before PSM matching and 85.8% VS 76.2%(P = 0.076) after matching. Due to the intersection of OS and CSS curves, this restricted mean survival time (RMST) method was chosen as a supplement. After 60 months, the OS difference in RMST between the postoperative RT group and the non-radiotherapy (noRT) group was 7.37 months (95%CI: 0.54–14.21; P = 0.034), and the CSS difference was 5.18 months (95%CI: -1.31-11.68; P = 0.118). Subgroup analysis found that in patients with right-sided breast cancer, postoperative RT improved the patient’s OS (HR = 0.45, 95%CI: 0.21–0.95, P = 0.037) and CSS (HR = 0.42, 95%CI: 0.18–0.98, P = 0.045). Conclusions Our results showed that additional postoperative RT improved the OS of cT1 − 2N1M0 breast cancer patients who received NAC, but failed to improve their CSS. It is worth noting that in the subgroup analysis of patients with right-sided breast cancer, we observed significant improvements in OS and CSS. And further prospective studies are still needed to verify the effect of postoperative RT in different subgroups.

Summary: Background: Neoadjuvant chemotherapy (NACT) is commonly used to downstage the tumor in locally advanced colon cancer (LACC) and improve the R0 resection rate. Neoadjuvant chemoradiotherapy (NACRT) is the standard treatment for locally advanced rectal and esophageal cancers, but its benefits in LACC remain poorly understood. This study aimed to compare the effects and safety of NACRT and NACT on R0 resection and survival rates in initially unresectable LACC. Methods: This was an open-label, single-center, randomized, controlled trial conducted between May 11, 2019 and May 30, 2022. Forty-five patients with initially unresectable LACC were randomly allocated to the NACT (control, n = 20) or NACRT (research, n = 25) group. The NACT group received XELOX (oxaliplatin 100–130 mg/m2, qd, d1, every 3 weeks; and capecitabine 1000 mg/m2, bid, d1-d14, every 3 weeks) for 4 cycles. The NACRT group, in addition to chemotherapy, received daily irradiation (GTV 45–50 Gy/25 F; CTV 42.5–45 Gy/25 F). Surgery was scheduled 6–12 weeks after neoadjuvant treatment and adjuvant chemotherapy was administered if the patient developed resectable LACC. The primary endpoint was the 5-year overall survival (OS) rate. The secondary outcomes included the 3-year progression-free survival (PFS) and R0 resection rates. This study was registered with ClinicalTrials.gov (NCT03970694). Findings: In short-term outcome analysis, NACRT significantly improved the R0 resection rate (80% for NACRT vs. 20% for NACT, P

Herein, a TiVNb medium-entropy alloy was prepared via vacuum arc melting. The alloy maintained a body-centred cubic (BCC)-dominant phase following an annealing treatment at 1300 °C for 12 h. Although its structure was coarsened due to grain growth during annealing, the alloy developed a few Ti-rich nanobands and showed an increase in dislocations, resulting in its hardness increasing from 241.7 to 341.1 HV and strength increasing by tens of MPa relative to that of the as-melt TiVNb alloy. The tensile strength of the coarsened alloy reached 647 MPa at room temperature and 405 MPa at 800 °C. Further, the compressive yield strength reached 438 MPa at 800 °C, under which condition the alloy exhibited fewer cracks. Rapid softening was observed at 1200 °C, reducing the yield strength to ∼50 MPa. The coarsened TiVNb alloy showed weak dependence of its strength on temperature.

The low-cycle fatigue properties of titanium alloys suffering cyclic loading determines the safety in service for their components used in submarine shells. It has been reported that tensile property could be improved by making use of Fe alloying element partitioning effect. However, the fatigue property and mechanism of titanium alloys with Fe addition remain unknown. In this study, the low-cycle fatigue property and cyclic deformation mechanism of Ti–6Al–4V-0.55Fe and Ti–6Al–4V ELI with a duplex microstructure were systematically investigated. With the addition of Fe element, Ti–6Al–4V-0.55Fe with longer lasting cyclic hardening behavior and lower cyclic softening rate, showed higher fatigue life under selected strain amplitudes. Under low strain amplitude, effect of Fe on dislocation motion, interface resistance, lattice distortion, and micro strain were responsible for the enhanced fatigue life. While under high strain amplitude, Fe brought out the pinning effect on interface. Besides, Fe addition also limited the fatigue crack propagation.

Abstract Background Distal radius fractures (DRFs) have become a public health problem for all countries, bringing a heavier economic burden of disease globally, with China’s disease economic burden being even more acute due to the trend of an aging population. This study aimed to explore the influencing factors of hospitalization cost of patients with DRFs in traditional Chinese medicine (TCMa) hospitals to provide a scientific basis for controlling hospitalization cost. Methods With 1306 cases of DRFs patients hospitalized in 15 public TCMa hospitals in two cities of Gansu Province in China from January 2017 to 2022 as the study object, the influencing factors of hospitalization cost were studied in depth gradually through univariate analysis, multiple linear regression, and path model. Results Hospitalization cost of patients with DRFs is mainly affected by the length of stay, surgery and operation, hospital levels, payment methods of medical insurance, use of TCMa preparations, complications and comorbidities, and clinical pathways. The length of stay is the most critical factor influencing the hospitalization cost, and the longer the length of stay, the higher the hospitalization cost. Conclusions TCMa hospitals should actively take advantage of TCMb diagnostic modalities and therapeutic methods to ensure the efficacy of treatment and effectively reduce the length of stay at the same time, to lower hospitalization cost. It is also necessary to further deepen the reform of the medical insurance payment methods and strengthen the construction of the hierarchical diagnosis and treatment system, to make the patients receive reasonable reimbursement for medical expenses, thus effectively alleviating the economic burden of the disease in the patients with DRFs.

In this study, we investigated the two-stage deformation behavior of near α Ti-6.5Al–2Zr–1Mo–1V alloy at various temperatures (915 °C, 950 °C, 1020 °C) and strain rates (0.01 s−1, 0.1 s−1). The alloy underwent differing holding periods (500s, 1000s) between deformation stages. The results demonstrated an increase in flow stress with decreasing deformation temperature and increasing strain rate. Work hardening of flow stress was observed during the two-stage thermomechanical processing within the α+β two-phase region. Microstructural evolution was characterized by the formation of α lamellar kink bands, the separation and migration of grain boundaries, and grain spheroidization. An increase in deformation temperature and a decrease in strain rate enhanced grain refinement, accelerated structural evolution, and intensified the degree of spheroidization. Dynamic recrystallization (DRX) was more prevalent at higher temperatures and lower strain rates, as the critical nucleation rate for DRX was more readily achieved. The increased interval between thermomechanical processing stages led to a transition from low-angle to high-angle grain boundaries, and a reduction in dislocation density due to static recovery occurred during the holding period. At 915 °C, hot deformation induced the formation of {10-10} twinning, altering grain orientation and reducing stress. The Schmid factor for {10-10} slip was higher at lower temperatures, which reduced the critical resolved shear stress necessary for yielding in the α phase of the Ti-6.5Al–2Zr–1Mo–1V alloy, thereby facilitating further plastic deformation.

The CrCoNiSi0.3 MEA exhibits excellent cryogenic mechanical properties upon both quasi-static and dynamic tension. Under quasi-static tension at cryogenic temperature, the engineering yield and ultimate tensile strengths (UTS) reach 980 MPa and 1800 MPa, respectively, with notable ductility (62 %). The product of UTS and total elongation (TE) is 111.6 GPa %, surpassing most cryogenic high strength-ductility alloys. The significant mechanical strength enhancement is attributed to the denser deformation twins (DTs), multiple twinning, and extensive face-centered-cubic to hexagonal-close-packed (HCP) phase transitions, resulting in a high work hardening capacity. Upon dynamic tension at cryogenic temperature, the strength and strain hardening are further improved, which originates from the thickening DTs and HCP sequence and localized plastic deformation. The effects of temperature and strain rate on phase transition are studied. It is proposed that there is a competing relationship between high strain rate and increased stacking fault energy (SFE) due to temperature rise. The coupling effect of cryogenic temperature and high strain rate inhibits phase transition due to the deformation inhomogeneity in CrCoNiSi0.3 MEA. The findings make a valuable contribution to understand the influence of temperature and strain rate on the mechanism of FCC-to-HCP phase transition.

Abstract Endometrial cancer (EC) is a common gynecological tumor in females with an increasing incidence over the past few decades. Alcohol consumption has been linked to the occurrence of various cancers; However, epidemiological studies have shown inconsistent associations between alcohol consumption and EC risk. In order to avoid the influence of potential confounding factors and reverse causality in traditional epidemiological studies, we used a method based on genetic principles-Mendelian randomization (MR) analysis to test whether there is a causal relationship between alcohol consumption and EC. MR analysis was conducted using publicly available summary-level data from genome-wide association studies (GWAS). Fifty-seven single nucleotide polymorphisms (SNPs) were extracted as instrumental variables for alcohol exposure from the GWAS and Sequencing Consortium of Alcohol and Nicotine GWAS summary data involving 941,287 participants of European ancestry. SNPs for EC were obtained from the Endometrial Cancer Association Consortium, the Endometrial Cancer Epidemiology Consortium, and the UK Biobank, involving 121,885 European participants. The inverse variance weighted (IVW) method was used as the primary method to estimate the causal effect, and the MR-Egger regression and weighted median method were used as supplementary methods. Sensitivity analyses were conducted using the Mendelian Randomization Pleiotropy RESidual Sum and Outlier global test, MR-Egger intercept test, and leave-one-out analysis to evaluate the impact of pleiotropy on causal estimates. An increase of 1 standard deviation of genetically predicted log-transformed alcoholic drinks per day was associated with a 43% reduction in EC risk [odds ratio (OR) = 0.57, 95% confidence interval (CI) 0.41–0.79, P

In certain neurological disorders such as stroke, the impairment of upper limb function significantly impacts daily life quality and necessitates enhanced neurological control. This poses a formidable challenge in the realm of rehabilitation due to its intricate nature. Moreover, the plasticity of muscle synergy proves advantageous in assessing the enhancement of motor function among stroke patients pre and post rehabilitation training intervention, owing to the modular control strategy of central nervous system. It also facilitates the investigation of long-term alterations in remodeling of muscle functional performance among patients undergoing clinical rehabilitation, aiming to establish correlations between changes in muscle synergies and stroke characteristics such as type, stage, and sites. In this study, a three-week rehabilitation monitoring experiment was conducted to assess the motor function of stroke patients at different stages of rehabilitation based on muscle synergy performance. Additionally, we aimed to investigate the correlation between clinical scale scores, rehabilitation stages, and synergy performance in order to provide a more comprehensive understanding of stroke patient recovery. The results of 7 healthy controls and 16 stroke patients showed that high-functioning patients were superior to low-functioning patients in terms of motor function plasticity towards healthy individuals. Moreover, there was a high positive correlation between muscle synergies and clinical scale scores in high-functioning patients, and the significance gradually emerged with treatment, highlighting the potential of muscle synergy plasticity as a valuable tool for monitoring rehabilitation progress. The potential of this study was also demonstrated for elucidating the physiological mechanisms underlying motor function reconstruction within the central nervous system, which is expected to promote the further application of muscle synergy in clinical assessment.

IntroductionThe increasing incidence of Klebsiella pneumoniae and carbapenem-resistant Klebsiella pneumoniae (CRKP) has posed great challenges for the clinical anti-infective treatment. Here, we describe the molecular epidemiology and antimicrobial resistance profiles of K. pneumoniae and CRKP isolates from hospitalized patients in different regions of China.MethodsA total of 219 K. pneumoniae isolates from 26 hospitals in 19 provinces of China were collected during 2019–2020. Antimicrobial susceptibility tests, multilocus sequence typing were performed, antimicrobial resistance genes were detected by polymerase chain reaction (PCR). Antimicrobial resistance profiles were compared between different groups.ResultsThe resistance rates of K. pneumoniae isolates to imipenem, meropenem, and ertapenem were 20.1%, 20.1%, and 22.4%, respectively. A total of 45 CRKP isolates were identified. There was a significant difference in antimicrobial resistance between 45 CRKP and 174 carbapenem-sensitive Klebsiella pneumoniae (CSKP) strains, and the CRKP isolates were characterized by the multiple-drug resistance phenotype.There were regional differences among antimicrobial resistance rates of K. pneumoniae to cefazolin, chloramphenicol, and sulfamethoxazole,which were lower in the northwest than those in north and south of China.The mostcommon sequence type (ST) was ST11 (66.7% of the strains). In addition, we detected 13 other STs. There were differences between ST11 and non-ST11 isolates in the resistance rate to amikacin, gentamicin, latamoxef, ciprofloxacin, levofloxacin, aztreonam, nitrofurantoin, fosfomycin, and ceftazidime/avibactam. In terms of molecular resistance mechanisms, the majority of the CRKP strains (71.1%, 32/45) harbored blaKPC-2, followed by blaNDM (22.2%, 10/45). Strains harboring blaKPC or blaNDM genes showed different sensitivities to some antibiotics.ConclusionOur analysis emphasizes the importance of surveilling carbapenem-resistant determinants and analyzing their molecular characteristics for better management of antimicrobial agents in clinical use.

Background and objectivesGlioblastoma (GBM) and brain metastasis (MET) are the two most common intracranial tumors. However, the different pathogenesis of the two tumors leads to completely different treatment options. In terms of magnetic resonance imaging (MRI), GBM and MET are extremely similar, which makes differentiation by imaging extremely challenging. Therefore, this study explores an improved deep learning algorithm to assist in the differentiation of GBM and MET.Materials and methodsFor this study, axial contrast-enhanced T1 weight (ceT1W) MRI images from 321 cases of high-grade gliomas and solitary brain metastasis were collected. Among these, 251 out of 270 cases were selected for the experimental dataset (127 glioblastomas and 124 metastases), 207 cases were chosen as the training dataset, and 44 cases as the testing dataset. We designed a new deep learning algorithm called SCAT-inception (Spatial Convolutional Attention inception) and used five-fold cross-validation to verify the results.ResultsBy employing the newly designed SCAT-inception model to predict glioblastomas and brain metastasis, the prediction accuracy reached 92.3%, and the sensitivity and specificity reached 93.5 and 91.1%, respectively. On the external testing dataset, our model achieved an accuracy of 91.5%, which surpasses other model performances such as VGG, UNet, and GoogLeNet.ConclusionThis study demonstrated that the SCAT-inception architecture could extract more subtle features from ceT1W images, provide state-of-the-art performance in the differentiation of GBM and MET, and surpass most existing approaches.

It has been confirmed that micro-alloying is the effective way to refine the grain size and elevate the properties of pure Ti alloy produced via additive manufacturing. The pure Ti, Ti–2Fe (wt.%) and Ti–4Fe (wt.%) alloys created via Laser Melting Deposition (LMD) are compared based on their grain size, orientation relationship, and mechanical properties. Ti–4Fe displays a significantly lower average grain size of 220 μm in comparison to pure Ti and Ti–2Fe alloys, with average size of 442.3 and 319.6 μm. The superior constitutional supercooling of the former is responsible for the decrease in grain size. The orientation of the α phase is found to be influenced by the solid solution of Fe, with greater Fe content resulting in a preference towards the (0 0 0 1) direction for growth. Furthermore, the inclusion of Fe led to a noteworthy increase in both the yields strength, peaking at 798 MPa, and tensile strength, reaching 880 MPa. This enhancement is attributed to both the fine grain strengthening (54.4%) and the solid solution strengthening of Fe atoms (45.6%).

The modulation of electrical properties in composite materials is critical for applications requiring tailored electrical functionality, such as electromagnetic shielding and absorption. This study focuses on Ti64/B4C composites, a material combination promising enhanced electromagnetic properties. Laser direct manufacturing (LDM) was utilized to fabricate coaxial samples of Ti64 blended with TiB and TiC in various mass ratios, with sample thicknesses ranging from 0.5 mm to 3.5 mm. The electrical characterization involved assessing the dielectric and magnetic permeability, as well as impedance and reflectance, across a frequency spectrum of 2 to 18 GHz. The result reveals that TiC, when incorporated into Ti64, exhibits strong dielectric polarization and achieves a reflectivity as low as −40 dB between 7 and 14 GHz. Conversely, TiB demonstrates effective electromagnetic absorption, with reflectivity values below −10 dB in the frequency band of 8.5 to 11.5 GHz. The study also notes that a lower B4C content enhances electronic polarization and increases the dielectric coefficient, while higher contents favor ionic polarization. This shift can lead to a timing mismatch in the establishment of electron and ion polarization, resulting in a decreased dielectric coefficient. In addition, adjusting the B4C content in Ti64/B4C composites effectively modulates their electrical properties, suggesting a strategic approach to designing materials for specific electromagnetic functions.

This work aimed to investigate the feasibility of fabricating Pickering emulsions stabilized by Desmodium intortum protein isolate (DIPI) aggregates. The DIPI aggregates were formed using heat treatment, and the effects of ionic strength and pH on their properties were investigated. The heat-treated protein exposes its hydrophobic groups due to structural damage, resulting in rapid aggregation of the protein into aggregates with a size of 236 nm. The results showed that the aggregates induced by ionic strength had larger particle size and higher surface hydrophobicity and partial wettability. Moreover, this study explored effective strategies for bolstering Pickering emulsion stability through optimized DIPI aggregate concentration (c) and oil fraction (ø). The DIPI Pickering emulsion (DIPIPE) formed at c = 5% and ø = 0.7 was still highly stable after 30 days of storage. As confirmed by laser confocal microscopy, DIPI aggregates could be adsorbed onto the oil–water interface to form a network structure that could trap oil droplets in the network. Collectively, the Pickering emulsion stabilized by DIPI aggregates exhibited excellent stability, which not only deeply utilizes the low-value protein resources in the Desmodium intortum for the first time, but also demonstrates the potential of DIPI for the bio-based field.

A novel Ni-Co-Cr-based medium-entropy superalloy with a high Si content (7.5 at%) strengthened by an L12 phase was developed. The pure L12 phase, characterized by an average size of 50 nm and a volume fraction of 46%, was precipitated within the FCC matrix. This alloy exhibits excellent mechanical properties over a wide range of temperatures from 77 K to 1073 K. A yield strength of 1005 MPa, an ultimate tensile strength of 1620 MPa, and a tensile elongation of 36% were achieved at 77 K, with a maximum value of 4.8 GPa at the second stage of the work-hardening rate. The alloy maintains a basically consistent yield strength of approximately 800 MPa from 298 K to 973 K, showcasing significant strain-hardening capabilities, with values of 2.5 GPa, 3.7 GPa, and 4.8 GPa at 873 K, 298 K, and 77 K, respectively. Microscopic analysis revealed that at room and cryogenic temperatures, multilayer stacking faults (SFs), SF bands, and SF networks, rather than twins, effectively stored a large number of dislocations and impeded dislocation movement, thereby enhancing the work-hardening ability of the alloy. Furthermore, at 773 K, the primary deformation mechanism involved high-density dislocation walls (HDDWs) consisting of dislocation tangles and SF lines. As the temperature rose to 973 K, the work-hardening process was influenced by the APB shearing mechanism (in the form of dislocation pairs), SF lines, and microtwins generated through atomic rearrangement. This study not only provides valuable insights for the development of new oxidation-resistant superalloys but also enhances our understanding of high-temperature deformation mechanisms.

The effects of Si addition on the microstructures and properties of CoCrNi medium-entropy alloy (MEA) were systematically investigated. The CrCoNiSix MEA possesses a single face-centered cubic (FCC) phase when x is less than 0.3 and promotes solution strengthening, while the crystal structure shows a transition to the FCC+σ phase structure when x = 0.4 and the volume fraction of the σ phase increases with a microstructure evolution as the Si content increases. The Orowan mechanism from σ precipitation effectively enhances the strength, hardness, and stain hardening of CrCoNiSix MEA, which also exhibits superior hardness at high temperatures. Furthermore, a large amount of σ phase decreases the wear resistance because of the transformation of the main wear mechanism from abrasion wear for σ-free CrCoNiSix MEA to adhesion wear for σ-contained CrCoNiSix MEA. This work contributes to the understanding of the effect of Si addition on FCC structured alloys and provides guidance for the development of novel Si-doped alloys.

Titanium alloys with high strength and good corrosion resistance have become one of the critical bearing structural materials in marine engineering. But in service, corrosion fatigue would occur under the synergetic action of cyclic external load and corrosion environment, threatening the safety of components. In this study, compared with low-cycle fatigue in laboratory air, the low-cycle corrosion fatigue deformation mechanism and fracture characteristic of the Ti-6Al-4V-0.55Fe alloy were investigated in 3.5% NaCl corrosion solution under selected stress amplitudes. The results showed that under low stress amplitude, corrosion fatigue was determined by fatigue damage and corrosion damage, causing a reduction in fatigue life. The local stress concentration caused by corrosion pits and dislocations pile-up accelerated the initiation of fatigue cracks, and other corrosion behavior including crevice corrosion promoted fatigue crack propagation; the corrosion solution increased the surface damage. While under high stress amplitude, due to the short contact time between the sample and solution and higher applied stress, the fatigue life is determined by fatigue damage caused by multiple slips.

The three levels of precipitation with the primary Ni16Ti6Si7 intermetallic, the secondary large-sized L12 phase and the tertiary diffused distributed nanoscale L12 particles is achieved in an aged Ni2CoCr0.5Si0.3Al0.2Ti0.2 medium entropy alloy (MEA). The yield strength of 1222 MPa and ultimate strength of 1626 MPa as well as the uniform elongation of 16% and excellent work hardening rate exceeding 4.5 GPa are obtained. The precipitation strengthening model is employed to understand the comprehensive effect of the shearing and Orowan strengthening on yield strength. The synergistic strengthening mechanisms, including dislocation Orowan mechanisms for the Ni16Ti6Si7 intermetallic, the shearing and Orowan mechanisms of large-sized L12 precipitation, the shearing mechanism and pining effect from the small-sized L12 precipitation, together with Lomer-Cottrell (LC) locks and nano-spacing stacking fault (SF) networks, result in the ultra-high work hardening during plastic deformation, which provides a novel strategy for the design of excellent precipitation-strengthened alloys.

A comprehensive investigation of friction stirring additive manufacturing (FSAM) Mg–10Li–3Al–3Zn alloy has been conducted to evaluate microstructure evolution and mechanical properties. The results indicated that new intermetallic compounds of Li2MgAl and LiMgZn are precipitated. The microstructure homogeneity is improved and the texture strength of [−1100] is decreased via FSAM. Compared to the base metal, the microhardness of nugget zone has increased by 33%, and the tensile strength of the samples along transverse direction and process direction are 206 MPa and 224 MPa, respectively. The strengthen mechanism of mechanical properties also has been analyzed through phase distribution and grain refinement. The study reveals that FSAM is a significant approach for the additive manufacturing magnesium alloys.

Abstract Background Standard treatment of locally advanced rectal cancer (LARC) was neoadjuvant chemoradiotherapy (CRT), followed by total mesorectal excision (TME). Total neoadjuvant treatment (TNT), a new concept, attempts to deliver both systemic chemotherapy and neoadjuvant CRT prior to surgery. Patients treated with neoadjuvant chemotherapy were more likely to show higher tumor regression. The objective of this trial was to increase complete clinical rate (cCR) for LARC patients by optimizing tumor response, using TNT regimen as compared to conventional chemoradiotherapy. TESS, a prospective, open‐label, multicenter, single‐arm, phase 2 study, is underway. Methods Main inclusion criteria include cT3‐4aNany or cT1‐4aN+ rectal adenocarcinoma aged 18‐70y; Eastern Cooperative Oncology Group (ECOG) performance 0–1; location ≤5 cm from anal verge. Ninety‐eight patients will receive 2 cycles of neoadjuvant chemotherapy Capeox (capecitabine + oxaliplatin) before, during, and after radiotherapy 50Gy/25 fractions, before TME (or other treatment decisions, such as Watch and Wait strategy) and adjuvant chemotherapy capecitabine 2 cycles. Primary endpoint is the cCR rate. Secondary endpoints include ratio of sphincter preservation strategy; pathological complete response rate and tumor regression grade distribution; local recurrence or metastasis; disease‐free survival; locoregional recurrence‐free survival; acute toxicity; surgical complications; long‐term anal function; late toxicity; adverse effect, ECOG standard score, and quality of life. Adverse events are graded per Common Terminology Criteria for Adverse Events V5.0. Acute toxicity will be monitored during antitumor treatment, and late toxicity will be monitored for 3 years from the end of the first course of antitumor treatment. Discussion The TESS trial aims to explore a new TNT strategy, which is expected to increase the rate of cCR and sphincter preservation rate. This study will provide new options and evidence for a new sandwich TNT strategy in patients with distal LARC.

Sexual hormone binding globulin (SHBG) is associated with the endocrine and reproductive systems. We aimed to investigate the role of SHBG in the reproductive process. Therefore, we conducted a secondary analysis of the PCOSAct (Polycystic Ovary Syndrome and Acupuncture Clinical Trial) study, which involved 21 sites in China and a total of 1000 women with PCOS. Out of these, 954 women with SHBG were included in the analysis. Through multivariate analysis of ovulation predictors, we found that age, BMI, estradiol, testosterone, and SHBG all showed a positive predictive value for ovulation (p = 0.0211, 0.0011, 0.0211, 0.0029, 0.0434, respectively). However, the LH to FSH ratio had a negative predictive value (p = 0.0539). Higher quartiles of SHBG were associated with a higher rate of ovulation, and per quartile increased was statistically significant (HR = 1.138, 95%CI [1.054,1.229]). The association remained significant even after adjusting for testosterone (HR = 1.263, 95%CI [1.059, 1.507]). On the other hand, quartiles of testosterone and estradiol did not exhibit any significant tendency toward ovulation. SHBG demonstrated predictive ability for ovulation, conception, pregnancy, and live birth (p

This study investigates the effect of the ω phase on the microstructure evolution and mechanical properties of the Ti–3Al–5Mo–4Cr–2Zr–1Fe (Ti-35421) near β titanium alloy. The study employed a solution treatment at 850 °C followed by two aging treatments, namely, Double Aging (DA) and Isothermal Annealing (IA). The results show that the DA alloy had finer precipitation and fewer Precipitation-Free Zones (PFZs) than the IA alloy. While the Ultimate Tensile Strength (UTS) of the DA alloy was higher (1376 MPa) than that of the IA alloy (1272 MPa), its plasticity was lower. On the other hand, the IA alloy exhibited a better balance between UTS (1272 MPa) and ductility (8.12%). The nucleation mechanism of DA was attributed to the presence of the α stable element Al, which diffused in the microstructure and aggregated in the ω phase, creating favorable nucleation sites for the precipitation of the secondary α phase during low temperature aging. As a result, the PFZs decreased, and the dispersion distribution strengthened the β matrix structure. Conversely, the high aging temperature during IA made it difficult to form the ω phase, resulting in coarser precipitation and increased PFZs as the temperature increased. This paper revealed the influence of ω on the relative precipitation during the phase transition, the microstructure and properties of the Ti–3Al–5Mo–4Cr–2Zr–1Fe, providing valuable insights for optimizing its heat treatment process.

This work proposes an oscillating wire laser additive manufacturing (O-WLAM), which is based on the wire laser additive manufacturing technology (WLAM) and combined with the laser oscillating welding technology. For different laser oscillation patterns, it shows a trend that metallurgical defects such as porosity, microstructural and columnar grain size decrease with the increase of oscillation frequency and oscillation amplitude. In solidified grains formed under laser oscillation, a complex oscillation of melt pool agitation could lead to a refining effect on the β grains size. The corresponding tendency of epitaxial growth of the prior β grains is weakened as well. The process experiments in this work provide a new idea of laser oscillation for wire laser additive manufacturing. The use of laser oscillation to achieve improvement of metallurgical defects and optimization of microstructure has some guiding significance for wire laser additive manufacturing.

Ovulation induction is a first-line medical treatment for infertility in polycystic ovary syndrome (PCOS). Poor ovulation responses are assumed to be due to insulin resistance and hyperandrogenism. In a prospective cohort (PCOSAct) of 1000 infertile patients with PCOS, whole-exome plus targeted single-nucleotide polymorphism (SNP) sequencing and comprehensive metabolomic profiling were conducted. Significant genome-wide common variants and rare mutations associated with anovulation were identified, and a prediction model was built using machine learning. Common variants in zinc-finger protein 438 gene (ZNF438) indexed by rs2994652 (p = 2.47 × 10–8) and a rare functional mutation in REC114 (rs182542888, p = 5.79 × 10–6) were significantly associated with failure of ovulation induction. Women carrying the A allele of rs2994652 and REC114 p.Val101Leu (rs182542888) had lower ovulation (odds ratio (OR) = 1.96, 95% confidence interval (95%CI) = 1.55–2.49; OR = 11.52, 95%CI = 3.08–43.05, respectively) and prolonged time to ovulation (mean = 56.7 versus (vs) 49.0 days, p

Titanium alloys have high specific strength and corrosion resistance, which have promising applications in industry. However, the machinability of titanium alloys is limited due to their crystal lattice and physical properties. Thus, in recent years, the superplastic forming of titanium alloys has been intensively developing, in particular, forming at low temperatures and/or high strain rates. In this work, a tensile test of low-cost Ti-2Fe-0.1B alloys was carried out at a temperature of 550~750 °C and a strain rate of 1 × 10−3 s−1~1 × 10−2 s−1. The results showed that the alloy exhibited good superplasticity even at a high strain rate (1 × 10−2 s−1) and a low deformation temperature of 550 °C; the elongation of the alloy in this state reached 137.5%. The high strain rate sensitivity coefficient m (0.3) and the maximum elongation (452%) were obtained at a strain rate of 1 × 10−3 s−1 and a temperature of 750 °C. Characteristics of the microstructure showed that during superplastic deformation, the recrystallization and grain boundary sliding of the alloy phases were accelerated, which could be ascribed to the effect of the element Fe. At the same time, the TiB phase located around the primary elongated α grains could also induce dynamic recrystallization and dynamic globularization during deformation.

Background: Birth weight (BW) is an indicator of fetal growth and development. Previous studies showed inconsistent results on the association of ambient particulate matter (PM) exposure with BW, and the role of maternal thyroid function has not been clarified. Methods: We recruited 1711 gravidas between 2017 and 2019 in Henan, China. All participants were followed up until delivery. Daily concentrations of PM, including PM2.5 and PM10, were evaluated by using the spatial-temporal model. Maternal thyroid hormone (TH) levels were quantified by electrochemiluminescent microparticle immunoassay. Linear regression models were employed to examine the association among PM, BW, and maternal TH. Mediating effects of maternal TH interrelated with PM exposure on BW were investigated by causal mediation analyses. Results: A total of 1049 gravidas were identified. We found that per 10 µg/m3 increase in PM2.5 and PM10 were associated with a decreased BW of 9.941 g, and 7.758 g (PM2.5: 95 %CI: −18.184, −1.698; PM10: 95 %CI: −14.436, −1.080). An inverse correlation of maternal FT4 levels with BW was found, with the pooled β of −319.983 g (95 %CI: −483.216, −156.750). We found a prominent positive correlation between gestational FT4 and PM exposure (PM2.5: β = 0.004, 95 %CI: 0.001, 0.007; PM10: β = 0.003, 95 %CI: 0.000, 0.006). Mediation analysis found that FT4 levels mediated the relationship between maternal PM exposure and BW, ranging from 5.55 % to 15.86 %. Conclusions: Maternal PM exposure may induce a reduction in newborn BW by affecting the maternal TH concentrations.

Two-phase titanium alloy Ti–6Al–2Sn–4Zr–6Mo (TC19) has an excellent application prospect in aerospace field. In order to study its hot deformation behavior and the microstructure evolution mechanism of TC19 titanium alloy, hot compression tests were carried out. The flow behavior of this alloy was predicted by the constitutive models. Besides, the hot processing map of TC19 alloy was drawn according to the dynamic material model (DMM) theory. The peak efficiency of energy dissipation region occurred in the temperature range of 850–1000 °C with the strain rate of 0.001–0.1 s−1. The main deformation mechanisms were dynamic recovery (DRV) and dynamic recrystallization (DRX). It seems that the region of deformation instability was concentrated in high strain rate. The main deformation mechanisms in the structure were deformation band (DB), flow localization (FL), and recrystallized grains produced by continuous dynamic recrystallization (CDRX). Deformation mechanism of TC19 alloy was mainly controlled by the deformation rate. When the deformation rate was low, the deformation mechanism was mainly DRV and the strain-induced grain boundary migration, which led to the bulging of the grain boundary and resulted in discontinuous dynamic recrystallization (DDRX) with the increasing deformation rate. Furthermore, the sub-grain rotated continuously to transform from low angle grain boundaries (LAGBs) into high angle grain boundaries (HAGBs) at the high deformation rate continuously. Recrystallized grains packed with HAGBs were observed in the microstructure. The existence of ω phase in the precipitated phase observed by diffraction pattern, which indicated that phase transition was related to the deformation rate.

ObjectiveThis study aims to evaluate the effect of acupuncture on the emotion domain and metabolic parameters of Chinese women with polycystic ovarian syndrome (PCOS) by secondary analysis of a randomized clinical trial, conducted from 6 July 2012 to 7 October 2015.MethodIn this study, we investigated the effects of acupuncture (458 patients) and sham acupuncture (468 patients) on metabolic parameters, serum ions, and all quality-of-life scale scores related to PCOS. The quality of life of patients was evaluated using five relevant scales, operated by the research assistant, namely, PCOSQ, SF-36, and ChiQOL, as well as Zung-SAS and Zung-SDS. Metabolic parameters and serum ions were measured.ResultsA reduction in acne score, AN, Hcy, and LDL-C, and an increase in the level of lipoprotein α, Apo A1, and Apo A1/Apo B were observed in the acupuncture group after 4 months’ intervention after adjusting clomiphene and reproductive outcome (p< 0.05). An increase in SF-36 total scores, RP and RE scores, ChiQOL total scores, and emotion domain scores was observed in the acupuncture group after 4 months’ intervention, while PF and HT scores were decreased (adjusted p< 0.05). Those same changes were observed in sham acupuncture. Meanwhile, the serum levels of Ca, K, and Cl were elevated in the acupuncture group after the interventions (adjusted p< 0.005). There were no significant differences in HOMA-IR, MetS, FPG, FINS, HDL-C, TG, Apo B, and level of serum P, Mg, and Na. Also, no changes in BP, GH, VT, SF, physical form domain, and spirit domain were observed after treatment.ConclusionAcupuncture can improve not only the emotional changes in SF-36 scores and ChiQOL scores, but also lipid metabolism, implying that it may have a correlation between emotional change and lipid metabolism. Furthermore, acupuncture can also regulate the changes of serum Ca, K, and Cl.Clinical trial registrationClinicalTrials.gov, identifier NCT01573858.

ObjectiveThis study aimed to investigate the reliability of a deep neural network (DNN) model trained only on contrast-enhanced T1 (T1CE) images for predicting intraoperative cerebrospinal fluid (ioCSF) leaks in endoscopic transsphenoidal surgery (EETS).Methods396 pituitary adenoma (PA) cases were reviewed, only primary PAs with Hardy suprasellar Stages A, B, and C were included in this study. The T1CE images of these patients were collected, and sagittal and coronal T1CE slices were selected for training the DNN model. The model performance was evaluated and tested, and its interpretability was explored.ResultsA total of 102 PA cases were enrolled in this study, 51 from the ioCSF leakage group, and 51 from the non-ioCSF leakage group. 306 sagittal and 306 coronal T1CE slices were collected as the original dataset, and data augmentation was applied before model training and testing. In the test dataset, the DNN model provided a single-slice prediction accuracy of 97.29%, a sensitivity of 98.25%, and a specificity of 96.35%. In clinical test, the accuracy of the DNN model in predicting ioCSF leaks in patients reached 84.6%. The feature maps of the model were visualized and the regions of interest for prediction were the tumor roof and suprasellar region.ConclusionIn this study, the DNN model could predict ioCSF leaks based on preoperative T1CE images, especially in PAs in Hardy Stages A, B, and C. The region of interest in the model prediction-making process is similar to that of humans. DNN models trained with preoperative MRI images may provide a novel tool for predicting ioCSF leak risk for PA patients.

Soft magnetic Fe81.3Si4B10P4Cu0.7 powders have been fabricated by using spinning-water atomization process (SWAP) under the water pressure of 17.5 MPa and gas pressure of 2 MPa. To clarify the amorphous forming ability, thermal stability, and the corresponding soft magnetism, the as-SWAPed powders have been sieved into 6 groups with different powder sizes from 0 – 150 μm. After the analysis of the amorphous and crystalline characteristics, the morphology, and soft magnetic properties of these 6 groups of as-SWAPed powders, it is concluded that the SWAPs with a high cooling rate of 105 K/s can improve the amorphous forming abilities of Fe81.3Si4B10P4Cu0.7 powders up to 53 μm, the saturated magnetic flux density as high as 170 – 173 emu/g and the thermal stabilities higher than 112.8 K. The characteristic parameters of as-SWAPed powders above mentioned are close to those of the counterpart rapid solidified ribbons. The surface oxide layers on as-SWAPed powders mainly consist of Fe2O3, and are 10 nm thick, much thicker than these counterpart ribbons, which might help to weaken the eddy effects accompanying with the slight decrease of the saturated magnetic flux density. Due to the higher cooling rates of SWAPs than gas atomization processes and the better spheroidization of powders for SWAPs than water atomization processes, it is key for NANOMET® family alloys to increase their amorphous forming abilities and better the soft magnetic performances.

Flow softening and microstructural evolution of a novel near β titanium alloy Ti–3Al–5Mo–4Cr–2Zr–1Fe (Ti-35421) with tensile strength beyond 1200 MPa have been investigated at temperatures of 710∼800 °C in the α+β region with strain rates of 0.001∼1 s−1 during hot deformation. The established Arrhenius constitutive model embedded softening mechanism and deformations can predict the flow stress and match the experimental data well. Two mechanisms of dynamic recrystallization (DRX) including the continuous dynamic recrystallization (CDRX) of subgrains rotating and the discontinuous dynamic recrystallization (DDRX) of grain boundaries bulging govern the hot deformation and microstructural evolution. Both CDRX and DDRX occur at high true strains and the number of DRX grains increases with increasing true strain. An obvious flow softening phenomenon presents during thermal compression at the low temperature and low strain rates in the α+β region, which might be attributed to the bending and fragmentation of α phases, inverse change of the texture intensity between α and β phases, and the formation of the new grains from DRX.

The phase transformation during continuous heating of Ti6Al4V-0.55Fe alloy with various initial microstructure including equiaxed, duplex and lamellar microstructures was investigated by thermal expansion test. The results illuminate that the β→α phase transition curves of the three samples all present the sigmoidal “S'' shape, which proves that this process is controlled by nucleation and growth. The activation energies and Avrami indexes of phase transformation were obtained by Kissinger-Achaia-Sunose (KAS) method and Kolmogorov-Johnson-Mehl-Avrami (KJMA) model. The average activation energies of the phase transitions in the three samples with initial equiaxed, duplex and lamellar microstructures are 163.9, 194.4 and 231.5 kJ/mol, respectively. The result implies that the phase transition is more likely to occur in equiaxed microstructure, which is consistent with the results of sigmoidal “S'' shaped curves. Besides, the phase transition mechanism of samples with different initial microstructures presents three different stages, including nucleation and diffusion of crystals, diffusion phase transition, and meaningless numerical interval. Furthermore, the microstructure evolutions of the three samples were analyzed by thermal expansion method at a heating rate of 5 K·min−1. The phase transformation is divided into three stages: lamellar α mainly merges into thicker α phase, thick α transforms into β phase and finally equiaxed α transforms into β phase. The layered α occurs obvious coarsening first and then redissolution phenomena during the α phase transition. The difference in the morphology, size and composition of layered α and primary equiaxed α can affect the phase transformation behavior of the alloy during the heating process.

Abstract Background High dose chemoradiotherapy offers a curative chance for patients with rectal cancer that are unfit or unwilling to undergo surgical resection, yet its long-term survival and functional outcomes have been rarely investigated. Methods Patients with non-metastatic rectal adenocarcinoma who received pelvic radiation for curative intent from April 2006 to July 2017 were retrospectively investigated. Survival rates were analyzed using the Kaplan–Meier method. Quality of life and functional outcomes were evaluated using the EORTC quality of life questionnaire. Results A total of 57 patients were included, with a median age of 59.0 (range, 29–84) years. The numbers of patients who were diagnosed as stage I, II and III were 5 (8.8%), 16 (28.1%) and 36 (63.2%), respectively. 53 (93.0%) patients had tumor located within 5 cm from the anal verge. All patients received fluorouracil-based concurrent chemoradiotherapy with a median radiation dose of 80 (range, 60–86) Gy. All kinds of grade 3–4 adverse events occurred in 18 (31.6%) patients. 42 (73.7%) patients achieved a clinical complete response after chemoradiotherapy. After a median follow-up of 43.5 (range 14.9–163.2) months, 12 (21.1%) patients had local progression and 11 (19.3%) developed distant metastasis. The 3-year local recurrence-free survival and distant metastasis-free survival were 77.3% (95% CI, 65.7–88.8%) and 79.2% (95% CI, 68.2–90.2%), while the 3-year progression-free survival, cancer-specific survival, overall survival were 61.9% (95% CI, 48.8–75.0%), 93.1% (95% CI, 85.8–100.0%) and 91.4% (95% CI, 83.6–99.2%), respectively. For patients who had tumor located within 3 cm from the anal verge, the sphincter preservation rate was 85.3% at last follow-up. Long-term adverse events mainly were anal blood loss. 21 patients completed the quality-of-life questionnaire and had a score of the global health status of 78.57 ± 17.59. Of them, 95.2% reported no urinary incontinence and 85.7% reported no fecal incontinence. Conclusions High dose chemoradiation demonstrated promising survival outcomes with acceptable short-term and long-term side effects, and satisfying long-term functional outcomes and quality of life. It could be considered as a non-invasive alternative for rectal cancer patients who refuse surgery.

Abstract Background Anal squamous cell carcinoma (ASCC) is a rare malignant tumor with increasing incidence. The goal of our study was to analyze the treatment outcome and prognostic factors of ASCC in South China in the past half‐century. Methods This study retrospectively included 59 patients with ASCC admitted from 1975 to 2018 in Sun Yat‐sen University cancer center. The clinical records and follow‐up information of all patients were collected. Survival analysis and univariate and multivariate regression analyses were performed using the “survival” and “survminer” packages of R software. Results In 59 patients, 5 patients had distant metastasis at diagnosis. Among 54 M0 stage patients, 33 patients received chemoradiotherapy (CRT), 19 patients received local surgery, and 2 patients refused curative treatment and received the best supportive treatment (BST). The most common grade 3–4 acute toxicities during treatment were myelosuppression and radiation dermatitis. The median follow‐up time was 32 months. For the whole group, the 3‐year and 5‐year overall survival (OS) rates and disease‐free survival (DFS) were 71.1% and 63.6%, and 73.4% and 69.0%, respectively. Multivariate regression analysis showed that the T3–4 stage was an independent prognostic risk factor for OS, progression‐free survival (PFS), and DFS. And M1 was an independent prognostic risk factor for PFS and DFS. Patients in stage M0 mainly treated with CRT had better local control than those mainly treated with surgery (p = 0.027). For M0 patients, induction chemotherapy combined with CRT tends to prolong OS compared with CRT alone (p = 0.26). The 3‐year colostomy‐free survival for the whole group was 81.1%. Conclusions CRT is recommended as the first choice for the treatment of M0 stage ASCC. Induction chemotherapy may bring better survival benefits for some patients. Patients with ASCC in China seem to have a better local control rate, which suggested different treatment strategies may be needed in China.

Abstract Background The ratio of serum apolipoprotein B (apoB) to apolipoprotein A-I (apoAI) had been reported as a prognostic factor in colorectal cancer. This retrospective study aimed to assess the implication of apoB-to-apoAI ratio in predicting liver metastasis from rectal cancer (RC). Methods The clinical data of 599 locally advanced RC patients treated with chemoradiotherapy followed by surgery were reviewed. Serum apoAI, apoB and apoB-to-apoAI ratio were analyzed for their correlation with the liver-metastasis-free, other-metastasis-free and overall survivals, together with the pretreatment and postsurgical pathoclinical features of the patients. Univariate and multivariate survival analyses were realized through the Kaplan-Meier approach and Cox model, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for independent predictors. Results Carbohydrate antigen 19 − 9 ≥ 26.3 U/ml, apoB-to-apoAI ratio ≥ 0.63, tumor regression grade 5 − 3, pT4 and pN + stage emerged as independent predictors of poorer liver-metastasis-free survival. The hazard ratios were 1.656 (95% CI, 1.094–2.506), 1.919 (95% CI, 1.174–3.145), 1.686 (95% CI, 1.053–2.703), 1.890 (95% CI, 1.110–3.226) and 2.012 (95% CI, 1.314–2.077), respectively. Except apoB-to-apoAI ratio, the other 4 factors were also independent predictors of poorer other-metastasis-free and overall survivals. And the independent predictors of poorer overall survival also included age ≥ 67 years old, distance to anal verge

Bulk Ti-6Al-4V alloys have been fabricated by selective laser melting (SLM) in three recipes with different combinations of powder sizes. Combinatorial effects of initial gas-atomized powder sizes on microstructure and corrosion properties of SLM-ed Ti-6Al-4V alloys have been investigated by optical microscopy, X-ray diffraction, electrochemical measurements and surface free energy. The SLM-ed Ti-6Al-4V alloys are composed of acicular α' martensite and α phases. Many pinhole defects and twin boundaries exist in the SLM-ed Ti-6Al-4V alloys. According to electrochemical tests and surface free energy calculation, the SLM-ed Ti-6Al-4V alloys with 0 – 53 μm powders have the most positive corrosion potential, the lowest current density and the smallest surface free energy of 20.89 mJ m2. The passive film of SLM-ed Ti-6Al-4V alloys with 0 – 53 μm powders has superior protection ability due to their large thickness. The carrier concentration of SLM-ed Ti-6Al-4V alloys with 0 – 53 μm powders is the lowest by the Mott-Schottky curves. The SLM-ed samples with contact angles higher than 90º are hydrophobic, but the small contact angle of 46.98º reflects the hydrophilic features of as-rolled Ti-6Al-4V alloys. The combinatorial recipe of SLM-ed Ti-6Al-4V alloys with 0 – 53 μm powders is optimal for improvements on the corrosion resistance.

Titanium alloys have great potential as candidate materials for the deep-sea facilities. Long-term creep deformation behavior of the pressure-bearing structures made of titanium alloys under alternating compressive stress has a direct impact on the structural stability. The compressive creep evaluations of Ti-6Al-4V ELI alloys with basketweave microstructure under alternating stresses have been carried out by a uniaxial compressive creep tester. The compressive creep deformations have strong stress sensitivity due to the larger creep strain by the higher applied compressive stress. The dislocation densities in α and β phases increase with the increase of applied compressive stresses. The dislocation slip and dislocation multiplication occur in α phases accompanying with high dislocations density in β phases caused by compressive deformation. The large strain concentration occurs at the grain boundaries of α/β phase due to dislocation plug after creep, which causes the grain boundary pinning. The compressive creep deformation of Ti-6Al-4V ELI alloys under alternating stress is a decelerating creep process and controlled by dislocation slip. The slight refinements of the grains and hardening have been confirmed after creeps. The synergistic effects of dislocation multiplication, grain boundary pinning and grain refinements lead to strengthening the Ti-6Al-4V ELI alloys and decelerating the compressive creeps.

Emerging evidence suggests residential surrounding green space is beneficial for human health. The association between green space and GDM showed inconsistent results, and potential effect modification of green space with air pollution is still unclear. This study aims to evaluate the association between green space and GDM, and further explore potential interaction and medication effects. Participants were recruited from a retrospective cohort study between 2015 and 2020 in Henan, China. Residential green space based on normalized difference vegetation index (NDVI) and air pollution exposure were estimated using spatial-statistical models. Multivariate logistic regression was applied to evaluate the association between per 0.1 unit increase in NDVI with 4 buffer sizes (250 m, 500 m, 1000 m, 2000 m) and GDM. We examined potential interaction of green space and air pollutants on GDM. Mediating effects of air pollution associated with green space exposure on GDM were also investigated by causal mediation analyses. A total of 46,665 eligible pregnant women were identified. There were 4092 (8.8 %) women diagnosed with GDM according to the IADPSG criteria. We found that per 0.1-unit increment in NDVI250 m, NDVI500 m, NDVI1000 m and NDVI2000 m in second trimester were associated with the decreased risk of GDM, with adjusted OR of 0.921(95 %CI: 0.890–0.953), 0.922 (95 %CI: 0.891–0.953), 0.921 (95 %CI: 0.892–0.952) and 0.921 (95 %CI: 0.892–0.951), respectively. We identified significant interactions between second trimester PM2.5 and O3 exposure and NDVI for GDM (Pinteraction < 0.001). The causal mediation analysis showed that PM2.5 mediated approximately 2.5–5.5 % of the association between green space and GDM, while the estimated mediating effect of O3 was approximately 30.1–38.5 %. In conclusion, our study indicates that residential green space was associated with a reduced risk of GDM, particularly second trimester. Green space may benefit to GDM partly mediated by a reduction in PM2.5 and O3.

Fructus Meliae Toosendan (FMT) is the dried and mature fruit of MeLia toosendan Sieb.et Zucc. It contains a variety of chemical constituents and reported to possess a variety of pharmacological activities. This review aims to provide a thorough and organized summary of botany, traditional uses, chemical ingredients, pharmacological actions, toxicity, quality control, and uses. In this review, we have compiled the data regarding FMT from 1994 to 2022 in the databases: Web of Science, PubMed, Google Scholar, CNKI, and Baidu Scholar. The keywords: ''Fructus Meliae Toosendan'', ''botany'', ''traditional uses'',''chemical components'', ''pharmacological activity'', ''toxicity'', ''quality control'' and ''clinical application'' have been used to collected the literature published in the online bibliographic databases. Based on the correlation of these documents and FMT, 126 articles were finally selected as references. This paper provides a reasonable summary of the 190 chemical components of FMT and its pharmacological effects and toxicity. Moreover, this paper also compiled the quality control studies and clinical applications. In the future, more experimental studies on FMT are needed to achieve the purpose of toxicity reducing and efficacy enhancing. This comprehensive review of FMT can provide a reference for subsequent relevant studies.

Abstract Background The optimal treatment of stage IV rectal cancer remains controversial. The purpose of this study was to assess the treatment outcomes and toxicity of neoadjuvant chemotherapy and radiotherapy followed by local treatment of all tumor sites and subsequent adjuvant chemotherapy in stage IV rectal cancer patients with potentially resectable metastases. Methods Adult patients diagnosed with locally advanced rectal adenocarcinoma with potentially resectable metastases, who received neoadjuvant chemotherapy and radiotherapy from July 2013 and September 2019 at Sun Yat-sen University cancer center, were included. Completion of the whole treatment schedule, pathological response, treatment-related toxicity and survival were evaluated. Results A total of 228 patients were analyzed with a median follow-up of 33 (range 3.3 to 93.4) months. Eventually, 112 (49.1%) patients finished the whole treatment schedule, of which complete response of all tumor sites and pathological downstaging of the rectal tumor were observed in three (2.7%) and 90 (80.4%) patients. The three-year overall survival (OS) and progression-free survival (PFS) of all patients were 56.6% (50.2 to 63.9%) and 38.6% (95% CI 32.5 to 45.8%), respectively. For patients who finished the treatment schedule, 3-year OS (74.4% vs 39.2%, P

In this study, the effect of Fe addition on microstructure evolution and grain refinement mechanism during hot deformation of new Ti-6Al-4V-xFe (x = 0–0.9 wt%) alloys were investigated. The peak stress showed a decreasing trend, and the microstructure presented obvious grain refinement with the increase of Fe content. The flow softening behavior was contributed by dynamic recovery (DRV) and dynamic recrystallization (DRX). The average grain size decreased from 52.2 μm to 11.3 μm, and the fraction of the high angle grain boundary (HAGB) increased from 66.49% to 76.33% when Fe concentration increased from 0 wt% to 0.9 wt%. Fe addition also facilitated in the annihilation of the dislocations, which resulted in a decrease in the average ρGND density. The high Schmid factor (>0.45) content increased with the Fe content in the basal slip (0001) and prismatic slip {101¯1} of the α phase, as well as in the {112¯} and {123¯} slip systems of the β phase. All evidence indicated that Fe addition promoted the hot workability of the Ti-6Al-4V-xFe (x = 0–0.9 wt%) alloys and refined the grain size during hot deformation.

In the present work, low cycle fatigue (LCF) behavior and fracture characteristic of Ti–6Al–4V-0.55Fe alloy with bimodal microstructure, consisted of equiaxed primary α (αp), lamellar α (αl) and β matrix, are systematically investigated at room temperature. Results indicate that Ti–6Al–4V-0.55Fe alloy mainly exhibits a continuous softening behavior both at high and low strain amplitudes, due to the interaction of back stress(σb) and friction stress(σf) mainly related to the plastic deformation heterogeneity and precipitates shearing, respectively. Compared with Ti–6Al–4V alloy, LCF life of Ti–6Al–4V-0.55Fe is similar at high strain amplitudes (Δεt/2 > 1.0%), while much higher at low strain amplitudes (Δεt/2

In this study, we prepared nickel and phosphorus decorated graphene nanoflakes (Ni–P@GNFs) as a reinforcement in Ti–6Al–4V (TC4) alloy matrix by an electroless plating method. It can enhance the interface bonding force between GNFs and TC4 matrix, and facilitate uniform dispersion of the GNFs in the TC4 matrix. This in turn relieve severe interface reactions between the metal and the carbon nanomaterial. The Ni–P@GNFs/TC4 composites with different GNFs content (0, 0.25, 0.5, 0.75, 1, 1.5 wt.%) were fabricated via short-term ball milling and spark plasma sintering (SPS). The effects of reinforcement content on microstructures and mechanical properties of Ni–P@GNFs/TC4 composites were studied while the sintered composites were characterized by X-Ray diffraction (XRD), Raman spectroscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The results indicated that the mechanical properties of Ni–P@GNFs/TC4 composites were dramatically improved due to the homogeneous dispersion of GNFs in the TC4 matrix. The compressive strength of 0.5 wt.% Ni–P@GNFs/TC4 composite reaches 1133 MPa: this was an increase of 30.6% versus TC4 (867 MPa) while maintaining 34.2% ductility. The strengthening mechanism of the mechanical properties of the composites are discussed.