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Abstract Aim This study seeks to elucidate the concept of shift work sleep disorder (SWSD) among nurses, thereby offering a comprehensive understanding that can inform future research and practical interventions. Methods Walker and Avant’s concept analysis method was employed to guide the study. A systematic literature review was conducted utilizing various databases, including PubMed, Embase, EBSCO, Web of Science, CNKI, WanFang, and Sino Med. The inclusion criteria were specifically designed to focus on studies that define SWSD, along with its attributes, antecedents, consequences, and assessment tools relevant to nursing professionals. Results The analysis identified four key attributes of SWSD: internal/external circadian rhythm imbalance, impaired sleep, multidimensional health problems, and dynamic changes in symptoms. Antecedents include individual factors like personal health, lifestyle, family support, shift patterns, work environment, and other organizational factors. Consequences of SWSD encompass physiological health issues, mental health challenges, impaired social adaptability, and decreased nursing performance. Conclusion SWSD has a significant impact on the health and performance of nurses. Understanding its attributes, antecedents, and consequences is crucial for developing targeted interventions. Enhancing sleep hygiene, fostering supportive work environments, and implementing appropriate shift scheduling can help mitigate the adverse effects associated with SWSD.

Using the GARCH-MIDAS model, we investigated the impact of Chinese and global macro-level determinants on the return volatility of Shanghai crude oil futures, covering Chinese and global economic policy uncertainty, Chinese and global crude oil demand as well as production, Chinese crude oil import, and global crude oil speculation. The in-sample empirical results showed that Chinese crude oil demand, Chinese crude oil production, Chinese economic policy uncertainty, and global crude oil speculation have significant impact on the long-term volatility component of Shanghai crude oil futures. The out-of-sample prediction results show that Chinese current crude oil production and previous crude oil import have the relatively best predictive power for the return volatility of Shanghai crude oil futures. As a whole, Chinese domestic macro-factors have a stronger impact and higher predictive power on the return volatility of Shanghai crude oil futures compared with corresponding global macro-factors. Besides, the global crude oil speculation is the global macro-level determinant, which deserves most attention.

Background Acrodermatitis continua of Hallopeau (ACH) is a rare pustular psoriasis variant predominantly affects the distal phalanges of the fingers and toes. However, data on aggravating factors and treatment outcomes is limited.Objective This study aims to analyze the aggravating factors and treatment outcomes of ACH in a three-tertiary-hospital in South China.Methods We analyzed ACH patients from Dermatology Hospital of Southern Medical University, considering patient and disease characteristics along with treatment experiences.Results We identified 96 ACH patients. Various predisposing events were identified, including lifestyle factors, vaccination, stress, trauma, menstruation and drug exposure. A total of 293 systemic treatment courses were analyzed. 54.3% of patients received at least one biologic therapy, while 45.7% were treated with nonbiologic treatments. Acitretin was the most common therapy (20.5%). However, the effectiveness of systemic treatments was low (excellent response rate: 26.3%). Among non-biologic treatments, Acitretin showed a significant response in 30.0% (18/60) of cases, followed by cyclosporin (20.0%, 2/10). Among biologics, spesolimab had the best response rate at 75.0% (n = 3), followed by ixekizumab (44.4%, 8/18). Small molecule drugs did not yeild satisfactory outcomes in ACH treatment.Conclusion Identifying triggers and aggravating factors is crucial for effective ACH treatment. We suggest that biologics may be a useful first-line treatment option for clinicians managing ACH.

Objectives To compare the long-term outcomes of microwave ablation (MWA) for primary hepatocellular carcinoma (HCC) in patients with metabolic-associated fatty liver disease (MAFLD) with those infected by hepatitis virus B (HBV).Methods The clinical data of HCC patients under the treatment of MWA were analyzed retrospectively between 2010 and 2021 at Chinese PLA General Hospital. Patients were divided into MAFLD-HCC and HBV-HCC group according to the chronic liver disease etiology. The propensity score matching (PSM) was performed to reduce the interference of confounders. The primary outcomes were overall survival (OS), recurrence-free survival (RFS), cancer-specific survival (CSS) and intrahepatic distant recurrence (IDR).Results A total of 648 patients (age range, 18–91 years) with 1019 lesions were enrolled including 601 with HBV-HCC and 47 with MAFLD-HCC. After a variable ratio of 1:n ≤ 4 PSM, 100 patients were included in the HBV-HCC and 41 in the MAFLD-HCC group. No statistical differences in OS and CSS (p = 0.880 and p = 0.980, respectively) were observed between the two groups in the matched cohort, while MAFLD-HCC exhibited better RFS and lower IDR rates compared to HBV-HCC (p = 0.043 and p = 0.041, respectively). Additionally, MAFLD-HCC generated lower ascending range in the liver function indexes like ΔALT (46.7 vs. 98.5, p

A mixed system with a 5:1 ratio of beef myofibrillar protein to type I collagen was prepared to mimic meat broths. The study aimed to determine the combined effects of various NaCl concentrations (0, 0.2 M, 0.4 M, 0.6 M) and heat treatment on solubility, emulsifying properties (EAI, ESI), viscosity, and particle size of the mixed protein system. Mechanistic changes were examined through molecular interactions, intrinsic fluorescence, protein molecular weight, and Raman spectroscopy. The results showed that, without heat treatment, NaCl enhanced solubility, EAI, ESI, emulsion viscosity, and hydrogen bonding. After heating (90 °C, 30 min), elevated 0.4–0.6 M NaCl created an unstable, crowded environment, resulting in protein aggregation and reduced solubility and emulsifying performance. The results indicated that heating at 90 °C with 0.2 M NaCl was beneficial for meat emulsification, providing valuable production guidance for optimizing the formulation of meat products with low salt and high emulsifying properties.

Abstract Background DNA methylation contributes to the epigenetic regulation of nuclear gene expression, and is associated with plant growth, development, and stress responses. Compelling evidence has emerged that long non-coding RNA (lncRNA) regulates DNA methylation. Previous genetic and physiological evidence indicates that lncRNA-CRIR1 plays a positive role in the responses of cassava plants to cold stress. However, it is unclear whether global DNA methylation changes with CRIR1-promoted cold tolerance. Results In this study, a comprehensive comparative analysis of DNA methylation and transcriptome profiles was performed to reveal the gene expression and epigenetic dynamics after CRIR1 overexpression. Compared with the wild-type plants, CRIR1-overexpressing plants present gained DNA methylation in over 37,000 genomic regions and lost DNA methylation in about 16,000 genomic regions, indicating a global decrease in DNA methylation after CRIR1 overexpression. Declining DNA methylation is not correlated with decreased/increased expression of the DNA methylase/demethylase genes, but is associated with increased transcripts of a few transcription factors, chlorophyll metabolism and photosynthesis-related genes, which could contribute to the CRIR1-promoted cold tolerance. Conclusions In summary, a first set of transcriptome and epigenome data was integrated in this study to reveal the gene expression and epigenetic dynamics after CRIR1 overexpression, with the identification of several TFs, chlorophyll metabolism and photosynthesis-related genes that may be involved in CRIR1-promoted cold tolerance. Therefore, our study has provided valuable data for the systematic study of molecular insights for plant cold stress response.

BackgroundThis investigation aimed to analyze the association between dietary vitamin E intake and constipation prevalence among United States adults.MethodsUtilizing data from the National Health and Nutrition Examination Survey (NHANES), this cross-sectional study assessed vitamin E intake through 24-h dietary recall and defined constipation based on the Bristol Stool Form Scale (BSFS). Logistic regression models were employed to evaluate the relationship between vitamin E intake and constipation, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs). Stratified analyses were conducted based on covariates such as age, and restricted cubic spline (RCS) models were generated to explore the potential linear or non-linear association.ResultsIndividuals experiencing constipation exhibited lower vitamin E intake compared to those without constipation. Weighted multivariate logistic regression models demonstrated a negative correlation between vitamin E intake and constipation risk, even after adjusting for potential confounding variables. Further RCS analysis revealed a statistically significant non-linear inverse relationship between vitamin E intake and constipation risk (p-value for non-linearity = 0.0473).ConclusionOur findings suggest an independent inverse association between vitamin E intake and constipation prevalence in United States adults. Prospective research is needed to validate these observations.

Accretion supermassive black holes in the center of active galaxies usually produce “jet”-collimated bipolar outflows of relativistic particles. Magnetic fields near the black hole event horizon may play a crucial role in the formation of jets/outflows. Both theory and observation indicate that jets/outflows driven by centrally active supermassive black holes have a feedback effect on the overall properties of the host galaxies. Therefore, the magnetic field is a key ingredient for the formation and evolution of galaxies. Here, we report a clear correlation between the magnetic field of jets and star formation rate for a large sample of 96 galaxies hosting supermassive black holes, which suggests that the star formation of active galactic nuclei host galaxies may be powered by the jets.

Although the COVID-19 pandemic is no longer considered a public health emergency of international concern, research is ongoing to determine whether and how financial markets have been affected. Using an event study methodology, we examine Chinese stock reactions to breaking news about COVID-19 during 2020–2023, covering nine important events from the first declaration of the novel coronavirus to classifying COVID-19 from top category A to B in China. The empirical results show that the Chinese stock market reacts negatively to bad news, such as the breakout of COVID-19 and the dynamic zero-COVID strategy, and positively to good news, such as COVID-19 vaccine approvals, ending the zero-COVID strategy, and reopening boards. The overall intensity of reactions to bad news is stronger than that to good news. Small-sized stocks react more positively to good news and more negatively to bad news. Different industries have different reactions to different events; however, the sector that responds strongly and negatively to bad news does not have to respond strongly and positively to good news, which, to some extent, reflects their profitability performance during the pandemic. In China, consumer discretionary, utilities and real estate are the most negatively affected by the pandemic, while materials, health care, and energy are the most positively affected. This study has important implications for reminding market participants to pay attention to breaking news announcements about COVID-19.

Drought stress impairs plant growth and other physiological functions. MeHDZ14, a homeodomain-leucine zipper I transcription factor, is strongly induced by drought stress in various cassava cultivars. However, the role of MeHDZ14 in cassava growth regulation has remained unclear. Here we report that MeHDZ14 affected plant height, such that a dwarf phenotype and altered internode elongation were observed in transgenic cassava lines. MeHDZ14 was found to negatively regulate the biosynthesis of lignin. Its overexpression resulted in abaxially rolled leaves. The morphogenesis of leaf epidermal cells was inhibited by overexpression of MeHDZ14, with decreased auxin and gibberellin and increased cytokinin contents. MeHDZ14 was found to regulate many drought-responsive genes, including genes involved in cell wall synthesis and expansion. MeHDZ14 bound to the promoter of caffeic acid 3-O-methyltransferase 1 (MeCOMT1), acting as a transcriptional repressor of genes involved in cell wall development. MeHDZ14 appears to act as a negative regulator of internode elongation and epidermal cell morphogenesis during cassava leaf development.

Abstract Background Nephrectomy, whether in the era of cytokine therapy or targeted therapy, has an important role in the treatment of metastatic renal cell carcinoma. With the advent of immunotherapy, immunotherapy combined with targeted therapy has become the mainstream of systemic therapy, but the role of nephrectomy in metastatic renal cell carcinoma is unclear. In this study, we retrospectively analyzed the impact of nephrectomy on survival in patients with metastatic renal cell carcinoma who received immune-targeted therapy. Methods Patients with metastatic renal cell carcinoma who received immune-targeted therapy at three centers between May 17, 2019 and August 1, 2022 were collected, who were divided into two groups based on whether nephrectomy was performed or not. Survival, response rate and adverse event were compared between the two groups. The primary end point was progression free survival, Subgroup analysis and univariate and multivariable prognostic analyses were also assessed. Results With a median follow-up time of 29.3 months (95% CI 28.5–30.2), 165 patients were recruited and divided into two groups based on whether they underwent nephrectomy or not. There were 68 patients in the non-nephrectomy group, 97 in the nephrectomy group. Compared to patients treated with immune-targeted therapy, patients treated with immune-targeted therapy plus nephrectomy were able to achieve survival benefits, with a median PFS of 10.8 months (95% CI 8.3–13.3) and 14.4 months (95% CI 12.6–16.2), respectively, as well as an HR of 0.476 (95% CI 0.323–0.701, p = 0.0002). The 12-month and 18-month PFS rates were 30.9% versus 60.8% and 7.4% versus 25.8%, respectively. The objective response rate (ORR) was 52.9% and 60.8%, respectively, in the non-nephrectomy and nephrectomy groups (p = 0.313), and the disease control rate (DCR) was 75% and 83.5%, respectively (p = 0.179). The most common adverse events related to treatment were hypothyroidism, immune-related pneumonitis and rash. Multivariate analysis showed that primary tumor nephrectomy prior to immune-targeted therapy, clear cell renal carcinoma and oligo metastasis were independent prognostic factors. Conclusions Nephrectomy may provide PFS benefit with tolerable safety for patients with metastatic renal cell carcinoma who receive immune-targeted therapy. In multivariate analysis, nephrectomy, clear cell carcinoma, and oligo-organ metastasis were found to be favorable independent prognostic factors.

Chilling-induced accumulation of reactive oxygen species (ROS) is harmful to plants, which usually produce anthocyanins to scavenge ROS as protection from chilling stress. As a tropical crop, cassava is hypersensitive to chilling, but the biochemical basis of this hypersensitivity remains unclear. We previously generated MeMYB2-RNAi transgenic cassava with increased chilling tolerance. Here we report that MeMYB2-RNAi transgenic cassava accumulated less ROS but more cyanidin-3-O-glucoside than the wild type under early chilling stress. Under this stress, the anthocyanin biosynthesis pathway was more active in MeMYB2-RNAi lines than in the wild type, and several genes involved in the pathway, including MeTT8, were up-regulated by MeMYB2-RNAi in the transgenic cassava. MeMYB2 bound to the MeTT8 promoter and blocked its expression under both normal and chilling conditions, thereby inhibiting anthocyanin accumulation. MeTT8 was shown to bind to the promoter of Dihydroflavonol 4-reductase (MeDFR-2) and increased MeDFR-2 expression. MeMYB2 appears to act as an inhibitor of chilling-induced anthocyanin accumulation during the rapid response of cassava to chilling stress.

To clarify the characteristic odor of compounds present in duck meat, especially reheating after storage, the effect of duck breast cooked at three temperatures (90 °C, 100 °C, 105 °C) and reheating after 7 days of storage was studied. Electronic nose analysis and sensory evaluation revealed a significant increase (p

IntroductionThe tumor immune environment and immune-related genes are instrumental in the development, progression, and prognosis of bladder cancer (BLCA). This study sought to pinpoint key immune-related genes influencing BLCA prognosis and decipher their mechanisms of action.Methods and resultsWe analyzed differentially expressed genes (DEGs) between high- and low- tumor mutational burden (TMB) groups. Subsequently, we constructed a reliable prognostic model based on immune-related gene pairs (IRGPs) and analyzed DEGs between high- and low-risk groups. A total of 22 shared DEGs were identified across differential TMB and IRGPs-derived risk groups in BLCA patients. Through univariate Cox and multivariate Cox analyses, we highlighted five genes - FLRT2, NTRK2, CYTL1, ZNF683, PRSS41 - significantly correlated with BLCA patient prognosis. Notably, the FLRT2 gene emerged as an independent prognostic factor for BLCA, impacting patient prognosis via modulation of macrophage infiltration in immune microenvironment. Further investigation spotlighted methylation sites - cg25120290, cg02305242, and cg01832662 - as key regulators of FLRT2 expression.DiscussionThese findings identified pivotal prognostic genes in BLCA and illuminated the intricate mechanisms dictating patient prognosis. This study not only presents a novel prognostic marker but also carves out potential avenues for immunotherapy and targeted therapeutic strategies in BLCA. By demystifying the profound impact of immune-related genes and the tumor immune environment, this study augments the comprehension and prognostic management of bladder cancer.

Abstract This study applies big data processing technology and parallel computing methods to assess the teaching effect of Japanese in the Flipped Classroom (FC) and task-based teaching mode. We propose a model for evaluating the Japanese teaching effect in this mode using feature offset compensation. We employ distributed mining of association rules to detect the teaching effect and extract ontology information and association rules related to the distribution of Japanese teaching effect in the FC and task-based teaching mode. Furthermore, we construct a fuzzy decision-making model for evaluating the teaching effect. The joint information entropy characteristic value of the teaching effect deviation is calculated, and the extracted characteristic quantity is classified and identified using feature deviation compensation and the C-means clustering method. Based on the classification and identification results, we achieve accurate evaluation of the Japanese teaching effect in the FC and task-based teaching mode. Our simulation results demonstrate high precision rates and confidence levels in the evaluation of Japanese teaching effect in this mode.

Using cowhide as raw material, the process of ultrasonic-assisted enzyme extraction of collagen from cowhide was optimized. Based on the single factor experiment, a response surface test was designed, and the extraction rate of cowhide collagen was used as the response value to optimize the optimal extraction process of collagen, and its structure was characterized. The results showed that the optimal extraction conditions of collagen from cowhide were ultrasonic power 161 W, ultrasonic treatment time 64 min, pepsin addition 109 U/g, and solid-liquid ratio 1:16 g/mL. Under these conditions, the extraction rate of collagen was 63.77%. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), ultraviolet spectroscopy (UV) and Fourier transform infrared spectroscopy (FTIR) analysis showed that the collagen extracted by ultrasound-assisted enzyme was in line with the characteristics of type I collagen, maintaining its complete triple helix structure, amino acid composition and scanning electron microscope (SEM) analysis showed that the collagen triple helix extracted by ultrasonic assisted enzyme was relatively stable. In this study, an effective process is optimized for the extraction of collagen from cowhide, besides, the extraction time of collagen is greatly shortened and it has high utilization value.

Summary: Background: Ablation has been recommended by worldwide guidelines as first-line treatment for hepatocellular carcinoma (HCC), while evidence regarding its efficacy for primary intrahepatic cholangiocarcinoma (iCCA) is lacking. We aimed to study the efficacy of ablation in treating iCCA by comparing its prognosis with surgery. Methods: In this real-world multicenter cohort study from January 2009 to June 2022, 10,441 iCCA patients from ten tertiary hospitals were identified. Patients who underwent curative-intent microwave ablation (MWA) or liver resection (LR) for tumors within Milan criteria were included. One-to-many propensity score matching (PSM) at variable ratios (1:n ≤4) was used to balance baseline characteristics. Mediation analysis was applied to identify potential mediators of the survival difference. Findings: 944 patients were finally enrolled in this study, with 221 undergoing MWA and 723 undergoing LR. After PSM, 203 patients in the MWA group were matched with 588 patients in the LR group. The median follow-up time was 4.7 years. Compared with LR, MWA demonstrated similar overall survival (5-year 44.8% versus 40.4%; HR 0.96, 95% CI 0.71–1.29, P = .761). There was an improvement in the 5-year disease-free survival rate for MWA from 17.1% during the period of 2009–2016 to 37.3% during 2017–2022, becoming comparable to the 40.8% of LR (P = .129). The proportion of ablative margins ≥5 mm increased from 25% to 61% over the two periods, while this proportion of surgical margins was 62% and 77%, respectively. 34.5% of DFS disparity can be explained by the mediation effect of margins (P

AbstractObjectives We aimed to evaluate the effect of intratumoral perfusion on microwave ablation (MWA) area in hepatocellular carcinoma (HCC).Methods Patients who underwent curative MWA for HCC between October 2013 and May 2015 were enrolled. Three days before MWA, contrast-enhanced ultrasound (CEUS) was performed to illustrate the perfusion characteristics of the target lesion. Using the Sonoliver quantification software, time-intensity curves of dynamic CEUS were obtained, and quantitative parameters were extracted. Two microwave antennae were inserted into the center of the tumor and MWA was performed with a continuous power output of 50 W for 5 min. A second CEUS was performed to measure the size of the ablated region. Thereafter, an additional MWA procedure was performed until complete ablation with a 5–10-mm safety margin was achieved.Results A total of 38 patients who underwent curative MWA for 39 HCC nodules were enrolled. The mean age was 57 years (34–80 years), and the median maximum diameter of the HCC was 3.4 cm (interquartile range, 2–6.8 cm). Time-intensity curves were obtained and the area under the curve (AUC) was selected as a parameter for intratumoral perfusion. The AUC was inversely and linearly correlated with the size of the MWA area, including long- and short-axis diameters and ablation volume. A 1,000-dB·s change in the AUC produced an average change of 1.17 ± 0.44 mm, 0.725 ± 0.355 mm, and 2.4995 ± 0.6575 cm³ in the long- and short-axis diameters and ablation volume, respectively.Conclusions The intratumoral perfusion of HCC was inversely correlated with MWA area size.

AbstractObjective To compare the long-term efficacy and safety of microwave ablation (MWA) as first-line therapy for hepatocellular carcinoma (HCC) adjacent versus nonadjacent to the gallbladder.Materials and Methods From 2006 to 2018, 657 patients with ≤5 cm HCC who underwent percutaneous ultrasound-guided MWA as first-line therapy from 5 hospitals were enrolled in this retrospective study. Patients were grouped into the adjacent group (n = 49) and the nonadjacent group (n = 608) according to whether the tumor was adjacent to the gallbladder. Propensity score matching (PSM) was used to balance baseline variables between the two groups.Results Forty-eight patient pairs were matched after PSM. For the PSM cohort, during a median follow-up time of 60 months, there were no differences in PFS (hazard ratio [HR], 1.011; 95% confidence interval [CI], 0.647-1.578; p = 0.963) or OS (HR 0.925; 95% CI 0.522-1.639; p = 0.789) between the adjacent and nonadjacent groups. Univariate and multivariate analyses revealed that the tumor adjacent to the gallbladder was not an independent risk factor for PFS or OS (all p > 0.05). Subgroup analysis showed comparable PFS and OS between the two groups in the 0.05). In addition to more use of assistive technology (p 0.05) to the nonadjacent group.Conclusion There were comparable long-term efficacy and complications between patients with HCC adjacent and nonadjacent to the gallbladder treated with MWA.

Entrepreneurial creativity is an important part of entrepreneurs’ competency structure, and studies have been conducted to explore its impact on outcome variables like entrepreneurial performance, etc., but there are fewer studies on its antecedent variables at the individual level. In the relational model of entrepreneurial creativity, cognitive flexibility, entrepreneurial alertness, and entrepreneurial self-efficacy are included to construct a mediated use spss26.0 model, and data are collected from a research sample of 325 entrepreneurs for empirical analysis. The results indicate that: cognitive flexibility has a positive effect on entrepreneurial creativity; entrepreneurial alertness plays an independent mediating role between cognitive flexibility and entrepreneurial creativity, which is similar to how entrepreneurial self-efficacy plays the role between cognitive flexibility and creativity; entrepreneurial alertness and entrepreneurial self-efficacy then play a chain mediating role between cognitive flexibility and creativity. These findings reveal that three variables jointly influence entrepreneurial creativity, providing new theoretical and practical insights for understanding and enhancing entrepreneurial creativity. In addition, the study provides valuable guidance for entrepreneurship education and training, which can help entrepreneurs to better utilize their creativity and thus promote innovation and success in entrepreneurial activities.

Objective To evaluate the potential risk factors influencing cure rate of ultrasound-guided microwave ablation (MWA) for primary hyperparathyroidism (PHPT). Materials and methods Seventy five patients (25 males and 50 females; mean age, 56.80 ± 12.34; age range, 26–85) with PHPT undergoing MWA under ultrasound guidance were enrolled between May 2017 and December 2020. The cure rate and complications were evaluated after treatment. The potential factors influencing cure rate of ultrasound-guided MWA for PHPT were analyzed by univariate and multivariate binary logistic regression. Results Fifty six of 75 patients had normal PTH and serum calcium levels after at least 6 months after one session MWA, and the cure rate was 74.7% (56/75). 6 uncured patients received the second session MWA during follow-up, and the cure rate achieved 81.3% (61/75) after the second session MWA. Voice changes occurred in 4 patients (5.33%) and recovered within 3 months after ablation without special treatment. Nodule volume was the independent risk factor associated with cure in PHPT patients undergoing MWA, whether after one session (p = 0.0224; odds ratio, 0.67) or the second session MWA (p = 0.0408; odds ratio, 0.74). The cutoff value for nodule volume in predicting the cure was 0.96 cm3 (one session: sensitivity, 76.8%; specificity, 73.7%; the second session: sensitivity, 72.1%; specificity, 71.4%). Conclusion In conclusion, parathyroid nodule volume was the independent risk factor associated with cure in PHPT patients undergoing MWA.

Objective To compare the long-term efficacy of microwave ablation (MWA) for subcapsular and non-subcapsular hepatocellular carcinomas (HCCs) using propensity score matching (PSM). Materials and methods Using a multicenter database, we enrolled 430 patients (347 men, 83 women; age range, 15–71 years) with HCCs who received percutaneous ultrasound-guided MWA, between January 2012 and December 2018. The patients were grouped as follows, based on whether the tumor was adjacent to the capsule: subcapsular group (n = 142) and non-subcapsular group (n = 142). To evaluate the correlation between subcapsular position and efficacy of MWA, a Cox proportional hazards model was used to calculate disease-free survival (DFS) and overall survival (OS) based on PSM data. Results In total, 142 pairs of patients were matched. In the PSM cohort, the 1-year, 3-year, and 5-year DFS rates of the subcapsular and non-subcapsular groups were 84%, 61%, and 47%, respectively, and 85%, 67%, and 58%, respectively, while the 1-year, 3-year, and 5-year OS rates were 98%, 90%, and 84%, respectively, and 98%, 90%, and 88%, respectively. In the PSM cohort, subcapsular position was not an independent risk factor for DFS (hazard ratio [HR] = 1.291, p = 0.196) or OS (HR = 0.926, p = 0.866). Additionally, there were no significant differences in the incidence of local tumor progression, major complications, technical success rate, number of puncture needles, and postoperative hospital stay between the two groups (p > 0.05). Conclusion There were no significant differences in DFS, OS, incidence of local tumor progression, and major complications between patients with subcapsular and non-subcapsular HCCs treated with MWA.

The traditional robust optimization algorithm can only provide the scheduling plan in the worst case, but due to the time coupling constraints such as climbing and energy storage SOC(State of Charge) constraints, it is difficult to provide an adjustment scheme for intra-day scheduling plan. In the first stage, the upper and lower bounds of equipment output are taken as decision variables, and the cumulative change of load is introduced to deal with the constraint of demand response, so as to form the economic operation domain of the park. The Column-and-Constraint generation method (CCG) is used to solve the three-layer optimization problem, and the scheduling plan and optimal operating domain in the worst case are obtained. The intra-day scheduling can be adjusted arbitrarily according to the new energy output within the interval. Carbon transaction cost is included in the goal function to account for reduced carbon emissions. Simultaneously, to take use of the benefits of flexible adjustment, FM income is incorporated into the goal function, and the charging and discharging behavior of energy storage is defined by optimizing calculations based on real-time capacity prices during daily scheduling. The calculation results show that the proposed robust optimization algorithm based on economic operation domain can be regarded as an extension of the traditional robust algorithm. Besides, the total cost can be reduced and the economy can be improved by adjusting the scheduling scheme according to the new energy output in real time under the premise of ensuring the time coupling constraint.

Understanding the key factors in the tumor microenvironment (TME) that affect the prognosis of gliomas is crucial. In this study, we sought to uncover the prognostic significance of immune cells and immune-related genes in the TME of gliomas. We incorporated data of 970 glioma patient samples from the Chinese Glioma Genome Atlas (CGGA) database as the training set, and an additional set of 666 samples from The Cancer Genome Atlas (TCGA) database served as the validation set. From our analysis, we identified 21 immune-related differentially expressed genes (DEGs) in the TME, which holds implications for glioma prognosis. Based on these genes, we constructed a prognostic risk model on the 21 genes. The prognostic risk model demonstrated robust performance with an area under the curve (AUC) value of 0.848. Notably, the risk score derived from the model emerged as an independent prognostic factor of gliomas, with high risk scores indicative of an unfavorable prognosis. Furthermore, we observed that high infiltration levels of certain immune cells, namely, activated dendritic cells, M0 macrophages, M2 macrophages, and regulatory T cells (Tregs), correlated with an unfavorable glioma prognosis. In conclusion, our findings suggested that the TME of gliomas harbored a distinct immune-associated signature, comprising 21 immune-related genes and specific immune cells. These elements significantly influence the prognosis and present potential as novel indicators in the clinical assessment of glioma patient outcomes.

Summary: Background: Ultrasonography is the most widely used technique to diagnose echinococcosis; however, challenges in using this technique and the demand on medical resources, especially in low-income or remote areas, can delay diagnosis. We aimed to develop a deep convolutional neural network (DCNN) model based on ultrasonography to identify echinococcosis and its types, especially alveolar echinococcosis. Methods: This retrospective, large-scale, multicentre study used ultrasound images from patients assessed at 84 hospitals in China, obtained between Jan 1, 2002, and Dec 31, 2021. Patients with a diagnosis of cystic echinococcosis, alveolar echinococcosis, or seven other types of focal liver lesions were included. We tested ResNet-50, ResNext-50, and VGG-16 as the backbone network architecture for a classification DCNN model and input the perinodular information from the ultrasound images. We trained and validated the DCNN model to diagnose and classify echinococcosis using still greyscale ultrasound images of focal liver lesions in four stages: differentiating between echinococcosis and other focal liver lesions (stage one); differentiating cystic echinococcosis, alveolar echinococcosis, and other focal liver lesions (stage two); differentiating cystic echinococcosis, alveolar echinococcosis, benign other focal liver lesions, and malignant focal liver lesions (stage three); and differentiating between active and transitional cystic echinococcosis and inactive cystic echinococcosis (stage four). We then tested the algorithm on internal, external, and prospective test datasets. The performance of DCNN was also compared with that of 12 radiologists recruited between Jan 15, 2022, and Jan 28, 2022, from Qinghai, Xinjiang, Anhui, Henan, Xizang, and Beijing, China, with different levels of diagnostic experience for echinococcosis and other focal liver lesions in a subset of ultrasound data that were randomly chosen from the prospective test dataset. The study is registered at ClinicalTrials.gov (NCT03871140). Findings: The study took place between Jan 1, 2002, and Dec 31, 2021. In total, to train and test the DCNN model, we used 9631 liver ultrasound images from 6784 patients (2819 [41·7%] female patients and 3943 [58·3%] male patients) from 87 Chinese hospitals. The DCNN model was trained with 6328 images, internally validated with 984 images, and tested with 2319 images. The ResNet-50 network architecture outperformed VGG-16 and ResNext-50 and was generalisable, with areas under the receiver operating characteristic curve (AUCs) of 0·982 (95% CI 0·960–0·994), 0·984 (0·972–0·992), and 0·913 (0·886–0·935) in distinguishing echinococcosis from other focal liver lesions; 0·986 (0·966–0·996), 0·962 (0·946–0·975), and 0·900 (0·872–0·924) in distinguishing alveolar echinococcosis from cystic echinococcosis and other focal liver lesions; and 0·974 (0·818–1·000), 0·956 (0·875–0·991), and 0·944 (0·844–0·988) in distinguishing active and transitional cystic echinococcosis from inactive echinococcosis in the three test datasets. Specifically, in patients with the hepatitis B or hepatitis C virus, the model could distinguish alveolar echinococcosis from hepatocellular carcinoma with an AUC of 0·892 (0·812–0·946). In identifying echinococcosis, the model showed significantly better performance compared with senior radiologists from a high-endemicity area (AUC 0·942 [0·904–0·967] vs 0·844 [0·820–0·866]; p=0·027) and improved the diagnostic ability of junior, attending, and senior radiologists before and after assistance with AI with comparison of AUCs of 0·743 (0·714–0·770) versus 0·850 (0·826–0·871); p

IntroductionCreativity is an important 21st-century skill that also plays an important role in second language use and development. This study examined the effects of creative pedagogy centered on student questioning activities for second language learners’ creativity, language proficiency, and questioning ability.MethodsIn the Japanese second language course, a creative activity intervention involving questioning activities was conducted for 81 university students. The students were taught how to ask higher-order questions, and they performed questioning activities and discussions about their questions after reading articles for eight lectures in 4 weeks.ResultsAfter the intervention, the quantity and quality of questions asked by participants increased and improved in the Questioning ability test. In the Creative thinking test, the three subscales of creative thinking (fluency, flexibility, and originality) improved after the intervention. In the Language proficiency test, there were also significant changes in vocabulary, grammar, and total scores after the intervention compared to before the intervention.DiscussionThe creative pedagogy significantly improved learners’ creativity, second language performance, and questioning ability, with a particularly positive impact on questioning ability, representing innovative thinking skills. The findings of this study not only contribute to future research on the development of creativity in second language instruction and deepen the exploration of the development of questioning ability for innovative thinking skills.

Objective To evaluate the benefits of the management of psoriatic patients treated with biological therapy using APP follow-up. Methods From June to September 2020, we enrolled 201 psoriatic patients who were treated with biological agents at the psoriasis center of dermatology hospital, Southern Medical University. Patients were randomly assigned APP follow-up (101 cases) and conventional follow-up (100 cases) groups. After one-year follow-up, a questionnaire was used to evaluate the patients' satisfaction rates, improvement in PASI scores and follow-up compliance. Results Compared to patients in conventional follow-up group, patients in the APP follow-up group had higher satisfaction rates with outpatient care, including registration, check-in, and outpatient clinic (all P

Objective: Thermal ablation poses challenges in the surgical resection (SR) of small hepatocellular carcinoma (HCC), and its therapeutic outcomes for larger lesions remain debated. Methods: This retrospective study evaluated 729 patients with HCC meeting the Milan criteria, who were treated with curative SR or microwave ablation (MWA) between 2008 and 2014. Overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and local tumor progression (LTP) were compared after propensity score matching (PSM). Co-variates associated with OS, CSS, LTP, and DFS were identified. The risk of death and tumor progression were compared. Results: During the median follow-up of 78.6 months, 253 patients were included in each group after PSM. For tumors ≤ 3.0 cm and 3.1–4.0 cm, MWA achieved comparable results in terms of OS, CSS, DFS, and LTP. For tumors 4.1–5.0 cm, MWA had lower OS, CSS, and DFS rates (all P < 0.05) than SR. Higher LTP rates were observed in the MWA group for tumors 4.1–5.0 cm, although the difference was not significant (P = 0.18). Complication rates (P = 0.41) were similar, but MWA led to less estimated blood loss (P < 0.01) and shorter postoperative hospitalization times (P < 0.01). Conclusions: MWA achieved comparable long-term oncologic outcomes with SR for ≤ 4 cm HCC, with lower complication rates and faster recovery.

The immunity potency upon natural infection or vaccination is the main concern for the vaccine strategy of severe acute respiratory syndrome coronavirus 2（SARS COV-2 variant）, especially the recently reported Omicron variant (B.1.1.529). In this study, 200 recipients immunized with three doses of a COVID-19-inactivated vaccine were enrolled, whose serum samples were collected within 2 months after the third immunization. The neutralizing activity of sera against the pseudotyped Omicron variant, prototype, and Delta variant was determined. Our results demonstrated that the positive neutralization activity was 95.5% for the Omicron variant, 99.5% for the prototype, and 98.5% for the Delta variant. The geometric mean titers （GMT） for the Omicron variant was 49 and maintained sustained immune levels for 2 months, which decreased by 4.9-fold and 3.0-fold compared with the prototype (GMT, 239) and Delta variant (GMT, 148), respectively. In summary, our study demonstrated that three doses of a COVID-19-inactivated vaccine effectively yielded potent cross-neutralizing activity against the Omicron variant at 2 months after the third vaccination.

Abstract Head and neck cancer (HNC) tumorigenesis involves a combination of multiple genetic alteration processes. Tumour necrosis factor-alpha-induced proteins (TNFAIPs) are involved in tumour development and progression, but few studies have been conducted on these factors in HNC. We aimed to analyse TNFAIPs and assess their potential as prognostic biomarkers and therapeutic targets using the Oncomine, UALCAN, Human Protein Atlas, LinkedOmics, cBioPortal, GeneMANIA, Enrichr, and Tumor IMmune Estimation Resource databases. We found that the transcript levels of TNFAIP1, TNFAIP3, EFNA1, TNFAIP6 and TNFAIP8 were increased, while those of TNFAIP8L3 and STEAP4 were reduced in HNC tissues versus normal tissues. The EFNA1, TNFAIP8 and TNFAIP8L3 expression levels were significantly correlated with the pathological stage. In HNC patients, high PTX3 and TNFAIP6 transcript levels were significantly associated with shorter overall survival (OS). Moreover, genetic alterations in TNFAIP1, TNFAIP6, and STEAP4 resulted in poorer disease-free survival, progression-free survival, and OS, respectively. TNFAIPs may mediate HNC tumorigenesis by regulating PI3K-Akt, Ras and other signalling pathways. TNFAIPs are also closely correlated with the infiltration of immune cells, including B cells, CD8+ T cells, CD4+ T cells, etc. The data above indicate that TNFAIPs may be potential biomarkers and therapeutic targets for HNC.

PurposeThe aim of this study was to assess the safety and efficacy of microwave ablation combined with apatinib [vascular endothelial growth factor receptor-2 (VEGFR-2) inhibitor] and camrelizumab [anti-programmed death-1 (PD-1) antibody] in patients with advanced hepatocellular carcinoma (HCC).Patients and methodsPatients (age, >18 years) with histologically confirmed HCC and refractory to at least the standard first-line therapy were enrolled from 2 September 2018 to 17 January 2022. They first received ultrasound-guided subtotal microwave ablation. Then, beginning at 7–14 days after ablation, they were given apatinib (250 mg once daily) and camrelizumab (200 mg once every 2 weeks) until unacceptable toxicity or disease progression or death. The coprimary end points were progression-free survival (PFS) and overall survival (OS).ResultsFourteen HCC patients with Barcelona Clinic of Liver Cancer (BCLC) B and C stages were retrospectively enrolled. At data cutoff, follow-up period ranged from 3.8 to 41.3 months (median, 17.4 months), and the median (95% confidence interval) duration of exposure (DE) was 6.4 (4.0–8.9) months. The PFS and OS were 10.8 (0–23.5) months and 19.3 (2.4–36.2) months, respectively. Three (21.4%) patients achieved a confirmed complete response (CR). Confirmed partial response (PR), stable disease (SD), and progression of disease (PD) were achieved in four (28.6%), four (28.6%), and three (21.4%) patients, respectively. The objective response rate (ORR) and disease control rate (DCR) were 50.0% (20.0%-80.0%) and 78.6% (54.0%-100%), respectively. The serious treatment-related adverse events included one (7.1%) case with reactive capillary hemangiomas (grade 4), one (7.1%) with hypertension (grade 3), two (14.3%) with elevated transaminase and bilirubin (grade 4), one (7.1%) with platelet count decrease (grade 4), one (7.1%) with hepatic failure (grade 4), and two (14.3%) with gastrointestinal bleeding (grades 3 and 4).ConclusionsMicrowave ablation combined with apatinib and camrelizumab treatment in advanced HCC patients demonstrated intriguing clinical activity and resulted in durable antitumor responses and significantly improved PFS and OS. The combination therapy is well tolerated, enabling further clinical studies.

Non-small cell lung cancer (NSCLC) is a major cause of death in those with malignant tumors. To achieve the early diagnosis of NSCLC, we investigated serum-derived Piwi-interacting RNA (piRNA) of extracellular vesicles to filter diagnostic biomarkers for NSCLC. High-throughput sequencing from cancerous tissues and adjacent noncancerous tissues in patients with NSCLC was first applied to recognize candidate piRNAs as diagnostic biomarkers. These screened piRNAs were further validated in 115 patients (including 95 cases in stage I) and 47 healthy individuals using quantitative real-time PCR (qRT-PCR). We showed that piR-hsa-164586 was significantly upregulated compared with paracancerous tissues and extracellular vesicles from the serum samples of healthy individuals. Moreover, the area under the curve (AUC) value of piR-hsa-164586 was 0.623 and 0.624 to distinguish patients with all stages or stage I of NSCLC, respectively, from healthy individuals. The diagnostic performance of piR-hsa-164586 was greatly improved compared with the cytokeratin-19-fragment (CYFRA21-1). Additionally, piR-hs-164586 was associated with the clinical characteristics of patients with NSCLC. Its expression was associated with the age and TNM stage of patients with NSCLC, indicating that it can serve as an effective and promising biomarker for the early diagnosis of NSCLC.

Mutations in the tumor suppressor M receptor (OSMR) gene are associated with primary localized cutaneous amyloidosis (PLCA). Recently, we confirmed that OSMR loss-of-function mutations enhance epidermal keratinocyte differentiation via inactivation of the STAT5/KLF7 signaling. However, no disease model was available for PLCA. Accordingly, we generated an OSMR c.1538G > A mutant human embryonic stem cell line (SMUDHe010-A-82) using CRISPR/Cas9-mediated homologous recombination. The cell line preserves normal karyotype, pluripotency and the ability to differentiate into all three germ layers. Moreover, the cell line can be used to prepare human skin organoid, which may provide a disease model for PLCA.

We investigate the impact of the global economic policy uncertainty (GEPU) on stock volatility for nine emerging economies (Brazil, Russia, India, China, South Africa, Mexico, Indonesia, South Korea, and Turkey). We employ an expanded GARCH-MIDAS approach to connect low-frequency GEPU data and high-frequency stock data, assuming that GEPU affects stock volatility via the long-run component of total volatility. We not only use DM and SPA tests to statically evaluate the out-of-sample forecasting ability of the extended model, taking traditional GARCH model and GARCH-MIDAS model as benchmarks, but also use the Fluctuation test to examine the time-varyingly relative forecasting performance in the presence of potential instability. From the in-sample estimation results, we find that GEPU has empirically significant impact on stock volatility for the nine emerging economies. The out-of-sample forecasting results show that the GEPU-based model can improve forecasting performance of stock volatility for emerging markets, especially in unstable environments.

Objective This retrospective study aimed to investigate the efficacy and safety of partial ablation (PA) for benign thyroid nodules (BTNs) using microwave ablation (MWA) in a long-term follow-up. Materials and methods Between February 2015 and April 2019, 236 patients with 236 BTNs (maximum diameter ≥2 cm) treated with ultrasound-guided MWA were enrolled. Contrast-enhanced ultrasound (CEUS) was performed within 3 d after ablation to determine whether there was residual tissue according to which the patients were assigned PA or complete ablation (CA). The volume reduction ratio (VRR) and complications were evaluated during follow-up. Results Eighty-two patients were enrolled in the PA group, and 154 were enrolled in the CA group. Both groups achieved continuous reductions in nodule volume and increases in VRR within 2 years after ablation. Although the VRR of the PA group at 4 years was lower than that of the CA group (65.54 vs. 95.08%; p.05). Conclusions Both PA and CA were safe and effective in reducing the volumes of BTNs in the long-term follow-up. For nodules with a large initial volume and dangerous location, PA with a small amount of residual tissue may be acceptable.

Abstract Background Postoperative pulmonary complications (PPCs) and hypoxaemia are associated with morbidity and mortality. We aimed to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose PPCs in patients suffering from hypoxaemia after general anaesthesia and compare the results to those of thoracic computed tomography (CT). Methods Adult patients who received general anaesthesia and suffered from hypoxaemia in the postanaesthesia care unit (PACU) were analysed. Hypoxaemia was defined as an oxygen saturation measured by pulse oximetry (SPO2) less than 92% for more than 30 s under ambient air conditions. LUS was performed by two trained anaesthesiologists once hypoxaemia occurred. After LUS examination, each patient was transported to the radiology department for thoracic CT scan within 1 h before returning to the ward. Results From January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopaedic surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) or other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis, while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan, and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%). Conclusions Lung ultrasound is feasible, efficient and accurate in diagnosing different aetiologies of postoperative hypoxia in healthy-weight patients in the PACU. Trial registration Current Controlled Trials NCT03802175 , 2018/12/05, www.ClinicalTrials.gov

Objective: To explore the association between cholecystectomy and the prognostic outcomes of patients with hepatocellular carcinoma (HCC) who underwent microwave ablation (MWA). Methods: Patients with HCC (n = 921) who underwent MWA were included and divided into cholecystectomy (n = 114) and non-cholecystectomy groups (n = 807). After propensity score matching (PSM) at a 1:2 ratio, overall survival (OS) and disease-free survival (DFS) rates were analyzed to compare prognostic outcomes between the cholecystectomy (n = 114) and non-cholecystectomy groups (n = 228). Univariate and multivariate Cox analyses were performed to assess potential risk factors for OS and DFS. Major complications were also compared between the groups. Results: After matching, no significant differences between groups were observed in baseline characteristics. The 1-, 3-, and 5-year OS rates were 96.5%, 82.1%, and 67.1% in the cholecystectomy group, and 97.4%, 85.2%, and 74.4% in the non-cholecystectomy group (P = 0.396); the 1-, 3-, and 5-year DFS rates were 58.4%, 34.5%, and 26.6% in the cholecystectomy group, and 73.6%, 44.7%, and 32.2% in the non-cholecystectomy group (P = 0.026), respectively. The intrahepatic distant recurrence rate in the cholecystectomy group was significantly higher than that in the non-cholecystectomy group (P = 0.026), and the local tumor recurrence and extrahepatic recurrence rates did not significantly differ between the groups (P = 0.609 and P = 0.879). Multivariate analysis revealed that cholecystectomy (HR = 1.364, 95% CI 1.023–1.819, P = 0.035), number of tumors (2 vs. 1: HR = 2.744, 95% CI 1.925–3.912, P < 0.001; 3 vs. 1: HR = 3.411, 95% CI 2.021–5.759, P < 0.001), and γ-GT levels (HR = 1.003, 95% CI 1.000–1.006, P < 0.024) were independent risk factors for DFS. The best γ-GT level cut-off value for predicting median DFS was 39.6 U/L (area under the curve = 0.600, P < 0.05). A positive correlation was observed between cholecystectomy and γ-GT level (r = 0.108, 95% CI −0.001–0.214, P = 0.047). Subgroup analysis showed that the DFS rates were significantly higher in the non-cholecystectomy group than the cholecystectomy group when γ-GT ≥39.6 U/L (P = 0.044). The 5-, 10-, 15-, 20-, and 25-year recurrence rates from the time of cholecystectomy were 2.63%, 21.93%, 42.11%, 58.77%, and 65.79%, respectively. A significant positive correlation was observed between cholecystectomy and the time from cholecystectomy to recurrence (r = 0.205, 95% CI 0.016–0.379, P = 0.029). There were no significant differences in complications between groups (P = 0.685). Conclusions: Patients with HCC who underwent cholecystectomy were more likely to develop intrahepatic distant recurrence after MWA, an outcome probably associated with increased γ-GT levels. Moreover, the recurrence rates increased with time.

Abstract: Background: Tumor recurrence is an abomination for hepatocellular carcinoma (HCC) patients receiving local treatment. Purpose: To build a hybrid machine learning model to recommend optimized first treatment (Laparoscopic hepatectomy (LH) or Microwave ablation (MWA)) for naïve single 3-5cm HCC patients based on early recurrence (ER, ≤2 years) probability. Methods: This retrospective study collected 20 semantic variables of 582 patients (LH:300, MWA:282) from 13 hospitals with at least 24 months follow-up. Both groups were divided into training, validation and test set, respectively. Five algorithms (Logistics Regression, Random Forest, Neural Network, Stochastic Gradient Boosting (SGB) and eXtreme Gradient Boosting (XGB)) were used for model building. Model with highest AUC in validation set of LH and MWA was selected to connect as a hybrid model which made decision based on ER probability. Model testing was performed in a comprehensive set composing of LH and MWA test set. Results: Four variables in each group were selected to build LH and MWA model, respectively. LH-XGB model (AUC=0.744) and MWA-SGM (AUC=0.750) model were selected for model building. In comprehensive set, a treatment confusion matrix was established based on recommended and actual treatment. The predicted ER probabilities were comparable with the actual ER rates for various types of patients in matrix (p>0.05). ER rate of patients whose actual treatment consistent with recommendation was lower than that of inconsistent patients (LH:21.2%vs46.2%, p=0.042; MWA:26.3%vs54.1%, p=0.048). By recommending optimal treatment, hybrid model can significantly reduce ER probability from 38.2% to 25.6% for overall patients (p

Objective: To determine the cause and high-risk factors for the development of intestinal fistulas (IFs) after ultrasound-guided microwave ablation (MA) of abdominopelvic lesions, and to identify effective prophylactic and therapeutic actions.Methods: Clinical data were collected from patients with an IF after ultrasound-guided MA of abdominopelvic lesions in our hospital from January 1, 2010 to December 31, 2018. The cause, diagnosis, and treatment of IFs in these patients were analyzed.Results: Among 8,969 patients who underwent ultrasound-guided MA of abdominopelvic lesions, eight patients developed IF after MA, Seven patients were discharged after being cured and one died.Conclusion: Abdominopelvic lesions are close to the intestines, so histories of surgery, radiotherapy, and abdominopelvic infection are high-risk factors for IF development after MA of these lesions. Surgical treatment should be provided as soon as an IF is identified.

We collect a large sample with a reliable redshift detected by the Fermi satellite after 10 yr of data (4FGL-DR2), including blazars, gamma-ray narrow-line Seyfert 1 galaxies ( γ NLS1s), and radio galaxies. The spectral energy distributions of these Fermi sources are fitted by using a second-degree polynomial, and some important parameters including spectral curvature, synchrotron peak frequency, and peak luminosity are obtained. Based on those parameters, we discuss the Fermi blazar sequence and the particle acceleration mechanism. Our main results are as follows: (i) By studying the relationship between the synchrotron peak frequency and the synchrotron peak frequency luminosity, jet kinetic power, and gamma-ray luminosity for jetted active galactic nuclei (AGNs), we find an “L” shape in the Fermi blazar sequence. (ii) There is a significant anticorrelation between the Compton dominance, the black hole spin, and the synchrotron peak frequency for jetted AGNs, respectively. These results support that the γ NLS1s and radio galaxies belong to the Fermi blazar sequence. (iii) On the basis of previous work, statistical or stochastic acceleration mechanisms can be used to explain the relationship between the synchrotron peak frequency and synchrotron curvature. For different subclasses, the correlation slopes are different, which implies that the Fermi sources of different subclasses have different acceleration mechanisms. (iv) Flat-spectrum radio quasars and γ NLS1s have a higher median spin of a black hole than BL Lac objects and radio galaxies.

We study the radio galaxies with known redshifts detected by the Fermi satellite after 10 yr of data (4FGL-DR2). We use a one-zone leptonic model to fit the quasi-simultaneous multiwavelength data of these radio galaxies and study the distributions of the derived physical parameters as a function of black hole mass and accretion disk luminosity. The main results are as follows. (1) We find that the jet kinetic power of most radio galaxies can be explained by the hybrid jet model based on ADAFs surrounding Kerr black holes. (2) After excluding the redshift, there is a significant correlation between the radiation jet power and the accretion disk luminosity, while the jet kinetic power is weakly correlated with the accretion disk luminosity. (3) We also find a significant correlation between inverse Compton luminosity and synchrotron luminosity. The slope of the correlation for radio galaxies is consistent with the synchrotron self-Compton (SSC) process. The result may suggest that the high-energy components of radio galaxies are dominated by the SSC process.

We study the general physical properties of Fermi blazars using the Fermi fourth source catalog data (4FGL-DR2). The quasi-simultaneous multiwavelength data of Fermi blazars are fitted by using the one-zone leptonic model to obtain some physical parameters, such as jet power, magnetic field, and Doppler factor. We study the distributions of the derived physical parameters as a function of black hole mass and accretion disk luminosity. The main results are as follows. (1) For a standard thin accretion disk, the jet kinetic power of most flat-spectrum radio quasars can be explained by the Blandford–Payne (BP) mechanism. However, the jet kinetic power of most BL Lacertae objects (BL Lacs) cannot be explained by either the Blandford–Znajek mechanism or the BP mechanism. The BL Lacs may have advection-dominated accretion flows surrounding their massive black holes. (2) After excluding the redshift, there is a moderately strong correlation between the jet kinetic power and jet radiation power and the accretion disk luminosity for Fermi blazars. These results confirm a close connection between jet and accretion. The jet kinetic power is slightly larger than the accretion disk luminosity for Fermi blazars. (3) There is a significant correlation between jet kinetic power and gamma-ray luminosity and radio luminosity for Fermi blazars, which suggests that gamma-ray luminosity and radio luminosity can be used to indicate the jet kinetic power.

The metastable β titanium alloys used in marine engineering applications suffered from stress-corrosion cracking in seawater. The different phase composition leads to the distinct stress-corrosion cracking behaviors of the alloy. In this work, the influence of the phase composition on the stress-corrosion cracking of a novel metastable β titanium alloy Ti-6Mo-5V-3Al-2Fe-2Zr was investigated. The alloys with different phase compositions were prepared by three types of thermal-mechanical processing, i.e., the single β phase (assigned as M(β)), the β phase plus fine α phase (assigned as M(β+fα)), and the β phase plus coarsened α phase (assigned as M(β+cα)). The electrochemical tests and constant-stress loading tests were performed, and the phase composition and microstructure were analyzed by XRD and SEM. The M(β) alloy exhibits the best corrosion resistance as well as the compact properties of oxide films, followed by the M(β+fα) alloy and the M(β+cα) alloy. Tear ridges and a flat facet with an undulating surface were observed on the stress-corrosion cracking fracture surface, which indicated the occurrence of high-degree dislocations movement and localized plastic deformation. Absorption-induced dislocation emission (AIDE) and hydrogen-enhanced localized plasticity (HELP) are the primary mechanisms for the stress-corrosion cracking of the alloy. The increased amount of β phase has a beneficial effect on stress-corrosion cracking resistance. For the alloy with β and α phases, the α phase with wider spacing has an adverse effect on stress corrosion performance.

The effect of the secondary α phase on stress corrosion cracking of a novel metastable β titanium alloy, Ti-6Mo-5V-3Al-2Fe, in 3.5% NaCl solution was investigated by slow strain rate testing. Fine acicular secondary α phase was obtained by aging at the low temperature of 520 °C, and coarsened rod-like secondary α phase was obtained by aging at the high temperature of 680 °C. The electrochemical measurement results and slow strain rate testing results show that the microstructure contained with fine acicular secondary α phase exhibits better corrosion resistance and less stress corrosion cracking susceptibility. The fracture morphology exhibits a mixed fracture characteristic with shallow and small dimples, as well as tear ridges and flat facets with undulating surfaces. The combination of Absorption Induced Dislocation Emission and Hydrogen Enhanced Localized Plasticity is the main mechanism for stress corrosion cracking. Fine acicular secondary α phase with narrow spacing leads to less accumulated dislocations and smaller localized stress, so that has a beneficial effect on stress corrosion performance.

Abstract Background The aim of this retrospective study was to compare the feasibility and efficiency of ultrasound-guided percutaneous microwave ablation (US-PMWA) assisted by three-dimensional visualization ablation planning system (3DVAPS) and conventional 2D planning for hepatocellular carcinoma (HCC) (diameter > 3 cm). Methods One hundred thirty patients with 223 HCC nodules (5.0 ± 1.5 cm in diameter, [3.0–10.0 cm]) who met the eligibility criteria divided into 3D and 2D planning group were reviewed from April 2015 to August 2018. Ablation parameters and oncological outcomes were compared, including overall survival (OS), recurrence-free survival (RFS), and local tumor progression (LTP). Multivariate analysis was performed on clinicopathological variables to identify the risk factors for OS and LTP. Results The median follow-up period was 21 months (range 3–44). Insertion number (5.4 ± 1.2 VS. 4.5 ± 0.9, P = 0.034), ablation time (1249.2 ± 654.2 s VS. 1082.4 ± 584.7 s, P = 0.048), ablation energy (57,000 ± 11,892 J VS. 42,600 ± 10,271 J, P = 0.038) and success rate of first ablation (95.0% VS. 85.7%, P = 0.033) were higher in the 3D planning group compared with those in 2D planning group. There was no statistical difference in OS, and RFS between the two groups (P = 0.995, P = 0.845). LTP rate of 3D planning group was less than that of 2D planning group (16.5% VS 41.2%, P = 0.003). Multivariate analysis showed tumor maximal diameters (P

Purpose To identify the beneficial body mass index (BMI) for patients with hepatocellular carcinoma (HCC) to achieve longer survival time following curative microwave ablation (MWA). Methods This retrospective study evaluated 474 patients with solitary primary HCC who underwent MWA. BMI at initial admission and other characteristics were collected. The associations of the BMI with the overall survival (OS) and disease-free survival (DFS) were analyzed by Cox proportional hazards regression analysis in multiple models. A two-piecewise linear regression model was applied to examine the threshold effect of the BMI on OS and DFS by maximized log likelihood method. The threshold level was determined by using trial and error. Results Patients with a normal BMI range achieved improved survival outcomes but similar DFS in multiple models. In the model with adjustments of the age, size, and Charlson score, patients with BMI ≤ 22.9 and ≤24.9 kg/m2 exhibited a lower death rate than patients with BMI ≤18.5 kg/m2 (p

Purpose To assess the oncologic outcomes of the hepatocellular carcinoma (HCC) patients in challenging locations (CLs) underwent ultrasound-guided percutaneous microwave ablation (US-PMWA) and the efficacy and safety of the advanced assistive technology (AAT). Materials and methods Data for 489 treatment-naïve patients with HCC who met Milan criteria and subsequently underwent US-PMWA were reviewed from March 2012 to November 2016. According to the distance (

Purpose To compare acute kidney injury (AKI) incidence between nephron sparing surgery (NSS) and microwave ablation (MWA) for T1a RCC patients, reveal the effect of AKI on survival prognosis, construct AKI nomogram and use Law of Total Probability for survival probability (SP) prediction. Materials and methods Patients were studied retrospectively after NSS (n = 1267) or MWA (n = 210) from January 1, 2011 to June 30, 2017. Using one to one Propensity Score Matching (PSM), 158 pairs of patients were identified for the cohort study. AKI incidence, risk factors and impact on survival outcomes were analyzed using Chi-square test, logistic and cox regression analysis. AKI risk and SP were predicted by nomogram and Law of Total Probability. The performance of the nomogram was assessed with respect to its discrimination, calibration, and clinical usefulness. Results AKI occurred more commonly in NSS (27.85%) cohort, when compared to MWA (17.72%) cohort (p = 0.032), but treatment modality was not independently predictive of AKI occurrence (odds ratio [OR]: 0.598; 95% confidence interval [CI]: 0.282–1.265; p = 0.178). The 5-yr overall survival (OS) was lower in AKI patients (73.5%) compared with non-AKI patients (94.8%; p 0.86, excellent calibration and net benefits at the decision curve analysis with probabilities ≥5%. SP predicted by Law of Total Probability was comparable to actual OS. Conclusion AKI was an early indicator for poor overall survival in RCC patients. It can be predicted by several oncological parameters. Nomogram and Law of Total Probability can accurately predict AKI risk and SP.

ObjectiveTo construct a nomogram based on the albumin-bilirubin (ALBI) grade to provide prognostic value for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) patients who underwent ultrasound-guided percutaneous microwave ablation (US-PMWA).MethodsFrom April 2005 to January 2018, 183 treatment-naïve patients with 251 HCV-related HCCs according to the Milan criteria received US-PMWA subsequently. The overall survival (OS) and recurrence-free survival (RFS) were compared between groups classified by ALBI grade. Cox proportional hazard regression model based on risk factors for survival and recurrence was used to construct the nomogram.ResultsThe cumulative OS rates at 1-, 3-, 5- and 10-year were 97.7%, 73.6%, 54.5% and 34.5%, respectively. Stratified according to ALBI grade, the 1-, 3-, and 5-year OS in the ALBI grade 1 group and grade 2 group were 99.2%, 92.4%, 77.9% and 97.7%, 52.3%, 38.6%, respectively, with significant statistical difference (P < 0.001). No significant statistical difference was detected in the 1-, 3-, and 5-year RFS rates in the ALBI grade 1 group and grade 2 group (P = 0.220). The major complication rate was 1.6%. Multivariate analysis results showed age, α-fetoprotein level, tumor number, platelet count, location, Child-Turcotte-Pugh (CTP) and ALBI grade were associated with OS, which generated the nomograms. Internal validation with 1000 bootstrapped sample sets had good concordance index of 0.769 (95%CI 0.699-0.839) in OS.ConclusionsThis nomogram based on ALBI grade was a visualization risk model, which could provide personalized prediction of long-term outcomes for HCV-related HCC patients after US-PMWA.