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Abstract The severe mismatch between solid bioelectronics and dynamic biological tissues has posed enduring challenges in the biomonitoring community. Here, we developed a reconfigurable liquid cardiac sensor capable of adapting to dynamic biological tissues, facilitating ambulatory cardiac monitoring unhindered by motion artifacts or interference from other biological activities. We employed an ultrahigh-resolution 3D scanning technique to capture tomographic images of the skin on the wrist. Then, we established a theoretical model to gain a deep understanding of the intricate interaction between our reconfigurable sensor and dynamic biological tissues. To properly elucidate the advantages of this sensor, we conducted cardiac monitoring alongside benchmarks such as the electrocardiogram. The liquid cardiac sensor was demonstrated to produce stable signals of high quality (23.1 dB) in ambulatory settings.

Abstract Background Worldwide, ulcerative colitis (UC) is becoming increasingly fast growing. Ginsenoside Rh2 has been reported to alleviate UC. However, the latent biological mechanism of Rh2 in the treatment of UC remains uncertain. In this study, the goal was to determine the therapeutic effect of Rh2 on dextran sulfate sodium (DSS)-induced UC. Methods A DSS-induced UC mouse model was established and divided into 7 groups for Rh2 gavage and/or miR-125a-5p lentivirus injection (n = 10 per group). Colonic specimens were collected for phenotypic and pathological analysis. miR-125a-5p and specific protein 1 (SP1) expression, inflammation-related factors IL-6 and IL-10, and apoptosis were detected in mice. Human normal colon epithelial cell line NCM460 was treated with H2O2 and ferric chloride hexahydrate to construct an in vitro cell model of colitis and induce ferroptosis. Independent sample t-test was used to compare cell proliferation, cell entry, apoptosis, and oxidative stress between the two groups. One way analysis of variance combined with the least significant difference t test was used for comparison between groups. Multiple time points were compared by repeated measurement analysis of variance. Results DSS-induced UC mice had significantly decreased body weight, increased disease activity index, decreased colon length, and decreased miR-125a-5p expression (all P

Abstract Background Liver transplantation (LT) is offered as a cure for Hepatocellular carcinoma (HCC), however 15–20% develop recurrence post-transplant which tends to be aggressive. In this study, we examined the transcriptome profiles of patients with recurrent HCC to identify differentially expressed genes (DEGs), the involved pathways, biological functions, and potential gene signatures of recurrent HCC post-transplant using deep machine learning (ML) methodology. Materials and methods We analyzed the transcriptomic profiles of primary and recurrent tumor samples from 7 pairs of patients who underwent LT. Following differential gene expression analysis, we performed pathway enrichment, gene ontology (GO) analyses and protein-protein interactions (PPIs) with top 10 hub gene networks. We also predicted the landscape of infiltrating immune cells using Cibersortx. We next develop pathway and GO term-based deep learning models leveraging primary tissue gene expression data from The Cancer Genome Atlas (TCGA) to identify gene signatures in recurrent HCC. Results The PI3K/Akt signaling pathway and cytokine-mediated signaling pathway were particularly activated in HCC recurrence. The recurrent tumors exhibited upregulation of an immune-escape related gene, CD274, in the top 10 hub gene analysis. Significantly higher infiltration of monocytes and lower M1 macrophages were found in recurrent HCC tumors. Our deep learning approach identified a 20-gene signature in recurrent HCC. Amongst the 20 genes, through multiple analysis, IL6 was found to be significantly associated with HCC recurrence. Conclusion Our deep learning approach identified PI3K/Akt signaling as potentially regulating cytokine-mediated functions and the expression of immune escape genes, leading to alterations in the pattern of immune cell infiltration. In conclusion, IL6 was identified to play an important role in HCC recurrence.

Abstract The rapid development of ultrawideband (UWB) communication systems has resulted in increasing performance requirements for the antenna system. In addition to a wide bandwidth, fast propagation rates and compact dimensions, flexibility, wearability or portability are also desirable for UWB antennas, as are excellent notch characteristics. Although progress has been made in the development of flexible/wearable antennas desired notch properties are still rather limited. Moreover, most presently available flexible UWB antennas are fabricated using environmentally not attractive subtractive etching-based processes. The usage of facile additive sustainably inkjet printing processes also utilizing low temperature plasma-activated conductive inks is rarely reported. In addition, the currently used tri-notched flexible UWB antenna designs have a relatively large footprint, which poses difficulties when integrated into miniaturized and compact communication devices. In this work, a silver nano ink is used to fabricate the antenna via inkjet printing and an efficient plasma sintering procedure. For the targeted UWB applications miniaturized tri-notched flexible antenna is realized on a flexible polyethylene terephthalate (PET) substrate with a compact size of 17.6 mm × 16 mm × 0.12 mm. The antenna operates in the UWB frequency band (2.9–10.61 GHz), and can shield interferences from WiMAX (3.3–3.6 GHz), WLAN (5.150–5.825 GHz) and X-uplink (7.9–8.4 GHz) bands, as well as exhibits a certain of bendability. Three nested "C" slots of different sizes were adopted to achieve notch features. The simulation and test results demonstrate that the proposed antenna can generate signal radiation in the desired UWB frequency band while retaining the desired notch properties and having acceptable SAR values on-body, making it a viable candidate for usage in flexible or wearable communication transmission devices. The research provides a facile and highly efficient method for fabricating flexible/wearable UWB antennas, that is, the effective combination of inkjet printing processing, flexible substrates, low temperature-activated conductive ink and antenna structure design.

ABSTRACTThe discrepancies in data across different phases and the unexplored optimal spatial resolution present challenges when using multi-temporal canopy height models to accurately discern actual forest growth. In this study, we evaluated the reliability of bi-temporal CHMs to characterize growth changes in a boreal natural forest over a four-year period. A maximum mosaic method was introduced to construct a CHM from various flight strips, aimed at minimizing data alignment errors. Subsequently, the canopy height and height changed derived from six different height percentile metrics and five spatial resolutions were evaluated. The results showed that higher resolution (e.g., < 2 m) and lower height metrics (e.g., 85th height percentile) consistently underestimated. Tree growth correlation with individual segmentation surpassed field-measurements at all resolutions and height metrics. for the optimal resolution and height metrics, the results suggest that using a 95th height percentile the 10 m scale effectively represents both canopy height ([Formula: see text] = 0.95, [Formula: see text] = 0.88 m, [Formula: see text] = 5.83%; [Formula: see text] = 0.96, [Formula: see text] = 1.11 m, [Formula: see text] = 6.91%) and height changes ([Formula: see text] = 0.59, [Formula: see text] = 0.86 m, [Formula: see text] = 18.38%). This study demonstrates the necessity of carefully evaluating data characteristics and resolutions when employing multi-temporal CHM for forest dynamics monitoring.

Vision-based smart agriculture is an important way to improve the efficiency of agricultural production. Labeling images for deep learning in complex field photos is a difficult task. In this paper, an image augmentation method that can help reduce the workload of image labeling based on synthetic images is proposed. The synthetic images consisted of three parts: crop, weed, and soil. The crop and weeds were obtained automatically by Excess Green (ExG) and minimum error threshold segmentation. The data augmentation method was tested on image classification, object detection, and semantic segmentation tasks by Resnet, YOLOV5, and DeeplabV3. The accuracy of the classification model reached 0.99. The IoU of object detection and semantic segmentation were 0.98 and 0.96, respectively. The results showed that the method in this paper was acceptable despite slight overfitting. This method was proposed based on the characteristics of field images, and it was meant for reducing the workload of labeling images.

Analyzing polysorbate 20 (PS20) composition and the impact of each component on stability and safety is crucial due to formulation variations and individual tolerance. The similar structures and polarities of PS20 components make accurate separation, identification, and quantification challenging. In this work, a high-resolution quantitative method was developed using single-dimensional high-performance liquid chromatography (HPLC) with charged aerosol detection (CAD) to separate 18 key components with multiple esters. The separated components were characterized by ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) with an identical gradient as the HPLC-CAD analysis. The polysorbate compound database and library were expanded over 7-time compared to the commercial database. The method investigated differences in PS20 samples from various origins and grades for different dosage forms to evaluate the composition-process relationship. UHPLC-Q-TOF-MS identified 1329 to 1511 compounds in 4 batches of PS20 from different sources. The method observed the impact of 4 degradation conditions on peak components, identifying stable components and their tendencies to change. HPLC-CAD and UHPLC-Q-TOF-MS results provided insights into fingerprint differences, distinguishing quasi products.

Abstract Background Post-radiation nasopharyngeal necrosis (PRNN) is a severe adverse event following re-radiotherapy for patients with locally recurrent nasopharyngeal carcinoma (LRNPC) and associated with decreased survival. Biological heterogeneity in recurrent tumors contributes to the different risks of PRNN. Radiomics can be used to mine high-throughput non-invasive image features to predict clinical outcomes and capture underlying biological functions. We aimed to develop a radiogenomic signature for the pre-treatment prediction of PRNN to guide re-radiotherapy in patients with LRNPC. Methods This multicenter study included 761 re-irradiated patients with LRNPC at four centers in NPC endemic area and divided them into training, internal validation, and external validation cohorts. We built a machine learning (random forest) radiomic signature based on the pre-treatment multiparametric magnetic resonance images for predicting PRNN following re-radiotherapy. We comprehensively assessed the performance of the radiomic signature. Transcriptomic sequencing and gene set enrichment analyses were conducted to identify the associated biological processes. Results The radiomic signature showed discrimination of 1-year PRNN in the training, internal validation, and external validation cohorts (area under the curve (AUC) 0.713–0.756). Stratified by a cutoff score of 0.735, patients with high-risk signature had higher incidences of PRNN than patients with low-risk signature (1-year PRNN rates 42.2–62.5% vs. 16.3–18.8%, P

Abstract Background Targeted therapy combined with immunotherapy is the current first-line treatment for metastatic renal cell carcinoma (mRCC), but patients with tumor thrombus (TT) may suffer from lower limb edema or even sudden cardiac death, so the purpose of this study is to investigate the efficacy and safety of surgical treatment in patients with mRCC and TT and explore worse factors to affect the prognosis in this series of patients. Patients and methods A total of 85 mRCC patients with TT who received cytoreductive nephrectomy and thrombectomy at our medical center from 2014 to 2023 are included. All patients received postoperative systemic therapy. Overall survival (OS) is defined as the time from surgery to death due to any reason or the last follow-up. Kaplan–Meier analysis was performed to evaluate OS and differences among groups were tested by log-rank. Multivariable Cox proportional hazards analysis was performed to ascertain independent relationships between clinicopathological factors and OS. Results The median age of patients was 58 years old. Eleven patients (12.9%) had no symptoms, 39 patients (45.9%) had local symptoms, 15 patients (17.6%) had systemic symptoms, and 20 patients (23.5%) had both. Mayo grade of TT was 0, 1, 2, 3, and 4 for 12, 27, 31, 7, and 8 patients respectively. Fifty-five patients had lung metastasis, 23 had bone metastasis, 16 had liver metastasis, 13 had adrenal metastasis, and 9 had lymph node metastasis. Of all patients, 17 patients had multiple metastases. The median operation time is 289 min and the median intraoperative hemorrhage is 800 ml. Twenty-eight patients experienced postoperative complications, 8 of which were serious complications of modified Clavien grade III or higher. The median OS of all patients was 33 months and median follow up time was 26 months. In multivariate analysis, systemic symptom (p = 0.00753), pathological type (p = 0.0166), sarcomatous degeneration (p = 0.0334), and perirenal fat infiltration (p = 0.0202) are independent predictors of OS. Conclusion Cytoreductive nephrectomy and thrombectomy is relatively safe and effective for patients with mRCC accompanied by TT. In this series of patients, the worse prognosis is associated with systemic symptoms, non-clear cell carcinoma, sarcomatous degeneration and perirenal fat infiltration.

Abstract In recent years, anisotropic 2D materials (black phosphorus, ReS2, WTe2, etc.) have garnered significant attention due to their orientation‐dependent physical and chemical properties, along with their potential applications in micro‐nano device development, such as crystal‐based diodes, polarized light photodetectors, and directional heat transfer. As a practical, quick, and nondestructive characterization tool, Raman spectroscopy, with its unique and unmatched advantages in studying anisotropic materials, plays a crucial role. It enables lattice orientation identification, investigation of structural phase transitions, and examination of anisotropic lattice vibrations, among other aspects. Here, a comprehensive review of recent developments in Raman spectroscopy research on anisotropic materials is provided. To begin, this study introduces the classification of anisotropic materials before delving into the polarized Raman spectroscopy principle. Various research directions of Raman spectroscopy in anisotropic materials are explored, including lattice orientation identification, temperature dependence, interlayer coupling, electron–phonon interaction, thickness dependence, and high‐pressure phase transition. Finally, potential future directions in the field of Raman spectroscopy for anisotropic materials are discussed, and the potential challenges that may arise are addressed.

Quantifying the relationship between light and stands or individual trees is of great significance in understanding tree competition, improving forest productivity, and comprehending ecological processes. However, accurately depicting the spatiotemporal variability of light under complex forest structural conditions poses a challenge, especially for precise forest management decisions that require a quantitative study of the relationship between fine-scale individual tree structure and light. 3D RTMs (3-dimensional radiative transfer models), which accurately characterize the interaction between solar radiation and detailed forest scenes, provide a reliable means for depicting such relationships. This study employs a 3D RTM and LiDAR (light detection and ranging) data to characterize the light environment of larch plantations at a fine spatiotemporal scale, further investigating the relationship between absorbed photosynthetically active radiation (APAR) and forest structures. The impact of specific tree structural parameters, such as crown diameter, crown area, crown length, crown ratio, crown volume, tree height, leaf area index, and a distance parameter assessing tree competition, on the daily-scale cumulative APAR per tree was investigated using a partial least squares regression (PLSR) model. Furthermore, variable importance in projection (VIP) was also calculated from the PLSR. The results indicate that among the individual tree structure parameters, crown volume is the most important one in explaining individual tree APAR (VIP = 4.19), while the competition from surrounding trees still plays a role in explaining individual tree APAR to some extent (VIP = 0.15), and crown ratio contributes the least (VIP = 0.03). Regarding the spatial distribution of trees, the average cumulative APAR per tree of larch plots does not increase with an increase in canopy gap fraction. Tree density and average cumulative APAR per tree were fitted using a natural exponential equation, with a coefficient of determination (R2 = 0.89), and a small mean absolute percentage error (MAPE = 0.03). This study demonstrates the potential of combining 3D RTM with LiDAR data to quantify fine-scale APAR in plantations, providing insights for optimizing forest structure, enhancing forest quality, and implementing precise forest management practices, such as selective breeding for superior tree species.

Abstract Background To define the incidence and risk factors of chyle leak (CL) after radical nephrectomy and thrombectomy and to determine the impact of chyle leak on oncological outcomes. Patients and Methods A total of 445 patients who underwent radical nephrectomy and thrombectomy between January 2014 and January 2023 were included. CL is defined as the drainage of chyle with a triglyceride level greater than 110 mg/dL after oral intake or enteral nutrition. Multivariate logistic regression analysis was performed to identify the risk factors of postoperative (CL). The Kaplan–Meier curves were used to compare overall survival and cancer‐specific survival. Results 44 patients (9.9%) were diagnosed as (CL). All patients developed CL within 6 days after the operation with a median time of 3 days. In multivariate logistic regression analysis, Mayo grade and side were independent patient‐related risk factors. In addition, operation approach, operation time, and number of lymph nodes harvested were independent surgery‐related risk factors. Between the CL group and the non‐CL group, neither overall survival nor cancer‐specific survival showed statistical differences. Conclusion Based on this retrospective study of renal cell carcinoma and tumor thrombus patients in our center, we found that the risk factors were Mayo grade, side, operation approach, operation time, and number of lymph nodes harvested, and the occurrence of CL significantly prolonged hospital stay, but had no effect on long‐term oncological outcomes.

Abstract Background We aimed to compare the oncological outcomes between the oblique occlusion technique and the traditional technique for robot-assisted radical nephrectomy (RARN) with inferior vena cava (IVC) thrombectomy, and to explore the safety and effectiveness of the oblique occlusion technique. Methods Overall, 21 patients with renal cell carcinoma (RCC) and IVC tumor thrombus (TT) were admitted to our hospital from August 2019 to June 2020. All the patients underwent RARN with IVC thrombectomy, of which the IVC oblique occlusion technique was used in 11 patients and traditional occlusion technique was used in 10 patients. The oblique occlusion technique refers to oblique blocking from the upper corner of the right renal vein to the lower corner of the left renal vein using a vessel tourniquet or a vessel clamp (left RCC with IVCTT as an example). Results Compared with patients in the traditional group, those in the oblique group had lower serum creatinine at follow-up (3 month) (95 ± 21.1 vs. 131 ± 30.7 μmol/L, P = 0.03). There was no significant difference in operation time [149 (IQR 143–245) min vs. 148 (IQR 108–261) min, p = 0.86], IVC clamping time [18 (IQR 12–20) min vs. 20 (IQR 14–23) min, p = 0.41], and estimated intraoperative blood loss [300 (IQR 100–800) mL vs. 500 (IQR 175–738) mL, p = 0.51] between both groups. During a 16-month (range, 15–23 months) follow-up period, two cases progressed in the oblique group and three cases progressed in the traditional group. Conclusions The modified IVC oblique occlusion technique procedure is relatively safe and effective in RARN with IVC thrombectomy. The IVC oblique occlusion technique may play a role in the protection of renal function.

The piezoelectricity of PVDF composites is mainly determined by the crystalline phases and spontaneous polarization. Here, the authors propose a Ti3C2Tx anchoring method to modulate the molecular interactions and conformation of polymer matrix.

Based on the risk hedging perspective, this paper examines the impact of directors’ and officers’ liability insurance (hereafter referred to as D&O liability insurance) on the pricing of corporate bonds. We find that the purchase of D&O liability insurance can effectively reduce corporate bond insurance pricing. The path test shows that the purchase of D&O liability insurance can reduce the bond insurance pricing by improving the quality of company’s internal control. Furthermore, the paper finds that when management power is greater, investor protection is poor or financial risk is high,the impact of the D&O liability insurance is stronger. After purchasing D&O liability insurance, creditors will reduce the use of corporate governance contractual terms, but will set more investments and financing as well as option contractual terms. In addition, companies that purchase D&O liability insurance issue bonds with higher credit ratings and longer bond maturities.

Liver cancers are the fourth leading cause of cancer-related mortality worldwide. In the past decade, breakthroughs in the field of artificial intelligence (AI) have inspired development of algorithms in the cancer setting. A growing body of recent studies have evaluated machine learning (ML) and deep learning (DL) algorithms for pre-screening, diagnosis and management of liver cancer patients through diagnostic image analysis, biomarker discovery and predicting personalized clinical outcomes. Despite the promise of these early AI tools, there is a significant need to explain the ‘black box’ of AI and work towards deployment to enable ultimate clinical translatability. Certain emerging fields such as RNA nanomedicine for targeted liver cancer therapy may also benefit from application of AI, specifically in nano-formulation research and development given that they are still largely reliant on lengthy trial-and-error experiments. In this paper, we put forward the current landscape of AI in liver cancers along with the challenges of AI in liver cancer diagnosis and management. Finally, we have discussed the future perspectives of AI application in liver cancer and how a multidisciplinary approach using AI in nanomedicine could accelerate the transition of personalized liver cancer medicine from bench side to the clinic.

Two-dimensional (2D) transitional metal dichalcogenides (TMDs) have garnered remarkable attention in electronics, optoelectronics, and hydrogen precipitation catalysis due to their exceptional physicochemical properties. Their utilisation in optoelectronic devices is especially notable for overcoming graphene’s zero-band gap limitation. Moreover, TMDs offer advantages such as direct band gap transitions, high carrier mobility, and efficient switching ratios. Achieving precise adjustments to the electronic properties and band gap of 2D semiconductor materials is crucial for enhancing their capabilities. Researchers have explored the creation of 2D alloy phases through heteroatom doping, a strategy employed to fine-tune the band structure of these materials. Current research on 2D alloy materials encompasses diverse aspects like synthesis methods, catalytic reactions, energy band modulation, high-voltage phase transitions, and potential applications in electronics and optoelectronics. This paper comprehensively analyses 2D TMD alloy materials, covering their growth, preparation, optoelectronic properties, and various applications including hydrogen evolution reaction catalysis, field-effect transistors, lithium-sulphur battery catalysts, and lasers. The growth process and characterisation techniques are introduced, followed by a summary of the optoelectronic properties of these materials.

Few-shot fine-grained image classification aims to solve the learning problem with few limited labeled examples. The existing methods use data augmentation to randomly transform the original examples to get new examples, and then use the new examples to train the model to improve the robustness and generalization ability of the learnt model. Due to each iteration of these methods uses a random transformation to get a new example, it will cause the unstable problem of the class center in the feature measurement stage. To solve this problem, a Multi-view Metric Learning (MML) method is proposed, which is based on a new concept (View Bag) and its effective similarity measurement method to achieve better few-shot fine-grained image classification. Firstly, a new example obtained by a kind of data augmentation is defined as a view, and a set of views generated by multiple data augmentation is defined as a view bag. Then, the view bag is sent into the model to extract the features, and a multi-view metric method with the view bag as the object is proposed to overcome the unstable problem of the class center. Finally, classification is performed by measuring the similarity between view bags. Experiments are conducted on three public datasets, CUB-2011-200, Stanford-Dogs and Stanford-Cars. The proposed method achieves 71.61±0.87%, 57.78±0.96% and 74.02±0.84% for the 5-way 1-shot classification task, and 88.72±0.51%, 76.30±0.68% and 92.94±0.37% for the 5-way 5-shot classification task, which have the state-of-the-art performances. Under the condition of the same backbone network, the proposed multi-view metric method can measure the similarity between examples more effectively, and improve the robustness and generalization ability of the model.

Abstract Circular RNAs (circRNAs) feature prominently in regulating the malignant biological behaviors of colorectal cancer (CRC), including cell viability, cell cycle progression, apoptosis, migration, invasion, and so on. This study is performed to probe into the biological function and molecular mechanism of circ_0087862 in CRC. The expression profile of GSE138589 was available from Gene Expression Omnibus (GEO), and the differentially expressed circRNAs were analyzed by GEO2R. The expression of circ_0087862, miR‐142‐3p, and BACH1 mRNA in CRC tissues and cells was measured by qRT‐PCR. CCK‐8 assay was employed to determine the proliferation of CRC cells. Scratch wound healing and transwell assays were used to examine the migration and invasion of CRC cells. The targeting relationships between circ_0087862 and miR‐142‐3p, and between miR‐142‐3p and BACH1 3′UTR were verified by dual‐luciferase reporter gene assay and RIP assay. BACH1 protein expression was probed by western blot. Circ_0087862 was highly expressed in CRC tissues and cell lines. Knocking down circ_0087862 significantly restrained the multiplication, migration and invasion of CRC cells. miR‐142‐3p inhibition weakened the impact of circ_0087862 knockdown on CRC cells. Circ_0087862 regulated BACH1 expressions by targeting miR‐142‐3p. Circ_0087862 regulates BACH1 expressions through sponging miR‐142‐3p, and promotes the proliferation, migration, and invasion of CRC cells.

Abstract Purpose To explore the effect of tumor thrombus growing against the direction of venous return (GADVR) tumor thrombus on the choice of surgical approach, the impact on the complexity of the surgery and the prognosis. Methods We retrospectively analyzed the clinicopathological data of 213 patients, who underwent surgery in a single center of Peking University Third Hospital between January 2016 and June 2020. For right renal cell carcinoma (RCC) and venous tumor thrombus (VTT), imaging revealed a filling defect in the left renal vein, which was significantly enhanced in enhanced imaging, suggesting that the tumor thrombus grew against the direction of venous return into the left renal vein. For left RCC and VTT, at least one of the left renal vein branches has tumor thrombus. The branches include the left adrenal vein, the left gonadal vein (testicular vein or ovarian vein), and the left ascending lumbar vein. The patients were divided into two groups according to whether they were GADVR tumor thrombus, and we compare the clinicopathological characteristics of GADVR tumor thrombus and non-GADVR tumor thrombus. Univariate and multivariate Cox regression analyses were performed to explore the risk factors that affect the prognosis of patients with RCC and VTT. Kaplan–Meier plots were conducted to evaluate the effect of GADVR on progression-free survival (PFS). Results Compared with non-GADVR tumor thrombus, patients with GADVR tumor thrombus had a higher proportion of open surgery (76.2% vs. 52.1%, P = 0.035), a higher proportion of tumor thrombus adhering to the inferior vena cava (IVC) vessel wall (81% vs. 45.8%, P = 0.002), a higher proportion of segmental resection of the IVC vessel wall (61.9% vs. 15.6%, P

The authors invented a textile magnetoelastic generator, weaving 1D soft fibers with conductive yarns to couple the observed magnetoelastic effect with magnetic induction, which paves a new way for biomechanical-to-electrical energy conversion.

Abstract Background To analyze the influence of inferior vena cava (IVC) interruption for perioperative and oncological results in patients with renal cell carcinoma and tumor thrombus and summarize the surgical strategies of IVC interruption for different situations. Methods We retrospectively analyzed the clinical and pathological data of 103 patients in our center. Patients were divided into two groups with 32 cases (31.1%) underwent IVC interruption (Group 1) while 71 cases (68.9%) did not. For comparison of continuous variables, the Mann–Whitney U test was used. For comparison of categorical variables, Chi-square tests were used. A propensity score based matching method was used to eliminate possible bias. Kaplan–Meier plots were performed to evaluate the influence of IVC interruption on overall survival and cancer specific survival. All the statistical analyses were performed using SPSS 24. A P value

Abstract Since its outbreak in 2019, COVID‐19 becomes a pandemic, severely burdening the public healthcare systems and causing an economic burden. Thus, societies around the world are prioritizing a return to normal. However, fighting the recession could rekindle the pandemic owing to the lightning‐fast transmission rate of SARS‐CoV‐2. Furthermore, many of those who are infected remain asymptomatic for several days, leading to the increased possibility of unintended transmission of the virus. Thus, developing rigorous and universal testing technologies to continuously detect COVID‐19 for entire populations remains a critical challenge that needs to be overcome. Wearable respiratory sensors can monitor biomechanical signals such as the abnormities in respiratory rate and cough frequency caused by COVID‐19, as well as biochemical signals such as viral biomarkers from exhaled breaths. The point‐of‐care system enabled by advanced respiratory sensors is expected to promote better control of the pandemic by providing an accessible, continuous, widespread, noninvasive, and reliable solution for COVID‐19 diagnosis, monitoring, and management.

Background and aimsThere are limited studies describing the association between dietary intake of one-carbon metabolism nutrients and hyperglycemia. The present study aimed to investigate the association of habitual dietary intake of one-carbon metabolism nutrients with hyperglycemia in a fluorosis area in China, and explored the interaction between these nutrients and fluorosis related to hyperglycemia.MethodIn a cross-sectional study, we recruited 901 villagers, ages ranging from 18–75, in Guizhou Province. Dietary data and other covariate data were obtained through an interviewer-administered questionnaire. We collected venous blood samples from participants who had fasted for one night to obtain fasting blood glucose levels and we categorized dietary intake of betaine, total choline, methionine, folate, vitamins B6 and B12, and choline subclasses into quartiles (Q1–Q4). The lowest quartile (Q1) served as the reference group. An unconditional logistic regression model was used to evaluate the protective effects of a dietary intake of one-carbon nutrients against hyperglycemia. We calculated Odds Ratios (ORs) with 95% confidence intervals (CIs). A presence or absence of fluorosis subgroup analysis was performed to determine the potential effect of fluorosis on hyperglycemia.ResultAfter adjusting for potential confounding factors, we found that a greater intake of dietary vitamin B6, total choline and methyl-donor index was inversely associated with the occurrence of hyperglycemia (P-trend 0.05). The results of subgroup analysis showed that dietary intake of folate, vitamin B6, total choline, free choline, glycerol phosphorylcholine, and phosphocholine had a protective effect against the occurrence of hyperglycemia in the non-fluorosis subgroup, although no effects were observed in the fluorosis subgroup. There were significant interactions between these nutrients and fluorosis (P = 0.010–0.048).ConclusionThe study demonstrated that higher dietary intake of vitamin B6, total choline, methyl-donor index, free choline, glycerol phosphorylcholine, and phosphocholine in choline compounds were associated with a lower incidence of hyperglycemia. Moreover, the associations were modified by the presence or absence of fluorosis. Further investigation is needed to test the association in large-scale follow-up studies.

In view of the insufficient analysis of the coupled joint seismic response of the intake tower–reservoir water–foundation boundary under the oblique incidence of SV wave space, a three-dimensional dynamic equation of the oblique incidence of SV wave space is established in this paper. The external wave input method of viscoelastic artificial boundary combined with equivalent load and the acoustic medium theory are used to simulate the action of reservoir water, and the angle change in the SV wave incidence is realized by controlling the incident vector. The dynamic response of the structure is analyzed and the dynamic response characteristics of the structure at different incidence angles are discussed. The results show that the dynamic response and damage degree of the intake tower decreases first and then increases with the change in angle. When the vertical incidence is 0°, the maximum displacement drop is 82.05%, and the displacement response of the intake tower is more sensitive to the change in SV wave incidence angle. When SV wave is vertically incident at 0° and 35° (near the maximum critical angle of incident), the dynamic response, dynamic water pressure, damage diffusion velocity, damage area, and damage degree of the intake tower are relatively large, which seriously affects the safety and stability of the intake tower. Therefore, the influence of the oblique incidence should be considered comprehensively in the aseismic stability design of the water intake tower to provide a new idea for the safety evaluation of the same type of engineering.

At present, traditional seismic design methods often ignore the structural damage caused by aftershocks in the evaluation of structural stability. In this paper, seven main aftershock sequences were constructed by using the attenuation method. The incremental dynamic analysis method (IDA) was used to analyze the nonlinear dynamic time history of the aqueduct structure. The main aftershock vulnerability curve of the aqueduct structure was obtained by taking the seismic intensity IM and the maximum ratio of the plastic strain energy to the total strain energy Dp as the structural performance parameter. The analysis results show that the residual displacement of the aqueduct increases by 33%, 66%, 44%, 37%, 0.01%, 60%, and 59%, respectively, under the seven main aftershock sequences. The incremental damage percentages of the aftershock at the end of the period were 9.85%, 15.00%, 26.53%, 2.10%, 0.9%, 35.97%, and 9.85%, respectively. The main aftershock made the damage at the bottom of the arch and the aqueduct more extensive. When the earthquake intensity is 0.3 g, the exceedance probabilities of moderate damage and severe damage are 62.68% and 14.39%, respectively, under the action of the main aftershock sequence. The exceedance probabilities under the action of the main aftershock sequence are 38.52% and 12.08% higher than that of the single main earthquake, respectively.

The Jiaopenba landslide, which represents a typical large basalt high-speed remote landslide, is located in Emeishan City, southwestern Sichuan province, China. Based on the field investigation, the characteristics of the Jiaopenba landslide have been revealed. The Jiaopenba landslide occurred on the steep Mount Emei. Landslide materials with a volume of approximately 6.75×108 m3 slid down from a high position, forming a large-scale high-speed remote debris flow, with the farthest sliding distance of about 7.5 km. The landslide area is located in the west wing of the Emeishan anticline, which is cut by faults to form a monoclinal fault-block mountain. Although the shear outlet of the landslide is near the slope toe and does not have good free conditions, there are faults passing through the slope toe of the bedding slope of the fault hanging wall, the landslide is affected by the fault activity, and the integrity of the layered slope is poor. When the foot of the slope is empty, the fault zone is compressed and plastic extrusion, which leads to bedding slip of the slope rock mass and greatly weakens the interlayer bonding force. When coupled with long structural planes on both sides to form side crack planes, a large-scale inclined plate structure is formed. Under the action of a strong earthquake and other external forces, the rock mass near the fault can be damaged by tension, and a large-scale high-position landslide can be formed by the mode of compression-slip-tension fracture.

BackgroundTo propose a quantitative model for predicting the surgical complexity of patients with renal cell carcinoma (RCC) and venous tumor thrombus (VTT).MethodThe clinical data of 226 cases of RCC with VTT in Peking University Third Hospital from January 2014 to August 2020 were retrospectively analyzed. Seven indicators were selected to establish the T.H.R.O.B.V.S. system, including alkaline phosphatase, tumor thrombus height, maximum tumor diameter, obesity, bland thrombus, vascular wall invasion, and side. Each indicator was assigned with 0, (1), and 2 points, and the total scores of 0~2, 3~5, and ≥6 were set as the low-, middle-, and high-risk groups, respectively. The surgical complexity was compared and validated among groups.ResultsAs the risk increased, the proportion of open surgery significantly increased (P

ObjectiveTo explore the role of tumor volume (TV) on surgical approach choice, surgical complexity, and postoperative complications in patients with renal cell carcinoma (RCC) and inferior vena cava tumor thrombus.MethodFrom January 2014 to January 2020, we retrospectively analyzed the clinical data of 132 patients who underwent radical nephrectomy with inferior vena cava thrombectomy (RN-IVCT). Primary renal tumor volume (PRTV), renal vein tumor thrombus volume (RVTTV), inferior vena cava tumor thrombus volume (IVCTTV), and total tumor thrombus volume (TTTV) were measured with the help of an internationally recognized 3D volume measurement software. The patients were divided into three groups according to the tumor volume within the inferior vena cava (IVC). Group 1 included 48 patients with IVCTTV between 0 and 15 cm3 (36.6%), group 2 included 38 patients with IVCTTV between 16 and 30 cm3 (28%), and group 3 included 46 patients with IVCTTV above 30 cm3 (35%). The three IVCTTV groups, as well as four different volume groups, were compared in terms of surgical approach choice, surgical complexity, and postoperative complications. One-way ANOVA and a non-parametric test were used to compare the clinicopathological characteristics and distribution differences between the three groups.ResultThis study found significant differences among the three groups in the proportion of open surgery (P < 0.001), operation time (P < 0.044), intraoperative bleeding (P < 0.001), and postoperative complications (P < 0.001). When the four different volumes were compared, we found that for higher volumes IVCTTV and TTTV, open surgery is used more often compared with laparoscopic surgery (P < 0.001). In addition, with the increase in renal vein tumor thrombus volume, inferior vena cava tumor thrombus volume, and total tumor thrombus volume, the operation time also increased. Finally, with the increase in tumor thrombus volume and total tumor thrombus volume, the amount of intraoperative bleeding increased.ConclusionWith the increase in tumor volume, the proportion of open surgery and the incidence of postoperative complications increased. In addition, larger tumor volume prolongs operation time, increases intraoperative blood loss, and makes the surgery more complicated.

Abstract Purpose To explore the safety and effectiveness of delayed occlusion of the proximal inferior vena cava (DOPI) technique in retroperitoneal laparoscopic radical nephrectomy (LRN) and thrombectomy for renal tumor with level II-III venous tumor thrombus (VTT). Materials and methods From August 2016 to October 2018, a total of 145 patients with renal tumor and VTT were admitted to our centre. Seventy-five patients underwent laparoscopic surgery, and 70 patients underwent open surgery. Among these patients, 17 patients underwent retroperitoneal LRN and thrombectomy with the DOPI technique. Clinical data were collected retrospectively, and a descriptive statistical analysis was conducted. Results All the patients successfully underwent retroperitoneal laparoscopic surgery. The mean operation time was 345.9 ± 182.9 min, the mean estimated blood loss was 466.7 ± 245.5 ml. Postoperative complications occurred in three patients, including two patients of Clavien grading system level IVa and one patient of level II. There were no complications related to carbon dioxide pneumoperitoneum, such as gas embolism, acidosis, and subcutaneous emphysema. During 21 months of median follow-up time, no local recurrence was found, and distant metastasis occurred in four patients. Cancer-specific death occurred in two patients. Conclusions The DOPI technique is safe and feasible in the treatment of renal tumor and level II-III VTT. With the DOPI technique, the procedures of dissociating and exposing proximal inferior vena cava are simplified.

Objective: To compare the operation complexity and prognosis of completely laparoscopic versus open radical nephrectomy and infrahepatic tumor thrombectomy. Methods: We reviewed and analyzed the clinical data of 87 patients with infrahepatic tumor thrombus from January 2015 to April 2019 retrospectively. Completely laparoscopic infrahepatic tumor thrombectomy was completed in 41 cases, and open surgery was completed in 46 cases. Results: All 41 patients successfully completed laparoscopic operation, and there were no cases of death during the operation. The completely laparoscopic group were older, had smaller renal tumor diameter, shorter median operation time, lower median intraoperative hemorrhage volume, and lower median transfusion volume of suspended red blood cells compared with open surgeries. The proportion of low-level tumor thrombus (Mayo I) in the completely laparoscopic group was higher (63.4%), while the proportion of low-level tumor thrombus in the open surgery group was lower (30.4%) (P = 0.002). The postoperative complications incidence of laparoscopic surgery was 19.5%, which was lower than that of open surgery (47.8%) (P = 0.004). The mean cancer-specific survival time of the laparoscopic surgery group was 36.6 ± 2.5 months, while that of the open surgery group was 32.3 ± 2.7 months (P = 0.277). There was no statistical difference between the two groups. Conclusion: Although completely laparoscopic radical nephrectomy and infrahepatic tumor thrombectomy is a challenging operation, it could be feasible and safely performed, especially in the hands of highly-experienced laparoscopic urologists for well selected cases.

Urban rail transit has become an important traffic mode in large cities and has brought great conveniences to urban residents, however traffic accidents often occur in daily operations, therefore the safety and robustness must be paid more attention. In this paper, the network utilization of urban rail transit networks (URTNs) is expressed by the travel time difference between user equilibrium and optimal system, and the travel time difference is considered as the assessment indicator of robustness. Meanwhile, Shanghai metro network is taken as the example to analyze the robustness of URTNs under different disturbances, such as node attack, link-demand attack and overall-demand attack. The results show that URTNs have better robustness subjected to the random link-demand attack than node attack, and the robustness decreases with the increase of the attack intensity when the network suffers overall-demand attack. Moreover, we find that the critical stations and links can be identified, and URTNs can be paralyzed when the attack intensity exceeds the critical threshold.

Abstract Background Autosomal recessive cutis laxa type IC (ARCL IC, MIM: #613177) results from a mutation in the LTBP4 gene (MIM: #604710) on chromosome 19q13. Case presentation A 28-day-old Chinese infant with generalized cutis laxa accompanied by impaired pulmonary, gastrointestinal, genitourinary, retinal hemorrhage, abnormality of coagulation and hyperbilirubinemia was admitted to our hospital. To find out the possible causes of these symptoms, whole-exome sequencing was performed on the infant. Two novel pathogenic frame-shift variants [c.605_606delGT (p.Ser204fs * 8) and c.1719delC (p.Arg574fs * 199)] of the LTBP4 gene associated with ARCL IC were found which was later verified by Sanger sequencing. The pathogenicity of mutations was subsequently assessed by several software programs and databases. In addition, an analytical review on the clinical phenotypes of the disease previously reported in literature was performed. Conclusions This is the first report of a Chinese infant with ARCL IC in China due to novel pathogenic variations of LTBP4. Our study extends the cutis laxa type IC mutation spectrum as well as the phenotypes associated with the disease in different populations.

BackgroundThis study aims to report the surgical management, complications, and outcomes for patients with retroperitoneal tumor and venous thrombus.MethodsWe retrospectively analyzed 19 cases of retroperitoneal tumor with venous tumor thrombus from August 2015 to March 2021. A new tumor thrombus PUTH-RT grading system was proposed on the basis of the characteristics of the surgical techniques.ResultsTwo cases of PUTH-RT-1a, two cases of PUTH-RT-1b, six cases of PUTH-RT-2, six cases of PUTH-RT-3, and three cases of PUTH-RT-4 were included. Surgeries were successfully performed in all 19 patients. Among them, five cases (26.3%) were operated via a completely laparoscopic approach and 13 cases (68.4%) via an open approach. One case (5.3%) was converted from laparoscopic to open approach. Five cases (26.3%) experienced postoperative complications. All patients were followed for a median of 14 months. Cancer-associated death occurred in three cases. Distant metastases occurred in seven cases.ConclusionsWe propose a new tumor thrombus grading system based on the anatomical characteristics of retroperitoneal tumors with venous tumor thrombus. Retroperitoneal tumor resection and removal of venous tumor thrombi are safe and effective for the treatment of such diseases.

BackgroundOxidative stress plays an important role in the pathogenesis of endemic fluorosis. We analyzed associations between oxidative stress-related gene polymorphisms (PON1 rs662, CAT rs769217, rs2300182, and SOD2 rs11968525) and skeletal fluorosis, and examined potential gene–environment interactions with dietary vitamin C, vitamin E, zinc, and selenium intake.MethodsA cross-sectional study was conducted in the Zhijin County, Guizhou Province of China. Skeletal fluorosis was identified according to the Chinese Diagnostic Criteria of Endemic Skeletal Fluorosis. Dietary information was assessed through face-to-face interviews by trained interviewers using a 75-item food frequency questionnaire. The genotype was detected by high throughput TaqMan-MGB RT-PCR technology. Odds ratios (ORs) and 95% CIs were calculated using an unconditional logistic regression model.ResultsIntake of vitamin E, zinc, and selenium was found to be inversely associated with the risk of skeletal fluorosis. The multivariable-adjusted ORs were 0.438 (95% CI: 0.268 to 0.715, P-trend < 0.001) for vitamin E, 0.490 (95% CI: 0.298 to 0.805, P-trend = 0.001) for zinc, and 0.532 (95% CI: 0.324 to 0.873, P-trend = 0.010) for selenium when comparing the highest with the lowest quartile. The relationship for vitamin C was not observed after adjustment for risk factors. Furthermore, participants with PON1 rs662 AA genotype had a significantly decreased risk of skeletal fluorosis compared with those with the GG genotype (OR = 0.438, 95% CI: 0.231 to 0.830). GG + AG genotype carriers were 2.212 times more likely to have skeletal fluorosis than AA carriers (OR = 2.212, 95% CI: 1.197 to 4.090). Compared with AA carriers, AG carriers had a 2.182 times higher risk of skeletal fluorosis (OR = 2.182, 95% CI: 1.143 to 4.163). Although we observed the risk of skeletal fluorosis was higher with a lower intake of antioxidant nutrients, the potential interactions between nutrient intake and genetic polymorphisms were not observed.ConclusionParticipants with a higher intake of vitamin E, zinc, and selenium have a lower likelihood of skeletal fluorosis. In addition, the PON1 rs662 polymorphism is related to skeletal fluorosis.

Background: Few studies have reported the influence of the histological classification of type-2 papillary renal cell carcinoma (PRCC), which may differ from that of clear cell renal carcinoma (ccRCC), on the prognosis of renal cell carcinoma with tumor thrombus. We investigated the clinicopathological features and prognosis of type-2 PRCC associated with venous tumor thrombi (PRCC-TT). Methods: We retrospectively analyzed 163 patients with renal cell carcinoma with venous tumor thrombus (RCC-TT) admitted to Peking University Third Hospital between June 2016 and June 2020. Twenty-five patients had type-2 PRCC-TT and 138 had ccRCC combined with tumor thrombus; there were 125 males and 38 females. All the included patients underwent radical nephrectomy and thrombectomy under either complete laparoscopic surgery or open surgery. Univariate and multivariate Cox regression analysis were performed to evaluate the prognostic significance of each variable on cancer-specific survival (CSS). Cancer-specific survival was calculated from the date of surgery to death or the last follow-up using the Kaplan–Meier method. Results: The blood vessels of type-2 PRCC-TT presented on CT images were not as abundant as those of ccRCC-TT. Slight enhancement was observed in the corticomedullary phase. While wash-out symptoms were observed, contrast agent extinction was not obvious in the nephrographic and excretory phases. We compared the macroscopic and microscopic appearances of the 2 cohorts. Compared to the ccRCC-TT cohort, lymph node invasion was more prevalent in the PRCC-TT cohort (88.0% vs. 60.9%, P = .009). Multivariate analysis revealed that sarcomatoid differentiation, distant metastasis, and pathological type were the independent predictors of poor CSS. The Kaplan–Meier analysis showed that the CSS of type-2 PRCC-TT and ccRCC-TT were 23.5 and 38.4 months, respectively, with statistical significance ( P = .002). Conclusion: Type-2 PRCC-TT varies with common ccRCC-TT in imaging manifestation and pathological characteristics. The prognosis of type-2 PRCC-TT patients was worse than that of ccRCC-TT patients.

Summary: An increasing demand for electric vehicles and flexible electronics focuses attention on developing a safe, high-energy, and sustainable battery that can work under severe conditions. Emerging high-voltage aqueous batteries based on highly concentrated salts and molecular crowding electrolytes are likely to be hampered by their poor low-temperature performance because of a high freezing point and salting out at low temperature. Inspired by the antifreezing ionogel electrolyte for transport measurements at subzero temperatures, we design a water-in-ionogel electrolyte with a low salt-concentration (2m NaTFSI) and high operational voltage (3.0 V) by changing the hydrogen bonding and introducing fluoride additives for low-temperature operation. A full cell with a P2-type Na2/3Mn2/3Co1/3O1.98F0.02 cathode and hard-carbon anode could deliver high energy densities of 109 and 23.4 Wh kg−1 at room temperature and −25°C. This eco-friendly aqueous polymeric battery could be free sealed and perform in water. This work opens an avenue for designing high-energy, free-sealed aqueous batteries for low-cost, sustainable energy storage, enabling subzero temperature operation.

Abstract Background We aimed to explore the causal analysis, clinical characteristics and treatment strategies of laparoscopic conversion to open approach (LCTOA) in radical nephrectomy and tumor thrombectomy. Methods We included all patients with Mayo level I–III renal tumors with inferior vena cava (IVC) tumor thrombus who underwent laparoscopic radical nephrectomy and tumor thrombectomy as the first choice from May 2015 to July 2019. Results There were 70 cases of renal tumor with IVC tumor thrombus treated with a laparoscopic approach as the first choice; 31 Mayo level I, 30 Mayo level II, and 9 Mayo level III. A completely laparoscopic approach was performed in 51 cases (72.9%), and 19 cases (27.1%) underwent active or passive LCTOA. The LCTOA group had higher median preoperative serum creatinine (110.0 μmol/L vs 92.0 μmol/L; P = 0.026), longer postoperative hospital stay (9 days vs 7 days; P = 0.008), longer median operation time (374 min vs 311 min; P = 0.017), higher median intraoperative hemorrhage volume (1300 vs 600 ml; P = 0.020), and higher proportion of male patients (94.7% vs 66.7%; P = 0.016) vs the completely laparoscopic group, respectively. Although preoperative serum creatinine and gender were risk factors in the univariate analysis, multivariate analysis revealed no independent risk factors for LCTOA. We divided the reasons for LCTOA into active conversion and passive conversion; 4 (21.1%) cases underwent active conversion, and 15 (78.9%) underwent passive conversion. Most of the patients undergoing passive conversion had multiple concurrent risk factors, among which perirenal adhesion (30.9%), organ invasion (16.4%), and IVC adhesion (25.5%) were the most common. Fourteen (73.7%) cases underwent renal treatment, and 5 (26.3%) cases underwent tumor thrombus treatment. Conclusions The LCTOA group had a higher median preoperative serum creatinine concentration, longer hospital stay, longer median operation time, and higher median intraoperative hemorrhage volume. However, none of the predictors in our study was an independent risk factor for LCTOA. Perirenal adhesion, organ invasion, and IVC adhesion were the most common causes of LCTOA. Considering the limitations of this study, studies with large sample sizes are required to validate our conclusions.

Abstract Objective To describe the clinical characteristics of renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and bland thrombus (BT), and to evaluate the influence of BT on surgical treatment and cancer‐specific survival (CSS) of RCC with VTT. Methods We retrospectively reviewed clinical data of 123 patients with RCC and VTT, who underwent surgical treatment in our center between February 2015 and May 2018. Patients were divided into the BT group (21 patients) and non‐BT group (102 patients). Chi‐square and Mann‐Whitney U test were used for categorical and continuous variables respectively. Univariable log‐rank tests and multivariable Cox regressions were conducted to evaluate the prognostic significance of each variable. Kaplan‐Meier plots were performed to evaluate the influence of BT. Results In the delayed phase of enhanced magnetic resonance imaging (MRI), BT and VTT had difference. Patients were divided according to the relative position of BT: proximal end BT (one patients), contralateral renal vein BT (two patients), distal end BT (12 patients), and multiple BT (six patients). The average length of BT was 8.4 ± 5.8 cm (range: 0.6‐20.0 cm). Patients with BT had longer operative time (P = .001), more surgical blood loss (P = .004), higher proportion of open surgery (P = .006), more postoperative complications (P = .011). BT (hazard ratio [HR] = 3.323, P = .007) were independent risk factors for poor prognosis. Conclusions In the delayed phase of enhanced MRI, BT showed no obvious enhancement, while VTT usually showed enhancement. This was an important basis for preoperative imaging diagnosis of BT. The presence of BT increases the difficulty of surgery, and is correlated with adverse survival outcomes in patients with RCC and VTT.

Abstract. Background. Radical nephrectomy and thrombectomy is the standard surgical procedure for the treatment of renal cell carcinoma (RCC) with tumor thrombus (TT). But the estimation of intra-operative blood loss is only based on the surgeon's experience. Therefore, our study aimed to develop Peking University Third Hospital score (PKUTH score) for the prediction of intra-operative blood loss volume in radical nephrectomy and thrombectomy. Methods. The clinical data of 153 cases of renal mass with renal vein (RV) or inferior vena cava tumor thrombus admitted to Department of Urology, Peking University Third Hospital from January 2015 to May 2018 were retrospectively analyzed. The total amount of blood loss during operation is equal to the amount of blood sucked out by the aspirator plus the amount of blood in the blood-soaked gauze. Univariate linear analysis was used to analyze risk factors for intra-operative blood loss, then significant factors were included in subsequent multivariable linear regression analysis. Results. The final multivariable model included the following three factors: open operative approach (P

Although fine-grained image classification is able to classify more fine-grained sub-categories compared to its coarse-grained counterpart, it often fails to identify individual instances. Therefore, we propose a new instance-level image classification task which further refines the granularity of fine-grained classification in order to identify unique instances rather than a sub-category containing multiple instances. In addition, we introduce an instance-level image classification dataset, AircraftCarrier, which contains 20 global aircraft carrier classes, as the first publically available dataset for instance-level image classification. The classification of instance-level aircraft carriers can prove to be a challenging task due to large intra-category differences as well as variations in the camera view, illumination, scale, and the presence of complex backgrounds. The AircraftCarrier dataset put forward here has the potential to improve the development of instance-level image classification. At the same time, we provide a Simple Classification Head (SCH) technique for the classification of aircraft carriers, with classical convolutional neural network models as the backbone network. The SCH has better performance than a direct classification head, and these results provide a benchmark performance result for researchers. Furthermore, we evaluate several fine-grained image classification methods and give their benchmark results. Finally, we present the challenges of instance-level classification and discuss further directions. This study provides the first publicly available instance-level image classification dataset and a performance benchmark for further research. The dataset and codes can be downloaded at https://github.com/tsingqsu/AircraftCarrier_Dataset/.

BackgroundTo evaluate the impact of deep invasive tumor thrombus (DITT) on the surgical complexity and prognosis of patients with renal cell carcinoma with venous tumor thrombus.MethodsWe retrospectively reviewed clinical data of 138 patients with non-metastatic renal cell carcinoma combined with venous tumor thrombus, who underwent surgical treatment in Peking University Third Hospital from January 2015 to June 2020. Patients were divided into the DITT group (84 patients) and non-invasive tumor thrombus (NITT) group (54 patients). Chi-square, t-test and Mann–Whitney U test were used for categorical and continuous variables, respectively. Kaplan–Meier plots were performed to evaluate the influence of DITT. Univariable and multivariable Cox regressions were conducted to determine independent prognostic factors and then assembled to make a nomogram to predict the survival. The performance of the nomogram was evaluated by Harrell’s consistency index (C-index) and calibration plot.ResultsDeep invasive tumor thrombus significantly increased the difficulty of surgery for patients with renal cell carcinoma with venous tumor thrombus, which is mainly reflected in longer operation time (p < 0.001), more surgical bleeding (p < 0.001), a higher proportion of perioperative blood transfusion (p = 0.006), a higher proportion of open surgery (p = 0.001), a longer postoperative hospital stay (p = 0.003), and a higher proportion of postoperative complications (p = 0.001). DITT (hazard ratio [HR] = 2.781, p = 0.040) was one of the independent risk factors for worse prognosis. Multivariate analysis showed that sarcoma-like differentiation (p = 0.040), tumor thrombus invasion (p = 0.040), low hemoglobin (p = 0.003), and pathological type (p < 0.001) were independent prognostic factors. The nomogram, combining all these predictors, showed powerful prognostic ability with a C-index of 78.8% (CI: 71.2%–86.4%). The predicted risk closely matches the observed recurrence probability.ConclusionDeep invasive tumor thrombus significantly increased the difficulty of surgeries for patients of renal cell carcinoma with venous tumor thrombus, and may lead to poor prognosis.

Background: The incidence of small renal mass (SRM) increases, and the prognosis of SRM is poor once metastasized. Therefore, we conducted this study to assess the clinical and pathological characteristics of SRM to determine the risk factors that influence the metastasis and prognosis of SRM. Methods: A small renal mass is defined as a solid tumor mass with the largest diameter of 4 cm or less on the pathological diagnosis. The metastasis is confirmed by imaging or pathological examination. We retrospectively included 40 patients with metastatic SRM (mSRM) treated in the department of urology of Peking University Third Hospital from October 2002 to October 2020. Meanwhile, 358 patients with nonmetastatic SRM treated in our hospital from January 2015 to December 2017 were selected as controls. Clinicopathologic features were compiled. Results: Multivariate logistic regression analysis showed that age ( P = .027, odds ratio [OR] = 1.037, 95% confidence interval [CI] 1.004-1.070), clinical symptoms ( P

PurposeTo explore the different treatment strategies for urinary tumors with Mayo IV thrombus.Materials and MethodsWe retrospectively analyzed the patients with Mayo IV thrombus in Peking University Third Hospital from January 2014 to April 2021. We used the Peking University Third Hospital (PUTH) grading system to classify urinary tumors with supradiaphragmatic thrombus. PUTH-A referred to the filled thrombus whose tip just reached above the diaphragm, or the thrombus entering the right atrium (< 2cm). PUTH-B referred to the filled thrombus entering the right atrium (> 2cm), or the thrombus invading the wall of the inferior pericardial vena cava. Detailed techniques were described for various scenarios. Clinicopathological data and perioperative outcomes were reported. Group difference statistical analysis was performed.ResultsA total of 26 cases of urinary tumors with supradiaphragmatic IVC thrombus (Mayo grade IV) underwent treatment were enrolled in this study. 19 patients in the PUTH-A group received the open approach without sternotomy and cardiopulmonary bypass. Seven patients in the PUTH-B group received open thoracotomy assisted by cardiopulmonary bypass. No intraoperative death occurred. After 56 months of follow-up, 46.2% (12 of 26) patients died of all causes. Estimated 1-year, 2-year, and 3-year overall survival were 72.0% (95% CI, 54.4%-89.6%), 58.2% (95% CI, 38.0%-78.4%), and 52.4% (95% CI, 31.2%-73.6%), respectively.ConclusionsWe introduced the PUTH grading system for the characteristics of urinary tumors with supradiaphragmatic tumor thrombus, and selected different surgical techniques according to different classifications. This grading system was relatively feasible and effective.

Ambient energy harvesting has great potential to contribute to sustainable development and address growing environmental challenges. Converting waste energy from energy-intensive processes and systems (e.g. combustion engines and furnaces) is crucial to reducing their environmental impact and achieving net-zero emissions. Compact energy harvesters will also be key to powering the exponentially growing smart devices ecosystem that is part of the Internet of Things, thus enabling futuristic applications that can improve our quality of life (e.g. smart homes, smart cities, smart manufacturing, and smart healthcare). To achieve these goals, innovative materials are needed to efficiently convert ambient energy into electricity through various physical mechanisms, such as the photovoltaic effect, thermoelectricity, piezoelectricity, triboelectricity, and radiofrequency wireless power transfer. By bringing together the perspectives of experts in various types of energy harvesting materials, this Roadmap provides extensive insights into recent advances and present challenges in the field. Additionally, the Roadmap analyses the key performance metrics of these technologies in relation to their ultimate energy conversion limits. Building on these insights, the Roadmap outlines promising directions for future research to fully harness the potential of energy harvesting materials for green energy anytime, anywhere.

Background: Hypophosphatasia (HPP) is an autosomal genetic disorder characterized biochemically by abnormal of bone parameters and serum alkaline phosphatase (ALP) activity as well as clinically by deficiency of teeth and bone mineralization. The clinical presentation is a continuum ranging from a prenatal lethal form with no skeletal mineralization to a mild form with late adult onset presenting with non-pathognomonic symptoms. ALP deficiency is the key to the pathogenesis of abnormal metabolism and skeletal system damage in HPP patients.Methods: We investigated five patients with skeletal dysplasia in the clinic. Whole-exome sequencing was performed in order to aid diagnosis of the patients.Results: Eight variants in the ALPL gene in the five unrelated Chinese patients (PA-1: c.649_650insC and c.707A > G; PA2: c.98C > T and c.707A > G; PA3: c.407G > A and c.650delTinsCTAA; PA4: c.1247G > T (homozygous); PA5: c.406C > T and c.1178A > G; NM_000478.5) were found. These variations caused two types of HPP: perinatal HPP and Odonto HPP. All cases reported in this study were autosomal recessive. Among the variants, c.1247G > T/p.Gly416Val (PA-4); c.1178A > G/p.Asn393Ser (PA-5) and c.707A > G/p.Tyr236Cys (PA-1, PA-2) have never been reported before.Conclusion: Clinical phenotypes of perinatal HPP (PA-1,PA-2,PA-3 and PA-4) include skeletal dysplasia, shorter long bones, bowing of long bones, tetraphocomelia, abnormal posturing and abnormal bone ossification. Odonto HPP (PA-5) only presents as dental abnormality with severe dental caries and decreased ALP activity. Our study extends the pool of ALPL variants in different populations.

Objective: This study aimed to investigate the associations between dietary one-carbon metabolism-related nutrients (betaine, choline, methionine, folate, vitamin B6, and vitamin B12) and fluorosis among the Chinese population in an area known for coal-burning fluorosis.Methods: A cross-sectional study was conducted, with 653 fluorosis patients and 241 non-fluorosis participants. Dietary intake was acquired using a validated semi-quantitative 75-item food frequency questionnaire. The risk associations were assessed by unconditional logistical regression.Results: We observed a significant inverse association between dietary betaine, total choline, methionine, folate, vitamin B6, and choline species and fluorosis. The adjusted OR (95% CI) in the highest quartile of consumption compared with the lowest were 0.59 (0.37–0.94) (P-trend = 0.010) for betaine intake, 0.45 (0.28–0.73) (P-trend = 0.001) for total choline intake, 0.45 (0.28–0.72) (P-trend < 0.001) for methionine intake, 0.39 (0.24–0.63) (P-trend < 0.001) for folate intake, 0.38 (0.24–0.62) (P-trend < 0.001) for vitamin B6 intake, and 0.46 (0.28–0.75) (P-trend = 0.001) for total choline plus betaine intake. Dietary intakes of choline-containing compounds, phosphatidylcholine, free choline, glycerophosphocholine, and phosphocholine were also inversely associated with lower fluorosis (all P-trend < 0.05). No significant associations were observed between dietary vitamin B12 or sphingomyelin and fluorosis.Conclusion: The present study suggested that the higher dietary intakes of specific one-carbon metabolism-related nutrients, such as betaine, choline, methionine, folate, and vitamin B6, are associated with lower fluorosis prevalence.