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Introduction Erogenous zones (EZs) of the body elicit sexual arousal in response to touch. While previous studies have attempted to map erogeneity throughout the body, they did not assess internal surfaces or individual genital structures/sub-areas. Furthermore, previous work did not query how important specific EZs were to subjects’ sexual pleasure, nor did it assess what body areas people specifically dislike having touched during sex. Objective To develop detailed, topographic maps of erogenous and aversive sensation throughout the vulva, vagina, and breasts. Methods A sample of 441 sexually active cisgender women (mean age 48.9 ± 15.6 years) completed our anonymous, online questionnaire via Qualtrics®. Respondents selected predefined areas from anatomic illustrations that bring them pleasure when touched during sex, and areas that they dislike having touched during sex. For each EZ, respondents rated its importance to their sexual pleasure on a 10-point Likert scale, and/or indicated why they dislike having a specific area touched. Maps of erogeneity and aversion were generated based on the percent of respondents that selected each zone. Results More respondents selected at least one area of the vulva as erogenous (82.0%), as compared to the breasts (77.4%) and vagina (59.4%). Of the EZs of the vulva (Figure 1a), the vaginal introitus (50.8%), peri urethra (42.6%), and clitoris (41.3%) were the three most frequently selected and highest rated structures for pleasure. Conversely, the anus (34.0%) and perineum (7.9%) were the most disliked areas (Figure 1b) for the primary reason of respondents finding “It’s gross,” followed by “It hurts” and “I’m ashamed/embarrassed.” The five EZs of the vagina (Figure 2a) revealed enhanced erogeneity in the superficial anterior (48.1%) and posterior (32.9%) regions. The cervix (6.8%) and posterior zones (3.4%, 5.0%) of the vagina were the most disliked areas (Figure 2b) due to respondents reporting that “It hurts” and “It’s overly sensitive.” Interestingly, two of the most erogenous zones of the breasts (Figure 3a) were also the most disliked (Figure 3b): fatty breast tissue (57.8% erogenous, 5.4% aversive) and the nipples (42.7%, 6.5%). Respondent reasoning for disliking these areas included “It’s overly sensitive,” “It hurts,” and “It reminds me of a bad experience.” Conclusions The vulva and vagina were associated with enhanced erogenous sensation not only at (but also in regions immediately peripheral to) the clitoris. These EZs were also rated as “highly important” to sexual pleasure. The anus was overwhelmingly associated with aversive sensation due to feelings of judgment/shame. Other aversive zones were primarily disliked for objective reasons of pain and sensitivity. Disclosure No

Introduction For thousands of years male circumcision (MC) has been performed for cultural, religious, aesthetic, and public health reasons, and it continues to be among the most common surgical procedure performed worldwide. The effects of MC on sexual function remains controversial, despite recent systematic reviews demonstrating no adverse effects. A key area of debate regarding MC has been the impact of MC on penile sensation. Existing literature evaluating changes in penile sensitivity and pleasure following MC have primarily focused on the penis glans and the frenulum-area of the shaft. Additionally, studies describing the effects of MC on orgasm have focused on the changes in ease of reaching orgasm/ejaculatory latency. In truth, although patients rely on providers to counsel them about what results they might expect to occur with MC, the effects of MC on erogenous sensation and other orgasm-related domains of sexual function are still not well understood. Objective We sought to expand on the existing literature by assessing erogenous sensation throughout the entire penis surface area, and to evaluate differences in reported orgasm function among circumcised and uncircumcised men. Methods Adult male subjects recruited from a paid anonymous online survey platform (QualtricsTM, USA) were shown anatomic illustrations of a penis whose entire surface area was divided into 12 different regions. Subjects were instructed to identify regions they found pleasurable when touched during sex, and to rate each on a 1-10 scale. Subjects were also asked to characterize their typical orgasm across the following six domains: 1. Lead-time, 2. Orgasm duration, 3. Perceived body-location(s) of orgasm-sensation, 4. Classification of orgasm experience as a single or multiple-peak event, 5. Refractory period duration, and 6. Overall satisfaction. Comparisons between circumcised and uncircumcised men were performed with a 2-tailed T-test. The Benjamini-Hochberg Procedure with FDR=0.05 was applied to control for multiple comparisons. Results The survey was completed by 227 circumcised (mean age ± SD, 46.6 ± 17.7y) and 175 uncircumcised men (47.8 ± 18.1y). There were no significant differences in ratings across all twelve regions among circumcised and uncircumcised cohorts. However, when subjects were asked to identify which regions gave pleasure when touched during sex, significantly more circumcised (vs. uncircumcised) men reported a preference for the penis-tip (38% vs 17%, p=0.024) and the middle third of their ventral shaft (63% vs 48%, p=0.036). There were no significant differences in reported experience with orgasm quality and function across all six queried domains among circumcised and uncircumcised cohorts. Conclusions Our findings suggest that both circumcised and uncircumcised men experience pleasure in their penis and experiences with orgasm function similarly. Although we often think of the tip of the penis as being the “most erogenous” location for men, we found that scored erogeneity was generally similar across the entire length of the penis. Although overall erogeneity ratings did not differ, we found that circumcised men reported more areas of their penis as “pleasurable when touched during sex”, as compared to their uncircumcised counterparts. These findings will be important to share with patients and their families considering MC. Disclosure No

The random existence of many irregular pore structures in geotechnical materials has a decisive influence on its permeability and other macroscopic properties. The analysis and characterization of the micropore structure of the material and its permeability are of great significance for geotechnical engineering. In this study, digital images with different magnifications were used to examine the pore structure and permeability of sandstone samples. The image processing method is used to obtain binary images, and then, the pore size distribution method is used to calculate the pore size distribution. Therefore, based on the Hagen-Poiseuille formula, we get the prediction value of material’s permeability and compare it with the value obtained from mercury intrusion porosimetry (MIP). It is found that different microscopic images with different magnification and various statistical methods of pore size have a specific influence on the characterization of pore structure and permeability prediction. The porosity of different magnifications is not the same, and the results obtained at higher magnifications are more consistent with the results obtained with MIP. With the increase of magnification, we can observe more pores in large sizes. The effect of CPSD (continuous pore size distribution) in pore size statistics is better than that of DPSD (discrete pore size distribution). In permeability prediction, the prediction result of higher magnification images are closer to the instrument test value, and the value of DPSD is more significant than that of CPSD. In future research, an appropriate method should be selected to obtain a reasonable prediction of the permeability of the target material.

Based on the platform of a proton accelerator facility, a 200 MHz high intensity continuous wave (CW) radio frequency quadrupole (RFQ) accelerator has been designed at the Sino-French Institute of Nuclear Engineering and Technology of Sun Yat-Sen University, China. Employing the conventional four-vane structure, the RFQ can accelerate 20 mA proton beam from 20 keV to 2.5 MeV. In the beam dynamics design, the simulated transmission efficiency reaches 99.5% and the vane length is less than 4 m. In the electromagnetic design, for the long-term stable operation, Pi-mode Stabilizer Loops (PISLs) are utilized to achieve more than 10 MHz mode frequency separation and to decrease the effects of dipole modes. The 48 tuners are optimized to provide a range of ± 2 MHz frequency tuning. Additionally, the undercuts are optimized to ensure a good field flatness along the longitudinal direction. Based on the coolant channel design, the multi-physics analysis is performed to investigate the deformation and stress resulting from the dissipation of RF power within the cavity, as well as determine the temperature tuning coefficients of the coolants within the vane and wall. The entire design and analysis of PAFA-RFQ has been completed, and the scheme of the design can also be applied to the design of other RFQ cavities.

To reduce Touschek scattering in the beam and extend the lifetime of the beam in the Shenzhen Innovation Light-source Facility (a fourth-generation light source), a 1500 MHz passive third harmonic system will be used. The present work is devoted to the RF design and frequency sensitivity analysis of the 1500 MHz passive third harmonic superconducting cavity, optimizing the RF parameters of the cavity, and giving a frequency scheme for the cavity in fabrication. The reliability of the cavity during operation is taken as the main goal for the optimization of the geometrical parameters, and its structural and RF parameters are obtained with E peak/E acc of 2.17, B peak/E acc of 5.12 mT/(MV/m) and G · R/Q of 25052 at 2 K. A pair of fluted beam pipes are used to propagate the higher order modes (HOMs) of the harmonic cavity, allowing a smooth transition of the first dipole mode to the absorber located at room temperature area. For the frequency sensitivity analysis, the frequency variations of the cavity in fabrication are obtained by multi-physics coupling simulation in the paper, which gives the target frequency of the cavity between welding and preloading. After electron beam welding (EBW), the resonant frequency of the cavity should be maintained at 1500.096 MHz, and the pre-tuning target frequency is 1497.456 MHz. The slow tuning range is ±400 kHz, the fast-tuning range is 600 Hz, and the maximum allowable tuning force is 15 kN.

This article presents a novel decoupling technique for the circularly polarized multiple-inputmultiple- output (CP-MIMO) system composed of Guoshaped patch antennas. A comparative study has been conducted on antenna performance as a function of packing distance before and after applying the technique. A prototype of two-element Guo-shaped patch MIMO at a small inter-element spacing of 12.5 mm has devised aiming for the 5G new radio n38 (2.57-2.62 GHz) applications. Simulation reinforced with experimental results confirmed the effectiveness of the proposed technique, whereas the two Guo-shaped patch elements packed in such small spacing can be operated independently. Both the envelope correlation coefficient and diversity gain are approaching their ideal values.

Introduction The World Professional Association for Transgender Health (WPATH) recommends referral letters from two mental-health providers within one year of gender-affirming genital surgery (gGAS) to ensure patient readiness before primary surgeries. Many U.S. health-insurance plans will not authorize second- and third-stage surgeries or revision surgeries without two referral letters. Such requirements are not supported by WPATH guidelines. Objective This study investigates insurance requirements for referral letters and their negative impact on care. Methods We retrospectively reviewed all gGAS cases over a 4-year period at our tertiary care medical center. Referral-letter requirements for insurance authorization were documented. The nation's largest insurance companies, including commercial, state-, and federally funded plans, were contacted to confirm requirements. We prospectively recorded time needed to complete insurance authorization for a patient subset. WPATH publications were reviewed. Results Nearly all reviewed U.S. health-insurance plans required annually updated referral letters for each gGAS procedure, including staged and revision surgeries. No updated letters changed clinical management. Referral-letter requirements delayed care. WPATH states that letters should not be needed for staged surgeries. Some plans required letters even for initial surgical consultation, a practice not supported by WPATH. Conclusions Insurance companies’ requirements for referral letters impede care and contradict WPATH guidelines. We advocate that referral letters should not be required for surgical consultations or for staged or revision surgeries after a patient has already had first-stage primary gGAS. Universal referral-letter requirements for secondary surgeries provide minimal clinical value, delay care, increase costs, and exacerbate gender dysphoria by invalidating gender transition. As with all procedures, surgeons themselves should be responsible for assessing patients’ surgical readiness. Significant changes in mental-health status or social situation should prompt surgeons to seek reassessment. WPATH recommendations regarding referral letters should be clarified and consolidated into a single document. Disclosure No

Introduction Gender-affirming bilateral orchiectomy (GABO) can be offered to patients in 3 ways: as a stand-alone procedure, as a separate pre-vaginoplasty surgery, or, during vaginoplasty surgery. Because testicles are the predominant source of endogenous testosterone, GABO affords patients cessation of anti-androgen therapy, usually coupled with a decrease in their estrogen dose. Hormone therapy has known side effects, including cardiovascular and urinary effects, that have been suggested to be dose-dependent. In this study we measure postoperative decrease in gender-affirming hormone therapy after pre-vaginoplasty orchiectomy. Objective To evaluate postoperative changes in gender-affirming hormone therapy dosages for transgender women that have undergone pre-vaginoplasty orchiectomy. Methods We performed a retrospective review of all trans-feminine patients who underwent pre-vaginoplasty gender-affirming GABO. We recorded surgical data, demographic data, and changes (preoperative vs. postoperative) in gender-affirming hormone regimens, dosages. Hormone regimens were managed by patients’ outpatient endocrinologists. Gender dysphoria changes were measured on a 10-point Likert scale. Results 89 patients underwent pre-vaginoplasty GABO from 4/2017 – 12/2020. Mean age was 35.9Y and mean BMI was 27.4. GABO was performed via a single 2-3 cm. midline scrotal incision immediately posterior to the penoscrotal junction. Pre-operative estrogen data was available for 80/89 patients, and preoperative vs postoperative PO estrogen comparative data (where estrogen was the same formulation) was available for 41/89 patients. Pre-orchiectomy: 86 patients (96.6%) patients were taking estradiol (Mean PO dose: 28.5 mg/day; Route: PO 56.9%; IM 38.4%; transdermal 2.3%, SL 1.2% of patients, implant 1.2%), 69 (80.2%) patients were on Spironolactone (mean dose 140.8 mg QD), and 24(27.9%) patients were on progesterone (mean dose 104.6 mg QD). Post-orchiectomy, all (100%) patients taking spironolactone pre-op were able to discontinue it. Of patients taking progesterone, 79.1% patients were able to discontinue it post-orchiectomy. For patients on Estradiol, 40.6% of patients transitioned to a lower dosage (*mean: 45 % of the pre-op dose). Also, postoperatively, (87/89) of patients endorsed decreased genital-associated gender dysphoria (mean: 30% decrease). All patients who tucked (100%) reported relief of tucking related discomfort. All patients reported significant satisfaction with surgery and reduced postoperative hormone usage. Conclusions This is the first study to characterize dose changes in hormone therapy after gender-affirming orchiectomy. After orchiectomy, patients benefit from decreased requirements for gender-affirming hormone therapy, which reduces risks of drug-related side effects and improves quality-of-life. As patients preparing for vaginoplasty must often wait for a year or longer due to wait lists and requirements for hair removal, pre-vaginoplasty orchiectomy should be offered as an elective option. Potential benefits of decreased hormone requirements and partial alleviation of gender dysphoria and discomfort should also be discussed. Disclosure No

OBJECTIVE To assess the current status of caesarean delivery (CD) in China, propose reference CD rates for China overall, and by regions, investigate the main indications for CDs and identify possible areas for safe reduction. DESIGN A multicentre cross-sectional study. SETTING A total of 94 hospitals across 23 provinces in China. POPULATION A total of 73 977 randomly selected deliveries. METHODS We used a modified Robson classification to characterise CDs in subgroups and by regions, and the World Health Organization (WHO) C-Model to calculate reference CD rates. MAIN OUTCOME MEASURES CD rates in China. RESULTS In 2015-2016, the overall CD rate in China was 38.9% (95% CI 38.6-39.3%). Considering the obstetric characteristics of the population, the multivariable model-based reference CD rate was estimated at 28.5% (95% CI 28.3-28.8%). Accordingly, an absolute reduction of 10.4% (or 26.7% relative reduction) may be considered. The CD rate varied substantially by region. Previous CD was the most common indication in all regions, accounting for 38.2% of all CDs, followed by maternal request (9.8%), labour dystocia (8.3%), fetal distress (7.7%) and malpresentation (7.6%). Overall, 12.7% of women had prelabour CDs, contributing to 32.8% of the total CDs. CONCLUSIONS Nearly 39% of births were delivered by caesarean in China but a reduction of this rate by a quarter may be considered attainable. Repeat CD contributed more than one-third of the total CDs. Given the large variation in maternal characteristics, region-specific or even hospital-specific reference CD rates are needed for precision management of CD. TWEETABLE ABSTRACT The caesarean rate in 2015-2016 in China was 38.9%, whereas the reference rate was 28.5%.

Long noncoding RNAs (lncRNAs) were reported to participate in the progression of gastric cancer (GC). However, litter is known about the biological functions of TTN antisense RNA 1 (TTN-AS1) in GC. Using qRT-PCR examination, we found that TTN-AS1 was expressed at a higher level in GC tissues and cell lines compared to the normal controls. Kaplan-Meier analysis of GC patients revealed the negative correlation between TTN-AS1 expression and the overall survival. To detect the biological function of TTN-AS1 in GC, we silenced TTN-AS1 to perform loss-of-function assays. The experimental results revealed that knockdown of TTN-AS1 obviously inhibited GC cell proliferation, induced cell apoptosis and impaired cell migration and invasion. In mechanism, TTN-AS1 was located in the cytoplasm of GC cells, indicating the post-transcriptional regulation of TTN-AS1 on gene expression. Bioinformatics analysis revealed the potential binding relation between TTN-AS1 and miR-376b-3p as well as between miR-376b-3p and KLF12. Mechanism experiments such as luciferase reporter assay and RNA pull-down assay demonstrated the interaction between TTN-AS1 and miR-376b-3p as well as between miR-376b-3p and KLF12 in GC cells. At last, rescue assays certified that miR-376b-3p and KLF12 involved in TTN-AS1-mediated GC progression. Similarly, the role of TTN-AS1-miR-376b-3p-KLF12 axis in GC progression was analyzed and validated. Taken together, we concluded that TTN-AS1 might function as a novel potential therapeutic target in the treatment of gastric cancer.

Carbon coated SnO2 hollow nanocubes were synthesized by a facile hydrothermal route. The sample with large surface area exhibits a hollow cube particle shape with an average length of ~400–500 nm. It is found that the SnO2@C−HNC shows a high discharge capacity of 799.1 mA h g−1 with the first cycle coulombic efficiency of 53.4% at the current density of 100 mA h g–1. At the high current density of 2 A g–1, it can still deliver a discharge capacity of 203.1 mA h g–1. The SnO2@C−HNC composite exhibits a good rate capability and stable cycling performance, indicating potential available as large-scale storage device.

报道1个以肾上腺皮质功能减退起病的X连锁肾上腺脑白质营养不良（X-ALD）家系。家系中3例患者均以肾上腺皮质功能减退起病，经基因检测发现位于X染色体的ABCD1基因（转录版本Exon编号：NM_000033.3 exon6）存在c.1552CT chrX-153005609 (p.R518W）变异, 该突变为致病突变。该家系报道的突变位点为国内第3次报道，为深入认识X-ALD提供信息。.

Introduction Postoperative pain control in gender-affirming penile-inversion vaginoplasty (PIV) significantly affects patient experience and satisfaction. With the rise of opioid misuse and over-prescription, non-narcotic adjuncts for post-surgical analgesia are greatly needed. Currently, there is limited data on postoperative pain control after genital gender-affirming surgery (gGAS). Objective To evaluate the effects of preoperative pudendal nerve block on post-op patient-reported pain scores and opioid usage. Methods We retrospectively reviewed all trans-female patients undergoing PIV (+ creation of vaginal canal) at a single institution from August 2017 to July 2021. We recorded patient demographics, operative details, surgical-site pain (using a Likert scale 0-10; 0=no pain, 10=severe pain), and analgesic medication usage. Baseline demographics, pain scores and opioid usage were compared between patients who received pudendal nerve block preoperatively (immediately before the surgical procedure) and those who did not. Independent sample t-tests were used for all comparisons. Results Out of 36 consecutive patients (mean age 36.6 years, mean BMI 25.3 kg/m2) that underwent PIV, 25/36 patients did not have pre-op pudendal nerve block, while the most recent 11/36 patients did. Patient characteristics across cohorts were similar, though the 11 patients who had pudendal nerve block had higher rates of depression (54.5% vs. 28.0%, p=0.043) and hypertension (18.2% vs. 4.0%, p=0.041). Surgical-site pain scores on postop day 0 (POD0) were compared: patients who received pudendal nerve block had 35% lower pain scores than those who did not (3.09 vs. 4.74, p Conclusions Our preliminary data suggests that pudendal nerve blocks are safe and effective adjuncts to improve pain control after gender-affirming PIV, thus improving patients’ postoperative experience. This modality should be further investigated and considered for routine usage in vaginoplasty, and other gGAS perioperative pain regimens. Similar opioid usage despite improved pain scores suggests that in-hospital opioid pain regimens should be more closely tailored to patient-reported pain scores. Disclosure No

Introduction Peritoneal vaginoplasty (PV) has been reported for congenital and primary gender-affirming cases, but few have reported its use as secondary vaginoplasty to treat post-op neovaginal canal shortening after penile-inversion vaginoplasty (PIV). Recent adaptations of PV have been modifications of the Davydov procedure, wherein peritoneum adherent to the bladder and rectum are incorporated to line the new terminal apex of the vaginal canal. Objective We describe our alternative technique using a urachus-peritoneal hinge flap and discuss proposed advantages. Methods We performed retrospective review of all trans-female patients who underwent our PV technique for revision/salvage vaginoplasty from May 2019 to August 2020 (minimum 10 months follow-up). Patients were asked questions about their experience and satisfaction. All cases were performed via combined trans-perineal and laparoscopic (robot-assisted) approaches. Pre-op and post-op neovaginal depth/circumference were recorded. After incision and spatulation of the terminal neovagina, a midline, inferiorly based peritoneal hinge flap (minimum 8-cm width) was elevated craniocaudally from the umbilicus to the mid-posterior bladder. The flap's free end was flipped posteriorly and sutured to the posterior edge of the open canal remnant to form a peritoneum-lined pouch. The pouch's lateral edges were sutured together, using a vaginal dilator as a guide. Results Five patients underwent peritoneal vaginoplasty with our technique from 5/2019 to 8/2020. Mean age was 32. All previously underwent PIV for primary vaginoplasty, with loss of neovaginal depth. Pre-op: mean neovaginal depth was 8.6 (±1.8) cm and girth was 12 cm. Immediate post-op: mean depth was 16.8 (±1.2) cm (mean net increase from pre-op: 8.2 cm) and girth was 12 cm. At mean follow-up of 1.4 years, mean depth was 12.8 (±2.4) cm (mean net increase from pre-op: 4.2 cm) and girth was 12 cm. There were no immediate complications. One patient developed anastomotic stenosis at 6 weeks post-op, managed conservatively with dilation under anesthesia. One patient stopped dilating due to a mental-health crisis and lost significant postoperative depth. Three of the 5 (60%) patients report satisfactory vaginal receptive intercourse. The other 2 have not yet attempted vaginal receptive intercourse. Conclusions Our PV vaginoplasty technique is a safe and effective option to treat neovaginal shortening after PIV. Advantages include no tension on peritoneal suture lines when vaginal canal is empty and total exclusion of the rectum. This technique also allows for omental interposition. We recognize the natural limited availability of peritoneum and so reserve this technique only for cases where there is adequate residual canal girth and at least 6-7 cm of residual depth. Disclosure No

OBJECTIVE: To determine the environmental contamination degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in corona virus disease 2019 (COVID-19) wards, to offer gui-dance for the infection control and to improve safety practices for medical staff, by sampling and detecting SARS-CoV-2 nucleic acid from the air of hospital wards, the high-frequency contact surfaces in the contaminated area and the surfaces of medical staff's protective equipment in a COVID-19 designated hospital in Wuhan, China. METHODS: From March 11 to March 19, 2020, we collected air samples from the clean area, the buffer room and the contaminated area respectively in the COVID-19 wards using a portable bioaerosol concentrator WA-15. And sterile premoistened swabs were used to sample the high-frequency contacted surfaces in the contaminated area and the surfaces of medical staff's protective equipment including outermost gloves, tracheotomy operator's positive pressure respiratory protective hood and isolation clothing. The SARS-CoV-2 nucleic acid of the samples were detected by real-time fluorescence quantitative PCR. During the isolation medical observation period, those medical staff who worked in the COVID-19 wards were detected for SARS-CoV-2 nucleic acid with oropharyngeal swabs, IgM and IgG antibody in the sera, and chest CT scans to confirm the infection status of COVID-19. RESULTS: No SARS-CoV-2 nucleic acid was detected in the tested samples, including the 90 air samples from the COVID-19 wards including clean area, buffer room and contaminated area, the 38 high-frequency contact surfaces samples of the contaminated area and 16 surface samples of medical staff's protective equipment including outermost gloves and isolation clothing. Moreover, detection of SARS-CoV-2 nucleic acid by oropharyngeal swabs and IgM, IgG antibodies in the sera of all the health-care workers who participated in the treatment for COVID-19 were all negative. Besides, no chest CT scan images of medical staff exhibited COVID-19 lung presentations. CONCLUSION: Good ventilation conditions, strict disinfection of environmental facilities in hospital wards, guidance for correct habits in patients, and strict hand hygiene during medical staff are important to reduce the formation of viral aerosols, cut down the aerosol load, and avoid cross-infection in isolation wards. In the face of infectious diseases that were not fully mastered but ma-naged as class A, it is safe for medical personnel to be equipped at a high level.

Recently, long non- coding RNAs (lncRNAs) have attracted much attention for their roles in tumor progression. The aim of this study was to investigate the exact role of lncRNA DLX6 antisense RNA 1 (DLX6-AS1) in the development of thyroid cancer (TC), and to explore the underlying mechanism.DLX6-AS1 expression in both TC cells and tissue samples was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Moreover, transwell assay and wound healing assay were conducted. QRT-PCR and Western blot assay were used to explore the underlying mechanism. Furthermore, the function of DLX6-AS1 was identified in vivo.DLX6-AS1 expression level in TC tissues was significantly higher than that of the corresponding normal tissues. Moreover, TC cell migration and invasion were markedly inhibited after DLX6-AS1 was knocked down in vitro. The mRNA and protein expressions of UPF1 were both remarkably up-regulated after knockdown of DLX6-AS1. Meanwhile, the expression level of UPF1 was negatively correlated with the expression of DLX6-AS1 in TC tissues. Furthermore, knockdown of DLX6-AS1 significantly inhibited tumor metastasis in vivo.Knockdown of DLX6-AS1 could inhibit TC cell migration and invasion via upregulating UPF1, which might be a potential therapeutic target in TC.

The aim of this work was to study the formability of 5754-O aluminum alloy sheet through utilizing the finite element M–K approach. The uniaxial tensile test and the Nakajima test were performed respectively for determining the mechanical properties and the forming limit strain pairs. The finite element M–K approach considering the Swift model, the Yld2000-2d yield function and the groove orientation was developed through utilizing software Abaqus. The predicted forming limit curve (FLC) agreed well with the Nakajima test results. Furthermore, the limit strains with the consideration of pre-strain under uniaxial tensile condition were experimentally determined, and numerically predicted by the original M–K approach. The numerical limit strains under different pre-strain paths and pre-major strains showed that the M–K approach could only predict partial FLC when the effective strain caused by the pre-strain was larger than the one at plane strain state. This phenomenon was interpreted by the evolution of the stress state in the groove of the M–K theory, i.e., the change of the strain path in loading process resulted in the stress state rotation, and consequently made the ratio of major strain increment in the groove to that out the groove increase when the stress state in the groove approached the stress state at plane strain state.

In this paper, the forming limit curve (FLC) of AA5754-O was predicted numerically through simulating the M-K approach with the consideration of initial groove orientation and investigated experimentally through the biaxial tensile tests. Firstly, the uniaxial tensile test and the equi-biaxial tensile test were performed to determine the mechanical properties and the anisotropic coefficients of Yld2000-2d yield criterion. Secondly, the numerical M-K approach considering the initial groove orientation and Yld2000-2d yield function was simulated to study the effects of the initial groove orientation and the imperfection coefficient on the predicted limit major strain. Finally, the shape of the cruciform specimen thinned at the center region was optimized for reducing the shear stress, and the optimized cruciform specimen was stretched under different loading paths to determine the experimental limit strains. Through comparing the predicted limit strain at uniaxial tensile stress state and the experimental one, the imperfection coefficient was confirmed, and a good agreement between the numerical result and experimental data was presented. This work showed that experimentally determining the limit strains through biaxial tensile test was achievable, and the proposed numerical M-K approach was effective for predicting the limit strains.

The wave field on the artificial boundary was separated into the free field without local topography effect and scattering field induced by local topography effect. The simulation of the free field under obliquely incident waves was conducted. Based on the assumption that the components of design ground motion were treated as the coincidence of oblique P wave and oblique SV wave, the relationship between the oblique input waves and the design ground motion was established in the free field. Further, the contributions to the two components of design ground motion of obliquely incident waves were discussed. The calculation model in time domain was achieved by the combination of the propagation characteristics of obliquely incident waves and the artificial boundary in the free field. The seismic response to the design ground motion was produced on the free surface. The verification of the 2D half-space model under oblique input waves indicated that the wave input method can accurately reflect the design ground motion on the free surface. Application of an earth-rock dam showed that oblique incidence of seismic waves results in significantly different dynamic response compared with the normal incidence. The proposed method can also be employed in the seismic analysis of large span structures with nonuniform ground motion input.

Deficits in social-emotional reciprocity, one of the diagnostic criteria of Autism Spectrum Disorder (ASD), greatly hinders children with ASD from responding appropriately and adapting themselves in various social situations. Although evidences have shown that virtual reality environment is a promising tool for emotional and social adaptation skills training on ASD population, there is a lack of large-scale trials with intensive evaluations to support such findings. This paper presents a virtual reality enabled program for enhancing emotional and social adaptation skills for children with ASD. Six unique learning scenarios, of which one focuses on emotion control and relaxation strategies, four that simulate various social situations, and one that facilitates consolidation and generalization, are designed and developed with corresponding psychoeducation procedures and protocols. The learning scenarios are presented to the children via a 4-side immersive virtual reality environment (a.k.a., half-CAVE) with non-intrusive motion tracking. A total number of 94 children between the ages of 6–12 with clinical diagnosis of ASD participated in the 28-session program that lasted for 14 weeks. By comparing pre- and post-assessments, results reported in this paper show significant improvements in the project's primary measures on children's emotion expression and regulation and social-emotional reciprocity but not on other secondary measures.

According to the standard EN 45545, fire resistant tests of floor structures in high-speed train were carried out. Two typical floor structures which were placed in the passenger train were tested. Integrity and insulation are main performance criteria to evaluate fire resistance of floor structures. The furnace temperature is in accordance with the requirements in the standard ISO 834. The surface temperature and deflection were recorded with time. Glass wool and aluminium corrugated sandwich structure in two structures were burned through. The experiments were terminated at 30 minutes and 31 minutes respectively for the two structures. A large amount of smoke and the sound of cracking of the exposed surface of the test piece were produced, although the unexposed surface of test pieces did not reach the failure condition.

The forming limit curve (FLC) is a line that is consisted of the major and minor strain pairs for variety kinds of strain paths. It has been widely adopted as a practical criterion in evaluating the formability of different sheet metals. Predicting FLC numerically could avoid the drawbacks of time-consuming and hard-sledding effectively which is shared by the corresponding experimental approach. In this paper, the formability of 2021 aluminum alloy was investigated by conducting forming experiments and corresponding simulations. Firstly, uniaxial tensile tests were conducted to acquire the material properties, as well as to calibrate the hardening model for the 2021 aluminum alloy. Secondly, the numerical model for Nakazima test was established with commercial FE software ABAQUS, and a finite element based criterion was then proposed for predicting the FLC. To verify the validity of predicted FLC, nine sets of tests have been performed, leading to the conclusion that the result of simulation has a better agreement with experimentally determined FLC. Finally, the influence of friction on the strain path was discussed.

1例表现为身材矮小、智力发育落后的4岁4月龄女性患儿2018年11月就诊于浙江大学医学院附属儿童医院内分泌科，经体格检查、血化验、影像学和基因分析，诊断为肢端发育不全。本患儿为PDE4D基因变异所致的肢端发育不全，是一种罕见的常染色体显性遗传综合征。.

This paper aims to investigate the expressions of Fibulin-3 and Profilin-1 in vascular remodeling and the relationship between the two factors and vascular remodeling in hypertensive rats.45 spontaneously hypertensive rats (SHR) and 15 healthy Wistar Kyoto (WKY) rats were collected. The 45 SHR were randomly divided into group A, group B, and group C. Group A was injected with Profilin-1 overexpression of adenoviral vector of pAd-Profilin-1-RES-EGFP; group B was injected with recombinant Fibulin3 protein solution; and group C was injected with normal saline. The rats in the control group were normally raised. All rats were anesthetized and dissected, and the thoracic aorta of rats was taken out at T0 (8 weeks old), T1 (12 weeks old), T2 (16 weeks old). The expressions of Fibulin-3 and Profilin-1 protein in the thoracic aorta were analyzed by Western blot. The overexpression of Profilin-1 and Fibulin-3 protein, blood pressure, and body weight were compared.The expression level and systolic blood pressure of Profilin-1 protein of rats in group A were significantly higher than those in the other two groups (p0.05). The expression level of Fibulin-3 protein of rats in group B at T2 was significantly higher than that in the other two groups (p0.05). The thickness of vascular wall in the control group and group C at T1 and T2 was significantly lower than that of group A and group B. The vascular wall/cavity ratio of rats in group A, B, C was significantly higher than that in the control group at T1 and T2 (p0.001).The changes in Profilin-1 and Fibulin-3 levels may affect the occurrence and development of vascular remodeling in hypertension. Therefore, Profilin-1 and Fibulin-3 can be used as sensitive detection indices for hypertension vascular remodeling.

Nanoimprinting behaviors of copper substrates and double-walled carbon nanotubes with interwall sp 3 bonds are investigated using molecular dynamics simulations. A high-frequency mechanical vibration with various amplitudes is applied on the carbon nanotube (CNT) mold and copper substrate in different directions. Results show that exciting mechanical resonances both on the CNT and substrate drastically decrease the maximum imprint force and interfacial friction up to 50% under certain amplitudes. Meanwhile, it is demonstrated that defects occur in the {111} plane in the copper substrate during nanoimprinting. For different CNT array densities, a higher grafting density needs more imprint force to transfer patterns. The maximum imprint force for a large range of CNT array densities can be reduced by vibrational perturbations, while reduction rates depend on the CNT grafting density. This work sheds deep insights into the nanoimprint process at the atomic level, suggesting that vibration perturbation is an effective approach for improving the nanoimprinting accuracy and preventing the fracture of nanopatterns.

Significant down-regulation of miR-5702 and its tumor-suppressive roles in non-small-cell lung cancer (NSCLC) have been reported previously. However, its clinical significance in NSCLC has not yet been reported. In this study, we aimed to identify the prognostic value of miR-5702 in NSCLC patients.The expression levels of miR-5702 were detected by Real-time quantitative polymerase chain reaction (RT-qPCR). The chi-square test was used for the examination of relationship between miR-5702 expression and clinicopathologic factors. The association between miR-5702 expression and overall survival in patients with NSCLC was statistically analyzed by Kaplan-Meier. Finally, univariate and multivariate models were conducted to determine the prognostic value of miR-5702 in NSCLC patients.MiR-5702 expression was lowly expressed in NSCLC tissue specimens compared with adjacent nontumor tissue (p0.01). It was observed that low expression of miR-5702 was associated with clinical stages (p = 0.029), lymph node metastasis (p = 0.016) and distant metastasis (p = 0.004). Moreover, Kaplan-Meier assay showed that patients with lower miR-5702 expression had worse overall survival time than that with higher miR-5702 expression (p = 0.0097). Finally, multivariate analysis showed that low expression of miR-5702 was independently associated with overall survival of NSCLC patients (HR = 3.128; 95 % CI: 1.237-5.668, p = 0.005).Our data, for the first time, indicated that miR-5702 expression may be considered as a prognostic biomarker in NSCLC patients.

Circular RNAs (circRNAs) have been known as important regulators in tumorigenesis. Whether circRNAs are involved in papillary thyroid carcinoma (PTC) requires to be determined. In the present study, we aimed to investigate the expression and function of has_circ_0008274 in PTC.Tissue expression of has_circ_0008274 was evaluated in Gene Expression Omnibus datasets (GSE93522). Real-time PCR assays were used to detect the expression of has_circ_0008274 in human PTC tissues and cell lines. The correlation of has_circ_0008274 expression with clinicopathological factors was statistically analyzed. The MTT assay, colony formation assay, transwell assays were performed to analyze and compare cell viability and invasion. Western blot analysis was used to quantify the expression of AMPK/mTOR signaling pathway proteins.We found that has_circ_0008274 was significantly upregulated in PTC tissues, and the level of has_circ_0008274 was negatively associated with TNM stage and lymph node metastasis. Loss-of-function assay indicated that knockdown of has_circ_0008274 suppressed PTC cells proliferation and invasion in vitro. Mechanistically, has_circ_0008274 could inhibit the activation of AMPK/mTOR signaling pathway, which was demonstrated by measuring the expression levels of p-AMPK and p-mTOR.These results demonstrate that increased has_circ_0008274 expression modulates has_circ_0008274 to enhance PTC cells proliferation and invasion. Has_circ_0008274/ AMPK/mTOR axis may be a novel therapeutic candidate target in PTC treatment.