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The content of stannous chloride is one of the key indicators for the quality control of Technetium [99mTc] radiopharmaceutical injection Kits，which directly affects the clinical use of Technetium [99mTc] radiopharmaceuticals. Consequently，it is crucial to choose the appropriate analytical method for its accurate determination. By comparing the quality standards of radiopharmaceuticals included in the 2020 edition of the Chinese Pharmacopoeia and other related literature，the characteristics，determination principles and applications of commonly used methods for the determination of stannous chloride，including potentiometric analysis，spectrophotometry and high-performance liquid chromatography，were analyzed and summarized. This work provided technical reference for the establishment of a more scientific and rational quality standard for Technetium [99mTc] radiopharmaceutical injection kits.

Previous studies indicated that the SNARC effect can stably present in numerical cognition, however how the orientation influence the SNARC effect when Arabic numbers were rotated to left or right space remains unclear. The present study rotated Arabic numbers 45° to the left or right space and randomly and centrally presented those rotated numbers for participants systematically to investigate above question in orientation task (experiment 1), parity task (experiment 2), and magnitude task (experiment 3) respectively. The results found that 1) the SNARC effect was absent, but orientation spatial association effect was present in the orientation classification task. 2) the SNARC effect was only present in the orientation-response consistent condition, but absent in the orientation-response inconsistent condition in the numerical parity task (experiment 2) and numerical magnitude classification task (experiment 3). From these results, it can be concluded that 1) rotating numbers to left or right can substantially influence the SNARC effect; 2) how rotated orientation influence the SNARC effect was moderated by the task performed when numbers were rotated to left or right space. These results imply that the additional cue can substantially influence the SNARC effect in processing of numbers and support the working memory account.

Abstract Melanoma is a malignant skin tumor. This study aimed to explore and assess the effect of novel biomarkers on the progression of melanoma. Differently expressed genes (DEGs) were screened from GSE3189 and GSE46517 datasets of Gene Expression Omnibus database using GEO2R. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were conducted based on the identified DEGs. Hub genes were identified and assessed using protein–protein interaction networks, principal component analysis, and receiver operating characteristic curves. Quantitative real-time polymerase chain reaction was employed to measure the mRNA expression levels. TIMER revealed the association between aldehyde dehydrogenase 2 (ALDH2) and tumor immune microenvironment. The viability, proliferation, migration, and invasion were detected by cell counting kit-8, 5-ethynyl-2′-deoxyuridine, wound healing, and transwell assays. Total 241 common DEGs were screened out from GSE3189 and GSE46517 datasets. We determined 6 hub genes with high prediction values for melanoma, which could distinguish tumor samples from normal samples. ALDH2, ADH1B, ALDH3A2, DPT, EPHX2, and GATM were down-regulated in A375 and SK-MEL-2 cells, compared with the human normal melanin cell line (PIG1 cells). ALDH2 was selected as the candidate gene in this research, presenting a high diagnostic and predictive value for melanoma. ALDH2 had a positive correlation with the infiltrating levels of immune cells in melanoma microenvironment. Overexpression of ALDH2 inhibited cell viability, proliferation, migration, and invasion of A375/SK-MEL-2 cells. ALDH2 is a new gene biomarker of melanoma, which exerts an inhibitory effect on melanoma.

We are examining a second-order system of non-stiff Initial Value Problems (IVP), focusing on a scenario where the first derivatives are not present. In the realm of solving IVPs, Runge-Kutta-Nyström (RKN) pairs have proven to be highly effective. In order to achieve a pair with eighth and sixth order accuracy, we need to find a solution to a well-defined set of equations regarding the coefficients. Traditionally, pairs are constructed to go through eight stages per step. However, we propose a novel approach with nine stages per step, which enables the creation of pairs with orders $ 8 $ and $ 6 $ that have notably smaller truncation errors. Our paper introduces a new pair that, as expected, outperforms existing pairs of the same orders in a range of important problems.

Background and objective: Cerebral edema (CED) is a serious complication of acute ischemic stroke (AIS), especially in patients with large hemispheric infarction (LHI). Herein, a deep learning-based approach is implemented to extract CSF from T2-Weighted Imaging (T2WI) and evaluate the relationship between quantified cerebrospinal fluid and outcomes. Methods: Patients with acute LHI who underwent magnetic resonance imaging (MRI) were included. We used a deep learning algorithm to segment the CSF from T2WI. The hemispheric CSF ratio was calculated to evaluate its relationship with the degree of brain edema and prognosis in patients with LHI. Results: For the 93 included patients, the left and right cerebrospinal fluid regions were automatically extracted with a mean Dice similarity coefficient of 0.830. Receiver operating characteristic analysis indicated that hemispheric CSF ratio was an accurate marker for qualitative severe cerebral edema (area under receiver-operating-characteristic curve 0.867 [95% CI, 0.781–0.929]). Multivariate logistic regression analysis of functional prognosis showed that previous stroke (OR = 5.229, 95% CI 1.013–26.984), ASPECT≤6 (OR = 13.208, 95% CI 1.136–153.540) and low hemispheric CSF ratio (OR = 0.966, 95% CI 0.937–0.997) were significantly associated with higher chances for unfavorable functional outcome in patients with LHI. Conclusions: Automated assessment of CSF volume provides an objective biomarker of cerebral edema that can be leveraged to quantify the degree of cerebral edema and confirm its predictive effect on outcomes after LHI.

Abstract Neural interfaces for stable access to the spinal cord (SC) electrical activity can benefit patients with motor dysfunctions. Invasive high‐density electrodes can directly extract signals from SC neuronal populations that can be used for the facilitation, adjustment, and reconstruction of motor actions. However, developing neural interfaces that can achieve high channel counts and long‐term intraspinal recording remains technically challenging. Here, a biocompatible SC hyperflexible electrode array (SHEA) with an ultrathin structure that minimizes mechanical mismatch between the interface and SC tissue and enables stable single‐unit recording for more than 2 months in mice is demonstrated. These results show that SHEA maintains stable impedance, signal‐to‐noise ratio, single‐unit yield, and spike amplitude after implantation into mouse SC. Gait analysis and histology show that SHEA implantation induces negligible behavioral effects and Inflammation. Additionally, multi‐unit signals recorded from the SC ventral horn can predict the mouse's movement trajectory with a high decoding coefficient of up to 0.95. Moreover, during step cycles, it is found that the neural trajectory of spikes and low‐frequency local field potential (LFP) signal exhibits periodic geometry patterns. Thus, SHEA can offer an efficient and reliable SC neural interface for monitoring and potentially modulating SC neuronal activity associated with motor dysfunctions.

The highly infectious Delta variant strain of SARS-CoV-2 remains globally dominant and undermines COVID-19 vaccines. Rapid detection of the Delta variant is crucial for the identification and quarantine of infected individuals. In this study, our aim was to design and validate a genotyping RT-LAMP method to detect Delta variants specifically. R203M in the N gene of SARS-CoV-2 was chosen as the Delta variant-specific mutation for genotyping. To target the R203M-harboring region and the conserved sequence of the N gene, two sets of primers were designed, and a Cq (quantification cycle) ratio-based RT-LAMP for SARS-CoV-2 and R203M detection was developed by analyzing the significant discrepancy in amplification efficiency of the two sets of primers. We validated the RT-LAMP method on 498 clinical specimens in parallel with RT-qPCR, and 84 Delta variants from 198 positive samples were determined by sequencing. Compared with traditional RT-qPCR analyses, RT-LAMP appears to be 100% accurate in detecting SARS-CoV-2 clinical samples. RT-LAMP has a good ability to distinguish between Delta and non-Delta variants under a Cq ratio threshold of 1.80. Furthermore, the AUC (area under the curve) of this method was 1.00; the sensitivity, specificity and accuracy were all 100%. In summary, we have proposed a rapid, accurate and cost-effective RT-LAMP method to detect SARS-CoV-2 and Delta variants, which may facilitate the surveillance of COVID-19.

Objective: To investigate the distribution of axial length (AL) and posterior staphyloma (PS) in congenital cataract (CC) patients. The correlation between AL and the concentration of tissue transglutaminase (TGM2) in the aqueous humor (AH) of cataractous eyes was also evaluated. Methods: Cross-sectional data were collected from 499 children with CC who underwent phacoemulsification, anterior vitrectomy, and IOL implantation. AL measured by IOLMaster or A-scan ultrasonography and the presence of PS examined by B-scan ultrasonography were recorded. TGM2 levels in AH of 15 CC patients with normal axial length (NAL) and 15 CC patients with PS or long axial length (LAL) were measured by enzyme-linked immunosorbent assay. Results: The presence of PS in congenital cataractous eyes was 11.02%, and the presence of PS + LAL in congenital cataractous eyes was 29.06%. The AH levels of TGM2 in the cataractous group with NAL were lower than those in the cataractous group with PS or LAL (P

As one of the main approaches to implement phase gradient in metasurfaces, Pancharatnam-Berry (PB) phase originated from the spin–orbit interaction (SOI) of light has attracted enormous interest during the past several decades. Different from classical PB phase in linear optics that equals to twice the rotational angle of anisotropic elements for half wave plate distance and circular polarization, the recently proposed generalized PB phase indicates that phase gradient equals to multiple times the rotation angle could be achieved by high-order symmetry metallic meta atoms. Here, we show that the generalized PB phase can also be implemented in all-dielectric metasurfaces with higher efficiency than their metallic counterparts. Besides, by merging generalized PB phase and propagation phase, several functional devices are designed that the symmetric performance of PB phase can be decoupled. Moreover, a detailed comparison between meta atoms with C2, C3, and C6 rotational symmetries is conducted to illustrate the difference between classical and generalized PB phase. These results may further supplement the concept of generalized PB phase and could find many applications in optics and photonics..

Acquired peripheral hearing loss in midlife is considered the primary modifiable risk factor for dementia, while the underlying pathological mechanism remains poorly understood. Excessive noise exposure is the most common cause of acquired peripheral hearing loss in modern society. This study was designed to investigate the impact of noise-induced hearing loss (NIHL) on cognition, with a focus on the medial prefrontal cortex (mPFC), a brain region that is involved in both auditory and cognitive processes and is highly affected in patients with cognitive impairment. Adult C57BL/6 J mice were randomly assigned to a control group and seven noise groups: 0HPN, 12HPN, 1DPN, 3DPN, 7DPN, 14DPN, and 28DPN, which were exposed to broadband noise at a 123 dB sound pressure level (SPL) for 2 h and sacrificed immediately (0 h), 12 h, or 1, 3, 7, 14, or 28 days post-noise exposure (HPN, DPN), respectively. Hearing assessment, behavioral tests, and neuromorphological studies in the mPFC were performed in control and 28DPN mice. All experimental animals were included in the time-course analysis of serum corticosterone (CORT) levels and mPFC microglial morphology. The results illustrated that noise exposure induced early-onset transient serum CORT elevation and permanent moderate-to-severe hearing loss in mice. 28DPN mice, in which permanent NIHL has been verified, exhibited impaired performance in temporal order object recognition tasks concomitant with reduced structural complexity of mPFC pyramidal neurons. The time-course immunohistochemical analysis in the mPFC revealed significantly higher morphological microglial activation at 14 and 28 DPN, preceded by a remarkably higher amount of microglial engulfed postsynaptic marker PSD95 at 7 DPN. Additionally, lipid accumulation in microglia was observed in 7DPN, 14DPN and 28DPN mice, suggesting a driving role of lipid handling deficits following excessive phagocytosis of synaptic elements in delayed and sustained microglial abnormalities. These findings provide fundamentally novel information concerning mPFC-related cognitive impairment in mice with NIHL and empirical evidence suggesting the involvement of microglial malfunction in the mPFC neurodegenerative consequences of NIHL.

Abstract Background Tumor deposits (TDs) have been identified as an independent prognostic factor in gastric cancer (GC). However, the associated clinicopathological factors and how to simply and reasonably incorporate TD into the TNM staging system remain undetermined. The aim of the current study was therefore to assess the significance of TD among radically resected GC patients. Methods We retrospectively reviewed 1915 patients undergoing radical resection between 2007 and 2012. The patients were classified into two groups according to TD status (absent vs. present), and the clinicopathologic characteristics, DFS, and OS were compared. Associations of TD presence with other clinicopathologic factors were evaluated by logistic regression analysis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic factors for DFS and OS in the primary cohort. Propensity score matching (PSM) was performed to reduce the possibility of selection bias according to the presence of TD. External validation of previously proposed modified staging systems incorporating TD was conducted. Results The detection rate of TD was 10.5% (201/1915). The presence of TD was significantly related to unfavorable clinicopathologic variables, including advanced T and N categories. According to the multivariate Cox regression analysis, the presence of TD was identified as an independent prognostic factor for DFS and OS in the primary cohort (both P < 0.001). In the after-PSM cohort, TD presence also significantly shortened DFS and OS. In the external validation, one system that incorporated TD into the pTNM stage had the best performance. Conclusions The presence of TD was significantly associated with poor survival in radically resected GC patients. The incorporation of TD into the TNM staging system can further improve the predictive capability. A multicenter cohort with a large sample size is needed to determine the appropriate method of incorporation.

BackgroundFibrosarcoma is a rare sarcoma of the soft tissue in adults, occurring most commonly in the extremities. This study aimed to construct two web-based nomograms to predict overall survival (OS) and cancer-specific survival (CSS) in patients with extremity fibrosarcoma (EF) and validate it with multicenter data from the Asian/Chinese population.MethodPatients with EF in the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015 were included in this study and were randomly divided into a training cohort and a verification cohort. The nomogram was developed based on the independent prognostic factors determined by univariate and multivariate Cox proportional hazard regression analyses. The predictive accuracy of the nomogram was validated with the Harrell’s concordance index (C-index), receiver operating curve, and calibration curve. Decision curve analysis (DCA) was utilized to compare the clinical usefulness between the novel model and the existing staging system.ResultA total of 931 patients finally were obtained in our study. Multivariate Cox analysis determined five independent prognostic factors for OS and CSS, namely, age, M stage, tumor size, grade, and surgery. The nomogram and the corresponding web-based calculator were developed to predict OS (https://orthosurgery.shinyapps.io/osnomogram/) and CSS (https://orthosurgery.shinyapps.io/cssnomogram/) probability at 24, 36, and 48 months. The C-index of the nomogram was 0.784 in the training cohort and 0.825 in the verification cohort for OS and 0.798 in the training cohort and 0.813 in the verification cohort for CSS, respectively, indicating excellent predictive performance. The calibration curves showed excellent agreement between the prediction by the nomogram and actual outcomes. Additionally, the results of DCA showed that the newly proposed nomogram was significantly better than the conventional staging system with more clinical net benefits. The Kaplan–Meier survival curves showed that patients assigned into the low-risk group had a more satisfactory survival outcome than the high-risk group.ConclusionIn this study, we constructed two nomograms and web-based survival calculators including five independent prognostic factors for the survival prediction of patients with EF, which could help clinicians make personalized clinical decisions.

Abstract The need for effective and adaptive technologies for carbon dioxide (CO2) mitigation targeting global net‐zero carbon emissions is critically growing. Hence, innovative technologies for CO2 reduction have attracted worldwide interest from scientific research communities. The use of liquid metals for the conversion of CO2 into carbon or solid carbonaceous products has gained increasing attention in recent years due to their high activity and resistance to coking. Here, a facile approach for the reduction of CO2 to solid carbon using liquid Mg at and near room temperature, and atmospheric pressure is presented. In this process, magnesium (Mg) plays a major role in driving the dissociation of CO2 to its elemental constituents, carbon and oxygen. During the reaction process, Mg ions dissolve in gallium (Ga) liquid metal alloy, diffuse to the gas–liquid interface, and reduce CO2 to carbon while undergoing an oxidation reaction. The electrochemical method ensures a sustainable cyclic process by reducing Mg and Ga ions back to their metallic counterpart. The use of liquid metal alloys for CO2 reduction reactions can enable to achieve CO2 capture and storage at room temperature, setting a new foundation for the future exploration of efficient CO2 mitigation issues.

PurposeTo investigate the impact of the pre-operative axial length (AL) on myopic shift (MS) 3 years after primary intraocular lens (IOL) implantation in congenital/developmental cataract patients.MethodsA retrospective study of patients who underwent congenital/developmental cataract surgery and primary IOL implantation at age 2–3 years at EENT Hospital was conducted. All patients were followed up regularly for at least 3 years after surgery. Refractive outcomes, including spherical equivalent (SE) and MS, were collected at each follow-up.ResultsForty eyes from 40 patients were included. The mean age at surgery was 2.56 ± 0.57 years old, and the mean follow-up time was 3.05 ± 0.22 years. Patients were divided into two groups: Group 1 included 20 patients with longer pre-operative ALs (≥22 mm), and Group 2 included 20 patients with average pre-operative ALs (

Since the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in December 2019, the spread of SARS-CoV2 infection has been escalating rapidly around the world. In order to provide more timely access to medical intervention, including diagnostic tests and medical treatment, the FDA authorized multiple test protocols for diagnostic tests from nasopharyngeal swab, saliva, urine, bronchoalveolar lavage and fecal samples. The traditional diagnostic tests for this novel coronavirus 2019 require standard processes of viral RNA isolation, reverse transcription of RNA to cDNA, then real-time quantitative PCR with the RNA templates extracted from the patient samples. Recently, many reports have demonstrated a direct detection of SARS-Co-V2 genomic material from saliva samples without any RNA isolation step. To make the rapid detection of SARS-Co-V2 infection more accessible, a point-of-care type device was developed for SARS-CoV-2 detection. Herein, we report a portable microfluidic-based integrated detection-analysis system for SARS-CoV-2 nucleic acids detection directly from saliva samples. The saliva cartridge is self-contained and capable of microfluidic evaluation of saliva, from heating, mixing with the primers to multiplex real-time quantitative polymerase chain reaction, detecting SARS-CoV-2 with different primer sets and internal control. The approach has a detection sensitivity of 1000 copies/mL of SARS-CoV-2 RNA or virus, with consistency and automation, from saliva sample-in to result-out.

Metasurface with simultaneous control of amplitude, phase, and polarization of electromagnetic (EM) waves has drawn great attention in modern optics and photonics. However, conventional metasurfaces are mainly designed for single frequency and functionality. Here, we proposed a simple yet powerful methodology for the design of a dual-frequency multifunctional Janus metasurface. The designed transmissive device with sub-wavelength thickness is not only able to achieve completely independent phase modulation at two preset frequencies, but can also realize efficient asymmetric transmission of EM waves. On the other hand, the out-of-plane symmetry breaking also enables the realization of different functions for opposite propagation directions. As a proof of concept, a Janus beam deflector and a Janus metalens with direction- and frequency-controlled functionalities are demonstrated numerically. A dual-frequency Janus metasurface for direction-dependent meta-holograms is validated both numerically and experimentally. Therefore, we believe the proposed metasurfaces with direction- and frequency-dependent versatile functionalities may have great potential in the fields such as polarization manipulation, chiral sensing and information encryption.

Age-related cataract (ARC) is one of the leading blinding eye diseases worldwide. Chronic oxidative stress and the apoptosis of human lens epithelial cells (HLECs) have been suggested to be the mechanism underlying cataract formation. Acetyl-11-keto-β-boswellic acid (AKBA) is a pentacyclic triterpene with antioxidative and antiapoptotic effects. In this study, we investigated the potential effects of AKBA on oxidative-induced HLECs injury and cataract formation. H2O2 was used to simulate HLECs oxidative injury in vitro, and Na2SeO3 was applied to establish an in vivo cataract model. In our current study, a cell counting kit-8 (CCK-8) assay was performed to evaluate the effects of H2O2 and AKBA on cell viability in vitro. Intracellular reactive oxygen species (ROS) levels were measured with the ROS assay to verify the antioxidant capacity of AKBA. Apoptotic cells were detected and measured by TUNEL staining and flow cytometry, and quantitative real-time (qRT)-PCR and Western blotting were applied to examine the transcription and expression of apoptosis-related proteins. Furthermore, immunofluorescence staining was performed to locate factor-erythroid 2-related factor 2 (Nrf2), and the protein levels of Nrf2, kelch-like ECH-associated protein 1 (Keap1) and heme oxygenase-1 (HO-1) were determined by Western blotting. Finally, we observed the degree of lens opacity and performed hematoxylin-eosin (H&E) staining to assess the protective effect of AKBA on cataract formation in vivo. AKBA increased HLECs viability under H2O2 stimulation, decreased intracellular ROS levels and alleviated the cell apoptosis rate in vitro. AKBA significantly decreased the expression of caspase-3 and Bax and increased the content of Bcl-2. The results of immunofluorescence and immunohistochemical staining proved that the expression and nuclear translocation of Nrf2 were activated with AKBA treatment in vivo and in vitro. Moreover, computational docking results showed that AKBA could bind specifically to the predicted Keap1/Nrf2 binding sites. After AKBA activation, Nrf2 dissociates from the Nrf2/Keap1 complex, translocates into the nucleus, and subsequently promotes HO-1 expression. In addition, AKBA attenuated lens opacity in selenite-induced cataracts. Overall, these findings indicated that AKBA alleviated oxidative injury and cataract formation by activating the Keap1/Nrf2/HO-1 cascade. Therefore, our current study highlights that AKBA may serve as a promising treatment for ARC progression.

Abstract Background This study is to determine the risk factors for metastasis of Ewing sarcoma (ES) patients in SEER database. Then explore clinicopathological factors associated with poor prognosis. Furthermore, develop the nomogram to predict the probability of overall survival and cancer-specific survival Methods Thus, we collected clinicopathological data of ES patients in SEER database, and then used chi-square test and logistic regression to determine risk factors associated to metastasis. We also did survival analysis including Kaplan-Meier curve and Cox proportional hazard model to explore the risk factors associated to overall survival and cancer-specific survival, and then developed the nomogram to visualize and quantify the probability of survival. Results After statistics, we find that patients with older ages (11–20 years old: OR = 1.517, 95% confidence interval [CI] 1.033–2.228, p = 0.034; 21–30 years old: OR = 1.659. 95%CI 1.054–2.610, p = 0.029), larger tumor size (> 8 cm: OR = 1.914, 95%CI 1.251–2.928, p = 0.003), and pelvic lesions (OR = 2.492, 95%CI 1.829–3.395, p < 0.001) had a higher risk of metastasis. ROC curves showed higher AUC (0.65) of combined model which incorporate these three factors to predict the presence of metastasis at diagnosis. In survival analysis, patients with older ages (11–20 years: HR = 1.549, 95%CI 1.144–2.099, p = 0.005; 21–30 years: HR = 1.808, 95%CI 1.278–2.556, p = 0.001; 31–49 years: HR = 3.481, 95%CI 2.379–5.094, p < 0.001; ≥ 50 years: HR = 4.307, 95%CI 2.648–7.006, p < 0.001) , larger tumor size (5–8 cm: HR = 1.386, 95%CI 1.005–1.991, p = 0.046; > 8 cm: HR = 1.877, 95%CI 1.376–2.561, p < 0.001), black race (HR = 2.104, 95%CI 1.296–3.416, p = 0.003), and wider extension (regional: HR = 1.373, 95%CI 1.033–1.823, p = 0.029; metastatic: HR = 3.259, 95%CI 2.425–4.379, p < 0.001) were associated with worse prognosis. Chemotherapy was associated with better prognosis (HR = 0.466, 95%CI 0.290–0.685, p < 0.001). The nomogram which developed by training set and aimed to predict OS and CSS showed good consistency with actual observed outcomes internally and externally. Conclusion In conclusion, tumor size and primary site were associated with distant metastasis at diagnosis. Age, tumor size, primary site, tumor extent, and chemotherapy were associated with overall survival and cancer-specific survival. Nomogram could predict the probability of OS and CSS and showed good consistency with actual observed outcomes internally and externally.

ObjectiveIschemic infarction of pituitary apoplexy (PA) is a rare type of pituitary apoplexy. This study aims to characterize ischemic PA via clinical presentations, imaging data, histopathological manifestations, and focus on the management and prognosis of the disease.MethodsThis study retrospectively identified 46 patients with ischemic PA confirmed using histopathology at a single institution from January 2013 to December 2020. The clinical presentations, imaging data, laboratory examination, management, and outcomes were collected. We then summarized the clinical presentations, imaging features, intraoperative findings, and histopathological manifestations, and compared the outcomes based on the timing of surgical intervention.ResultsHeadache was the most common initial symptom (95.65%, 44/46), followed by visual disturbance (89.13%, 41/46), and nausea and vomiting (58.70%, 27/46). 91.3% of the patients had at least one pituitary dysfunction, with hypogonadism being the most common endocrine dysfunction (84.78%, 39/46). Cortisol dysfunction occurred in 24 (52.17%) patients and thyroid dysfunction occurred in 17 (36.96%). Typical rim enhancement and thickening of the sphenoid sinus on MRI were seen in 35 (85.37%) and 26 (56.52%) patients, respectively. Except for one patient with asymptomatic apoplexy, the remaining patients underwent early (≤ 1 week, 12 patients) and delayed (> 1 week, 33 patients) transsphenoidal surgery. Total tumor resection was achieved in 27 patients and subtotal tumor resection in 19 patients. At surgery, cottage cheese–like necrosis was observed in 50% (23/46) of the patients. At the last follow-up of 5.5 ± 2.7 years, 92.68% (38/41) of the patients had gained a significant improvement in visual disturbance regardless of surgical timing, and 65% of the patients were still receiving long-term hormone replacement therapy.ConclusionPatients with ischemic PA can be accurately diagnosed by typical imaging characteristics preoperatively. The timing of surgical intervention does not significantly affect the resolution of neurological and endocrinological dysfunctions. Preoperative endocrine dysfunctions are common and usually appear to be poor after surgical intervention.

Flare frequency distributions represent a key approach to addressing one of the largest problems in solar and stellar physics: determining the mechanism that counterintuitively heats coronae to temperatures that are orders of magnitude hotter than the corresponding photospheres. It is widely accepted that the magnetic field is responsible for the heating, but there are two competing mechanisms that could explain it: nanoflares or Alfvén waves. To date, neither can be directly observed. Nanoflares are, by definition, extremely small, but their aggregate energy release could represent a substantial heating mechanism, presuming they are sufficiently abundant. One way to test this presumption is via the flare frequency distribution, which describes how often flares of various energies occur. If the slope of the power law fitting the flare frequency distribution is above a critical threshold, α = 2 as established in prior literature, then there should be a sufficient abundance of nanoflares to explain coronal heating. We performed >600 case studies of solar flares, made possible by an unprecedented number of data analysts via three semesters of an undergraduate physics laboratory course. This allowed us to include two crucial, but nontrivial, analysis methods: preflare baseline subtraction and computation of the flare energy, which requires determining flare start and stop times. We aggregated the results of these analyses into a statistical study to determine that α = 1.63 ± 0.03. This is below the critical threshold, suggesting that Alfvén waves are an important driver of coronal heating.

Abstract Purpose It is recommended for colorectal cancer to harvest at least 12 lymph nodes (LNs) during surgery to avoid understaging of the disease. However, it is still controversial whether it is necessary to harvest from locally advanced rectal cancer (LARC) patients who underwent neoadjuvant chemoradiotherapy (neo‐CRT). The impact of lymph node yield (LNY) on prognosis in LARC patients was analyzed. Materials/Methods In total, 495 LARC patients who underwent neo‐CRT in 2006‐2015 were analyzed. After examining clinicopathological distribution differences between the LNY subgroups (with the threshold of 12), univariate and multivariate Cox survival analyses were performed. Survival plots were obtained from Kaplan‐Meier analyses. Similar subgroup analyses were performed according to the tumor regression grade (TRG) and metastatic status of post‐operational LNs. Results Of the 495 patients, 287 (57.98%) had an LNY of less than 12. Nearly no significant clinicopathological difference was found between the LNY subgroups, including the TRG scores. Multivariate survival analysis demonstrated that at least 12 LNs examined was an independent prognostic feature of good overall survival (OS), disease‐free survival (DFS), and distant metastasis free survival (DMFS), but not local recurrence free survival (LRFS). However, in the subgroup analyses, no association was found between LNY and prognosis in patients with good TRG scores (0‐1) or negative LNs. Conclusions For LARC patients treated with neo‐CRT, an LNY of at least 12 indicated an improved survival. Decreased LNY was not related to better tumor regression. It suggests that a sufficiently high LNY is still required, especially in those with a potentially poor tumor response.

Abstract In this paper, a broadband and tunable radar cross section (RCS) reduction structure is proposed by using the hybrid physical mechanism that is based on high-order reflections and Salisbury-type absorption. Our design combines the high-index grating structure with a traditional Salisbury screen in which the lossy sheet is made of a graphene structure. When it is illuminated by a plane wave with normal incidence, the Salisbury screen can absorb the incoming wave, and the introducing high-index grating structure could further reduce the backward scattering wave by generating high-order reflection beams, which broadens the RCS reduction bandwidth. In addition, the RCS reduction level can be dynamically controlled by tuning the surface resistance of the graphene layer. Simulated results show that the proposed structure can realize tunable RCS reduction between 4.1 and 18 GHz under normal incidence with different graphene resistances. Experimental results are in accordance with those of the simulation results. In addition, the scattering field distributions and the plots of surface power loss density have been illustrated to analyze the RCS-reduction mechanism of our structure.

In this paper, leveraging the resonant phase and the geometry phase simultaneously, we demonstrated a low scattering lens antenna, which can work at both transmission and reflection mode. Different from the traditional microwave lens which only realizes wavefront shaping in half-space, the proposed metasurface lens not only squeezes the transmitted divergent beam to improve the gain of the conventional circular-polarized antenna, but also scatters the electromagnetic wave to maintain a low reflection property in broadband. The proposed lens antenna working in full space may provide a new approach for an integrated communication system.

To explore application and effect of nursing quality target management in free flap transplantation for hand injury. 140 patients with free skin flap transplantation for hand injury admitted to the hand and foot surgery ward of the hospital from January 2017 to December 2019 were selected as the research objects. They were randomly divided into observation group and control group. There were 70 patients in each group, and both groups of patients received microscopic free flap transplantation. The observation group adopted traditional nursing mode and nursing quality target management mode to carry out nursing, while the control group adopted traditional nursing mode to carry out nursing. The treatment compliance, skin flap survival, occurrence of vascular crisis, occurrence of complications, VAS and Barthel comparison score of the two groups were compared. The treatment compliance of patients in the observation group was significantly higher than that in the control group (P < 0.05). The survival rate of skin flap in the observation group was higher than that in the control group (P < 0.05). The incidence of vascular crisis in the observation group was lower than that in the control group (P < 0.05). The postoperative pain in the observation group was better than that in the control group (P < 0.05). There was no significant difference in Barthel score between the observation group and the control group at admission (P > 0.05), but the improvement range of Barthel score in the observation group was higher than that in the control group at discharge (P < 0.05), The satisfaction of patients in the observation group to nurses was higher than that in the control group (p < 0.05). The application of nursing quality target management can improve the treatment compliance of patients, improve the survival rate of free skin flap transplantation for hand injury, reduce the incidence of vascular crisis within 48 hours after operation, reduce the occurrence of postoperative complications, relieve the pain of patients, improve self-care ability and ensure the quality of life.

Responses to neoadjuvant chemoradiotherapy (nCRT) and therapy-related toxicities in rectal cancer vary among patients. To provide the individualized therapeutic option for each patient, predictive markers of therapeutic responses and toxicities are in critical need. We aimed to identify the association of gut microbiome with and its potential predictive value for therapeutic responses and toxicities. In the present study, we collected fecal microbiome samples from patients with rectal cancer at treatment initiation and just after nCRT. Taxonomic profiling via 16S ribosomal RNA gene sequencing was performed on all samples. Patients were classified as responders versus non-responders. Patients were grouped into no or mild diarrhea and severe diarrhea. STAMP and high-dimensional class comparisons via linear discriminant analysis of effect size (LEfSe) were used to compare the compositional differences between groups. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) was utilized to predict differences in metabolic function between groups. Ten patients were classified as responders and 12 patients were classified as non-responders. Fourteen patients experienced no or mild diarrhea and 8 patients experienced severe diarrhea. Several bacteria taxa with significantly different relative abundances before and after nCRT were identified. Similarly, several baseline bacteria taxa and predicted pathways with significantly different relative abundances between responders and non-responders or between patients no or mild diarrhea and severe diarrhea were identified. Specifically, Shuttleworthia was identified as enriched in responders and several bacteria taxa in the Clostridiales order etc. were identified as enriched in non-responders. Pathways including fatty acid metabolism were predicted to be enriched in responders. In addition, Bifidobacterium, Clostridia, and Bacteroides etc. were identified as enriched in patients with no or mild diarrhea. Pathways including primary bile acid biosynthesis were predicted to be enriched in patients with no or mild diarrhea. Together, the microbiota and pathway markers identified in this study may be utilized to predict the therapeutic responses and therapy-related toxicities of nCRT in patients with rectal cancer. More patient data is needed to verify the current findings and the results of metagenomic, metatranscriptomic, and metabolomic analyses will further mine key biomarkers at the compositional and functional level.

Background: Awake craniotomy with intraoperative stimulation has been utilized in glioma surgical resection to preserve the quality of life. Epilepsy may occur in 5–20% of cases, leading to severe consequences. This study aimed to discuss the mechanism of intraoperative stimulation-related epilepsy (ISE) using DTI-based graph theoretical analysis. Methods: Twenty patients with motor-area glioma were enrolled and divided into two groups (Ep and nEp) according to the presence of ISE. Additionally, a group of 10 healthy participants matched by age, sex, and years of education was also included. All participants underwent T1, T2, and DTI examinations. Graph theoretical analysis was applied to reveal the topological characteristics of white matter networks. Results: Three connections were found to be significantly lower in at least one weighting in the Ep group. These connections were between A1/2/3truL and A4ulL, A1/2/3truR and A4tR, and A6mL and A6mR. Global efficiency was significantly decreased, while the shortest path length increased in the Ep group in at least one weighting. Ten nodes exhibited significant differences in nodal efficiency and degree centrality analyses. The nodes A6mL and A6mR showed a marked decrease in total four weightings in the Ep group. Conclusions: The hub nodes A6mL and A6mR are disconnected in patients with ISE, causing subsequent lower efficiency of global and regional networks. These findings provide a basis for presurgical assessment of ISE, for which caution should be taken when it involves hub nodes during intraoperative electrical stimulation.

We report the development of system for packaging critical components of the traditional collection kit to make an integrated fingerstick blood collector for self-collecting blood samples of 100 μl or more for radiation countermeasures. A miniaturized vacuum tube system (VacuStor system) has been developed to facilitate liquid reagent storage, simple operation and reduced sample contamination. Vacuum shelf life of the VacuStor tube has been analyzed by the ideal gas law and gas permeation theory, and multiple ways to extend vacuum shelf life beyond one year have been demonstrated, including low temperature storage, Parylene barrier coating and container vacuum bag sealing. Self-collection was also demonstrated by healthy donors without any previous fingerstick collection experience. The collected blood samples showed similar behavior in terms of gene expression and cytogenetic biodosimetry assays comparing to the traditionally collected samples. The integrated collector may alleviate the sample collection bottleneck for radiation countermeasures following a large-scale nuclear event, and may be useful in other applications with its self-collection and liquid reagent sample preprocessing capabilities.

Environmental sensing is a key technology for the development of unmanned cars, drones and robots. Many vision sensors cannot work normally in an environment with insufficient light, and the cost of using multiline LiDAR is relatively high. In this paper, a novel and inexpensive visual navigation sensor based on structured-light vision is proposed for environment sensing. The main research contents of this project include: First, we propose a laser-stripe-detection neural network (LSDNN) that can eliminate the interference of reflective noise and haze noise and realize the highly robust extraction of laser stripes region. Then we use a gray-gravity approach to extract the center of laser stripe and used structured-light model to reconstruct the point clouds of laser center. Then, we design a single-line structured-light sensor, select the optimal parameters for it and build a car–platform for experimental evaluation. This approach was shown to be effective in our experiments and the experimental results show that this method is more accurate and robust in complex environment.

Objective: To evaluate gastrointestinal and cardiovascular adverse event risks associated with optical colonoscopy (OC) among Medicare outpatients who received computed tomography colonography (CTC) as their initial method of colorectal evaluation. Methods: Medicare claims were compared between 6114 outpatients ≥66 years who received initial CTC and 149,202 outpatients who received initial OC between January 2007 and December 2008. OC patients were matched on county of residence and year of evaluation. Outcomes included lower gastrointestinal bleeding, gastrointestinal perforation, other gastrointestinal events and cardiovascular events resulting in an emergency department visit or hospitalization within 30 days. Results: Among 1000 outpatients undergoing initial CTC, 12.4 experienced lower gastrointestinal bleeding, 0.7 perforation, 18.0 other gastrointestinal events and 45.5 cardiovascular events within 30 days. After multivariate adjustment, risks of lower gastrointestinal bleeding, other gastrointestinal events and cardiovascular events were higher with initial OC than CTC, with or without subsequent OC (Odds Ratio 1.91 95 Confidence Interval [1.47,2.49], Odds Ratio 1.35 95 Confidence Interval [1.07,1.69] and Odds Ratio 1.38 95 Confidence Interval [1.18,1.62], respectively); however, perforation risk did not differ (p = 0.10). This pattern is similar in older and symptomatic populations. Conclusion: Rates of gastrointestinal bleeding, other gastrointestinal events and cardiovascular events are lower following initial CTC than OC, but rates of perforation do not differ.