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Abstract As a critical technology, anomaly detection ensures the smooth operation of cloud systems while maintaining the market competitiveness of cloud service providers. However, the resource data in real-world cloud systems is predominantly unannotated, leading to insufficient supervised signals for anomaly detection. Moreover, complicated topological associations existed between cloud servers (e.g., computation, storage, and communication). While acquiring resource information, correlating the system topology is challenging. To this end, we propose the GCAD for cloud system anomaly detection, which integrates data augmentation, GraphGRU, contrastive learning, and reconstruction. First, GCAD constructs positive and negative sample pairs through the masking and Gaussian noise data augmentation. Then, the GraphGRU processes extended temporal graph data, extracting and fusing spatiotemporal features from resource status and system topology. In addition, GCAD introduces linear attention for encoding spatiotemporal representations to capture their global correlation information. The weight parameters of the encoder are optimized using a contrastive learning mechanism. Finally, GCAD utilizes a reconstruction technique to calculate anomaly scores, facilitating the evaluation of the state of the cloud system at each time point. Experimental results indicate that GCAD outperforms state-of-the-art compared methods on two real-world datasets that contain topology information.

Abstract Background Growth hormone-secreting pituitary neuroendocrine tumors can be pathologically classified into densely granulated (DGGH) and sparsely granulated types (SGGH). SGGH is more aggressive and associated with a poorer prognosis. While epigenetic regulation is vital in tumorigenesis and progression, the role of N6-methyladenosine (m6A) in aggressive behavior has yet to be elucidated. Methods We performed m6A-sequencing on tumor samples from 8 DGGH and 8 SGGH patients, complemented by a suite of assays including ELISA, immuno-histochemistry, -blotting and -fluorescence, qPCR, MeRIP, RIP, and RNA stability experiments, aiming to delineate the influence of m6A on tumor behavior. We further assessed the therapeutic potential of targeted drugs using cell cultures, organoid models, and animal studies. Results We discovered a significant reduction of m6A levels in SGGH compared to DGGH, with an elevated expression of fat mass and obesity-associated protein (FTO), an m6A demethylase, in SGGH subtype. Series of in vivo and in vitro experiments demonstrated that FTO inhibition in tumor cells robustly diminishes hypoxia resistance, attenuates growth hormone secretion, and augments responsiveness to octreotide. Mechanically, FTO-mediated m6A demethylation destabilizes desmoplakin (DSP) mRNA, mediated by the m6A reader FMR1, leading to prohibited desmosome integrity and enhanced tumor hypoxia tolerance. Targeting the FTO-DSP-SSTR2 axis curtailed growth hormone secretion, therefor sensitizing tumors to octreotide therapy. Conclusion Our study reveals the critical role of FTO in the aggressive growth hormone-secreting pituitary neuroendocrine tumors subtype and suggests FTO may represent a new therapeutic target for refractory/persistent SGGH.

Abstract Load prediction tasks aim to predict the dynamic trend of future load based on historical performance sequences, which are crucial for cloud platforms to make timely and reasonable task scheduling. However, existing prediction models are limited while capturing complicated temporal patterns from the load sequences. Besides, the frequently adopted global weighting strategy (e.g., the self-attention mechanism) in temporal modeling schemes has quadratic computational complexity, hindering the immediate response of cloud servers in complex real-time scenarios. To address the above limitations, we propose a Wavelet decomposition-enhanced External Transformer (WETformer) to provide accurate yet efficient load prediction for cloud servers. Specifically, we first incorporate discrete wavelet transform to progressively extract long-term trends, highlighting the intrinsic attributes of temporal sequences. Then, we propose a lightweight multi-head External Attention (EA) mechanism to simultaneously consider the inter-element relationships within load sequences and the correlations across different sequences. Such an external component has linear computational complexity, mitigating the encoding redundancy prevalent and enhancing prediction efficiency. Extensive experiments conducted on Alibaba Cloud’s cluster tracking dataset demonstrate that WETformer achieves superior prediction accuracy and the shortest inference time compared to several state-of-the-art baseline methods.

Abstract Background This study aimed to elucidate the methodology and assess the efficacy of the aortic arch inclusion technique using an artificial blood vessel in managing acute type A aortic dissection (ATAAD). Methods We conducted a retrospective review of 18 patients (11 males and 7 females, average age: 56.2 ± 8.6 years) diagnosed with ATAAD who underwent total aortic arch replacement (TAAR) using an artificial vascular “inclusion” between June 2020 and October 2022. During the operation, deep hypothermic circulatory arrest (DHCA) and selective antegrade cerebral perfusion (ACP) of the right axillary artery were employed for brain protection. The ‘inclusion’ total aortic arch replacement and stented elephant trunk (SET) surgery were performed. Results Four patients underwent the Bentall procedure during the study, with one additional patient requiring coronary artery bypass grafting (CABG) due to significant involvement of the right coronary orifice. Three patients died during postoperative hospitalization. Other notable complications included two cases of postoperative renal failure necessitating continuous renal replacement therapy (CRRT), one case of postoperative double lower limb paraplegia, and one case of cerebral infarction resulting in unilateral impairment of the left upper limb. Eleven patients underwent computed tomography angiography (CTA) examinations of the aorta three months to one-year post-operation. The CTA results revealed thrombosis in the false lumen surrounding the aortic arch stent in seven patients and complete thrombosis of the false lumen around the descending aortic stent in eight patients. One patient had partial thrombosis of the false lumen around the descending aortic stent, and another patient’s false lumen in the thoracic and abdominal aorta completely resolved after one year of follow-up. Conclusions Incorporating vascular graft in aortic arch replacement simplifies the procedure and yields promising short-term outcomes. It achieves the aim of total arch replacement using a four-branch prosthetic graft. However, extensive sampling and thorough, prolonged follow-up observations are essential to fully evaluate the long-term results.

Abstract Urban green space is a direct way to improve the carbon sink capacity of urban ecosystems. The carbon storage assessment of megacity green spaces is of great significance to the service function of urban ecosystems and the management of urban carbon zoning in the future. Based on multi-period remote sensing image data, this paper used the CASA model and the InVEST model to analyze the spatio-temporal variation and driving mechanism of carbon storage in Shenzhen green space and discussed the applicability of the two models to the estimation of carbon storage in urban green space. The research results showed that, from 2008 to 2022, in addition to the rapid expansion of construction land, the area of green space and other land types in Shenzhen showed a significant decrease trend. The estimation results of the carbon storage model showed that the carbon storage of green space shows a significant trend of reduction from 2008 to 2022, and the reduction amounts are 0.8 × 106 t (CASA model) and 0.64 × 106 t (InVEST model), respectively. The evaluation results of the model show that, in megacities, the spatial applicability of InVEST model is lower than that of CASA model, and the CASA model is more accurate in estimating the carbon storage of urban green space. The research results can provide a scientific basis for the assessment of the carbon sink capacity of megacity ecosystems with the goal of "dual carbon".

The determination of the critical sliding surface is a crucial aspect of slope stability analysis. In reality, the environment in which slopes are located is often very complex, and the sliding surfaces have different shapes. Therefore, a three-dimensional stability study is proposed, using irregular ellipsoidal shapes as the sliding surface. By constructing the equation of the irregular ellipsoid and applying spatial geometric transformations, an irregular ellipsoid controlled by six parameters, (semi-axis length (a), width (b), height (c), rotation angle (θ), and spatial displacements (tx and tz)), is obtained. The interpolation method is employed to apply the irregular ellipsoid to 3D slopes, thereby generating irregular ellipsoidal sliding surfaces. The slope stability coefficient is calculated by using the residual thrust method and genetic algorithm to determine the critical sliding surface. A comparative stability analysis is conducted between the standard ellipsoidal sliding surface and the irregular ellipsoidal sliding surface through a classic case study. The results show that the Type II irregular ellipsoidal sliding surface aligns well with the mining area. Finally, the research findings are applied to the 3D slope stability analysis of the Shengli West No.2 Open-Pit Coal Mine in China, validating the feasibility of the proposed method.

Abstract The overall picture of degloving skin and soft tissue injuries (DSTI) remains a blank space in China. Therefore, a retrospective study was designed to summarize the current situation of this injury. Patients diagnosed with DSTI hospitalized between 2013 and 2018 were identified from the Hospital Quality Monitoring System (HQMS) database, of whom demographics, injury characteristics, hospitalization and cost information were analyzed. A total of 62,709 patients were enrolled in this study. Male sex predominated, with a mean age of 43.01 ± 19.70 years. Peasants seemed to be the most vulnerable. East China and Hubei province had the most patients. The most and least frequently injured anatomic site were lower extremity and torso, respectively. Traffic-related accidents and summer accounted for the highest proportion in terms of injury mechanism and season. The operation rate of DSTI roughly showed a growing trend, and the average length of stay was 22.02 ± 29.73 days. At discharge, 0.93% of DSTI patients ended up in death. Medicine accounted mostly for hospitalization cost, while the proportion decreased year by year. More than half DSTI patients paid at their own charge. This study made a relatively detailed description of DSTI patients nationwide, and might provide enlightenments for better prevention and treatment.

Abstract State-of-the-art cloud computing platforms such as Google Earth Engine (GEE) enable regional-to-global land cover and land cover change mapping with machine learning algorithms. However, collection of high-quality training data, which is necessary for accurate land cover mapping, remains costly and labor-intensive. To address this need, we created a global database of nearly 2 million training units spanning the period from 1984 to 2020 for seven primary and nine secondary land cover classes. Our training data collection approach leveraged GEE and machine learning algorithms to ensure data quality and biogeographic representation. We sampled the spectral-temporal feature space from Landsat imagery to efficiently allocate training data across global ecoregions and incorporated publicly available and collaborator-provided datasets to our database. To reflect the underlying regional class distribution and post-disturbance landscapes, we strategically augmented the database. We used a machine learning-based cross-validation procedure to remove potentially mis-labeled training units. Our training database is relevant for a wide array of studies such as land cover change, agriculture, forestry, hydrology, urban development, among many others.

Periaqueductal gray (PAG), an integration center for neuronal signals, is located in the midbrain and regulates multiple physiological and pathological behaviors, including pain, defensive and aggressive behaviors, anxiety and depression, cardiovascular response, respiration, and sleep-wake behaviors. Due to the different neuroanatomical connections and functional characteristics of the four functional columns of PAG, different subregions of PAG synergistically regulate various instinctual behaviors. In the current review, we summarized the role and possible neurobiological mechanism of different subregions of PAG in the regulation of pain, defensive and aggressive behaviors, anxiety, and depression from the perspective of the up-down neuronal circuits of PAG. Furthermore, we proposed the potential clinical applications of PAG. Knowledge of these aspects will give us a better understanding of the key role of PAG in physiological and pathological behaviors and provide directions for future clinical treatments.

In order to optimize the process conditions for the preparation of waxy rice resistant starch by ultrasonic annealing method, this study took the content of resistant starch as an index, and based on the single factor experiment, the response surface analysis method was used to explore the effects of water content, ultrasonic time, annealing temperature and annealing time on the content of resistant starch, and the physicochemical properties of the prepared resistant starch were analyzed. The results showed that the optimum conditions were as follows: Water content 68%, ultrasonic time 23 min, annealing temperature 55 ℃, annealing time 25 h. Under these conditions, the content of resistant starch was 45.61%±0.95%. Compared with original starch, the transparency of waxy rice resistant starch increased by 38.19%, and the solubility at 90 ℃ increased from 6.03% to 52.45%, while the swelling power decreased from 41.04 g/g to 6.38 g/g. Under scanning electron microscope, the surface morphology of resistant starch changed significantly, which showed that it was a rough structure with many holes. Fourier infrared spectroscopy showed that ultrasonic annealing promoted the generation of short-range ordered structures of starch. Differential scanning calorimetry analysis showed that the enthalpy of resistant starch increased by 5.05 J/g after ultrasonic annealing, and X-ray diffraction analysis displayed that the crystalline shape was changed and the crystallinity of resistant starch was improved. This study provided a reference for the industrial production of waxy rice resistant starch.

The evaluation of ecosystem service value (ESV) is crucial for decision making in regional sustainable development. The close relationship between ecosystem services and land use/cover change (LUCC) is well acknowledged. However, the impact of the mutual transformation among different land use types on the temporal and spatial differences in the ESV is still unclear. To fulfill this gap, this study evaluates the ESV in the Wuhan Urban Agglomerations based on LUCC, taking the spatiotemporal characteristics into consideration. The results show that (1) The land use structure in the Wuhan Urban Agglomerations has undergone great changes from 2012 to 2021, and the area of cultivated land converted to forest land is the largest, which may be related to policies such as returning farmland to forests. (2) The total amount of ESV shows a downward trend, and the spatial distribution of ESV is “low in the west and high in the central and eastern regions”, which may be related to the natural factors in study area. (3) The spatial distribution of ESV in the study area will remain unchanged in the future. However, the transformation among land use types may exacerbate the reduction in the total ESV, which will have an adverse impact on the ecological environment and sustainable development of the region. This study initiates a more comprehensive framework to better reflect the real scenario of ESV, which will hopefully provide a reference for regional sustainable development.

Immunotherapies have shown significant promise as an impactful strategy in cancer treatment. However, in glioblastoma multiforme (GBM), the most prevalent primary brain tumor in adults, these therapies have demonstrated lower efficacy than initially anticipated. Consequently, there is an urgent need for strategies to enhance the effectiveness of immune treatments. AURKA has been identified as a potential drug target for GBM treatment. An analysis of the GBM cell transcriptome following AURKA inhibition revealed a potential influence on the immune system. Our research revealed that AURKA influenced PD-L1 levels in various GBM model systems in vitro and in vivo. Disrupting AURKA function genetically led to reduced PD-L1 levels and increased MHC-I expression in both established and patient-derived xenograft GBM cultures. This process involved both transcriptional and non-transcriptional pathways, partly implicating GSK3β. Interfering with AURKA also enhanced NK-cell-mediated elimination of GBM by reducing PD-L1 expression, as evidenced in rescue experiments. Furthermore, using a mouse model that mimics GBM with patient-derived cells demonstrated that Alisertib decreased PD-L1 expression in living organisms. Combination therapy involving anti-PD-1 treatment and Alisertib significantly prolonged overall survival compared to vehicle treatment. These findings suggest that targeting AURKA could have therapeutic implications for modulating the immune environment within GBM cells.

Urban agriculture, the cultivation, processing and distribution of plants and animals within urban or suburban boundaries, is becoming an increasingly relevant strategy to enhance food safety for urban residents. With the rapid urbanization in the past decades, three forms of urban agriculture have emerged in China: small-scale, capital-intensive, and tourism-type. Each form presents unique benefits and challenges, and their development has been largely shaped by the local socio-economic context and government policies. The benefits of urban agriculture are numerous including the improvement of community cohesion, promotion of physical health, enhancement of environmental sustainability, and creation of new economic opportunities. However, it also faces many challenges such as land availability, capital shortage, market access, and governmental support. This review summarized the benefits of urban agriculture and its current limitations and challenges, and proposed strategies to overcome these hurdles in China based on successful examples in the Global North. Four specific recommendations were provided to promote urban agriculture in China: integration of urban agriculture into cities, solutions for land and resource use, government support and actions, as well as planning and regulations. Adoption of these recommendations is expected to result in healthier cities and a more robust agricultural system in China.

The Landsat global consolidated data archive now exceeds 50 years. In recognition of the need for consistently processed data across the Landsat satellite series, the U.S. Geological Survey (USGS) initiated collection-based processing of the entire archive that was processed as Collection 1 in 2016. In preparation for the data from the now successfully launched Landsat 9, the USGS reprocessed the Landsat archive as Collection 2 in 2020. This paper describes the rationale for, and the contents and advancements provided by Collection 2, and highlights the differences between the Collection 1 and Collection 2 products. Notably, the Collection 2 products have improved geolocation and, for the first time, the USGS provides a global inventory of Level 2 surface reflectance and surface temperature products. Also for the first time, the USGS used a commercial cloud computing architecture to efficiently process the archive and enable direct cloud access of the Landsat products. The paper concludes with discussion of likely improvements expected in Collection 3 in preparation for the Landsat Next mission that is planned for launch in the early 2030s.

Abstract Background Preoperative analgesia of hip fracture in elderly patients is important, but it is also lacking. In particular, nerve block was not provided in time. In order to provide more effective analgesia, we designed a multimodal pain management mode based on instant messaging software. Methods From May to September 2022, a total of 100 patients with unilateral hip fracture aged over 65 were randomly divided into the test group and the control group. Finally, 44 patients in each group completed the result analysis. A new pain management mode was used in the test group. This mode focuses on the full information exchange between medical personnel in different departments, early fascia iliaca compartment block (FICB), and closed-loop pain management. Outcomes include the time when FICB is completed for the first time; The number of cases of FICB completed by emergency doctors; Patients' pain score, pain duration. Results The time for patients in the test group to complete FICB for the first time was 3.0 [1.925–3.475] h, which was less than the time for patients in the control group (4.0 [3.300–5.275] h). The difference was statistically significant (P 3 time (35.00 [20.00–45.00] mins vs 72.50 [60.00–45.00] mins). The analgesic satisfaction of patients in the test group (5.00 [4.00–5.00]) was also significantly higher than that of the control group (3.00 [3.00–4.00]). The above four indexes were different between the two groups (P

Abstract Resistance to radiotherapy remains a major unmet clinical obstacle in the treatment of locally advanced rectal cancer. Cancer stem cells (CSCs) are considered to mediate tumor development and radioresistance. However, the role of CSCs in regulating resistance to radiotherapy in colorectal cancer (CRC) remains largely unknown. We established two radioresistant CRC cell lines, HCT116-R and RKO-R, using fractionated irradiation. Analysis using miRNA sequencing and quantitative real-time PCR confirmed lower levels of miR-7-5p in both of the radioresistant cells compared to their parental cells. Subsequently, we validated that miR-7-5p expression was decreased in cancerous tissues from radiotherapy-resistant rectal cancer patients. The Cancer Genome Atlas (TCGA) database analyses revealed that low miR-7-5p expression was significantly correlated with poor prognosis in CRC patients. Overexpression of miR-7-5p led to a rescue of radioresistance and an increase in radiation-induced apoptosis, and attenuated the stem cell-like properties in HCT116-R and RKO-R cells. Conversely, knocking down miR-7-5p in parental HCT116 and RKO cells suppressed the sensitivity to radiation treatment and enhance cancer cell stemness. Stemness-associated transcription factor KLF4 was demonstrated as a target of miR-7-5p. Rescue experiments revealed that miR-7-5p/KLF4 axis could induce radiosensitivity by regulating CSCs in colorectal cancer cells. Furthermore, we used CRC tumor tissues which exhibited resistance to neoadjuvant radiotherapy to establish a patient-derived xenograft (PDX) mouse model. Tail vein injection of magnetic nanoparticles carrying miR-7-5p mimics into the PDX mice significantly inhibited tumor growth with or without irradiation treatment in vivo. Our current studies not only demonstrate an anti-cancer function of miR-7-5p in regulating CSC properties and radiosensitivity in colorectal cancer, but also provide a novel potential strategy for delaying or reverse radiation resistance in preoperative radiotherapy of CRC patients.

Abstract 3D morphable models (3DMMs) are generative models for face shape and appearance. Recent works impose face recognition constraints on 3DMM shape parameters so that the face shapes of the same person remain consistent. However, the shape parameters of traditional 3DMMs satisfy the multivariate Gaussian distribution. In contrast, the identity embeddings meet the hypersphere distribution, and this conflict makes it challenging for face reconstruction models to preserve the faithfulness and the shape consistency simultaneously. In other words, recognition loss and reconstruction loss can not decrease jointly due to their conflict distribution. To address this issue, we propose the Sphere Face Model (SFM), a novel 3DMM for monocular face reconstruction, preserving both shape fidelity and identity consistency. The core of our SFM is the basis matrix which can be used to reconstruct 3D face shapes, and the basic matrix is learned by adopting a two-stage training approach where 3D and 2D training data are used in the first and second stages, respectively. We design a novel loss to resolve the distribution mismatch, enforcing that the shape parameters have the hyperspherical distribution. Our model accepts 2D and 3D data for constructing the sphere face models. Extensive experiments show that SFM has high representation ability and clustering performance in its shape parameter space. Moreover, it produces high-fidelity face shapes consistently in challenging conditions in monocular face reconstruction. The code will be released at https://github.com/a686432/SIR

Forest covers about one-third of the land area of the conterminous United States (CONUS) and plays an important role in offsetting carbon emissions and supporting local economies. Growing interest in forests as relatively cost-effective nature-based climate solutions, particularly restoration and reforestation activities has increased the demand for information on forest regrowth and recovery following natural and anthropogenic disturbances (e.g. fire, harvest, or thinning). However, a wall-to-wall mapping of the CONUS tree regrowth duration at an annual time interval and 30-m resolution is still challenging. In this study, we utilized the annual land cover products to develop a dataset to quantify forest regrowth duration for CONUS over 1985–2017. The land cover data used to derive the tree regrowth duration map is from the primary land cover product in the U.S. Geological Survey’s Land Change Monitoring, Assessment, and Projection (LCMAP) collection. The LCMAP product used all available Landsat images to detect disturbances over forest and classify Grass/Shrub to Tree Cover transitions on an annual basis. The average regrowth duration was then calculated for each pixel. The regrowth duration map was validated using human-interpreted annual reference data that were collected independently. The validation results show 1 year of underestimation and 6-year standard deviation of error between the reference data and the regrowth duration map. In southeastern CONUS, where major tree regrowth activities have been observed, our map showed higher accuracy with less than one-year bias and 3.6 years standard deviation of error. Forest in the southeast took around 5 years to recover, which was faster than other regions of CONUS. Many pixels had multiple disturbances during the 33-year study period in the region. The spatial pattern of the tree regrowth indicated intense harvesting activities in this region. The Pacific Northwest coast region was the second main area of tree regrowth, but this region often took multiple decades to recover. Given the increasing interest in forests as nature-based climate solutions, the tree regrowth duration map can be used to assess reforestation activities as well as forest recovery following natural disturbance and harvesting.

Myostatin (MSTN) resulted in reduced backfat thickness in MSTN-knockout (MSTN-KO) pigs, whereas the underlying mechanism remains elusive. In this study, RNA sequencing (RNA-seq) was used to screen differentially expressed genes (DEGs) in porcine fat tissues. We identified 285 DEGs, including 4 adipocyte differentiation-related genes (ADRGs). Matrix Metalloproteinase-2/7 (MMP-2/7), fibronectin (FN), and laminin (LN) were differentially expressed in MSTN-KO pigs compared with wild-type (WT) pigs. To investigate the molecular mechanism, we treated the preadipocytes with siRNA and recombinant MSTN protein. The results indicated that MSTN increased the expression of MMP-2/7/9 and promoted the preadipocyte differentiation. To further validate the effect of MSTN on MMP-2/7/9 expression, we treated MSTN-KO PK15 cells with recombinant MSTN protein and detected the expression of MMP-2/7/9. The data showed that MSTN increases the expression of MMP-2/7/9 in PK15. This study revealed that MSTN promoted preadipocyte differentiation and provided the basis for the mechanism of fatty deposition in pigs.

Abstract Background This study provides a detailed description of a Chinese family with North Carolina macular dystrophy (NCMD) and explores its possible pathogenesis. Methods Five individuals from a three-generation family underwent general ophthalmic examination, multi-imaging examinations and visual electrophysiology examinations when possible. Genetic characterization was carried out by target region sequencing and high-throughput sequencing in affected patients. Results Despite severe fundus changes, patients had relatively good visual acuity. Genetic analysis showed that affected patients had PRDM13 gene duplication and heterozygous mutations of the ABCA4 gene. Optical coherence tomography (OCT) showed an abnormal retinal pigment epithelium (RPE) layer in patients with grade 2 lesions, while the neurosensory retina was relatively normal. In grade 3 patients, RPE and choroid atrophy were greater than that of the neurosensory retina, showing concentric atrophy. Conclusions RPE and choroidal atrophy were found to play an important role in the development of macular caldera.

Zika virus (ZIKV) infection suppresses the induction of dendritic cell (DC)-derived immunity, but the underlying mechanistical insights are still lacking. Here the authors show, using in vitro systems profiling of DC transcriptome and epigenome, that ZIKV specifically alters SREBP2-related expression of inflammation- and metabolism-related genes to modulate DC functions.

Abstract Objective Viscoelastic hemostatic assay (VHA) provides a graphical representation of a clot’s lifespan and reflects the real time of coagulation. It has been used to guide trauma resuscitation; however, evidence of the effectiveness of VHAs is still limited. This systematic review aims to summarize the published evidence to evaluate the VHA-guided strategy in resuscitating trauma patients. Methods The PubMed, Embase, and Web of Science databases were searched from their inception to December 13, 2021. Randomized controlled trials (RCTs) or observational studies comparing VHA-guided transfusion to controls in resuscitating trauma patients were included in this systematic review. Results Of the 7743 records screened, ten studies, including two RCTs and eight observational studies, met the inclusion criteria. There was great heterogeneity concerning study design, enrollment criterion, VHA device, VHA-guided strategy, and control strategy. Thrombelastography (TEG) was used as a guiding tool for transfusion in eight studies, and rotational thromboelastometry (ROTEM), and TEG or ROTEM were used in the other two studies. The overall risk of bias assessment was severe or mild in RCTs and was severe or moderate in observational studies. The main outcomes reported from the included studies were blood transfusion (n = 10), mortality (n = 10), hospital length of stay (LOS) (n = 7), intensive care unit LOS (n = 7), and cost (n = 4). The effect of the VHA-guided strategy was not always superior to the control. Most of the studies did not find significant differences in the transfusion amount of red blood cells (n = 7), plasma (n = 5), platelet (n = 7), cryoprecipitate/fibrinogen (n = 7), and mortality (n = 8) between the VHA-guided group and control group. Notable, two RCTs showed that the VHA-guided strategy was superior or equal to the conventional coagulation test-guided strategy in reducing mortality, respectively. Conclusion Although some studies demonstrated VHA-guided strategy probable benefit in reducing the need for blood transfusion and mortality when resuscitating trauma patients, the evidence is still not robust. The quality of evidence was primarily downgraded by the limited number of included studies and great heterogeneity and severe risk of bias in these. Further studies are strongly recommended.

BackgroundVitamin D deficiency is a widespread issue globally, resulting in increased use of vitamin D supplements. However, it is unclear whether intermittent (weekly or monthly) vitamin D supplementation is as effective as daily supplementation in improving circulating 25-hydroxyvitamin D [25(OH)D] levels.MethodsThree databases including Medline, EMBASE, and the Cochrane Library were systematically searched up to 10 November 2020. The risk of bias was evaluated according to Cochrane Collaboration’s tool for rating methodological quality assessment. Direct and indirect comparisons between interventions and controls were performed by a Bayesian network meta-analysis (NMA), where the mean difference (MD) and its 95% confidence interval (CI) were used to indicate the efficacy.ResultsThis NMA analysis included 116 RCTs with a total of 11,376 participants. Generally, we observed that 25(OH)D concentrations were significantly elevated regardless of vitamin D supplementation frequency. Although the findings of SUCRA indicated that daily vitamin D supplementation had a higher rank value than intermittent supplementation when the supplement dosage was similar, no statistically significant pooled mean differences of 25(OH)D concentration were noted between the daily supplementation group and intermittent supplementation group. Additionally, weekly supplementation with a total of 600,000 IU vitamin D supplementation during 3 months had the best efficacy in elevating 25(OH)D concentration (pooled MD = 63 nmol/L, 95%CI: 49–77). To achieve optimal 25(OH)D concentration (>75 nmol/L), we recommend 60,000 IU vitamin D supplementation monthly (~2,000 IU/day).ConclusionThe efficacy of intermittent vitamin D supplementation was similar to daily supplementation. Coupled with its convenience, the frequency and dosage of intermittent vitamin D supplements were recommended to reach the optimal 25(OH)D level.Systematic review registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257257, PROSPERO CRD42021257257.

Traditional analogous π-shape transmission line models are mainly designed based on the amplitude and phase response characteristics of the distributed-parameter transmission lines at the power frequency. It cannot be directly used to build analogous high-voltage direct current (HVDC) transmission line models because the signals in a wide frequency band from 0 Hz to 10 kHz are used to protect HVDC transmission lines instead of power frequency components. In this paper, a novel model parameter identification method for scaled-down analogous HVDC transmission lines is proposed based on broad spectral response analysis. The broad spectral responses of distributed parameter-based and π-shape lumped parameter-based models are analyzed and compared with each other first. And then frequency-dependent per-unit parameters of HVDC transmission lines are obtained and used to form a modified π-shape HVDC transmission line model with the same zero- and positive-sequence​ impedance as those of distributed parameter lines. The element parameters of the π-shape circuit model are identified optimally based on the weighted sum of the results at selected several frequencies in the broadband from 0 hertz to thousands of hertz. The simulation results show that the amplitude and polarity of the dc voltage and current in our scaled-down analogous lines are close to distributed parameter-based HVDC transmission lines once a fault occurred on the lines.

The prognosis for patients with advanced gastric cancer (AGC) is poor, with limited treatment options available due to the difficulty of resection. In recent years, chemotherapy and immunotherapy for AGC have shown promising efficacy. However, there is a controversy regarding the surgery of primary tumors and/or metastases in patients with stage IV gastric cancer after systematic therapy. Here, we present a 63-year-old retired female of AGC with supraclavicular metastasis with positive PD-L1 and tumor mutational burden-high (TMB-H). After receiving 8 cycles of capecitabine and oxaliplatin (XELOX) in combination with tislelizumab, the patient achieved complete remission (CR). No evidence of recurrence was identified during follow-up. To the best of our knowledge, this is the first case of AGC with supraclavicular metastasis who achieved CR after treatment with tislelizumab. The mechanism of CR was discussed by genomic and recent clinical studies. The results indicated that programmed death ligand-1 (PD-L1) combined positive score (CPS) ≥5 may serve as a clinical indication and standard for chemo-immune combination therapy. In combination with other similar reports, patients with microsatellite instability-high/defective mismatch repair (MSI-H/dMMR), (TMB-H), and positive PD-L1 had better sensitivity to tislelizumab. The patient recovered successfully except for symptoms of gastrointestinal hemorrhage during treatment, which may be associated with the treatment cycle and age. Immunotherapy with tislelizumab has been well-established in the treatment of malignant melanoma, lung cancer, and clear-cell kidney cancer, but its efficacy and safety for esophageal and gastric cancers remain to be validated. The CR of our patient suggested the prospects of tislelizumab in the immunotherapy of gastric cancer. Additionally, a watch-and-wait (WW) method maybe offered for patients with AGC who achieved complete clinical remission (CCR) after immune combination therapy if the patient was older or in poor physical condition.

Abstract Pyroptosis is inflammation-associated caspase-1-dependent programmed cell death, which confers a crucial role in sepsis. The present study intends to investigate the regulatory network and function of the microarray-predicted YTHDF1 in caspase-1-dependent pyroptosis of sepsis. Peripheral blood of patients with sepsis was collected to determine WWP1 and YTHDF1 expression. An in vitro sepsis cell model was induced in RAW264.7 cells using lipopolysaccharide (LPS) and ATP and an in vivo septic mouse model by cecal ligation and perforation (CLP). After gain- and loss-of-function assays in vitro and in vivo, TNF-α and IL-1β levels and the cleavage of gasdermin-D (GSDMD) were detected by ELISA and Western blot assay, followed by determination of lactate dehydrogenase (LDH) activity. Immunoprecipitation and meRIP assay were performed to detect the ubiquitination of NLRP3 and the m6A modification of WWP1 mRNA. The binding of WWP1 to YTHDF1 was explored using RIP-RT-qPCR and dual luciferase gene reporter assay. It was noted that WWP1 and YTHDF1 were downregulated in clinical sepsis samples, LPS + ATP-treated RAW264.7 cells, and CLP-induced mice. The ubiquitination of NLRP3 was promoted after overexpression of WWP1. WWP1 translation could be promoted by YTHDF1. Then, WWP1 or YTHDF1 overexpression diminished LDH activity, NLRP3 inflammasomes and caspase-1-mediated cleavage of GSDMD in LPS + ATP-induced RAW264.7 cells. Overexpressed YTHDF1 restrained inflammatory response in CLP-induced mice. Collectively, the alleviatory effect of m6A reader protein YTHDF1 may be achieved through promotion of NLRP3 ubiquitination and inhibition of caspase-1-dependent pyroptosis by upregulating WWP1.

Abstract Background Pregnancy-associated listeriosis is a severe infectious disease and potentially leads to fetal/neonatal fatal, while limited information on pregnancy-associated listeriosis is available in China. This study aimed to reveal the clinical characteristics and outcomes of pregnancy-associated listeriosis cases and provide references for treating and managing this disease. Methods We performed a retrospective study on maternal and neonatal patients with pregnancy-associated listeriosis. The clinical characteristics of pregnancy-associated listeriosis were studied, and the outcome determinants of neonatal listeriosis were explored. Results 14 cases of pregnancy-associated listeriosis were identified. The incidence of pregnancy-associated listeriosis in our hospital was 16.69/100,000 births. All of the 14 maternal patients eventually recovered after delivery shortly with no sequelae. None of the 12 mothers who delivered in this hospital received antepartum first-line empirical treatment. Among the 14 neonatal cases, 1 was late-onset listeriosis and 13 were early-onset cases; 11 survived and 3 died. Fatality rates were significantly higher in outborn neonates (P = 0.005). Besides, higher mortality rates were observed in neonates with lower birth weight (P = 0.038), gestational age

Offshore wind power industry presents to be one of the emerging industries with big strategic and pioneering significance in the world. In order to promote the high quality development of this industry in Shandong, the paper analyzed problems in the industry development and proposed corresponding strategies based on a thorough investigation. The results showed that offshore wind resources were abundant in Shandong with relatively solid foundation on the industry. But there were still acute problems including not detailed plan on the industry development, not strong enough support of science and technology on the industry, not systemic supporting industries, not enough grid capacity on the wind power, and lack of investors on manufacture. It was recommended to adhere to the principle of "develop innovative technologies and widen various channels based on overall layout to realize coordinated development through planning and piloting" to facilitate the industry development in a steady way.

Due to its intuitive stroke-based user interface, edit propagation has wide applications such as image recoloring and relighting, tone editing, image matting, etc. This paper presents a function interpolation method for efficient edit propagation on 360 degree panoramas. Given a panoramic image as input and user-specified strokes as edit hints, our approach adopts an adaptive sampling strategy based on the diversity of local color distribution. By selecting the most representative samples, this strategy can significantly reduce the number of samples. We assume that the projection of the input panorama is known, so that it can be mapped to a 3D unit sphere where the spherical distance metric can be defined. Then edit propagation is formulated as a radial basis function interpolation problem, which can be efficiently solved by using the non-negative linear least squares. We also utilize a multi-resolution strategy and a function look-up table for further acceleration. Experimental results show that our method can efficiently propagate edits on high-resolution panoramas and produce seam-free and smooth editing results.

Abstract Background Herein, we report two cases of unilateral retinal pigment epithelium dysgenesis (URPED) in Chinese patients and explore the relationship between URPED and combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). Case presentation The lesion margins in the two cases showed pathognomonic clinical features of URPED, namely, a scalloped reticular margin in hyperplastic retinal pigment epithelium and mild fibrosis. The hypoautofluorescence observed by fundus autofluorescence was inverted compared with that observed by fundus fluorescence angiography. A large amount of fibroglial proliferation and disorganization of the retina involving the whole layer, which are also found in peripapillary CHRRPE, were found in the lesions. Conclusions URPED appears to share some clinical features with CHRRPE, and the relationship between URPED and CHRRPE needs further study.

The National Land Cover Database (NLCD) 2016 products show that, between 2001 and 2016, nearly half of the land cover change in the conterminous United States (CONUS) involved forested areas. To ensure the quality of NLCD land cover and land cover change products, it is important to accurately detect the location and time of forest disturbance. We designed a comprehensive strategy to integrate a continuous time series forest change detection method and a discrete 2-date forest change detection method to produce the NLCD 1986–2019 forest disturbance product, which shows the most recent forest disturbance date between the years 1986 and 2019 for every 2- to 3-year interval. This method, the Time-Series method Using Normalized Spectral Distance (NSD) index (TSUN), uses NSD to detect multi-date forest land cover changes and was shown to be easily extended to a new date even when new images were processed in a different way than previous date images. The discrete 2-date method uses the Multi-Index Integrated Change Analysis (MIICA) method to detect changes between 2-date images. A method based on confidence and object grouping was designed to combine the multiple MIICA outputs to improve change detection accuracy. Finally, an aggregation scheme was implemented to combine the TSUN output, the integrated MIICA results, and ancillary data to produce the NLCD 2019 forest disturbance 1986–2019 product. The initial accuracy assessments from 1,600 samples over 4 Landsat path/rows show that the producer’s and user’s accuracies of the 2001–2019 forest disturbance map are 76% and 74%, respectively. The final CONUS-wide forest disturbance product is provided at https://www.mrlc.gov/nlcd-2019-science-research-products.

National Land Cover Database (NLCD) 2019 is a new epoch of national land cover products for the conterminous United States. Image quality is fundamental to the quality of any land cover product. Image preprocessing has often taken a considerable proportion of overall time and effort for this kind of national project. An approach to prepare image inputs for NLCD 2019 production was developed to ensure efficiency and quality of operational production. Here, we introduce a new and comprehensive strategy to produce clear Landsat composite images for NLCD 2019 production. First, we developed a new median-value compositing method. Second, we designed parameter settings for selecting images and pixels to generate 4 composite images (leaf-on, leaf-off, primary reference, and complementary reference) for a target year based on the US Landsat Analysis Ready Data surface reflectance dataset. Third, we developed a method, referred to as Detection and Filling with Simulated Image, to detect and replace clouds and cloud shadow pixels to produce the final clean leaf-on and leaf-off image composites. This image compositing and processing strategy was implemented for the entire conterminous United States to produce images for NLCD 2019. Our image results and NLCD 2019 change detection and land cover products, which were released in July 2021, showed this new strategy to be effective and efficient.

Burn is one of the leading causes of death and disability in children worldwide, and wound infection is an excellent challenge in burn treatment. We performed a retrospective review of pediatric burn patients with wound infections to reveal their clinical data and investigate pathogens’ distribution and drug resistance patterns to provide references for treatment. As a result, 330 pediatric burn patients with wound infections were identified; 65.8% (217/330) were

Abstract Background Hip fracture is common in older adults, and can cause severe post-fracture pain. Fascia iliaca nerve block has consequently been used for preoperative analgesia. Methods We performed a randomized, controlled, double-blind clinical trial and recruited older patients with hip fractures. These patients were randomized into two groups and received ultrasound-guided fascia iliaca compartment block using either the supra-inguinal approach (group F) or the classical approach (group C). Heart rate, blood pressure, and resting and exercising visual analog scales were recorded before the procedure and at 30 min, and 6, 12, and 24 h after completion of the procedure. We recorded the duration of the procedure—as well as complications such as bleeding, hypotension, and intractable vomiting; the sleep duration in a 24 h period was also documented. Results A total of 38 patients completed the trial, and we observed no differences in the baseline characteristics or pre-procedural measurements between the two groups. Compared with the patients in group C, patients in group F exhibited significantly lower exercising VAS scores at 6 and 12 h after the procedure, faster heart rates at 6 and 24 h after the procedure, a longer procedural duration, and a longer sleep duration. There were no differences in the frequencies of complications between the two groups. The percentages of patients who took oral analgesics and the numbers of medications consumed were also not different between the two groups. Conclusions The supra-inguinal FICB provided effective analgesia and improved exercise tolerance compared with the classical approach. Trial registration The trial was registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2100045644, registration date: 2021 April 20).

Abstract Existing color editing algorithms enable users to edit the colors in an image according to their own aesthetics. Unlike artists who have an accurate grasp of color, ordinary users are inexperienced in color selection and matching, and allowing non-professional users to edit colors arbitrarily may lead to unrealistic editing results. To address this issue, we introduce a palette-based approach for realistic object-level image recoloring. Our data-driven approach consists of an offline learning part that learns the color distributions for different objects in the real world, and an online recoloring part that first recognizes the object category, and then recommends appropriate realistic candidate colors learned in the offline step for that category. We also provide an intuitive user interface for efficient color manipulation. After color selection, image matting is performed to ensure smoothness of the object boundary. Comprehensive evaluation on various color editing examples demonstrates that our approach outperforms existing state-of-the-art color editing algorithms.

The ten-eleven translocation (TET) enzyme family, which includes TET1/2/3, participates in active DNA demethylation in the eukaryotic genome; moreover, TET1/2/3 are functionally redundant in mice embryos. However, the combined effect of TET1/2/3 triple-gene knockdown or knockout on the porcine oocytes or embryos is still unclear. In this study, using Bobcat339, a specific small-molecule inhibitor of the TET family, we explored the effects of TET enzymes on oocyte maturation and early embryogenesis in pigs. Our results revealed that Bobcat339 treatment blocked porcine oocyte maturation and triggered early apoptosis. Furthermore, in the Bobcat339-treated oocytes, spindle architecture and chromosome alignment were disrupted, probably due to the huge loss of 5-hydroxymethylcytosine (5hmC)and concurrent increase in 5-methylcytosine (5mC). After Bobcat339 treatment, early parthenogenetic embryos exhibited abnormal 5mC and 5hmC levels, which resulted in compromised cleavage and blastocyst rate. The mRNA levels of EIF1A and DPPA2 (ZGA marker genes) were significantly decreased, which may explain why the embryos were arrested at the 4-cell stage after Bobcat339 treatment. In addition, the mRNA levels of pluripotency-related genes OCT4 and NANOG were declined after Bobcat339 treatment. RNA sequencing analysis revealed differentially expressed genes in Bobcat339-treated embryos at the 4-cell stage, which were significantly enriched in cell proliferation, cell component related to mitochondrion, and cell adhesion molecule binding. Our results indicated that TET proteins are essential for porcine oocyte maturation and early embryogenesis, and they act by mediating 5mC/5hmC levels and gene transcription.

Abstract Scar contracture, a common destructive complication causing increased re-hospitalisation rate of burn survivors and aggravated burden on the medical system, may be more seriously in Chinese population because of their higher susceptibility to scar formation. This study aims to evaluate the prevalence and predictors of scar contracture-associated re-hospitalisation among Chinese burn inpatients. This cross-sectional study screened burn inpatients hospitalised during 2013 to 2018 through the Hospital Quality Monitoring System database, among whom re-hospitalised for scar contracture were identified. Variables including sex, age, occupations, burn area, burn site and surgical treatment were analysed. Potential predictors of scar contracture-associated re-hospitalisation among burn inpatients were determined by univariate regression analyses. Of the 220,642 burn inpatients, 2146 (0.97%) were re-hospitalised for scar contracture. The re-hospitalised inpatients were predominantly men and blue-collar workers, showing younger median age at the time of burns, larger burn sizes, and higher percentage of surgical treatment compared other burn inpatients. Significant univariate predictors of scar contracture-associated re-hospitalisation included male sex, age

Abstract Background Laparoscopic anterior resection with trans-rectal specimen extraction (NOSES) has been demonstrated as a safe and effective technique in appropriate patients with upper rectal cancer (RC). However, improper selection of RC candidates for NOSES may lead to potential surgical and oncological unsafety as well as complications such as bacteria contamination and anastomotic leak. Unfortunately, no tools are available for evaluating the risk and excluding improper cases before surgery. This study aims to estimate its clinical relevancy and to investigate independent clinical-pathological predictors for identifying candidates for NOSES in patients with upper RC and to develop a validated scoring nomogram to facilitate clinical decision making. Methods The study was performed at Shanghai East hospital, a tertiary medical center and teaching hospital. 111 eligible patients with upper RC who underwent elective laparoscopic anterior resection between February and October of 2017 were included in the final analysis. Univariate and multivariate analyses were performed to compare characteristics between the two surgical techniques. Odds ratios (OR) were determined by logistic regression analyses to identify and quantify the clinical relevancy and ability of predictors for identifying NOSES candidate. The nomogram was constructed and characterized by c-index, calibration, bootstrapping validation, ROC curve analysis, and decision curve analysis. Results Upper RC patients with successful NOSES tended to be featured with female gender, negative preoperative CEA/CA19-9, decreased mesorectum length (MRL), ratio of diameter (ROD) and ratio of area (ROA) values, while no significant statistical correlations were observed with age, body mass index (BMI), tumor location, and tumor-related biological characteristics (ie., vascular invasion, lymph node count, TNM stages). Furthermore, the two techniques exhibited comparably low incidence of perioperative complications and achieved similar functional results under the standard procedures. The nomogram incorporating three independent preoperative predictors including gender, CEA status and ROD showed a high c-index of 0.814 and considerable reliability, accuracy and clinical net benefit. Conclusions NOSES for patients with upper RC is multifactorial; while it is a safe and efficient technique if used properly. The nomogram is useful for patient evaluation in the future.

PurposeTo compare the dosimetric parameters and clinical outcomes between volumetric modulated arc therapy (VMAT) and tomotherapy for treating late T-stage nasopharyngeal carcinoma (NPC).MethodsPatients with non-metastatic late T-stage NPC who received definitive radiotherapy with tomotherapy or VMAT were selected. 1:1 propensity score matching (PSM) was used to control the balance of confounding factors. The dosimetric parameters and clinical outcomes were compared.ResultsA total of 171 patients were enrolled before matching, with 61 patients in the VMAT group and 110 patients in the tomotherapy group. In the post-PSM cohort, 54 sub-pairs of 108 patients were included after matching. Tomotherapy was superior to VMAT in the dosimetric parameters of planning target volumes, brainstem, spinal cord, lenses, and parotid glands but inferior in the optic nerves and optic chiasm. The tomotherapy group had a lower incidence of grade ≥ 3 acute mucositis (22.2% vs. 40.7%, p = 0.038) and a higher rate of complete response (83.3% vs. 66.7%, p = 0.046) after radiotherapy. However, there were no significant differences in locoregional failure-free survival (p = 0.375), distant metastasis-free survival (p = 0.529), or overall survival (p = 0.975) between the two groups.ConclusionTomotherapy is superior to VMAT in terms of most dosimetric parameters, with less acute mucositis and better short-term efficacy. There are no significant differences in the survival outcomes between the VMAT and tomotherapy groups.

Land cover maps are essential for characterizing the biophysical properties of the Earth’s land areas. Because land cover information synthesizes a rich array of information related to both the ecological condition of land areas and their exploitation by humans, they are widely used for basic and applied research that requires information related to land surface properties (e.g., terrestrial carbon models, water balance models, weather, and climate models) and are core inputs to models and analyses used by natural resource scientists and land managers. As the Earth’s global population has grown over the last several decades rates of land cover change have increased dramatically, with enormous impacts on ecosystem services (e.g., biodiversity, water supply, carbon sequestration, etc.). Hence, accurate information related to land cover is essential for both managing natural resources and for understanding society’s ecological, biophysical, and resource management footprint. To address the need for high-quality land cover information we are using the global record of Landsat observations to compile annual maps of global land cover from 2001 to 2020 at 30 m spatial resolution. To create these maps we use features derived from time series of Landsat imagery in combination with ancillary geospatial data and a large database of training sites to classify land cover at annual time step. The algorithm that we apply uses temporal segmentation to identify periods with stable land cover that are separated by breakpoints in the time series. Here we provide an overview of the methods and data sets we are using to create global maps of land cover. We describe the algorithms used to create these maps and the core land cover data sets that we are creating through this effort, and we summarize our approach to accuracy assessment. We also present a synthesis of early results and discuss the strengths and weaknesses of our early map products and the challenges that we have encountered in creating global land cover data sets from Landsat. Initial accuracy assessment for North America shows good overall accuracy (77.0 ± 2.0% correctly classified) and 79.8% agreement with the European Space Agency (ESA) WorldCover product. The land cover mapping results we report provide the foundation for robust, repeatable, and accurate mapping of global land cover and land cover change across multiple decades at 30 m spatial resolution from Landsat.

The Landsat program has the longest collection of moderate-resolution satellite imagery, and the data are free to everyone. With the improvements of standardized image products, the flexibility of cloud computing platforms, and the development of time series approaches, it is now possible to conduct global-scale analyses of time series using Landsat data over multiple decades. Efforts in this regard are limited by the density of usable observations. The availability of usable Landsat Tier 1 observations at the scale of individual pixels from the perspective of time series analysis for land change monitoring is remarkably variable both in space (globally) and time (1985–2020), depending most immediately on which sensors were in operation, the technical capabilities of the mission, and the acquisition strategies and objectives of the satellite operators (e.g., USGS, commercial company) and the international ground receiving stations. Additionally, analysis of data density at the pixel scale allows for the integration of quality control data on clouds, cloud shadows, and snow as well as other properties returned from the atmospheric correction process. Maps for different time periods show the effect of excluding observations based on the presence of clouds, cloud shadows, snow, sensor saturation, hazy observations (based on atmospheric opacity), and lack of aerosol optical depth information. Two major discoveries are: 1) that filtering saturated and hazy pixels is helpful to reduce noise in the time series, although the impact may vary across different continents; 2) the atmospheric opacity band needs to be used with caution because many images are removed when no value is given in this band, when many of those observations are usable. The results provide guidance on when and where time series analysis is feasible, which will benefit many users of Landsat data.

Abstract Background It is critical to monitor the optic disc’s vessel density using Optical coherence tomography angiography (OCTA) and evaluate its determinants. In the current study, we investigate the superficial vessel density (VD) of the papillary microvasculature and its determinants in healthy subjects of Southern China. Methods This was a prospective, cross-sectional study. Superficial VD in healthy individuals’ optic disc region was measured by OCTA. The factors associated with ocular and systemic parameters were analyzed using a generalized estimation equation (GEE) model. Results A total of 510 eyes of 260 healthy subjects were analyzed in the study. The total VD in the optic disc area was 17.21 ± 2.15 mm− 1 (95% CI, 17.02–17.40 mm− 1). The VD in the inner ring and the outer ring of the optic disc were significantly higher compared with the central ring, while the VD of the superior quadrant and inferior quadrant was significantly higher compared with the temporal and nasal quadrant. After adjusting for the ocular factors and systemic factors, AL (β = − 0.4917, P = 0.0003), disc area (β = − 0.3748, P = 0.0143), CMT (β = − 0.0183, P = 0.0003) and SSI (β = 1.0588, P

Miniaturized energy storage devices with superior performance and compatibility with facile fabrication are highly desired in smart microelectronics. Typical fabrication techniques are generally based on powder printing or active material deposition, which restrict the reaction rate due to the limited optimization of electron transport. Herein, we proposed a new strategy for the construction of high-rate Ni-Zn microbatteries based on a 3D hierarchical porous nickel (Ni) microcathode. With sufficient reaction sites from the hierarchical porous structure as well as excellent electrical conductivity from the superficial Ni-based activated layer, this Ni-based microcathode is featured with fast-reaction capability. By virtue of facile electrochemical treatment, the fabricated microcathode realized an excellent rate performance (over 90% capacity retention when the current density increased from 1 to 20 mA cm−2). Furthermore, the assembled Ni-Zn microbattery achieved a rate current of up to 40 mA cm−2 with a capacity retention of 76.9%. Additionally, the high reactivity of the Ni-Zn microbattery is also durable in 2000 cycles. This 3D hierarchical porous Ni microcathode, as well as the activation strategy, provides a facile route for the construction of microcathodes and enriches high-performance output units for integrated microelectronics.

Abstract Background Controlling Nutritional Status (CONUT) score is a novel nutrition-based biomarker that has been reported for predicting survival in various cancers. However, the relationship between CONUT score and prognosis of urological cancers remains unclear. Hence, we performed this meta-analysis to evaluate the prognostic significance of CONUT score for patients with urological cancers. Methods PubMed, Embase, the Cochrane Library and National Knowledge Infrastructure (CNKI) were systematically searched up to October 2020. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to evaluate the association of CONUT score with overall survival (OS), cancer-specific survival (CSS) and recurrence/disease/progress-free survival (RFS/DFS/PFS) in urological cancers. Results A total of 12 articles with 13 studies were included in the analysis. Pooled results indicated that increased CONUT score predicted poor OS (HR: 1.78, 95% CI 1.51–2.09, p

Background: A few factors influence the feasibility of transrectal natural orifice specimen extraction (NOSE) surgery for colorectal cancers. However, little is known about the underlying factors of NOSE surgery. Methods: Consecutive patients with rectal and sigmoid colon cancers treated laparoscopically between January 2014 and April 2017 were enrolled in this study. The transrectal NOSE performed laparoscopically was the first choice of all patients. When NOSE failed, the specimen was removed through a midline abdominal wall incision. Univariate and multivariate logistic regression analyses were performed to identify challenging factors influencing the intraoperative specimen extraction. Results: Overall, 412 consecutive patients were included. NOSE performed laparoscopically was successful in 278 patients (75.5%) and unsuccessful in 90 patients (24.5%). The multivariate analyses indicated that body mass index (BMI; odds ratio [OR] = 3.510, 95% confidence interval [CI]: 1.333–9.243, p = 0.011), mesenteric thickness (OR = 1.069, 95% CI: 1.032–1.107, p

Peripheral nerve injury (PNI) is common and, unlike damage to the central nervous system injured nerves can effectively regenerate depending on the location and severity of injury. Peripheral myelinating glia, Schwann cells (SCs), interact with various cells in and around the injury site and are important for debris elimination, repair, and nerve regeneration. Following PNI, Wallerian degeneration of the distal stump is rapidly initiated by degeneration of damaged axons followed by morphologic changes in SCs and the recruitment of circulating macrophages. Interaction with fibroblasts from the injured nerve microenvironment also plays a role in nerve repair. The replication and migration of injury-induced dedifferentiated SCs are also important in repairing the nerve. In particular, SC migration stimulates axonal regeneration and subsequent myelination of regenerated nerve fibers. This mobility increases SC interactions with other cells in the nerve and the exogenous environment, which influence SC behavior post-injury. Following PNI, SCs directly and indirectly interact with other SCs, fibroblasts, and macrophages. In addition, the inter- and intracellular mechanisms that underlie morphological and functional changes in SCs following PNI still require further research to explain known phenomena and less understood cell-specific roles in the repair of the injured peripheral nerve. This review provides a basic assessment of SC function post-PNI, as well as a more comprehensive evaluation of the literature concerning the SC interactions with macrophages and fibroblasts that can influence SC behavior and, ultimately, repair of the injured nerve.

This study aimed to compare the short-term clinical efficacy between prior and traditional approach of Henle trunk in laparoscopic right hemicolectomy (LRH) for right colon cancer. A total of 161 patients underwent LRH for right colon cancer between June 2018 and December 2020 by the same group of physicians. The prior approach of Henle trunk (priority group) was used in 82 patients and traditional approach in 79 (traditional group). The demographics and clinicopathological characteristics were recorded and retrospectively analyzed. As compared to the traditional group, the mean blood loss reduced significantly [73.84 ± 17.31 mL vs. 83.42 ± 30.16 mL; P = 0.001], the operation time was markedly shorter [151.35 ± 6.75 min vs. 159.13 ± 18.85 min; P = 0.014], and the intraoperative vascular injury rate was significantly lower [6.1% (5/82). vs. 17.7% (14/79); P = 0.022]. There were no significant differences in the postoperative complications, first exhaust time, first defecation time, drainage time, postoperative hospital stay, quality evaluation of surgical specimens and pathological findings between two groups. Our study shows that the priority management of Henle trunk in the LRH for right colon cancer is a safe and feasible procedure with less blood loss, shorter operation time and lower intraoperative vascular injury rate.